2型糖尿病患者心率变异性分析

Analysis of heart rate variability about the patients with type 2 diabetes

目的 通过对糖尿病和非糖尿病患者心率变异性进行对比分析,以了解糖尿病患者心脏自主神经功能受损情况。方法 选取2014年1月~2015年2月在北京市回民医院住院并做动态心电图检查的老年患者103例。分为两组：糖尿病组45例,非糖尿病组58例,比较时域指标及昼夜节律变化。结果 糖尿病组的24 h全程正常窦性R-R间期的标准差（SDNN）、全程记录中每5分钟平均R-R间期的标准差（SDANNindex）、全程记录中每5分钟R-R间期标准差的平均值（SDNNindex）、全程相邻RR间期之差的均方根值（r MSSD）和全程内差值超过50 ms的连续正常R-R间期所占的百分率（PNN50）指标值均低于非糖尿病组,差异有统计学意义（P〈0.05）。糖尿病患者昼夜SDNN、r MSSD、PNN50指标差异无统计学意义（P〉0.05）。非糖尿病患者日间的SDNN、r MSSD指标低于夜间指标值,差异有统计学意义（P〈0.05）。结论 老年糖尿病患者心脏自主神经受损,增加了心血管恶性事件的发生率,严重影响糖尿病患者的预后。心率变异性（HRV）有助于早期诊断自主神经病变,建议糖尿病患者做24 h动态心电图检查和HRV分析,及早干预治疗。

Objective To find out cardiacautonomic function in type 2 diabetes patients by analysis of heart rate variability between diabetic and non-diabetic patients. Methods 103 cases of elderly patients hospitalized and measured by dynamic ecg recordings examination from January 2014 to February 2015 in Moslem Hospital were selected. All patients were given 24-hour dynamic electrocardiogram and divided into two groups： diabetic group （45 cases） and non-diabetic group （58 cases）. The time domain of heart rate variability index and circadian rhythm changes were compared between two groups. Results The time domain analysis indicators （SDNN, SDANNindex, SDNNindex, rMSSD, PNNS0） of diabetic group were significantly decreased than those of non-diabetic group, the difference was statistically significant （P 〈 0.05）.The difference was not statistically significant about the time domain analysis indicators （SDNN, rMSSD, PNNSO） of circadian rhythm in diabetic group （P 〉 0.05）. The time domain analysis indicators （SDNN, rMSSD） during the day in non-diabetic group was lower than those at night. The difference was statistically significant （P 〉 0.05）. Conclusion The damage of elderly patients with cardiac autonomic nerve can increase the incidence of cardiovascular adverse events, seriously impact the prognosis of patients with diabetes. HRV contributes to early diagnosis of autonomic neuropathy, it is suggested that diabetes patients do 24-hour Hoher monitoring and HRV analysis and get early intervention.