糖尿病肾病与非糖尿病所致慢性肾脏病患者心律失常的对比研究  

Comparative study on arrhythmia between diabetic nephropathy and non-diabetic chronic kidney disease

作　　者：张海英[1] 薛勤[1] 简桂花[1] 李青[2] 高许萍[1] 陈海冰[2] 汪年松[1] 

机构地区：[1]上海交通大学附属第六人民医院肾脏内科,上海200233 [2]上海市糖尿病临床医学中心、上海市糖尿病研究所、内分泌代谢科,上海200233

出　　处：《上海医学》2014年第5期378-381,共4页Shanghai Medical Journal

基　　金：国家自然科学基金面上项目(81270824);上海市国际科技合作基金项目(11410708500);上海市科学技术委员会课题(114119a6100、11DZ1921904、124119a8400);上海市科学技术委员会基础研究重大项目(11DJ1400101);上海市科学技术委员会重大课题科研基金(11DZ1973103);上海交通大学医学院科技基金(11xj21058)资助

摘　　要：目的比较分析糖尿病肾病(DN)与非糖尿病所致慢性肾脏病(CKD)患者心律失常的发生情况及其临床特点。方法收集上海交通大学附属第六人民医院住院且尚未行肾脏替代治疗的135例DN患者(DN组)和270例非糖尿病所致CKD患者(对照组)的24h动态心电图资料和一般临床资料,并进行比较分析。结果 DN组的空腹血糖(FPG)、早餐后2h血糖(2hPG)和糖化血红蛋白(HbA1c)水平均显著高于对照组(P值均<0.05)。DN组CKD 1期的发生率为25.9%,显著高于对照组的12.6%(P<0.05);DN组CKD 4期、CKD 5期的发生率分别为16.3%、17.0%,显著低于对照组的24.4%、23.7%(P值均<0.05)。DN组24h平均心率>100次/min、频发室性早搏、多源性室性早搏、Ⅰ度房室传导阻滞、Ⅱ度房室传导阻滞和严重心律失常的发生率均显著高于对照组(P值均<0.05)。结论 DN患者较非糖尿病所致CKD患者更易发生严重的心律失常。Objective To compare the clinical features of arrhythmia between diabetic nephropathy （DN） and non-diabetic chronic kidney disease （CKD） patients. Methods A total of 135 DN patients and 270 non- diabetic CKD patients were enrolled in this study. Their dynamic electrocardiogram, and general clinical data were collected and compared. Results The levels of fasting plasma glucose （FPG）, 2-hour postprandial plasma glucose （2hPG） and glycosylated hemoglobin （HbA1C） in DN group were significantly higher than those in non- diabetic CKD group （all P〈0.05）. The proportion of patients in CKD stage 1 in DN group were significantly higher than that in non-diabetic CKD group （P〈0.05）, while the proportion of patients in CKD stage 4 and stage 5 in DN group were significantly lower than that in non-diabetic CKD group （both P 〈 0. 05）. The incidences of tachyrhythmia （heart rate〉 100/min）, frequent and multifocal premature ventricualr contraction, atrioventricular block （ I or II grade） and serious cardiac arrhythmias in DN group were significantly higher than those in non- diabetic CKD group （all P〈0.05）. Conclusion The incidence of serious arrhythmia in DN patients is higher than that of non-diabetic CKD patients.

关 键 词：糖尿病肾病 慢性肾脏病 动态心电图 心律失常 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]