2型糖尿病合并代谢综合征患者心脏变时性功能变化及意义

目的分析2型糖尿病合并代谢综合征(MS)患者心脏变时性功能改变特点,探讨其与心肌缺血的关系,研究2型糖尿病患者心脏变时性功能相关因素。方法选择200例2型糖尿病患者和50例正常健康者作为研究对象,分别分为MS组、T2DM组和对照组,根据心电图ST-T改变将MS组和T2DM组的研究对象分为心肌缺血组和非心肌缺血组,根据心脏变时性功能将MS组和T2DM组的研究对象分为CI组和变时性功能正常组,进行症状限制性平板心电运动试验并收集临床资料。结果 MS组和T2DM组HRmax、rHR、心率储备、变时性指数均低于对照组,其中MS组最小(P<0.05),心肌缺血组CI率和MS患病率均显著高于非心肌缺血组(P<0.05),CI和MS与心肌缺血相关性有统计学意义(OR=3.225,3.568,P<0.05),血脂异常、高血压、MS是2型糖尿病患者心脏CI的独立危险因素(OR=1.952,1.993,2.685,P<0.05)。结论 2型糖尿病患者心脏变时性功能不全发生心肌缺血风险高,变时性功能可作为反映心肌缺血的指标,MS则是2型糖尿病患者心脏变时性功能不全和心肌缺血的高危因素。

Cardiac chronotropic changes and its significance in type 2 diabetes patients with metabolic syndrome

Objective To analyze the type 2 diabetic patients with metabolic syndrome （MS） patients with cardiac chronotropie change characteristics, to explore its relationship with myocardial ischemia, patients with type 2 dia- betes, cardiac ehronotropic relevant factors. Methods Selected 200 cases of type 2 diabetes patients and 50 cases of normal healthy persons as research subjects which were divided into MS group, T2DM group and control group, ac- cording to the ECG ST-T changes the MS group and T2DM subjects were divided into groups of myocardial ischemia blood group and non-ischemic group, according to the heart becomes dysfunctional when the MS group and T2DM group subjects were divided into groups and a change becomes dysfunctional when the normal group, for flat ECG ex- ercise test and collect clinical data. Results MS group and T2DM group HRmax, rHR, heart rate reserve, chronotrop- ic index were lower than the control group, in which the minimum MS group （P〈0.05）, myocardial isehemia group chronotropic defect rate and MS prevalence rate were significantly higher in non-ischemic group （P〈0.05）, and MS chronotropie dysfunction associated with myocardial isehemia was significantly （0R=3.225,3.568, P 〈0.05）, dyslipi- demia, hypertension, MS type 2 diabetic cardiac chronotropic dysfunction were the independent risk factors （OR= 1.952, 1.993, 2.685, P〈0.05）. Conclusion Patients with type 2 diabetes dysfunction occurs when the heart becomes high risk of myocardial ischemia, a change in function could be used as an indicator of myocardial ischemia, MS pa- tients with type 2 diabetes are when the heart becomes ischemie myocardial dysfunction and risk factors.