癫癎患者发作间期心血管自主神经功能与心率变异性

Interictal cardiovascular autonomic function and heart rate variability in patients with epilepsy

目的 探讨癫 患者发作间期心血管自主神经功能与心率变异性（ＨＲＶ）的变化。方法 ５１例癫 患者根据标准心血管自主神经功能试验结果分为阳性（ＡＮＦＴ＋）组及阴性（ＡＮＦＴ－）组，与正常对照组３６例对比，进行ＨＲＶ分析。结果 癫 患者发作间期心血管自主神经功能异常率为４５．１％，且病程越长异常率越高。癫 患者在ＨＲＶ时域分析及非线性定量分析指标上均较对照组降低，且以 ＡＮＦＴ＋组患者最明显。ＨＲＶ直方图、散点图亦有特征性改变，以ＡＮＦＴ＋组患者最为显著。结论 癫 患者发作间期心血管自主神经功能存在紊乱现象，这种现象可能与癫 患者的猝死发生有关，ＨＲＶ是测定这一变化的敏感方法。

Objective To explore autonomic nervous, function in patients with epilepsy by studing heart rate variability (HRV) and cardiovascular reflex tests( CRT). Methods 51 patients with epilepsy and 36 healthy controls were involved in the study. According to the results of CRT, the epilepsy patients were divided into two groups-ANFT+ group (patients with positive autonomic nervous function tests) and ANFT- group (patients with negative autonomic nervous function tests). HRV and CRT were performed in all subjects. Results The overall frequency of abnormal autonomic nervous function in 51 patients was 45.1%, which correlated with the duration of epilepsy. Compared with the control group, the time domain and nonlinear dynamics indices were markedly and significantly reduced in both ANFT+ and ANFT- group, especially in ANFT+ group. Conclusions There is interictal cardiovascular autonomic nervous dysfunction in patients with epilepsy, which may be implicated in sudden unex- plained death in epilepsy. HRV could be used as a reliable and sensitive method to detect it.