代谢综合征患者动态心电图监测结果分析
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摘要
目的探讨代谢综合征患者动态心电图变化情况,为临床防治提供参考。方法选取进行健康体检筛查并确诊的100例代谢综合征患者(MS组)和100例体检正常人群(对照组),行24h动态心电图检查,分析心电图改变情况及全程正常窦性R-R间期标准差(SDNN)、全程相邻R-R间之差均方根值(rMSSD)、全程记录中5min R-R间期标准差的平均值(SDNNindex)、全程记录中5min R-R间期标准差(SDANNindex)、全程内差值超过50ms的连续正常R-R间期所占百分率(PNN50)变化情况。结果 MS组53例有心电图异常,异常率为53.00%,对照组6例异常,异常率为6.00%,差异有统计学意义(P<0.05),MS组有26例(26.00%)阵发性房性心动过速,8例(8.00%)房扑,4例(4.00%)交界性逸博及房性逸博,2例(2.00%)房性早搏,27例(27.00%)室性早搏,3例(3.00%)房室传导阻滞,2例(2.00%)左束支阻滞,3例(3.00%)右束支阻滞;对照组有2例(2.00%)阵发性房性心动过速,4例(4.00%)室性早搏,MS组SDNN、rMSSD、SDNNindex、SDANNindex和PNN50均低于对照组,差异均有统计学意义(P<0.05)。结论代谢综合征患者明显存在心电异常和自主神经功能紊乱,动态心电图检查有助于尽早发现心电异常,进行早期干预治疗。
Objective To discuss of dynamic electrocardiogram(ecg)monitoring in patients with metabolic syndrome,Provide reference for clinical prevention and treatment.Methods Select 100 cases of patients with metabolic syndrome(MS group)and 100 cases of medical examination normal people(control group),24 hECG recording were observes,Analysis of ecg changes and SDNN,rMSSD,SDNNindex,SDANNindex,PNN50.Results The 53 cases patients with abnormal ecg of the MS group,the abnormal rate was 53.00%,6 cases patients with abnormal ecg of the control group,the abnormal rate was 6.00%,there was significant difference between two groups(P<0.05).The MS group:Paroxysmal atrial tachycardia in 26 cases patients(26.00%),Atrial flutter in 8 cases patients(8.00%),Junctional escape beat and atrial escape Bo in 4 casescases patients(4.00%),Atrial premature beat in 2 casescases patients(2.00%),Ventricular premature beat in 27 casescases patients(27.00%),Atrioventricular block in 3 casescases patients(3.00%),Left bundle branch block in 2 casescases patients(2.00%),Right bundle branch block in 3 casescases patients(3.00%),The control group:Paroxysmal atrial tachycardia in 2 cases patients(2.00%),entricular premature beat in 4 casescases patients(4.00%).SDNN,rMSSD,SDNNindex,SDANNindex,PNN50,the MS group lower than the control group(P<0.05).Conclusion The abnormal ecg and obvious autonomic nerve dysfunction in patients with metabolic syndrome,Dynamic electrocardiogram examination helps to detect ecg abnormalities,early intervention treatment.
Objective To discuss of dynamic electrocardiogram(ecg)monitoring in patients with metabolic syndrome,Provide reference for clinical prevention and treatment.Methods Select 100 cases of patients with metabolic syndrome(MS group)and 100 cases of medical examination normal people(control group),24 hECG recording were observes,Analysis of ecg changes and SDNN,rMSSD,SDNNindex,SDANNindex,PNN50.Results The 53 cases patients with abnormal ecg of the MS group,the abnormal rate was 53.00%,6 cases patients with abnormal ecg of the control group,the abnormal rate was 6.00%,there was significant difference between two groups(P<0.05).The MS group:Paroxysmal atrial tachycardia in 26 cases patients(26.00%),Atrial flutter in 8 cases patients(8.00%),Junctional escape beat and atrial escape Bo in 4 casescases patients(4.00%),Atrial premature beat in 2 casescases patients(2.00%),Ventricular premature beat in 27 casescases patients(27.00%),Atrioventricular block in 3 casescases patients(3.00%),Left bundle branch block in 2 casescases patients(2.00%),Right bundle branch block in 3 casescases patients(3.00%),The control group:Paroxysmal atrial tachycardia in 2 cases patients(2.00%),entricular premature beat in 4 casescases patients(4.00%).SDNN,rMSSD,SDNNindex,SDANNindex,PNN50,the MS group lower than the control group(P<0.05).Conclusion The abnormal ecg and obvious autonomic nerve dysfunction in patients with metabolic syndrome,Dynamic electrocardiogram examination helps to detect ecg abnormalities,early intervention treatment.
