Sampson M J, Chambers J, Sprigings D, Drury P L
Department of Diabetes, Kings College Hospital, Denmark Hill, London, UK.
Diabet Med. 1990 Feb;7(2):126-31. doi: 10.1111/j.1464-5491.1990.tb01346.x.
To investigate whether the slightly increased blood pressure that occurs in early diabetic renal disease is associated with hypertensive left ventricular hypertrophy, M-mode echocardiograms were recorded in 11 non-diabetic control subjects and four groups of Type 1 diabetic patients. These were 15 patients without microvascular complications, 10 with microalbuminuria, 12 with early persistent proteinuria, and 8 with established renal impairment. Mean blood pressure was 133/80 mmHg (uncomplicated patients), 143/85 mmHg (microalbuminuria), 147/92 mmHg (early proteinuria) and 158/85 mmHg (renal impairment). Mean intraventricular septal width in the uncomplicated diabetic patients was 9.8 (SE 1.2) mm which did not differ from non-diabetic control subjects. Mean septal width was significantly greater in the other groups (microalbuminuria, 12.7 (1.1) mm, p less than 0.02; proteinuria, 12.0 (0.7) mm, p less than 0.05; renal impairment, 15.5 (1.8) mm, p less than 0.001). Left ventricular mass increased progressively between groups and was significantly increased in those with renal impairment (140 (21) vs 103 (5) g m-2 in uncomplicated patients, p less than 0.05). Septal width in the diabetic population not receiving antihypertensives (n = 37) was significantly correlated with systolic blood pressure (r = 0.45, p less than 0.005) which was the only variable independently related to septal width and ventricular mass. It appears that the slight increase in blood pressure that occurs in microalbuminuria and early proteinuria is frequently associated with hypertensive left ventricular hypertrophy.
为了研究早期糖尿病肾病时出现的轻度血压升高是否与高血压性左心室肥厚相关，对11名非糖尿病对照受试者和四组1型糖尿病患者进行了M型超声心动图检查。这四组患者分别为：15例无微血管并发症的患者、10例有微量白蛋白尿的患者、12例有早期持续性蛋白尿的患者和8例有已确诊肾功能损害的患者。平均血压分别为133/80 mmHg（无并发症患者）、143/85 mmHg（微量白蛋白尿患者）、147/92 mmHg（早期蛋白尿患者）和158/85 mmHg（肾功能损害患者）。无并发症的糖尿病患者的平均室间隔宽度为9.8（标准误1.2）mm，与非糖尿病对照受试者无差异。其他组的平均室间隔宽度明显更大（微量白蛋白尿组，12.7（1.1）mm，p<0.02；蛋白尿组，12.0（0.7）mm，p<0.05；肾功能损害组，15.5（1.8）mm，p<0.001）。左心室质量在各组之间逐渐增加，在肾功能损害患者中显著增加（无并发症患者为103（5）g m-2，肾功能损害患者为140（21）g m-2，p<0.05）。未接受抗高血压治疗的糖尿病患者（n = 37）的室间隔宽度与收缩压显著相关（r = 0.45，p<0.005），收缩压是与室间隔宽度和心室质量唯一独立相关的变量。看来微量白蛋白尿和早期蛋白尿时出现的血压轻度升高常与高血压性左心室肥厚相关。
