2 型糖尿病患者心率变异性的可靠性。
Reliability of heart rate variability in patients with type 2 diabetes mellitus.
机构信息
School of Medicine, The University of Queensland, Brisbane, Qld, Australia.
出版信息
Diabet Med. 2012 Jul;29(7):e33-40. doi: 10.1111/j.1464-5491.2011.03557.x.
AIMS
Heart rate variability may be used to assess diabetic cardiac autonomic neuropathy. The aim of the present study was to determine the reliability of standard short-term clinical measurements of heart rate variability in patients with Type 2 diabetes.
METHODS
In 24 patients with Type 2 diabetes (11 male, age 61 ± 9 years), parameters of heart rate variability in the time domain (standard deviation of RR intervals, coefficient of variation of RR intervals and root mean square of successive RR interval differences) and frequency domain (very low frequency, low frequency, high frequency and total spectral power) were derived from a 5-min electrocardiograph recorded during two laboratory visits separated by 16 ± 8 days. Absolute and relative reliability were assessed by 95% limits of random variation and the intraclass correlation coefficient, respectively. Categorical agreement of classifications of heart rate variability and sample size estimates for clinical trials were calculated.
RESULTS
Despite no significant difference in mean heart rate variability between tests, 95% limits of random variation indicated that repeated measurements were between 58% higher/37% lower (most reliable parameter; coefficient of variation of RR intervals) and 443% higher/82% lower (least reliable parameter; very low frequency power) than the first measure. The intraclass correlation coefficient ranged from 0.58 to 0.90 and sample size requirements from 20 to 93 patients per group. Agreement of categories of heart rate variability ranged from 79 to 96%.
CONCLUSIONS
Short-term clinical measurements of heart rate variability in patients with Type 2 diabetes are characterized by poor absolute reliability, but substantial to good relative reliability, suggesting greater clinical utility in diagnosis than in sequential follow-up.
目的
心率变异性可用于评估糖尿病心脏自主神经病变。本研究旨在确定 2 型糖尿病患者短期临床心率变异性测量的可靠性。
方法
在 24 例 2 型糖尿病患者（男性 11 例，年龄 61 ± 9 岁）中，从两次实验室就诊期间记录的 5 分钟心电图中得出时域（RR 间期标准差、RR 间期变异系数和连续 RR 间期差值的均方根）和频域（极低频、低频、高频和总频谱功率）的心率变异性参数。分别通过随机变异 95%界限和组内相关系数评估绝对和相对可靠性。计算心率变异性分类的分类一致性和临床试验的样本量估计。
结果
尽管两次测试的平均心率变异性无显著差异，但随机变异 95%界限表明，重复测量的结果比第一次测量高 58%/低 37%（最可靠的参数；RR 间期变异系数）和高 443%/低 82%（最不可靠的参数；极低频功率）。组内相关系数范围为 0.58 至 0.90，每组所需的样本量为 20 至 93 例。心率变异性分类的一致性范围为 79%至 96%。
结论
2 型糖尿病患者的短期临床心率变异性测量具有较差的绝对可靠性，但具有较大的相对可靠性，这表明在诊断方面比在连续随访方面具有更大的临床应用价值。
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