Poincare散点图在分析糖尿病合并慢性充血性心力衰竭心率变异中的应用

目的探讨Poincare散点图在分析糖尿病(DM)、慢性心力衰竭(HF)及糖尿病合并慢性心力衰竭(DM+HF)患者心率变异(HRV)中的使用价值。方法分别分析100例DM患者,100例HF患者,100例DM+HF患者和100例正常人24 h HRV的Poincare散点图及其定量指标,矢量长度指数(VLI)和矢量角度指数(VAI),并与部分时域指标(SDNN,SDSD)进行相关分析。结果正常人散点图均呈慧星型;DM组、HF组呈鱼雷型及短棒型;DM+HF组短棒型,3组患者24 h、清醒、睡眠时的SDNN、SDSD、VLI、VAI与正常组比较均显著降低,且昼夜变化节律消失。与DM组、HF组比较,DM+HF组SDNN、SDSD、VLI、VAI明显降低。相关分析显示VLI与SDNN和VAI与SDSD分别呈正相关。结论DM合并HF时自主神经受损严重。Poincare散点图能直观地反映DM、HF、DM+HF患者心脏自主神经功能状况,结合其量化指标可定量分析其HRV。

Poincare plot analysis of heart rate variability in patients with diabetes and chronic heart failure

Objective It is to approach the value of Poincare plot analysis of heart heart rate variability(HRV) in patients with diabetes mellitus(DM) and chronic heart failure(HF).Methods Poincare plot and its quantitative index such as vector length index(VLI),vector angle index(VAI) of HRV were analyzed in 100 patients with DM,100 patients with HF,and 100 patients with DM+HF,and 100 control subjects.The correlations among those indexes and standard deviation(SDNN) and mean successive difference(SDSD) were studied.Results Poincare plot was comet shape in control subjects,fish torpedo and cosh shape in HF groups and DM groups,cosh shape in DM+HF groups;The values of SDNN,SDSD,VLI and VAI were lower in HF group than those in control subjects in 24 hours,sober and dormancy state.The rhythm of day-night change was disappeared.There was significant correlation between VLI and SDNN,VAI and SDSD.Conclusion There is serious injury in heart autonomic nerve of patients with DM+HF.Poincare plot can directly reflect heart autonomic nerve function state.Poincare plot associate with its quantitative index may be used to analyze quantitatively HRV in patients with DM,HF and DM+HF.