2型糖尿病患者心电图碎裂QRS波与血尿酸、尿微量蛋白相关性的研究  

Correlation analysis of fragmented QRS on electrocardiogram and microalbuminuria and serum uric acid in patients with type 2 diabetes mellitus

作　　者：汪丽丽 包丽芳[2] 郑林筠 胡嘉瑜 黄华英 蒋峻[1] WANG Lili;BAO Lifang;ZHENG Linjun(Department of Cardiology,The Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院心血管内科,杭州310009 [2]浙江大学医学院附属金华医院心电生理科 [3]浙江大学医学院附属金华医院超声科 [4]浙江大学医学院附属金华医院内分泌科

出　　处：《中国糖尿病杂志》2024年第9期652-656,共5页Chinese Journal of Diabetes

摘　　要：目的 探讨T2DM患者心电图(ECG)碎裂QRS(f QRS)波与血尿酸(SUA)及尿微量蛋白(MAU)的相关性。方法 选取2022年10月至2023年6月浙江大学医学院附属金华医院内分泌科就诊的T2DM患者245例,根据ECG结果分为合并f QRS组(f QRS,n=111)和单纯T2DM组(n=134),比较两组一般资料、生化指标、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、室间隔(IVS)、左室后壁厚度(LVPW)、左室射血分数(LVEF)、左房内径(LAd)、二尖瓣口舒张早晚期血流速度峰值比(E/A)及舒张早期二尖瓣口血流速度(E)与二尖瓣环运动速度比值(E/e’)。Pearson相关分析T2DM患者f QRS波与其他指标的相关性,Logistic回归分析f QRS的影响因素。结果 f QRS组UACR、SUA、Hb A1c及合并MAU率均高于T2DM组(P<0.05或P<0.01)。QRS组LVEDd、LAd、E、E/e’、E/A>1.5高于T2DM组(P<0.05或P<0.01)。Pearson相关分析显示,f QRS波与吸烟史、BMI、Hb A1c、UACR、MAU、SUA、LVEDd、LAd、E/A及E/e’呈正相关(P<0.05)。Logistic回归分析显示,MAU是T2DM患者发生f QRS波的影响因素。结论 T2DM患者ECG的f QRS波与MAU及SUA相关,可能是亚临床心脏舒张功能不全相关心肌纤维化的重要依据。Objective To analyze the relationship between fragmented QRS(fQRS)and microalbuminuria(MAU)and serum uric acid(SUA)in patients with type 2 diabetes mellitus(T2DM).Methods From October 2022 to June 2023,245 T2DM patients diagnosed by The Department of Endocrinology,Jinhua Hospital Affiliated to Zhejiang University School of Medicine were selected and divided into fQRS group(fQRS,n=111)and T2DM group(n=134)according to ECG results.The general data,biochemical indexes,left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),interventricular septum(IVS),left ventricular posterior wall(LVPW),left ventricular ejection fraction(LVEF),left atrial diameter(LAd),peak value ratio of mitral orifice blood flow velocity in early and late diastole(E/A)and mitral orifice blood flow velocity in early diastole were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between fQRS wave and other indexes in T2DM patients,and Logistic regression analysis was used to analyze the influencing factors of fQRS.Results The prevalence rates of UACR,SUA,HbA1c and MAU in fQRS group were higher than in T2DM group(P<0.05 or P<0.01).LVEDd,LAd,E,E/e’and E/A>1.5 in QRS group were higher than in T2DM group(P<0.05 or P<0.01).Pearson correlation analysis showed that fQRS wave was positively correlated with smoking history,BMI,HbA1c,UACR,MAU,SUA,LVEDd,LAd,E/A and E/e’( P<0. 05). Logistic regression analysis showed that MAU was the influencing factor of fQRS wave inT2DM patients. Conclusions The fQRS in ECG in patients with T2DM is associated with MAU andSUA and may be an important evidence of myocardial fibrosis associated with subclinical cardiac diastolicdysfunction.

关 键 词：心电图 碎裂QRS波 尿微量蛋白 血尿酸 糖尿病 2型 

分 类 号：R587.2[医药卫生—内分泌]