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[胰岛素依赖型糖尿病伴或不伴自主神经病变患者在症状限制性运动试验中的心血管适应性]

[Cardiovascular adaptation during cycloergometric exercise test in insulin-dependent diabetics with or without autonomic cardiopathy].

作者信息

Irace L, Iarussi D, Langella S, Santangelo L, Coppola V, Iacono A

机构信息

Istituto Medico-Chirurgico di Cardiologia, I Facoltà di Medicina E Chirurgia, Università degli Studi Federico II, Napoli.

出版信息

Cardiologia. 1991 Aug;36(8):611-7.

PMID:1799897
Abstract

Sixty patients with type I diabetes mellitus underwent an ergometric stress test (EST) to evaluate the relationship between cardiac autonomic neuropathy (CAN) and hemodynamic changes during EST. All patients were divided into 2 groups: in the Group A were included 26 patients (mean age 43 +/- 9 years) with impairment of 2 or more autonomic tests according to Ewing (patients with CAN) and in the Group B were included 34 patients (mean age 38 +/- 13 years) without CAN. The EST was symptom-limited and performed with load increases of 25 W every 3 min. No positive EST were observed in both groups. Heart rate (HR) at rest and systolic blood pressure (SBP) at maximum common workload were significantly higher in Group A than in Group B. Moreover, a significant linear correlation was found between a CAN score and SBP x HR product at rest and at maximal workload. These findings are correlated with increased sympathetic activity due to a parasympathetic impairment. The data show the relationship between hemodynamic changes during EST and the Ewing test used in the diagnosis of CAN.

摘要

60例1型糖尿病患者接受了运动负荷试验(EST),以评估心脏自主神经病变(CAN)与EST期间血流动力学变化之间的关系。所有患者分为2组:A组纳入26例患者(平均年龄43±9岁),根据尤因标准,这些患者有2项或更多自主神经测试受损(CAN患者);B组纳入34例患者(平均年龄38±13岁),无CAN。EST为症状限制性试验,每3分钟负荷增加25W。两组均未观察到阳性EST。A组静息心率(HR)和最大常见工作量时的收缩压(SBP)显著高于B组。此外,在静息和最大工作量时,CAN评分与SBP×HR乘积之间存在显著的线性相关性。这些发现与因副交感神经损伤导致的交感神经活动增加有关。数据显示了EST期间血流动力学变化与用于诊断CAN的尤因试验之间的关系。

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