心血管自主神经病变是 2 型糖尿病患者左心室舒张功能障碍的独立危险因素。
Cardiovascular Autonomic Neuropathy Is an Independent Risk Factor for Left Ventricular Diastolic Dysfunction in Patients with Type 2 Diabetes.
机构信息
Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, Jiangsu, China.
Department of Endocrinology, Drum Tower Clinical Medical College, Nanjing Medical University, Jiangsu, China.
出版信息
Biomed Res Int. 2017;2017:3270617. doi: 10.1155/2017/3270617. Epub 2017 May 30.
AIM
This study aimed to evaluate the association between cardiovascular autonomic neuropathy (CAN) and left ventricular diastolic dysfunction (LVDD) in type 2 diabetes patients.
METHODS
315 type 2 diabetes patients from inpatients of Drum Tower Hospital were included and classified into no CAN (NCAN), possible CAN (PCAN), and definite CAN (DCAN) based on cardiovascular autonomic reflex tests. The left ventricular diastolic function was assessed by tissue Doppler imaging echocardiography.
RESULTS
The distribution of NCAN, PCAN, and DCAN was 11.4%, 51.1%, and 37.5%, respectively. The proportion of LVDD increased among the groups of NCAN, PCAN, and DCAN (39.4%, 45.3%, and 68.0%, = 0.001). Patients with DCAN had higher filling pressure (/' ratio) (10.9 ± 2.7 versus 9.4 ± 2.8, = 0.013) and impaired diastolic performance (') (6.8 ± 1.7 versus 8.6 ± 2.4, = 0.004) compared with NCAN. CAN was found to be an independent risk factor for LVDD from the multivariate regression analysis (OR = 1.628, = 0.009, 95% CI 1.131-2.344).
CONCLUSIONS
Our results indicated that CAN was an independent risk marker for the presence of LVDD in patients with diabetes. Early diagnosis and treatment of CAN are advocated for preventing LVDD in type 2 diabetes.
目的
本研究旨在评估 2 型糖尿病患者中心血管自主神经病变（CAN）与左心室舒张功能障碍（LVDD）之间的关系。
方法
纳入 315 例来自鼓楼医院住院患者的 2 型糖尿病患者，并根据心血管自主反射试验将其分为无 CAN（NCAN）、可能 CAN（PCAN）和明确 CAN（DCAN）。通过组织多普勒成像超声心动图评估左心室舒张功能。
结果
NCAN、PCAN 和 DCAN 的分布分别为 11.4%、51.1%和 37.5%。LVDD 的比例在 NCAN、PCAN 和 DCAN 组中逐渐增加（39.4%、45.3%和 68.0%， = 0.001）。与 NCAN 相比，DCAN 患者的充盈压（/'比值）更高（10.9 ± 2.7 比 9.4 ± 2.8， = 0.013），舒张功能更差（'）（6.8 ± 1.7 比 8.6 ± 2.4， = 0.004）。多元回归分析发现，CAN 是 LVDD 的独立危险因素（OR = 1.628， = 0.009，95%CI 1.131-2.344）。
结论
我们的研究结果表明，CAN 是糖尿病患者 LVDD 的独立危险因素。提倡早期诊断和治疗 CAN，以预防 2 型糖尿病患者的 LVDD。
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