2型糖尿病患者心率变异与下肢动脉病变关系的研究

Relationship between heart rate variability and peripheral vascular disease in patients with type 2 diabetes mellitus

目的 探讨 2型糖尿病患者心率变异 (HRV)各指标的变化 ,了解HRV与 2型糖尿病患者下肢动脉病变的关系及其临床意义。方法 将 2 0 0 1- 0 2～ 2 0 0 3- 11浙江大学医学院附属第一医院住院的 135例 2型糖尿病患者 (其中 6 7例无下肢动脉病变、6 8例合并下肢动脉病变 )及 2 0例正常对照者作为研究对象 ,所有研究对象测定了心率变异中总体标准差 (SDNN)、均值标准差 (SDANN)、标准差平均值 (SDNN指数 )、差值均方的平方根 (RMSSD)、爱丁堡指数 (PNN5 0 )、低频与高频比 (LF/HF)各指标。结果 (1) 2型糖尿病有或无下肢动脉病变组各HRV指标除LF/HF外均较正常对照组低 ,差异有显著性。 (2 ) 2型糖尿病合并下肢动脉病变患者心率变异指数较无下肢动脉病变患者有进一步的下降 ,而且心率变异指数与下肢动脉病变程度呈负相关。结论 心率变异是 2型糖尿病下肢动脉病变的独立相关因素。

Objective To investigate the changes of heart rate variability (HRV) and the relationship between HRV and peripheral vascular disease(PVD)in type 2 diabetic patients.Methods A total of 135 type 2 diabetic patients (67 patients without PVD and 68 patients with PVD),admitted to our hospital from Feb. 2002 to Nov. 2003 and 20 normal controls were included in our study.The parameters of HRV both in the patients and controls were evaluated by 24-hours dynamic electrocardiogram.Results (1)The SDNN,SDANN,RMSSD,PNN 50 ,and SDNNind in type 2 diabetic patients were significantly lower than those in normal controls (P<0.01 or P<0.001 ).(2)The type 2 diabetic patients with PVD had further lower HRV than the patients without PVD.There was nagative correlation between HRV and the severity of PVD.Conclusion HRV is an independent correlative factor for peripheral vascular disease in patients with type 2 diabetes mellitus.