不同运动亚型帕金森病患者心脏自主神经调节功能存在差异

严嫚莉.不同运动亚型帕金森病患者心脏自主神经调节功能存在差异[J].内科急危重症杂志,2023,29(2):133-136

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DOI：10.11768/nkjwzzzz20230209

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基金项目:国家自然科学基金青年项目（No:81901303）

作者	单位	E-mail
严嫚莉	湖北医药学院附属随州医院神经内科	zhijuanjoy@163.com

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中文摘要:

目的：比较震颤为主型和少动-强直为主型帕金森病(PD)患者心脏自主神经调节功能的差异。方法：收集120例PD患者（震颤为主型、少动-强直为主型各60例），招募同期健康者60例为对照组，分别进行24h动态心电图检查，收集其一般资料及自主神经功能量表(SCOPA-AUT)评分等，比较各组的SCOPA-AUT评分及心率变异性(HRV)参数。结果：无论震颤为主型还是少动-强直为主型PD患者，其SCOPA-AUT评分高于对照组(P均<0.001)，低频成分(LF)、相邻NN间期差异≥50ms占所有NN间期总数的百分比(pNN50)均低于对照组(LF：P=0.005,P=0.003；pNN50：P=0.049,P=0.002)，而少动-强直为主型PD患者的高频成分(HF)显著低于震颤为主型及对照组(P=0.019,P=0.001)，LF/HF与震颤为主型存在差异，24h内全部相邻窦性R-R间期差值的均方根值（rMSSD）、24h内全部窦性R-R间期的标准差(SDNN)明显低于对照组(P=0.003，P=0.035)。结论：帕金森病患者的自主神经功能普遍受损，少动-强直为主型PD患者的自主神经功能受损更严重，迷走神经活性明显降低。

英文摘要:

Objective: To compare the differences in cardiac autonomic nervous regulation between patients with Parkinson disease (PD) of tremor-dominated type and hypokinetic-rigidity-dominated type. Methods: A total of 120 PD patients (60 cases of tremor-dominated type and 60 cases of hypokinetic-rigidity-dominated type) were collected, and 60 healthy controls were recruited for 24h dynamic electrocardiogram examination. The general information and the Scale for Outcomes in Parkinson disease-Automotive (SCOPA-AUT) scores were recorded. The SCOPA-AUT scores and heart rate variability (HRV) parameters were compared between two groups. Results: The SCOPA-AUT scores of PD patients with either tremor-dominated or hypokinetic-rigidity-dominated type were higher than those of the healthy controls(all P<0.001), and low frequency(LF) and the percentage difference between adjacent NN intervals greater than 50ms(pNN50) were lower than those of the control group(LF: P=0.005, P=0.003; pNN50: P=0.049, P=0.002). The high frequency (HF) of patients with hypokinetic-rigidity-dominated PD was significantly lower than that of tremor-dominated and healthy controls(P=0.019, P=0.001). LF/HF in hypokinetic-rigidity-dominated PD patients was different from that of tremor-dominated patients. The root mean square successive difference of normal R-R intervals(rMSSD) and standard deviation of normal R-R intervals(SDNN) were significantly lower in PD patients than those in the control group(P=0.003, P=0.035). Conclusion: The autonomic nerve function of patients with PD is generally impaired, and it is more severely impaired in PD patients with hypokinetic-rigidity-predominant, and vagal activity is significantly reduced.