2型糖尿病合并冠心病患者的心率变异性及其与心脏结构功能变化的关系

发布时间：2018-03-06 23:04

本文选题：心率变异性　切入点：型糖尿病　出处：《山东医药》2017年17期 　论文类型：期刊论文

【摘要】：目的观察2型糖尿病、冠心病、2型糖尿病合并冠心病患者心率变异性(HRV)变化及其与心脏结构功能指标的关系。方法选择糖尿病合并冠心病患者33例,2型糖尿病患者32例,冠心病患者32例,健康体检者31例,行24 h动态心电图监测、心脏彩超检查,对HRV时域指标、昼夜节律变化、HRV指标与心脏结构功能指标的相关性等进行分析。结果四组比较2型糖尿病合并冠心病组HRV降低发生率最高,而冠心病组与2型糖尿病组之间则无显著性差异。糖尿病合并冠心病组清醒状态与睡眠状态的HRV指标相比较无明显差异,而对照组各指标睡眠状态均显著高于清醒状态。糖尿病合并冠心病组较T_2DM组、冠心病组LVEF、E/A降低,左心室舒张末期内径(LVEDD)、左心房内径(LA)增大。正常窦性心搏RR间期总体标准差与LA、LVEDD呈负相关,与LVEF、E/A呈正相关;每5 min窦性RR间期均值标准差与LVEDD呈负相关,与LVEF、E/A呈正相关;每5 min RR间期标准差均值与LVEF呈正相关;正常连续窦性RR间期差值均方根与LVEF、E/A呈正相关。结论 2型糖尿病合并冠心病组自主神经损害最严重、心率变异的昼夜节律消失;HRV可反映心脏结构重构的严重程度及心功能的损坏程度。
[Abstract]:Objective to observe the changes of heart rate variability (HRV) in patients with type 2 diabetes mellitus (DM) and coronary heart disease (CHD) and the relationship between HRV and cardiac structural and functional indexes. Methods Thirty-three patients with type 2 diabetes mellitus complicated with coronary heart disease were selected. 32 patients with coronary heart disease (CHD) and 31 healthy persons were examined by 24 h ambulatory electrocardiogram (ECG) and color Doppler echocardiography (CDFI). The time domain indexes of HRV were measured. The correlation between circadian rhythm and cardiac structure and function was analyzed. Results compared with the four groups, the incidence of HRV in type 2 diabetes with coronary heart disease was the highest. However, there was no significant difference between coronary heart disease group and type 2 diabetes group. There was no significant difference in HRV between awake state and sleep state in diabetic patients with coronary heart disease. However, the sleep state of the control group was significantly higher than that of the awake state, and the LVEF E / A decreased in the diabetic patients with coronary heart disease compared with that in the patients with TCI 2DM. The total standard deviation of RR interval for normal sinus beats was negatively correlated with LVEDD and positively correlated with LVEFE / A, and negatively correlated with LVEDD and positively correlated with LVEFE / A for every 5 min. The mean standard deviation per 5 min RR interval was positively correlated with LVEF, and the root mean square root of normal continuous RR interval was positively correlated with LVEF E / A. Conclusion the autonomic nerve damage is the most serious in type 2 diabetic patients with coronary heart disease. The disappearance of circadian rhythm of heart rate variability and HRV can reflect the severity of cardiac structural remodeling and the degree of damage to cardiac function.
【作者单位】：郑州大学第二附属医院;
【基金】：河南省医学科技攻关计划项目(201403091)
【分类号】：R541.4;R587.1

【相似文献】