2型糖尿病周围神经病变患者心率变异性与颈内动脉内膜厚度相关性研究  

Correlation study of heart rate variability and carotid intima-media thickness in patients with type 2 diabetes and peripheral neurpathy

作　　者：虞春宜[1] 

机构地区：[1]三峡大学第一临床医学院宜昌市中心人民医院心电图室,湖北宜昌443003

出　　处：《中国医药导报》2015年第4期99-102,共4页China Medical Herald

摘　　要：目的探讨2型糖尿病合并周围神经病变患者心率变异性(HRV)与颈内动脉内膜厚度(IMT)的相关性。方法随机选择138例2型糖尿病患者,根据是否合并周围神经病变分为2型糖尿病组(DM组,n=62)和2型糖尿病周围神经病变组(DPN组,n=76)。进行24 h动态心电图及颈动脉多谱勒超声检查,并对其HRV相关指标与IMT进行相关性分析。结果 DPN组糖化血红蛋白(Hb A1c)[(5.9±2.6)%]明显高于DM组[(4.8±1.9)%],差异有高度统计学意义(P<0.01);DPN组IMT[(1.4±0.4)mm]明显高于DM组[(0.9±0.3)mm],差异有高度统计学意义(P<0.01);HRV时域参数比较:正常相邻窦性心搏间期的标准差[(96.0±32.8)ms]、24 h全程监测记录中每5分钟窦性心搏平均值的标准差[(94.0±22.2)ms]、24 h全程监测记录中每5分钟的N-N间期标准差[(44.3±15.2)ms]、相邻N-N间期差值的均方根值[(18.6±6.5)ms]均明显低于DM组[(120.0±21.4)、(115.0±19.8)、(62.5±23.8)、(23.8±6.6)ms],差异均有高度统计学意义(均P<0.01)。在DPN组患者中,校正Hb A1c等影响后,IMT与HRV相关参数呈负相关(r=-0.31、-0.25、-0.30、-0.34,均P<0.01)。在DM组患者中,IMT与HRV相关参数无明显相关性(P>0.05)。结论2型糖尿病合并周围神经病变患者IMT显著增高,HRV则显著降低,并且IMT与HRV是密切相关的。故IMT和HRV可以作为评价2型糖尿病患者其心血管事件危险程度的重要参考指标,并对其预后有重要临床参考价值。Objective To discuss the correlation of heart rate variability（HRV） and carotid intima-media thickness（IMT） in patients with type 2 diabetes and peripheral neurpathy. Methods 138 cases of patients with type 2 diabetics were divided into type 2 diabetics group（DM group, n=62） and type 2 diabetics peripheral neuropath group（DPN group,n = 76） according to whether combined with peripheral neuropathy. All were given 24 hours dynamic electrocardiogram and carotid artery Doppler ultrasound examinati-on, the correlation between HRV and IMT was analyzed. Results Glycated hemoglobin（Hb A1c） of the DPN group [（5.9±2.6）%] was significantly higher than that of the DM group [（4.8 ±1.9）%], the difference was statistically significant（P 0.01）; IMT of the DPN group [（1.4±0.4） mm] was significantly higher than that of the DM group [（0.9±0.3） mm], the difference was statistically significant（all P 〈0.01）. HRV time domain parameter comparisom： in the DPN group, standard deviation of all normal to normal R-R intervals [（96.0 ±32.8） ms],standard deviation of all means 5-minute R-R intervals [（94.0±22.2） ms], mean of the standard deviation of all 5-min segments of 24 hour [（44.3±15.2） ms], the root mean square of successive differences between adjacent normal cycles[（18.6 ±6.5） ms] were significantly lower than those of the DM group [（120.0 ±21.4）,（115.0 ±19.8）,（62.5 ±23.8）,（23.8 ±6.6） ms], the differences were statistically significant（P 0.01）. But in the patients of the DPN group, after adjusting the impact of Hb A1 c, IMT showed a negative correlation with HRV parameters（r=-0.31,-0.25,-0.30,-0.34, all P〈 0.01）. In DM group, there was no significant correlation between IMT and HRV parameters（P 〉0.05）. Conclusion In patients with type 2 diabetes peripheral neuropathy, the IMT is significantly increased, and HRV is significantly reduced, and IMT are closely associated with HRV. IMT and HRV can be used as a cardiovascular event in

关 键 词：2型糖尿病 周围神经病变 心率变异性 颈动脉内膜厚度 相关性 

分 类 号：R587.1[医药卫生—内分泌]