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目的探讨冠心病、糖尿病患者对平板运动试验后心率恢复的影响以及心率恢复异常对无症状的糖尿病患者合并冠心病的诊断价值。方法对88例拟诊冠心病患者行平板运动试验,以糖尿病史及血糖水平分为非糖尿病组(n=45)、糖尿病组(n=43)。根据冠脉造影结果,非糖尿病组分为非冠心病组(A组,n=22)和冠心病组(B组,n=23),糖尿病组分为非冠心病组(C组,n=22)和冠心病组(D组,n=21)。计算运动后1、2、3、4和5min心率恢复值并进行比较。研究心率恢复异常对非糖尿病和糖尿病患者合并冠心病的诊断价值。结果平板运动后1、2、3、4和5min心率恢复值由大到小依次为A、C、B和D组。与非糖尿病组相比,心率恢复异常诊断糖尿病所合并冠心病的灵敏性高,特异性和准确性无差别。结论冠心病对心率恢复的影响大于糖尿病,心率恢复异常可以作为筛选糖尿病患者是否合并冠心病的指标之一。
Objective To investigate the effect of coronary heart disease and diabetes on heart rate recovery after treadmill exercise test and the diagnostic value of abnormal heart rate recovery in patients with asymptomatic diabetes mellitus complicated with coronary heart disease. Methods Eighty-eight patients with suspected coronary artery disease undergoing treadmill exercise test were divided into non-diabetic group (n = 45) and diabetic group (n = 43) according to the history of diabetes mellitus and blood glucose level. According to the result of coronary angiography, non-diabetic patients were non-coronary heart disease (group A, n = 22) and coronary heart disease (group B, n = 23) 22) and coronary heart disease group (D group, n = 21). Heart rate recovery values at 1, 2, 3, 4, and 5 minutes after exercise were calculated and compared. To investigate the diagnostic value of abnormal heart rate recovery in non-diabetic and diabetic patients with coronary heart disease. Results 1, 2, 3, 4 and 5 minutes after exercise, the values of heart rate recovery were A, C, B and D in descending order. Compared with the non-diabetic group, the diagnosis of abnormal heart rate in the diagnosis of diabetes with coronary heart disease sensitivity, specificity and accuracy of no difference. Conclusion The effect of coronary heart disease on heart rate recovery is greater than that of diabetes mellitus, and the abnormal rate of heart rate recovery can be used as one of the indexes to screen whether patients with diabetes mellitus have coronary heart disease.