观察急性重症脑卒中患者预后与早期心率变异的关系  

ANALYSIS OF EARLY HEART RATE VARIABILITY IN PATIENTS WITH CRITICAL CEREBRAL VASCULAR DISEASE

作　　者：曾超胜[1] 苏庆杰[1] 蔡毅[1] 龙发青[1] 李鹏翔[1] 吴海荣[1] 周经霞[1] 

机构地区：[1]海南省农垦总医院神经内科,海口570311

出　　处：《现代预防医学》2011年第13期2580-2581,2583,共3页Modern Preventive Medicine

基　　金：海南省自然科学基金项目(808222)

摘　　要：[目的]探讨急性重症脑卒中患者预后与早期心率变异的关系。[方法]大脑半球部位脑卒中患者33例,根据格拉斯哥昏迷评分(GCS)分为急性重症组(GCS≤8分15例)和非重症组(GCS﹥8分18例)。所有患者发病5d内进行Hoher连续记录。[结果]动态监测发现正常RR间期标准差(SDNN)≤60ms、总频谱(TF)≤1500ms/Hz、高频谱(HF)≤600ms/Hz、低频谱(LF)≤1000ms/Hz是预测预后的界限值;上述指标低于界限值提示病情恶化,预后不良;高于界限值则提示病情向好的方向发展,预后良好,其动态变化早于传统的GCS。[结论]监测HRV不仅可以反映植物神经平衡破坏情况,而且可以预测急性重症脑卒中患者预后的一个独立、定量的指标。[Objective]To discuss the relationship of prognosis of patients with acute severe stroke and early heart rate variability.[Methods]33 patients with the parts of the brain hemispheres stroke,according to Glasgow coma scale（GCS）,who were divided into acute severe group（GCS ≤ 8 minutes,15 cases）and non-severe group（GCS﹥ 8 minutes,18 cases）.The incidences of all patients within 5d were recorded continuously with Hoher.[Results]It found that the standard deviation of dynamic monitoring of normal RR intervals（SDNN）was ≤60 ms,total frequency（TF）was ≤1 500 ms/Hz,high frequency（HF）was ≤600 ms/Hz,low frequency（LF）was ≤1 000 ms/Hz was cutoff value of predicting prognosis;these indicators deteriorated below the limit values prompted a poor prognosis;that were higher than the limit values suggested development of the disease was in the right direction,with a good prognosis,the dynamic changes were earlier than conventional GCS.[Conclusion]The monitoring of HRV can not only reflect damage situation of autonomic nervous balance,and also be an independent,quantitative indicator for predicting the prognosis of patients.

关 键 词：脑卒中 脑功能 植物神经系统 心率变异 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]