急性重度脑外伤患者自主神经功能变化的研究

为探讨急性重度脑外伤（ASTBI）患者是否存在自主神经（ANS）功能障碍及其临床意义，对30例ASIBI患者（ASTBI组，GCS评分≤8分）于入院1周内进行24小时心率变异性（HRV）检测，动态心电图分析系统自动计算HRV各项指标（包括时域、频域和非线性分析），绘制HRV直方图、散点图，并与31例正常人（对照组）进行比较。结果 ASTBI组HRV多数指标均明显降低（P＜0．05－0．001）；HRV直方图、散点图；均有特 征性改变，存活者和死亡者的HRV时域分析、频域分析各项指标比较有统计学意义。认为HRV能定量、全面、直观地反映ASTBI患者交感神经和迷走神经的功能状态；ASTBI患者存在明显的ANS功能障碍；ANS功能障碍与病情严重性呈正相关，且常直接影响预后。

Heart rate variability in acute severe traumatic brain injury

To investigate the characteristics of autonomic function(AF)and heart rate variability(HRV)in patients with acute severe traumatic brain injury(ASTBI) The 24hour circadian rhythm of heart rate and the time and frequency domain and non linear analysis measures of HRV were analyzed in 30 patients with STBI and 31 age and sex matched healthy control subjects HRV(included 24hour time domain,24hour frequency domain,and non linear analysis methods)were measured to assess the changes of AF in STBI patients Results showed that the indices of HRV(SDNN?SDANN?SDNN Index?RMSSD?HRV Triangular Index?TINN?PNN50?SDSD?TP?VLF?LF?HF?VAI?VLI)were markedly and significantly feduced in STBI group These results suggest that circadian fulctuation of HRV is reversibly abolished in the acute phase of the severe trauma brain injury As a stable,reliable and sensitive method,HRV could be obtained clearly,directly and quantitatively for the assessment of STBI All indices of HRV reflecting sympathetic and parasympathetic functions decreased significantly