心率变异性频谱分析诊断糖尿病心脏自主神经病变

Diagnosis of cardiac autonomic neuropathy by spectral analysis of heart rate variability in diabetes mellitus

目的早期发现糖尿病自主神经病变。方法应用２４小时动态心电图心率变异性频谱分析检查了５６例糖尿病合并或不合并心脏自主神经病变患者。结果常规检查有心脏自主神经病变组（ＤＭ２组）入睡后高频（ＨＦ）成份明显＜无自主神经病变组（ＤＭ１组）＜正常对照组（Ｐ＜０．００１），而卧位及入睡后低频（ＬＦ）成份又高于对照组（Ｐ＝０．０００１）。从卧位到立位状态ＬＦ／ＨＦ比值上升幅度在ＤＭ１组小于对照组。

Objective Detecting diabetic cardiac autonomic neuropathyinitsearlystage. Methods The 24 hour dynamic electrocardiographic spectral analysis of heart rate variability was performed in 56 diabetic subjects with or without this complication. Results The high frequency (HF) component during sleep in the diabetics with cardiac autonomic neuropathy (DM2 group) was significantly lower than that in the diabetics without cardiac autonomic neuropathy (DM1 group), which was lower than that of normal subjects, (P<0.001). The low frequency (LF) component was much higher in DM1 group as compared with normal subjects, (P>0.0001). From supine to standing posture, the increase in range of LF/HF was less in DM1 group than that of normal subjects. Conclusion The spectral analysis of heart rate variability is a sensitive method in the diagnosis of diabetic autonomic neuropathy.