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本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见 Arrhythmias in Type 2 Diabetes Mellitus 背景与目的 2型糖尿病形成的慢性高血糖致使心脏长期受损，诱发冠状动脉疾病（CAD），心肌梗塞（MI），充血性心力衰竭（CHF）和心律失常从而导致猝死。本研究探讨不同类型心律失常在2型糖尿病中的患病率，特别是与心脏自主神经病变（CAN）相关联。 方 法 横断面研究包括100例住院2年以上的2型糖尿病（T2DM）性心律失常患者。详细的病例记录以及CAN的体检和测试均已完成。常规检查如超声心动图，血压监测，动态心电图监测也已完成。 结 果 最常见的心律失常为心动过速，约在32%的病人中出现。20％有完全心脏阻滞（CHB），15％有窦性心动过缓（SB），15％有心房颤动（房颤）。10％的病人出现室性早搏（VPC）和3％有房性早搏（APC）。3％有一度房室传导阻滞，而1％有阵发性室上性心动过速（PSVT），另有1％有室性心动过速（VT）。糖尿病控制不佳、糖尿病并发症与较高的心律失常发生率有关。 62％的患者有延长的QTc，其中大部分有CAN。大多数患者对标准治疗有效。 结 论 2型糖尿病与心律失常、心源性猝死风险显着增加有关。 2型糖尿病各种心律失常均需进一步评估。心脏自主神经病变（CAN）是2型糖尿病中发生心律失常的最重要的预测因子。糖尿病并发症，血糖控制不佳，QTc延长和高钾血症与预后不良有关。 原始文献摘要 Agarwal G, Singh S K. Arrhythmias in Type 2 Diabetes Mellitus[J]. Indian Journal of Endocrinology & Metabolism, 2017, 21(5):715-718. Background: Chronic hyperglycaemia of Type 2 diabetes mellitus causes long term damage to heart resulting in coronary artery disease (CAD), myocardial infarction (MI), congestive heart failure (CHF), and sudden death from arrhythmias. AIMS:To study the prevalence of different types of arrhythmias in T2DM, particularly in association with Cardiac Autonomic Neuropathy (CAN). METHODS:A cross-sectional study including 100 patients of Type 2 Diabetes Mellitus (T2DM) presenting with cardiac arrhythmias, was done at our hospital over 2 years. Detailed history along with physical examination and tests for CAN were done. Routine investigations along with echocardiography, stress test, Holter monitoring were done. RESULTS: Sinus Tachycardia (ST) was the commonest arrhythmia, found in 32% of patients. 20% had Complete Heart Block (CHB), 15% had Sinus Bradycardia (SB), and 15% had Atrial Fibrillation (AF). Ventricular Premature Complex (VPC) was found in 10% and 3% had Atrial Premature Complex (APC). 3% had first degree AV block, whereas 1% had Paroxysmal Supra Ventricular Tachycardia (PSVT), and another 1% had Ventricular Tachycardia (VT). Poorly controlled diabetes and co-morbidities was associated with higher incidence of arrhythmias. 62% of patients had prolonged QTc, majority of which had CAN. Most of the patients responded to standard therapy. conclusIons: T2DM is associated with a signifcant increase in the risk for arrhythmias and sudden cardiac death, as demonstrated in our study. Each case of arrhythmia in T2DM warrants further evaluation. CAN is the most important predictor for the development of arrhythmias in T2DM. QTc, QTd, Tp-e interval, and Tp-e/QTc ratio along with reduced sinus arrhythmia are simple, yet invaluable tools to arouse the suspicion of CAN. Comorbidities, poor glycemic control,prolonged QTc, and hyperkalemia are associated with worse prognosis. 麻醉学文献进展分享 联系我们 |
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