摘要
目的：糖尿病患者大部分死于心血管系统并发症，近来证明心率变异性是反映心脏自主神经活动的一项无创性指标，本文旨在研究ＩＩ型糖尿病合并缺血性心脏病患者的心率变异性。方法：应用２４小时动态心电图测定了７２例ＩＩ型糖尿病患者心率变异指数和心率，并与５０例年龄、性别配对的正常人比较。结果：ＩＩ型糖尿病患者心率变异指数比正常人明显减低（２３．４４±７．８７比３８．７３±１０．６８，Ｐ＜０．０１）。且２４小时平均心率和最慢心率比正常人增快（７８．６±８．５比７０．３±６．２，Ｐ＜０．０１；５７．０±８．９比４８．６±５．２，Ｐ＜０．０１）。其中２２例合并缺血性心脏病患者心率变异指数减低的阳性率明显高于其它ＩＩ型糖尿病患者（８２％比４８％，Ｐ＜０．０５）。结论：ＩＩ型糖尿病患者交感神经张力升高，迷走神经张力减低，伴有缺血性心脏病患者更显著，这可能意味着患者日后发生心性猝死的危险性增加。
Objective:Most patients of diabetes mellitus die vascular complications. Heart rate variability has been proposed as a noninvasive means to monitor the autonomic nerve activity of the heart. This study was aimed to know the relationship between heart rate variability in diabetics and ischemic heart disease.Methods:Twenty-four-hour heart rate variability index(HRVI)and heart rate of 72 cases of nonin sulin dependent diabetes mellitus(NIDDM)were analyzed by ambulatory electrocardiograph and compared with 50 age-and sex-matched controls. Results:In comparing with controls, HRVI of NIDDM patients decreased(23.44±7.87 vs,38.73±10.68,p<0.01),the average and lowest heart rate in 24 hours increased(78.6±8.5vs 70.3±6.2,p<0.01;57.0±8.9vs.48.6±5.2,p<0.01).The positive rate of decreased HRVI in 22 NIDDM patients with ischemic heart disease was higher than NIDDM patients without ischemic heart disease(82%vs.48%,respectively,p<0.05).Conclusion:It suggests increased sympathetic nerve tone and decreased parasympathetic nerve tone in NIDDM patient,especially those with ischemic heart disease.It implies increased risk of subsequent sudden cardiac death.
出处
《中国循环杂志》
CSCD
1996年第1期12-14,共3页
Chinese Circulation Journal
关键词
糖尿病
缺血性心脏病
心率变异
动态心电图
Diabetes mellitus(type II)
Ischemic heart disease
Heart rate variability
Ambulatory electro cardiograph
