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目的:探讨炎症性肠病患者的自主神经功能状态。方法:选取炎症性肠病(IBD)患者60例作为观察组,包括活动期溃疡性结肠炎(UC)37例,活动期克罗恩病(CD)23例,同期健康体检者50例作为对照组。交感神经功能采用握力试验以及卧立位血压差的方式进行检查;迷走神经功能则采用卧立位心率变化和Valsalva动作反应指数检查方法。结果:(1)观察组卧立位心率变化均值明显低于对照组,其中溃疡性结肠炎和克罗恩病心率变化均值均明显低于对照组,差异有统计学意义(P<0.05);溃疡性结肠炎与克罗恩病心率变化均值差异无统计学意义(P>0.05);溃疡性结肠炎和克罗恩病Valsalva动作反应指数与对照组相比差异无统计学意义(F=1.06,P>0.05)。(2)观察组卧立位血压差均值明显高于对照组,握力试验的血压反应均值明显低于对照组,溃疡性结肠炎和克罗恩病卧立位血压差均值均明显低于对照组,握力试验的血压反应均值均明显低于对照组差异有统计学意义(P<0.05);而溃疡性结肠炎和克罗恩病卧立位血压差均值及血压反应均值比较均无统计学差异。结论:炎症性肠病患者存在自主神经功能紊乱,交感神经功能增强而迷走神经功能相对减弱。
Objective: To investigate the status of autonomic nervous system in patients with inflammatory bowel disease. Methods: Sixty patients with inflammatory bowel disease (IBD) were selected as the observation group, including 37 cases of active ulcerative colitis (UC), 23 cases of active Crohn’s disease (CD) and 50 cases of healthy physical examination in the same period group. Sympathetic nerve function test using grip strength and lying position blood pressure difference way to check; vagus nerve function is to use lying heart rate changes and Valsalva action response index test. Results: (1) Mean changes of heart rate in lying position in observation group were significantly lower than those in control group. Mean changes of heart rate in ulcerative colitis and Crohn ’s disease were significantly lower than those in control group (P <0.05). There was no significant difference in the mean change of heart rate between ulcerative colitis and Crohn’s disease (P> 0.05). There was no significant difference in Valsalva motion response index between ulcerative colitis and Crohn’s disease (F = 1.06 , P> 0.05). (2) In the observation group, the average blood pressure difference between the lying position and the control group was significantly higher than that of the control group. Mean blood pressure response in the grip strength test was significantly lower than that in the control group. The average values of lying-position blood pressure difference in ulcerative colitis and Crohn’s disease were significantly lower than those in the control group , The mean value of blood pressure response in the grip test was significantly lower than that of the control group (P <0.05), while there was no significant difference between the mean value of BP and the average of BP in ulcerative colitis and Crohn’s disease . Conclusion: There are autonomic dysfunction in patients with inflammatory bowel disease, the sympathetic function is enhanced and the vagus nerve function is relatively weakened.