标题：甲状腺功能亢进患者机体植物神经功能昼夜周期变化临床观察

      作者：李淑芸 1，张鹏 2
    (江门市中心医院神经内科 1、重症医学科 2，广东 江门 529000)

      卷次： 2016年27卷4期

      【摘要】 目的 观察甲状腺功能亢进(甲亢)患者机体植物神经功能昼夜周期变化情况。方法 选取2012年6
月至2015年8月在我院接受治疗的甲亢患者45例作为观察组，另选取同期在我院进行体检的健康者42例作为对
照组，利用心电工作站计算出两组受试者的24 h心率变异性，比较两组的RR间期标准差(SDNN)、相邻RR间期差
值均方根(RMSSD)、低频段功率(LF)、高频段功率(HF)、低高段频率比(LF/HF)、极低频段功率(VLF)、植物神经平衡
指数，以及两组受试者不同时期的短时频域指标差异情况，并分析观察组植物神经平衡指数与SDNN、RMSSD及
LF/HF的相关性。结果 观察组患者的 SDNN、RMSSD及HF水平分别是(69.73±13.61) ms、(13.04±3.18) ms及
(53.35±15.78) ms2，明显低于对照组的(136.65±12.02) ms、(29.67±5.82) ms及(221.45±50.12) ms2，LF、LF/HF、VLF及
植物神经平衡指数分别是(502.36±92.55) ms2、(5.94±1.23)、(1 824.13±239.02) ms2、(0.69±0.16)，均高于对照组的
(404.82±51.37) ms2、(2.17±0.56)、(326.72±60.53) ms2、(0.38±0.12)，以上各项指标比较差异均有统计学意义(P<0.05)；
两组受试者的VLF、LF及HF的差异主要分布在白天，其中HF为散在性差异，而LF/HF在白天无明显差异；根据
Pearson法分析相关性发现，观察组植物神经平衡指数与SDNN及RMSSD均呈负相关(r=-0.648、-0.702；P=0.001、
0000)，与LF/HF呈正相关(r=0.728、P=0.000)。结论 甲亢患者机体植物神经功能易发生昼夜周期的变化，临床主
要表现在交感神经、迷走神经功能的异常以及心率变异性较差等方面，值得深入研究。

      【关键词】 甲亢；植物神经功能；昼夜周期；变化；临床分析

      【中图分类号】 R581.1 【文献标识码】 A 【文章编号】 1003—6350（2016）04—0539—03


Clinical observation of day and night cycle changes of the autonomic nerve function in patients with
hyperthyroidism.
LI Shu-yun 1, ZHANG Peng 2. Department of Neurology 1, Department of Severe Medical Science 2,
Jiangmen Central Hospital, Jiangmen 529000, Guangdong, CHINA

【Abstract】 Objective To study the changes of the autonomic nerve function in day and night cycle in patients
with hyperthyroidism. Methods Forty-five patients with hyperthyroidism treated in our hospital from June 2012 to Au-
gust 2015 were enrolled as the observation group, and 42 healthy people who came to our hospital for physical examina-
tion were selected as the control group. ECG workstation was applied to calculate the 24-hour heart rate variability in
the two groups. Standard deviation of normal RR intervals (SDNN), root mean square difference of successive normal
RR intervals (RMSSD), low frequency power (LF), high frequency power (HF), low frequency power/high frequency
power (LF/HF), very low frequency power (VLF), autonomic nervous balance index, and difference of short-term fre-
quency domain index in different periods were compared between the two groups. Correlation between autonomic ner-
vous balance index and SDNN, RMSSD and LF/HF was analyzed. Results The levels of SDNN, RMSSD, HF in the
observation group were (69.73±13.61) ms, (13.04±3.18) ms, (53.35±15.78) ms2, which were significantly lower than
those in the control group of (136.65±12.02) ms, (29.67±5.82) ms and (221.45±50.12) ms2. The LF, LF/HF, VLF and au-
tonomic nerve balance index in the observation group were (502.36±92.55) ms2, (5.94±1.23), (1 824.13±239.02) ms2,
(0.69 ± 0.16), which were significantly higher than those in the control group of (404.82 ± 51.37) ms2, (2.17 ± 0.56),
(326.72±60.53) ms2, (0.38±0.12). The differences were all statistically significant (P<0.05). The differences of HF, LF
and VLF in the two groups were mainly distributed in the daytime, and the HF was scattered in the daytime, while the
LF/HF was not significantly different during the day. According to Pearson analysis, autonomic nervous balance index
were negatively correlated with RMSSD and SDNN in the observation group (r=-0.648, -0.702; P=0.001, 0000), and
·论 著·
6350.2016.04.007