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目的探讨老年糖尿病患者非心脏手术后心脏自主神经功能的变化。方法择期行非心脏手术老年患者30例,分为糖尿病组(DM组,n=15)和非糖尿病组(NDM组,n=15)。用三通道动态心电图监测仪分别于手术前日(术前)、术后第1天和第2天记录当晚23:00至次日早晨7:00总的心率变异性(HRV),包括总功率(TP)、高频功率(HF)、低频功率(LF)、极低频功率(VLF)及LF/HF。结果术前DM组TP、HF低于NDM组(P<0．05),术后第1天:两组TP、HF、LF、VLF、LF/HF下降,DM组 HF低于NDM组而LF/HF高于NDM组(P<0．05或0．01),术后第2天:DM组TP、HF、LF及VLF较术后第1天进一步降低,亦低于NDM组(P<0．05或0．01)。结论与非糖尿病患者比较,糖尿病患者非心脏手术后发生心脏自主神经功能紊乱更为严重和持久。
Objective To investigate the changes of cardiac autonomic nervous function after non-cardiac surgery in elderly diabetic patients. Methods A total of 30 elderly patients undergoing noncardiac surgery were enrolled in the study. They were divided into diabetic group (DM group, n = 15) and non-diabetic group (n = 15). Total heart rate variability (HRV) was recorded from 23:00 the evening of the same night to 7:00 the next morning on the preoperative day (preoperative), postoperative day 1 and postoperative day 2, using a three-channel ambulatory ECG monitor, including total power TP, HF, LF, VLF and LF / HF. Results The levels of TP and HF in preoperative DM group were lower than those in NDM group (P <0.05). On the first postoperative day, the levels of TP, HF, LF, VLF and LF / HF decreased in both groups, / HF was higher than that of NDM group (P <0.05 or 0.01). On the second postoperative day, the levels of TP, HF, LF and VLF in DM group were lower than those on the first day after operation and also lower than those in NDM group (P < 0.05 or 0.01). Conclusion Compared with non-diabetic patients, diabetic autonomic dysfunction is more serious and persistent after non-cardiac surgery.