1566例住院2型糖尿病患者心率现状调查

发布时间：2018-06-25 22:21

  本文选题：心率 + 糖化血红蛋白　； 参考：《临床心血管病杂志》2017年01期

【摘要】：目的:分析2型糖尿病患者的静息心率和与年龄、糖尿病病程、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2h血糖(2hPG)、体质指数(BMI)的相关性,及伴高血压、冠心病患者的心率现状和危险因素,为降低心性猝死发病率提供理论依据。方法:采用横断面调查方法对2014-04-2016-03我院住院的2型糖尿病患者按顺序入组,进行病案检索,记录一般情况和心率、糖尿病病程、HbA1c、FPG、2hPG、BMI、合并症及用药情况。共调查2 012例患者,进入分析的2型糖尿病患者1 566例。其中单纯2型糖尿病患者830例,2型糖尿病合并高血压患者588例,2型糖尿病合并冠心病患者46例,2型糖尿病合并高血压和冠心病患者102例,有影响心率因素(起搏器植入、发热、甲亢、应用β受体阻滞剂和非二氢吡啶类钙拮抗剂)、影响血红蛋白因素(贫血、脾亢)、严重肝肾损害疾病患者341例和溯源问题105例均未纳入分析。心率的测量用12导联心电图机以卧位静息为准;HbA1c、FPG、2hPG以空腹静脉血为准,采用葡萄糖氧化酶法,进行生化仪检测;BMI的采集用体重身高测量仪测量身高、体重,用BMI=体重(kg)/身高(cm)~2公式求得。结果:2型糖尿病住院患者的静息平均心率为76.24次/min,主要分布区间在70~79次/min,在单纯2型糖尿病患者中心率≥80次/min者占37.47%,≥90次/min者占14.82%。双变量相关分析显示年龄与心率呈负相关(r=-0.098,P=0.005),HbA1c、FPG和2hPG分别与心率呈正相关(分别为r=0.170,P=0.000;r=0.148,P=0.000;r=0.199,P=0.000),而与糖尿病病程和BMI不相关。HbA1c、FPG、2hPG控制欠佳者心率显著增快。2型糖尿病患者、2型糖尿病伴高血压患者、伴冠心病患者、伴高血压和冠心病患者的静息平均心率分别为(76.42±11.86)、(76.58±11.42)、(77.37±11.08)及(72.28±11.50)次/min。糖尿病合并高血压风险增加与年龄、BMI有关,合并冠心病风险增加与糖尿病病程有关。结论:2型糖尿病患者心率偏快,与长期血糖控制不理想致糖尿病心肌损害有关。因此,HbA1c达标对防治糖尿病心肌损害具有重要意义。
[Abstract]:Objective: to analyze the relationship between resting heart rate and age, diabetes course, HbA1c, FPG, 2 h postprandial blood glucose (2hPG), body mass index (BMI) and hypertension in type 2 diabetic patients. The present situation and risk factors of heart rate in patients with coronary heart disease provide theoretical basis for reducing the incidence of sudden cardiac death. Methods: the patients with type 2 diabetes mellitus hospitalized in our hospital from 2014-04-2016-03 were selected by cross-sectional investigation. The medical records were searched, the general situation and heart rate were recorded, the course of diabetes mellitus (HbA1cFPGN) 2hPGN BMIs, complications and drug use were recorded. A total of 2 012 patients were investigated and 1 566 patients with type 2 diabetes were enrolled in the analysis. Among them, there were 830 patients with type 2 diabetes mellitus complicated with hypertension, 588 patients with type 2 diabetes mellitus complicated with coronary heart disease, 46 patients with type 2 diabetes mellitus complicated with hypertension and 102 patients with coronary heart disease. Hyperthyroidism, 尾 -receptor blockers and non-dihydropyridine calcium antagonists), hemoglobin factors (anemia, hypersplenism), serious liver and kidney damage in 341 patients and traceability in 105 cases were not included in the analysis. The heart rate was measured by 12-lead electrocardiograph in the resting position of HbA1cFPGG 2hPG, the fasting venous blood was measured by glucose oxidase method, and the body height and weight were measured by weight height meter. BMI = weight (kg) / height (cm) 2 formula was used. Results the average resting heart rate of the hospitalized patients with type 2 diabetes mellitus was 76.24 beats / min, the main distribution was 70 ~ 79 times / min, and the center rate 鈮，

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