急性脑梗死患者心率减速力变化及临床意义

摘要

目的：研究脑梗死患者心率减速力（ DC）等自主神经功能指标的变化规律。方法：对86例急性脑梗死患者及54例对照行24 h动态心电图检测，计算DC及心率变异性各指标。对患者进行OCSP分型，采用NIHSS评分记录患者病情严重程度。分析脑梗死患者DC、心率加速力（AC）、窦性心律RR间期标准差（SDNN）、相邻RR间期差值的均方根（RMSSD）等指标变化情况及与NIHSS评分的关系。结果：脑梗死组DC较对照组降低（P＜0．05）。相关性分析发现，脑梗死组DC与AC绝对值、SDNN、RMSSD均呈正相关（r＝0．864、0．603、0．216，P＜0．05），与NIHSS评分呈负相关（rS ＝－0．223，P＝0．039）。结论：急性脑梗死患者特别是部分前循环脑梗死患者心脏迷走神经活性降低，且与疾病严重程度相关。%Aim:To explore the changes of deceleration capacity of heart rate ( DC) of patients with acute ischemic stroke .Methods:A total of 86 patients with first-ever acute ischemic stroke and 54 controls without stroke were collected . OCSP typing was performed , and NIHSS was used to assess the severity of the disease .Holter monitoring for 24 h was per-formed in patients and controls .DC, acceleration capacity of heart rate ( AC) and heart rate variability ( HRV) values were calculated by computer automatically .DC, AC, standard deviation of all normal-to-normal intervals ( SDNN) and square root of the mean of the sum of the squares of differences between adjacent NN interval (RMSSD) were analyzed.Results:DC in acute ischemic stroke group was lower than that in control group (P<0.05).Correlation analysis showed that DC was negatively correlated with NIHSS (rS =-0.223, P=0.039),and positively correlated with AC,SDNN,and RMSSD (r=0.864,0.603,0.216,P<0.05).Conclusion: The activity of vagus nerve of patients ,especially for those with sub-type of partial anterior circulation infarct decreases ,which is associated with the severity of stroke .