糖尿病治療により，心機能低下が短期間に改善した2症例

Two diabetic patients with improvement of cardiac dysfunction In a short period with blood-sugar control

　Rubler^1），Hamby^2）の報告以来，Diabetic cardiom—yopathyの心機能については，非観血的手技などを用い数多くの検討がなされている。われわれも，心エコー図，心機図を用い糖尿病患者の心機能を観察し，糖代謝異常の是正後，収縮期および拡張期心機能低下が改善したと述べてきた^3）。

　今回，心エコー図，心機図に加え，RI angiographyを用い，多方面から収縮期および拡張期心機能を検討したところ，糖尿病治療後心機能低下が著明に改善を示した2症例を経験したので，その所見について詳細に報告します。

We experienced two diabetic patients, whose car-diac dysfunction improved in a few months with blood-sugar control.

The first patient was a 46-year-old male with a 11-year history of diabetes. He was admitted on Febru-ary 22, 1982, for poor control of blood glucose. The blood glucose and HbA₁ levels were 308 mg/dl and 11.6%, respectively, on admission. He had been re-ceiving insulin therapy. After treatment, FBS and HbA₁ fell markedly, ET/PEP increased from 2.1 to 2.8, ETi increased from 390 msec to 422 msec, PEPi decreased from 150 msec to 135 msec. EF increased from 42% to 46%, respectively. Then cardiac dias-tolic function in RI time activity curve also impro-ved.

The second patient was a 57-year-old male with a 8-year history of diabetes. He was admitted on May 24, 1982, for poor control of blood glucose. The blood glucose and HbA, levels were 275 mg/dl and 11. 9%, respectively, on admission. He had been receiving insulin therapy. After treatment, FBS and HbA, fell markedly, ET/PEP increased from 1.8 to 2. 5, ETi increased from 377 msec to 421 msec, PEPi decreased from 171 msec to 144 msec, II A-MVO shor-tened from 151 msec to 99 msec, D/S ratio increased from 0.88 to 1. 24, respectively.

This report suggests that cardiac dysfunction (both systole and diastole) occurring in untreated diabetics are influenced by the control of blood sugar, therfore it is necessary to treat diabetes mellitus as early as possible.