2型糖尿病患者心电图Tp-Te的分析及临床意义  

Analysis of Tp-Te and its clinical significance in patients with type 2 diabetes mellitus

作　　者：唐文红[1] 黄颖[1] 田晓芬[1] 陈晓婕[1] 钟华[2] 张琴[1] 

机构地区：[1]广西壮族自治区人民医院心电诊断科,广西南宁530021 [2]广西壮族自治区人民医院内分泌与代谢科,广西南宁530021

出　　处：《实用心电学杂志》2015年第6期427-430,共4页Journal of Practical Electrocardiology

基　　金：广西壮族自治区卫生厅自筹经费科研课题(Z2012257)

摘　　要：目的分析2型糖尿病患者T波峰末间期(Tpeak-Tend interval,Tp-Te)的变化,并探讨其与室性心律失常的关系。方法选择60岁以下无心脏疾病的2型糖尿病患者60例(DM组)与60例健康者(对照组),进行常规12导联心电图及动态心电图检查,并对两组病例的一般临床资料、Tp-Te、Tp-Te间期离散度(Tp-Ted)、室性心律失常的发生进行比较。结果 1 DM组体质量指数、空腹血糖、糖化血红蛋白、尿酸、空腹胰岛素、总胆固醇、低密度脂蛋白、心率均高于对照组(P<0.05);V_5导联Tp-Te明显延长(P<0.05);Tp-Ted较对照组显著延长(P<0.01),心律失常的发生率明显增高(P<0.01);2 DM组中随着Tp-Te的延长,室性心律失常的发生率明显增高(P<0.05)。结论糖尿病患者易出现心肌电活动的不稳定,诱发心律失常的发生,Tp-Te能够反映心室跨壁复极离散度,可作为2型糖尿病患者室性心律失常发生的预测指标。Objective To analyze the changes of Tp-Te in patients with type 2 diabetes and dis- cuss the relationship with the ventricular arrhythmias. Methods Choosing 60 patients under the age of 60 without heart disease of type 2 diabetes mellitus as the DM group, and the 60 healthy as the control group. Then comparing the routine electrocardiogram in 12 leads and ambulatory ECG between these two groups, basing on the clinical data, Tp-Te, Tp-Ted, ventricular arrhythmias. Results ① In DM group, BM][, fasting plasma glucose, glycated hemoglobin, UA, fasting insu- lin, total cholesterol, low density lipoprotein （LDL）, heart rate were higher than the control group （ P 〈 0. 05 ）. The Tp-Te was significantly longer in V5 lead （ P 〈 0. 05 ）, and Tp-Ted of diabetic pa- tients were significantly longer than the control group （P 〈 0. 01 ）, ventricular arrhythmias incidence was increased significantly （P 〈0. 01 ）. ② In DM group, as the extension of Tp-Te, the incidence of ventricular arrhythmias was significantly increased （ P 〈 0.05 ）. Conclusion Diabetic patients are prone to appear the instability of cardiac electrical activity, and induces the occurrence of arrhythmia. Tp-Te can react the transmural dispersion of repolarization, and can become the forecast index of ven- tricular arrhythmias occurrence in patients with type 2 diabetes mellitus.

关 键 词：2型糖尿病 T波峰末间期 室性心律失常 

分 类 号：R540.41[医药卫生—心血管疾病]