| 摘要: |
| 目的 探讨2型糖尿病患者冠状动脉狭窄程度与心率变异性（HRV）下降的关系。方法 按性别分层随机选取2型糖尿病合并重度冠状动脉狭窄患者（冠脉动脉造影提示单支或多支血管狭窄≥75%）（A组）、2型糖尿病合并中度冠状动脉狭窄患者（冠状动脉造影提示≥50%狭窄）（B组）和2型糖尿病无或合并轻度冠状动脉粥样硬化患者（CTA提示冠状动脉无或轻度狭窄，运动平板阴性，C组）患者共90例，每组30例。回顾3组患者冠状动脉造影或冠状动脉CTA扫描前6个月内的24h动态心电图检查结果，比较、分析3组的HRV时域指标（SDNN、SDANN、rMSSD及pNN50）及频域指标（VLF、LF、HF及LF/HF）。结果A组、B组和C组的SDNN值、SDANN值分别为（105.57±28.20）、(126.24±26.11）、（144.91±25.52）ms，（89.77±25.81）、（102.09±30.32）、（126.13±27.48）ms，3组间的差异均有统计学意义（均P＜0.05）。线性趋势字2检验显示SDNN和SDANN值下降程度与冠状动脉狭窄程度呈线性相关（P＜0.01）。此外，rMSSD和pNN50在B组与C组间的差异有统计学意义（P＜0.05），LF/HF在A组与C组间的差异有统计学意义（P＜0.05）。结论2型糖尿病患者冠状动脉狭窄程度越重，HRV指标的SDNN、SDANN值越小，在中重度冠状动脉狭窄患者中rMSSD、pNN50同时降低，反映HRV时域指标将来可能成为预测冠状动脉狭窄程度的指标。 |
| 关键词: 心率变异性 冠心病 2 型糖尿病 自主神经系统 24h 动态心电图 |
| DOI： |
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| Association between severity of coronary stenosis and heart rate variability in patients with type 2 diabetes |
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WANG Qijun, WU Tianfeng, YUAN Fang, JIANG Ying, HUANG Hong, ZHENG Hexin, RUAN Yuan, WANG Shaoguan
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Zhejiang Hospital
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| Abstract: |
| Objective To evaluate the relationship between the severity of coronary stenosis and heart rate variability (HRV). Methods Thirty patients with severe coronary stenosis (≥75%)(group A), 30 patients with moderate coronary stenosis (≥50%)(group B) and 30 patients with mild or no coronary stenosis(group C) were recruited in the study. The dynamic electro- cardiogram results, including time-domain HRV parameters SDNN, SDANN, rMSSD and pNN50, and frequency-domain HRV parameters VLF, LF, HF and LF/HF 6 months before coronary angiogram or CT scan were retrospectively analyzed. Results SDNN had a linear trend of decline in group A, group B and group C [(105.57±28.20), (126.24±26.11), (144.91±25.52)ms, P＜0.05], SDANN had a linear trend of decline in groups A, B and C [(89.77±25.81),(102.09±30.32), (126.13±27.48)ms, P＜ 0.05]. The severity of coronary stenosis showed a trend of increase with SDNN and SDANN declining (P＜0.01). The difference of rMSSD and pNN50 between group B and group C was statistically significant (P＜0.05). The difference of LF/HF between group A and group C was statistically significant (P＜0.05). Conclusion The severity of coronary stenosis is negatively corre- lated with SDNN and SDANN values in patients with type 2 diabetes; rMSSD and pNN50 values are decreased in patients with severe and moderate coronary stenosis, which indicating that time parameters of HRV may be used as the predictors of coro- nary stenosis. |
| Key words: Heart rate variability Coronary heart disease Type 2 diabetes Autonomic nervous system Dynamic electrocardiogram |
