糖尿病性冠心病患者动态心电图参数变化及诊断价值观察

Changes and Diagnostic Value of Dynamic Electrocardiogram Parameters in Patients with Diabetic Coronary Heart Disease

目的:探讨糖尿病性冠心病患者动态心电图参数变化及诊断价值观察。方法:选取2019年1月-2021年1月在某院确诊的50例糖尿病性冠心病患者作为糖尿病冠心组,并选取同期50例患单纯冠心病患者作为单纯冠心组,两组患者均行24h动态心电图和血糖相关指标检测,观察两组患者的动态心电图的参数差异,采用ROC曲线面积评价动态心电图对糖尿病性冠心病的诊断价值。结果:糖尿病冠心组患者的FPG和GHb水平均高于单纯冠心组(P<0.05);糖尿病冠心组患者的AVGHR高于单纯冠心组,RMSSD、SDNN、PNN50均低于单纯冠心组(P<0.05);糖尿病冠心组患者的ST-T的变化情况与单纯冠心组对比无明显差异(P>0.05)。糖尿病冠心组患者的室速和房速发生率为16.00%、34.00%,与单纯冠心组的8.00%、20.00%比较无明显差异(P>0.05),糖尿病冠心组患者的室性早搏和房性早博的发生率为7.00%、60.00%,高于单纯冠心组的44.00%、38.00%(P<0.05)。ROC曲线面积显示AVGHR、RMSSD、SDNN、PNN50对糖尿病性冠心病具有诊断价值。结论:24h动态心电图在糖尿病性冠心病患者中的应用可以尽早地发现患者的早期症状,以便及时对患者进行治疗干预。

Objective:To explore the changes and diagnostic value of dynamic electrocardiogram(ECG)parameters in patients with diabetic coronary heart disease(CHD).Methods:A total of 50 patients with diabetic coronary heart disease diagnosed in a hospital from January 2019 to January 2021 were selected as the diabetic coronary heart group,while other 50 patients with simple CHD during the same period were selected as simple CHD group.Both groups were given 24h dynamic ECG and blood glucose related indexes detection.The difference of dynamic ECG parameters between the two groups was observed.The diagnostic value of dynamic ECG for diabetic CHD was evaluated by area under ROC curve(AUC).Results:The levels of FPG and GHb in diabetic CHD group were higher than those in simple CHD group(P<0.05),AVGHR was higher than that in simple CHD group,and RMSSD,SDNN and PNN50 were lower than those in simple CHD group(P<0.05).There was no significant difference in the changes of ST-T between the two groups(P>0.05).There was no significant difference in the incidence of ventricular velocity and atrial velocity between diabetic CHD group and simple CHD group(16.00%,34.00%vs 8.00%,20.00%)(P>0.05).The incidence of ventricular premature beats and atrial premature beats in diabetic CHD group was 7.00%and 60.00%,higher than those in simple CHD group(44.00%,38.00%)(P<0.05).The area of ROC curve showed that AVGHR,RMSSD,SDNN and PNN50 had diagnostic value for diabetic coronary heart disease.Conclusion:The application of 24h dynamic ECG in patients with diabetic CHD can detect early symptoms as soon as possible,and timely treatment and intervention can be given for patients.