妊娠期糖尿病共病抑郁障碍患者心电图评价及相关因素分析

Electrocardiogram evaluation and related factor analysis in patients with gestational diabetes mellitus complicated by depressive disorder

目的研究妊娠期糖尿病共病抑郁障碍患者心电图特征以及相关因素。方法回顾性分析北京大学第三医院2021年9月至2022年12月收治的妊娠期糖尿病患者243例的临床资料,根据抑郁自评量表(SDS)评分结果分为妊娠期糖尿病共病抑郁障碍患者的观察组(51例)与单纯妊娠期糖尿病患者的对照组(192例)。采用χ^(2)检验分析妊娠期糖尿病共病抑郁障碍与心电图诊断结果的关系,采用t检验比较两组心电图指标的差异。结果与对照组相比,观察组心电图诊断为心动过缓(χ^(2)=4.68,P=0.030)、期前收缩(χ^(2)=10.78,P=0.001)、房室传导阻滞(χ^(2)=15.04,P<0.001)发生率较高,两组心动过速、束支传导阻滞、ST-T发生率差异均无统计学意义(均P>0.05)。另外,与对照组相比,观察组心率[(73.43±8.24)次/min比(67.22±5.08)次/min]、最大QT间期[(419.09±36.00)ms比(351.95±32.07)ms]、最小QT间期[(363.31±30.78)ms比(316.52±29.10)ms]、QT离散度[(55.78±17.87)ms比(35.42±13.18)ms]均明显增加(t=-5.13、-12.95、-10.08、-7.60,均P<0.001)。结论妊娠期糖尿病患者中,共病抑郁障碍的患者发生心电图异常的风险较高。

Objective To investigate electrocardiogram(ECG)characteristics and related factors of gestational diabetes mellitus(GDM)complicated by depressive disorder.Methods The clinical data of 243 patients with GDM who received treatment at Peking University Third Hospital from September 2021 to December 2022 were retrospectively analyzed.According to the scoring results of the Self-rating Depression Scale(SDS),these patients were divided into an observation group(GDM+depressive disorder,n=51)and a control group(GDM alone,n=192).Theχ^(2) test was used to analyze the relationship between GDM complicated by depressive disorder and ECG diagnosis results.Additionally,the t-test was used to compare ECG indicators between the two groups.Results Compared with the control group,patients in the observation group had a higher incidence of abnormal ECG indicators,including bradycardia(χ^(2)=4.68,P=0.030),premature contraction(χ^(2)=10.78,P=0.001),and atrioventricular block(χ^(2)=15.04,P<0.001).However,there were no significant differences in the incidences of tachycardia,bundle branch block,or ST-T changes between the two groups(all P>0.05).Compared with the control group,the observation group exhibited significantly increased heart rate[(73.43±8.24)beats/min vs.(67.22±5.08)beats/min],maximum QT interval[(419.09±36.00)ms vs.(351.95±32.07)ms],minimum QT interval[(363.31±30.78)ms vs.(316.52±29.10)ms],and QT dispersion[(55.78±17.87)ms vs.(35.42±13.18)ms,t=-5.13,-12.95,-10.08,-7.60,all P<0.001].Conclusion Among patients with gestational diabetes mellitus,those with depressive disorder have an increased risk of exhibiting abnormal electrocardiogram patterns compared with those without depressive disorder.