학술논문
心率变异性和脑钠肽对糖尿病肾病的交互作用研究 / Interaction effect of heart rate variability and brain natriuretic peptide on diabetic nephropathy
Document Type
Academic Journal
Source
心电与循环 / Journal of Electrocardiology and Circulation. 42(6):556-560
Subject
Language
Chinese
ISSN
2095-3933
Abstract
目的 探讨心率变异性和脑钠肽对糖尿病肾病(DKD)的交互作用.方法 选择2016年1月至2021年10月浙江中医药大学附属杭州市中医院收治的2型糖尿病患者105例.其中,DKD患者32例纳入观察组,非DKD患者73例纳入对照组.比较两组患者一般资料、心率变异性[相邻RR间期之差的均方根值(rMSSD)、正常间隔到正常间隔的标准差(SDNN)、相邻RR间期相差＞50 ms的数量占总心搏数的百分比(PNN50)、低频/高频]、脑钠肽及Mogensen分期,使用多因素logistic回归分析糖尿病患者发生DKD的影响因素,使用交互作用系数γ分析心率变异性与脑钠肽对糖尿病肾损害的交互作用.结果 观察组rMSSD、SDNN、PNN50、低频/高频低于对照组,脑钠肽水平高于对照组,差异均有统计学意义(均P＜0.05).观察组Mogensen分期优于对照组,差异均有统计学意义(均P＜0.05).心率变异性异常亚组患者Mogensen分期优于心率变异性正常亚组患者,差异有统计学意义(P＜0.05).脑钠肽异常亚组患者Mogensen分期Ⅰ、Ⅱ期患者占比低于脑钠肽正常亚组患者,Ⅲ、Ⅳ期患者占比高于脑钠肽正常亚组患者,差异有统计学意义(P＜0.05).多因素logistic回归分析显示,rMSSD、SDNN、PNN50、低频/高频、脑钠肽均是DKD的影响因素(均P＜0.05).心率变异性与脑钠肽异常在DKD中呈正向交互作用,两者符合超相乘模型.结论 心率变异性与脑钠肽异常在DKD中呈正向交互作用.
Objective To explore the interaction effect of heart rate variability(HRV)and brain natriuretic peptide(BNP)on diabetes nephropathy(DKD).Methods One hundred and five patients with diabetes admitted to Hangzhou Hospital of Traditional Chinese Medicine from January 2016 to October 2021 were included.Among them,32 cases had DKD(observation group),73 cases had no DKD(control group).The general data,HRV[root mean square differences of successive RR intervals(rMSSD),standard deviation of normal-to-normal intervals(SDNN),percentage of successive normal-to-normal interval differences larger than 50 ms(PNN50),low frequency/high frequency],brain natriuretic peptide(BNP)and Mogensen stage were compared between the two groups.Logistic regression was used to analyze influencing factors of renal damage in diabetes patients.Interaction analysis was used to analyze the interaction effect of HRV and BNP on DKD.Results rMSSD,SDNN,PNN50,and low-frequency/high-frequency were significantly lower while NBP was significantly higher in the observation group than in the control group(all P＜0.05).The Mogensen stage was better in the observation group than in the control group(P＜0.05).The Mogensen stage was better in patients with abnormal HRV than in patients with normal HRV,and in patients with abnormal BNP than in patients with normal BNP(P＜0.05).Logistic regression analysis showed that rMSSD,SDNN,PNN50,low-frequency/high-frequency,and BNP were influence factors of DKD(all P＜0.05).HRV and BNP had a positive interaction effect on DKD,which was consistent with multiplicative model.Conclusion Abnormal HRV and BNP have a positive interaction effect on DKD.
Objective To explore the interaction effect of heart rate variability(HRV)and brain natriuretic peptide(BNP)on diabetes nephropathy(DKD).Methods One hundred and five patients with diabetes admitted to Hangzhou Hospital of Traditional Chinese Medicine from January 2016 to October 2021 were included.Among them,32 cases had DKD(observation group),73 cases had no DKD(control group).The general data,HRV[root mean square differences of successive RR intervals(rMSSD),standard deviation of normal-to-normal intervals(SDNN),percentage of successive normal-to-normal interval differences larger than 50 ms(PNN50),low frequency/high frequency],brain natriuretic peptide(BNP)and Mogensen stage were compared between the two groups.Logistic regression was used to analyze influencing factors of renal damage in diabetes patients.Interaction analysis was used to analyze the interaction effect of HRV and BNP on DKD.Results rMSSD,SDNN,PNN50,and low-frequency/high-frequency were significantly lower while NBP was significantly higher in the observation group than in the control group(all P＜0.05).The Mogensen stage was better in the observation group than in the control group(P＜0.05).The Mogensen stage was better in patients with abnormal HRV than in patients with normal HRV,and in patients with abnormal BNP than in patients with normal BNP(P＜0.05).Logistic regression analysis showed that rMSSD,SDNN,PNN50,low-frequency/high-frequency,and BNP were influence factors of DKD(all P＜0.05).HRV and BNP had a positive interaction effect on DKD,which was consistent with multiplicative model.Conclusion Abnormal HRV and BNP have a positive interaction effect on DKD.