老年高血压及合并2型糖尿病对心脏自主神经功能及左室结构、功能的影响

目的探讨老年高血压及合并2型糖尿病对心脏自主神经功能及左室结构、功能的影响。方法回顾性分析140例老年高血压门诊患者临床资料,根据其合并2型糖尿病情况分为糖尿病组(38例)和对照组(102例),均予以彩色多普勒超声心动图检查。对比2组受试者入组时血浆神经肽Y(NPY)、神经降压素(NT)等自主神经功能指标、舒张末期左心室内径(LVEDd)、收缩末期左心室内径(LVESd)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)等左室结构指标、心室射血分数(LVEF)、左心室短轴缩短率(FS)等左室收缩功能指标及二尖瓣口舒张早期/晚期血流充盈速度(E/A)等左室舒张功能指标检查结果差异。结果糖尿病组受试者入组时血浆NPY水平、LVEDd、LVESd、IVST、LVPWT及二尖瓣口舒张晚期血流充盈速度(A)水平均显著高于对照组(P0.05或P0.01);血浆NT水平、LVEF、FS及部分左室舒张功能指标包括E、E/A检查结果则显著低于对照组(P0.05或P0.01)。结论老年高血压患者合并2型糖尿病会对其心脏自主神经功能、左室结构及左室功能造成较大的影响,需引起临床重视。

Effects of elderly hypertension with type 2 diabetes mellitus on cardiac autonomic nervous function and left ventricular structure and function

Objective To investigate the effects of elderly hypertension with type 2 diabetes mellitus on cardiac autonomic nervous function and left ventricular structure and function.Methods The clinical data of 140 elderly outpatients with hypertension were retrospectively analyzed,and they were divided into diabetes group (n =38) and control group (n =102) according to situation of being complicated with type 2 diabetes mellitus.All patients underwent color Doppler echocardiography.The autonomic nerve functional indicators such as plasma neuropeptide Y (NPY),neurotensin (NT),left ventricular structure indicators such as left ventricular end diastolic diameter (LVEDd),left ventricular end systolic diameter (LVESD),interventricular septal thickness (IVST),left ventricular posterior wall thickness (LVPWT),left ventricular systolic function indicators such as left ventricular ejection fraction (LVEF),lefi ventricular shortening fraction (FS) and left ventricular diastolic function indicators such as mitral valve orifice diastolic early/late flow filling velocity (E/A)were observed and compared between the two groups when enrolled in the study.Results The plasma NPY level,LVEDd,LVESD,IVST,LVPWT and A level of diabetes group were significantly higher than that of control group when enrolled in the study (P ＜ 0.05 or P ＜ 0.01) while the plasma NT level,left ventricular systolic function indexes such as LVEF,FS and part of the left ventricular diastolic function indexes such as E,E / A were significantly lower than that of the control group (P ＜ 0.05 or P ＜ 0.01).Conclusion Elderly hypertension combined with type 2 diabetes mellitus have a greater effect on cardiac autonomic nervous function,left ventricular structure and left ventricular function,so it needs great attention.