脑出血患者急性期窦性心率震荡结果分析  

Heart Rate Turbulence in Patients with Acute Intracerebral Hemorrhage

作　　者：王恒[1] 张雪芳[1] 曲松滨[1] 

机构地区：[1]哈尔滨医科大学附属第一医院神经内三科,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2013年第19期3700-3703,共4页Progress in Modern Biomedicine

摘　　要：目的:观察首次脑出血(intracerebral hemorrhage,ICH)患者急性期窦性心率震荡(heart rate turbulence,HRT)的变化特点。方法:从44例脑出血患者选择20例符合HRT分析条件的患者为脑出血组,选择无心脑器质性疾病且符合HRT分析条件的20例患者作为对照组。所有患者发病5天内行24小时动态心电图监测,计算并分析HRT指标震荡初始(turbulence onset,TO)、震荡斜率(turbulence slope,TS),同时收集患者临床资料。结果:与对照组TO、TS比较,脑出血组TO值升高有统计学意义(P<0.05),TS值降低无显著性意义(P>0.05)。不同部位脑出血患者TO及TS差异无统计学意义(渐进显著性>0.01)。结论:脑出血组患者急性期的HRT减弱,自主神经功能受到损害,推测脑出血患者急性期心脏意外发生可能性大。左右半球、蛛网膜下腔出血时自主神经损害程度是否存在差异仍待探讨。Objective： To evaluate heart rate turbulence （HRT） in patients with acute intracerebral hemorrhage （ICH）and its relation to the lesion. Methods： Of 44 patients with new-onset ICH, 20 patients eligible for HRT analysis were studied （Group Case）. Twenty sub- jects without cardiovascular diseases who had a recent Holter recording were served as normal controls （Group Control）. 24-hour Holter ECGs were recorded from all study patients within 5 days of IHC onset. Computerised HRT analysis was performed including indices turbulence onset （TO） and turbulence slope （TS）. Results： Significantly higher TO was observed in Group Case compared with Group Control （P〈0.05）. The TS was lower in Group Case but not statistically significant （P〉0.05）. There was no significant association of TO or TS with the region oflCH; the difference in HRT between groups classified by region oflCH was not statistically significant （progressive significance 〉0.01）. Conclusion： Remarkably altered HRT is found in patients with acute ICH suggesting impaired autonomic nervous function. It is speculated that there is an increased risk of acute cardiac events in ICH patients. Further investigation is need as to if the re- gion of ICH, such as the left-fight hemisphere and subarachnoid hemorrhage, may effect on the autonomic nervous function in acute ICH patients.

关 键 词：脑出血急性期 室性早搏 窦性心率震荡 自主神经功能 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R54[医药卫生—临床医学]