目的: 探讨慢性心力衰竭合并糖调节受损对心率减速力(DC)、连续心率减速力(DRs)及预后的影响。方法: 选取慢性心力衰竭合并糖调节受损患者116例,其中慢性心力衰竭合并糖耐量减低(IGT)患者65例(IGT组),慢性心力衰竭合并空腹血糖受损(IFG)患者51例(IFG组),选择同期住院的年龄、性别相匹配的慢性心力衰竭且血糖正常的患者70例为对照组。比较三组患者的一般临床资料、DC及DRs检测结果、心血管事件的发生率。结果: IGT组患者的平均心率及血浆N末端B型脑钠肽前体(NT-proBNP)升高,左心室射血分数(LVEF)降低,DC及DRs指标显著降低,心源性死亡发生率增加,与其他二组比较,差异均有统计学意义(P＜0.05)。结论: 慢性心力衰竭合并IGT或合并IFG时患者的心迷走神经功能损害比血糖正常组更明显。慢性心力衰竭合并IGT患者的心功能受损最严重,DC及DRs指标降低更显著,且预后更差。
Objective: To further investigate the effect of impaired glucose regulation on deceleration capacity of heart rate (DC), heart rate deceleration runs (DRs) and prognosis in patients with chronic heart failure. Methods: A total of 116 patients with chronic heart failure and impaired glucose regulation were selected, including 65 patients with chronic heart failure and impaired glucose tolerance (IGT group), 51 patients with chronic heart failure and impaired fasting glucose (IFG group), and 70 patients with chronic heart failure and normal blood glucose matched with age and sex were selected as the control group. The general clinical data, DC and DRs test results, and the incidence of cardiovascular events were compared among the three groups. Results: In IGT group, the average heart rate and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) increased, the left ventricular ejection fraction (LVEF) decreased, the DC and DRs were significantly lower, and the incidence of cardiac death was significantly higher. There were significantly statistic differences compared with the other two groups (P＜0.05). Conclusion: The impairment of cardiac vagus nerve function in patients with chronic heart failure and IGT or IFG was more obvious than that in the normal blood glucose group. The impairment of cardiac function in patients with chronic heart failure and IGT was the most serious, with significantly decreased DC and DRs indexes and worse prognosis.
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