心肌梗死合并糖尿病患者QT间期和QT离散度的改变及不同治疗方法对其的影响

Objective To compare the QTc and QTcd between type 2 diabetic and non-diabetic patients with post-myocardial infarction (post-MI) ,and to compare the QTcd in type 2 diabetic patients with post-MI treated with insulin,sulfonylurea,mefformin,or diet alone. Methods We measured the QTc and QTcd through simultaneous 12-lead Electrocardiogram in 138 post-MI patients,including 70 type 2 diabetic (of which,23 were assigned to re-ceive insulin,20 glipizide,16 mefformin,11 diet control) and 68 non-diabetic patients. Result Compared with post-MI patients without diabetes,those with type 2 diabetes had significantly higher QTc [(377.2±24.3) ms vs (342.9±27.5)ms,t=7.79,P<0.01] and QTcd [(48.8±19.7)ms vs (40.3±26.6)ms,t=2.14,P<0.05]. There were no significant difference between the mefformin group and the diet control group (P>0.05). The QTc and QTcd in the insulin group were significantly higher than those in the other three group s(P<0.05),and the QTc and QTcd in the glipizide group were higher than those in the mefformin group or diet control group(P<0.05,and P<0.01,respectively). Conclusion Type 2 diabetes is associated with an additional increase in the QTcd in post-MI patients,suggesting higher mortality risk in post-MI patients with type 2 diabetes. Insulin and glipizide may in-crease the QTc and QTcd in post-MI patients with diabetes. These effects were more significant in the insulin therapy group.

QT-interval and its dispersion in type 2 diabetic and non-diabetic patients with post-myocardial infarction and effects of different hypoglycemic drugs on QT-interval dispersion