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.