糖尿病自主神经病变患者直立倾斜试验特点

Characterization of patients with cardiovascular autonomic diabetic neuropathy during head-up tilt table test

目的探讨糖尿病自主神经病变患者直立倾斜试验的特点及其对阳性结果的影响。方法对72例因晕厥就诊的糖尿病自主神经病变患者在安静环境下进行直立倾斜试验,观察其心率、血压变化。结果试验阳性率为87.5%,其中血管抑制型9例,心脏抑制型51例,混合型3例,阴性9例。实验开始后各型心率均呈现逐渐上升的趋势,但心脏抑制型的峰值提前出现,在晕厥前各型心率均明显上升而后在晕厥时快速回落。结论糖尿病自主神经病变患者晕厥主要为心脏抑制型,晕厥前心率变化可以作为直立倾斜试验阳性的预测指标。

Objective To investigate the characterization and effect of positive result of patients with cardiovascular autonomic diabetic neuropathy during head-up tilt table test.Methods Seventy-two patients with cardiovascular autonomic diabetic neuropathy were accepted for head-up tilt test（HUT）,heart rate,dynamic alternation in blood pressure were analyzed.Results Nine cases applied to the vasodepressor type,cardioinhibitory（CI） type 51 cases,mixed type 3 cases;9 cases were negative response to the testing,the total positive rate was 87.5%.With the performing of HUT,the HR increase gradually.The HR peak of CI type come earlier than other type;during pre-syncope stage,HR increase rapidly（P0.01） and then decrease significantly（P0.01）.Conclusion Alternation of HR in patients with cardiovascular autonomic diabetic neuropathy during pre-syncope stage can be considered being the index of predicting the positive result.