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目的 对心率变异性 (HRV)、QT离散率 (QTd)及心室晚电位 (VLP) 3种方法判定自主神经功能进行比较 ,以期选择一种较为特异、可靠及敏感的方法。方法 68例 2型糖尿病 (DM)患者分别进行 HRV、QTd及 VLP测定 ,与 33例正常人进行对比分析。结果 DM患者正常 R-R间期的标准差 (SDNN)显著小于正常人 (P <0 .0 1 ) ,QTd显著大于正常人 (P <0 .0 1 ) ,VLP阳性率明显增高 (P <0 .0 1 )。 VLP阳性组 SDNN明显低于 VLP阴性组 (P <0 .0 0 1 ) ,QTd显著高于 VLP阴性组 (P <0 .0 0 1 ) ;同时具有 SDNN<1 0 0 ms,QTd≥ 50 ms,VLP阳性者占43.9%。结论 3种方法相比 ,SDNN敏感性及特异性较高 ,可靠性较好 ;VL P特异性较高 ,可靠性较好 ;QTd虽然敏感性高 ,但可靠性差。建议 QTd作为粗筛指标 ,以长程 HRV列入心血管自主神经功能的常规检查 ,而将 VLP与 HRV结合起来作为判断疾病严重程度的指标并进行危险分级
Objective To compare the autonomic nervous function of three methods of heart rate variability (HRV), QTd (QTd) and ventricular late potential (VLP) in order to select a more specific, reliable and sensitive method. Methods Sixty-eight patients with type 2 diabetes mellitus (DM) were measured by HRV, QTd and VLP, respectively, and compared with 33 healthy controls. Results The standard deviation (SDNN) of normal RR interval was significantly lower in DM patients than that in normal controls (P <0.01). The QTd was significantly higher than that in normal controls (P <0.01). 0 1). SDNN in VLP positive group was significantly lower than that in VLP negative group (P <0.01), QTd was significantly higher than that in VLP negative group (P <0.01), and SDNN was less than 100 ms and QTd was more than 50 ms , VLP-positive accounted for 43.9%. Conclusion Compared with the three methods, SDNN has higher sensitivity and specificity, better reliability, higher VLP specificity and better reliability. Although QTd is more sensitive, its reliability is poor. It is suggested that QTd should be used as a coarse screening index to include long-range HRV routine examination of cardiovascular autonomic nervous function, and VLP should be combined with HRV as an indicator of the severity of the disease and be graded for risk