2型糖尿病合并急性心肌梗死患者心率减速力与变异性的相关性分析

Analysis on the correlation between deceleration capacity of rate and heart rate variability in patients with type 2 diabetes mellitus complicated with acute myocardial infarction

目的探讨2型糖尿病(T2DM)合并急性心肌梗死(AMI)患者心率减速力(DC)与心率变异性(HRV)指标的相关性。方法选择2015年3月至2017年3月该院收治的30例T2DM+AMI患者作为T2DM+AMI组,另选同期收治的30例单纯T2DM患者作为T2DM组,并以同期健康体检者30例作为对照组,记录三组研究对象DC以及HRV时域指标并进行分析。结果 T2DM组患者DC、相邻窦性心率正常R-R间期差值均方根(rMSSD)、相邻正常R-R间期差值≥50ms所占百分比(PNN50%)、24h内每5min节段R-R间期均值标准差(SDANN)以及24h内R-R间期标准差(SDNN)与对照组比较差异有统计学意义(P<0.05);T2DM+AMI组DC、rMSSD、PNN50%、SDANN、SDNN均明显低于T2DM组,差异有统计学意义(P<0.05)。T2DM组与T2DM+AMI组DC<4.5 ms的发生率均明显高于对照组,差异有统计学意义(P<0.05);T2DM+AMI组DC<4.5ms的发生率明显高于T2DM组,差异有统计学意义(χ~2=3.744,P<0.05)。相关性分析结果表明,T2DM组DC与rMSSD、PNN50%、SDANN、SDNN均呈正相关(P<0.05),T2DM+AMI组DC与rMSSD、PNN50%、SDANN、SDNN均呈正相关(P<0.05)。结论 T2DM+AMI患者DC及HRV均明显降低,且DC与HRV时域指标呈正相关,DC可定量评估T2DM+AMI患者迷走神经张力,可作为反映自主神经系统损害的有效指标。

Objective To investigate the correlation between deceleration capacity of rate(DC)and heart rate variability(HRV)in patients with type 2 diabetes mellitus complicated with acute myocardial infarction(T2DM+AMI).Methods A total of 30 cases of patients with T2DM+AMI in the hospital from March 2015 to March 2017 were selected as T2DM+AMI group,and 30 patients with T2DM only as T2DM group in the same period,and 30 healthy volunteers were selected as control group.DC,HRV and time domain index of three groups were recorded and analyzed.Results There were significant differences found between T2DM group,T2DM+AMI group and control group in DC,rMSSD,PNN50%,SDANN and SDNN(P<0.05);DC,rMSSD,PNN50%,SDANN and SDNN of T2DM+AMI group were statistically lower than the T2DM group(P<0.05).The incidence of DC lower than 4.5 ms in T2DM group and T2DM+AMI group were statistically higher than in the control group(P<0.05).And the incidence of DC lower than 4.5 ms in T2DM+AMI group were statistically higher than in the T2DM group(χ2=3.744,P<0.05).The correlation analysis showed that DC were positively correlated with rMSSD,PNN50%,SDANN,SDNN(P<0.05)in T2DM group and T2DM+AMI group,respectively.Conclusion DC and HRV in patients with T2DM+AMI are significantly decreased,and DC is positively correlated with the HRV time-domain index,and DC could quantitatively assess the vagus nerve tension in T2DM+AMI patients as an effective index reflecting the damage of the autonomic nervous system.