标题：合并2型糖尿病的维持性血液透析患者左心室舒张功能特点分析

      作者：廖兵，余湘宁，石宏斌，沈文翔，钟焕
    (南宁市第一人民医院肾内科，广西 南宁 530022)

      卷次： 2016年27卷4期

      【摘要】 目的 探讨合并2型糖尿病的血液透析患者的左室舒张功能变化特点。方法 选择接受规律透析的
终末期肾病(ESRD)患者105例，根据有无2型糖尿病，将患者分为合并糖尿病组37例和非糖尿病组68例。对两组
患者进行常规和组织多普勒显像(TDI)超声心动检查，观察两组左室舒张功能的区别。结果 常规超声心动图结
果显示，合并糖尿病组患者的左心房内径(LAD)为(42.1±6.0) mm，而非糖尿病组为(39.8±7.3) mm，P=0.022；合并糖
尿病组的室间隔舒张末期厚度(IVSd)为(15.1±4.2) mm，而非糖尿病组为(13.5±4.8) mm，两组比较差异均具有统计学
意义(P=0.017<0.05)，提示合并2型糖尿病组患者左心房内径较大，舒张期室间隔变厚。TDI显示，合并2型糖尿病
组的二尖瓣舒张早期与瓣环运动峰值速度比值(E/e')为(13.2±4.3)，非糖尿病组为(11.9±4.3)，两组比较差异具有
统计学意义(P<0.05)；两组的二尖瓣环舒张早期峰值速度(e')分别为(7.0±2.1) cm/s和(7.6±1.8) cm/s；两组的二尖
瓣瓣环运动峰值早期和晚期速度比值(e'/a')分别为(0.66±0.43)和(0.79±0.32)，差异均具有统计学意义(P<0.05)。
结论 与非糖尿病组比较，合并 2型糖尿病的维持性血液透析患者的左室舒张功能不全更为严重。

      【关键词】 血液透析；糖尿病；舒张功能不全；超声心动图

      【中图分类号】 R459.5 【文献标识码】 A 【文章编号】 1003—6350（2016）04—0542—03


Characteristics of left ventricular diastolic function in patients with type 2 diabetes mellitus on maintenance
hemodialysis.
LIAO Bing, YU Xiang-ning, SHI Hong-bin, SHEN Wen-xiang, ZHONG Huan. Department of Nephrology,
the First People's Hospital of Nanning, Nanning 530022, Guangxi, CHINA

【Abstract】 Objective To explore the change of left ventricular diastolic function in patients with type 2 diabe-
tes mellitus (T2DM) on maintenance hemodialysis. Methods A total of 105 patients of end-stage renal disease (ESRD)
on maintenance hemodialysis were divided into two groups based on the presence or absence of T2DM: T2DM group (n=
37) and non-T2DM group (n=68). The two groups of patients all received conventional and tissue Doppler imaging
(TDI) echocardiography, and the left ventricular diastolic function was observed in the two groups. Results Conven-
tional echocardiography showed that the left atrial diameter (LAD) was (42.1±6) mm in T2DM group and (39.8±7.3) mm
in non-T2DM group, with statistically significant difference between the two groups (P=0.022<0.05). The interventricu-
lar septal diastolic (IVSd) was (15.1±4.2) mm in T2DM group and (13.5±4.8) mm in non-T2DM group, with statistically
significant difference between the two groups (P=0.017<0.05). The results suggest that LAD is larger in patients with
T2DM than those without T2DM, and IVSd is thicker. TDI showed that early-diastolic mitral annulus motion and peak
velocity ratio (E/e') was (13.2±4.3) in T2DM group and (11.9±4.3) in non-T2DM group, and the difference was statisti-
cally significance (P<0.05). Early-diastolic peak velocity of mitral annulus (e') of the two groups were (7.0±2.1) cm/s
and (7.6±1.8) cm/s, and the ratio of early-diastolic and late-diastolic peak velocity of the mitral annulus (e'/a) of the two
groups were (0.66±0.43) and (0.79±0.32), with statistically significant differences between the two groups (P<0.05)).
Conclusion Compared with patients without diabetes mellitus, patients with diabetes mellitus on maintenance hemodi-
alysis had worse left ventricular diastolic dysfunction.

      【Key words】 Hemodialysis; Diabetes mellitus; Diastolic dysfuction; Echocardiography
·论 著·
6350.2016.04.008