摘要
目的：探讨高血压合并2型糖尿病患者心率震荡现象的变化及其临床意义。方法：选择我院心内科收治的原发性高血压合并2型糖尿病患者60例（I组），单纯原发性高血压患者50例（II组），另选择同期健康体检者40例作为对照（III组）。三组均行24h动态心电图（DCG）监测，分析单次室性期前收缩（PVS）后HRT的初始值（TO）、斜率（TS）、震荡斜率起始时间（TT）以及心率变异的参数SDNN，比较三组之间各指标的差异。结果：按III组-II组-I组的顺序，TO呈逐渐增高趋势，而TS、SDNN则呈降低趋势，三组间比较存在显著差异（P〈0．05）。而三组间TT均无显著差异（P〉0．05）。高血压合并2型糖尿病患者的T0与SDNN均呈负相关（r=-0．547，P〈0．05）；TS与SDNN呈正相关（r=0．695，P〈0．01）；而TT与SDNN无明显相关性。结论：高血压合并2型糖尿病患者的HRT明显减弱，自主神经功能受损更严重。HRT可作为判断高血压合并2型糖尿病患者预后的重要心电指标。
Objective：To investigate the variations and clinical implications of heart rate turbulence（HRT） parameters among pa- tients with essential hypertension （EH） accompanied with diabetes mellitus. Methods：The total of 60 patients with EH accompanied with T2DM, 50 patients with EH and 40 control subjects were investigated. Turbulenee onset （TO）, turbulence slope （TS）, turbulence timing （TT） and SDNN were measured by using recorded 24 hours dynamic electrocardiogram. The differences among them were compared,and the correlation between them was analyzed. Resuhs：From III group,II group to I group,TO.showed significantly high and TS,SDNN showed significantly low.There were significantly differently among three groups （P〈0.05）.Bnt TT was no significantly differently among three groups （P 〉 0.05 ）. There, were significant correlations between TO and SDNN（r=-0.547, P〈0.05）, TS and SDNN （r=-0.695,P〈0.01）.Conclusion：HRT in patients with EH accompanied with T2DM are significantly abnormal,suggesting evidenced damage to autonomic nerve function in this condition. HRT can be a important Index of ECG to assess the nrognosis of patients with EH accompanied with T2DM.
关键词
高血压
2型糖尿病
动态心电图
心率震荡
Hypertensin
type 2 diabetes mellitus
24 hours dynamic electrocardiogram
Sinus heart rate turbulence
