糖尿病心脏自主神经病变超声心动图参数分析

Analysis of the parameter of supersonic and enchanted graph to cardiovascular autonomic neuropathy in diabetes patients

目的:观察并分析不同程度糖尿病心脏自主神经病变(DCAN)患者心率变异性(HRV)指标及超声心动图参数的变化及意义。方法:采用Holter分析系统检出纳入对象24h全部窦性心搏进行HRV时域和频域指标分析,依据心脏自主神经病变(CAN)评价标准对非DCAN、DCAN临床前期及DCAN组患者分组观察和分析HRV指标及超声心动图参数。结果:278例观察对象中筛查并分类出DCAN阳性组62例(22.30%),DCAN临床前期组88例(31.65%),DCAN阴性组128例(46.04%);3组间HRV指标中SDNN、SDANN、SDNNI、LF及Mean HR比较其差异均有统计学意义(P<0.05);3组间超声心动图参数中LADs、EF值比较其差异均有统计学意义(P<0.05),IVSD、LVDs、LVPWd比较其差异均无统计学意义(P>0.05),DCAN阳性组与阴性组间LVDd比较其差异有统计学意义(P<0.05)。结论:临床关注HRV中SDNN、SDANN、SDNNI、LF及超声心动图LADs、EF等参数可早期识别DCAN并提高对个体高危患者心血管事件的预测能力。

[Objective]Obseving and analysing the parameter changes and clinical significances of supersonic and enchanted graph in the different stages of DCAN patients. [Method]Using Holter analysis system into the including objects and detecting sinus heart beat and heart rate variability（ HRV） for 24 hours of time domain and frequency domain indexes.Observing the parameters of HRV,the supersonic and enchanted graph for the DCAN,preclinical DCAN and positive DCAN patients based on the CAN evaluation standard. [Result]Classified the 62 cases of positive DCAN（ 22. 30/%）,88 cases of preclinical DCAN（ 31. 65/%） and 128 cases of negative DCAN（ 46. 04/%） in 278 objects. The difference of SDNN,SDANN,SDNNI,LF and Mean HR had statistical significance among these three groups parameters of HRV（ P 〈0. 05）; the difference of LADs and EF values were statistically significance among three groups parameters of supersonic and enchanted graph（ P〉 0. 05）; There were no significant differences in IVSD,LVDs and LVPWd（ P 〈0.05）,and the LVDd difference was statistically significant between DCAN positive group and negative group（ P〈 0.05）. [Conclusion]： Pay attention to the parameter changes of SDNN,SDANN,SDNNI and LF for HRV and LADs and EF values for supersonic and enchanted graph,we could easily identify and improve forecasting ability of cadiovascular event for the high risk of DCAN patients.