老年2型糖尿病性冠心病患者的心电图改变及其特点研究

ECG Changes and Characteristics of Elderly Patients with Type 2 Diabetic Coronary Heart Disease

目的 研究分析老年2型糖尿病性冠心病患者的心电图改变及其心电图特点。方法 回顾性选取2020年2月—2022年3月于陕西省府谷县人民医院接受治疗的120例老年2型糖尿病性冠心病患者,纳入观察组,同期选取120例单纯老年2型糖尿病患者,纳入对照组,均进行动态心电图检测,同时进行血糖检测,对比两组的血糖(糖化血红蛋白、空腹血糖以及餐后2 h血糖)水平,并对二者的心电图改变及其特点进行研究分析,包括心率变异性(heart rate variability,HRV)时域指标、心律失常发生情况以及有症状心肌缺血、无症状心肌缺血检出率。结果 观察组患者的糖化血红蛋白(8.42±1.10)%、空腹血糖(8.24±3.20)mmol/L以及餐后2 h血糖(12.81±2.19)mmol/L高于对照组,差异有统计学意义(t=8.608、5.209、25.047,P<0.05)。观察组患者的24 h平均心率、相邻正常RR间期差期的均方根、正常RR间期的标准差、相邻RR间期差值超过50 ms以上个数比等HRV时域指标与对照组比较,差异有统计学意义(P<0.05)。观察组患者的室速、室性期前收缩、房速、房性期前收缩发生率高于对照组,差异有统计学意义(P<0.05)。观察组患者的有症状心肌缺血、无症状心肌缺血检出率高于对照组,差异有统计学意义(P<0.05)。结论 相较于单纯老年2型糖尿病患者,老年2型糖尿病性冠心病患者的心律失常发生率较高,定期进行动态心电图检测对早期发现糖尿病性冠心病有一定作用,以便及时对患者进行治疗干预。

Objective To study the changes and characteristics of electrocardiogram in elderly patients with type 2 diabetic coronary heart disease.Methods A total of 120 elderly patients with type 2 diabetic coronary heart disease who received treatment in Fugu County People's Hospital from February 2020 to March 2022 were retrospectively selected and included in the observation group,while 120 elderly patients with simple type 2 diabetes were selected and included in the control group during the same period.Dynamic electrocardiogram(holter) and blood glucose levels(HBA1c,fasting blood glucose and 2 h postprandial blood glucose) were compared between the two groups.The ECG changes and characteristics of the two groups were studied and analyzed,including HRV time domain indexes,arrhythmia(ventricular tachycardia,ventricular premature beat,atrial tachycardia,atrial premature beat) and the detection rate of symptomatic myocardial ischemia and asymptomatic myocardial ischemia.Results The HBA1c(8.42±1.10) %,fasting blood glucose(8.24±3.20) mmol/L and 2-hour postprandial blood glucose(12.81±2.19) mmol/L in observation group were higher than those in control group,and the difference was statistically significant(t=8.608,5.209,25.047,P<0.05).HRV time domain indexes such as AVGHR,RMSSD,SDNN and PNN50 in observation group were significantly different from those in control group,and the difference was statistically significant(P<0.05).The incidence of ventricular tachycardia,ventricular premature disease,atrial tachycardia and atrial premature beat in observation group were higher than those in control group,and the difference was statistically significant(P<0.05).The detection rate of symptomatic myocardial ischemia and asymptomatic myocardial ischemia in observation group were higher than those in control group,and the difference was statistically significant(P<0.05).Conclusion Compared with control elderly patients with type 2 diabetes,elderly patients with type 2 diabetes have a higher incidence of arrhythmia.Regular holter ECG detection has a certain effect on early detection of diabetic coronary heart disease,so as to timely treatment and intervention.