Low SpO2 and myocardial ischemia within two days after operation in diabetic neuropathy patient.

糖尿病神经病变患者术后两天内出现低 SpO2 和心肌缺血。

• 批准号: 14571470
• 负责人: HONGO Takashi
• 金额: $ 1.79万
• 依托单位: Nippon Medical School
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2002
• 资助国家: 日本
• 起止时间: 2002 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14571470/
• 关键词: after operation; diabetic neuropathy; myocardial ischemia; arterial oxygen saturation; 動脈血酸素飽和度

It is well known that patients with diabetes are associated with significant rates of diabetic neuropathy. Recently asymptomalic myocardial ischemia induced by diabetic neuropathy is going to be a problem.Six nondiabetic patients (control group) and 10 diabetic patients (diabetic group) were scheduled to receive general anesthesia participated in this study. Three standard noninvasive autonomic tests (heart rate variation during deep period breathing, Valsalva maneuver and head-up tilt) were performed in each patient at operating theater before anesthesia. Patients with autonomic dysfunction by autonomic tests were categorized as diabetic autonomic dysfunction group (DM-AD (+) group) and they were undergoing to check holter-ECG and arterial oxygen saturation (SpO2) after 48 hours after surgery. Spectral characteristics of heart rate variability was investigated by holter-ECG.(Results) There are no patients with low SpO2 or myocardial ischemia (ST depression) in this study. But one patient of DM-AD (+) group (n=4) showed negative T wave at least temporarily. There were no significant change of HF value and LF/HF ratio in this study. HF value on postoperative days (POD) two was larger than that of POD 1 (70.8±63.6 v.s. 54.3±46.0ms^2) at control group, but relatively there was no change in DM-AD (+) group. LF/HF ratio on POD2 was smaller than that of POD1 (2.34±1.02 v.s. 3.26±1.78) at control group, but relatively there was no change in DM-AD (+) group.

众所周知，糖尿病患者与糖尿病神经病变的显著发生率相关。本研究选择6例非糖尿病患者（对照组）和10例糖尿病患者（糖尿病组），拟行全身麻醉。麻醉前在手术室对每位患者进行三项标准无创自主神经测试（深呼吸期间心率变化、Valsalva动作和头高位倾斜）。将自主神经功能障碍患者分为糖尿病自主神经功能障碍组（DM-AD（+）组），术后48 h行动态心电图（Holter-ECG）和动脉血氧饱和度（SpO 2）检查。采用动态心电图研究心率变异性的频谱特征。（结果）本组无低SpO 2或心肌缺血（ST段压低）患者。但DM-AD（+）组1例患者（n=4）至少暂时出现负T波。HF值和LF/HF比值在本研究中无显著变化。术后第2天的HF值大于术后第1天（70.8±63.6 vs.对照组为54.3±46.0ms^2），而DM-AD（+）组无明显变化。POD 2的LF/HF比值小于POD 1（2.34±1.02 vs.对照组为3.26±1.78，DM AD（+）组无明显变化。