摘要
目的探讨肝豆状核变性患者心率变异性(HRV)变化及其与临床分型之间的关系。方法选择2011年10月—2012年10月在郑州人民医院肝豆状核变性病区住院治疗确诊为肝豆状核变性的患者107例,按照肝豆状核变性临床分型标准分成:脑型组62例、肝型组29例、混合或其他型组16例。另选取同期在本院体检性别和年龄与患者相匹配的50例体检健康者为对照组。记录其12导联同步24 h动态心电图,获得HRV指标:24 h全部正常心动周期的标准差(SDNN)、三角指数、全程相邻两正常心动周期差值的均方根(RMSSD)和一定时间内相邻两正常心动周期差值>50 ms的个数所占的百分比(PNN50),用于评价自主神经功能。结果与对照组比较,肝豆状核变性组平均心率增快,SDNN和三角指数减小,差异均有统计学意义(P<0.05);两组RMSSD、PNN50比较,差异均无统计学意义(P>0.05)。分组后,对照组、脑型组、肝型组及混合或其他型组的心率和HRV指标比较,差异均有统计学意义(P<0.05);其中与对照组比较,脑型组和肝型组心率增快、三角指数降低,肝型组RMSSD降低,脑型组、肝型组及混合或其他型组SDNN降低,混合或其他型组PNN50降低,差异均有统计学意义(P<0.05);与肝型组比较,混合或其他型组心率降低,差异有统计学意义(P<0.05)。结论肝豆状核变性患者伴有不同程度的自主神经功能损害,肝型组以副交感神经受累为主。
Objective To investigate the heart rate variability （HRV） and its relationship with clinical classification in patients with hepatolentieular degeneration （HD） . Methods 107 HD patients confirmed in the People＇s Hospital of Zheng- zhou from October 2011 to October 2012 were divided into cerebral type group （62 cases） , hepatic type group （29 cases） and Hepatocerebral type and others group （16 cases） . Another 50 healthy people with matched gender and age were involved as the control group. All the patients were given standard 12 - lead ECG and 12 - lead 24 - hour ambulatory electrocardiogram （AECG） with the Version 12. 5 system made by DMS. The value of heart rate variation （HRV） parameters, SDNN, HRV triangle index, RMSSD and PNN50 automatically calculated by the system was used to evaluate the function of autonomic nervous system. Results Compared with the control group, the hepatic type group had increased heart rate, decreased SDNN and triangle index, and the difference was statistically significant （ P 〈 0.05 ） . While the RMSSD and PNN50 showed no statistically significant differ- ence between the two groups （ P 〉 0. 05 ） . The heart rate and HRV between control group, cerebral type group, hepatic type group and hepatocerebral type and others group all showed statistically significant differences （ P 〈 0. 05 ） . Compared with the control group, the cerebral type group and hepatic type group had increased heart rate, decreased triangle index; the cerebral type group, hepatic type group and hepatocerebral type and others group had decreased SDNN; hepatic type group had decreased RMSSD ; the hepatocerebral type and others group had decreased PNN50, and all the differences were statistically significant （P 〈 0. 05） . Compared with the hepatic type group, the hepatocerebral type and others group had decreased heart rate, and the difference was statistically significant （ P 〈 0.05 ） . Conclusion Autonomic dysfunction occurs in HD. Parasympathetic functions are mainly affected in cerebral type group.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第24期2842-2844,共3页
Chinese General Practice
关键词
肝豆状核变性
自主神经通路
心率变异性
Hepatolenticular degeneration
Autonomic pathways
Heart rate variation
