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目的:分析2型糖尿病患者的静息心率和与年龄、糖尿病病程、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2h血糖(2hPG)、体质指数(BMI)的相关性,及伴高血压、冠心病患者的心率现状和危险因素,为降低心性猝死发病率提供理论依据。方法:采用横断面调查方法对2014-04-2016-03我院住院的2型糖尿病患者按顺序入组,进行病案检索,记录一般情况和心率、糖尿病病程、HbA1c、FPG、2hPG、BMI、合并症及用药情况。共调查2 012例患者,进入分析的2型糖尿病患者1 566例。其中单纯2型糖尿病患者830例,2型糖尿病合并高血压患者588例,2型糖尿病合并冠心病患者46例,2型糖尿病合并高血压和冠心病患者102例,有影响心率因素(起搏器植入、发热、甲亢、应用β受体阻滞剂和非二氢吡啶类钙拮抗剂)、影响血红蛋白因素(贫血、脾亢)、严重肝肾损害疾病患者341例和溯源问题105例均未纳入分析。心率的测量用12导联心电图机以卧位静息为准;HbA1c、FPG、2hPG以空腹静脉血为准,采用葡萄糖氧化酶法,进行生化仪检测;BMI的采集用体重身高测量仪测量身高、体重,用BMI=体重(kg)/身高(cm)~2公式求得。结果:2型糖尿病住院患者的静息平均心率为76.24次/min,主要分布区间在70~79次/min,在单纯2型糖尿病患者中心率≥80次/min者占37.47%,≥90次/min者占14.82%。双变量相关分析显示年龄与心率呈负相关(r=-0.098,P=0.005),HbA1c、FPG和2hPG分别与心率呈正相关(分别为r=0.170,P=0.000;r=0.148,P=0.000;r=0.199,P=0.000),而与糖尿病病程和BMI不相关。HbA1c、FPG、2hPG控制欠佳者心率显著增快。2型糖尿病患者、2型糖尿病伴高血压患者、伴冠心病患者、伴高血压和冠心病患者的静息平均心率分别为(76.42±11.86)、(76.58±11.42)、(77.37±11.08)及(72.28±11.50)次/min。糖尿病合并高血压风险增加与年龄、BMI有关,合并冠心病风险增加与糖尿病病程有关。结论:2型糖尿病患者心率偏快,与长期血糖控制不理想致糖尿病心肌损害有关。因此,HbA1c达标对防治糖尿病心肌损害具有重要意义。
PURPOSE: To analyze the relationship between resting heart rate and age, duration of diabetes, HbA1c, fasting blood glucose (FPG), 2hPG, BMI in patients with type 2 diabetes mellitus Blood pressure, heart rate in patients with coronary heart disease and risk factors, to reduce the incidence of sudden death to provide a theoretical basis. Methods: A cross-sectional investigation was performed on patients with type 2 diabetes mellitus who were hospitalized in our hospital from April 2014 to June 2016 with case records. The general conditions and heart rate, diabetes duration, HbA1c, FPG, 2hPG, BMI, Symptoms and medication. A total of 2 012 patients were enrolled into the analysis of 566 patients with type 2 diabetes. Among them, 830 patients with type 2 diabetes mellitus, 588 patients with type 2 diabetes mellitus and hypertension, 46 patients with type 2 diabetes mellitus and coronary heart disease, 102 patients with type 2 diabetes mellitus complicated with hypertension and coronary heart disease, Implantation, fever, hyperthyroidism, the use of β-blockers and non-dihydropyridine calcium antagonists), hemoglobin factors (anemia, hypersplenism), severe liver and kidney damage in 341 patients and traceability of 105 cases were not Included in the analysis. HbA1c, FPG, 2hPG fasting venous blood shall prevail, the use of glucose oxidase method for biochemical analyzer; BMI collection using height and weight measurement instrument to measure the height , Body weight, with BMI = body weight (kg) / height (cm) ~ 2 formula obtained. Results: The average resting heart rate of hospitalized patients with type 2 diabetes was 76.24 beats / min, with the main distribution range being 70-79 beats / min, those with type 2 diabetes ≥ 37 beats / min with ≥ 80 beats / min, ≥ 90 beats / min accounted for 14.82%. Bivariate analysis showed that age was negatively correlated with heart rate (r = -0.098, P = 0.005). HbA1c, FPG and 2hPG were positively correlated with heart rate (r = 0.170, P = 0.000; ; r = 0.199, P = 0.000), but not with diabetes duration and BMI. HbA1c, FPG, 2hPG poor control of heart rate was significantly faster. The resting resting heart rate was 76.42 ± 11.86, (76.58 ± 11.42) and (77.37 ± 11.08), respectively, in patients with type 2 diabetes mellitus, patients with type 2 diabetes mellitus and patients with coronary heart disease, and with hypertension and coronary heart disease (72.28 ± 11.50) times / min. Increased risk of diabetes with hypertension and age, BMI, increased risk of coronary heart disease associated with the duration of diabetes. Conclusion: Patients with type 2 diabetes have faster heart rate and are associated with myocardial damage caused by inadequate long-term glycemic control. Therefore, HbA1c compliance is of great significance in the prevention and treatment of diabetic myocardial damage.