带状疱疹后神经痛病人自主神经功能观察研究  

Observational study of autonomic function in patients with postherpetic neuralgia

作　　者：李冉 樊碧发[2] 毛鹏[2] 刘波涛[2] 王海宁[2] 张毅[2] 闫龙涛[2] 李怡帆 LI Ran;FAN Bifa;MAO Peng;LIU Botao;WANG Haining;ZHANG Yi;YAN Longtao;LI Yifan(Department of Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China;Department of Pain Medicine,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中日友好医院疼痛科,北京100029

出　　处：《中国疼痛医学杂志》2021年第12期905-910,共6页Chinese Journal of Pain Medicine

基　　金：国家临床重点研发计划(2016-KJBYF-004);北京化工大学-中日友好医院生物医学转化工程研究中心联合项目(XK2020-13)。

摘　　要：目的:评价带状疱疹后神经痛(postherpetic neuralgia,PHN)病人的自主神经功能。方法:选取中日友好医院疼痛科2021年1月至2021年6月PHN病人33例为实验组(O组),同时段健康受试者47例为对照组(C组),两组均行24 h动态心电图检测,比较两组心率变异性(heart rate variability,HRV)指标和昼夜变化情况。结果:组间比较:O组受试者24 h的SDNN(standard deviation of NN intervals)、SDANN(standard deviation of the average NN intervals)、SDNN Index(the average value of SDANN)、rMSSD(root mean square successive differences between successive R-R intervals)、pNN50(the proportion of adjacent NN intervals differing by>50 ms)、总功率(total power,TP)、极低频功率(very low frequence,VLF)、低频功率(low frequence,LF)、高频功率(high frequence,HF)均明显低于C组(P<0.05),LF/HF与C组相似(P>0.05);O组受试者昼间rMSSD与C组相近,其余指标均明显低于C组;O组受试者夜间LF/HF与C组相近,其余指标均明显低于C组。组内比较:O组受试者昼间的SDNN和LF/HF明显高于夜间(P<0.05),LF、rMSSD与夜间相近(P>0.05),其余指标均明显低于夜间;C组受试者昼间的SDNN与夜间相近,LF和LF/HF均明显高于夜间,其余指标均明显低于夜间(P<0.05)。结论:PHN病人的自主神经功能较正常下降,交感、副交感神经功能均减弱,昼夜的自主神经功能均低于正常水平;交感神经功能昼夜无差异,副交感神经功能日间减弱,夜间增强。Objective:To evaluate the autonomic nerve function of patients with postherpetic neuralgia(PHN).Methods:A total of 33 PHN patients from the pain department of China-Japan Friendship Hospital from January 2021 to June 2021 were selected as the observation group(group O),and 47 normal subjects at the same time were selected as the control group(group C).Both groups were treated the 24 h dynamic electrocardiogram.It was used to compare the heart rate variability(HRV)indicators and diurnal variation between the two groups.Results:The 24 h SDNN,SDANN,SDNN Index,rMSSD,pNN50,TP,VLF,LF,and HF of patients in group O were significantly lower than those in group C(P<0.05),and LF/HF was similar to that in group C(P>0.05).The daytime rMSSDof patients in group O was approximate to those in group C,while the rest of parameters were significantly lower than those in group C.LF/HF of the group O at night was similar to that in group C,other indicators were significantly lower than those in group C.The daytime SDNN and LF/HF of the group O were significantly higher than those at night(P<0.05),LF,rMSSD was similar to that at night(P>0.05),and other indicators were significantly lower than the night.The SDNN of the patients in group C during the day was similar to that of the night,LF and LF/HF were significantly higher than that at night,and the other indicators were significantly lower than that at night(P<0.05).Conclusion:The autonomic nerve function of PHN patients is lower than normal,while the sympathetic and parasympathetic nerve functions are weakened.There is no difference in sympathetic nerve function between day and night.Parasympathetic nerve function weakens during daytime and strengthens at night.

关 键 词：带状疱疹后神经痛 心率变异性 自主神经功能 昼夜节律 疼痛 

分 类 号：R752.12[医药卫生—皮肤病学与性病学]