糖尿病心率变异性分析与微量白蛋白尿的关系  

The relationship between heart rate variability and microalbuminuria in patients with diabetes

作　　者：袁莉[1] 陈璐璐[1] 吴剑平 

机构地区：[1]同济医科大学附属协和医院内科,邮政编码430022

出　　处：《中国糖尿病杂志》2000年第4期201-203,共3页Chinese Journal of Diabetes

摘　　要：目的　探讨糖尿病患者微白蛋白尿与心脏自主神经病变之间的关系。方法　应用 2 4小时动态心率变异性(HRV)频谱分析技术 ,对 46例糖尿病患者及 31例正常对照者测定了 HRV,并与尿白蛋白排泄率作相关分析。结果　糖尿病患者在不同尿白蛋白排泄 (UAE)阶段 ,心率变异性时域分析各项指标参数均降低 ,其中伴微白蛋白尿组 (DMB)较正常蛋白尿组 (DMA) HRV各项参数降低更明显 ,有极显著性差异 (P<0 .0 1)。糖尿病患者反映迷走神经活动的夜间高频 (HF)显著低于对照组。 DMA组夜间低频 /高频时明显高于对照组 (P<0 .0 5 ) ,而 DMB组反映交感神经活动的低频(L F)也明显降低。结论　糖尿病患者时域分析和频域分析的各项指标参数均减低 ,尤以反映迷走神经张力的夜间高频降低显著。糖尿病伴微白蛋白尿组 ,HRV的各项指标减低显著加重 ,并出现迷走 -交感神经的联合损害 ,心脏自主神经活动的昼夜节律改变丧失。Objective To evaluate the relationship between microalbuminuria(MAU) and cardiac autonomic neuropathy in diabetes.Methods The urinary albumin excretion (UAE) was measured,and the cardiac autonomic function was detected using 24 hour ambulatory ECG spectral analysis of heart rate variability (HRV) in 46 patients with diabetes and 31 normal control subjects.Results Parameters of time and frequency domain of HRV were reduced in patients with diabetes.The high frequency at night reflecting the cardiac vagus nerve function was significantly lower in diabetic patients than control group.In diabetic patients with MAU,the detected values of HRV were significantly decreased,combined vagosympathetic impairment occurred,and 24 hour rhythm from day to night in autonomic nervous activity disappeared.Conclusion MAU in diabetes is related with HRV.

关 键 词：糖尿病 微白蛋白尿 心率变异性 

分 类 号：R587.1[医药卫生—内分泌]