论文部分内容阅读
目的 探讨糖尿病患者微白蛋白尿与心脏自主神经病变之间的关系。方法 应用 2 4小时动态心率变异性(HRV)频谱分析技术 ,对 46例糖尿病患者及 31例正常对照者测定了 HRV,并与尿白蛋白排泄率作相关分析。结果 糖尿病患者在不同尿白蛋白排泄 (UAE)阶段 ,心率变异性时域分析各项指标参数均降低 ,其中伴微白蛋白尿组 (DMB)较正常蛋白尿组 (DMA) HRV各项参数降低更明显 ,有极显著性差异 (P<0 .0 1)。糖尿病患者反映迷走神经活动的夜间高频 (HF)显著低于对照组。 DMA组夜间低频 /高频时明显高于对照组 (P<0 .0 5 ) ,而 DMB组反映交感神经活动的低频(L F)也明显降低。结论 糖尿病患者时域分析和频域分析的各项指标参数均减低 ,尤以反映迷走神经张力的夜间高频降低显著。糖尿病伴微白蛋白尿组 ,HRV的各项指标减低显著加重 ,并出现迷走 -交感神经的联合损害 ,心脏自主神经活动的昼夜节律改变丧失。
Objective To investigate the relationship between microalbuminuria and cardiac autonomic neuropathy in diabetic patients. Methods 24 h dynamic heart rate variability (HRV) spectral analysis technique was used to measure HRV in 46 diabetic patients and 31 normal controls, and correlated with urinary albumin excretion rate. Results The indexes of heart rate variability time domain analysis in diabetic patients with different urinary albumin excretion (UAE) decreased, and the parameters of HRV in patients with microalbuminuria (DMB) and normal albuminuria (DMA) were lower More significantly, there was a significant difference (P <0.01). The nighttime high frequency (HF) of patients with diabetes reflecting vagal activity was significantly lower than that of the control group. DMA group at night was significantly higher than the low-frequency / high-frequency control group (P <0.05), while the DMB group reflects the low frequency of sympathetic activity (LF) was also significantly reduced. Conclusion The parameters of time domain analysis and frequency domain analysis of diabetic patients decreased, especially at night, which reflected the vagal tone. Diabetes mellitus with microalbuminuria, HRV significantly reduced the various indicators, and vagal - sympathetic joint damage, cardiac autonomic activity of circadian rhythm loss of change.