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非胰岛素依赖型糖尿病患者心血管自主神经功能与心率变异性 |
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苗青 吕卓人 夏仲淘 钱新叶 刘淑媛
【摘要】 目的 探讨非胰岛素依赖型糖尿病（NIDDM）患者心血管自主神经功能变化与心率变异性（HRV）的关系。方法 NIDDM患者41例，按照标准心血管自主神经功能试验的结果分成阳性组(DAN+)及阴性组(DAN-)；61例健康人为对照组，进行HRV分析。结果 NIDDM患者心血管自主神经功能异常的发生率为53.7%，其发生率与病程呈正相关。DAN+及DAN-组HRV多数指标均明显降低(P值<0.05～0.0001)； HRV直方图、散点图、三维立体图均有特征性改变，以DAN+组最为显著。DAN-组LF/HF值明显增大。结论 HRV能较全面、立体、直观、定量地反映NIDDM患者心血管交感神经及迷走神经各自的功能状态，且稳定性、重复性及敏感性较好。因此，HRV分析是一种为临床早期发现NIDDM患者心血管自主神经功能异常的较好方法。
【关键词】 糖尿病，非胰岛素依赖型 糖尿病神经病变 心率变异性
Cardiovascular autonomic function and heart rate variability in patients with non-insulin-dependent diabetes mellitus (NIDDM) Miao Qing*, Lü Zhuoren, Xia Zhongtao, et al. * Department of Geriatrics, Shanxi Provincial People s Hospital , Xi an 710068
【Abstract】 Objective To investigate the characteristics of cardiovascular autonomic function (CAF) and heart rate variability (HRV) in NIDDM patients.Methods 41 patients with NIDDM and 61 healthy controls were involved in the study. According to the results of standard test of CAF, the NIDDM patients were divided into two groups——DAN+ group (patients with diabetic autonomic neuropathy) and DAN- group (patients without diabetic autonomic neuropathy). HRV (included 24-hour time-domain, 24-hour frequency-domain, 5-minute frequency-domain, and non-linear analysis methods) were measured to assess the changes of CAF in NIDDM patients. Results The positive rate of diabetic autonomic neuropathy in NIDDM patients was 53.7%, which correlated with duration of diabetic history. Compared with the control group, the indices of HRV (SDNN, RMSSD, PNN50, SDNNindex, SDANN, LF, HF, TP, VAI, VLI) were markedly and significantly reduced in both DAN- and DAN+ groups (P<0.05-0.0001), especially in DAN+ group. In DAN- group, LF and HF were significantly decreased (P<0.05 ), meanwhile, LF/HF was markedly increased (P<0.05) than those in DAN+ group.Conclusion (1)The positive rate of diabetic autonomic neuropathy in NIDDM pati[1] [2] [3] 下一页
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