| 何楚婕,陈家隆,陈 巧,张永杰,胡贵方.2型糖尿病住院患者心脏自主神经病变的影响因素及对夜间AH和夜间VA的影响[J].,2023,(14):2672-2676 |
| 2型糖尿病住院患者心脏自主神经病变的影响因素及对夜间AH和夜间VA的影响 |
| Influencing Factors of Cardiac Autonomic Neuropathy in Hospitalized Patients with Type 2 Diabetes Mellitus and Its Effect on Nocturnal AH and Nocturnal VA |
| 投稿时间：2023-03-07 修订日期：2023-03-31 |
| DOI：10.13241/j.cnki.pmb.2023.14.013 |
| 中文关键词: 2型糖尿病 心脏自主神经病变 影响因素 夜间无症状低血糖 夜间室性心律失常 |
| 英文关键词: Type 2 diabetes mellitus Cardiac autonomic neuropathy Influencing factors Nocturnal asymptomatic hypoglycemia Nocturnal ventricular arrhythmia |
| 基金项目:广东省基础与应用基础研究基金项目（2021B1515140032） |
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| 中文摘要: |
| 摘要 目的：分析2型糖尿病（T2DM）住院患者心脏自主神经病变（CAN）的影响因素，探讨其对夜间无症状低血糖（AH）和夜间室性心律失常（VA）的影响。方法：选取2020年1月～2022年7月肇庆医学高等专科学校附属医院收治的174例T2DM患者，根据是否发生CAN分为CAN组和非CAN组，采用多因素Logistic回归分析T2DM住院患者CAN的影响因素。采用动态血糖监测系统监测夜间AH发生情况，动态心电图监测夜间VA发生情况。结果：174例T2DM患者CAN发生率为37.93%（66/174）。单因素分析显示，CAN组年龄大于非CAN组，病程长于非CAN组，收缩压、舒张压、糖化血红蛋白（HbA1c）、稳态模型评估-胰岛素抵抗（HOMA-IR）、血尿酸和微血管并发症比例高于非CAN组（P＜0.05）。多因素Logistic回归分析显示，年龄增加、病程延长、HOMA-IR升高、血尿酸升高、微血管并发症为T2DM住院患者CAN的独立危险因素（P＜0.05）。与非CAN组比较，CAN组夜间AH、VA发生率增加（P＜0.05）。结论：年龄、病程、HOMA-IR、血尿酸和微血管并发症为T2DM住院患者CAN的影响因素，CAN增加了T2DM住院患者夜间AH和夜间VA的发生率，早期筛查CAN可能有助于降低T2DM住院患者夜间AH和夜间VA的发生风险。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the influencing factors of cardiac autonomic neuropathy (CAN) in hospitalized patients with type 2 diabetes mellitus (T2DM), and to investigate its effect on nocturnal asymptomatic hypoglycemia (AH) and nocturnal ventricular arrhythmia (VA). Methods: 174 patients with T2DM who were admitted to Affiliated Hospital of Zhaoqing Medical College from January 2020 to July 2022 were selected, and they were divided into CAN group and non-CAN group according to whether they were complicated with CAN. Multivariate Logistic regression was used to analyze the influencing factors of CAN in hospitalized patients with T2DM. The incidence of nocturnal AH was monitored by dynamic blood glucose monitoring system, and the incidence of nocturnal VA was monitored by dynamic electrocardiogram. Results: The incidence rate of CAN in 174 patients with T2DM was 37.93% (66/174). Univariate analysis showed that the age in the CAN group was older than that in the non-CAN group, and the course of disease was longer than that in the non-CAN group, and systolic blood pressure, diastolic blood pressure, glycosylated hemoglobin (HbA1c), homeostasis model assessment - insulin resistance (HOMA-IR), blood uric acid and the proportion of microvascular complications were higher than those in the non-CAN group (P＜0.05). Multivariate Logistic regression analysis showed that increased age, prolonged course of disease, elevated HOMA-IR, elevated blood uric acid and microvascular complications were independent risk factors for CAN in hospitalized patients with T2DM (P＜0.05). Compared with the non-CAN group, the incidence rate of nocturnal AH and VA in the CAN group were increased (P＜0.05). Conclusion: Age, course of disease, HOMA-IR, blood uric acid and microvascular complications are influencing factors for CAN in hospitalized patients with T2DM, and CAN increases the incidence rate of nocturnal AH and nocturnal VA in hospitalized patients with T2DM, early screening of CAN may help reduce the risk of nocturnal AH and nocturnal VA in hospitalized patients with T2DM. |
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