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2型糖尿病患者糖尿病自主神经病变中校正QT间期的临床实用性。

Clinical usefulness of corrected QT intervals in diabetic autonomic neuropathy in patients with type 2 diabetes.

作者信息

Takebayashi K, Aso Y, Sugita R, Takemura Y, Inukai T

机构信息

Department of Medicine, Koshigaya Hospital, Dokkyo University School of Medicine, Japan.

出版信息

Diabetes Metab. 2002 Apr;28(2):127-32.

Abstract

BACKGROUND

It is recognized that QTc intervals reflect autonomic nerve function. To investigate the clinical usefulness of corrected QT intervals (QTc) in assessing autonomic nerve function in type 2 diabetes, we measured QTc intervals using Bazett's formula in 58 type 2 diabetic patients and 20 age-matched healthy subjects.

METHODS

We examined relationships between QTc intervals and the coefficient of variation of RR intervals (CV(RR)), systolic blood pressure response to standing, and sympathetic skin response (SSR) whose tests reflect autonomic nerve function. We also studied the correlation between QTc and blood pressure or serum lipid concentrations.

RESULTS

QTc intervals in diabetic patients were significantly longer than those in healthy subjects and showed a significant but weak negative correlation with CV(RR), as well as systolic blood pressure response to standing. No significant difference in QTc intervals was observed between patients with and without a detectable SSR. QTc intervals showed a significant positive correlation with systolic and diastolic blood pressure although it did not correlate with serum lipid concentrations. QTc also tended to be long in obese diabetic subjects (body mass index > 25).

CONCLUSION

QTc intervals might also be affected by other factors such as arteriosclerotic macroangiopathy and obesity, and not only autonomic nerve function. Therefore it might be considered as an overall index for complications, and not for pure autonomic impairment.

摘要

背景

已知QTc间期反映自主神经功能。为研究校正QT间期(QTc)在评估2型糖尿病患者自主神经功能中的临床实用性,我们使用巴泽特公式对58例2型糖尿病患者和20例年龄匹配的健康受试者测量了QTc间期。

方法

我们研究了QTc间期与RR间期变异系数(CV(RR))、站立时收缩压反应以及反映自主神经功能的交感皮肤反应(SSR)之间的关系。我们还研究了QTc与血压或血脂浓度之间的相关性。

结果

糖尿病患者的QTc间期显著长于健康受试者,且与CV(RR)以及站立时收缩压反应呈显著但较弱的负相关。在有或无可检测到的SSR的患者之间,QTc间期未观察到显著差异。QTc间期与收缩压和舒张压呈显著正相关,尽管它与血脂浓度无关。肥胖糖尿病患者(体重指数>25)的QTc也往往较长。

结论

QTc间期可能还受动脉粥样硬化大血管病变和肥胖等其他因素影响,而不仅是自主神经功能。因此,它可能被视为并发症的综合指标,而非单纯自主神经损害的指标。

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