论文部分内容阅读
目的：糖尿病患者大部分死于心血管系统并发症，近来证明心率变异性是反映心脏自主神经活动的一项无创性指标，本文旨在研究ＩＩ型糖尿病合并缺血性心脏病患者的心率变异性。方法：应用２４小时动态心电图测定了７２例ＩＩ型糖尿病患者心率变异指数和心率，并与５０例年龄、性别配对的正常人比较。结果：ＩＩ型糖尿病患者心率变异指数比正常人明显减低（２３．４４±７．８７比３８．７３±１０．６８，Ｐ＜０．０１）。且２４小时平均心率和最慢心率比正常人增快（７８．６±８．５比７０．３±６．２，Ｐ＜０．０１；５７．０±８．９比４８．６±５．２，Ｐ＜０．０１）。其中２２例合并缺血性心脏病患者心率变异指数减低的阳性率明显高于其它ＩＩ型糖尿病患者（８２％比４８％，Ｐ＜０．０５）。结论：ＩＩ型糖尿病患者交感神经张力升高，迷走神经张力减低，伴有缺血性心脏病患者更显著，这可能意味着患者日后发生心性猝死的危险性增加。
PURPOSE: Most patients with diabetes die from cardiovascular complications. It has recently been demonstrated that heart rate variability is a noninvasive indicator of autonomic activity in the heart. This article aims to investigate the relationship between heart rate variability (HRV) in patients with type 2 diabetes and ischemic heart disease . Methods: The heart rate variability index and heart rate of 72 patients with type 2 diabetes mellitus were measured by 24-hour ambulatory electrocardiogram and compared with 50 age-matched and sex matched normal subjects. Results: The heart rate variability index of patients with type II diabetes was significantly lower than that of normal people (23.44 ± 7.87 vs. 38.73 ± 10.68, P <0.01). And the 24-hour average and the slowest heart rate were faster than those of normal subjects (78.6 ± 8.5 vs 70.3 ± 6.2, P <0.01; 57.0 ± 8.9 vs. 48.6 ± 5 .2, P <0.01). The positive rate of heart rate variability index in 22 patients with ischemic heart disease was significantly lower than those in other type 2 diabetes patients (82% vs 48%, P <0.05). CONCLUSIONS: Patients with type 2 diabetes have increased sympathetic tone and decreased vagal tone, and are more pronounced in patients with ischemic heart disease, which may indicate an increased risk of sudden cardiac death in the future.