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  Česky / Czech version Vnitřní lékařství, 50, 2004, č. 12, s. 894 - 900
 
Factors Participating in Development of Bleeding Varices in Portal Hypertension - Part II: Possible Im-pact of Kidney Damage and Malnutrition, Mortality 
Charvát J.1, Michalová K.2, Táborská K.2, Chlumský J.1, Kvapil M.1, Vojáček J.1 

1Interní klinika 2. lékařské fakulty UK a FN Motol, Praha, přednosta doc. MUDr. Milan Kvapil, CSc. 2Klinika nukleární medicíny 2. lékařské fakulty UK a FN Motol, Praha, přednosta doc. MUDr. Petr Vlček, CSc.
 


Summary:

       The patients with diabetes mellitus and another risk factors háve significantly higher risk to suf-fer from ischemic heart disease. Myocardial stress SPÉCT represents the examination which cor-relates very well with the results of selective coronary angiography even in asymptomatic diabetic patients. The aim of our study was to evaluate the relation of SPÉCT result to diabetes compensation, presence of micro/macroalbuminuria, blood level of fibrinogen, CRP, homocystein and uric acid. Out of 126 diabetic 2. type abnormal SPÉCT has been found in 33 (26 %). Fasting blood sugar (9.3 ± 1.4 mmol/1 in patients with abnormal SPÉCT vs. 9.7 ± 1.9 mmol/1 in the other dia-betics, n.s.) and HbAic (7.5 ± 1.3 % vs. 7.5 ± 1.3 %, n.s.) are not significantly different in the patients with abnormal SPÉCT to the other diabetics without this finding. Micro/macroalbuminurie was significantly more frequently seen in patients with abnormal SPÉCT (60 % of patients with abnormal SPÉCT and 29 % in the rest of diabetics, p = 0.01). Fibrinogen was significantly more elevated in diabetics with abnormal SPÉCT (3.76 ± 0,5 g/l in the group with abnormal SPÉCT vs. 3.23 ± 0.43 g/l, p = 0.0003). In the diabetics with abnormal SPÉCT we háve found significantly higher CRP (3.84 ± 1.51 mg/l vs. 2.79 ± 1.13 mg/l, p = 0.024) and homocystein (13.78 ± 3.26 |imol/l vs. 10.98 ± 2.33 |imol/l, p = 0.006). Uric acid level was not significantly different in the group of diabetics with abnormal SPĚT to the rest of the patients (361 ± 64 |imol/l in abnormal SPÉCT vs. 353 ± 51 |imol/l, n.s.). When we analyse our results we háve found that abnormal SPÉCT is rarely discovered in the asymptomatic 2n type diabetics with the combination of negative micro/macroalbumiburie and fibrinogen level below 3.5 g/l.

        Key words: Stress myocardial SPECT - Coronary heart disease - Diabetes mellitus
       

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