肝硬化患者心血管反射和心率变异

AUTONOMIC FUNCTION IN CIRRHOSIS ASSESSED BY CARDIOVASCULAR REFLEX TESTS AND 24- HOUR HEART RATE VARIABILITY

目的：了解肝硬化患者的自主神经功能及其有病情严重程度的关系。方法：应用心血管反射试验和心率变异分析技术，检测了５５例肝硬化患者的自主神经功能。结果：６７％的肝硬化患者有一项以上心血管反射试验异常。肝硬化组心率变异值明显低于正常人。Ｃｈｉｌｄ积分与ｒ－ＭＳＳＤ、ＰＮＮ５０均呈负相关。结论：肝硬化患者自主神经功能异常的发生率较高，且与病情严重程度有关。

Aim : To assess the prevalence of autonomic dysfunction in cirrhosis and to observe the effects of disease severity on autonomic dysfunction. Methods : Fifty five patients with cirrhosis underwent stand- ard cardiovascular reflex tests. In addition. 24-hour heart rate variability(HRV) tests were perfortned to detect autonomic function in 30 patients. ResuIts : Thirty-seven of 55 patients(67%) had cardiovascular reflex dysfunction. HRV values were signicantly lower in 30 cirrhosis than those in controls, the patients with cirrhosis showed negative correlation between Child's scores and the root mean square successive differeces on adiacent normal RR intervals, the similar correlation was also found between child's scores and percent of difference adjacent normal RR intervals which are greater than 50 msec during the entire 24-hour ECG recording. Conclusion: There is a high prevalence of autonomic dysfunciton which is related to disease severity in cirrhosis.