糖尿病控制血糖治疗对右心室长轴收缩功能的影响

Effect of glycemic control on the right ventricular longitudinal systolic function in diabetic patients

关键词:  2型糖尿病  心力衰竭  超声心动图  右心室长轴功能

Key words:  [Key words] type 2 diabetes mellitus  heart failure  echocardiography  right ventricular longitudinal function

摘要:

[摘要]　目的　探讨血糖控制不佳的2型糖尿病严格治疗前后右心室功能的变化。　方法　随机连续入组65例2型糖尿病患者，检测控制血糖前后患者的空腹血糖、糖化血红蛋白、血脂等指标；应用超声诊断仪测量三尖瓣环收缩位移、收缩期峰值速度、右室游离壁基底段应变和中间段应变。　结果　控制血糖后与控制前比较，右室基底段和中间段应变均明显改善（29.7±6.4 vs. 26.1±6.7, 30.3±6.3 vs. 26.5±5.5, P均<0.05）；其改善幅度与糖化血红蛋白的降低程度呈正相关（相关系数为0.369和0.345，P均<0.01），与空腹血糖降低幅度呈正相关（相关系数为0.378和0.372，P均<0.01），与血脂和血压无相关性（P均>0.05）。　结论　积极药物治疗能减轻糖尿病患者血糖控制不佳对右室长轴收缩功能的损伤。

Abstract:

[Abstract] Objective To explore the changes of right ventricular function in patients with poor controlled diabetes before and after glycemic regulation was achieved. 　Methods Sixty-five consecutive type 2 diabetes patients were enrolled randomly. Levels of fasting plasma glucose, glycosylated hemoglobin, and lipid parameters were measured before the onset of the treatment and after glycemic regulation was achieved. The tricuspid annulus systolic displacement, the tricuspid annular peak systolic velocity, the strain at basal segments and at middle segments of right ventricular free wall were acquired by echocardiography. 　Results A significant improvements in the strain at basal segments and at middle segments of right ventricle (29.7±6.4 vs. 26.1±6.7, 30.3±6.3 vs. 26.5±5.5, P<0.05, both) were observed, after improving glycemic control. The improvement in the strain levels was positively correlated with the decrease in glycosylated hemoglobin (r=0.369 and r=0.345, respectively, P<0.01, both), and the decrease in fasting plasma glucose (r=0.378 and r=0.372, respectively, P<0.01, both). There was no correlation between the glycemic regulation and lipid parameters and blood pressures (P>0.05, all). 　Conclusion The damage of poor glycemic control to the right ventricular longitudinal systolic function in diabetes could be relieved after active medications.