2型糖尿病患者心率变异性与尿白蛋白排泄率的关系  

Study on relationship between heart rate variability(HRV) and urinary albumin excretion ratio(UAER) in patients with type 2 diabetes

作　　者：陈越[1] 潘文志[1] 钟一红[1] 丁小强[1] 

机构地区：[1]复旦大学附属中山医院,200032

出　　处：《浙江临床医学》2008年第3期304-305,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨2型糖尿病患者心率变异性(HRV)与尿白蛋白排泄率(UAER)的相关性。方法将90例2型糖尿病患者按照UARE不同分为糖尿病正常白蛋白尿组(N组,51例),糖尿病微量白蛋白尿组(Mi组,25例),糖尿病大量白蛋白尿组(Ma组,14例),并且选取正常健康人30例作为对照组(C组,30例),用24h动态心电图分析其HRV,检测其自主神经功能。结果(1)糖尿病各组的全程内相邻正常窦性心率R-R间期的标准差(SDNN)、全程内每5minR-R间期均值的标准差(SDANN)明显低于正常对照组,且Mi组显著低于N组,Ma组明显低于Mi组(P<0.05)。(2)N组和Mi组的全程内每5minR-R间期标准差的平均值(SDNNI)、相邻正常R-R间期差值的均方根(rMSSD)、相邻正常R-R间期相差>50ms的个数占总心跳次数的百分比(PNN50)与C组相比无显著差别,但Ma组较C组显著降低(P<0.01)。结论糖尿病患者随着尿白蛋白排泄率增加,自主神经损害加重。Objective To investigate the relationship between HRV and UAER in patients with type 2 diabetes. Methods According to different UAERs, 90 patients with type 2 diabetes are divided into three groups , including normal UAER （group N, 51 ）, mieroalburninuria （group Mi, 25 ） and maeroalbuminuria（group Ma, 14）, while 30 healthy adults are selected as control group（group C, 30）. The fimetion of autonomic nerve is tested by 24- hour electrocardiogram analysis of HRV. Results （1）SDNN 、 SDANN in group N、 Mi, Ma decreased more significantly than in control group, aral those in group Mi were significantly lower than in group N, the differences were statistically significant（ P 〈0.05） .But the difference of SDNN,SDANN in group Mi and group Ma had no statistical significance（P 〉0.05 ）. （2） There is no difference about SDNNI, rMSSD, PNN50 between group N, Mi and group C, but they decreases more significantly in group Ma than those in group C, and the difference has statistical significance （ P 〈0.01）. Conclusion Before autonomic neuropathy, especially vagal nerve injury. Diabetic autonomic neuropathy contributes to the occurrence and development of kidney injury.

关 键 词：2型糖尿病 心率变异性 尿白蛋白排泄率 

分 类 号：R587.1[医药卫生—内分泌]