摘要
目的探讨伴或不伴糖尿病的慢性心力衰竭(chronic heart failure,CHF)患者入院时空腹血清C肽水平与心功能的关系。方法分析2017年7月至2018年12月于上海市浦东医院心内科住院的262例伴或不伴糖尿病的CHF患者,心功能为纽约心脏病学会(New York Heart Association,NYHA)分级Ⅱ~Ⅳ级,分为糖尿病组(80例)和非糖尿病组(182例)。同时随机选取62例在体检中心体检的无糖尿病和心脏疾病的研究对象作为对照组。分析糖尿病和非糖尿病的CHF患者空腹血清C肽水平与心功能的关系。结果(1)糖尿病组患者空腹血糖为(8.70±2.90)mmol/L、血清C肽为(0.78±0.67)nmol/L,非糖尿病组分别为(5.80±1.67)mmol/L、(0.56±0.61)nmol/L,对照组分别为(5.10±0.69)mmol/L、(0.16±0.12)nmol/L,3组比较差异均有统计学意义(P均<0.001),糖尿病组患者空腹血糖和血清C肽水平显著高于非糖尿病组和对照组(P均<0.01),非糖尿病组患者空腹血糖和血清C肽水平显著高于对照组(P<0.05或P<0.01);糖尿病组患者左心室射血分数(left ventricular ejection fraction,LVEF)为(44.1±8.3)%,非糖尿病组和对照组分别为(46.7±7.2)%、(64.8±3.8)%,3组比较差异有统计学意义(P<0.001),糖尿病组LVEF显著低于非糖尿病组和对照组(P均<0.01),非糖尿病组显著低于对照组(P<0.01);糖尿病组患者C反应蛋白(C reactive protein,CRP)为(1.39±0.91)mg/L、N末端B型利钠肽原(n-terminal pro-b-type natriuretic peptide,NT-pro BNP)为(1771.3±23.1)ng/L、血红蛋白为(125.6±16.7)g/L,非糖尿病组分别为(1.22±0.73)mg/L、(1659.2±19.3)ng/L、(126.1±16.5)g/L,对照组分别为(0.85±0.72)mg/L、(87.2±17.2)ng/L、(136.4±15.2)g/L,3组比较差异均有统计学意义(P均<0.001),糖尿病组和非糖尿病组患者CRP、PRO-BNP显著高于对照组(P均<0.01),血红蛋白水平均显著低于对照组(P均<0.01),糖尿病组和非糖尿病组间CRP、PRO-BNP和血红蛋白比较差异均无统计学意义(P均>0.05)。(2)在全部心力衰�
Objective To evaluate the relationships between admission fasting serum C-peptide concentration and cardiac function status in chronic heart failure(CHF)patients with or without diabetes.Methods From July 2017 to December 2018,262 CHF patients with or without diabetes in the Department of Cardiology of Pudong hospital in Shanghai were analyzed.Their cardiac function was classified as New York Heart Association(NYHA)gradeⅡtoⅣ,and they were divided into diabetes group(80 cases)and non diabetes group(182 cases).At the same time,62 subjects without diabetes and heart disease were randomly selected as the control group.To analyze the relationship between fasting serum C-peptide level and cardiac function in diabetic and nondiabetic CHF patients.Results(1)The fasting plasma glucose and serum C-peptide concentrations of diabetes group paitents were(8.7±2.9)mmol/L and(0.78±0.67)nmol/L respectively,the nondiabetes group paitents were(5.8±1.67)mmol/L and(0.56±0.61)nmol/L respectively,the control group were(5.1±0.69)mmol/L and(0.16±0.12)nmol/L respectively.The difference in the three groups was statistically significant(all P<0.001).The levels of fasting blood glucose and serum C-peptide in diabetic group were significantly higher than those in non diabetic group and control group(all P<0.01).The levels of fasting blood glucose and serum C-peptide in non diabetic group were significantly higher than those in control group(P<0.05 or P<0.01).The left ventricular ejection fraction(LVEF)in diabetic group was(44.1±8.3)%,and those in non diabetic group and control group were(46.7±7.2)%and(64.8±3.8)%.The difference in the three groups was statistically significant(<0.001).The LVEF of diabetic group was significantly lower than that of non diabetic group and control group(all P<0.01),and the CRP of diabetic group was(1.39±0.91)mg/L,the N-terminal pro-B-type natriuretic peptide(pro-BNP)was(1771.3±23.1)ng/L,the hemoglobin was(125.6±16.7)g/L in the diabetic group,and(1.22±0.73)mg/L,(1659.2±19.3)ng/L,(126.1±16.5)g/L
作者
李志强
傅咏华
朱中生
胡春燕
Li Zhiqiang;Fu Yonghua;Zhu Zhongsheng;Hu Chunyan(Department of Cardiology,Shanghai Pudong Hospital&Fudan University Pudong Medical Center,Shanghai 201399,China)
出处
《中国综合临床》
2020年第1期45-51,共7页
Clinical Medicine of China
基金
上海市浦东新区科技和经济委员会科研项目(PKJ2017-Y46)
上海市浦东新区重点专科建设项目(PWZzk2017-17)。
关键词
慢性心力衰竭
糖尿病
血清C肽
N末端B型利钠肽原
心功能
Chronic heart failure
Diabetes mellitus
Serum C-peptide
N-terminal B-type natriuretic peptide
Cardiac function
