Jyotsna Viveka P, Sahoo Abhay, Sreenivas V, Deepak K K
Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi 110029, India.
Diabetes Res Clin Pract. 2009 Jan;83(1):83-8. doi: 10.1016/j.diabres.2008.09.054. Epub 2008 Nov 29.
Cardiac autonomic functions were assessed in 145 consecutive recently detected type 2 diabetics. Ninety-nine healthy persons served as controls. Criteria for normalcy were, heart rate variation during deep breathing >or=15 beats/min, deep breathing expiratory to inspiratory R-R ratio >or=1.21, Valsalva ratio >or=1.21, sustained handgrip test >or=16 mm of mercury, cold pressor test >or=10, BP response to standing <or=10mm of mercury and 30:15 R-R ratio on standing >or=1.04. An abnormal test was defined as the above parameters being <10 beats/min, <1.21, <1.21, <or=10mm of mercury, <10, >or=30 mm of mercury and <or=1.0, respectively. A borderline test was defined as, heart rate variation during deep breathing 11-14, sustained handgrip test 11-15 mm of mercury, BP response to standing 11-29 mm of mercury and 30:15 R-R ratio on standing 1.01-1.03. Parasympathetic dysfunction was found in 44.2% and sympathetic dysfunction in 51.9% diabetics. Among healthy controls, these figures were 11.9% and 22.1%, respectively. Cardiac autonomic function was normal in 7.8% patients and 32.5% healthy controls.
对145例近期确诊的2型糖尿病患者连续进行心脏自主神经功能评估。99名健康人作为对照。正常标准为:深呼吸时心率变异性≥15次/分钟,深呼吸呼气与吸气时的R-R比值≥1.21,瓦尔萨尔瓦比值≥1.21,持续握力试验≥16毫米汞柱,冷加压试验≥10,站立时血压反应≤10毫米汞柱,站立时30:15的R-R比值≥1.04。异常试验定义为上述参数分别<10次/分钟、<1.21、<1.21、≤10毫米汞柱、<10、≥30毫米汞柱和≤1.0。临界试验定义为:深呼吸时心率变异性为11 - 14,持续握力试验为11 - 15毫米汞柱,站立时血压反应为11 - 29毫米汞柱,站立时30:15的R-R比值为1.01 - 1.03。发现44.2%的糖尿病患者存在副交感神经功能障碍,51.9%存在交感神经功能障碍。在健康对照组中,这些数字分别为11.9%和22.1%。7.8%的患者和32.5%的健康对照者心脏自主神经功能正常。