老年代谢综合征患者心率变异性分析

摘要

目的：分析老年代谢综合征（MS）患者的心率变异性（HRV），探讨老年代谢综合征对心脏自主神经功能的影响及意义。方法选择在内科就诊并行动态心电图检查的55岁以上老年患者103例，测量身高、体重、血压、空腹血糖、甘油三酯（TG）、高密度脂蛋白（HDL - C），并计算体重指数（BMI）。根据中华医学会糖尿病学分会（CDS）建议代谢综合征的诊断标准分为 MS 组57例和对照组46例，同时将 MS 组分为糖尿病组39例和非糖尿病组18例两亚组，分别比较两组 HRV 时域指标（ SDNN、SDANNindex、SDNNindex、rMSSD、PNN50）。结果 MS 组与对照组比较，MS 组的HRV 时域指标值下降，差异有统计学意义（ P ﹤0.05）；MS 组中糖尿病与非糖尿病组比较，糖尿病组 HRV 时域指标值下降明显，差异有统计学意义（ P ﹤0.05）。结论老年 MS 患者，尤其伴有糖尿病者，HRV 降低，提示心脏自主神经的调节功能受损，心血管危险因素增加。应加强对老年 MS 患者 HRV 的检测，控制高血糖、高血压、高血脂等危险因素，预防心血管事件的发生。%Objective To explore the variation of heart rate in elderly patients with metabolic syndrome(MS),and to explore the signifi-cance of influence of elderly metabolic syndrome on cardiac autonomic nerve function. Methods A total of 103 elderly patients over 55 years old in this hospital were examined by dynamic ECG and their height,weight,blood pressure,blood levels of fasting glucose,triglyceride(TG)and high - density lipoprotein(HDL - C)were examined and their body mass index(BMI)had been calculated. They were divided into MS group(n= 57 cases)and control group(n = 46 cases)according to the diagnostic criteria of Chinese Society of Diabetes,Chinese Medical Association,at the same time patients in MS group can further be divided into diabetes subgroup(n = 39 cases)and non - diabetic subgroup(n = 18 cases),they were compared with HRV time domain indexes(SDNN,SDANN index,SDNN index,rMSSD and PNN50). Results In comparison with control group,HRV time domain indexes of MS group was declined,and their difference was statistically significant( P ﹤ 0. 05). In MS group,diabetes subgroup in comparison with non - diabetic group,HRV time domain indexes in diabetes subgroup were significantly decreased,their difference was statistically significant( P ﹤ 0. 05). Conclusion In elderly patients with MS especially associated with diabetes,the autonomic nervous function of heart has been impaired,the regulation of cardiovascular risk factors should be strengthened in the detection of HRV in old patients with MS,control of hyperglycemia,hypertension,hyperlipidemia and other risk factors are very important in order to prevent the occurrence of cardio-vascular events.