摘要
目的：监测小儿甲状腺功能亢进症(简称甲亢) 24 h的心率变异的昼夜规律，探讨其自主神经功能异常的意义。方法：24 h动态心电图记录后，分别对13例甲亢和26例正常人(对照组)的进行心率变异分析。结果：1. 24 h总HRV比较提示甲亢组与对照组比较均有显著差异（P<0.01）。2. 昼夜频域指标比较: 对照组， LFNU，LF/HF在清醒期明显增高（P < 0.01），HF，HFNU在睡眠期明显增高（P < 0.01）; 甲亢组TP , VLF, LF , HF，LFNU，HFNU LF/HF在清醒期和睡眠期比较无显著差异。3. 时域动态变化比: 对照组：24 h HRV时域变化有明显昼夜节律，以rMSSD和pNN50指标最敏感；甲亢组：24 h HRV时域各指标明显低于对照组（P<0.01），失去昼夜规律。结论：由于持续性的甲状腺素刺激，甲亢症患儿心脏自主神经受损，而表现为持续性交感神经占优势，失去昼夜规律，及时控制甲亢，并重新调整自主神经平衡对甲亢性心脏病发生有不可忽视的价值。
Objective: To assess autonomic nervous system (ANS) function in patients with hyperthyroidism by the heart rate variability (HRV) and to analyse the impact of hyperthyroidism on the cardiovascular system. Methods: Indexes of HRV were measured in 13 hyperthyroidism patients and 26 healthy controls. Time domain indexes and spectral indexes of HRV were derived. Results : 1. There was marked difference in both HFNU and LF/HF between hyperthyroidism and the control group over a 24-hour period. 2. In patients in control group, there were significant increases in the indexes of LFNU and LF/HF ratio during waking hours, whereas both HFNU and HF bands significantly increased during sleeping hours. In patients with hyperthyroidism, there were no significant differences in all spectral indexes of HRV. 3. There were significant differences in patients with hyperthyroidism in any time domain indexes of HRV compared with control group over a 24-hours period. In hyperthyroidism group, the night-day difference in HRV was significantly smaller compared with the control group. Conclusion: In patients with hyperthyroidism an autonomic imbalance and thyroid hormone excess may determine reduced parasympathetic activity and, thus, leading to a relative hypersympathetic tone. It will be important to adjust the abnormal cardiac autonomic activity promptly.
出处
《重庆医科大学学报》
CAS
CSCD
2002年第4期488-490,508,共4页
Journal of Chongqing Medical University
关键词
小儿
甲状腺功能亢进症
心率变异
Heart rate variability
Hyperthyroidism
Autonomic nervous system
