2型糖尿病患者HRV指标现状及与颈动脉粥样硬化的相关性研究

HRV status in type 2 diabetes patients and its correlation with carotid atherosclerosis

目的:探究2型糖尿病(T2DM)患者心率变异性(HRV)指标现状及与颈动脉粥样硬化(AS)的相关性。方法:收集2018-12~2020-06我院收治的T2DM患者104例,据颈动脉超声诊断病变程度分3组,对照组(无颈动脉病变,30例)、研究A组(颈动脉ITM增厚,41例)、研究B组(颈动脉粥样斑块,33例)。均预先行颈动脉超声检查,并采用动态心电图仪器进行连续24h分析HRV相关指标,后分析HRV指标与颈动脉AS的相关性。结果:与对照组比较,研究A组与研究B组HRV相关指标均呈下降趋势(P<0.05),且伴随颈总动脉AS程度加重,HRV相关指标数值逐步降低;T2DM患者颈动脉AS与HRV相关指标均呈负性相关(P<0.05)。结论:研究发现T2DM患者HRV相关指标数值明显降低,提示患者交感-福交感神经调节能力减弱,且HRV指标与颈动脉AS呈显著负相关,表明T2DM患者心血管自主神经病变能加重颈动脉AS,需加强重视。

Objective:To investigate the status of heart rate variability(HRV)and its correlation with carotid atherosclerosis(AS)in patients with type 2 diabetes mellitus(T2DM).Methods:A total of 104 T2DM patients admitted to Jiangmen Central Hospital from December 2018 to June 2020 were selected and divided into three groups according to the degree of lesions diagnosed by carotid artery ultrasound:control group(no carotid artery lesions,30 cases),study group A(carotid artery ITM thickening,41 cases),and study group B(carotid atheromatous plaque,33 cases).Carotid artery ultrasound was performed in all patients in advance,and dynamic electrocardiogram instrument was used to analyze HRV related indexes for 24 hours continuously,and then the correlation between HRV indexes and carotid artery AS was analyzed.Results:Compared with the control group,HRV related indexes in study group A and study group B decreased(P<0.05).With the aggravation of common carotid artery AS,HRV related indexes decreased.There was a negative correlation between carotid AS and HRV in T2DM patients(P<0.05).Conclusion:The value of HRV related indexes in patients with T2DM is significantly decreased,suggesting that the ability of sympathetic-parasympathetic nerve regulation is weakened.There was a significant negative correlation between HRV and carotid atherosclerosis,suggesting that cardiovascular autonomic neuropathy in T2DM patients could aggravate carotid atherosclerosis,which should be paid more attention.