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[目的]探讨男性2型糖尿病合并高血压患者的心脏改变及其影响因素意义。[方法]选择住院的男性2型糖尿病合并高血压病的患者为研究对象,全部病例入院后均测体重指数、血糖、血脂、糖化血红蛋白、血尿肌酐、尿白蛋白/肌酐比值,行常规心电图、眼底、动态血压监测(ABPM)及超声心动图(UCG)等检查。按左室质量指数(LVMI)是否≥125 g/m2分组,LVMI≥125 g/m2者为左室肥厚(LVH)组,否则为非左室肥厚组。完成相关检查后执行相同治疗方案,依那普利、非洛地平缓释片、坎地沙坦及氢氯噻嗪片降压治疗,使血压控制达标(BP﹤130/80 mmHg);选择口服降糖药降糖治疗,使血糖控制达标;每月门诊随访1次,每隔6月复查1次ABPM及UCG等指标,1年后与基线水平进行比较。[结果]①基线水平,LVH的发生率为26.69%,LVH组的BMI、HbA1c显著高于非LVH组。②治疗1年后,全部病人的HbA1c及ABPM各项指标均显著改善。③治疗1年后LVH组LVEDD、LVMI均明显高于非LVH组;与基线水平比较,1年后两组病人在UCG上的表现,除LVH组LVEDD外,其他指标均有显著下降。[结论]①男性2型糖尿病合并高血压患者LVH的发生率较高。②严格控制血糖及血压对逆转左室重构有积极作用,但对左室重构指标的作用不一致,除观注LVMI外,还应观注相对室壁厚度的改变。
[Objective] To investigate the cardiac changes in male patients with type 2 diabetes mellitus and its significance. [Methods] Inpatients with type 2 diabetes mellitus and hypertension were selected as study subjects. Body mass index, blood glucose, blood lipid, glycosylated hemoglobin, serum creatinine, urinary albumin / creatinine ratio were measured in all cases after admission. Fundus, ambulatory blood pressure monitoring (ABPM) and echocardiography (UCG) and other tests. According to LVMI ≥125 g / m2 group, LVMI≥125 g / m2 were LVH group, otherwise non-LV hypertrophy group. After completion of the relevant examinations, the same treatment regimen was followed, and enalapril, felodipine extended release tablets, candesartan and hydrochlorothiazide tablets were given antihypertensive treatment to achieve blood pressure control (BP <130/80 mmHg); oral hypoglycemic agents Hypoglycemic treatment, so that blood glucose control standards; monthly outpatient follow-up 1, reviewed every 6 months ABPM and UCG and other indicators, one year later compared with the baseline level. [Results] ① At baseline, the incidence of LVH was 26.69%. The BMI and HbA1c in LVH group were significantly higher than those in non-LVH group. ② After 1 year of treatment, all the indexes of HbA1c and ABPM in all patients were significantly improved. ③ After 1 year, LVEDD and LVMI in LVH group were significantly higher than those in non-LVH group. Compared with baseline, the other two indexes of UCG in LVH and LVH group were significantly decreased after 1 year. [Conclusion] ① The incidence of LVH is higher in male patients with type 2 diabetes mellitus and hypertension. ② Strict control of blood glucose and blood pressure on the reversal of left ventricular remodeling has a positive effect, but on the role of left ventricular remodeling indicators are inconsistent, in addition to watching the LVMI, the relative wall thickness should be observed.