【摘要】 目的探讨2型糖尿病合并冠心病患者心率变异性及其昼夜节律的变化特征。方法选择30例糖尿病合并冠心病患者(A组),32例2型糖尿病患者(B组),另30例健康体检者作对照组(C组),分别行24 h动态心电图监测,分析其心率变异性时域指标和频域指标。比较三组间心率变异性指标的变化和2型糖尿病合并冠心病患者心率变异性昼夜时域指标变化。结果B组心率变异性的各项指标(全部正常R-R间期的标准差、正常相邻R-R间期差值的均方根、正常相邻R-R间期差值>50 ms的百分比和低频,高频)均较C组显著下降(P=0.0411,0.0169,0.0355,0.0440,0.0249);A组心率变异性的各项指标均显著低于C组(P=0.0001,0.0004,0.0001,0.0002,0.0002),也低于B组(P=0.0117,0.0337,0.0032,0.0416,0.0335),且昼夜时域指标变化差异无统计学意义(P=0.0701,0.0625,0.0637)。结论2型糖尿病患者合并冠心病时会显著加重其心脏自主神经功能损害,使心率变异性进一步降低,心率变异的昼夜节律消失,因此,2型糖尿病合并冠心病患者进行心率变异性分析有助于早期发现高危患者。更多还原

【Abstract】 Objective To investigate the heart rate variability(HRV) and its circadian rhythm in patients with type 2 diabetes mellitus(T2DM) complicated with coronary heart disease(CHD).Methods Thirty patients with T2DM complicated with CHD were classified as group A,32 patients with T2DM as group B and 30 healthy subjects as control group C.The 24 h time domain and frequency domain parameters were recorded by holter electrocardiogram(ECG).The parameters of HRV were compared in 3 groups and the day and night HRV in patients with T2DM complicated with CHD was also studied.Results The parameters of HRV of the patients in group B were significantly lower than those of the group C(all P<0.05).The parameters of HRV in group A were also significantly lower than those of the group B and C(all P<0.05),but there was no significant difference in the day and night HRV time domain parameters between the three groups(all P>0.05).Conclusion The cardiovascular autonomic nerve damage in patients with T2DM complicated with CHD is more severe than that of the patients with T2DM.In the patients with T2DM complicated with CHD,the parameters of HRV are lowered and the circadian rhythms are lost.Checking HRV in patients with T2DM complicated with CHD is helpful in the early discovery of high risk patients.更多还原