老年冠心病合并2型糖尿病患者心率变异性分析研究

Analysis of heart rate variability in old patients with coronary heart disease and type 2 diabetes mellitus

目的探讨心率变异性对冠心病、冠心病合并2型糖尿病心脏自主神经病变的意义。方法选择40例冠心病患者、36例冠心病合并2型糖尿病患者和30例健康人进行24 h动态心电图记录,分析比较。结果 A组(冠心病)、B组(冠心病并发糖尿病)患者R-R间期总体标准差(SDNN)、平均值标准差(SDANN)、标准差的平均值(SDN-Nindex)、平方根(RMSSD)、总R-R间期数的百分比(PNN50%)较C组(正常对照)均有显著性差异(P<0.05);B组与A组比较有显著性差异(P<0.05)。结论冠心病或合并2型糖尿病患者心率变异性检查可作为衡量其心脏自主神经损害的一个有效的无创方法,此方法不仅能够准确反映患者自主神经功能及其损害情况,并可对其损害程度进行初步判断、评估,为临床诊疗提供理论依据。

Objective To discuss the significance of heart rate variability（HRV） analysis in the discovery of the heart autonomic neuropathy in old patients with coronary heart disease（CHD） and old patients with CHD and type 2 diabetes.Methods 24 hrs dynamic electrocardiogram was recorded and analyzed in 40 patients with CHD（group A）,36 patients with CHD and type 2 diabete mellitus（group B） and 30 healthy subjects（control group）.Results The reports showed that SDNN,SDANN,SDNN index,rMSSD and PNN50 in patients in group A and group B were lower than those in healthy subjects in control group（P0.05）,especially in patients in group B（group B vs group A,P0.05）.Conclusion HRV analysis is an effective and non-invasive way to find heart autonomic neuropathy in patients with CHD and patients with CHD and type 2 diabetes,it can accurately reflect the function and lesion extent of the autonomic nerve,and provide the basis for clinical diagnosis and treatment.