摘要
目的:采用基于24 h动态心电图分析2型糖尿病(T2DM)患者心率变异性(HRV)与肾功能的关系。方法:选取2020年1月─2022年1月于广东药科大学附属第一医院就诊并接受治疗的86例T2DM患者作为研究对象,根据疾病类型进行分类,41例合并糖尿病肾病(DN)患者纳入DN组,其余45例未合并DN患者纳入Non-DN组,另选取同期在医院接受健康体检的30例健康体检者作为对照组。采用24 h动态心电图检测三组正常窦性心律RR间期总体标准差(SDNN)、每5分钟正常RR间期均值标准差(SDANN)、相邻RR间期之差的均方根值(rMSSD)、相邻RR间期相差>50 ms的数量占总心搏数百分比(PNN50%)、超低频成分(ULF)、极低频成分(VLF)、低频成分(LF)、高频成分(HF)水平;采用Pearson相关性分析T2DM患者HRV与肾功能的关系。结果:三组SDNN、SDANN、rMSSD、PNN50%、ULF、VLF、LF、HF比较,差异有统计学意义(P<0.05);DN组、Non-DN组SDNN、SDANN、rMSSD、PNN50%、ULF、VLF、LF、HF均低于对照组,DN组SDNN、SDANN、rMSSD、PNN50%、VLF、LF、HF均低于Non-DN组,差异有统计学意义(P<0.05);但DN组、Non-DN组ULF比较,差异无统计学意义(P>0.05)。Pearson相关性分析显示,T2DM患者SDNN、rMSSD、PNN50%、LF、HF与eGFR呈正相关,SDNN、SDANN、PNN50%、VLF、LF与尿微量白蛋白/肌酐呈负相关(P<0.05)。结论:T2DM患者HRV各项参数降低情况与肾病进展密切相关。
Objective:To analyze the relationship between heart rate variability(HRV)and renal function in patients with type 2 diabetes mellitus(T2DM)based on 24 h dynamic electrocardiogram.Method:A total of 86 patients with T2DM who were received treatment in the First Affiliated Hospital of Guangdong Pharmaceutical University from January 2020 to January 2022 were selected as the study objects.According to the disease type,41 patients with diabetic nephropathy(DN)were included in the DN group,and the other 45 patients without DN were included in the Non-DN group,30 healthy subjects who received physical examination in the hospital during the same period were selected as the control group.The standard deviation of all normal-to-normal intervals(SDNN),normal RR interval mean per 5 minutes(SDANN),root mean square differences of successive R-R(rMSSD),percentage of total stroke numbers with a difference of>50 ms between adjacent R-R(PNN50%),ultra-low frequency(ULF),very low frequency(VLF),low frequency(LF)and high frequency(HF)in the three groups were detected by 24 h dynamic electrocardiogram.Pearson correlation analysis was conducted to analyze the relationship between HRV and renal function in patients with T2DM.Result:There were significant differences in SDNN,SDANN,rMSSD,PNN50%,ULF,VLF,LF and HF among the three groups(P<0.05).SDNN,SDANN,rMSSD,PNN50%,ULF,VLF,LF and HF in DN group and Non-DN group were lower than those in control group,SDNN,SDANN,rMSSD,PNN50%,VLF,LF and HF in DN group were lower than those in Non-DN group,the differences were statistically significant(P<0.05).However,there was no significant difference in ULF between DN group and Non-DN group(P>0.05).Pearson correlation analysis showed that SDNN,rMSSD,PNN50%,LF and HF were positively correlated with eGFR,while SDNN,SDANN,PNN50%,VLF and LF were negatively correlated with urinary microalbumin/creatinine in T2DM patients(P<0.05).Conclusion:The reduction of HRV parameters is closely related to the progression of nephropathy in patients with T2DM.
作者
金文敏
余瑾
JIN Wenmin;YU Jin(The First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510080,China;不详)
出处
《中外医学研究》
2023年第20期64-67,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
T2DM患者
心率变异性
肾功能
24
h动态心电图
Type 2 diabetes mellitus patient
Heart rate variability
Renal function
24 h dynamic electrocardiogram
