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目的探讨中青年初发2型糖尿病患者窦性心率震荡(HRT)的可能变化及其临床意义。方法选择初发室性期前收缩(VPB)的中青年2型糖尿病患者76例(糖尿病组),有VPB的健康人76例作为对照组。两组均行24h动态心电图(DCG)检查,分析单次VPB后HRT的初始值(TO)、斜率(TS)以及TO和TS异常的发生率。结果糖尿病组TO、TS值明显异常,与对照组比较均有显著性差异(p<0.01);糖尿病组TO及TS异常发生率分别为35.3%和38.2%,而对照组分别为7.9%和5.3%,糖尿病组TO、TS值异常率较对照组明显升高,差异有显著性意义(p<0.01)。结论初发青中年2型糖尿病患者HRT现象明显减弱,同时HRT异常率明显增高。临床上HRT可作为青中年初发2型糖尿病自主神经病变的预测指标。
Objective To explore the possible changes and clinical significance of sinus rhythm heart rate turbulence (HRT) in middle-aged and early-onset type 2 diabetic patients. Methods 76 patients with type 2 diabetes mellitus (diabetic group) and 76 healthy persons with VPB were selected as the control group. 24h ambulatory electrocardiogram (DCG) examination was performed in both groups, and the initial value (TO), slope (TS), and the incidence of TO and TS abnormalities after single VPB were analyzed. Results The values of TO and TS in diabetic group were significantly different from those in control group (p <0.01). The incidences of TO and TS abnormalities in diabetic group were 35.3% and 38.2%, while those in control group were 7.9% and 5.3%, respectively %, The abnormal rate of TO, TS in diabetic group was significantly higher than that in control group, the difference was significant (p <0.01). Conclusion The onset of middle-aged patients with type 2 diabetes mellitus significantly reduced the HRT phenomenon, at the same time HRT abnormal rate was significantly higher. Clinically, HRT can be used as a predictor of type 2 diabetic autonomic neuropathy in early-middle-aged patients.