冠心病心力衰竭患者糖代谢调节激素的变化与心率变异

The study of glycoregulatory hormone and heart rate variability in patients with heart failure of coronary heart disease

目的:探讨冠心病心衰患者糖代谢调节激素的变化与植物神经功能之间的关系。方法:分别测定47例(B组)冠心病心衰患者治疗前、后和正常对照组(A组)空腹血糖、胰岛素、胰高血糖素、C肽水平及短程心率变异指标。结果:①各组间血糖无显著差异(P>0.05);②B组治疗前后胰岛素、胰高血糖素均显著高于A组(P<0.05),其中B组治疗后较治疗前显著降低(P<0.05);③B组治疗前后AVLF、ALF、AHF、TP均显著低于A组(P<0.05),且治疗前明显低于治疗后(P<0.05);④B组治疗前后ALF/AHF明显高于对照组(P<0.05),但治疗前后无显著性差异(P>0.05)。结论:冠心病心力衰竭患者存在植物神经功能的损害,不仅损害迷走神经,同时也损害交感神经。

Objective ： To explore the relationship between the changes of glycoregulatory hormone secreted by islets of langerhans and autonomic nervous function in patients with heart failure of coronary heart disease （HFCHD）. Methods ： Fasting plasma levels of glucose, insulin, glucagon, C - peptide and frequency domain of heart rate variability were measured in 47 patients with HFCHD and in normal control group, respectively, before and after treatment. Results：①There were no significant differences in glucose levels among all groups （P 〉0.05 ） ;②Insulin and glucagon in patients with HFCHD whatever before and after treatment were higher than those in the control group （ P 〈 0.05 ）, and those after treatment were lower than before treatment. ③AVLF, ALF, AHF,TP in patients with HFCHD whatever before and after treatment were higher than those in the control group（ P 〈 0.05 ）, particularly those before treatment were lower than after treatment（ P 〈 0.05 ）. ④ALF/AHF in patients with HFCHD whatever before and after treatment were higher than those in the control group （ P 〈 0.05 ）, but there were no significant differences between before and after treatment （ P 〉 0. 05 ）. Conclusion ： Autonomic nervous function injures exist in patients with heart failure of coronary heart disease, including both not only injured pneumogastric and sympathia nerve.