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背景:目前针对早期糖尿病自主神经病变(diabeticautonomicneuropa-thy,DAN)的诊断和检测方法的研究十分薄弱。目的:利用非线性心率变异性(HeartRateVariability,HRV)方法帮助了解自主神经受损的程度,从而为糖尿病自主神经病变的早期诊断提供临床依据。设计:单一样本研究。单位:一所大学分校的计算机教研室和一所大学生物医学工程系的医学物理教研室。对象:本实验于2003-03/05在解放军第一军医大学生物医学工程系医学物理教研室。实验纳入的糖尿病患者34例为解放军第一军医大学附属南方医院内分泌科住院患者;伴有DAN者22例。正常人40例为解放军第一军医大学师生和解放军体育学院体育系学生。采样点数(去除异常值后)为512个。方法:采用自行研制的基于虚拟仪器开发平台LabVIEW的HRV采集分析系统,分别采集了74组(74组信号来源于34例糖尿病和40例正常人)标准相邻R波的间期(RwavetoRwaveintervals,RRI)信号。用非线性预测方法对糖尿病患者与正常人的RRI信号进行分析。主要观察指标:74组标准相邻R波的间期信号的采集与分析结果。结果:采用NMSE分析时,无DAN病变的患者与正常人比较,差异无显著性意义(P=0.075),而发生DAN的患者与正常人比较,差异有显著性意义(P=0.001);采用MAE分析时,无论有无DAN病变的糖尿病患者
BACKGROUND: The current research on the diagnosis and detection of early diabetic autonomic neuropathy (DAN) is very weak. OBJECTIVE: To help understand the extent of autonomic nerve damage by using the method of nonlinear heart rate variability (HRV) to provide a clinical basis for the early diagnosis of diabetic autonomic neuropathy. Design: Single Sample Study. Unit: a university branch of computer teaching and research and a university Department of Biomedical Engineering Department of Medical Physics. PARTICIPANTS: The experiment was performed at the Department of Medical Physics of the Department of Biomedical Engineering, the First Military Medical University, People’s Liberation Army from March to May 2003. 34 patients with diabetes were enrolled in the Department of Endocrinology, Nanfang Hospital affiliated to the First Military Medical University of PLA; 22 patients were accompanied by DAN. 40 cases of normal people for the PLA First Military Medical University and PLA Sports Institute of Physical Education students. The number of sampling points (after removing the abnormal value) is 512. Methods: The HRV acquisition and analysis system based on LabVIEW, a virtual instrument development platform, was used to collect the RwavetoRwaveintervals (RRIs) of 74 groups (74 signals from 34 cases of diabetes mellitus and 40 normal controls) )signal. Nonlinear prediction methods were used to analyze RRI signals in diabetic patients and normal subjects. MAIN OUTCOME MEASURES: The results of the collection and analysis of 74 groups of interphase signals of adjacent R waves. Results: There was no significant difference (P = 0.075) between patients without DAN lesions and normal subjects when using NMSE analysis, while there was significant difference between normal and DAN patients (P = 0.001) MAE analysis, with or without DAN disease in diabetic patients