2型糖尿病患者24小时平均脉压与冠状动脉病变程度和心率变异性及心律失常的关系研究

Relationship among 24 Hour Average Pulse Pressure and Coronary Artery Disease and Heart Rate Variability and Arrhythmia in Patients with Type 2 Diabetes Mellitus

目的探讨2型糖尿病患者24h平均脉压与冠状动脉病变程度、心率变异性(HRV)及心律失常的关系。方法选择2010—2012年在我院住院的2型糖尿病患者86例,均进行冠状动脉造影、24h动态血压检测(ABPM)及24h动态心电图检查,依据24h平均脉压将其分为A组(≥60mmHg)和B组(<60mmHg),对比两组冠状动脉病变程度、心律失常发生情况及HRV指标。结果 A组冠状动脉病变发生率高于B组(P<0.05);A组复杂性、恶性心律失常发生率高于B组(P<0.05);A组心率变异性时域指标均低于B组(P<0.05)。结论 2型糖尿病患者24h脉压增大与复杂性、恶性心律失常的发生及自主神经功能受损关系密切,可早期预测靶器官损害和心血管事件。

Objective To evaluate the relationship among 24h average puise pressure, coronary disease, heart rate variability （HRV） and arrhythmia in patients with type ：2 diabetes mellitus. Methods 86 patients with type 2 diabetes were chosen from 2010 to 2012. Coronary angiography, 24h ambulatory blood pressure detection （ABPM） and 24h dynamic electro- cardiogram inspection were performed, they were divided into group A （~〉60mmHg） and group B （ 〈 60mmHg） based 24h mean pulse pressure. The coronary artery lesion severity, occurrence arrhythmia and heart rate variability of two groups were compared. Results The incidence of coronary artery disease in group A was higher than B group （ P 〈 O. 05 ） ; The complexity, the incidence of malignant arrhythmia group A was higher than group B （ P 〈 0. 05 ） ; The heart rate variability in group A were lower group B （P 〈 0. 05）. Conclusion 24h pulse pressure in patients with type 2 diabetes increases with the complexity, the occurrence of malignant arrhythmia and autonomic nerve function damage are closely related, can early prediction target organ damage and cardiovascular events.