脑梗死患者心脏自主神经活性变化与心电图异常的关系

目的 探讨不同部位脑梗死与心脏自主神经活性变化和ECG异常的关系。方法 检测156例急性大脑半球梗死患者和206名正常对照组心率变异性和标准12导联ECG,分析不同部位大脑半球梗死对心脏自主神经活性和ECG的影响。结果 与对照组比较,仅右侧岛叶梗死组心率变异性相邻心搏间期差的均方根(RMSSD)、相邻心搏间期差大于50ms的心搏问期数占心搏问期总数的百分比(PNN50)和高频功率谱(HF)明显降低,心脏副交感神经活性降低;低频功率谱(LF)与高频功率谱的比值(LF／HF)明显升高,心脏交感神经活性增强;腔隙性脑梗死组、非岛叶梗死组和左侧岛叶梗死组的心率变异性各项指标均无明显差异;右侧岛叶梗死患者快速心律失常和QTc延长发生率显著增加．左侧岛叶脑梗死患者srr段上升或下降显著增加;快速心律失常组RMSSD、PNN50和HF明显低于非快速心律失常组．LF／HF则明显高于非快速心律失常组。结论 影响脑梗死患者心脏自主神经活性和ECG的主要病变部位为岛叶。

Relationship between variation of autonomic nerve activity and abnormal electrocardiogram in patients with acute cerebral infarction

Objective To study the relationship between cerebral infarction localization and variation of cardiac autonomic balance and abnormal electrocardiogram.Methods Time domain and power spetral components of heart rate variability(HRV) and electrocardiogram were measured in 156 patients with hemisphere cerebral infarction in the acute phase and in 206 contral subjects.Results All the measured components of HRV,i.e.,standard deviation(SD) of RR intervals,total power(TP),low frequency power(LF),high frequency power(HF),RMSSD and PNN50 was significantly lower,while LF/HF was significantly higher in group of insular infarction in acute phase as compared with control group.Incidences of supraventricular arrhythmias and prolonged QTc were significantly increased in group of right insular infarction as compared with groups of lesions in other regions.A significantly increased incidence of ST segment abnormality was found in group of left insular infarction as compared with groups of lesions in other regions.Conclusion The effect of hemispheric cerebral infarction on cardiac autonomic balance and electrocardiogram is mainly correlated with destruction of insular lobe.