躯体形式自主神经紊乱患儿心率变异性改变

Heart rate variability changes in children with somatoform autonomic dysfunction.

【目的】 观察心率变异 (heartratevariability ,HRV )在躯体形式自主神经紊乱患儿组的改变。 【方法】 对 41例躯体形式自主神经紊乱患儿、40例正常儿童行 2 4h动态心电图分析 ,观察HRV时域、频域十项指标参数 ,2 4h内清醒期和睡眠期的改变 ,并以其主要症状系数为因变量 ,HRV 2 4h、清醒期、睡眠期各测值为自变量进行相关分析及多因素回归分析。 【结果】 躯体形式自主神经紊乱患儿的HRV升高 ,以睡眠期最为明显 ,睡眠期与清醒期HRV差异幅度昼夜波动增大 ,以相邻RR间期差值 >5 0ms的个数所占的百分比 (pNN50 )最为显著 ;低频带 /高频带 (LF/HF)清醒期比对照组增高 ,而睡眠期则低于对照组。心悸的发生与睡眠期 pNN50 呈正相关 ,疲劳与HF、LF和清醒期HF有关 ,胸痛与清醒期相邻正常RR间期差值的均方根 (rMSSD)呈正相关。 【结论】 躯体形式自主神经紊乱患儿的自主神经活动较正常儿童的稳定性差 ,其常见症状与HRV测值有相关关系。

Objective To study the heart rate variability (HRV) changes in children with somatoform autonomic dysfunction. HRV indexes in time and frequency domain were derived in 41 somatoform autonomic dysfunction and 40 healthy children. The HRV changes in awake-time and sleeping-time were observed also.Multiple correlation and regression analysis were carried out with the indexes of common sympotom as dependent variable and all the HRV measures as independent variables. HRV abnormality was found in somatoform autonomic dysfunction children.The HRV was increased,the difference in awake time and sleeping time was significantly greater than controls.Palpitation correlated with pNN 50 ,fatigue was related with HF/LF and awake HF, chest pain was positively correlated with awake rMSSD. [Conclusions] Abnormal HRV changes had happened in somatoform autonomic dysfunction children,which indicated the autonomic nerve function in this group was not as stable as normals, there were relations between common sympotoms and some HRV indexes. HRV analysis had important significance in the study of autonomic function and the diagnosis of this group.