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目的探讨住院T2DM患者心脏功能和IR的关系并明确影响其变化的危险因素。方法选取338例伴或不伴高血压(EH)T2DM患者,应用心脏多普勒超声观察心脏结构及功能的变化,研究左室射血分数(LVEF)、二尖瓣心室充盈早期血流速度峰值(E峰)、晚期心室充盈心房收缩血流速度峰值(A峰)的比值(E/A)与患者年龄、病程、BMI、HbA1c、TG、HDL-C、LDL-C及胰岛素抵抗指数(HOMA2-IR)的相互关系,以及影响其变化的危险因素。结果 LVEF在伴或不伴EH患者间及不同EH分级间比较差异有统计学意义(P<0.01)。在不伴EH(NEH)组中,LVEF仅与HOMA2-IR相关(r=-1.898,P=0.028)。对于E/A值,年龄、EH、HOMA2-IR是其独立危险因素(OR分别为1.059、4.079、3.403,P均<0.01)。结论 IR可作为独立危险因素作用于心脏功能。
Objective To investigate the relationship between cardiac function and IR in inpatients with T2DM and to identify the risk factors that influence their changes. Methods A total of 338 patients with T2DM with or without hypertension (EH) were enrolled in this study. Changes of cardiac structure and function were observed with Doppler echocardiography. The changes of left ventricular ejection fraction (LVEF), peak velocity of mitral inflow early ventricular filling (E peak), peak E (A peak), and age, course of disease, BMI, HbA1c, TG, HDL-C and insulin resistance index (HOMA2 -IR), as well as the risk factors that affect their changes. Results There was significant difference in LVEF between patients with and without EH and between different EH grades (P <0.01). In the group without EH (NEH), LVEF was only associated with HOMA2-IR (r = -1.898, P = 0.028). For E / A value, age, EH, HOMA2-IR were independent risk factors (OR = 1.059, 4.079, 3.403, P <0.01 respectively). Conclusion IR can act as an independent risk factor on cardiac function.