糖尿病心脏植物神经功能障碍与尿流率测定的关系及其临床意义

RELATIONSHIP BETWEEN URINARY FLOW RATE AND CARDIAC AUTONOMIC NERVE DYSFUNCTION IN DIABETES AND ITS CLINICAL SIGNIFICANCE

根据心脏植物神经功能试验，将５０例糖尿病患者分为功能正常组（Ⅰ组）１１例，轻度异常组（Ⅱ组）１８例，重度异常组（Ⅲ组）２１例。尿流率测定结果表明三组排尿量（Ｖ）、最大尿流率（ＭＦＲ）及平均尿流率（ＡＰＲ）均低于对照组。Ⅱ组的ＭＦＲ和ＡＦＲ低于Ⅰ组，Ⅲ组最低。最大尿流率时间（ＭＦＲＴ）和排尿总时间（ＶＴ）在Ⅱ、Ⅲ组中延长。三组ＭＦＲ的异常发生率分别为３６．４％、６１．１％和９５．２％；ＡＦＲ为２７．２％、４４．４％和８５．７％；ＶＴ为１８．２％、２７．８％和６１．９％。揭示心脏植物神经功能异常者大多有尿流率异常，病程长、病情重及伴有其他并发症者尤为显著。

Fifty cases of diabetes mellitus were divided into three groups according to their cardiac autonomic nerve function: Group 1,normal function (n=11);group 2,slightly abnormal function (n = 18)and group3,severely abnormal function(n=21).Urinaryflow rates were examined in all patients.The results showed that urinary voiding volumes(V),maximum flow rate(MFR)and av-erage flow rate(AFR)of diabetic patients were lower than those of the controls. The MFR and AFR of group 2 were lower thanthose in group 1.The group 3 had the lowest MFR and AFR. Maximum flow rate time(MFRT)and voiding time (VT) of group2and group 3 were longer than those of group 1 and controls. In groups 2 and 3 the positive rates of MFR were 36.4%,61.1%and 95.2%,the positive rates of AFR were 27.2%,44.4%and 85.7%and VT were 18.2%,27.8%and 61.9%respectively.These results indicate that diabetic patients with dysfunction of the cardiac autonomic nerve are usually accompanied by abnormalurinary flow rate,especially so in those with severe symptoms,of long duration and with other complications.