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目的:探讨2型糖尿病患者血糖波动与心律失常的相关性。方法:收集2型糖尿病住院患者410例为研究对象,连续3d对患者给予动态血糖监测,平均血糖水平(MBG)及标准差(SD)、日内平均血糖波动幅度(MAGE)以及日间血糖平均绝对差(MODD);按照患者住院期间的心电图检查分为心律失常组(n=112例)和非心律失常组(n=298例),分析两组患者血糖波动指标的差异。结果:410例住院的2型糖尿病患者中112例患者发心律失常,发生率为27.3%,心律失常中以房性早搏为主、其次为窦性心动过速。心律失常组患者收缩压(SBP),LDL-C、Hb A1c、HOMA-IR高于非心律失常组(P<0.05);而MBG及SD、MAGE以及MODD亦高于非心律失常组(P<0.05);Logistic回归分析提示,MAGE(OR=2.478,CI 1.632~5.145,P<0.05)与心律失常的发生呈现独立相关。此外糖尿病病程、SBP、Hb A1c、HOMA-IR亦是心律失常的发生的独立危险因素(P<0.05)。结论:2型糖尿病患者发生心律失常的比例较高,且与血糖波动具有一定的相关性,合理控制血糖波动水平对于降低心律失常的发生具有临床意义。
Objective: To investigate the correlation between blood glucose fluctuation and arrhythmia in type 2 diabetic patients. Methods: 410 inpatients with type 2 diabetes mellitus were enrolled in this study. Dynamic blood glucose monitoring, mean blood glucose (MBG) and standard deviation (SD), mean intra-day blood glucose fluctuation (MAGE) and mean daytime blood glucose (MODD). According to the electrocardiogram examination during hospitalization, patients were divided into arrhythmia group (n = 112) and non-arrhythmia group (n = 298). The differences of blood glucose fluctuation index between the two groups were analyzed. Results: Of the 410 inpatients with type 2 diabetes, 112 patients had arrhythmia, with a rate of 27.3%. Atrial arrhythmia was mainly atrial premature beat, followed by sinus tachycardia. The systolic blood pressure (SBP), LDL-C, HbA1c and HOMA-IR in arrhythmia group were higher than those in non-arrhythmia group (P <0.05), while MBG, SD, MAGE and MODD were also higher than those in non- arrhythmia group (P < 0.05). Logistic regression analysis showed that MAGE (OR = 2.478, CI 1.632-5.145, P <0.05) was independently associated with arrhythmia. Diabetes course, SBP, Hb A1c and HOMA-IR were also independent risk factors of arrhythmia (P <0.05). Conclusion: The incidence of arrhythmia in patients with type 2 diabetes is higher than that in patients with type 2 diabetes, and has some correlation with the fluctuation of blood glucose. It is of clinical significance to reduce the level of arrhythmia by reasonably controlling the blood glucose level.