Okada S, Ishii K, Hamada H, Tanokuchi S, Ichiki K, Ota Z, Shimizu M, Hiraki Y
Third Department of Internal Medicine, Okayama University Medical School, Japan.
J Int Med Res. 1996 Jan-Feb;24(1):92-8. doi: 10.1177/030006059602400112.
The relationship between cardiac autonomic neuropathy and diabetic microangiopathies and macroangiopathy was investigated in 103 patients with non-insulin-dependent diabetes mellitus. Cardiac autonomic nerve function was assessed by determining the uptake of [123I]metaiodobenzyl-guanidine into the myocardium. Cardioparasympathetic nerve function was assessed by comparing electrocardiographically the expiratory and inspiratory respiratory rate (RR) interval ratios, during a period of deep breathing, and the coefficients of variation of the RR intervals. Nerve conduction velocity measurements were used to assess diabetic somatic neuropathy, and measurement of pulse-wave velocity provided an indication of the extent of aortic sclerosis. The only correlations between the parameters of cardiac autonomic neuropathy and parameters of diabetic microangiopathies and macroangiopathy were between the expiratory to inspiratory RR interval ratio and both the conduction velocity of the tibial nerve and pulse-wave velocity, and between the heart to lung ratio (cardiac autonomic nerve function) and nephropathy. These correlations may have occurred by chance; alternatively they may indicate a difference in the onset mechanisms of cardiac parasympathetic and sympathetic neuropathies in diabetics.
对103例非胰岛素依赖型糖尿病患者的心脏自主神经病变与糖尿病微血管病变及大血管病变之间的关系进行了研究。通过测定[123I]间碘苄胍在心肌中的摄取来评估心脏自主神经功能。通过在深呼吸期间心电图比较呼气和吸气时的呼吸频率（RR）间期比值以及RR间期的变异系数来评估心脏副交感神经功能。神经传导速度测量用于评估糖尿病性躯体神经病变，脉搏波速度测量可提示主动脉硬化的程度。心脏自主神经病变参数与糖尿病微血管病变及大血管病变参数之间仅有的相关性存在于呼气与吸气RR间期比值与胫神经传导速度及脉搏波速度之间，以及心/肺比值（心脏自主神经功能）与肾病之间。这些相关性可能是偶然出现的；或者它们可能表明糖尿病患者心脏副交感神经和交感神经病变的发病机制存在差异。
