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目的:观察首次脑出血(intracerebral hemorrhage,ICH)患者急性期窦性心率震荡(heart rate turbulence,HRT)的变化特点。方法:从44例脑出血患者选择20例符合HRT分析条件的患者为脑出血组,选择无心脑器质性疾病且符合HRT分析条件的20例患者作为对照组。所有患者发病5天内行24小时动态心电图监测,计算并分析HRT指标震荡初始(turbulence onset,TO)、震荡斜率(turbulence slope,TS),同时收集患者临床资料。结果:与对照组TO、TS比较,脑出血组TO值升高有统计学意义(P<0.05),TS值降低无显著性意义(P>0.05)。不同部位脑出血患者TO及TS差异无统计学意义(渐进显著性>0.01)。结论:脑出血组患者急性期的HRT减弱,自主神经功能受到损害,推测脑出血患者急性期心脏意外发生可能性大。左右半球、蛛网膜下腔出血时自主神经损害程度是否存在差异仍待探讨。
Objective: To observe the changes of heart rate turbulence (HRT) in patients with first intracerebral hemorrhage (ICH). Methods: From 44 patients with cerebral hemorrhage, 20 patients who were eligible for HRT were selected as intracerebral hemorrhage. Twenty patients who did not have cardiocerebral disease and were eligible for HRT analysis were selected as the control group. All patients were monitored within 24 hours of onset of electrocardiogram (ECG) within 5 days of onset. The HRT indexes turbulence onset (TO) and turbulence slope (TS) were calculated and analyzed. Clinical data were also collected. Results: Compared with TO and TS in control group, TO increased in cerebral hemorrhage group was statistically significant (P <0.05), but no significant change was found in TS value (P> 0.05). There was no significant difference in TO and TS in different parts of patients with cerebral hemorrhage (progressive significance> 0.01). Conclusion: The HRT of acute cerebral hemorrhage patients is weakened and the function of autonomic nerve is impaired. It is speculated that the acute cardiac accident may occur in patients with intracerebral hemorrhage. Left and right hemispheres, subarachnoid hemorrhage autonomic nerve damage whether there is a difference between the extent of the remains to be explored.