脑卒中患者的心率振荡检测及其临床意义  

Detection and clinical significance of heart rate turbulence in patients with acute cerebral stroke

作　　者：胡立群[1] 陈莉[1] 汤洁[1] 章琦[1] 高敏[1] 

机构地区：[1]安徽医科大学附属省立医院安徽省心血管病研究所,合肥230001

出　　处：《中国临床保健杂志》2009年第2期119-120,共2页Chinese Journal of Clinical Healthcare

摘　　要：目的观察脑卒中患者的心率振荡(HRT)现象的特征并探讨其临床意义。方法123例脑卒中患者(伴有高血压)和66例对照组(单纯高血压患者)。测得基础血压,72 h内接受24 h Holter监测,获取心率振荡的参数:振荡起始(TO)和振荡斜率(TS)值。同时获得心率变异的参数SDNN,r-MSSD,PNN50值,并进行相关性分析。结果脑卒中组TO明显高于对照组(0.12±2.27与-0.17±2.03,P<0.01);TS明显低于对照组(3.18±2.58与5.63±4.45,P<0.01)。脑卒中组TO与SDNN,r-MSSD,PNN50的相关系数分别为-0.192(P<0.05),-0.300(P<0.01),-0.617(P<0.01);TS与SDNN,r-MSSD,PNN50的相关系数无统计学意义(P值>0.05)。对照组TO与SDNN,r-MSSD,PNN50的相关系数分别为:-0.372(P<0.01),-0.105(P=0.403),-0.326(P<0.01);TS与SDNN,r-MSSD,PNN50的相关系数无统计学意义。结论脑卒中的HRT现象明显减弱,并且心率振荡和心率变异有显著相关性。Objective To explore the change of heart rate turbulenc（HRT） in patients with cerebral stroke. The clinical significance of HRT was also observed. Methods The HRT and HRV （ Heart rate variability ） were measured in 123 patients with cerebral stroke and 66 patients with Hypertension only. Turbulence onset（TO） ,Turbulence slope （TS） and SDNN, r-MSSD, PNN50 were measured by the original definitions using digitized Holter recordings. Results The value of TO was significantly higher in the case group than in the control group（0.12 ± 2.27vs - 0.17 ± 2.03 ,P 〈 0.01 ） ,The value of TS was significantly lower in the ease group than that in the control group （3. 18 ±2.58vs 5.63 ±4.45,P 〈0.01 ）;In case group, the correlation coefficient between TO and SNDD, r-MSSD, PNN50 was - 0. 192, - 0. 300, - 0.617 respectively （ P 〈 0.05 ）. The correlation coefficient between TS and SNDD, r-MSSD, PNN50 had no significance. Conclusion HRT was significantly blunted in patients with cerebral stroke. There was negative correlation between TO and SNDD,r-MSSD,PNN50.

关 键 词：脑血管意外 高血压 心率 自主神经系统 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R544.1[医药卫生—临床医学]