血糖的变化影响了老年2型糖尿病和冠心病患者的心率动态
1Department of Metabolism and Endocrinology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421000, Hunan Province, China.
血糖的变化对患有2型糖尿病和冠心病的老年人心率动态产生负面影响. 平均血糖偏差幅度 (MAGE) 和平均食后葡萄糖偏差幅度 (MPPGE) 有效预测心肌缺血.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 糖尿病学 糖尿病学
背景情况:
- 心脏自主神经病变与冠状动脉疾病和2型糖尿病 (T2DM) 患者的心血管并发症和死亡率有关.
- 血糖 (BG) 变化是已知的导致心血管事件和突然死亡的因素.
研究的目的:
- 研究BG变异性对T2DM和冠状动脉心脏病 (CHD) 的老年人心率 (HR) 动态的影响.
- 评估功能性心肌缺血的预测能力,以此患者队列的结果.
主要方法:
- 招募了143名老年T2DM + CHD患者,并根据BG标准偏差 (异常与正常波动) 分层.
- 进行了72小时的动态BG监测和动态心电图,以评估HR变化.
- 计算了接收器运行特征曲线 (AUC) 下的面积,以评估预测效率.
主要成果:
- 患有异常BG波动的患者表现出更高的血糖外流指数 (MAGE,MODD,LAGE,MPPGE) 和更低的HR变化指数 (SDNN,SDANN,SDNNindex,rMSSD,pNN50).
- 血糖外流指数与HR变化指数呈负相关性.
- 结合MAGE和MPPGE,在预测功能性心肌缺血症方面显示出高AUC (0.912),表现优于SDNN (0.694).
结论:
- 在患有CHD + T2DM的老年患者中,BG变异性和HR动态之间存在显著的负相关性.
- 在这个人群中,MAGE和MPPGE是功能性心肌缺血的有效预测因子,需要进行临床考虑.
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