甲亢患者心率变异性分析

甲亢患者心率变异性分析

甲亢患者心率变异性分析

2010-04-24胡宇美王关炎陆广华

【摘要】目的探讨甲亢患者心率变异性(HRV)测定的意义。方法分别对47例甲亢患者和37例正常人、32例甲亢患者治疗后作HRV分析。结果甲亢患者HRV时域指标比正常对照组均明显降低；频域指标低频功率(LF)和高频功率(HF)都显著降低，表明甲亢患者的交感神经活性和迷走神经活性均降低。但LF/HF比正常组增加，说明交感-迷走平衡性失调，相对表现为交感兴奋性增加。LF/HF的增加与FT3呈非常显著正相关，HF、心率(HR)和相邻正常窦性心搏间期之差的均方根值(r-MSSD)都与FT3呈显著相关性。典型甲亢患者散点图呈短棒状，而正常人呈慧星状。甲亢患者HRV时域指标和频域指标治疗后明显改善，与FT3、FT4的恢复相对应。结论HRV分析表明甲亢患者的自主神经活动明显改变，并与病情严重程度相关。

【关键词】心率变异性(HRV)甲状腺功能亢进症

Analysis of heart rate variability in hyperthyroid patients

Hu Yumei,Wang Guanyan,Lu Guanghua.Department of Internal Medicine,Renji Hospital,Shanghai Second Medical

University,Shanghai,200001

【Abstract】Objective To study the significance of the measurements of heart rate variability(HRV)in hyperthyroid patients.Methods The HRV of47hyperthyroid patients was compared with that of normal control and the effects of treatment on HRV of32hyperthyroid patients were also evaluated.Results HRV time domain in hyperthyroid patients was much lower than that in normal control group.As to HRV frequency domain,the low frequency power(LF)and high frequency power(HF)in hyperthyroid patients were also significantly lower than that of the control group,reflecting that activity of autonomic neuropathy in hyperthyroid patients was obviously suppressed.But LF/HF of hyperthyroid patients was higher than that of normal group,indicating a relative lack of sympathetic tone in hyperthyroid patients.The increase of LF/HF is positively related to FT3.HF,heart rate(HR)and square root of the mean squared differences of successive normal-to-normal RR intervals(r-MSSD)are also positively related to FT3.The scattergram was short stick-like in hyperthyroid patients,but was comet-like in normal group.The HRV of hyperthyroid patients was improved after treatment and associated with the recovery of FT3and FT4.Conclusion HRV analysis showed that activity of autonomic neuropathy in hyperthyroid patients was obviously changed,which

related to the severity of the disease.

【Key words】Heat rate variability(HRV)Hyperthyroidism

(Chin J Endocrinol Metab,1998,14:377-379)

心率变异性(HRV)分析被认为是判断心脏自主神经活动的最敏感方法，它作为一种无创指标，能够揭示交感-迷走神经间的相互作用〔1，2〕。甲状腺

功能亢进常表现对心血管系统功能的影响。有关甲亢的HRV分析，研究甚少。所以本文通过分析甲亢病人HRV，定量观察甲亢病人交

感和迷走神经活性及与甲亢病情的关系，并与正常人对比，探讨甲亢患者HRV 测定的意义。

对象与方法

一、对象

1.甲亢组：甲亢病人47例，男11，女36，平均年龄39±10岁，均有较典型的临床症状，实验室检查：FT3＞7.2pmol/L、FT4＞24pmol/L、S-TSH ＜0.4mU/L，采用美国DPC公司IMMULITE全自动化学发光仪，且排除高血压、冠心病、糖尿病等有可能影响HRV的疾病。

2.正常对照组：37人，男16，女21，平均年龄36±8岁，无自觉症状，无慢性病史，无异常体征，ECG正常。

3.治疗组：甲亢组中的32例作了治疗后HRV分析，男9，女23，平均年