临床医学毕业论文_范文.doc

PAGE  PAGE 6 糖尿病与心率失常的关系及机制探讨 XXXX医院XXX学生姓名 摘要 目的 初步探讨患者发生糖尿病与心律失常的内在联系及机制。方法 回顾分析239例2型糖尿病患者，根据常规心电图检测有无心律失常，分为糖尿病心律失常组66例，糖尿病无心律失常组173例，另外选取70例单纯心律失常患者作为心律失常无糖尿病组，对以上3组患者的相关临床资料、血糖、心电图检查结果进行分析比较。结果 糖尿病患者心律失常发生率为27．6％。以房性期前收缩最多见；2型糖尿病伴高血压、冠心病更易发生心律失常(P0.01或P0.05；心律失常组的年龄、体重，体质指数、糖尿病病程、高血压病程、冠心病病程、收缩压、空腹胰岛素、LDL-C、胰岛素抵抗指数高于无心律失常组P0.01或P0.05)；糖尿病合并心律失常组和单纯心律失常对照组心律失常发生率分别为93.9％、52．9％，其中窦性心律失常、房性心律失常、交界性心律失常、传导阻滞、室性心律失常均显著高于对照组，差异有统计学意义(P0．01)。结论 2型糖尿病患者伴其他心血管疾病与单纯糖尿病无心律失常患者及单纯心血管疾病无糖尿病患者相比更易发生心律失常，可能与疾病病程长、胰岛素抵抗程度重、伴其他疾病而造成心脏血管、心肌、神经病变有关。 关键词：糖尿病；心律失常；心血管疾病 Explore the relationship and mechanism of diabetes and heart disorders Abstract: Objective Internal relations and explore the mechanism of diabetes in patients with arrhythmia. Methods Retrospective analysis of 239 cases of type 2 diabetes, according to the presence or absence of ECG arrhythmia detection, divided into 66 cases of arrhythmia diabetes, diabetes without arrhythmia group 173 cases, while 70 cases selected purely as arrhythmia arrhythmia patients without diabetes group clinical data related to the above three groups of patients, blood glucose, ECG results were analyzed and compared. Results Patients with diabetes and arrhythmia was 27.6%. In atrial contraction most common; Type 2 diabetes and hypertension, coronary heart disease more arrhythmias (P 0.01 or P 0.05 occurred; Age arrhythmia, weight, body mass index, duration of diabetes, duration of hypertension, coronary heart disease duration, systolic blood pressure, fasting insulin, LDL-C, insulin resistance index than those without arrhythmia group P 0.01 or P 0.05); diabetic patients with arrhythmia group and the control group, the incidence of arrhythmia arrhythmia 93.9%, respectively,52.9%, including sinus arrhythmia, atrial arrhythmias, junctional arrhythmias, conduction block, ventricular arrhythmias were significantly higher, the difference was statistically significant (P 0.01). Conclusion Other patients with type 2 diabetes, cardiov