2型糖尿病患者心率变异性分析及依帕司他对其的影响  

Heart rate variability in patients with type 2 diabetes and the effect of epalrestat on cardiac autonomic neuropathy

作　　者：陶少平 杭宇 陈学峰 周蓓 TAO Shao-ping;HANG Yu;CHEN Xue-feng;et al(Department of Endocrinology, the Second Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241000, China)

机构地区：[1]皖南医学院第二附属医院内分泌科,安徽芜湖241000

出　　处：《中华全科医学》2018年第1期80-82,共3页Chinese Journal of General Practice

基　　金：安徽省临床医学应用技术项目(06B003)

摘　　要：目的观察2型糖尿病患者心率变异性(HRV)改变的特征及依帕司他对其的影响。方法应用24 h动态心电图对2007年7月—2011年7月皖南医学院第二附属医院收治的46例2型糖尿病患者进行心率变异性分析,并与28例正常人进行比较。将46例2型糖尿病患者随机分为常规治疗组和依帕司他组;依帕司他组在常规治疗基础上加依帕司他治疗,观察治疗6个月后各组心率变异性时域和频域各项指标,时域指标包括24 h连续正常R-R间期的标准差(SDNN),24 h内每5 min正常R-R间期平均值的标准差(SDANN),全程相邻窦性心搏RR间期之差的均方根值(r MSSD),24 h内相邻的两个正常R-R间期差值>50 ms的个数占总心率数的百分比(PNN50);频域指标包括:低频功率(LF)、高频功率(HF)、低频与高频的比(LF/HF)的变化。结果 2型糖尿病患者心率变异性时域和频域各项指标与正常对照组相比,差异有统计学意义(P<0.01)。2型糖尿病常规治疗组治疗6个月后SDNN、SDANN、r MSSD、PNN50、LF、HF、LF/HF等各项指标与治疗前比较,差异无统计学意义(均P>0.05);而依帕司他组治疗6个月后HRV时域和频域各项指标与治疗前比较,差异有统计学意义(P<0.05)。结论 2型糖尿病患者HRV降低,自主神经功能受损;依帕司他可改善其自主神经功能。Objective To investigate the changes of heart rate variability（HRV） in patients with type 2 diabetes mellitus and the effects of epalrestat on HRV. Methods Twenty-four hour Holter monitoring was conducted in 46 type 2 diabetic patients and compared with that in 28 healthy controls. All the 46 type 2 diabetic cases were randomly divided into conventional treatment group and epalrestat group. The epalrestat group was given epalrestat in addition to conventional treatment. HRV was observed after 6 months. Indices of HRV, including time domain indices and frequency domain indices, were observed. The time domain indices were as follows： 24 h standard deviation of all normal to normal RR intervals （ SDNN）, standard deviation of 5 rain mean RR intervals （ SDANN ） , the square root of the mean of the sum of the squares of differences between adjacent NN intervals（rMSSD） , percentage of successive normal RR intervals exceeding 50 ms（pNNSO）. The frequency domain indices were as follow：LF, HF and LF/HF. Results There were significant difference in the time domain indices and frequency domain indices of HRV between healthy controls and type 2 diabetic patients（P 〈0. 01 ）. After 6 months of treatment, SDNN, SDANN, rMSSD, PNNSO, LF, HF and LF/H were not improve in the control group（P 〉 0. 05）, however, all the time domain indices and frequency domain indices in the epalrestat group were all significantly improved, the differences were statistically significant （ P 〈0. 05 ）. Conclusion The HRV decreases and the function of autonomic nervous system was impaired in patients with diabetic mellitus. Epalrestat may improve the function of autonomic nervous system in patients with diabetic patients.

关 键 词：2型糖尿病 心率变异性 依帕司他 

分 类 号：R587.1[医药卫生—内分泌] R540.41[医药卫生—内科学]