中青年2型糖尿病患者窦性心率震荡的分析

The analysis of heart rate turbulence in young-middle aged patients with type 2 diabetes mellitus

目的探讨中青年初发2型糖尿病患者窦性心率震荡(HRT)的可能变化及其临床意义。方法选择初发室性期前收缩(VPB)的中青年2型糖尿病患者76例(糖尿病组),有VPB的健康人76例作为对照组。两组均行24h动态心电图(DCG)检查,分析单次VPB后HRT的初始值(TO)、斜率(TS)以及TO和TS异常的发生率。结果糖尿病组TO、TS值明显异常,与对照组比较均有显著性差异(p<0.01);糖尿病组TO及TS异常发生率分别为35.3%和38.2%,而对照组分别为7.9%和5.3%,糖尿病组TO、TS值异常率较对照组明显升高,差异有显著性意义(p<0.01)。结论初发青中年2型糖尿病患者HRT现象明显减弱,同时HRT异常率明显增高。临床上HRT可作为青中年初发2型糖尿病自主神经病变的预测指标。

Objective To observe the change of Heart Rate Turbulence （HRT） and its clinic significance in onset young-middle patients with type 2 diabetes mellitus. Methods The subjects included 76 onset young-mid- dle diabetic patients with ventricular premature beat（VPB） and 76 healthy subjects with VPB as controls. All pa- tients and subjects were examined by 24-hour Holter monitoring, Turbulence Onset （TO） and Turbulence Slope （TS） after single VPB were calculated from Holter records and the abnormal incidence of TO and TS were com- pared in two groups. Results The values of TO, TS in diabetic group have significant difference compared with control group （p〈0.01）; The abnormal incidence of TO, TS in diabetic group were 35.3% and 38.2% but 7.9% and 5.3% in control group, respectively. The abnormal incidence of TO, TS in diabetic group have significant dif- ference compared with control group （p〈0.01）. Conclusion The reduction and the abnormal incidence of HRT in onset young-middle type 2 diabetic patients appear, HRT maybe become a important clinic index to predict the diabetic autonomic neuropathy.