Popović-Pejicić Snjezana, Todorović-Dilas Ljiljana, Pantelinac Pavle
Kliniki centar Banja Luka.
Med Pregl. 2006 Mar-Apr;59(3-4):118-23. doi: 10.2298/mpns0604118p.
Diabetes is strongly associated with macrovascular complications, among which ischemic heart disease is the major cause of mortality. Autonomic neuropathy increases the risk of complications, which calls for an early diagnosis. The aim of this study was to determine both presence and extent of cardiac autonomic neuropathy, in regard to the type of diabetes mellitus, as well as its correlation with coronary disease and major cardiovascular risk factors.
We have examined 90 subjects, classified into three groups, with 30 patients each: those with type 1 diabetes, type 2 diabetes and control group of healthy subjects. All patients underwent cardiovascular tests (Valsalva maneuver, deep breathing test, response to standing, blood pressure response to standing sustained, handgrip test), electrocardiogram, treadmill exercise test and filled out a questionnaire referring to major cardiovascular risk factors: smoking, obesity, hypertension, and dyslipidemia.
Our results showed that cardiovascular autonomic neuropathy was more frequent in type 2 diabetes, manifesting as autonomic neuropathy. In patients with autonomic neuropathy, regardless of the type of diabetes, the treadmill test was positive, i.e. strongly correlating with coronary disease. In regard to coronary disease risk factors, the most frequent correlation was found for obesity and hypertension.
Cardiovascular autonomic neuropathy is considered to be the principal cause of arteriosclerosis and coronary disease. Our results showed that the occurrence of cardiovascular autonomic neuropathy increases the risk of coronary disease due to dysfunction of autonomic nervous system.
Cardiovascular autonomic neuropathy is a common complication of diabetes that significantly correlates with coronary disease. Early diagnosis of cardiovascular autonomic neuropathy points to increased cardiovascular risk, providing a basis for preventive and therapeutic measures.
糖尿病与大血管并发症密切相关，其中缺血性心脏病是主要的死亡原因。自主神经病变会增加并发症的风险，这就需要早期诊断。本研究的目的是确定心脏自主神经病变的存在情况和程度，涉及糖尿病的类型，以及其与冠状动脉疾病和主要心血管危险因素的相关性。
我们检查了90名受试者，分为三组，每组30例：1型糖尿病患者、2型糖尿病患者和健康受试者对照组。所有患者均接受了心血管测试（瓦尔萨尔瓦动作、深呼吸试验、站立反应、持续站立时的血压反应、握力试验）、心电图、跑步机运动试验，并填写了一份关于主要心血管危险因素的问卷：吸烟、肥胖、高血压和血脂异常。
我们的结果表明，心血管自主神经病变在2型糖尿病中更为常见，表现为自主神经病变。在患有自主神经病变的患者中，无论糖尿病类型如何，跑步机试验均为阳性，即与冠状动脉疾病密切相关。关于冠状动脉疾病危险因素，肥胖和高血压的相关性最为常见。
心血管自主神经病变被认为是动脉硬化和冠状动脉疾病的主要原因。我们的结果表明，心血管自主神经病变的发生由于自主神经系统功能障碍而增加了冠状动脉疾病的风险。
心血管自主神经病变是糖尿病的常见并发症，与冠状动脉疾病显著相关。心血管自主神经病变的早期诊断表明心血管风险增加，为预防和治疗措施提供了依据。
