摘要
目的观察急性脑梗死患者心率变异性特点,分析其与发病90 d后预后的相关性。方法选取急性脑梗死患者47例(半球梗死30例,脑干梗死17例;大动脉粥样硬化型21例,小动脉闭塞型16例及其他10例),健康体检者30例。记录所有对象年龄、血化验、24 h动态心电图心率变异性指标,并随访患者发病90 d后m RS得分情况。结果半球梗死组、脑干梗死组较健康对照组NN间期标准差(SDNN)、相邻NN间期差值均方的平方根(r MSSD)、相邻NN间期之差>50 ms的个数占总心搏次数的百分比(p NN50)、低频功率(LF)、高频功率(HF)降低,LF/HF升高;半球梗死组较脑干梗死组SDNN、LF/HF升高,HF降低;大动脉粥样硬化组较小动脉闭塞组SDNN、r MSSD降低,LF、LF/HF升高,差异均有统计学意义(P<0.05);相关性分析示SDNN、r MSSD与发病90 d不良预后呈负相关(r值分别为-0.351、-0.368,均P<0.05),LF、LF/HF与不良预后正相关(r值分别为0.333、0.380,均P<0.05)。结论不同部位、病因的脑梗死患者心率变异性变化亦不同,心率变异性对脑梗死预后具有提示意义。
Objective To observe the characteristics of heart rate variability（HRV） in patients with acute cerebral infarction, and to analyze the correlation between HRV and prognosis of 90 days after onset.Methods We chose 47 cases of patients with acute cerebral infarction（30 hemispheric infarction and 17 brain stem infarction, 21 large artery atherosclerosis, 16 small artery disease and other 10 patients） and 30 cases of healthy controls. Age, blood tests, 24-hour HRV of all the subjects and m RS scores of 90 days after stroke onset were recorded. Results Compared to the control group, the hemispheric infarction group and brain stem infarction group were lower in standard deviation of normal-to-normal intervals（SDNN）, square root of the mean squared successive differences between normal-to-normal RR intervals（r MSSD）,percentage of adjacent normal-to-normal intervals that differed more than 50 ms（p NN50）, low-frequency power（LF） and higher frequency power（HF） and higher in LF/HF; In patients with hemispheric infarction,SDNN, LF/HF were higher and HF were lower than those with brain stem infarction; The SDNN, r MSSD were lower and the LF, LF/HF were higher in large-artery atherosclerosis group than in the small artery disease group, the differences were statistically significant（P 0.05）. Correlation analysis showed that SDNN, r MSSD were negatively correlated with poor prognosis of 90 days after acute cerebral infarction（r=-0.351,-0.368, all P〈0.05）, while, LF, LF/HF were positively correlated with it（r=0.333, 0.380, all P〈0.05）.Conclusion HRV of the acute cerebral infarction patients with different lesions and etiology is different,and the HRV is suggestive for the prognosis of cerebral infarction.
作者
王金
巫嘉陵
WANG Jin WU Jia-ling(Tianjin Huanhu Hospital, Key Laboratory of Cerebrovascular Disease and Neurodegeneration in Tianjin, Tianjin 300350, Chin)
出处
《中国城乡企业卫生》
2017年第10期11-13,共3页
Chinese Journal of Urban and Rural Enterprise Hygiene
关键词
急性脑梗死
心率变异性
自主神经系统
Acute cerebral infarction
Heart rate variability
Autonomic nervous system
