脑卒中患者睡眠结构与心率变异性的相关性研究

Study on correlation between stroke patients with sleep structure and heart rate variability

目的观察脑卒中患者睡眠结构对心率变异性的影响,研究脑卒中患者睡眠结构与心率变异性的相关性。方法对确诊为脑卒中的51例患者应用24 h全信息动态心电图系统和多导睡眠图进行全夜监测,并与24名正常相同年龄范围人群对照。结果与对照组相比,脑卒中患者HRV时域参数各项指标均显著降低(P均<0.01);总睡眠时间(TST)、睡眠效率(SE)、REM期均明显减少(P均<0.01),而觉醒期(WASO)明显增加(P<0.01);与脑卒中后无睡眠结构紊乱组相比,脑卒中伴睡眠结构紊乱组SDNN、SDANN、RMSSD下降(P均<0.05)。结论在脑卒中已存在交感神经激活的状态下,睡眠结构紊乱更增加了交感神经的张力,使人交感神经兴奋,影响自主神经功能导致猝死风险增大。

Objective It is to research the correlation between stroke patients with sleep structure and heart rate variability by observing the effects of sleep structure of patients with stroke on heart rate variability. Methods 24 h dynamic electrocardio- gram information system and Polysomnography were used to monitor 51 patients who were diagnosed acute stroke all night and in contrast with 24 normal same age range crowd. Results Compared with the control group, acute stroke patients＇ index were all decreased significantly in HRV time domain parameters, and the differences were statistically significant （ P 〈 0.01 ） , total sleep time（TST） , sleep efficiency （SE） , percentage of REM time/total sleep time were significantly reduced （P 〈 0.01 ） , WASO was obviously increased（ P 〈 0.05 ）. Compared with groups of no structural disorder of sleep after stroke, SDNN, SDANN, RMSSD of stroke associated with sleep structure disordered group was decreased, and the differences were statistically sig- nificant （P 〈0.05）. Conclusion In state of sympathetic been activated, structural disorder of sleep increased sympathetic tone even more to make sympathetic nerve excited and effect autonomic function which causes an increased risk of sudden death.