论文部分内容阅读
目的探讨2型糖尿病(T2DM)患者合并亚临床甲状腺功能减退(SCH)对左心室舒张功能及纤维蛋白原(FIB)的影响。方法选取T2DM患者356例,其中T2DM合并SCH(T2DM+SCH)患者78例,单纯T2DM患者278例。分别测定FIB、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)和临床生化指标,超声心动图测定心室舒张功能。计量资料组间比较采用t检验,相关性分析采用多元线性回归分析。结果 (1)T2DM+SCH组年龄、FIB、CRP均高于单纯T2DM组[(61.09±11.10)岁vs.(58.0±12.38)岁、(3.07±0.77)g/L vs.(2.79±0.72)g/L、(5.54±5.92)mg/L vs.(3.94±3.96)mg/L,P<0.05];空腹及餐后C肽均低于单纯T2DM组[(0.95±0.46)ng/L vs.(1.35±0.77)ng/L,(1.78±1.11)ng/L vs.(3.27±2.67)ng/L,P<0.05]。(2)T2DM+SCH组A峰增加,E/A减小[(93.18±25.37)cm/s vs.(86.85±25.26)cm/s、0.82±0.34 vs.0.94±0.40,P<0.05]。(3)E/A<1组HCY、FIB与TSH值均高于E/A≥1组[(18.42±9.25)mmol/L vs.(15.06±7.07)mmol/L、(3.11±0.91)g/L vs.(2.78±0.71)g/L、(3.43±3.34)m U/L vs.(2.58±1.88)m U/L,P<0.05]。(4)多元回归分析显示病程、舒张压、LDL、HCY、TSH引入男性回归方程(β=-0.732,-0.520,-0.325,-0.395,-0.582,P均<0.05)。病程、收缩压、Hb A1c、TSH引入女性回归方程(β=-0.438,-0.807,-0.462,-0.415,P均<0.05)。结论 T2DM合并SCH患者左心室舒张功能减退,FIB升高可能参与其过程。
Objective To investigate the effects of subclinical hypothyroidism (SCH) on left ventricular diastolic function and fibrinogen (FIB) in type 2 diabetic patients (T2DM). Methods A total of 356 patients with T2DM were selected, including 78 patients with T2DM complicated with SCH (T2DM + SCH) and 278 patients with T2DM alone. FIB, free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH) and clinical biochemical parameters were measured respectively. The diastolic function was measured by echocardiography. Measurement data were compared between groups using t test, correlation analysis using multiple linear regression analysis. Results (1) The age, FIB and CRP in T2DM + SCH group were significantly higher than those in T2DM group [(61.09 ± 11.10) vs. 58.0 ± 12.38 years (3.07 ± 0.77) g / L vs. (2.79 ± 0.72) (5.54 ± 5.92) mg / L vs. (3.94 ± 3.96) mg / L, P <0.05]. Both fasting and postprandial C-peptide levels were lower than those in T2DM alone group [(0.95 ± 0.46) ng / L vs (1.35 ± 0.77) ng / L, (1.78 ± 1.11) ng / L vs. (3.27 ± 2.67) ng / L, P <0.05]. (2) Peak A increased and E / A decreased in T2DM + SCH group [(93.18 ± 25.37) cm / s vs. (86.85 ± 25.26) cm / s, 0.82 ± 0.34 vs 0.94 ± 0.40, P <0.05]. (3) The values of HCY, FIB and TSH in E / A <1 group were significantly higher than those in E / A≥1 group [(18.42 ± 9.25) mmol / L vs. (15.06 ± 7.07 mmol / L, (3.11 ± 0.91) g / L vs. (2.78 ± 0.71) g / L, (3.43 ± 3.34) m U / L vs. (2.58 ± 1.88) m U / L, P <0.05]. (4) Multivariate regression analysis showed that the course of disease, diastolic blood pressure, LDL, HCY and TSH were introduced into the regression equation of men (β = -0.732, -0.520, -0.325, -0.395, -0.582, P <0.05 respectively). The course of disease, systolic blood pressure, Hb A1c and TSH were introduced into the female regression equation (β = -0.438, -0.807, -0.462, -0.415, P <0.05). Conclusion Left ventricular diastolic dysfunction in patients with T2DM complicated with SCH may be involved in the process.