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目的探讨冠心病合并糖尿病患者的心率变异性及其临床价值。方法应用24h动态心电图对86例冠心病合并糖尿病患者进行HRV分析,并与68例正常对照者比较。结果冠心病合并糖尿病患者HRV的时域和频域指标即SDNN、SDANNI、SDNN—index(ms)rMSSD(ms)PNN(%)较对照组明显降低(P<0.01)。冠心病合并糖尿病患者心律失常及心肌缺血发生率均明显高于对照组(P<0.05)。结论冠心病合并糖尿病患者存在心脏自主神经失调,HRV明显降低,心律失常发生率明显增高,易于发生严重心血管事件。心率变异性可以作为早期发现冠心病合并2型糖尿病患者心脏植物神经损害的一个有效的无创方法。
Objective To investigate the heart rate variability and its clinical value in patients with coronary heart disease complicated with diabetes mellitus. Methods 24h dynamic electrocardiogram was used to analyze the HRV of 86 patients with coronary heart disease complicated with diabetes and compared with 68 normal controls. Results The time and frequency indices of HRV in patients with coronary heart disease complicated with diabetes mellitus (SDNN, SDANNI, SDNN-index (ms) rMSSD (ms) PNN) were significantly lower than those in the control group (P <0.01). The incidence of arrhythmia and myocardial ischemia in patients with coronary heart disease complicated with diabetes mellitus was significantly higher than that in the control group (P <0.05). Conclusion There is autonomic dysfunction in patients with coronary heart disease complicated with diabetes mellitus, HRV was significantly reduced, the incidence of arrhythmia was significantly increased, prone to serious cardiovascular events. Heart rate variability can be used as an early detection of coronary heart disease complicated with type 2 diabetes in patients with autonomic nerve damage is an effective noninvasive method.