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心率变异性与帕金森病严重程度

Heart rate variability and Parkinson's disease severity.

作者信息

Devos D, Kroumova M, Bordet R, Vodougnon H, Guieu J D, Libersa C, Destee A

机构信息

Department of Neurology, EA 2683, CHU Lille, France.

出版信息

J Neural Transm (Vienna). 2003 Sep;110(9):997-1011. doi: 10.1007/s00702-003-0016-8.

Abstract

Heart rate variability (HRV) decrease in Parkinson's disease (PD) could only be a consequence of reduce motor activity besides of being a marker of cardiovascular dysautonomia. Under continuously recorded and standardised motor activity, we studied thirty patients compared to controls in 3 PD stages: group I: less than 2 year-evolution, slight impaired without L-dopa; group II: mildly impaired with L-dopa; group III: advanced PD with motor complications. No difference was observed between group I and controls. The diurnal low frequency power (LF) and the ratio of LF/high frequency (HF) power decreased in groups II and III. The nocturnal vagal indicators: HF power and pNN50 were decreased in group III. Those parameters were correlated with Off-drug-motor handicap, suggesting an evolutive HRV decrease with disease severity but not with On-drug-motor activity. The low LF despite the higher motor activity in group III, due to dyskinesias, suggested a defective cardiovascular up-regulation.

摘要

帕金森病(PD)患者心率变异性(HRV)降低,除了是心血管自主神经功能障碍的一个标志物外,可能仅是运动活动减少的结果。在持续记录并标准化运动活动的情况下,我们研究了30例患者,与3个PD阶段的对照组进行比较:第一组:病程小于2年,轻度受损,未使用左旋多巴;第二组:使用左旋多巴后轻度受损;第三组:伴有运动并发症的晚期PD。第一组与对照组之间未观察到差异。第二组和第三组的日间低频功率(LF)以及LF/高频(HF)功率比值降低。第三组的夜间迷走神经指标:HF功率和pNN50降低。这些参数与停药后的运动障碍相关,提示HRV随疾病严重程度而逐渐降低,但与用药时的运动活动无关。第三组尽管运动活动较多但LF较低,这是由于运动障碍所致,提示心血管上调存在缺陷。

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