摘要
目的探讨入院空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(HbA1c)、C肽水平及是否并发糖尿病与慢性心力衰竭(CHF)患者心功能的关系。方法选取健康体检者100例作为对照组。选取CHF患者235例,划分为非糖尿病组(n=143)与糖尿病组(n=92),比较非糖尿病组与糖尿病组心功能NYHA分级与左心室射血分数(LVEF),比较CHF患者不同组别同组NYHA分级的FPG、HbA1c、C肽水平;应用Pearson相关性及多元线性回归分析CHF患者临床参数与LVEF的关系。结果三组一般资料差异无统计学意义;与对照组比较,非糖尿病组的BMI升高(P<0.05),HbA1和c肽升高(P<0.01),糖尿病组的体质量指数(BMI)、收缩压、FPG、HbA1c、C肽升高(P<0.01);与非糖尿病组相比,糖尿病组BMI升高(P<0.05),收缩压、FPG、C肽明显升高(P<0.01)。与非糖尿病组比较的秩和检验结果为,糖尿病组NYHA心功能分级整体更高(P<0.05)。非糖尿病组左心室射血分数LVEF水平为(48±8)%,糖尿病组LVEF水平为(43±8)%,非糖尿病组LVEF水平明显高于糖尿病组,差异具有统计学意义(P<0.01)。NYHA不同级的FPG、HbA1c、C肽水平比较存在显著差异,NYHAⅡ级<NYHAⅢ级<NYHAⅣ级,差异具有统计学意义(P<0.01)。多元线性回归分析表明:对于非糖尿病组和非糖尿病组,均有FPG、HbA1c、C肽与LVEF呈负相关(P<0.05)。结论非糖尿病及糖尿病CHF患者的FPG、HbA1c及C肽水平均有所升高,三项指标与心力衰竭严重程度存在关联性。
AIM To investigate the relationship between fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),C-peptide levels at admission and cardiac functions in patients with diabetes and non-diabetic chronic heart failure(CHF).METHODS Two hundred and thirty-five CHF patients with or without diabetes were selected.According to the order of clinical diagnosis and whether they were accompanied by diabetes,the patients were divided into diabetic group(92 cases)and non-diabetic group(143 cases).One hundred cases of healthy subjects were selected at the same time and served as control group.Respectively compared were the general data of the three groups,the NYHA classification and left ventricular ejection fraction(LVEF)of diabetic group and non-diabetic group,and the levels of FPG,HbA1c and C peptide in CHF patients with different NYHA classifications.Pearson correlation and multiple linear regression analysis were used to analyze the relationship between clinical parameters and LVEF in CHF patients.RESULTS There were no statistically significant differences between the three groups in gender,age and distribution,smoking,history of hypertension,diastolic blood pressure,TBIL,ALT,creatinine,TG,TC,HDL-C,LDL-C and WBC.The comparison of BMI,systolic blood pressure,FPG,HbA1c and C peptide in the three groups showed statistically significant differences(P<0.05).The results of the rank sum test showed that the overall NYHA heart function classification in diabetes group was significantly higher than that in non-diabetic group,and the difference was statistically significant(P<0.01).LVEF level in diabetic group was significantly lower than that in non-diabetic group.There were significant differences in the levels of FPG,HbA1c and C-peptide in all CHF patients,diabetic groups and non-diabetic groups with different NYHA grades(NYHAⅡ<NYHAⅢ<NYHAⅣ)and the difference was statistically significant(P<0.01).Multiple linear regression analysis showed that for diabetes group,adjusting BMI,systolic blood pressure,diastolic blood press
作者
董玉梅
王红
苑雯雯
韩静
张彬
姜先雁
DONG Yu-mei;WANG Hong;YUAN Wen-wen;HAN Jing;ZHANG Bin;JIANG Xian-yan(Heart Center,Fuwai Qingdao Cardiovascular Hospital,Qingdao 266034,Shandong,China)
出处
《心脏杂志》
CAS
2021年第2期151-155,共5页
Chinese Heart Journal
基金
重大慢病国家注册登记研究心力衰竭前瞻队列研究项目资助(2015BA112B02)。
关键词
慢性心力衰竭
糖尿病
空腹血糖
C肽
左室射血分数
糖化血红蛋白
chronic heart failure
diabetes
fasting plasma glucose
C peptide
left ventricular ejection fraction
glycosylated hemoglobin
