2型糖尿病合并代谢综合征患者心电图运动试验反应  

Exercise electrocardiographic response to metabolic syndrome patients complicated with type 2 diabetes mellitus

作　　者：高民[1] 陈伟[2] 韩良[2] 张丽[3] 

机构地区：[1]徐州医学院研究生学院2009级康复医学与理疗学专业,江苏徐州221004 [2]徐州医学院徐州临床医院（徐州市中心医院）康复医学科,江苏徐州221009 [3]徐州医学院徐州临床医院（徐州市中心医院）心电图室

出　　处：《徐州医学院学报》2012年第2期109-112,共4页Acta Academiae Medicinae Xuzhou

基　　金：2011年徐州市科技计划项目（XF11C069）

摘　　要：目的 观察2型糖尿病（T2DM）合并代谢综合征（MS）的心电图运动试验反应,比较心脏变时指标、代谢当量及发生心肌缺血的心电图改变.方法 随机抽取门诊T2DM患者120例,按是否合并MS分为2组：合并MS组和非MS组.所有受试者完成症状限制性运动平板试验,并求心脏变时功能不全（CI）指标：运动最高心率与预测最大心率值之比（rHR）和心率储备率（HRR）,以及运动能力中的最大代谢当量（maxMETs）.以ST-T改变作为心肌缺血的心电图改变标准.结果 T2DM 合并MS患者其心脏变时功能、代谢当量指标均低于不合并MS的T2DM患者,差异有统计学意义（P〈0.05）.T2DM合并MS患者发生心肌缺血的心电图改变者占35.9%,非MS组为19.6%（P〈0.05）.心肌缺血患者心脏变时功能指标及maxMETs 较无心肌缺血者为低（P〈0.05）.结论 T2DM合并MS者其潜在的心肌缺血与心电图运动试验结果相关,发生心肌缺血者其心脏变时功能指标及maxMETs较无心肌缺血者为低.T2DM合并MS者心肌缺血的发生率较不合并MS者为高.MS及CI作为心血管高危因素,对合并MS及CI的T2DM患者进行预防和康复有临床意义.Objective To observe the exercise electrocardiographic responses to metabolic syndrome patients complicated with type 2 diabetes mellitus （T2DM）, compare the CI index and maxMETs and the electrocardiographic change of ischemia. Methods A total of 120 patients with T2DM were devided into MS group and non- MS group, and all of them completed the electrocardiographic exercise testing, the indexes of＇CI： ratio of heart rate （rHR） , heart rate reserve （HRR） were measured and the maxMETs were measured. Coronary ischemia was measured by ST change of electrocardi- ogram（ECG）. Results Patients in MS group had a higher prevalence of CI indexes （ rHR, HRR） and maxMETs than in the non - MS group, the difference between the two groups was remarkable （ P 〈 0.05 ）. The percentage of ST change of ECG with coronary isehemia in MS group is 35.9%, the non- MS group is 19.6% （P 〈 0.05 ）. Patients with coro- nary ischemia had lower CI indexes and lower maxMETs （ P 〈 0.05 ）. Conclusion In the patients with metabolic syn- drome complicated with T2DM had silent coronary ischemia, the CI indexes（ rHR, HRR） and maxMETs are lower than those without metabolic syndrome. Metabolic syndrome complicated T2DM had higher coronary ischemia occurred than those without metabolic syndrome. Metabolic syndrome and CI are predictors of cardiovascular risk. The prevention and rehabilitation to patients of metabolic syndrome complicated with T2DM have clinical significance.

关 键 词：2型糖尿病 代谢综合征 心电图运动试验 心脏变时功能不全 代谢当量 心肌缺血 

分 类 号：R493[医药卫生—康复医学]