【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。更多还原

【Abstract】 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( r MSSD),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 r MSSD,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.更多还原