有胃肠症状糖尿病患者自主神经功能的变化研究  

Damage of autonomic nerve function in diabetic patients with gastrointestinal symptoms

作　　者：张月霞[1] 蓝宇[1] 

机构地区：[1]北京积水潭医院消化内科,100035

出　　处：《中华全科医师杂志》2010年第11期765-768,共4页Chinese Journal of General Practitioners

摘　　要：目的观察有胃肠症状的糖尿病患者自主神经功能损害情况。方法对2008年12月至2009年5月于积水潭医院消化内科门诊就诊的24例有胃肠症状的糖尿病患者（有症状组），20例初发无胃肠症状糖尿病患者（初发无症状组），17例健康志愿者（健康对照组），分别用标准心血管反射试验行自主神经功能测试。结果初发无症状组患者副交感神经指标中呼吸心率差[（14±5）次／min]明显低于健康对照组[（20±10）次／min]，有症状组[（9±6）次／min]明显低于健康对照组及初发无症状组，均P〈0．05。自主神经功能5项指标测定计分及交感神经计分、副交感神经计分、自主神经总分均呈现出有症状组〉初发无症状组〉健康对照组的趋势。有症状组自主神经异常率为96％（23／24），其中明确累及和严重累及占58％（14／24），初发无症状组明确累及和严重累及仅占5％（1／20）。结论糖尿病患者存在明显的自主神经功能异常，交感神经、副交感神经均有累及，糖尿病早期以副交感神经损害为主，随胃肠及全身并发症的出现，自主神经病变逐渐加重。Objective To observe autonomic nerve function damage in diabetic patients with gastrointestinal symptoms. Methods Twenty-four patients of diabetes mellitus （DM） with gastrointestinal symptoms, as well as 20 cases of DM without gastrointestinal symptoms and 17 health volunteers were recruited from the clinic of gastroenterology, Jishuitan Hospital, Beijing during December 2008 to May 2009, and standard cardiovascular reflex test was performed for all of them to determine their functions of the autonomic nerve. Results Respiratory rate （an indicator of parasympathetic nerve function） was （14 ± 5 ） times per minute in patients of DM without dyspepsia, obviously lower than that in healthy controls [ （20 ±10） times per minute] , and that in patients of DM with dyspepsia was （9 ±6） times per minute, obviously lower than that in healthy controls and asymptomatic ones （ P 〈 0. 05 ）. Scores of five indicators of the autonomic nerve functions, and the sympathetic, parasympathetic nerve and overall autonomic nerve functions were significantly higher in patients of DM with gastrointestinal symptoms than those in the patients without dyspepsia and healthy controls. Abnormality rate of autonomic nerve functions was 96 percent （ 23/ 24） in the patients with dyspepsia, 58 percent （14/24） in those definitely and seriously involved, and five percent （1/20） in those without dyspepsia. Conclusions Autonomic neuropathy exists in most diabetic patients with dyspepsia, both sympathetic and parasympathetic nerve involved. Impairment of parasympathetic nerve function occurs earlier than that of sympathetic nerve in patients of DM.

关 键 词：糖尿病 自主神经系统 心血管反射试验 

分 类 号：R587[医药卫生—内分泌]