摘要
目的探讨糖尿病、高血压、血脂紊乱对心率变异性(HRV)的影响。方法对单纯33例糖尿病、30例高血压及76例血脂紊乱患者,进行24h HRV时域、频域分析,同时与34例无明显临床疾病、肥胖或超重及血脂异常的正常成人进行HRV的差异比较。结果1.糖尿病和高血压组与正常组比较HRV各指标除FL/HL均降低(P<0.05);血脂异常组HRV各指标除FL/HL也均低于正常组,但仅HF有统计学差异(P<0.05)。2.血脂异常组与糖尿病及高血压组比:反映交感神经张力的SDNN,SDANN,SDNN index,LH均降低(P均<0.05),而反映迷走神经张力的RMSSD、PNN50及HF也降低,仅糖尿病与血脂异常组HF有统计学意义(P<0.05);3.糖尿病组HRV各指标均低于高血压组,但无统计学差异。校正年龄、性别、吸烟、W c,SBP,DBP,FPG,UA,FATc,Tc,TG,HDL-c,LDL-c后上述差异仍存在。结论糖尿病、高血压与血脂异常、正常人间存在HRV差异。糖尿病和高血压血脂紊乱HRV各指标减低,提示存在交感神经活性增加,迷走神经活性降低,自主神经的功能紊乱可能是糖尿病、高血压血脂紊乱患者心血管事件增加的原因之一。
Objective To study the effects of diabetes mellitus （ DM）, essential hypertension （EH） and dyslipoidoses on heart rate variability （HRV） and to explore the predictive index of cardiovascular diseases. Methods The 24h time domain and 24h frequeney domain of HRV were analyzed in 34 healthy adults, 33 patients with simple DM and 30 patients with EH. Results （ 1 ） The indexes of HRV except LF/HF in the normal group were higher than that in DM and EH （P 〈 0. 05） . The index of HRV except LF/HF were lower in dyslipoidoses than normal group, but only HF was significantly （P 〈0. 05） ; （2） The HRV indices reflecting sympathetic function, such as SDNN, SDANN, SDNN index and LH were significantly lower in DM and EH than dyslipoidoses （P 〈0. 05）, and the HRV indices reflecting parasympathetic function, such as RMSSD, PNN50 and HF were decreased, but only the lowering of HF was significantly （P 〈0. 05） in DM and dyslipoidoses; （3） All HRV were lower in DM than EH （P 〉0.05） . After adjusting confounding effects of age, gender, smoking, WHR, SBP, and DBP by analysis of covariance, the statistical differences of HRV in the groups were existed as before. Conclusion HRV is different among the patients with DM, EH, dyslipoidoses and the normal. DM and EH could decrease the index of HRV. It suggests the increasing of sympathetic activity and decreasing of parasympathetic activity. The effects of dyslipoidoses on autonomic nervous function may be a factor contributing to increase cardiovascular event. The changes of HRV in simple dyslipoidosc are less serious than in the DM and EH, only the injuring of parasympathetic function.
出处
《云南医药》
CAS
2006年第3期210-214,共5页
Medicine and Pharmacy of Yunnan
基金
云南省教育厅资助
(02ZD25)
关键词
糖尿病
高血压
血脂紊乱
心率变异
自主神经功能
Diabetes mellitus
Hypertention
Dyslipoidoses
Heart rate variability
Autonomic nervous function
作者简介
杨秋萍（1964-）女，云南昆明人，副教授，主要从事内分泌代谢病的临床工作及研究。
