Torffvit O, Agardh C D
Department of Internal Medicine, University Hospital, Lund, Sweden.
J Intern Med. 1993 Feb;233(2):131-7. doi: 10.1111/j.1365-2796.1993.tb00665.x.
The objective was to study ambulatory blood pressure and heart rate variability between day and night in patients with type 1 (insulin-dependent) diabetes mellitus with different degrees of diabetic nephropathy, and to evaluate the influence of autonomic neuropathy and type of antihypertensive treatment. Twenty type 1 diabetic patients with diabetic nephropathy and antihypertensive treatment were studied with 24-h ambulatory blood pressure monitoring using an oscillometric method. They were compared with eight insulin-treated diabetic patients with short duration of diabetes (1-5 years) and with 10 apparently healthy subjects. The degree of autonomic neuropathy was evaluated by measuring the RR-interval during deep breathing and uprising. The 24-h blood pressure was generally higher in patients with diabetic nephropathy compared to those other two groups. These patients also had a lower ratio between day and night in diastolic blood pressure compared to the control subjects (1.15 +/- 0.12 vs. 1.25 +/- 0.76, P < 0.05) and heart rate compared to the diabetic patients without nephropathy, as well as the control subjects (1.15 +/- 0.08 vs. 1.26 +/- 0.09 vs. 1.27 +/- 0.08, P < 0.01, respectively). All patients with diabetic nephropathy had clinical signs of autonomic neuropathy as judged by RR-interval measurements during deep breathing and uprising.
目的是研究不同程度糖尿病肾病的1型（胰岛素依赖型）糖尿病患者昼夜动态血压和心率变异性，并评估自主神经病变和降压治疗类型的影响。对20例接受降压治疗的糖尿病肾病1型糖尿病患者采用示波法进行24小时动态血压监测。将他们与8例糖尿病病程较短（1 - 5年）的胰岛素治疗糖尿病患者以及10例明显健康的受试者进行比较。通过测量深呼吸和起立过程中的RR间期来评估自主神经病变的程度。与其他两组相比，糖尿病肾病患者的24小时血压总体较高。与对照组相比，这些患者的舒张压昼夜比值也较低（1.15±0.12 vs. 1.25±0.76，P < 0.05），与无肾病的糖尿病患者以及对照组相比，心率也较低（分别为1.15±0.08 vs. 1.26±0.09 vs. 1.27±0.08，P < 0.01）。根据深呼吸和起立过程中RR间期的测量判断，所有糖尿病肾病患者均有自主神经病变的临床体征。
