下蹲-站立试验测定糖尿病心脏植物神经病变

Squatting-Standing Test Estimating Cardiovascular Autonomic Neuropathy in Diabetes

目的 寻找一种理想的心脏自主神经功能试验。方法 标准做法 :受试者静立 3分钟 ,然后下蹲 1分钟 ,最后在一个吸气期站立。下蹲 站立试验 (SST) :SST迷走 [SSTv] =下蹲前R R间期均值与下蹲后最长R R间期比值 ;SST交感[SSTs] =基础R R间期与站立后最短R R间期比值。结果 计算了 362例健康人和 2 19例糖尿病人 ,取得 2 0～ 64岁健康人的 95 %和 99%可信性区间 (CIs)的正常值。糖尿病人和健康人SSTv超出 99%CI分别是 91(42 % )和 5例 (1.4% )。SSTs分别是 88例 (40 % )和 3例 (0 .8% )。SST还与其它常用检查比较。结论 (1)SST区别健康人和糖尿病人等于或优于其它试验。 (2 )SST可以同时给出交感和副交感神经功能的资料。

Objective To search for an ideal cardiovascular autonomic function test.Method In the standard maneuver,each subject stood still for 3 min,then squated down for 1 min,and finally stood up during an inspiratory period.Squatting standing test(SST):SST vagal=ratio of the mean of R R interval before squatting to the longest R R interval after squatting;SST sympathetic=ratio of the basal R R interval to the shortest R R interval after standing.Results 362 healthy subjects and 219 diabetic patients were calculated.The normal range[95% and 99% confidence intervals (CIs)] for subjects aged 20～64 was obtained and SSTv outside the 99% CI was 91(42%) in diabetic patients and 5(1.4%) in the control subjects.The corresponding figures for SSTs were 88(40%) and 3(0.8%),respectively.SST ratios were compared with other reflex tests commonly used.Conclusions (1)SST is equal or superior to other tests in discriminating healthy subjects and diabetic patients;(2)SST can offer information of parasympathetic and sympathetic activity synchronously.