弥漫性甲状腺肿治疗前后心率变异性的变化

目的 探讨弥漫性甲状腺肿（又称Graves病,简称GD）患者心率变异性（HRV）的变化。方法 选取30例GD患者,另选取30例健康志愿者作为对比研究。观察GD患者治疗前后HRV指标：所有窦性心搏RR间期标准差（SDNN）、全程记录中每5 min窦性心搏RR间期平均值的标准差（SDANN）、相邻RR间期差大于或等于50 ms的个数占总心跳次数的百分比（PNN50）、低频LF（0. 04 ~ 0. 15 Hz）、高频HF（0. 15 ~ 0. 40 Hz）、LF/ HF值、极低频VLF（0. 003 3 ~0. 04 Hz）。结果 GD组治疗后与治疗前相比,时域指标：SDNN、RMSDNN、SDANN、PNN50均改善（P 均〈0. 01）;频域指标LF、HF、VLF亦均明显改善（P 均〈0. 01）;GD组治疗前HRV指标：SDNN、PNN50、LF、HF、VLF均低于对照组（P〈0. 01）;GD组治疗后与对照组相比,HRV上述指标两组无显著性差异。 GD组治疗前频域指标24 h波动曲线趋于平稳,治疗后波动性有所恢复。结论 GD患者存在心脏自主神经调节功能异常,以迷走神经受损为主;24 h频域指标波动性则趋于平稳,治疗后调节功能异常和波动性可有不同程度恢复。

Research on the change of heart rate variability in toxic diffuse goiter

Objective To investigate the trait of autonomic nervous cardiovascular regulation in toxic diffuse goiter. Methods Thirty patients with toxic diffuse goiter（ GD group）and 30 health subject（ Control group）were enrolled according to certain criteria. Following indexes were determined as standard deviation of normal to normal intervals（SDNN） , every 5 minutes in a time interval（ SDANN ）, the percentage of RR intervals differing ≥ 50 ms （PNN50）, very low frequency power （VLF） ,low frequency power（ LF）, high frequency power（ HF）, LF/HF ratio（LF/HF）. Results Comparing between GD patients before and after treatment, SDNN, PNN50, LF, HF, VLF were significantly different. Comparing once an hour spectral power indices among three groups, LF, HF and VLF were significantly lower in GD group （ P〈O. 05 ） , and the fluc- tuation of the curves decreased;LF,HF,and VLF increased GD patients treated and accessed to Control group. Conclu- sions There is impairment of heart autonomic nervous regulation in GD patients especially the vague nerve, and recovered a bit after treatment.