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目的:分析心率变异性指标(HRV)评估急性脑卒中患者心脏自主神经功能的应用价值。方法:选取在本院接受治疗的急性脑卒中患者90例为观察组,选取同期入院的非心脑血管疾病且无各大系统严重疾病患者90例为对照组。采用动态心电图监测仪检测患者动态心电图,记录患者24 h的心电信号,分析对比两组心率变异指标,包括窦性R-R间期的标准差(SDNN)、每5 min时段窦性R-R间期平均值标准差(SDANN)、窦性R-R间期的平方根(r MSSD)和相邻R-R间期互差>50 ms的心跳数所占分析信息期间内心搏数百分比(PNN50)。结果:观察组患者SDNN、SDANN、r MSSD以及PNN50明显低于对照组比较,差异具有统计学意义(P<0.05)。观察组脑梗死患者和脑出血患者SDNN、SDANN、r MSSD以及PNN50,差异无统计学意义(P>0.05)。结论:综上所述,心率变异指标可以有效的预测急性脑卒中患者心脏自主神经功能变化,对监测患者心脏功能障碍程度有一定意义,可在一定程度上避免心源性猝死事件发生。
Objective: To analyze the value of heart rate variability (HRV) in assessing cardiac autonomic nervous system function in patients with acute stroke. Methods: Ninety patients with acute stroke admitted to our hospital were selected as the observation group. Ninety non-cardiovascular and cerebrovascular diseases without major system serious diseases were selected as the control group. The ambulatory electrocardiogram (ECG) was recorded by Holter monitor, and the ECG signal of 24 h was recorded. The heart rate variability index was analyzed and compared between two groups, including the standard deviation of sinus RR interval (SDNN), sinus RR interval average SDANN, the square root of the RR interval (r MSSD), and the number of heartbeats> 50 ms between adjacent RR intervals accounted for PNN50 during the analysis period. Results: The SDNN, SDANN, MSSD and PNN50 in the observation group were significantly lower than those in the control group, the difference was statistically significant (P <0.05). There was no significant difference in SDNN, SDANN, r MSSD and PNN50 between the observation group and the patients with cerebral hemorrhage (P> 0.05). Conclusion: In summary, the heart rate variability index can effectively predict the changes of cardiac autonomic nervous function in patients with acute stroke, which has some significance for monitoring the degree of cardiac dysfunction in patients and can to some extent avoid the occurrence of sudden cardiac death.