摘要
目的:探讨动态心电图相关检测指标对2型糖尿病(T2DM)患者心脏自主神经病变(DCAN)的评估价值。方法:选取2020年1月~2021年8月弋矶山医院内分泌科收住的T2DM患者82例,根据Ewing评分将患者分为心脏自主神经功能正常[DCAN(-)]组和病变[DCAN(+)]组,比较两组患者基线资料及动态心电图指标的差异,采用多因素Logistic回归模型分析T2DM患者自主神经病变的相关影响因素,运用ROC曲线评价动态心电图指标对T2DM患者自主神经病变的诊断效能。结果:DCAN(+)组患者病程时间长于DCAN(-)组(P<0.05),24 h平均心率高于DCAN(-)组(P<0.05),而心率变异性(HRV)时域指标(SDNN、SDANN和pNN50)、HRV频域指标(VLF和LF)、Lorenz散点图指标长轴(L)及心率减速力(DC)均低于DCAN(-)组(P<0.05)。多因素Logistic回归分析显示,病程时间延长(OR=1.008,95%CI:1.002~1.014)是T2DM病人患DCAN风险的危险因素,而pNN50(OR=0.908,95%CI:0.833~0.990)和DC值(OR=0.561,95%CI:0.328~0.960)升高是DCAN风险的保护因素(P<0.05)。ROC曲线显示动态心电图pNN50、DC联合病程时间对T2DM患者DCAN具有较好的诊断效能。结论:动态心电图相关指标可作为评估T2DM患者发生DCAN的有效方法。
Objective:To assess the value of dynamic electrocardiogram(ECG)-related detection indexes in estimating diabetic cardiac autonomic neuropathy(DCAN) in patients with type 2 diabetes mellitus(T2 DM).Methods:Eighty-two patients of T2 DM treated in the Department of Endocrinology of our hospital were included from January 2020 to August 2021,and divided into DCAN(-) group and DCAN(+) group by Ewing scoring.The differences were compared between groups pertinent to the baseline data and ECG-related indexes.Logistic regression model was used to analyze the related factors affecting DCAN. ROC curve was plotted to evaluate the diagnostic efficacy of DCG-related indexes in DCAN. Results: There were significant differences in course time,average heart rate,24h mean heart rate,SDNN,pNN50,VLF,LF,heart rate decelerating force( DC) and long axis L between DCAN(-) and DCAN( +) groups( all P<0. 05).Logistic regression analysis revealed that prolonged course of disease( OR = 1. 008,95% CI: 1. 002-1. 014) was the factors for risks of DCAN in T2DM patients,whereas elevated p NN50( OR = 0. 908,95% CI: 0. 833-0. 990) and DC values( OR =0. 561,95%CI: 0. 328-0. 960) were protective factors for DCAN.The ROC curve indicated that the combined disease duration of DCG index pNN50 and DC had good diagnostic efficacy for DCAN in T2DM patients.Conclusion: DCG indexes can be effective approach to estimating DCAN in T2DM patients.
作者
杨涛
丁昆
俞蓓蓓
樊紫青
周文娇
华强
孟祥健
孔祥
YANG Tao;DING Kun;YU Beibei;FAN Ziqing;ZHOU Wenjiao;HUA Qiang;MENG Xiangjian;KONG Xiang(Department of Electrophysiology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)
出处
《皖南医学院学报》
CAS
2022年第4期340-343,共4页
Journal of Wannan Medical College
基金
国家自然科学基金项目(81600645)
弋矶山医院三新项目(Y20027)。
关键词
动态心电图
2型糖尿病
心率变异性
自主神经病变
dynamic electrocardiogram
Type 2 diabetes mellitus
heart rate variability
autonomic neuropathy
