- 期刊
六分鐘走路測試後異常心跳回復與第二型糖尿病人罹患糖尿病視網膜病變之相關性：初步研究
Abnormal Heart Rate Recovery after 6-minute Walk Test is Associated with Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus: A Preliminary Study
摘要
糖尿病人罹患糖尿病視網膜病變（diabetic retinopathy）已證實與心臟自主神經功能異常有關。無論是次大運動或極限運動，異常心跳回復率（heart rate recovery，HRR）是一種容易被檢測，代表心臟自主神經功能下降的指標。臨床上，六分鐘走路測試（6-minute walk test，6MWT）屬於一種次大運動且更貼近日常活動能力，各種類型病人皆可從事此測試，且不需要複雜器材。本篇研究目的是要探討第二型糖尿病人在六分鐘走路測試後心跳回復率與罹患糖尿病視網膜病變的關係。共有60位第二型糖尿病人完成本研究。依據六分鐘走路測試後心跳回復率高低分做四組進行探討。結果發現心跳回復率較低組別休息時心率顯著地較大、心率增加量較少，且六分鐘走路測試距離也相對較短。整體第二型糖尿病受試者中，在心跳回復率較低、心臟自主神經功能較差的組別，有較低的運動能力表現與可能有相對較高罹患糖尿病視網膜病變機率的趨勢。六分鐘走路測試後心跳回復率在臨床上容易被執行與推廣，以往並未將此測試應用在第二型糖尿病人心臟自主神經功能的相關探討。未來仍需要更多研究加以證明六分鐘走路測試後心跳回復率，可以做為檢測第二型糖尿病人的心臟自主神經功能與罹患糖尿病視網膜病變的指標，並可進一步應用此測試評估病人接受復健訓練之後的成效。
並列摘要
Diabetic retinopathy is associated with cardiac autonomic dysfunction in patients with diabetes mellitus. Abnormal heart rate recovery (HRR) after exercise can be used as a marker of reduced cardiac autonomic function in submaximal and symptom-limited exercise stress testing. The 6-minute walk test (6MWT) is considered as a submaximal test that is more appropriate to assess the capacity of performing activities of daily living, and can be applied to a variety of patients in clinical settings without the need of sophisticated equipment. The aim of the present study was to investigate the association of diabetic retinopathy with HRR after 6MWT in patients with Type 2 diabetes mellitus (T2DM).A total of 60 patients with T2DM completed the study. The participants were divided into four groups for further analyses according to the values of HRR. The results indicated that the group with lower HRR value had a significantly higher resting heart rate, a less increased heart rate and a relatively smaller 6MWT distance. There was also a trend towards higher possibility of developing diabetic retinopathy among the T2DM patients with a lower HRR, poor cardiac autonomic function.HRR after the 6MWT can be easily conducted and promoted for clinical applications; however, it had not been used in related study to test the cardiac autonomic nerve function for T2DM patients. More research is needed to demonstrate whether or not that the HRR after the 6MWT can be used as an indicator of cardiac autonomic function and diabetic retinopathy in T2DM, and as a performance indicator for the assessment of patient receiving rehabilitation courses.
延伸閱讀
- 余佳馨、林佳霈、林士祥（2022）。探討糖尿病衛教介入對門診第2型糖尿病患血糖控制與認知功能之影響。台灣營養學會雜誌，46(4)，112-125。https://doi.org/10.6691/NSJ.202212_46(4).0001
- 陳巧雲（2017）。『糖尿病看圖對話』衛教工具介入第2型糖尿病個案之用藥遵從度及血糖管理成效。彰化護理，24(1)，2-4。https://doi.org/10.6647/CN.24.01.02
- 李書芬、紀玫如、鄭綺（2015）。運用跨理論模式探討認知行為教育課程介入對第二型糖尿病患者運動階段、運動自我效能及血糖控制之影響。新臺北護理期刊，17(1)，21-31。https://doi.org/10.6540/NTJN.2015.1.003
- Kirboga, K., Ozec, A. V., Kosker, M., Dursun, A., Toker, M. I., Aydin, H., Erdogan, H., Topalkara, A., & Arici, M. K. (2014). The Association between Diabetic Retinopathy and Levels of Ischemia-Modified Albumin, Total Thiol, Total Antioxidant Capacity, and Total Oxidative Stress in Serum and Aqueous Humor. Journal of Ophthalmology, (2014-4), 15-20. https://doi.org/10.1155/2014/820853
- D, B., CS, B., K, G., V, R., & A, B. (2017). Estimating the Lag Between Onset and Diagnosis of Diabetes from the Prevalence of Diabetic Retinopathy Among Indian Population. International Journal of Diabetology & Vascular Disease Research (IJDVR), 5(2), 189-195. https://doi.org/10.19070/2328-353X-1700039