2型糖尿病合并急性心梗患者的窦性心率震荡现象

Phenomenon of heart rate turbulance in patients with type 2 diabetes mellitus complicated by acute myocardial infraction

目的探讨2型糖尿病合并急性心肌梗死(AMI)患者是否存在心率震荡(HRT)的进一步降低,并了解HRT参数与心率变异(HRV)参数之间的相关性。方法根据53例AMI后窦性心律患者是否合并2型糖尿病,分为单纯AMI组30例和AMI合并2型糖尿病组23例,并选择同期性别、年龄相匹配的30例健康人作为正常对照组。心率震荡值用两个参数TO(震荡起始)、TS(震荡斜率)表示,并通过24小时动态心电图计算获得。同时利用动态心电图对患者心率变异的时域指标SDNN进行测量。结果53例AMI患者存在HRT的全面减弱,表现为TS降低,TO升高;AMI合并2型糖尿病者HRT减弱更加明显。相关性分析表明,TS与SDNN之间存在相关性(r=0.447,P=0.009)。结论HRT参数TS值在AMI患者减少,在合并糖尿病的患者中HRT减弱更加明显,在AMI患者中HRT参数TS与SDNN呈正相关。

Objective To analyze the phenomenon of heart rate turbulance （HRT） in patients with type 2 diabetes mellitus complicated by acute myocardial infraction （AMI）. To find the correlation between HRT and heart rate variability （HRV）. Methods Fifty-three patients after AMI with sinus rhythm were enrolled in this study. HRT was compared among 30 patients with simple AMI, 23 AMI patients associated with type 2 diabetes mellitus, and 30 healthy subjects as normal control. HRT was signified by two parameters： turbulance onset （TO） and turbulance slope （TS）. The numerical values of TO and TS were obtained by using dynamic electrocardiogram. The parameters of HRV were exhibited by SDNN, which was obtained also by dynamic electrocardiogram. Results in AMI patients,TS stepped down and TO elevated obviously compared with control group. Compared with simple AMI patients, the parameters of HRT reduced more obviously in patients with type 2 diabetes mellitus complicated by AMI. There was a correlation between TS and SDNN in AMI patients（r=0. 447,P=0. 009）. Conclusion TS is positively related to SDNN in AMI patients.