Karpenko A I, Moskalenko V V
Lik Sprava. 2010 Apr-Jun(3-4):63-8.
In spite of considerable success in the study of basic pathogenetic mechanisms of arrhythmias development in patients without diabetes mellitus 2 type (DM), the problem of impact of DM on disorders of the cardiac rhythm of patients with acute myocardial infarction is still not resolved. Disorders of the cardiac rhythm have been analyzed in all groups of patients. So, the first group of patients, for certain, had more patients with fibrillation and palpitation of auricles, i.e. hypoglycemia more frequent induced the development of supra ventricular disorders of cardiac rhythm. Fibrillation of auricles, for certain, was more frequently observed in the group of patients with Hba1c less than 7 mkmol/l (P < 0,001). Single VE (ventricular extra systoles) and SVE (supra ventricular extra systoles) prevailed in the 2nd group. Patients with Hba1c more than 9 mkmol/l and hyperglycemia episodes prevailed with ventricular disorders, namely ventricular extra systoles of high degree. Thus, hypoglycemia provokes the development of supra ventricular disorders of the cardiac rhythm in a greater degree, while hyperglycemia results in the development of ventricular disorders of the cardiac rhythm.
尽管在研究非2型糖尿病(DM)患者心律失常发生的基本发病机制方面取得了相当大的成功,但DM对急性心肌梗死患者心律紊乱的影响问题仍未得到解决。已对所有患者组的心律紊乱进行了分析。因此,第一组患者中,肯定有更多患有心房颤动和心悸的患者,即低血糖更频繁地诱发室上性心律紊乱的发生。肯定地说,在糖化血红蛋白(Hba1c)低于7微摩尔/升的患者组中,心房颤动更频繁出现(P < 0.001)。第二组中单个室性期前收缩(VE)和室上性期前收缩(SVE)占主导。糖化血红蛋白高于9微摩尔/升且有高血糖发作的患者,以心室紊乱为主,即高度室性期前收缩。因此,低血糖在更大程度上诱发室上性心律紊乱的发生,而高血糖则导致室性心律紊乱的发生。