目的:心血管自主神经病变(CAN)是糖尿病自主神经病变最严重的类型之一,是一类小纤维神经病变。在许多检查方法中,定量感觉检测是诊断糖尿病小纤维神经病变的一种有效而方便的方法。这项横断面研究旨在确定2型糖尿病患者心血管自主神经病变的发展与定量感觉测试参数之间的相关性。
方法:南京鼓楼医院266例2型糖尿病患者纳入本研究,他们每个人都接受了心血管反射测试(CART)和定量感觉测试,包括寒冷的测试,温暖,寒冷的疼痛,和热痛检测阈值(CDT,WDT,CPT,和HPT,分别)。使用SPSS26.0将CART的结果与定量感官测试中的热检测阈值进行比较。
结果:总共266名参与者被分为CAN组,早期CAN(ECAN)组,无CAN(NCAN)组。三组的定量感官测试参数存在显著差异,CART与WDT和HPT呈正相关,与CDT呈负相关。此外,在调整了年龄之后,性别,糖尿病持续时间,和其他影响因素,WDT,HPT,和CDT是心血管自主神经病变的独立危险因素。
结论:热检测阈值,包括寒冷,温暖,和热痛检测阈值,在定量感官测试中,发现与CART的结果显着相关。一些热检测阈值是心血管自主神经病变的独立危险因素。因此,这项研究表明,定量感觉测试对心血管自主神经病变的发生和发展具有可靠的预测能力。
OBJECTIVE: Cardiovascular autonomic neuropathy (CAN) is one of the most serious types of diabetic autonomic neuropathy and is a class of small fibre neuropathy. Among many inspection methods, quantitative sensory testing is an effective and convenient method for diagnosing diabetic small fibre neuropathy. This cross-sectional study aimed to identify the correlation between the development of cardiovascular autonomic neuropathy and quantitative sensory testing parameters in patients with type 2 diabetes mellitus.
METHODS: A total of 266 participants with type 2 diabetes mellitus from Nanjing Drum Tower Hospital were enrolled in this study, and each of them received cardiovascular reflex tests (CARTs) and quantitative sensory testing, including testing of cold, warm, cold pain, and heat pain detection thresholds (CDT, WDT, CPT, and HPT, respectively). The results of CARTs were compared with the thermal detection thresholds in quantitative sensory testing by using SPSS 26.0.
RESULTS: A total of 266 participants were divided into the CAN group, early CAN (ECAN) group, and without CAN (NCAN) group. There were significant differences in quantitative sensory testing parameters among three groups, and CARTs presented a positive correlation with the WDT and HPT and a negative correlation with the CDT. Moreover, after adjusting for age, sex, diabetes duration, and other influencing factors, WDT, HPT, and CDT were independent risk factors for cardiovascular autonomic neuropathy.
CONCLUSIONS: The thermal detection thresholds, including cold, warm, and heat pain detection thresholds, in quantitative sensory testing were found to be significantly related to the results of CARTs. Some thermal detection thresholds were independent risk factors for cardiovascular autonomic neuropathy. Therefore, this study showed that quantitative sensory testing has a reliable predictive ability for the occurrence and development of cardiovascular autonomic neuropathy.