王艺明,李玉华,安淑华
Wang Yiming; Li Yuhua; An Shuhua Department of Neurology;

• 1:贵阳医学院附院神经内科!贵阳550004
• 2:贵阳医学院附院神经内科!贵阳550004
• 3:贵阳医学院附院神经内科!贵阳550004

摘要(Abstract)：

探讨急性脑血管病 (ACVD)患者心率变异性 (HRV)所反映的植物神经功能变化及其临床应用价值。方法 :对 60例ACVD患者 (包括 30例脑梗塞、30例脑出血 ,其中 10例脑出血破入脑室 )及 30例正常人 ,进行 2 4h动态心电图检查 ,分析HRV的时域指标所反映的植物神经改变情况 ,同时对患者神经功能缺损评分进行分型 ,并分析轻、中、重三型神经功能缺损与植物神经受损程度的关系。结果 :ACVD的 2 4h正常窦性心搏间期的标准差 (SDNN )明显低于对照组 (P <0 0 0 1) ;急性脑出血的SDNN显著低于脑梗塞组 (P <0 0 0 1) ;破入脑室的脑出血组较未破入脑室组的SDNN显著降低 (P <0 0 0 1)。在SDNN <50ms组 ,重型神经功能缺损发生率及死亡率明显多于SDNN >50ms组 (P <0 0 1)。结论 :SDNN可作为一项定量评价ACVD发病后迷走神经受损程度的指标 ,并对ACVD预后判断有一定意义
To explore the changes in vegetative nerve function by heart rate variability (HRV) and its clinical applicative value in patients with ACVD. Twenty four-hour ECG was recorded in 60 patients with ACVD including 30 cases with brain infarction, 30 cases with brain bemorrhage (in 10 of them, the hemorrhage was broken into the brain ventricles) and 30 normal subjects. The changes of vegetative nerve function reflected by the time domain (SDNN) of HRV were analyzed and the neurologic deficit was classified into mild type, moderate type and severe type. The relationship between the neurological deficit and the degree of the vegetative nerve injury was observed. SDNN in ACVD was significantly lower than that in controls and SDNN in patients with acute cerebral hemorrhage was significantly lower than that in patients with brain infarction. SDNN in patients with cerebral hemorrhage broken into brain ventricles was singificantly lower than that in those without hemorrhage in the ventricles. The results showed that significant changes in vegetative function were existed in patients with AVCD. In patient with SDNN<50 ms,the incidence of the severe neurological deficit and the mortality were significantly higher than that in patients with SDNN>50 ms. HRV might be an index to evaluate the degree of the vegetative nerve injury after the onset of AVCD and might be of significance for judging the prognosis in ACVD.

关键词(KeyWords)： 脑梗塞;脑出血;植物性神经功能;心率变异性
cerebral infarction; cerebral hemorrhage; vegetative nerve function; heart rate variability

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 王艺明,李玉华,安淑华
Wang Yiming; Li Yuhua; An Shuhua Department of Neurology;

DOI: 10.19367/j.cnki.1000-2707.2000.03.004

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