【摘要】 目的观察糖尿病合并冠心病患者不同分期动态心电图各项指标(SDNN、ST、ST/HR)的变化,并初步评价其在糖尿病合并冠心病患者安放支架术前后中的价值。方法收集无糖尿病冠心病者(为对照组)以及糖尿病合并冠心病患者(为试验组)不同分期动态心电图,采用12导动态心电图仪观测各组患者的SDNN、ST及ST/HR各项指标的变化,比较各指标在1期、2期、3期中的变化,分析各指标与冠状动脉支架术的相关性。结果支架安放前1期组ST异常(25±4)次、SDNN(107.68±15.83)ms;2期无药物洗脱支架组ST异常(28±8)次,SDNN(99.44±20.15)ms,2期药物洗脱支架组ST异常(28±7)次,SDNN(99.07±17.46)ms;3期组ST异常(37±9)次,SDNN(93.54±13.70)ms各指标与对照组比较均有统计学意义(P<0.05)。支架安放后1期组ST异常(10±3)次、SDNN(107.62±14.79)ms;2期无药物洗脱支架组ST异常(17±6)次,SDNN(99.11±14.99)ms,2期药物洗脱支架组SDNN(99.64±17.01)ms,ST异常(9±4)次;3期组ST异常(29±11)次,SDNN(95.81±12.66)ms各指标与对照组比较有统计学意义(P<0.05);支架后2期无药物洗脱支架组ST异常(17±6)次,ST(0.12±0.04)mV,ST/HR(1.87±0.65)μV/bpm,与药物洗脱支架组ST异常(9±4)次,ST(0.10±0.04)mV,ST/HR(1.39±0.44)μV/bpm比较有统计学意义(P<0.05);1、2、3期支架前后比较SDNN、ST异常次数有统计学意义(P<0.05)。糖尿病组ST、ST/HR、SDNN各指标与冠状动脉支架术有相关性,与年龄性别有相关性。结论在糖尿病合并冠心病(1期、2期、3期),SDNN、ST次数指标水平逐渐升高,可以间接反映冠心病的程度,对糖尿病合并冠心病的早期诊断具有重要价值以及糖尿病合并冠心病的不同分期支架的安放及安放支架术后期的指导治疗具有重要意义。更多还原

【Abstract】 Objective To observe the different stages in diabetic patients with coronary heart disease indicators dynamic electrocardiogram(SDNN、ST、ST/HR) changes,and preliminary evaluate the value of their patients with coronary heart disease in diabetic patients before and after stent placement.Methods without diabetes,coronary heart disease(control group) and diabetic patients with coronary heart disease(the test group) in different stages,using 12-lead Holter monitoring instrument observed ST,ST/HR,SDNN indexes changes in patients,compared the indicators 1,2,3 mid-term changes and analysed the indicators with the relevance of coronary artery stenting.Results stent placed before the test group ST(25±4) times,SDNN(107.68±15.83)ms;2 period(no) ST(28±8) times,SDNN(99.44±20.15)ms,2 period(has)ST(28±7) times,SDNN(99.07±17.46)ms;3 period ST(37±9) times,SDNN(93.54±13.70)ms compared with control group(P<0.05).After stent placement test group ST(10±3) times,SDNN(107.62±14.79)ms;2 period(no) ST(17±6) times,SDNN(99.11±14.99)ms,2 period(has)SDNN(99.64±17.01)ms,ST(9±4) times;3 period ST(29±11) times,SDNN(95.81±12.66)ms compared with the control(P<0.05);2 period(no)(17±6) times,ST(0.12±0.04) mV,ST/ HR(1.87±0.65) μV/bpm compared with 2(has) ST(9±4)times,ST/HR(1.39±0.44) μV/bpm(P<0.05);The SDNN、 STtimes had statistically significant in 1,2,3 period before and after placement in the test group(P<0.05).The test group:ST,ST/HR,SDNN index and coronary stenting correlated with the age and sex are related.Conclusion In diabetic patients with coronary heart disease(1,2,3),SDNN,ST level gradually increased,can indirectly reflect the degree of coronary heart disease,there has important value in the early diagnosis of diabetes with coronary heart disease and important guiding significancein for treatment in different stages of heart disease befor and after stent placement.更多还原