CAJ | 학술논문

目的：探讨老年II型糖尿病合并高血压病（T2DM+EH）患者心血管自主神经功能变化的无创评价指标组合。方法单纯老年II型糖尿病（T2DM）患者27例，单纯老年高血压病（EH）患者27例，老年T2DM+EH患者30例，互为对照，进行HRV、HRT、Lorenz散点图、BPV分析。结果①HRV参数：T2DM+EH与T2DM组相比，SDNN、pNN50有统计学意义（P＜0.05，P＜0.01）；T2DM+EH与EH组相比，SDNN、rMSSD、pNN5、TRI均明显降低，差异有统计学意义。除rMSSD的P＜0.05外，余参数P＜0.01。②HRT参数：T2DM+EH与T2DM组相比，TS下降，差异有统计学意义（P＜0.05）；T2DM+EH与EH组相比，T0、TS均有显著差异，P＜0.05； EH与T2DM组相比，TS下降，差异有统计学意义（P＜0.05）。③Lorenz散点图面积：3组均无显著差异。④BPV参数：T2DM+EH与T2DM组相比，收缩压下降率、舒张压下降率降低（P＜0.01，P＜0.05）；T2DM+EH与EH组相比，两者均无显著差异； T2DM与EH组相比，两者均有显著差异，P＜0.01。结论多项无创检查技术能较全面、定量地反映老年T2DM+EH患者心血管自主神经功能异常状态，其中以HRV+BPV指标组合最佳，尤其HRV中的SDNN、pNN50和TRI及BPV中的收缩压下降率四项指标有较可靠的参考价值，推荐临床医师选用。
목적：탐토노년II형당뇨병합병고혈압병（T2DM+EH）환자심혈관자주신경공능변화적무창평개지표조합。방법단순노년II형당뇨병（T2DM）환자27례，단순노년고혈압병（EH）환자27례，노년T2DM+EH환자30례，호위대조，진행HRV、HRT、Lorenz산점도、BPV분석。결과①HRV삼수：T2DM+EH여T2DM조상비，SDNN、pNN50유통계학의의（P＜0.05，P＜0.01）；T2DM+EH여EH조상비，SDNN、rMSSD、pNN5、TRI균명현강저，차이유통계학의의。제rMSSD적P＜0.05외，여삼수P＜0.01。②HRT삼수：T2DM+EH여T2DM조상비，TS하강，차이유통계학의의（P＜0.05）；T2DM+EH여EH조상비，T0、TS균유현저차이，P＜0.05； EH여T2DM조상비，TS하강，차이유통계학의의（P＜0.05）。③Lorenz산점도면적：3조균무현저차이。④BPV삼수：T2DM+EH여T2DM조상비，수축압하강솔、서장압하강솔강저（P＜0.01，P＜0.05）；T2DM+EH여EH조상비，량자균무현저차이； T2DM여EH조상비，량자균유현저차이，P＜0.01。결론다항무창검사기술능교전면、정량지반영노년T2DM+EH환자심혈관자주신경공능이상상태，기중이HRV+BPV지표조합최가，우기HRV중적SDNN、pNN50화TRI급BPV중적수축압하강솔사항지표유교가고적삼고개치，추천림상의사선용。
Objective To investigate the noninvasive evaluation index combination of changes of autonomic cardiovascular function in old patients with hypertension and type 2 diabetes mellitus.Methods 27 old patients with single T2DM, 27 old patients with single EH and 30 old patients with T2DM+EH were involved in the annlyses of HRV,HRT,Lorenz plot’s role and BPV. Results (1)HRV parameters: T2DM+EH group compared with T2DM group, there were ststistical significance in SDNN(P<0.05) and pNN50(P<0.01); T2DM+EH group compared with EH group,There were significant differences in all parameters(P<0.01) except rMSSD(P<0.05). T2DM group compared with EH group, it was TRI(P<0.05).(2)HRT parsmeters: T2DM+EH compared with T2DM, TS had ststistical significance(P<0.05); T2DM+EH compared with EH, both had ststistical significance(P<0.05); T2DM compared with EH, it was TS(P<0.05).(3) Lorenz plot’s role area: There were no significant differences between the three groups. (4)BPV parameters: T2DM+EH compared with T2DM, Systolic blood pressure dicline rate(P<0.01) and diastolic blood pressure dicline rate(P<0.05)both had ststistical significance. T2DM+EH compared with EH, both had no significant differences. T2DM compared with EH, both had significant differences(P<0.01).Conclusion Several noninvasive diagnostic technique can more comprehensively and quantificationally reflect the abnormal state of autonomic nervous function in old patients with hypertension and type 2 diabetes mellitus. The best combination among these was HRV+BPV index( prticularly SDNN、pNN50 and TRI of HRV and Systolic blood pressure dicline rate of BPV). we recommended for physicians in the selection.