2型糖尿病患者心率变异性与糖尿病肾病的关系

目的探讨2型糖尿病患者自主神经功能损害与糖尿病肾病的关系。方法按照尿白蛋白测定结果将160例2型糖尿病患者分为正常白蛋白尿组(NAU)52例、微量白蛋白尿组(MAU)70例、临床白蛋白尿组(CAU)38例,采用5分钟短程频域分析法分析其心率变异性(HRV)指数。结果与NAU组比较MAU组高频功率(HF)明显下降,3.32±1.40vs 2.44±1.77(P<0.05)。CAU组总功率(TP),5.67±1.28vs 4.14±1.41(P<0.01),极低频功率(VLF),4.70±1.31vs 3.28±1.50(P<0.01),低频功率(LF),3.97±1.30vs 2.75±1.35(P<0.05),高频功率(HF),4.21±1.69vs 2.44±1.77(P<0.01)明显降低,平均心率明显增加(P<0.05)。结论随着尿白蛋白增加,HRV各指标降低。糖尿病自主神经损害与糖尿病肾病有关。

Relationship between heart rate variability and nephropathy in patients with type 2 diabetes meilitus

Objective To investigate the relationship between autonomic neuropathy and diabetic nephropathy in patients with type 2 diabetes mellitus （T2DM）. Methods According to different urinary microalbumin （MAU）,160 patients with T2DM were divided into three groups,including normal MAU group（NAU, n =52）, micro MAU group （MAU, n = 70） and clinical MAU group CAU, n = 38）. The function of autonomic nerve was tested by 5-minute short-range analysis of HRV. Results Compared with that of NAU group, HF in MAU group was significantly lower, 3.32±1.40 vs 2.44 ± 1.77 （ P d0.05）. TOtal power（TP） 5.67 ±1.28 vs 4.14±1.41 （ P 〈0.01）, very low frequency power（VLF） 4.70±1.31 vs 3.28±1, 50 （ P d0.01）,low frequency power（LF） 3.97 d： 1.30 vs 2.75±1.35 （ P 0.05） ,high frequency power（HF） 4.21±1.69 vs 2.44±1.77 （ P d0.01） in CAU group decreased more significantly than in NAU group,and mean HR was significantly more increased than in NAU group （P 〈0.05） ,TP,VLF in CAU group decreased more significantly than in MAU group. Conclusion As the urinary albumin increased, the index of HRV reduced. Diabetes autonomic neuropathy has negative relation with diabetes nephropathy in patients with T2DM.