脑梗死患者心率变异性分析(附50例报告)

目的　研究脑梗死患者的自主神经功能状态。方法　应用时域法对 5 0例脑梗死患者进行心率变异性分析。结果　脑梗死组与正常对照组相比所有 R- R间期均值的标准差 (SDNN)明显降低 (10 2 .0 6± 2 8.5 1,137.0 6± 2 9.0 8) ms,P<0 .0 1,HRV三角指数明显降低 (2 5 .86± 9.18,37.5 7± 14 .88;P<0 .0 5 )。相邻 R- R间期之差的均方根值 (RMSSD)、爱丁堡指数 (p NN5 0 )较正常对照组低 ,但无统计学意义。脑梗死患者心率变异昼夜比较RMSSD夜间高于日间 (18.70± 7.30 ,2 6 .2 3± 8.85 ) m s,P<0 .0 5。余指标昼夜有所变化但无统计学意义。脑梗死首次发作组与非首次发作组相比 SDNN、RMSSD、p NN5 0、HRV三角指数等指标无明显差别。结论　脑梗死患者的自主神经功能以交感神经活性占优势 ,心率变异程度降低 ,且失去了正常的昼夜规律。脑梗死后自主神经功能的改变主要与本次发作有关

Heart rate variability decreased in brain infarction

Objective To investigate the statue of autonomic nervous system activity of the patients after non-brainstem and non-large hemispheric brain infarction.Methods The long-term time domain measures of heart rate variability(HRV) were analysed prospectively from 24h Holter ECG recording in 50 patients after ischemic stroke, and in healthy control subjects.Results The significant decrease in the standard deviation of all R-R intervals (SDNN) and Triangular index(P<0.05)component were found in patients after ischemic stroke. The component of HRV,root-mean-square deviation of R-R intervals(RMSSD),pNN50 were similar in the patients after ischemic stroke with those of the healthy control subjects.The RMSSD significant increased more significantly at night than that in the daytime (P<0.05).All components of HRV, SDNN,Triangular index ,RMSSD and pNN50 were similar in the first-infarction patients with those of the non-first-infarction patients.Conclusion Sympathetic is predominance and HRV loses circadian fluctuation in the patients after ischemic stroke .