QT间期相关指标评价2型糖尿病及其合并冠心病

Analysis of QT interval in type 2 diabetic patients with coronary heart disease

目的:探讨2型糖尿病及其合并冠心病患者QTc间期、QTd(QT离散度)、QT间期变异(QTv)改变及QT离散度与室性心律失常的关系。方法:用同步12导联心电图和24h心电Holter测定38例单纯2型糖尿病患者、48例2型糖尿病合并冠心病患者的QT间期、QTc(QTc=Q-T/R-R1/2)、QTd、QTcd(最长QTc与最短QTc之差)、QTcmax(最大QTc)、QT间期变异(QTv)以及QT离散度与室性心律失常发生率的关系,并与30例非糖尿病正常对照组进行对比分析。结果:(1)糖尿病组、糖尿病合并冠心病组QTd、QTcmax、QTv较对照组增加差别显著(P<0.05)。2型糖尿病合并冠心病组QTd、QTcmax、QTv较单纯2型糖尿病组增加。(2)糖尿病组、糖尿病合并冠心病组QTd与室性心律失常存在着显著的正相关,而对照组QTd与室性心律失常的发生无相关性。(3)对照组QTv有明显的昼夜节律变化,糖尿病组QTv昼夜节律减小或消失。结论:QTd可作为预测糖尿病患者发生恶性室性心律失常、心脏猝死的有用指标。

Objective： To study QTc interval 、QT interval dispersion and QT interval variability in type 2 diabetic patients and type 2 diabetic patients with coronary heart disease and the relationship of QT interval dispersion and ventricular arrhythmias. Methods：We examined QT interval, QTc interval,QT interval dispersion, QTcd , QTcmax、QTv in 38 type 2 diabetic patients and 48 type 2 diabetic patients with coronary heart disease and analyzied the relationship of QT interval dispersion and ventricular arrhythmias.Meanwhile, 30 healthy persons were used for control group.The parameters were measured with 12-lead standard ECGs and 24 h Hoher recording.Results：（1）There were more significant differences from QTd ,QTc- max, QTv between diabetic patients and normal cases （P〈0.05）.The QTd,QTcmax, QTv of type 2 diabetic patients with coronary heart disease were higher than those of type 2 diabetic patients. （2） The QTd in type 2 diabetic patients and type 2 diabetic patients with coronary heart disease were positively correlated to ventricular arrhythmias. But the control group was zero correlated to ventricular arrhythmias.（3） There was significant circadian rhythm of QTv in control group .The circadian rhythm of QTv was the low quartile group or disappearance in diabetic patients .Conclusion： QTd as predictor can be applied to the early discovery risk ventricular arrhythmias and sudden cardiac death in diabetes.