老年2型糖尿病跨室壁复极离散度特点及其临床意义探讨  

The characteristic of trans-mural dispersion of repolarization in elderly patients with type 2 diabetes

作　　者：胡英[1] 徐蓉[1] 叶明浩[1] 廖德宁[1] 

机构地区：[1]上海市徐汇区中心医院老年病科,200031

出　　处：《疑难病杂志》2013年第6期419-421,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察老年2型糖尿病患者跨室壁复极离散度(TDR)的心电学指标特点并探讨其与不良室性心律失常事件的关系。方法选择2009年1月—2011年12月门诊或住院的2型糖尿病患者80例(B组)、2型糖尿病合并冠心病患者75例(C组)、同期体检的健康老年人63例(A组),均行12导联心电图检查,测定T波峰末间期(Tp-e)、校正QT间期(QTc)、QT间期离散度(QTd)、Tp-e/QTc;行24h动态心电图,观察不良室性心律失常发生情况。结果 (1)与A组比较,B组Tp-e、QTc、QTd、Tp-e/QTc均无显著差异(P>0.05),C组患者各项指标均显著延长(P<0.01);与B组比较,C组患者各项指标亦显著延长(P<0.05,P<0.01)。(2)A、B、C组不良室性心律失常发生率分别为1.6%(1/63)、5.0%(4/80)和18.7%(14/75),A、B组间比较差异无统计学意义(P>0.05);C组发生率高于A组、B组(P<0.05);(3)B组及C组的Tp-e、QTd、Tp-e/QTc与不良心律失常发生率呈正相关(B组:r=0.478、r=0.386、r=0.584;C组:r=0.557、r=0.498、r=0.586)。结论 Tp-e、QTc、QTd、Tp-e/QTc增大可能是合并冠心病的老年2型糖尿病患者发生不良室性心律失常的危险指标。Objective To investigate and compare the characteristics of electrocardiology indicators of trans-mural dispersion of repolarization （TDR） between elderly patients with type 2 diabetes mellitus （T2DM） complicated with coronary heart disease （CHD） and patients with rlEDM uncomplicated with CHD. Methods 63 normal healthy subjects were in group A as control, 80 patients with T＇2DM were in group B and 75 patients with T2DM complicated with CHD were in group C. Then examined Tp-e, QTc, QTd, Tp -e/QTc with 12 lead standard ECGs. Meanwhile we observed malignant arrhythmia oc- currence though 24h Holter recording. Results （ 1 ） It was showed that Tp-e, QTc （ P 〈 0.05, QTd, Tp-e/QTc in group C were longer than those in group A and B （ P 〈 0.01 ）. （2）It was showed that malignant arrhythmia occurrence in group C were more higher than those in group A and B （ P 〈0.05）. （3） There was a positive correlations between Tp-e, QTd, Tp- e/QTc and malignant arrhythmia occurrence in group B and C （ Group B ： r = 0.478, r = 0. 386, r = 0. 584, Group C ： r = 0.577, r = 0.498, r = 0. 586）. Conclusion Degree of arterial damage of elderly patients with type 2 diabetes mellitus was related to trans-mural dispersion of repolarization and increased malignant arrhythmia occurrence. It can forecast malignant ar- rhythmia occurrence though measuring TDR and provide the bases of clinical electro-cardiology of malignant arrhythmia occur- rence and sudden cardiac death in elderly patients with type II diabetes mellitus.

关 键 词：糖尿病 2型 跨室壁复极离散度 心律失常 

分 类 号：R587.1[医药卫生—内分泌]