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目的观察和分析急性冠脉综合征(ACS)并发2型糖尿病患者的超声心动图(UCG)特点及其相关因素。方法纳入2012年6月~11月因ACS在我院住院的患者300例,其中糖尿病组126例,非糖尿病组174例,比较两组的一般资料、临床检验指标、UCG各指标以及GRACE危险评分。结果糖尿病组中女性比例更高,入院即刻血糖、空腹血糖(FPG)、三酰甘油、GRACE评分更高(P<0.05或P<0.01)。UCG检查显示糖尿病组左室射血分数(LVEF)、每搏输出量和左室短轴缩短分数均显著降低,左室收缩末期内径和左室收缩末期容积显著增大(P<0.01),左室收缩功能轻度受损(LVEF 45%~54%)的比例显著升高(P<0.05)。相关分析提示糖尿病组LVEF与FPG、肌酐、GRACE评分显著负相关,而非糖尿病组LVEF与入院即刻血糖、肌酐、GRACE评分显著负相关(P<0.05或P<0.01)。多元线性回归分析结果表明FPG、体质量指数及性别是影响左室收缩功能的重要因素,其中FPG的标准回归系数最大(-0.312)。结论 ACS并发2型糖尿病患者,更早出现左室收缩功能障碍,与空腹血糖水平更高密切相关。
Objective To observe and analyze the characteristics and related factors of echocardiography (UCG) in patients with acute coronary syndrome (ACS) complicated with type 2 diabetes. Methods A total of 300 hospitalized patients with ACS in our hospital from June 2012 to November 2012 were enrolled in the study. Among them, 126 cases were diabetic group and 174 cases were non-diabetic group. The general data, clinical test indexes, UCG indexes and GRACE risk score . Results There was a higher proportion of women in the diabetic group. Immediate blood glucose, fasting blood glucose (FPG), triglyceride, and GRACE scores were higher in the diabetic group (P <0.05 or P <0.01). UCG examination showed that left ventricular ejection fraction (LVEF), stroke volume and left ventricular fractional shortening fraction were significantly decreased, LV end systolic diameter and left ventricular end-systolic volume were significantly increased (P <0.01), left The percentage of mildly impaired systolic function (LVEF 45% -54%) was significantly higher (P <0.05). Correlation analysis showed that LVEF was significantly and negatively correlated with FPG, creatinine and GRACE in diabetic group, while LVEF in non-diabetic group was significantly negatively correlated with immediate glucose, creatinine and GRACE admission scores (P <0.05 or P <0.01). Multivariate linear regression analysis showed that FPG, body mass index and gender were the important factors influencing left ventricular systolic function. The standard regression coefficient of FPG was the largest (-0.312). Conclusions ACS patients with type 2 diabetes mellitus have an earlier onset of left ventricular systolic dysfunction, which is associated with higher and higher fasting blood glucose levels.