糖尿病患者中QTc间期延长与糖尿病视网膜病变的相关性分析

Correlation between QTc interval prolongation and diabetic retinopathy in type 2 diabetic patients

目的探讨心电图QTc间期延长与糖尿病视网膜病变（DR）的相关性。方法选取2014年5月至2016年3月于西京医院内分泌科住院的2型糖尿病（T2DM）患者797例，根据眼底照相结果分为无视网膜病变（NDR）组539例和有视网膜病变组（DR）组258例。比较两组性别比例、年龄、病程、空腹血糖（FPG）、血脂等一般资料和生化指标，及QTc间期长度。根据数据类型，两组间比较采用t检验或非参数秩和检验。采用Spearman相关分析QTc间期、DR与各生化指标的相关性，采用Logistic回归分析QTc间期和DR的影响因素。结果本研究中所有患者QTc间期为（404±47）ms。DR组QTc间期高于NDR组[（417±47）比（396±44）ms，t=-4.227，P〈0.01]。Logistic回归分析结果显示，QTc〉404ms是QTc≤404ms的T2DM患者患DR风险的1.659倍（OR=1.659，95%CI：1.208-2.378，P〈0.05）；QTc〉440ms是QTc≤440ms的T2DM患者患DR风险的2.729倍（OR=2.729，95%CI：1.627-4.578，P〈0.05）。结论心电图QTc延长与DR具有相关性。

ObjectiveTo evaluate the relationship between QTc interval prolongation and diabetic retinopathy （DR）.MethodsA total of 797 inpatients with type 2 diabetes mellitus, from May 2014 to March 2016 at the Department of Endocrinology and Metabolism of Xijing Hospital affiliated to the Fourth Military Medical University, were selected and divided into two groups according to their fundus photography results： patients without diabetic retinopathy （NDR group, n=539） and patients with diabetic retinopathy （DR group, n=258）. The general data and biochemical markers including the age, gender, diabetic duration, fasting plasma glucose （FPG） , blood lipid, and the length of the QTc interval were compared and analyzed among two groups. Statistical comparisons were performed using the Student t test or Nonparametric Tests. Pearson correlation analysis between QTc interval prolongation, diabetic retinopathy and various influencing factors. Logistic regression analysis were used to study the influencing factors for QTc interval prolongation and diabetic retinopathy.ResultsThe mean QTc interval of all patients was （404±46） ms. The QTc interval in patients with diabetic retinopathy were significantly longer than those in patients without retinopathy [ （417±47） vs （396±44） ms, t=-4.227, P〈0.01]. Logistic regression analysis showed that the risk of DR for T2DM patients with QTc〉404 ms was 1.659 times higher than those with QTc≤404 ms （OR=1.659, 95%CI： 1.208-2.378, P〈0.05）, and the risk of DR for T2DM patients with QTc〉440 ms was 2.729 time higher than those with QTc≤440 ms （OR=2.729, 95%CI：1.627-4.578, P〈0.05）.ConclusionElectrocardiogram QTc interval length is positively correlated with diabetic retinopathy in type 2 diabetic patients.