基于光电容积脉搏波的2型糖尿病患者心血管系统功能状况研究

Analysis of health status of cardiovascular system in the patients with type 2 diabetes mellitus based on digital volume pulse

目的寻求基于光电容积脉搏波的有效波形指标来评价糖尿病患者的心血管系统健康状况。方法选择健康人21例(A组),其中男性14例,女性7例;年龄20～23岁,平均年龄20.7岁。48例2型糖尿病患者(B组),其中男性22例,女性26例,年龄42～82岁,平均年龄62.0岁;其中单纯糖尿病患者20例(C组),男性7例,女性13例,年龄44～81岁,平均年龄62.3岁;糖尿病合并心血管疾病患者28例(D组),男性15例,女性13例,年龄42～82岁,平均年龄61.7岁。采用基于光电容积脉搏波描记法的HC2180-DCU指夹式无创血流参数检测仪记录指端容积血流脉动波形图,提取大量基于脉搏波形图及其一阶微分、二阶微分的指标,通过统计分析得出能区分糖尿病及其患病程度的指标。结果在糖尿病患者和健康人中有显著差异的指标包括xg1(上升支面积重心横坐标)、xg-xg1(整周期与上升支面积重心横坐标之差)、yg2(下降支面积重心纵坐标)、yg-yg2(整周期与下降支面积重心纵坐标之差)、ACIx[(xg2-xg)/(xg-xg1)]、ACIy[(yg-yg2)/(yg1-yg)]、1jgy(脉搏波一阶微分波谷纵坐标)、2jfx(脉搏波二阶微分波峰横坐标)、2jgx(脉搏波二阶微分波谷横坐标)。能区分单纯糖尿病患者与糖尿病并发心血管疾病患者的指标有yg2、yg-yg2、ACIy、2jfx,且相比于传统生理指标,波形指标能更准确地区分单纯糖尿病患者与糖尿病并发心血管疾病患者。结论基于光电容积脉搏波的新型指标能有效评价2型糖尿病患者心血管系统损伤程度。

Objective To find out the valid indexes based on digital volume pulse （DVP）, and evaluate the health status of cardiovascular system of the patients with type 2 diabetes mellitus（T2DM）. Methods A total of 21 healthy subjects（group A, male 14, female 7; aged 20 - 23 years old, mean age 20.7 years old） and 48 T2DM subjects（group B, male 22, female 26; aged 42 - 82 years old, mean age 62.0 years old） were enrolled, of which 20 subjects were simple diabetes（group C, male 7, female 13; aged 44 - 81 years old, mean age 62.3 years old） and 28 were diabetes mellitus combined with cardiovascular disease（group D, male 15, female 13; aged 42 - 82 years old, mean age 61.7 years old）. The blood volume pulsation map was recorded with HC2180-DCU which was a non-invasive instrument for the detection of blood parameters. Then a large number of indexes from the map, the first order differential map and the second order differential map were selected. At last, the valid indexes which distinguished the T2DM subjects, mild diabetes and severe diabetes were selected by statistical analysis. Results The following indexes had noticeable differences between healthy subjects and diabetes subjects, which include xgl（abscissa of the centroid of rising part）, xg - xgl （difference between abscissa of the centroid in rising part and the whole cycle）, yg2（ordinate of the centroid in declining part）, yg - yg2（difference between ordinate of the centroid in declining part and the whole cycle）, ACIx[（xg2 - xg）/（xg- xg1）], ACIy[（yg - yg2）/ （ygl - yg）], 1jgy（ordinate of the wave trough in the first order differential map）, 2fix（abscissa of the wave peak in the second order differential map）, 2jgx（abscissa of the wave trough in the second order differential map）. The indexes yg2, yg - yg2, ACIy and 2fix could discriminate the simple diabetic subjects from the diabetes subjects combined with cardiovascular disease, and the results showed that the waveform indexes had a higher accuracy to distinguish the simple diabetic subjects from the diabetes subjects combined with cardiovascular disease, in comparison with the traditional physiological indexes. Conclusion It is demonstrated that the novel indexes based on DVP could estimate the lesion degree of cardiovascular system in T2DM.