摘要
目的 分析老年缺血性脑小血管病患者心率变异性参数与认知功能障碍的关系。方法 选择2020年12月至2022年12月西南医科大学附属医院神经内科收治的老年缺血性脑小血管病患者120例,依据蒙特利尔认知评估量表(Montreal cognitive assessment, MoCA)评分分为认知障碍组(MoCA评分<26分)38例及认知正常组(MoCA评分≥26分)82例。所有患者进行动态心电图检查获取心率变异性参数,包括全部窦性心搏R-R间期标准差(standard deviation of the R-R interval, SDNN)、相差>50 ms的相邻R-R间期占R-R间期总数百分比(percentage of the number of pairs of adjacent R-R intervals differing by more than 50 ms, PNN50)、低频功率(power in low frequency range, LF)、高频功率(power in high frequency range, HF)。采用Spearman分析心率变异性参数与认知障碍的相关性,ROC曲线分析心率变异性参数对认知障碍的评估价值。结果 认知障碍组SDNN、PNN50、LF、HF明显低于认知正常组,差异有统计学意义(P<0.05,P<0.01)。Spearman相关性显示,SDNN、PNN50、LF、HF与老年缺血性脑小血管病患者认知障碍呈负相关(r=-0.185,r=-0.720,r=-0.278,r=-0.387,P<0.05)。ROC曲线分析显示,SDNN、PNN50、LF、HF联合评估老年缺血性脑小血管病患者认知障碍的曲线下面积为0.972(95%CI:0.949~0.996),敏感性为94.70%,特异性为89.00%,联合评估效能明显优于各指标单独评估(P<0.01)。结论 老年缺血性脑小血管病患者心率变异性参数与认知障碍密切相关,早期测定SDNN、PNN50、LF、HF等心率变异性参数可为认知障碍的评估提供参考价值。
Objective To analyze the relationship between heart rate variability(HRV)parameters and cognitive impairment in elderly patients with ischemic cerebral small vessel disease(CSVD).Methods A total of 120 elderly patients with ischemic CSVD admitted in Affiliated Hospital of Southwest Medical University from December 2020 to December 2022 were recruited,and accord-ing to Montreal cognitive assessment(MoCA)score,they were divided into cognitively impaired group(MoCA scores<26,n=38)and cognitively normal group(MoCA score≥26,n=82).All pa-tients received dynamic electrocardiography to obtain HRV parameters,including standard devia-tion of R-R interval(SDNN),percentage of the number of pairs of adjacent R-R intervals differing by more than 50 ms(PNN50),power in low frequency range(LF)and power in high frequency range(HF).The relationship between HRV parameters and cognitive impairment was analyzed by Spearman correlation analysis,and the value of HRV parameters in evaluating cognitive impair-ment was explored by ROC curve analysis.Results The cognitively impaired group had signifi-cantly lower SDNN,PNN50,LF and HF than the cognitively normal group(P<0.05,P<0.01).Spearman correlation analysis indicated that SDNN,PNN50,LF and HF were negatively correla-ted with cognitive impairment in elderly patients with ischemic CSVD(r=-0.185,r=-0.720,r=-0.278,r=-0.387;P<0.05).ROC curve analysis manifested that the AUC value,sensitivi-ty and specificity of com bination of SDNN,PNN50,LF and HF in evaluating cognitive impair-ment in the patients was 0.972(95%CI:0.949-0.996),94.70%and 89.00%,respectively.The efficiency of combined evaluation was better than that of each indicator alone(P<0.01).Conclusion The HRV parameters are closely associated with cognitive impairment in elderly patients with ischemic CSVD.Early determination of SDNN,PNN50,LF,HF and other HRV pa-rameters can provide reference for the evaluation of cognitive impairment.
作者
杨艳蓉
吕志宇
李铮
Yang Yanrong;Lu Zhiyu;Li Zheng(Department of Neurology,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China)
出处
《中华老年心脑血管病杂志》
北大核心
2025年第6期770-773,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
成都市医学科研课题(2022180)。
关键词
老年人
认知障碍
心率
数据相关性
aged
cognition disorders
heart rate
correlation of data
