肝豆状核变性患者心率变异性观察

摘要

Objective To investigate the changes of autonomic nerve function in patients with hepatolenticular degeneration ( HLD) . Methods Time domain methods of heart rate variability ( HRV) tests were performed in 90 HLD patients without regular treatment ( HLD group) and 30 healthy cases( control group). Results Compared with the control group, SDNN, SDANN, rMSSD and pNN50 of HLD liver type and brain-visceral type patients in the HLD group were significantly reduced (all P <0. 01 ) ; Comparison between HLD cerebral and brain-visceral on standard deviation of the R-R intervals (SDNN) , standard deviation of the averages of R-R intervals in all 5-minute segments(SDANN) and rate mean square of the differences of successive RR intervals (rMSSD), the percentage of RR intervals differing >50ms ( pNN50) were significantly different ( all P < 0. 05 ) ; Comparison between brain type and liver type on SDNN, SDANN were significant different (all P <0. 05). Comparison between cases of Child A level and cases of Child B, C level, control group on SDNN, SDANN, rMSSD, pNN50 were significantly different (all P <0.0 ). Conclusions HRV of liver-type and cerebral-visceral HLD patients is significantly lower, and which decreased with the severity of cirrhosis%目的 探讨肝豆状核变性(HLD)患者自主神经功能变化.方法 对未经正规治疗的90例HLD患者(观察组)和30例健康人(对照组)进行心率变异性(HRV)分析.结果 观察组HLD肝型、脑—内脏型平均窦性R-R间期的标准差(SDNN)、每5 min正常R-R间距平均值的标准差(SDANN)、相邻窦性R-R间距差值的均方根(rMSSD)、窦性相邻R-R间距差值＞50 ms的百分比(pNN50)与对照组比较,P均＜0.01;HLD脑型SDNN、SDANN、rMSSD、pNN50与脑—内脏型比较,P均＜0.05;HLD脑型SDNN、SDANN与肝型比较,P均＜0.01.Child B、C级患者的SDNN、SDANN、rMSSD、pNN50与Child A级患者及对照组比较,P均＜0.01.结论 肝型及脑—内脏型HLD患者HRV明显降低,且肝硬化病变程度越严重,HRV降低越明显.