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Int J Stroke:急性梗死时的心率变异性和压力反射敏感性

2015-08-17 phylis 译 MedSci原创

背景:急性梗死后,自主神经系统功能异常比较常见,并且这能提高心率失常的发生率,增加患者死亡率。心率变异性(heart rate variability,HRV)和压力反射敏感性(baroreflex sensitivity,BRS)作为调查自主神经系统功能障碍的指标,用于预测梗死预后。总结:在急性梗死中,对表示自主神经功能的参数,心率变异性和压力反射敏感性进行系统综述。一共包括有22个研究。主要分

背景:急性梗死后,自主神经系统功能异常比较常见,并且这能提高心率失常的发生率,增加患者死亡率。心率变异性(heart rate variability,HRV)和压力反射敏感性(baroreflex sensitivity,BRS作为调查自主神经系统功能障碍的指标,用于预测梗死预后。

总结:在急性梗死中,对表示自主神经功能的参数,心率变异性和压力反射敏感性进行系统综述。一共包括有22个研究。主要分析心率变异性或压力反射敏感性与梗死严重性、早晚期并发症和死亡率之间的关系。但是,由于一些混杂因素,比如方法学不同、小样本量、生存率的选择和梗死并发其他疾病患者的排除,这些混杂因素使得一些研究的解释和对梗死患者的推断存在局限性。并未对主要问题调查:比如溶栓治疗对自主神经功能的影响,梗死超急性期时自主神经系统功能障碍,溶栓治疗与再发梗死的危险的相互关系。并未对上述问题进行非线性分析,尽管这些有利于对梗死患者心率失常发生的评估。

主要结论:

心脏自主神经功能异常,即心率变异性下降或者压力反射敏感性下降,与梗死严重性、早晚期并发症和死亡率相关。在急性梗死病人中,应该进行大规模国际水平的前瞻性研究,对心率变异率和压力感受器敏感性进行标准化的测量和分析。

原始出处:

Yperzeele L, van Hooff RJ, Nagels G, De Smedt A, De Keyser J, Brouns R.Heart rate variability and baroreceptor sensitivity in acute stroke: a systematic review.Int J Stroke. 2015 Aug;10(6):796-800. 


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