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目的研究合并冠心病的2型糖尿病患者的心率变异性(HRV)及QT间期离散度(QTd)的特点。方法选择163例2型糖尿病患者为Ⅰ组,其中单纯糖尿病者78例(A组),合并冠心病的2型糖尿病者85例(B组);115例健康体检者作为对照组Ⅱ组,将Ⅰ组与Ⅱ组、A组与B组的最小心率、平均心率和最大心率的值;HRV的时域指标SDNN、PNN50、SDANN、RMSSD以及最大QT间期(QTmax)、最小QT间期(QTmin)、QTd(QTmax-QTmin)进行比较分析。结果合并冠心病的2型糖尿病患者的最小心率、平均心率、最大心率较单纯糖尿病患者和健康体检者增高;其HRV的时域指标均较前两者降低,QTd较健康体检者增大,差异均具有统计学意义(P<0.05)。结论合并冠心病的2型糖尿病患者的HRV及QTd异常率高,应与自主神经对心脏的调节能力减弱有关,易发生心源性猝死,临床上应采取措施减少其发生,并改善预后。
Objective To investigate the characteristics of heart rate variability (HRV) and QT dispersion (QTd) in type 2 diabetic patients with coronary heart disease. Methods One hundred and sixty-three patients with type 2 diabetes mellitus were selected as group Ⅰ, including 78 cases of simple diabetes mellitus (group A) and 85 cases of type 2 diabetes mellitus (group B) with coronary heart disease. One hundred and seventy-one healthy subjects were served as control group Ⅱ The values of minimum heart rate, average heart rate and maximum heart rate of group Ⅰ and group Ⅱ, group A and group B; the time-domain indexes SDNN, PNN50, SDANN, RMSSD, QTmax and QTmin of HRV ), QTd (QTmax-QTmin) for comparative analysis. Results The minimum heart rate, average heart rate and maximum heart rate of patients with type 2 diabetes mellitus with coronary heart disease were higher than those of patients with simple diabetes mellitus and healthy subjects. The time domain indexes of HRV were lower than those of the former two and the QTd was higher than that of healthy subjects All were statistically significant (P <0.05). Conclusions The abnormal rate of HRV and QTd in patients with type 2 diabetes mellitus complicated with coronary heart disease should be related to the diminished ability of autonomic nervous system to regulate the heart. Sudden occurrence of sudden cardiac death may occur. Therefore, measures should be taken to reduce the occurrence and improve the prognosis of patients with type 2 diabetes mellitus.