老年2型糖尿病合并冠心病患者心房晚电位检测的临床价值

Clinical value of atrial late potential detection for aged type 2 diabetics with coronary artery disease

目的分析对老年2型糖尿病合并冠心病患者检测心房晚电位的临床价值。方法采用MACVU型多功能记录仪记录正常老年人、老年2型糖尿病、老年冠心病及老年2型糖尿病合并冠心病患者P波滤波后时限(Ad),P波终末40、30、20 m s电压均方根值(LP40、LP30、LP20)。结果正常组Ad(133.5±13.1)m s低于2型糖尿病组(142.3±28.8)m s和冠心病组(143.7±15.0)m s(P均<0.05),显著低于2型糖尿病合并冠心病组(154.3±16.3)m s(P<0.01)。正常组LP40(1.87±0.28)μV显著高于2型糖尿病组(1.35±0.36)μV,冠心病组(1.33±0.39)μV和2型糖尿病合并冠心病组(1.30±0.66)μV(P均<0.01)。正常组LP30(1.70±0.32)μV显著高于2型糖尿病组(1.08±0.49)μV,冠心病组(1.28±0.38)μV和2型糖尿病合并冠心病组(1.06±0.36)μV(P均<0.01)。正常组LP20(1.70±0.32)μV显著高于2型糖尿病组(1.06±0.49)μV,冠心病组(1.27±0.36)μV和2型糖尿病合并冠心病组(1.04±0.64)μV(P均<0.01)。结论老年2型糖尿病合并冠心病患者Ad明显延长,LP明显下降。心房晚电位检测可预测老年2型糖尿病合并冠心病患者心房颤动的发生。

Objective To investigate the clinical value of atrial late potential （ALP） detection for aged type 2 diabetics with coronary artery disease. Methods 128 aged persons were enrolled. They were classified into 4 groups： normal controls （ NC group）, type 2 diabetes mellitus group （ T2DM group）, coronary artery disease group（CAD group） and type 2 diabetes with coronary artery disease（T2DM ＋ CAD group）. They had their ALP measured, including the P wave duration after filtered （Ad）, mean roof of square （MRS） of voltages for the last 40ms （LP40） ,30ms （LP30） and 20ms （LP20） by P wave triggered signal-averaged electrocardiogram （SAECG）. The variances in different groups were analyzed. Results The Ad in NCgroup（ 133.5 ± 13. lms） was decreased compared to that in T2DM group （ 142.3 ± 28.8ms） and CAD group（ 143.7 ± 15.0ms） （ P 〈 0.05 ）, and significantly decreased compared to that in T2DM ± CAD group （ 154.3 ± 16.3ms） （ P 〈 0.01 ）. The LP40 （ 1.87 ± 0.28μV） in NC group was significantly in- creased compared with that in T2DM group（ 1.35 ±0. 36μV ） ,CAD group（ 1.33 ±0. 39μV） and T2DM ± CAD group（ 1.30 ±0. 66μV） （P 〈0.01 ）. The LP30 in NC group（ 1.70 ±0. 32μV） was also increased compared to that in T2DM, CAD and T2DM ± CAD group（ 1.08 ± 0. 49μV, 1.28 ± 0. 38μV, 1.06 ± 0.36 IxV respectively） （ P 〈 0.01 ）. LP20 result was similar： NC group （ 1.70 ± 0.32μV） vsT2DM （ 1.06 ± 0.49 μV）, CAD group （ 1.27 ± 0.36μV） and T2DM ± CAD group （ 1.04 ± 0. 64μV） （ P 〈 0.01 ）. Conclusion In aged type 2 diabetics with coronary artery disease, the P wave duration after filtered is significantly prolonged, LP amplitude is reduced. The ALP detection may predict atrial arrhythmia in aged type 2 diabetics with coronary artery disease.