甲状腺机能亢进症患者内科用药及放射性^(131)碘治疗前后对心率变异性的影响及临床意义  

Clinical Investigation of Heart Rate Variability in Patients With Hyperthyroidism Before and After the Medication and Radioactive Iodine-131 Treatment

作　　者：刘玺芳[1] 王静[1] 李芳巍[2] 武杨[1] 邵君[1] 郝葳[1] 隋鑫[1] 王烨[1] 

机构地区：[1]牡丹江医学院红旗医院心电室,黑龙江省牡丹江市157011 [2]牡丹江医学院红旗医院同位素科,黑龙江省牡丹江市157011

出　　处：《中国循环杂志》2011年第6期458-460,共3页Chinese Circulation Journal

基　　金：黑龙江省卫生厅2009年科研立项项目(2009-451)

摘　　要：目的:观察甲状腺机能亢进症(甲亢)患者治疗前以及内科用药和放射性^(131)碘治疗两种治疗方法对心率变异性的影响,以进一步了解自主神经功能与甲亢的关系。方法:109例甲亢患者为甲亢组,将其分成内科用药者60例及放射性^(131)碘治疗者(^(131)碘治疗者)49例,同时设立110例健康体检者为对照组,采用短程静态仰卧5 min记录心率变异性频域对比分析法。结果:甲亢组治疗前与对照组相比总功率谱密度明显降低[(332±69)ms^2比(2 832±460)ms^2],高频段明显降低[(479±33)ms^2比(752±106)ms^2],低频段明显升高[(1798±227)ms^2比(1079±211)ms^2],低频段/高频段值明显增高(2.85±0.94比1.19±0.46),差异均有统计学意义(P均<0.01)。甲亢患者经过内科用药与放射性^(131)碘两种方法治疗后与对照组相比,总功率谱密度、高频段、低频段、低频段/高频段值差异无统计学意义(P>0.05)。结论:心率变异性分析表明甲亢患者的自主神经功能明显降低,经内科用药及放射性^(131)碘治疗两种方法治疗,对心率变异性均有显著的改善,两种治疗方法对心率变异性的影响无差异。临床上心率变异性可以作为一项评价甲亢治疗效果的有效指标。Objective ： To investigate the clinical significance of heart rate variability before and after the medication and radioactive iodine-131 （131I） treatment, and to observe the autonomic nervous function in patients with hyperthyroidism. Methods：A total of 109 hyperthyroidism patients were divided into Medication group, n = 60 and 131I group, n = 49, in addi- tion, 110 healthy subjects were set as Control group. A short-range static lying on the back 5 min recording and the frequency do- main analysis method was used to study the heart rate variability. Results ： Before treatment, compared with Control group, hyperthyroidism patients had decreased total heart rate power spectral density （TP）, （2832±460） ms2 vs. （332±69） ms2 and decreased high frequency （HF） components, （752±106） ms2vs. （479 ±33） ms2; had increased low frequency （LF） component （1079 ±211 ）ms2 vs. （1798 ±227 ）ms2 and increased LF/HF ratio （ 1.19±0.46 vs. 2. 85±0. 94）, P 〈0. 01 respectively. After either medication or 1311 treatment, hyperthyroidism patients presented similar TP, HF, LF, LF/HF ratio to Control group, P〉0. 05. Conclusion ： Our work indicates that autonomic nerve function was significantly decreased in hyperthyroidism patients for their heart rate variability, medication or 131I treatment could significantly improve it. Heart rate variability can be used as a valid indi-cator for hyperthyroidism treatment in clinical practice.

关 键 词：甲状腺机能亢进 心率变异性 频域分析 内科用药 放射性~131碘 

分 类 号：R541[医药卫生—心血管疾病]