2型糖尿病患者心率变异性分析
|
摘要
目的探讨2型糖尿病患者心率变异性(HRV)情况。方法按纳入与排除标准将收集的160名患者分为两组:2型糖尿病组,对照组。行24h动态心电图检查,观察24hHRV时域分析指标。结果2型糖尿病组HRV时域分析指标SDNN、PNN50、SDANN、RMSSD均较对照组偏低,差异有统计学意义(p<0.05)。2型糖尿病组平均心率、夜间平均心率、最小心率也均较血糖正常对照组偏快,差异有统计学意义(p<0.05)。结论2型糖尿病患者HRV降低,即自主神经对心脏的调节能力减弱。对2型糖尿病患者应早期进行动态心电图监测,关注心率变异指标,了解有无心率变异性异常,及早发现糖尿病伴心率变异性异常患者。
Objective To explore the heart rate variability in patients with type 2 diabetes. Methods According to the inclusion and exclusion criteria,the 160 patients were divided into two groups: type 2 diabetes group, normal control group.All of research cases were detected the time domain of heart rate variability index with 24 hours of dynamic electrocardiogram.The heart rate variability indicators were recorded and statistical analysis. Results The HRV time domain analysis indicators(SDNN, PNN50, SDANN, RMSSD)of type 2 diabetes group significantly decreased than in the normal control group(p<0.05).Theaverageheartrate,averageheartrateatnight,minimumheart rate in type 2 diabetes group were faster than the control group, the difference was statistically significant(p<0.05).Conclusions Heart rate variability,patients with type 2 diabetes decreased,which may indicate the capacity of autonomic nervous system regulation on heart diminished.Type 2 diabetes mellitus patients should be early do Holter monitoring. To attention HRV indicators and understand whether have abnormal heart rate variability, to early discoverabnormalheartratevariabilityin diabetespatients.
Objective To explore the heart rate variability in patients with type 2 diabetes. Methods According to the inclusion and exclusion criteria,the 160 patients were divided into two groups: type 2 diabetes group, normal control group.All of research cases were detected the time domain of heart rate variability index with 24 hours of dynamic electrocardiogram.The heart rate variability indicators were recorded and statistical analysis. Results The HRV time domain analysis indicators(SDNN, PNN50, SDANN, RMSSD)of type 2 diabetes group significantly decreased than in the normal control group(p<0.05).Theaverageheartrate,averageheartrateatnight,minimumheart rate in type 2 diabetes group were faster than the control group, the difference was statistically significant(p<0.05).Conclusions Heart rate variability,patients with type 2 diabetes decreased,which may indicate the capacity of autonomic nervous system regulation on heart diminished.Type 2 diabetes mellitus patients should be early do Holter monitoring. To attention HRV indicators and understand whether have abnormal heart rate variability, to early discoverabnormalheartratevariabilityin diabetespatients.
引文
1沈稚舟,吴松华,邵福源,等.糖尿病慢性并发症.上海:上海医科大学出版社1999;107-116.
2 Azarbal B,Hayes S W,Lewin H C,et al.The incremental prognostic value of percentage of heart rate reserve achieved over myocardial perfusion single-photon emission computed tomography in the prediction of cardiac death and all-cause mortalitysuperiority over 85 %of maximal age-predicted heart rate.Journal of the American CollegeofCardiology2004;44:423-430.
3 许亮,彭屹.心率变异性在反映心脏自主神经损伤和重构中的应用.中国生物医学工程学报2007;26:618-618.
4 中国中华医学会,中华医学会糖尿病学分会.中国2型糖尿病防治指南(2010年版讨论稿).2010;11.10.
5 黄永麟,曲秀芬,郭继鸿.心率变异性的临床应用的评价.郭继鸿.新概念心电图(第二版).北京:北京医科大学出版社,2002:344-348.
6 孙瑞龙,吴宁,杨世豪,等.心率变异性检测临床应用的建议.中华心血管病杂志1998;26:252-255.
7 章结楼,吕雪峰,毕连英.44例2型糖尿病患者心脏植物神经功能检测分析.安徽医学2004;25:289.
8 张强,乔鹏,杨丽红,等.原发性高血压患者伴左心室肥厚与室性早搏的心率变异性及可达龙干预的探讨.中国实用神经疾病杂志,2007;10:12-13.
