糖尿病QT离散度改变及与心脏植物神经病变关系探讨

The Relationship Between the Change of QT Dispersion and Autonomic Neuropathy in Diabetes

目的 :探讨糖尿病患者QT离散度 (QTd)改变及与糖尿病植物神经病变和室性心律失常间的关系。方法 :用同步 12导联心电图测定 6 9例糖尿病患者的QTd、最大QT间期 (QTmax)和经心率校正的QTmax (QTc max) ,同时用Holter监测其心率变异性 (HRV)和室性心律失常发生率 ,并与 6 1例非糖尿病人进行对比分析。结果 :①糖尿病组QTd较非糖尿病组显著增加 (P <0 0 1) ;②糖尿病组心率变异性指标中正常RR间期的标准差(SDNN)、每 5分钟正常间期标准差的平均值 (SDNN -index)较非糖尿病组显著降低 (P <0 0 5 )。糖尿病组QTd与每 5分钟正常RR间期平均值标准差 (SDANN)、SDNN -index存在明显相关性 (P <0 0 5 )。③糖尿病组QTd与室性心律失常存在着明显的正相关 ,而非糖尿病组QTd与室性心律失常的发生无明显相关性。结论 :糖尿病组QTd较非糖尿病组延长 ,且QTd与植物神经病变和室性心律失常相关 ,QTd可作为预测糖尿病患者发生恶性室性心律失常的有用指标。

Objective： To investigate the relationship between the QT dispersion （QTd） and autonomic neuropathy and ventrieular arrhythmias in diabetes. Methods： QTd, Maximun QT （QTmax） and heart rate- corrected QTmax were mearsured on standard 12- lead electrocardiogram （ECG） at baseline in 69 diabetic patients. Holler was used to detect heart rate variation （HRV） and incidence of ventricular arrhythmias, 69 diabetics were compared with 61 laondiabeties. Results： ①QTd was significantly higher in diabetics than nondlabeties （ P 〈 0.01 ） ; ②HRV indices SDDN, SDDN - index were significantly lower in aliabelles than nondiabetics （ P 〈 0.05）, definite correlation of QTd with SDANN and SDNN - index in diabetics; ③There was a significantly positive correlation between QTd and ventrieular arrhythmias in diabetics, but definite correlation was not found between QTd and ventrieular arrhythmias in nondiabeties. Conclusion： QTd was longer in diabetics than nondiabeties, there was correlation QTd with autonomic neuropathy and ventrieular arrhythmias, QTd may be an useful predictor of severe ventrieular arrhythmias in diabetics.