【摘要】 目的 探讨2型糖尿病和2型糖尿病合并缺血性心脏病患者对心血管自主神经活动的影响。方法 用24 h动态心电图检测2型糖尿病患者48例，2型糖尿病合并心肌缺血患者35例及对照组43例健康人的心率变异性（HRV）指标。结果 2型糖尿病患者心率变异性指标比正常人明显减低，合并心肌缺血比没有合并心肌缺血的2型糖尿病患者，心率变异性指标仅rMSSD、PNN50减低。结论 2型糖尿病患者存在植物神经损害，心率变异性减低，心率变异性减低程度与心脏损害程度有关。合并心肌缺血患者对心血管自主神经损害较没有合并心肌缺血者重。
【关键词】 2型糖尿病；心肌缺血；心率变异性；自主神经
Study on heart rate variability of type 2 diabetes patients with myocardial ischemia
DONG Chun-qiu，LI Yi-yan，LUO Jian-xing.Internal Medical Department，the Second People’s Hospital of Haizhu District，Guangdong 510250，China
［Abstract］ Objective To study the effects of type 2 diabetes and type 2 diabetes with myocardial ischemia (MI) on autonomic nervous activity of heard and blood vessel（HRV）.Methods One hundered and thirty-eight cases were divided into three groups，including 43 health controls，48 patients with type 2 diabetes without myocardial ischemia and 35 patients with type 2 diabetes with myocardial ischemia HRV was measured by Holter EKG.Results HRV in patients with type 2 diabetes were significantly diminished.There were no significant diflerences between type 2 diabetes with and without myocardial ischemia except rMSSD，PNN50 in HRV.Conclusion Patients in type 2 diabetes have autonomic nervous injure and diminished HRV，and HRV diminution degree is related with myocardial injure degree，especially in patients with type 2 diabetes with myocardial ischemia.
［Key words］ type 2 diabetic；myocardial ischemia；heart rate variability；autonomic nervous
心率变异性（HRV）分析是评价心血管系统自主神经功能的一项无创性指标，是一项有价值的预测心脏事件发生的指标。本文旨在探讨2型糖尿病患者以及合并缺血性心脏病患者心率变异性的临床特点及意义［1］。
1 资料与方法
11 一般资料 糖尿病组：78例2型糖尿病患者均为2000年11月～2004年11月在我院住院的病例，其诊断符合WHO糖尿病分类及诊断标准，并除外合并有严重肾功能不全、心力衰竭、高血压病患者。其中男51例，女27例，
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