Grenfell A, Monaghan M, Watkins P J, McLeod A A
Diabetic Department, King's College Hospital, London, UK.
Diabet Med. 1988 Dec;5(9):840-4. doi: 10.1111/j.1464-5491.1988.tb01121.x.
Echocardiography was used to study the prevalence and severity of left ventricular hypertrophy in patients with established diabetic nephropathy (persistent proteinuria for at least 2 y plus severe retinopathy). Fifteen patients had mild renal impairment (serum creatinine less than 150 mumol l-1), 14 patients had moderate renal impairment (serum creatinine 150-400 mumol l-1), and 20 patients had severe renal impairment (serum creatinine greater than 400 mumol l-1). Thirty-six of the 49 (73%) were on anti-hypertensive treatment, despite which mean blood pressure was 161 +/- 25/89 +/- 9 (+/- SD) mmHg. Left ventricular hypertrophy was demonstrated in 42 of the 49 patients (85%), and increased in severity with increasing renal impairment. Interventricular septal + left ventricular posterior wall thickness was 25 +/- 3 mm in those with mild renal impairment, 28 +/- 6 mm in those with moderate renal impairment and 30 +/- 4 mm in those with severe renal impairment. The most severe left ventricular hypertrophy was seen in the Afro-Caribbean patients. Left ventricular hypertrophy was present even in those with marginally raised blood pressure and was related to age and serum creatinine but not to present blood pressure or duration of proteinuria.
超声心动图用于研究已确诊糖尿病肾病（持续蛋白尿至少2年加严重视网膜病变）患者左心室肥厚的患病率和严重程度。15例患者有轻度肾功能损害（血清肌酐低于150 μmol/L），14例患者有中度肾功能损害（血清肌酐150 - 400 μmol/L），20例患者有重度肾功能损害（血清肌酐大于400 μmol/L）。49例患者中有36例（73%）正在接受抗高血压治疗，尽管如此，平均血压仍为161±25/89±9（±标准差）mmHg。49例患者中有42例（85%）出现左心室肥厚，且随着肾功能损害加重，严重程度增加。轻度肾功能损害患者的室间隔+左心室后壁厚度为25±3 mm，中度肾功能损害患者为28±6 mm，重度肾功能损害患者为30±4 mm。最严重的左心室肥厚见于非洲加勒比裔患者。即使在血压略有升高的患者中也存在左心室肥厚，且与年龄和血清肌酐有关，而与当前血压或蛋白尿持续时间无关。