9 Task Force of the European society of Cardidoxy and the north American society of Pacing and electrophysiology,heart rate variability standards of measurement physiological interpretation and clinicaluse.Circulation1996;93:1043-1065.
10 胡秀玮,孙冬宁,张坤.慢性充血性心力衰竭患者心率变异性及其昼夜节律的变化.中国误诊学杂志2008;8:6579-6580.
11 Aaron I,Raelene E,Braxton D,et al.Diabetic Autonomic Neuropathy.DiabetesCare2003;26:1553-1579.
12 廖禹林,贾世纯,付真,等.正常例心率变异时域值及其相互关系.心脏杂志1997;4.
13 Kautzner J,John CammA.Clinical relevanceof heart rate variability.Clinicalcardiology1997;20:162-168.
14 张慧文.心率变异性评价糖尿病患者的自主神经功能.临床心电学杂志2013;.
15 李若汝,郭小玉,翟军鹏,李方洁,.心率变异性的影响因素.临床心电学杂志2010;272-273.
16 BaumertM,SacreJW.Heart ratecomplexityand cardiacsympathetic dysinnervation in patients with type 2 diabetes mellitus.Conf Proc IEEEEngMedBiolSoc.2013;2013:5570-5573.
17 Tarvainen MP,Cornforth DJ,Kuoppa P,et al.Complexity of heart rate variability in type 2 diabetes-effect of hyperglycemia.Conf Proc IEEEEngMedBiolSoc.2013;2013:5558-5561.
2 Azarbal B,Hayes S W,Lewin H C,et al.The incremental prognostic value of percentage of heart rate reserve achieved over myocardial perfusion single-photon emission computed tomography in the prediction of cardiac death and all-cause mortalitysuperiority over 85 %of maximal age-predicted heart rate.Journal of the American CollegeofCardiology2004;44:423-430.
3 许亮,彭屹.心率变异性在反映心脏自主神经损伤和重构中的应用.中国生物医学工程学报2007;26:618-618.
4 中国中华医学会,中华医学会糖尿病学分会.中国2型糖尿病防治指南(2010年版讨论稿).2010;11.10.
5 黄永麟,曲秀芬,郭继鸿.心率变异性的临床应用的评价.郭继鸿.新概念心电图(第二版).北京:北京医科大学出版社,2002:344-348.
6 孙瑞龙,吴宁,杨世豪,等.心率变异性检测临床应用的建议.中华心血管病杂志1998;26:252-255.
7 章结楼,吕雪峰,毕连英.44例2型糖尿病患者心脏植物神经功能检测分析.安徽医学2004;25:289.
8 张强,乔鹏,杨丽红,等.原发性高血压患者伴左心室肥厚与室性早搏的心率变异性及可达龙干预的探讨.中国实用神经疾病杂志,2007;10:12-13.
9 Task Force of the European society of Cardidoxy and the north American society of Pacing and electrophysiology,heart rate variability standards of measurement physiological interpretation and clinicaluse.Circulation1996;93:1043-1065.
10 胡秀玮,孙冬宁,张坤.慢性充血性心力衰竭患者心率变异性及其昼夜节律的变化.中国误诊学杂志2008;8:6579-6580.
11 Aaron I,Raelene E,Braxton D,et al.Diabetic Autonomic Neuropathy.DiabetesCare2003;26:1553-1579.
12 廖禹林,贾世纯,付真,等.正常例心率变异时域值及其相互关系.心脏杂志1997;4.
13 Kautzner J,John CammA.Clinical relevanceof heart rate variability.Clinicalcardiology1997;20:162-168.
14 张慧文.心率变异性评价糖尿病患者的自主神经功能.临床心电学杂志2013;.
15 李若汝,郭小玉,翟军鹏,李方洁,.心率变异性的影响因素.临床心电学杂志2010;272-273.
16 BaumertM,SacreJW.Heart ratecomplexityand cardiacsympathetic dysinnervation in patients with type 2 diabetes mellitus.Conf Proc IEEEEngMedBiolSoc.2013;2013:5570-5573.
17 Tarvainen MP,Cornforth DJ,Kuoppa P,et al.Complexity of heart rate variability in type 2 diabetes-effect of hyperglycemia.Conf Proc IEEEEngMedBiolSoc.2013;2013:5558-5561.