摘要
目的分析2型糖尿病中影响心血管自主神经病变(CAN)的危险因素,探讨这些因素对 CAN 的危害程度,并建立回归模型。方法 325例2型糖尿病患者根据心血管自主神经功能试验结果分为:正常组、早期病变组、确诊组和严重组。对所有患者询问病史、体格检查、生化检查及ECG、神经传导速度、眼底镜检查、颈动脉和下肢动脉 Doppler 检查。结果 64.0%的病人存在自主神经病变,30.2%确诊为 CAN;相关指标随自主神经病变程度加重而恶化;等级回归显示,年龄、平均糖化血红蛋白、高血压、周围神经病变、视网膜病变、静息心动过速和周围神经病变病程是显著影响因素(P<0.05);根据这些因素,建立数学模型,可推算患者自主神经病变的病情。结论除年龄和血压外,其他自主神经病变的影响因素都与血糖有关,进一步证实控制血糖是预防糖尿病并发症的首要因素。
Objective Risk factors for diabetic cardiovascular autonomic neuropathy （CAN） in patients with type 2 diabetes were analyzed to establish a regression model for evaluating the diagnosis of CAN. Methods 325 patients with type 2 diabetes were divided into four groups according to the results of four standard function tests. Every patient was required to offer detailed disease history and accept physical examination, serum and urine tests and examinations including ECG, nerve conduction velocity, retinoscope and Doppler of carotid and lower limb arteries. Results 64. 0% of the patients had abnormal autonomic function and 30. 2% definite CAN. There was significant difference among groups about age, average glycosylated forms of hemoglobin （HbAlc）, systolic blood pressure, corrected 24 h albumin excretion and heart rate at rest （P 〈 0. 001 ）. The incidence of diabetic complications and accompanying diseases increased with deterioration of CAN （P 〈 0.05 ）. The regression model showed that age, average HbAlc, hypertension, peripheral neuropathy, retinopathy, tachycardia at rest and duration of peripheral neuropathy were significant related factors for CAN. With these factors, a mathematic formula was established which could be used for evaluating the diagnosis of CAN. Conclusion Except for age and hypertension, risk factors were all induced by hyperglycemia. It is suggested that control of hyperglycemia is of primary importance in preventing diabetic complications.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2006年第10期815-819,共5页
Chinese Journal of Internal Medicine
