2型糖尿病合并代谢综合征患者平板运动试验分析

目的探讨2型糖尿病合并代谢综合征（MS）患者平板运动试验（TET）特点和临床意义。方法回顾性分析184例有胸痛症状的2型糖尿病患者,所有患者均行TET和冠状动脉造影（CAG）检查,分为MS组（n=96）和非MS组（n=88）。另设立健康对照组（n=96）。比较分析三组TET有关指标。腹围增加程度和ST段下移程度的相关性研究采用直线相关分析。结果三组患者年龄和性别匹配。三组TET结果显示：试验阳性率MS组最高,非MS组较低,对照组最低,差异均有统计学意义（P〈0.05或P〈0.01）。腹围增加者的试验阳性率也是MS组最高,非MS组较低,对照组最低,差异均有统计学意义（P〈0.05）。MS组腹围增高程度和ST段下移程度呈显著正相关（男性r=0.766,P〈0.01;女性r=0.617,P〈0.01）。结论 TET表明多数2型糖尿病合并MS者运动时存在不同程度心肌缺血以及诸多指标的异常,提示在无条件行CAG的医院MS者应常规行TET以早期发现心肌缺血和评估其程度;MS的腹围增加者多数心肌缺血程度增加,提示MS者必须控制和减小腹围。

Analysis of treadmill exercise test for patients with type 2 diabetes mellitus combining metabolic syndrome

Objecave To explore the characteristics and clinical significance of treadmill exercise test （TET） for patients with type 2 diabetes mellitus （T2DM） combining metabolic syndrome （MS）. Methods A total of 184 cases of T2DM with paroxysmal chest pain were retrospectively analyzed. All patients underwent TET and coronary angiography （GAG） and were divided into the MS group （n =96） and non-MS group （n =88）. The health control group （ n =96） was also established. Indexes relevant to TET were compared and analyzed among three groups. The correlation of abdominal circumference and ST-segment depression was studied by the linear correlation analysis. Results The distribution of age and gender of three groups matched. The results of TET of three groups showed that the positive rate of the MS group was the highest; the positive rate of the non-MS group was low; and the positive rate of the control group was the lowest. The differences were statistically significant （P〈0. 05 or P〈0. 01）. For patients with increased abdominal circumference, the positive rate of the MS group was the highest; the positive rate of the non-MS group was low; and the positive rate of the control group was the lowest. The differences were statistically significant （ P 〈 0.05） . The increase of abdominal circumference was positively and significandy correlated to the ST-segment depression （for male r =0. 766, P〈 0.01 and for female r =0. 617, P〈0.01）. Conclusion The results of TET show that most patients with T2DM combing MS present different degrees of myocardial ischemia and many abnormal indexes duringexercise, which indicate in order to achieve early detection and evaluation of myocardial ischemia, TET should be routinely conducted for hospitals in which MS patients can not undergo the CAG. The degree of myocardial ischemia of most MS patients with increased abdominal circumference aggravates. Therefore those patients should control and decrease the abdominal circumference.