心率变异性与急性高原反应评分关系初探

Correlation between acute mountain sickness and heart rate variability

目的应用心率变异性(HRV)探讨自主神经功能与急性高原反应(AMS)症状学评分的相关性。方法86例健康汉族男性新兵在平原560m和空运至海拔3675m西藏高原2～4d内,分别接受了短程HRV检测,进藏后当日接受了AMS症状学评分调查。根据该评分将受试者分为基本无AMS组(49例)和AMS组(37例)。结果AMS组平原HRV中平均正常RR间期的标准差(SDNN)、相邻RR间期差的均方根(rMSSD)、低频(LF)以及急进高原rMSSD、SDNN、LF、总功率(TP)、相邻RR间期相差>50ms百分数(PNN50)的下降幅度均显著高于基本无AMS组(P<0.05,P<0.01),但其平原标准化高频(HFnu)则显著低于后者(P<0.05)。AMS症状学评分与平原rMSSD、SDNN、LF/HF以及急进高原rMSSD、SDNN变化幅度均呈正相关(P<0.05),但与平原HFnu呈负相关(P<0.01)。结论自主神经功能与AMS相关,平原自主神经活性较高、交感神经占优势且对应激反应过强者AMS症状较重,检测心率变异性可在一定程度上预测AMS。

Objective To explore the correlation between the autonomic nerve function and the symptomatic scores of acute mountain sickness （AMS） by using heart rate variability （HRV）. Methods In 86 healthy young men of Han nationality, the short-term （5 min） HRV were measured at 560 meter above sea level and during 2-4 day after arival at Tibet （3 675 m above sea level） by airplane, and the symptomatic scores of AMS were investigated on the first day at Tibet. All subjects were divided into AMS group （ n = 49） and nonAMS group （n = 37） according to AMS scores. Results Compared with non-AMS subjects, AMS subjects had higher standard deviation of normal to normal intervals （ SDNN）, root mean square of delta RR （ rMSSD）, low frequency （LF） and lower normalized high frequency （HFnu） of HRV at 560 m, greater decrease of SDNN, rMSSD, LF, percentage of delta RR 〉50 ms （PNN50） and total power （TP） after arrival at Tibet （P 〈0. 05, P 〈0. 01 ）. Positive correlation was found between the AMS scores and rMSSD, SDNN, LF/HF at 560 m above sea level （ P 〈 0. 05 ）, as well as the decrease of rMSSD, SDNN （ P 〈 0. 05 ） , while negative correlation was between AMS scores and HFnu at 560 above sea level （P 〈 0. 01 ）. Conclusion The autonomic nerve function is correlated with AMS. The higher autonomic nerve activity at plain, sympathetic dominance and over-reactivity of autonomic nerve to stress may lead to more serious symptom of AMS. HRV can predict AMS to some degree.