2型糖尿病患者心脏自主神经病变的影响因素  

Influencing factors for cardiac autonomic neuropathy in patients with type 2 diabetes mellitus

作　　者：吴利 朱红 曹长春 王双 王茜茜 魏晟光 李茜 江亚龙 吴研哲 WU Li;ZHU Hong;CAO Changchun;WANG Shuang;WANG Xixi;WEI Shengguang;LI Qian;JIANG Yalong;WU Yanzhe(Department of Endocrinology,the Affiliated Suqian Hospital of Xuzhou Medical University,Suqian 223800,Jiangsu,China;Department of Clinical Nutrition,the Affiliated Suqian Hospital of Xuzhou Medical University,Suqian 223800,Jiangsu,China;School of Clinical Medicine,Chengde Medical University,Chengde 067050,Hebei,China)

机构地区：[1]徐州医科大学附属宿迁医院(南京鼓楼医院集团宿迁医院)1内分泌科,江苏省宿迁市223800 [2]徐州医科大学附属宿迁医院(南京鼓楼医院集团宿迁医院)临床营养科,江苏省宿迁市223800 [3]承德医学院临床医学系,河北省承德市067050

出　　处：《广西医学》2025年第1期61-65,共5页Guangxi Medical Journal

基　　金：宿迁市指导性科技计划项目(Z2019159);宿迁市科技项目(S202113)。

摘　　要：目的探讨2型糖尿病(T2DM)患者发生心脏自主神经病变(CAN)的影响因素。方法选取351例T2DM患者作为研究对象,根据心血管自主神经反射试验结果分为CAN组(n=135)和非CAN组(n=216)。比较两组一般临床资料、实验室指标、人体成分分析指标。采用多因素Logistic回归模型分析T2DM患者发生CAN的影响因素。结果351例T2DM患者中有135例患者发生CAN,发生率为38.46%。与非CAN组相比,CAN组患者的年龄更高、收缩压更高、糖尿病病程更长、甘油三酯水平更低、HbA1c水平更高、骨骼肌质量(SMM)更低、高血压病史比例更高(P<0.05)。多因素Logistic回归分析结果显示,高龄、高收缩压、HbA1c水平升高、SMM降低的T2DM患者发生CAN的风险越高(P<0.05)。结论T2DM患者CAN发生率较高,且年龄越高、收缩压越高、HbA1c水平越高、SMM越低的患者,越容易发生CAN。Objective To explore the influencing factors for patients with type 2 diabetes mellitus(T2DM)suffering from cardiac autonomic neuropathy(CAN).Methods A total of 351 T2DM patients were selected as the research subjects,according to the results of cardiovascular autonomic reflex test,they were assigned to CAN group(n=135)or non-CAN group(n=216).General clinical data,laboratory indices,body composition analysis indices were compared between the two groups.The multivariate Logistic regression model was employed to analyze the influencing factors for T2DM patients suffering from CAN.Results A total of 135 patients suffered from CAN among 351 T2DM patients,resulting in the incidence rate of 38.46%.Compared with the non-CAN group,the CAN group exhibited higher age,systolic blood pressure,and a longer disease course of diabetes mellitus,a lower triglyceride level,a higher HbA1c level,lower skeletal muscle mass(SMM),as well as a higher proportion of hypertension history(P<0.05).The results of multivariate Logistic regression analysis revealed that T2DM patients with advanced age,high systolic blood pressure,elevated HbA1c level,decreased SMM had a higher risk of suffering from CAN(P<0.05).Conclusion The incidence rate of T2DM patients suffering from CAN is high,patients with more advanced age,higher systolic blood pressure,higher HbA1c level,and lower SMM more easily suffer from CAN.

关 键 词：2型糖尿病 心脏自主神经病变 心血管自主神经反射试验 人体成分分析 影响因素 

分 类 号：R587.1[医药卫生—内分泌]