河北医科大学学报

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急性缺血性脑卒中患者心率变异性与同型半胱氨酸的相关性分析

  

  1. 河北医科大学第一医院神经内科，河北省脑老化与认知神经科学实验室，河北 石家庄 050031
  • 出版日期:2017-09-25 发布日期:2017-09-18
  • 作者简介:邱会卿（1984-），女，河北石家庄人，河北医科大学第一医院主治医师，医学硕士，从事神经内科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题(20160202)

Correlation analysis of heart rate variability and plasma homocysteine in patients with ischemic stroke#br#

  1. Department of Neurology, the First Hospital of Hebei Medical University， Brain Aging and Cognitive Neuroscience Laboratory of Hebei Province， Shijiazhuang 050031, China
  • Online:2017-09-25 Published:2017-09-18

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摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗探讨急性缺血性脑卒中患者心率变异性（heart rate viability,HRV）与血浆同型半胱氨酸（homocysteine,Hcy）的相关性。
〖HTH〗方法〖HTSS〗〖KG*2〗收集神经内科住院患者中，根据影像学检查确诊为急性缺血性脑卒中的患者94例为病例组，选择同期在我院体检的健康志愿者82例作为对照组。根据美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale, NIHSS）对病例组进行神经功能评分；采用酶联免疫法常规检测2组的Hcy水平，采用频谱分析技术对2组进行短程5 min的HRV监测及记录，比较2组间Hcy及HRV各指标差异，分析病例组HRV与NIHSS评分、Hcy水平的相关性。
〖HTH〗结果〖HTSS〗〖KG*2〗①与对照组相比，病例组的Hcy水平显著增高（P＜005）；②与对照组相比，病例组HRV时域指标RR间期标准差（standard deviation of NN intervals, SDNN）、相邻RR间期之差的均方根（rootmeansquare successive difference,RMMSD）、相邻RR间期差值大于50 ms的百分比（percentage value of NN50 count,PNN50）、频域指标中的低频（low frequency,LF）和高频（high frequency,HF）均显著降低（P＜005），而频域指标中反映交感-迷走神经平衡的低频与高频比值（LF/HF）显著增高（P＜005）；③病例组HRV指标LF/HF与NIHSS呈正相关，而HRV其余指标与NIHSS评分均呈负相关；④病例组HRV指标除LF/HF与Hcy水平呈正相关外，HRV其余指标均与Hcy呈负相关。
〖HTH〗结论〖HTSS〗〖KG*2〗急性缺血性脑卒中患者同时存在Hcy和HRV水平的异常；HRV水平随神经功能缺损的加重变异程度增加，并且与Hcy水平密切相关。

关键词: 卒中, 心率变异性, 同型半胱氨酸

Abstract: ［Abstract］ Objective〖HTSS〗〓To investigate the correlation between heart rate variability(HRV) and plasma homocysteine(Hcy) in patients with ischemic stroke.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Among the patients in neurology department, ninetyfour cases that were diagnosed as ischemic stroke according to the imaging examination were colleted into case group, and eightytwo healthy volunteers for medical examination in our hospital were selected into control group. Neurological scores of case group were evaluated by the National Institutes of Health Stroke Scale(NIHSS), Hcy levels of both groups were tested by routine detection of enzyme linked immune method, and shortrange 5 min of HRV monitoring and HRV indices recording were conducted by spectrum analysis technology. We compared the Hcy levels and HRV values in two groups, and analyzed the relationship between Hcy, HRV and NIHSS in case group.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓①Compared with the control group, Hcy levels of case group was significantly higher(P＜005). ②Compared with the control group, HRV time domain index RR interval standard deviation(SDNN), rootmeansquare successive difference(RMMSD), the percentage value of NN50 count(PNN50), low frequency(LF), high frequency(HF) of case group were all significantly decreased(P＜005), and the frequency domain index that reflects sympathovagal balance index(LF/HF) increased significantly(P＜005). ③NIHSS score in case group was positively correlated with LF/HF, and negatively correlated with all the other index of HRV. ④Hcy level in case group was positively correlated with LF/HF, and had a negative correlation with other indicators of HRV.
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The level of Hcy and HRV are abnormal in the patients with acute ischemic stroke. Variation of HRV increases with aggravation of neurologic defect, and is closely related to the level of Hcy.

Key words: stroke, heart rate viability, homocysteine

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