碎裂QRS波对2型糖尿病患者左心室功能的预测价值  

Value of fQRS in predicting left ventricular function in patients with type 2 diabetes mellitus

作　　者：张炳山[1] 谈君[2] 李宗斌 洪侃[1] 王滨[1] 万鹤鸣[1] ZHANG Bingshan;TAN Jun;LI Zongbin(Department of Geriatrics, Wuxi People＇s Hospital, Wuxi 214023, CHINA)

机构地区：[1]无锡市人民医院老年医学科,江苏214023 [2]无锡市人民医院心功能科,江苏214023 [3]无锡市人民医院心血管内科,江苏214023

出　　处：《江苏医药》2018年第6期630-634,共5页Jiangsu Medical Journal

摘　　要：目的探讨常规心电图上碎裂QRS(fQRS)波对2型糖尿病(T2DM)患者左心室收缩和舒张功能受损检测的价值。方法选取冠状动脉造影结果正常的T2DM患者110例(病例组)和冠状动脉造影结果正常的非糖尿病患者90例(对照组),计算心电图上fQRS波的发生率;并行常规超声心动图和多普勒检查,比较两组左心室功能。病例组患者按照是否存在fQRS波进行分层分析左心室功能。结果病例组fQRS检出率高于对照组(27.3%vs.5.6%)(P<0.01)。与对照组相比,病例组舒张末期室间隔厚度(IVS)、左心室后壁厚度(PW)、左心室质量(LVM)、左心室重量指数(LVMI)和左心房最大容积(LAMV)增大,E峰和E峰降低,E/E升高,A峰和A峰升高,左室等容收缩加速度(IVA)降低(P<0.01)。与不存在fQRS波组相比,存在fQRS波组患者IVS、PW、LVM、LVMI、LAMV和左心室收缩末期内径更大,E峰和IVA更低,A峰和E/E更高(P<0.05或P<0.01)。结论 T2DM患者fQRS波的检出率高;存在fQRS波的T2DM患者亚临床左心室收缩和舒张功能受损更严重。Objective To investigate the value of fragmented QRS（fQRS）waves on routine electrocardiogram in detecting the left ventricular systolic and diastolic dysfunction in the patients with（T2 DM）.Methods The incidence of fQRS waves on electrocardiogram was detected in 110 patients with T2 DM（group A）and 90 non-diabetic patients with normal coronary angiogram（group B）.The left ventricular function was compared between two groups by conventional echocardiography and Doppler examination.The left ventricular functions were compared in the patients with fQRS waves and without fQRS waves in group A.Results The detection rate of fQRS waves in group A was higher than that in group B（27.3% vs.5.6%）（P〈0.01）.Compared with group B,the end-diastolic interventricular septum thickness（IVS）,left ventricular posterior wall thickness（PW）,left ventricular mass（LVM）,left ventricular mass index（LVMI）,left atrial maximum volume（LAMV）,E/E,A peak and Apeak were increased,E peak,Epeak and left ventricular iso-contraction acceleration（IVA）were decreased in group A（P〈0.01）.Compared with patients without fQRS waves in group A,patients with fQRS waves had larger IVS,PW,LVM,LVMI,LAMV,and left ventricular end systolic diameter,lower Epeak and IVA,and higher Apeak and E/E（P〈0.05 or P〈0.01）.Conclusion The detection rate of fQRS waves in patients with T2 DM is higher.T2 DM patients with fQRS waves have more severe subclinical left ventricular systolic and diastolic dysfunction.

关 键 词：2型糖尿病 碎裂QRS波 糖尿病心肌病 左心室功能 

分 类 号：R541[医药卫生—心血管疾病]