Department of Psychosomatic Medicine and Psychotherapy, University Hospital, Tübingen, Germany.
Neurogastroenterol Motil. 2011 Nov;23(11):e470-8. doi: 10.1111/j.1365-2982.2011.01785.x. Epub 2011 Sep 14.
Many studies have reported disturbances of heart rate variability (HRV) in patients with psychosomatic disorders such as anorexia nervosa (AN) and the irritable bowel syndrome (IBS). However, both have never been directly compared.
We compared HRV in AN (n = 21) and in IBS (n = 21) (all females) with 42 healthy female control subjects who were matched for age and in IBS to body mass index (BMI). Recovery periods between different cardiac load tests were compared with baseline recordings and tilt test to estimate time [mean successive difference (MSD)] and frequency domain (Goldberger dimension, frequency of HF peak location and HF power, log HF power) values and to assess general reactivity of the autonomic nervous system (ANS).
Significantly longer inter-beat intervals (IBIs) in AN patients and lower values of MSD in IBS patients were found in comparison with respective controls; both were independent from experimental conditions and are found in baseline recordings only. Both effects were independent of age and BMI. We also demonstrate a significant relationship between age, BMI and some HRV parameters.
CONCLUSIONS & INFERENCES: Opposite autonomic patterns were found in AN and IBS: stronger vagal withdrawal in IBS and weaker vagal inhibition in AN patients. Records made at rest and without any autonomic load may be representative for assessment of ANS function. Age and BMI should be taken into consideration during assessment of HRV data.
许多研究报告称,神经性厌食症(AN)和肠易激综合征(IBS)等心身障碍患者的心率变异性(HRV)存在紊乱。然而,这两种疾病从未被直接比较过。
我们比较了 AN(n = 21)和 IBS(n = 21)(均为女性)患者与 42 名年龄和 IBS 与体重指数(BMI)相匹配的健康女性对照者的 HRV。不同心脏负荷试验之间的恢复期与基线记录和倾斜试验进行了比较,以估计时间[平均连续差异(MSD)]和频域(Goldberger 维数、HF 峰值位置和 HF 功率的频率、HF 功率的对数)值,并评估自主神经系统(ANS)的总体反应性。
与各自的对照组相比,AN 患者的心动间期(IBI)明显延长,IBS 患者的 MSD 值较低;这两个参数均不受实验条件的影响,仅存在于基线记录中。这两种效应均独立于年龄和 BMI。我们还证明了年龄、BMI 和某些 HRV 参数之间存在显著的相关性。
在 AN 和 IBS 中发现了相反的自主神经模式:IBS 患者的迷走神经抑制作用较强,而 AN 患者的迷走神经抑制作用较弱。在没有任何自主神经负荷的情况下进行的记录可能代表了对 ANS 功能的评估。在评估 HRV 数据时,应考虑年龄和 BMI。