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目的探讨T2DM合并心功能不全患者APN及抵抗素水平改变的临床意义。方法96例T2DM患者分为新诊断T2DM组33例,T2DM+心功能Ⅰ~Ⅱ级组32例和T2DM+心功能Ⅲ~Ⅳ级组31例。另选健康体检者35名(NC组)。比较各组FPG、FIns、脑钠肽(BNP)、APN、抵抗素水平。心脏彩色多普勒测定左室射血分数(LVEF)、二尖瓣口舒张早期流速峰值E峰/舒张晚期流速峰值A峰(E/A)、舒张早期波e峰/舒张晚期波a峰(e/a)、峰值肺静脉血流收缩期S波/峰值肺静脉舒张早中期D波(S/D)。结果 T2DM各组糖尿病病程、BMI、WC、HbA1c、抵抗素较NC组升高,APN较NC组降低。T2DM+心功能Ⅲ~Ⅳ级组E/A、LVEF、APN较其他组低(P<0.05),抵抗素水平较其他组高(P<0.05)。T2DM+心功能Ⅰ~Ⅱ级组和T2DM+心功能Ⅲ~Ⅳ级组e/a、S/D较其他组低(P<0.05)。心脏彩色多普勒显示,T2DM各组E/A、e/a、S/D、LVEF较NC组下降(P<0.05)。结论随着T2DM病程延长及心功能逐渐衰竭,APN、抵抗素水平及心肌舒张顺应性减低和收缩力下降。
Objective To investigate the clinical significance of APN and resistin levels in patients with T2DM complicated with cardiac insufficiency. Methods Totally 96 T2DM patients were divided into three groups: newly diagnosed T2DM group (n = 33), T2DM + cardiac function Ⅰ ~ Ⅱ group (n = 32) and T2DM + cardiac function Ⅲ ~ Ⅳ group (n = 31) Another 35 healthy subjects (NC group). The levels of FPG, FIns, BNP, APN and resistin in each group were compared. Left ventricular ejection fraction (LVEF), early diastolic mitral flow peak E peak / late diastolic flow peak A peak (E / A), early diastolic eta / diastolic a wave peak e / a), Peak pulmonary venous systolic S wave / Peak pulmonary venous diastolic early D wave (S / D). Results The duration of diabetes, BMI, WC, HbA1c and resistin in T2DM groups were higher than those in NC group and APN was lower than that in NC group. The levels of E / A, LVEF and APN in T2DM + Ⅲ ~ Ⅳ group were lower than those in the other groups (P <0.05). The resistin level in T2DM + Ⅲ ~ Ⅳ group was higher than that in other groups (P <0.05). The levels of e / a and S / D in T2DM + cardiac function Ⅰ ~ Ⅱ group and T2DM + Ⅲ ~ Ⅳ group were lower than other groups (P <0.05). Cardiac color Doppler showed that the E / A, e / a, S / D and LVEF in T2DM groups were lower than those in NC group (P <0.05). Conclusion With the prolongation of T2DM and the progressive failure of heart function, the levels of APN, resistin, myocardial relaxation compliance and contractility decreased.