心率变异性在糖尿病心脏自主神经病变中的临床意义

目的 利用动态心电图观测糖尿病患者心率变异性(HRV)的变化及诊断糖尿病心脏自主神经病变.方法 47例糖尿病患者和49例正常对照组记录24小时动态心电图,HRV时域分析指标为:正常R-R间期标准差(SDNN)、连续5分钟正常R-R间期标准差的均值(SDANNindex)及相邻正常R-R间期差值的均方根(rMSSD).结果 糖尿病患者HRV的各参数指标SDNN(86.06±35.97)ms、SDANNindex(77.83±34.72)ms、rMSSD(21.11±18.20)ms均低于正常对照组,差异有显著性意义.有糖尿病周围神经病变或眼低病变的患者各参数指标较无并发症者低,差异有显著性意义.糖尿病组rMSSD病变发生率最高(46.81%),这与糖尿病早期出现迷走神经病变相一致.结论HRV作为一种测量心脏自主神经的定量检测方法,具有灵敏、简便、无创伤性的特点,为早期发现糖尿心脏自主神经障碍,及早防治糖尿病严重并发症的发生提供了一个良好的工具.

The Assessment of HRV in the Patients with Diabetes

Objective To observe the alterations of heart rate variability (HRV) in the diabetes and the diagnostic significance of autonomic neuropathy Methods A group of 47 patients with diabetes and a controlled group of 49 persons were monitored by continuous 24-hour DCG. The indicators of HRV time domain analysis are:SDNN,SDANN and rMSSD. Results The SDNN(86. 06± 35. 97ms),SDANN index (77. 83±34. 72ms),and rMSSD(21. 11 ±18. 20) for the group of diabetic patients are all below those for the healthy controlled group,among which the occurrence rate of rMSSD pathology tops the rest (46. 81%). Conclusion HRV can be applied to diagnose the early stage autonomic neuropathy dysfunction for the patients with diabetes,to provide guidance for clinical practice and to prevent serious complication in time.