2型糖尿病合并高血压患者的心率变异性特点

Heart rate variability character of the patients with the secondary type diabetes complicated with hypertension

目的:探讨2型糖尿病(DM)合并原发性高血压患者(EH)自主神经功能变化和心率变异(HRV)特点。方法:随机选取本中心就诊的30例DM病人为DM组,30例EH病人为EH组,30例DM+EH病人为DM+EH组,30例健康人为对照组,分别行24 h动态心电图记录,分析HRV时域和频域指标,对各组HRV指标进行比较研究。结果:EH组中反映交感神经张力的HRV指标数值升高,反映迷走神经张力的HRV指标数值降低,与对照组之间有明显变化(P<0.05);DM组、DM+EH组中反映交感神经和迷走神经张力的HRV指标数值均明显降低,其中DM+EH组的HRV指标数值降低最为明显,与对照组比较差异有统计学意义(P<0.05)。结论:EH组、DM组较对照组存在自主神经功能受损害。DM+EH组较对照组自主神经功能受损害程度更加明显,发生心源性猝死的危险性增加,应定期检查,密切随访。

Objective： To explore the characters of the autonomous nerve function change and HRV of the patients with secondary type DM and EH. Method： 30 cases with DM consulted in the health service centre were selected as the DM group. 30 cases with EH as the EH group. 30 cases with DM and EH as the DM＋EH group.30 health cases as the control group. All of them had 24 h dynamic electrocardiogram record and their HRV time domain and frequency domain indicators were analyzed and indicator of HRV of each group was compared. Results： The HRV indicator number which reflected the sympathetic nerve tension in EH group rose and the HRV indicator number which reflected the vague nerve tension reduced. They had obvious change compared with those in the control group （P〈0.05）. The HRV indicator numbers which reflected the sympathetic nerve tension and the vague nerve tension in the groups of DM and DM＋EH reduced obviously, of which the HRV indicator number in the DM＋EH group fell most obviously. Its difference had statistical significance compared with that in the control group （P〈0.06）. Conclusion： The autonomous nerve function had damaged in the EH and DM groups compared with that in the control group. The autonomous nerve function had damaged more in the DM＋EH group than that in the control group. The risk of occurrence of carcinogenic sudden death increased, which should have the regular examination and close following-up.