高血压合并2型糖尿病患者心率变异性分析

Analysis of heart rate variability in hypertensives complicating type 2 diabetes

目的分析高血压合并2型糖尿病患者的心率变异性(heart rate variability,HRV)。方法收集本院收治的60例高血压合并2型糖尿病患者作为A组、60例高血压患者作为B组、60例正常体检者作为C组。对3组研究对象均行24 h动态心电图记录。比较各组的HRV指标。结果 A组患者的1 d内正常RR标准差(SDNN)、5 min时段RR间期均值标准差(SDANN)、5 min节段RR间期平均值标准差(SDNN index),连续RR间期差值均方根(rMSSD)和相邻正常RR间期差值>50 ms百分比(pNN50)分别为(97.88±25.77)ms、(83.24±20.13)ms、(14.55±10.57)ms、(17.95±8.55)ms、(3.56±2.44)%,显著低于B组的(122.41±20.33)ms、(104.56±19.73)ms、(45.22±12.45)ms、(22.44±6.44)ms、(8.83±4.95)%和C组的(138.23±22.44)ms、(127.95±21.84)ms、(59.35±16.44)ms、(35.96±14.33)ms、(13.56±11.24)%。B组亦低于C组,差异均有统计学意义(P<0.05)。结论利用HRV可在早期有效发现高血压合并2型糖尿病患者自主神经功能损伤程度,安全可靠,值得临床推广。

Objective To analyze the heart rate variability（HRV）of hypertensives complica-ting type 2 diabetes.Methods Sixty cases of hypertensives complicating type 2 diabetes（group A）, 60 cases of hypertensives（group B）,and 60 cases of health check-up people（group C）were select-ed and carried out 24 h ambulatory electrocardiography.The HRV indices were compared among the 3 groups.Results For group A,the standard deviation of normal to normal intervals（SDNN）,ev-ery 5 minutes average standard deviation（SDANN）and every 5 minutes standard deviation of mean RR intervals（SDNN index）within 1 d,and rate mean square of the differences of successive RR in-tervals （rMSSD ） and percentage of RR intervals differing 〉50 ms （pNN50 ） were separately （97.88 ±25.77）ms,（83.24 ±20.13）ms,（14.55 ±10.57）ms,（17.95 ±8.55）ms,and （3.56 ±2.44）%,significantly lower than those of group B[（122.41 ±20.33）ms,（104.56 ± 19.73）ms,（45.22 ±12.45）ms,（22.44 ±6.44）ms,and （8.83 ±4.95）%,respectively] and those of group C [（138.23 ±22.44）ms,（127.95 ±21.84）ms,（59.35 ±16.44）ms, （35.96 ±14.33）ms,and （13.56 ±11.24）%,respectively].And compared with group C,the above HRV indices of group B were also much lower.The differences were all statistically significant （P〈0.05）.Conclusion For hypertensives complicating type 2 diabetes,HRV can be applied in identif-ying the degree of autonomic nerve functional lesions at an early phase.The method proves to be safe,reliable and worthy of clinical promotion.