老年2型糖尿病患者血糖波动与心电图异常变化的相关性研究

Relationship between blood glucose fluctuation and abnormal changes in electrocardiogram in elderly patients with type 2 diabetes

目的探讨老年2型糖尿病(T2DM)患者血糖波动与心电图变化的关系。方法回顾性分析196例老年T2DM患者的临床资料,所有患者均实施动态血糖与24 h动态心电图监测,观察患者血糖指标变化和心电图波动情况,并分析老年T2DM患者血糖波动与心电图变化的相关性。结果治疗前,高血糖患者61例(31.12%),低血糖患者42例(21.43%),血糖异常的总发生率为52.55%。血糖异常患者的心电图异常变化发生率高于血糖正常患者,差异有统计学意义(P<0.05);Logistics回归分析结果表明,老年T2DM患者血糖异常是导致心电图异常变化的影响因素(P<0.05);纠正血糖后,心电图异常变化发生率低于治疗前,差异有统计学意义(P<0.05)。结论老年T2DM患者血糖波动与心电图变化密切相关,且血糖波动较大是诱发心律失常和ST-T改变的影响因素。因此,临床可加强患者血糖及心电图的监测,以合理控制血糖,降低心血管疾病发生率。

Objective To explore the relationship between blood glucose fluctuation and changes in electrocardiogram in elderly patients with type 2 diabetes (T2DM). Methods The clinical data of 196 elderly patients with T2DM was analyzed retrospectively. All patients were monitored by dynamic blood glucose and 24 h dynamic electrocardiogram. Blood glucose fluctuation and changes in electrocardiogram between the two groups were observed,and the correlation between blood glucose fluctuation and changes in electrocardiogram in elderly patients with T2DM was analyzed. Results Before treatment,there were 61 patients (31. 12%) with hyperglycemia and 42 patients (21. 43%) with hypoglycemia,and the total incidence of glucose abnormality was 52. 55%. The incidence of abnormal changes in electrocardiogram of patients with abnormal blood glucose was higher than that in patients with normal blood glucose,and the difference was statistically significant (P < 0. 05). Logistic regression analysis results showed that abnormal blood glucose in elderly T2DM patients was influencing factor leading to abnormal changes in electrocardiogram (P < 0. 05). After correcting blood glucose,the incidence of abnormal changes in electrocardiogram was lower than that before treatment,and the difference was statistically significant (P < 0. 05). Conclusion The blood glucose fluctuation in elderly patients with T2DM is closely related to changes in electrocardiogram,and great fluctuation in blood glucose is the influencing factor of arrhythmia and ST-T changes. The clinical monitoring of patients’ blood glucose can be strengthened to reasonably control blood glucose and reduce the incidence of cardiovascular disease.