引文
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[11]Fogari R,Mugellini A,Zoppi A,et al.Effect of telmisartan and ramipril on atrial fibrillation recurrence and severity in hypertensive patients with metabolic syndrome and recurrent symptomatic paroxysmal and persistent atrial fibrillation[J].Journal of Cardiovascular Pharmacology and Therapeutics,2012,17(1):34.
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[15]Altuncu M E,Baspinar O,Keskin M.The use of short-term analysis of heart rate variability to assess autonomic function in obese children and its relationship with metabolic syndrome[J].Cardiol J,2012,19(5):501.
[16]Feng W,He X,Chen M,et al.Urinary metals and heart rate variability:a cross-sectional study of urban adults in Wuhan,China[J].Environmental Health Perspectives(Online),2015,123(3):217.
[2]Esser N,Legrand-Poels S,Piette J,et al.Inflammation as a link between obesity,metabolic syndrome and type 2diabetes[J].Diabetes Research and Clinical Practice,2014,105(2):141.
[3]Drager L F,Togeiro S M,Polotsky V Y,et al.Obstructive sleep apnea:a cardiometabolic risk in obesity and the metabolic syndrome[J].Journal of the American College of Cardiology,2013,62(7):569.
[4]Grundy S M.Pre-diabetes,metabolic syndrome,and cardiovascular risk[J].Journal of the American College of Cardiology,2012,59(7):635.
[5]Beltrán-Sánchez H,Harhay M O,Harhay M M,et al.Prevalence and trends of metabolic syndrome in the adult US population,1999-2010[J].Journal of the American College of Cardiology,2013,62(8):697.
[6]王瑞,周卫,郭春江,等.深圳市代谢综合征流行情况及影响因素分析[J].中国初级卫生保健,2014,28(2):93.
[7]刘晓芬,赵清水,李娜,等.北京市房山区居民代谢综合征流行特征分析[J].疾病监测,2013,28(10):844.
[8]Albarado-Ibaez A,Avelino-Cruz J E,Velasco M,et al.Metabolic syndrome remodels electrical activity of the sinoatrial node and produces arrhythmias in rats[J].PloS one,2013,8(11):e76534.
[9]李奔,孙红茜,桑小银,等.代谢综合征患者左房扩大与房性心律失常间关系的探讨[J].宁夏医学杂志,2015,37(2):114.
[10]向鸿鹄,刘小雪,董岩,等.静息心率与代谢综合征的关系[J].中华内分泌代谢杂志,2015,31(3):230.
[11]Fogari R,Mugellini A,Zoppi A,et al.Effect of telmisartan and ramipril on atrial fibrillation recurrence and severity in hypertensive patients with metabolic syndrome and recurrent symptomatic paroxysmal and persistent atrial fibrillation[J].Journal of Cardiovascular Pharmacology and Therapeutics,2012,17(1):34.
[12]Yilmaz M,Akyazici F,Arican Ozluk O,et al.Heart rate turbulence in patients with metabolic syndrome[J].Metabolic Syndrome and Related Disorders,2013,11(2):132.
[13]Jarczok M N,Li J,Mauss D,et al.Heart rate variability is associated with glycemic status after controlling for components of the metabolic syndrome[J].International Journal of Cardiology,2013,167(3):855.
[14]Chang Y W,Lin J D,Chen W L,et al.Metabolic syndrome and short-term heart rate variability in adults with intellectual disabilities[J].Research in Developmental Disabilities,2012,33(6):1701.
[15]Altuncu M E,Baspinar O,Keskin M.The use of short-term analysis of heart rate variability to assess autonomic function in obese children and its relationship with metabolic syndrome[J].Cardiol J,2012,19(5):501.
[16]Feng W,He X,Chen M,et al.Urinary metals and heart rate variability:a cross-sectional study of urban adults in Wuhan,China[J].Environmental Health Perspectives(Online),2015,123(3):217.