Bravenboer B, Hendriksen P H, Oey L P, Gispen W H, van Huffelen A C, Erkelens D W
Department of Internal Medicine, University Hospital Utrecht, The Netherlands.
Diabetes Care. 1993 Sep;16(9):1249-53. doi: 10.2337/diacare.16.9.1249.
We investigated whether the corrected QT interval correlated with two other tests for diagnosing autonomic dysfunction in 60 type I diabetic patients with proven peripheral neuropathy. The mean age +/- SD was 48.3 +/- 11.2 yr, the mean duration of diabetes was 24.9 +/- 11.4 yr, and the mean HbA1 was 9.3 +/- 2.4%.
All patients underwent three autonomic function tests: 1) the standard five cardiovascular Ewing tests, each scored 0 (normal), 0.5 (borderline), or 1.0 (abnormal). We used the sum of the abnormal findings for the analysis, the cardiovascular autonomic score; 2) measurement of the corrected QT interval taken from a routine electrocardiogram recording; and 3) static and dynamic pupillometry: measurement of dark adapted pupil diameter as percentage of total iris diameter and of pupil constriction latency using an infrared light reflex technique.
No significant correlation was found between age, duration of diabetes, or HbA1 and any of the autonomic function tests, except for one between age and cardiovascular autonomic score (r = 0.3202, P = 0.0126). Corrected QT interval did not correlate with cardiovascular autonomic score, pupil diameter, or constriction latency. A significant inverse correlation was found between cardiovascular autonomic score and pupil diameter (r = -0.4861, P < 0.001) and constriction latency (r = 0.3783, P < 0.001). Pupil diameter and constriction latency correlated well (r = -0.4276, P < 0.001).
The corrected QT interval did not correlate with cardiovascular autonomic tests nor pupillometry results. The corrected QT interval therefore should not be used for the diagnosis of the severity of diabetic autonomic neuropathy.
我们研究了校正QT间期与另外两项用于诊断60例已证实存在周围神经病变的I型糖尿病患者自主神经功能障碍的检查之间是否存在相关性。平均年龄±标准差为48.3±11.2岁，糖尿病平均病程为24.9±11.4年，平均糖化血红蛋白为9.3±2.4%。
所有患者均接受了三项自主神经功能检查：1）标准的五项心血管尤因检查，每项评分为0（正常）、0.5（临界）或1.0（异常）。我们使用异常结果的总和进行分析，即心血管自主神经评分；2）从常规心电图记录中测量校正QT间期；3）静态和动态瞳孔测量法：使用红外光反射技术测量暗适应瞳孔直径占总虹膜直径的百分比以及瞳孔收缩潜伏期。
除年龄与心血管自主神经评分之间存在相关性（r = 0.3202，P = 0.0126）外，未发现年龄、糖尿病病程或糖化血红蛋白与任何自主神经功能检查之间存在显著相关性。校正QT间期与心血管自主神经评分、瞳孔直径或收缩潜伏期均无相关性。发现心血管自主神经评分与瞳孔直径（r = -0.4861，P < 0.001）和收缩潜伏期（r = 0.3783，P < 0.001）之间存在显著负相关。瞳孔直径与收缩潜伏期相关性良好（r = -0.4276，P < 0.001）。
校正QT间期与心血管自主神经检查及瞳孔测量结果均无相关性。因此，校正QT间期不应被用于诊断糖尿病自主神经病变的严重程度。
