糖尿病患者合并急性心肌梗死的窦性心率震荡分析  

Analysis of heart rate turbulence in diabetic patients with acute myocardial infarction

作　　者：唐文军[1] 倪爱珍[1] 雷涛[2] 

机构地区：[1]上海市同济医院心电图室,上海200065 [2]上海市同济医院内分泌科,上海200065

出　　处：《临床荟萃》2011年第17期1503-1505,共3页Clinical Focus

摘　　要：目的探讨2型糖尿病患者合并急性心肌梗死时窦性心率震荡(HRT)的可能变化及其临床意义。方法选择2型糖尿病合并心肌梗死患者47例(1组)、单纯心肌梗死患者40例(2组)、单纯2型糖尿病患者40例(3组)和对照组40例(4组)作为研究对象。4组均行24小时动态心电图(DCG)检查,分析单次室性期前收缩(PVS)后HRT的初始值(TO)、斜率(TS)以及TO和TS异常的发生率。结果 1、2、3组TO、TS值明显异常,分别为0.49(0.86)%和(4.31±3.64)ms/R-R、0.33(0.57)%和(8.83±7.55)ms/R-R、0.16(0.39)%和(10.77±8.39)ms/R-R,与4组比较差异均有统计学意义(P<0.01),1、2组的TO、TS值与3组比较差异均有统计学意义(P<0.01),1组与2组比较差异亦有统计学意义(P<0.05,P<0.01)。4组TO及TS异常发生率分别为1组59.5%、63.8%,2组47.5%、52.5%,3组35.0%、37.5%和4组7.5%、10.0%,1、2、3组TO、TS值异常率较4组明显升高(P<0.01),1、2组TO、TS值异常率较3组明显升高,1组TO、TS值异常发生率增高最明显。结论青中年糖尿病合并心肌梗死患者HRT现象明显减弱,同时HRT异常率增高较明显。HRT可作为临床上青中年糖尿病合并心肌梗死患者预后判断的重要指标。Objective To observe the change of heart rate turbulence（HRT） and its clinic significance in diabetic patients with acute myocardial infarction（AMI）.Methods The study included 47 patients with diabetes mellitus and AMI（group 1）,40 patients with AMI（group 2） or diabetes mellitus（group 3） respectively and 40 subjects severed as controls（group 4）.All patients and subjects were examined by 24-hour holter monitoring,turbulence onset（TO） and turbulence slope（TS） after single premature ventricular systole（PVS） were calculated from holter records and the abnormal incidence of TO and TS were compared in four groups.Results The values of TO,TS in group 1,2 and 3 were 0.49（0.86）% and（4.31±3.64） ms/R-R,0.33（0.57）% and（8.83±7.55） ms/R-R,0.16（0.39）% and（10.77±8.39） ms/R-R,respectively.The values of TO,TS in group 1,2 and 3 had significant difference in abnormality compared with those of group 4（P〈0.01）.The values of TO,TS in group 1 and 2 were significantly different from that in group 3（P〈0.01）.The values of TO,TS in group 1 were significantly different from that in group 2（P〈0.05,P〈0.01,respectively）.The abnormal incidence of TO,TS in four groups were 59.5% and 63.8%（group 1）,47.5% and 52.5%（group 2）,35.0% and 37.5%（group 3） and 7.5% and 10.0%（group 4）,respectively.The abnormal incidences of TO,TS in group 1,2 and 3 had significant difference compared with those of group 4（P〈0.01）,the abnormal incidences of TO,TS in 1 and 2 groups were significantly different from those in group 3（P〈0.01）,and the abnormal incidences of TO,TS in group 1 were the highest in four groups.Conclusion The reduction and the abnormal incidence of HRT in young-middle aged diabetic patients with AMI are more obvious than patients with AMI or diabetes mellitus alone,HRT may become an important clinic index to predict the prognosis in diabetic patients with AMI.

关 键 词：糖尿病 心肌梗死 心电描记术 

分 类 号：R587.1[医药卫生—内分泌]