2型糖尿病伴高血压患者QT离散度的影响因素

Multifactorial analysis of QTc dispersion in type 2 diabetes mellitus with hypertension

目的 探讨 2型糖尿病伴高血压患者QT离散度 (QTcd)的影响因素。方法 对 6 0例 2型糖尿病伴高血压患者 ,包括左心室肥厚 (LVH) 2 1例 ,非左心室肥厚 (NLVH) 39例 ,分别测量QTcd等 ,并与 38例单纯 2型糖尿病及 6 0例正常组进行对照。应用相关分析及多因素逐步回归方法进行分析。结果 2型糖尿病各组的QTcd、QTd均较对照组明显延长 ,其中LVH组较NLVH组和单纯 2型糖尿病组的QTcd、QTd的延长更为显著 (P <0 .0 0 1)。相关分析表明 ,QTcd与左心室重量指数 (LVMI)、糖尿病病程及空腹胰岛素水平显著正相关。逐步回归分析表明 ,QTcd主要决定于LVMI、糖尿病病程和空腹胰岛素水平。结论 影响 2型糖尿病伴高血压患者QTcd的主要因素为左心室肥厚、糖尿病病程及空腹胰岛素水平。

Objective To investigate the influences upon QTc dispersion in type 2 diabetes mellitus with hypertension.Methods QTd and QTcd were measured in 60 diabetic patients with hypertension(including LVH 21,NLVH 39) and 38 diabetic patients without hypertension and in 60 healthy control subjects.Correlation and stepwise regression analyses were used to study the influences on QTcd. Results QTcd and QTd were significantly longer in each group of type 2 diabetes mellitus (2 DM)than those in control group.QTcd and QTd in LVH were significantly greater than those in NLVH and in pure 2 DM ( P <0.001).Correlation analysis showed that QTcd correlated with LVMI?diabetic duration?FIns positively.Stepwise regression analysis showed that QTcd was mainly determined by LVMI,diabetic duration and fasting insulin.Conclusion Left ventricular hypertrophy,diabetic duration and elevated fasting insulin level are independently correlated to QTcd in type 2 diabetic patients with hypertension.