心肌梗死合并糖尿病患者的心率震荡变化.DOCVIP

临床医学论文-心肌梗死合并糖尿病患者的心率震荡变化 ?????????????? 作者：马芷琴　张焕鑫　何琼　章艳萍 　[摘要]　　目的:探讨心肌梗死伴糖尿病患者和单纯心肌梗死患者的心率震荡（HRT）的变化。方法:选择24小时动态心电图有室性早搏的心肌梗死伴糖尿病患者（A组）、单纯心肌梗死患者（B组）和无器质性心脏病患者（C组）各30例，分别手工测量反映HRT的两项指标震荡初始（TO）和震荡斜率（TS），对三组患者进行比较。结果:A、B、C组TO值分别为（0.0078±0.0123）、（0.0120±0.0225）、（0.0312±0.0337）。TS值分别为（4.5182±2.3321）、（8.1430±5.7362）、（13.4520±7.5310）；A、B组的TO、TS值与C组比较均有显著性差异（P＜0.01），A组与B组的TO、TS值比较差异亦有显著性（分别为P＜0.05，P＜0.01）。结论:心肌梗死合并糖尿病患者较单纯心肌梗死患者的HRT值变化更明显，提示心肌梗死合并糖尿病患者的HRT受损更严重。 　　[关键词]　　心肌梗死;糖尿病;心率震荡;室性早搏 　　Abstract: Objective To observe the change of Heart Rate Turbulence (HRT) in patients with acute myocardial infarction and diabetes mellitus and patients with acute myocardial infarction alone. Methods Thirty patients with acute myocardial infarction and diabetes mellitus with ventricular premature beat in 24-hour ambulant electrocardiogram, thirty patients with acute myocardial Infarction alone and thirty patients withiout obvious heart diseases were categorized into A group,B group and C group,respectively.The value of Turbulence Onset(TO)and Turbulence Slope (TS) was measured and compared among three groups. Results? TO, TS in A group （0.0078±0.013, 4.5182±2.3321）and B group （0.0120±0.0225, 8.1430±5.7362） have significant difference compared with C group （0.0312±0.034,13.4520±7.5310）（P＜0.01），and TO, TS in A group was significant difference from that in B group（P＜0.05，P＜0.01,respectively）.Conclusion The change of HRT in patients with acute myocardial infarction with diabetes mellitus are more obvious than patients with acute myocardial infarction alone,which suggests that the deterioration of HRT in? patients with acute myocardial infarction and diabetes mellitus is more serious. 　　Key Words: Acute myocardial Infarction；Diabetes mellitus；Heart Rate Turbulence；Ventricular premature beat 　　心率震荡（Heart Rate Turbulence，HRT）是一种新的心电学诊断指标,是指室性早搏后窦性心律规律出现双重作用即先加速后减速。HRT已成为器质性心脏病患者危险分层的预后判断的一个重要预测指标。本文对心肌梗死（Acute Myocardial Infarction，AMI）伴有糖尿病患者和单纯AMI患者HRT的变化进行临床观察并探讨其临床意义。 　　1　　资料与方法 　　1.1