功能性消化不良患者心率变异性分析及其临床意义

The clinical significance of heart rate variability analysis for patients with functional dyspepsia

目的探讨功能性消化不良患者心率变异性的特点及临床意义。方法分别对80例功能性消化不良患者、66例十二指肠溃疡患者、60例健康体检者(对照组)行24 h动态心电图监测,作心率变异时域和频域分析。结果①功能性消化不良组SDNN、rMSSD、PNN50、LF、HF均低于对照组,差异有统计学意义(P<0.05);SDANN和ULF差异有统计学意义(P<0.01);用于评估交感、迷走神经平衡的指标LF/HF较对照组显著增大(P<0.05);②十二指肠溃疡组的SDNN、SDANN、ULF、LF、LF/HF指标与对照组比较,差异无统计学意义(P>0.05),rMSSD、PNN50、HF较对照组显著升高,差异有统计学意义(P<0.05);③功能性消化不良组除LF/HF较十二指肠溃疡组升高外,其余各项指标均显著降低,差异有统计学意义(P<0.05)。结论功能性消化不良患者的心率变异性有明显改变,伴有自主神经功能紊乱,表现为迷走神经张力降低、交感神经兴奋性增强。心率变异性检测对综合诊治功能性消化不良具有一定的临床参考价值。

Objective Toexplorethecharacteristicsofheartratevariability（HRV）andits clinicalsignificanceforpatientswithfunctionaldyspepsia.Methods Themonitoringof24-houram-bulatory electrocardiography（AECG）was carried out on 80 patients with functional dyspepsia（FD group）,66 patients with duodenal ulcer（DU group）and 60 cases of healthy people as control group.Based on AECG,we made HRV analysis in time and frequency domain.Results ①The in-dexes of SDNN,rMSSD,PNN50,LF and HF in FD group were lower than those of the control group with statistically significant differences（P〉0.05）while there was also statistical significance （P〈0.01 ）in the difference of SDANN and ULF.Compared with the control group,the index of LF/HF applied in evaluating the balance of sympathetic nerve and pneumogastric nerve significantly increased（P〈0.05）in FD group.②Compared with the control group,the differences of SDNN, SDANN,ULF,LF and LF/HF in DU group weren’t statistically significant（P 〉0.05）while rMSSD,PNN50 and HF increased significantly and the differences were statistically significant（P〈0.05）.③Compared with DU group,all of the other indexes in FD group decreased significantly＆amp;nbsp;and the difference was statistically significant（P〈0.05）except for the increase of LF/HF.Conclu-sion Therearesignificantchangesinheartratevariabilityofpatientswithfunctionaldyspepsia, accompanied by autonomic nervous dysfunction which is evidenced by decreased tension of pneumo-gastric nerve and enhanced excitability of sympathetic nerve.The HRV detection proves some clinical reference value for comprehensive diagnosis of functional dyspepsia.