癫痫发作期心脏自主神经功能的研究  

An analysis of heart rate changes during partial seizures

作　　者：陈伟 徐军 钱洪玉 王桂芳 贾培兰 郭常利 孟凡刚[4] 

机构地区：[1]山东省聊城市脑科医院神经外科二病区,252000 [2]山东省聊城市脑科医院神经内科,252000 [3]山东省聊城市脑科医院儿科,252000 [4]首都医科大学北京市神经外科研究所

出　　处：《中华临床医师杂志（电子版）》2013年第16期26-29,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(81071224);北京市卫生系统高层次卫生技术人才培养计划(2011-3-032)

摘　　要：目的通过视频脑电-心电监测，研究部分性癫痫发作期心率变化，探讨不同部位起源、不同发作形式以及睡眠与觉醒对心率变化的影响，总结并分析癫痫发作前后心率演变规律。方法回顾性分析2011-2013年81例癫痫患者181次发作的视频脑电-心电监测资料，将癫痫发作期心率变化幅度分成5种类型，绘制心率变化曲线图，并从发作部位（额、颞、枕）、发作形式（SPS、CPS和CPS．G）、睡眠与觉醒等方面分析癫痫发作对心率变化的影响。结果181次发作心率差值（53．2±26．7）次/min，额、颞、枕心率差值分别为（53．3±28．5）次／min、（53．2±24．1）次／min和（52．8±31．9）次／min；睡眠期（72次）和清醒期（109次）发作心率差值分别为（62．8±25．4）次／min和（46．8±25．7）次，min；SPS、CPS和CPS-G发作心率差值分别为（32．8±24．4）次/min、（47．7±20．6）次／min和（79．3±22．4）次／min。结论发作类型为CPS．G、睡眠期、右侧起源、男性、年龄大于14岁的患者心率变化显著，癫痫发作期的心率随时间变化有一定的演变规律。Objective To analysis the heart rate changes during partial seizures, evaluate the relationship between different epileptogenic focus, types, sleep/wakefulness, and summarize the regularity of heart rate changes. Methods A total of 181 seizures recorder in 81 epilepsy patients during EEG and ECG performed between 2011 and 2013 were retrospectively reviewed. Heart rate before and during seizures was determined and correlated with epileptogenic focus. Differences in heart rate before and during seizures were grouped into 5 types. Differences between location （frontal, temporal and occipital lobe）, types （SPS, CPS and CPS-G） and sleep/wakefulness on the heart rate changes were discussed. Results The mean heart rate changes was （53.2±26.7） beats per rain （BPM）. The mean heart rate changes of frontal, temporal and occipital lobe epilepsy were （53.3±28.5）, （53.2 ±24.1） and （52.8±31.9） BPM respectively. The mean heart rate changes of sleep and wakefulness was （62.8±25.4） and （46.8 ± 25.7） BPM, whereas SPS, CPS and CPS-G were （32.8± 24.4）, （47.7± 20.6） and （79.3 ±22.4） BPM respectively. Conclusions We conclude that CPS-G, sleep, male and right focus, led to higher ictal HI（, the observed alterations could potentially facilitate sudden cardiac death. The heart rate in the stage of epilepsy has regular evolution as time varying.

关 键 词：癫痫 部分性 睡眠 觉醒 心率变异 视频脑电-心电 

分 类 号：R742.1[医药卫生—神经病学与精神病学]