تحري إقفار العضلة القلبية الصامت عند المرضى السكريين بالهولتر
Abstract
أجريت هذه الدراسة لتقييم انتشار إقفار العضلة القلبية الصامت عند المرضى السكريين غيرالعرضيين وصفات هذا الإقفار. تناولت الدراسة / 50/ مريضاً / 24/ رجلاً و/ 26/ امرأة ، متوسط أعمارهم ± الانحراف المعياري ( 58.3 ± 6.4 سنة) ولديهم تخطيط قلب كهربائي طبيعي بالراحة . خضعت المجموعة كلها لتخطيط قلب كهربائي مستمر لمدة /48/ساعة بواسطة الهولتر كما أجري لها استجواب سريري و فحص سريري شامل . إن انتشار إقفار العضلة القلبية الصامت عند المرضى السكريين غير العرضيين مع استمرار النشاطات اليومية مرتفع جداً / 58% / . ويتعلق الإقفار الصامت عند المرضى السكريين بشكل واضح بتقدم العمر ، و وزيادة المدة المعلومة للإصابة بالداء السكري ؛ ويزداد بوجود عوامل خطورة قلبية وعائية أخرى كارتفاع قيم التوتر الشرياني ، وفرط كوليسترول الدم الكلي وLDL كوليسترول ، وبظهور المضاعفات التالية للداء السكري : اعتلال شبكية سكري ، اعتلال وعائي محيطي أو سباتي ، اعتلال عصبي محيطي ، بيلة بروتينية صريحة ، عنانة ؛ مع تغير ملحوظ يوماً عن آخر .
The aim of this study is to evaluate the prevalence and characteristics of silent myocardial ischemia in asymptomatic patients with mellitus diabetes. 50 diabetic patients (24 males, 26 females; mean age ± SD = 58.3 ± 6.4 years) with a normal resting electrocardiogram are prospectively studied. The total group has undergone 48 hours of electrocardiographic Holter monitoring. The prevalence of silent myocardial ischemia during daily activities in asymptomatic diabetic patients is very high (58%). In diabetic patients, silent ischemia is clearly related to age advancement and an increase in the duration of mellitus diabetes; and it increases with the presence of other risk factors for coronary artery disease, such as high blood pressure, increased values of total cholesterol and LDL cholesterol; it also increases with the presence of diabetic complications and noticeable variability day in day out..
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