高血压合并2型糖尿病患者心率变异与颈动脉内中膜厚度的相关性分析

Correlation analysis of heart rate variability and carotid intima-media thickness in patients with hypertension and type 2 diabetes mellitus

目的探讨高血压(EH)合并2型糖尿病(T2DM)患者心率变异(HRV)的改变及其与颈动脉内中膜厚度(IMT)的关系。方法选择27例高血压患者、22例高血压合并2型糖尿病患者和25例健康人进行24h动态心电图监测和颈动脉内中膜厚度测量。结果高血压组、高血压合并2型糖尿病组的SDNN、SDANN、RMSSD、SDNNidex较正常对照组均有明显减低(P<0.01),高血压合并2型糖尿病组较高血压组也有显著差异(P<0.05)。高血压或高血压合并2型糖尿病伴颈动脉内中膜增厚者HRV参数较无增厚者有进一步的下降,而且HRV参数与IMT呈负相关。结论心率变异性分析可以作为早期发现高血压和(或)合并2型糖尿病患者心脏自主神经损伤的有价值的指标,HRV也是颈动脉粥样硬化的独立相关因素,可对大血管并发症作出早期的预测,有助于及时治疗,改善预后。

Objective To discuss the change of heart rate variability in hypertension concomitance with type 2 diabites mellitus and the relationship between heart rate variability and carotid intima-media thickness. Methods In 27 patients with hypertension and 22 patients with hypertension co-exists type 2 diabetes mellitus and 25 healthy persons,24h dynamic electrocardiogram and carotid intima-media thickness were recorded and analysed. Results SDNN,SDANN,RMSSD,SDNNindex in patients with hypertension and hypertension with type 2 diabetes mellitus were lower than those in the normal control group, especially in the hypertension with type 2 diabetes mellitus.Hypertension and hypertension co-exist type 2 diabetes mellitus with increased carotid intima-media thickness had even lower HRV indicates than the patients without increased IMT. HRV indexes were negative relativity compared with IMT. Conclusion HRV is validly and non-invention way to evaluate heart autonomicneuropathy in hypertension and type 2 diabetes mellitus.HRV is an independent determinant factor for the carotid theroscalerosis in the patients with hypertension and （or） type 2 diabetes mellitus and can provide a clue to find early-stage vascular disease with the patients.