目的 :探讨糖尿病患者QT离散度 (QTd)改变及与糖尿病植物神经病变和室性心律失常间的关系。方法 :用同步 12导联心电图测定 6 9例糖尿病患者的QTd、最大QT间期 (QTmax)和经心率校正的QTmax (QTc max) ,同时用Holter监测其心率变异性 (HRV)和室性心律失常发生率 ,并与 6 1例非糖尿病人进行对比分析。结果 :①糖尿病组QTd较非糖尿病组显著增加 (P <0 0 1) ;②糖尿病组心率变异性指标中正常RR间期的标准差(SDNN)、每 5分钟正常间期标准差的平均值 (SDNN -index)较非糖尿病组显著降低 (P <0 0 5 )。糖尿病组QTd与每 5分钟正常RR间期平均值标准差 (SDANN)、SDNN -index存在明显相关性 (P <0 0 5 )。③糖尿病组QTd与室性心律失常存在着明显的正相关 ,而非糖尿病组QTd与室性心律失常的发生无明显相关性。结论 :糖尿病组QTd较非糖尿病组延长 ,且QTd与植物神经病变和室性心律失常相关 ,QTd可作为预测糖尿病患者发生恶性室性心律失常的有用指标。 Objective: To investigate the relationship between QTd changes and diabetic autonomic neuropathy and ventricular arrhythmia in diabetic patients. Methods: QTd, QTmax and QTmax of QTc were measured in 6 patients with diabetes mellitus by synchronous 12-lead electrocardiogram. Heart rate variability (HRV) and ventricular arrhythmia Incidence and comparative analysis with 61 non-diabetic patients. Results ① The QTd in diabetic group was significantly higher than that in non-diabetic group (P <0.01); ②The standard deviation of normal RR interval (SDNN), the standard deviation of normal interval in every 5 minutes in heart rate variability index of diabetic group (SDNN-index) was significantly lower than non-diabetic group (P <0 05). There was a significant correlation between QTd in diabetic group and standard deviation (SDANN) and SDNN-index of normal RR interval every 5 minutes (P <0 05). There was a significant positive correlation between QTd and ventricular arrhythmia in diabetic group, but there was no significant correlation between QTd and ventricular arrhythmia in non-diabetic patients. CONCLUSION: QTd in diabetic patients is prolonged compared with non-diabetic patients, and QTd is associated with autonomic neuropathy and ventricular arrhythmias. QTd can be used as a useful predictor of malignant ventricular arrhythmias in patients with diabetes mellitus.