糖尿病患者心脏自主神经与感觉神经病变关系的探讨  

Relationship between Diabetic Autonomic and Sensory Neuropathies

作　　者：尹致文[1] 罗平[1] 李林[1] 田青[2] 王玮[2] 翟彪[2] 

机构地区：[1]昆明市第一人民医院内分泌科,650011 [2]昆明市第一人民医院心内科,650011

出　　处：《天津医药》1999年第8期469-471,共3页Tianjin Medical Journal

摘　　要：探讨糖尿病患者心脏自主神经与感觉神经病变的关系。方法：用 Ｂｉｏｍｅｄｉｃａｌ　 Ｓｙｓｔｅｍ动态心电图仪对５７例糖尿病患者进行２４小时心率变异时域分析。结果：糖尿病组平均心率和最低心率高于正常（对照）组（Ｐ＜０．０５，Ｐ≤０．０１），心率变异指数低于对照组（Ｐ＜０．０５，Ｐ≤０．０１）。糖尿病夜间心率变异不良者中有９３％伴有远端原发感觉神经病变。伴有感觉神经病变患者的平均心率和最低心率高于无感觉神经病变者（ Ｐ＜ ０．０５， Ｐ≤０．０１） ；前者心率变异参数低于后者（Ｐ＝ ０．０５，Ｐ≤０．０１）。糖尿病病程≥１０年者其最低心率高于病程＜ １０年者（Ｐ＜０．０１）；前者心率变异参数大都低于后者（Ｐ＜０．０５，Ｐ≤０．０１）。结论：（１）心率变异可作为早期诊断糖尿病心脏自主神经病变的指标。（２）糖尿病患者的自主神经与感觉神经病变可共存，此时，心脏自主神经功能障碍程度严重。（３）心脏自主神经病变的发生和损害程度与病程有关。Heart rate variance(HRV) analysis for 24 hours was done in 57 diabetic patients (DM-group) and normal subjects (Normal-group). It was found that averaged heart rate(AHR) and minimal heart rate(MHR)of DM-group were significantly higher than those of normal-group(P < 0 .05, P≤0 .01 ) and HRV was significantly lower than normal-group (P < 0. 05, P< 0. 01 ). Ninety-three percent of patients with a low HRV had terminal sensory neuropathy. AHR and MHR of patients with sensory neuropathy were much higher than those without the problem(P< 0. 05, P≤0 .01 ), and HRV was on the contrary(P = 0. 05, P≤0. 01 ). Both of MHR and HRV were significantly different between patients with diabetic history of 10 years or longer and those less than 10 years (P<0.05,P≤0.01). It suggested that(1) HRV may be an index for early diagnosis of cardiac autonomic neuropathy. (2)Both of autonomic and sensory neuropathies may develop in diabetic patients and result in abnormal changes pf HRV. (3) Cardiac neuropathy and its severity were related to the history of diabetes mellitus.

关 键 词：糖尿病 心脏 自主神经通路 感觉神经病变 

分 类 号：R587.1[医药卫生—内分泌] R745[医药卫生—内科学]