甲亢患者心率变异性分析  

Analysis of heart rate variability in hyperthyroid patients

作　　者：胡宇美[1,2] 王关炎[1,2] 陆广华[1,2] 

机构地区：[1]上海第二医科大学附属仁济医院内科 [2]上海第二医科大学生物医学工程教研室

出　　处：《中华内分泌代谢杂志》1998年第6期377-379,共3页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的探讨甲亢患者心率变异性（ＨＲＶ）测定的意义。方法分别对４７例甲亢患者和３７例正常人、３２例甲亢患者治疗后作ＨＲＶ分析。结果甲亢患者ＨＲＶ时域指标比正常对照组均明显降低；频域指标低频功率（ＬＦ）和高频功率（ＨＦ）都显著降低，表明甲亢患者的交感神经活性和迷走神经活性均降低。但ＬＦ／ＨＦ比正常组增加，说明交感迷走平衡性失调，相对表现为交感兴奋性增加。ＬＦ／ＨＦ的增加与ＦＴ３呈非常显著正相关，ＨＦ、心率（ＨＲ）和相邻正常窦性心搏间期之差的均方根值（ｒＭＳＳＤ）都与ＦＴ３呈显著相关性。典型甲亢患者散点图呈短棒状，而正常人呈慧星状。甲亢患者ＨＲＶ时域指标和频域指标治疗后明显改善，与ＦＴ３、ＦＴ４的恢复相对应。结论ＨＲＶ分析表明甲亢患者的自主神经活动明显改变，并与病情严重程度相关。Objective To study the significance of the measurements of heart rate variability (HRV) in hyperthyroid patients. Methods The HRV of 47 hyperthyroid patients was compared with that of normal control and the effects of treatment on HRV of 32 hyperthyroid patients were also evaluated. Results HRV time domain in hyperthyroid patients was much lower than that in normal control group. As to HRV frequency domain, the low frequency power (LF) and high frequency power (HF) in hyperthyroid patients were also significantly lower than that of the control group, reflecting that activity of autonomic neuropathy in hyperthyroid patients was obviously suppressed. But LF/HF of hyperthyroid patients was higher than that of normal group, indicating a relative lack of sympathetic tone in hyperthyroid patients. The increase of LF/HF is positively related to FT 3. HF, heart rate (HR) and square root of the mean squared differences of successive normal to normal RR intervals (r MSSD) are also positively related to FT 3. The scattergram was short stick like in hyperthyroid patients, but was comet like in normal group. The HRV of hyperthyroid patients was improved after treatment and associated with the recovery of FT 3 and FT 4. Conclusion HRV analysis showed that activity of autonomic neuropathy in hyperthyroid patients was obviously changed, which related to the severity of the disease.

关 键 词：心率变异性 HRV 甲状腺机能亢进 

分 类 号：R581.104[医药卫生—内分泌] R540.41[医药卫生—内科学]