急性脑血管病患者的心率变异研究

目的探讨不同部位脑梗死对心率变异(HRV)的影响及发病后HRV的变化。方法70例脑梗死组和50例年龄及性别相匹配的对照组进行24hHRV记录分析,于发病后第5d及5周进行2次记录,脑梗死位置经CT或MRI证实并符合临床定位。结果(1)与对照组比较,脑梗死组发病后第5d的HRV各项指标降低,呈显著性差异(P<0.01);5周后,各项指标均有所恢复,部分指标恢复呈显著性差异(P<0.05);(2)右侧脑梗死组较左侧脑梗死组HRV的各项指标更低,呈显著性差异(P<0.05),右侧岛叶脑梗死组HRV的各项指标最低。结论急性脑梗死后导致HRV降低,影响心脏自主神经活性的主要部位在右侧岛叶,受损的心脏自主神经活性随时间的延长而有恢复趋势。

Research on Heart Rate Variability (HRV) in Acute Ischemic Stroke

Objective To explore the differential effects of stroke localization on autonomic function parameters assessed by HRV and study the circadian fluctuation of HRV in acute phase of ischemic stroke. Methods 24 h HRV of 70 stroke patients were recorded and analyzed in acute stage （5 d and 5 w） to contract with 50 age - and sex- matched health as control groups. Clinical location of hemispheric brain infarction were verified by CT or MRI. Results （ 1 ） In acute phase of ischemic stroke （5 d） all index of heart rate variability had significantly decreased （ P 〈 0.01 ）, and they all recovered after 5 weeks （ P 〈 0.05）. （2）The index in Patients with right cerebral infarction had significantly lower than that in left localization （ P 〈 0.05）. The index of right insular lobe was the lowest in all groups. Conclu- sion Acute cerebral infarction significantly decreased heart rate variability as a result of cardiovascular autonomic dys- regulation. The decreased autonomic function has reversible tendency following the time went by.