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目的 观察脑梗死患者不同局部定位对反映心脏自主神经功能的心率变异性 (heart ratevariability,HRV)各测值的影响。方法 对经 CT和 MRI证实的 10 3例脑梗死患者和 6 8例健康对照组HRV各测值进行分析。结果 (1)脑梗死组的 HRV各参数与对照组比较均显著降低 (P<0 .0 5 )。 (2 )半球梗死组中 ,右侧半球组各参数在半球中最低。 (3)脑干梗死组中 ,延髓各指标均低于对照组 ,SDNN、RMSSD、PNN50 降低显著 ;桥脑和中脑的 SDANN、SDNNindex显著降低。结论 脑梗死患者局部定位对心脏自主神经功能具有不同的影响。右侧半球及脑干 (尤其延髓 )梗死患者的 HRV下降对预测心血管事件有着十分重要的价值。
Objective To observe the effect of different local localization on the measurement of heart rate variability (HRV) reflecting the function of cardiac autonomic nervous system in patients with cerebral infarction. Methods The data of HRV in 103 cerebral infarction patients and 68 healthy controls confirmed by CT and MRI were analyzed. Results (1) The parameters of HRV in cerebral infarction group were significantly lower than those in control group (P <0.05). (2) In the hemispheric infarction group, the parameters of the right hemisphere group were the lowest in the hemisphere. (3) In the brainstem infarction group, the indexes in the medulla oblongata were all lower than those in the control group, and the SDNN, RMSSD and PNN50 were significantly decreased. The SDANN and SDNNindex in the pontine and midbrain were significantly decreased. Conclusion Localization of patients with cerebral infarction has different effects on cardiac autonomic function. The decrease of HRV in right hemisphere and brainstem (especially medulla oblongata) infarction patients is of great value in predicting cardiovascular events.