替米沙坦对心力衰竭合并2型糖尿病患者心率变异性的影响

目的：探讨心力衰竭合并2型糖尿病患者24 h心率变异性（HRV）的特点及替米沙坦对其的影响。方法：首先,67例不同程度的心力衰竭合并2型糖尿病的患者与70例健康成年人的24 h心率变异性指标进行比较;其次,前者被随机分为2组,替米沙坦组（34例）和常规治疗组（33例）,疗程为16周,分别测定治疗前后24 h的心率变异性及左室功能。结果：前者的HRV各项指标均明显低于后者（P〈0.01）,说明心率变异性小,HRV昼夜节律消失;替米沙坦组治疗前后24 h的心率变异性及左室收缩功能明显改善（P〈0.01,P〈0.05）,与常规治疗组比较SDNN、SDANN、SDNN-index均有提高（P〈0.05）。结论：心力衰竭合并2型糖尿病患者的HRV明显下降,替米沙坦对该类患者的心脏自主神经系统及左室收缩功能产生有益的影响。

Effect of Telmisartan on Heart Rate Variability in Patients with Heart Failure Complicating Type 2 Diabetes Mellitus

OBJECTIVE：To study the characteristics of the 24-hour heart rate variability（HRV） in patients with heart failure（HF） complicating 2 type diabetic（T2DM） and the effect of telmisartan on the HRV.METHODS： Firstly,the HRV index was compared between 67 patients with HF of different degree complicating T2DM and 70 healthy adults;secondly,the 67 patients with HF of different degree complicating T2DM were randomly divided into 2 groups,i.e.telmisartan group（n = 34） and routine therapy group（n = 33）.The course of treatment was 16 weeks.The 24-hour HRV and left ventricle function of both groups were measured before and after the treatment.RESULTS： HRV indexes in the former（HF and T2DM patients） were significantly lower than in the latter（healthy adults）（P 0.01）,suggesting small HRV and disappearance of HRV circadian rhythm.Telmisartan group showed significant improvement in 24-hour HRV and left ventricle systolic function after treatment（P 0.01,P 0.05）,showing better improvement in SDNN,SDANN and SDNN indexes of HRV than in the routine therapy group（P 0.05）.CONCLUSION： For patients with HF complicating T2DM patients,there is significant reduction in HRV and Telmisartan has beneficial effect on the autonomic nervous system and left ventricle systolic function of the heart in these patients.