心电图Q-T间期离散度与2型糖尿病伴慢性心力衰竭患者MACE风险的关联性分析

Relationship Between Q-T Interval Dispersion of Electrocardiogram and MACE Risk of Type 2 Diabetes Mellitus with Chronic Heart Failure

目的研究心电图Q-T间期离散度(QTd)与2型糖尿病(T2DM)伴慢性心力衰竭(CHF)患者主要心脏不良事件(MACE)风险的关联性。方法选取我院T2DM伴CHF患者95例(2019年2月至2020年2月),其中31例发生MACE,64例未发生MACE。分析T2DM伴CHF患者发生MACE的单因素,包括性别、年龄、QTd、校正Q-T间期离散度(QTcd)、生化指标[尿酸(UA)、血肌酐(Scr)、N末端B型脑钠肽前体(NT-proBNP)、空腹血糖(FPG)]、心脏超声指标[左心室舒张末期内径(LVEDd)、左心室射血分数(LVEF)、左心房内径(LAD)],并进行Logistic多因素分析MACE危险因素。结果MACE患者QTd、QTcd、UA、NT-proBNP大于非MACE患者,LVEF小于非MACE患者(P<0.05);经Logistic回归分析显示,QTd、QTcd、UA升高是T2DM伴CHF患者发生MACE的危险因素,LVEF升高是保护因素(P<0.05)。结论 T2DM伴CHF患者QTd、QTcd、UA、LVEF变化会增加MACE风险,且具有密切关联性,临床应据此制定干预措施,以降低MACE发生风险。

Objective To study the relationship between Q-T interval dispersion(QTd)of electrocardiogram(ECG)and the risk of major cardiac adverse events(MACE)in patients with type 2 diabetes mellitus(T2 DM)with chronic heart failure(chronic heart failure),and to study the relationship between ECG and the risk of cardiac adverse events.Methods 95 patients with T2 DM CHF in our hospital(February 2019~February 2020),MACE,occurred in31 cases 64 cases not MACE.occurred Univariate analysis of MACE in T2 DM patients with CHF,including gender,age、QTd、Calibration Q-T Interval Dispersion(QTcd)、biochemical indicator[Uric acid(UA),serum creatinine(Scr),N-terminal B brain natriuretic peptide precursor(NT-proBNP),fasting blood glucose(FPG)]、echocardiographic indicators[left ventricular end-diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF),left atrial diameter(LAD)],The risk factors MACE Logistic multivariate analysis were carried out.Results MACE patients QTd、QTcd、UA、NT-proBNP more than non MACE patients,LVEF less than MACE patients(P<0.05);According to Logistic regression analysis,QTd、QTcd、UA elevation is a risk factor for MACE in T2 DM patients,LVEF elevation is a protective factor(P<0.05).Conclusions T2 DM changes QTd、QTcd、UA、LVEF patients with CHF increase the risk,And closely related,Clinical intervention should be developed accordingly,To reduce the risk of MACE occurrence.