摘要
背景原发性高血压(EH)和2型糖尿病(T2DM)常易并发。已有研究证实了 EH 可致心律失常,但对于二者合并存在时心律失常发生状况及心脏结构和功能的变化特征,还未见报道。目的研究 EH 合并 T2DM患者心律失常的发生状况及其可能机制。方法住院患者168例,分为 EH 组、T2DM 组、EH 合并 T2DM 组及正常组,对4组患者的相关临床资料、24 h 动态心电图及超声心动图检查结果进行分析比较。结果 1)EH 合并T2DM 组与 EH 组和 T2DM 组相比易发生心律失常(P<0.05)。2)EH 合并 T2DM 组左心房内径(LAD)、升主动脉内径(AO)、左心室内径(LVD)、室间隔厚度(IVS)、左心室质量(LVM)值、E/A 比值异常例数和二尖瓣返流程度(MR)均高于 EH 组和 DM 组(P 均<0.05),EF 值低于 EH 组和 DM 组(P<0.05)。3)多元线性回归分析显示 EH合并 T2DM 时,房性心律失常次数与 LAD、IVS、MR 正相关,与 LVD 负相关;室性心律失常次数与 LVD、IVS、LVM 正相关。4)Logistic 回归分析显示年龄、疾病种类、高血压病程和 LVM 的升高是患者发生心律失常的风险因素。结论 EH 合并 T2DM 时更易发生心律失常,且能明显加重患者左心室结构和功能损害。
Background Essential hypertension [EH） and type 2 diabetes mellitus （T2DM） are frequently coexisted. Previous studies proved that EH can cause arrythmia, whereas, the arrythmia and the structure changed in hypertensive patients coexisted with T2DM are scarely reported. Objective To study the characteristics and mech- anism of arrhythmia in essential hypertension （ EH ） patients with type 2 diabetes mellitus （ T2DM）. Methods One hundred sixty eight patients were groupped as follows ： EH group （ n = 65 ）, T2DM group （ n = 31 ）, EH ＋ T2DM group （n=52）, and normal group （n=20）. The clinical data, echocardiographies and 24-hour dynamic eletrocardiogram were determined in all patients. Results 1 ） Arrhythmia incidence in EH±T2DM group was a statistically higher compared to EH group and T2DM group （P〈0.05 ）. 2 ） Left atrium inner diameter（ LAD）, aortic inner diameter（ AO）, left ventricle inner diameter（ LVD）, interventricular septum I IVS）, left ventricular mass （ LVM）, the prevalence of abnormal E/A and mitral regurgitation（MR） is higher in EH with T2DM group compared to EH group and T2DM group（P〈0. 05）, while ejection fraction （EF） is lower than EH group and T2DM group（P〈0. 05）. 3 ） Multiple regression analysis showed： LAD, IVS and MR were positively correlated with atrial arrhythmia preva- lence rate, and LVD were negatively correlated with atrial arrhythmia, LVD, IVS and LVM were positively correlated with ventricular arrhythmia. 4） Logistic regression analysis showed：age, type of diseases, hypertension duration and LVD are predisposed risk factors for arrhythmia. Conclusion Hypertension coexist with type 2 diabetes mellitus aggravated the damage of left ventricle structure and function leading to increases in arrhythmia.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2008年第3期220-224,共5页
Chinese Journal of Hypertension
