糖尿病合并阵发性心房颤动心率变异性分析  

Analysis of heart rate variability in diabetic patients with paroxysmal atrial fibrillation

作　　者：黄静和 许研 陈思敏[1] 翟南江[1] Huang Jing-he;Xu Yan;Chen Si-min;Zhai Nan-jiang(Department of Ultrasound Electrocardiogram,Guangdong Second Provincial General Hospital,Guangzhou Guangdong 510317;Department of Internal Medicine,Guangzhou Care Health Management Center,Guangzhou Guangdong 510530,China)

机构地区：[1]广东省第二人民医院超声科心电图室,广东广州510317 [2]广州市干部健康管理中心内科,广东广州510530

出　　处：《实用心电学杂志》2020年第3期173-176,共4页Journal of Practical Electrocardiology

基　　金：广东省医学科学技术研究基金资助项目(A2019132)。

摘　　要：目的分析糖尿病合并阵发性心房颤动患者的心率变异性特点。方法选取26例2型糖尿病合并阵发性心房颤动患者(房颤组)以及50例糖尿病未合并阵发性心房颤动病例(对照组)作为观察对象。对比分析2组患者心率变异性各指标,具体包括窦性R-R间期的标准差(SDNN),相邻R-R间期差的均方(r MSSD),连续5 min窦性R-R间期均值标准差(SDANN),相邻窦性R-R间期差值> 50 ms的百分比(PNN50),低频成分(LF),高频成分(HF),低频与高频比值(LF/HF)。结果房颤组r MSSD、PNN50以及HF分别为(50. 9±21. 8) ms、(22. 5±13. 9)%、704. 0±157. 7,均明显高于对照组[(25. 5±9. 5) ms,(5. 9±6. 9)%以及132. 3±10. 9,P均<0. 05];房颤组LF/HF值(0. 65±0. 0)明显小于对照组[(2. 1±0. 2),P <0. 05];LF/HF <1诊断糖尿病患者合并阵发性心房颤动的敏感性为84. 6%,特异性为80. 0%,ROC曲线下面积为0. 823 (95%CI:0. 720~0. 926,P=0. 000)。结论糖尿病患者LF/HF <1在一定程度上可以预测阵发性心房颤动的发生。评估糖尿病患者心率变异性,有助于心律失常的诊断和预防。Objective To investigate the characteristics of heart rate variability in diabetic patients with paroxysmal atrial fibrillation.Methods Twenty-six cases of type 2 diabetic patients with paroxysmal atrial fibrillation were selected as case group while fifty cases of type 2 diabetic patients without paroxysmal atrial fibrillation were selected as control group.Heart rate variability indexes including standard deviation of sinus R-R interval(SDNN),root mean square of the successive normal sinus R-R interval difference(rMSSD),standard deviation of the average normal 5-minute R-R interval(SDANN),the percentage of differences between adjacent normal R-R intervals more than 50 ms(PNN50),low frequency(LF),high frequency(HF),and the ratio of low frequency to high frequency(LF/HF)were analyzed between the two groups.Results The rMSSD,PNN50 and HF of case group were larger than the control group[(50.9±21.8)ms vs.(25.5±9.5)ms,(22.5±13.9)%vs.(5.9±6.9)%and(704.0±157.7)vs.(132.3±10.9)].The LF/HF of case group was smaller than that of the control group[(0.65±0.0)vs.(2.1±0.2),P<0.05].The sensitivity and specificity of LF/HF<1 in the diagnosis of paroxysmal atrial fibrillation in diabetic patients were 84.6%and 80.0%respectively,and the area under the ROC curve was 0.823(95%CI:0.720-0.926,P=0.000).Conclusions LF/HF<1 in diabetic patients can predict the occurrence of paroxysmal atrial fibrillation to a certain extent.The assessment of heart rate variability is helpful for the prevention and detection of arrhythmia in diabetes.

关 键 词：糖尿病 阵发性心房颤动 心率变异性 

分 类 号：R540.41[医药卫生—心血管疾病]