2型糖尿病患者心电图T波峰末间期变化与室性心律失常关系的观察

摘要

Objective To analyze the changes of Tpeak-Tend interval (Tp-Te) in patients with type 2 diabetes mellitus (T2DM),and to explore the relationship between the changes of Tp-Te and ventricular arrhythmias. Methods A total of 112 patients with T2DM were selected from the Department of endocrinology of our hospital from June 2014 to May 2016 (T2DM group),and 65 subjects underwent healthy physical examination in our hospital were selected as the normal control group (NC group) during the same period.The general data,fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1c),Tp-Te,Tp-Te dispersion (Tp-Ted) were compared between the two groups.The changes of Tp-Te in patients with or without ventricular arrhythmia in T2DM group were also analyzed. Results The FPG,HbA1c,LDL-C,TC and heart rate were significantly higher in T2DM group than in the NC group (P<0.05).Compared with the control group,V5 lead Tp-Te and Tp-Ted in T2DM group was significantly prolonged (P<0.05).IN T2DM group,V5 lead Tp-Te and Tp-Ted were significantly longer in patients with ventricular arrhythmias than in patients without ventricular arrhythmia (P<0.05).Multiple logistic regression analysis showed that the increase of HbA1c and FPG were independent risk factors for prolonged Tp-Ted,and Tp-Ted was an independent risk factor for ventricular arrhythmia. Conclusion Patients with T2DM are more likely to have prolonged Tp-Ted.The prolonged Tp-Te and Tp-Ted could increase the incidence of ventricular arrhythmias.%目的 分析T2DM患者心电图T波峰末间期(Tp-Te)的变化并探讨其与室性心律失常的关系. 方法 选取2014年6月至2016年5月于我院内分泌科收治的T2DM患者112例(T2DM组),以同期在我院体检的65名健康体检者作为正常对照(NC)组.对比分析各组的一般资料、FPG、HbA1c、Tp-Te、Tp-Te离散度(Tp-Ted)及T2DM组有无室性心率失常发生时患者心电图Tp-Te的变化. 结果T2DM组FPG、HbA1c、LDL-C、TC、心率均高于NC组(P<0.05);与NC组比较,T2DM组V5导联Tp-Te和Tp-Ted延长(P<0.05);T2DM组室性心律失常亚组V5导联Tp-Te和Tp-Ted均长于未发生室性心律失常亚组(P<0.05).多因素Logistic回归分析显示,HbA1c及FPG增高是影响Tp-Ted延长的独立危险因素,Tp-Ted是影响室性心律失常的独立危险因素. 结论 T2DM患者易出现Tp-Ted的延长,且Tp-Te和Tp-Ted的延长会增加室性心律失常的发生率.