【摘要】 目的:研究糖尿病人植物神经病变与心率变异的关系。对象:正常对照组和根据临床有无糖尿病植物神经病变(DAN)分组的糖尿病人。方法:应用24小时动态心电图对正常组和糖尿病人进行心率变异的线性、非线性散点图和非线性定量参数分析。结果:单纯糖尿病组SDNN、SDANN和PNN50低于正常组(P<0.05);糖尿病+DAN组各项线性时域分析指标均低于正常和单纯糖尿病组(P<0.01—0.001)。散点图分析结果:正常组多呈彗星状、单纯糖尿病组多呈鱼雷状图形、糖尿病+DAN组多呈短棒状态图形。非线性定量参数中单纯糖尿病组向量角度指数(VAI)、散点分布面积和短轴比正常组明显降低(P<0.05),糖尿病+DAN组向量长度指数(VLI)、VAI、散点分布面积、长轴和短轴比正常组和单纯糖尿病组明显降低(P<0.001～P<0.01)。提示心率变异的各项指标与临床DAN症状有较好的相符性,同时非线性定量参数能较好地反映自主神经的调节状态且个体差异小,有望成为诊断DAN的客观指标。更多还原

【Abstract】 The time domain: nonlinear Poincare plot and nonlinear quantitative analyysis of heart rate variability were studied from 24 - hours ambulatory electrocardiogram in 22 diabetic patients without diabetic autonomic neuropathy (DAN) (Group DAN - ), 18 diabetic patients with DAN (Group DAN+)and 30 healthy controls (Group C).The results showed that SDDNN.SDANN and PNN50 were markly decreased in Group DAN -compared with Group C(P<0. 05). In Group DAN+ the indidcators of all heart rate variability in time Domain were decreased obviously compared with Group C and Group DAN-(P<0.01-0. 001). nonlinear studying,Group C showed a comet -shaped Poincare Plot patterns. Most subjects in Group DAN -exhibit a torpedo-shaped Poincare plot patterns and thd majority of Group DAN+ had a short stick - shaped Poincare plot patterns. The results of nonlinear quantitative analysis presented that vector angle index ( VAI) : short axis and area of plot in Group DAN -were lower than that in Group C. The indices of vector length index(VLI), VAI,long axis,short axis and area of plot in Group DAN+ were much lower than that in Group C and Group DAN- (P<0. 01~P<0. 001).The results indicated that the heart rate variability has a good relationship with diabetic autonomic neuropathy in clinical and have a hope to become the effective objective diagnosis standard. Also the analysis of nonlinear heart rate variability can help to predict the risk stratification in diabetes.更多还原