心率变异性与自发性脑出血的预后相关。

Heart rate variability is associated with outcome in spontaneous intracerebral hemorrhage.

机构信息

First Dept. of Neurology, University Hospital Bratislava, Comenius University Bratislava, Slovakia.

Div. of Neurosurgery, Department of Clinical Neurosciences, Cambridge University, Cambridge, UK.

出版信息

J Crit Care. 2018 Dec;48:85-89. doi: 10.1016/j.jcrc.2018.08.033. Epub 2018 Aug 25.

DOI:10.1016/j.jcrc.2018.08.033

PMID:30176528

Abstract

PURPOSE

Autonomic imbalance as measured by heart rate variability (HRV) has been associated with poor outcome after stroke. Observations on HRV changes in intracerebral hemorrhage (ICH) are scarce. Here, we aimed to investigate HRV in ICH as compared to a control group and to explore associations with stroke severity, hemorrhage volume and outcome after ICH.

METHODS

We examined the autonomic modulation using frequency domain analysis of HRV during the acute phase of the ICH and in a healthy age- and hypertension-matched control group. Hematoma volume, intraventricular extension, initial stroke severity and baseline demographic, clinical parameters as well as mortality and functional outcome were included in the analysis.

RESULTS

47 patients with ICH and 47 age- and hypertension matched controls were analyzed. ICH patients showed significantly lower total high frequency band (HF) and low frequency band (LF) powers (p = 0.01, p < 0.001), higher normalized HF power (p = 0.03), and lower LF/HF ratio (p < 0.001) as compared to the controls. Autonomic parameters showed associations with stroke severity (p = 0.004) and intraventricular involvement (p = 0.01) and predicted poor outcome independently (p = 0.02).

CONCLUSIONS

Autonomic changes seems to be present in acute ICH and are associated with poor outcome independently. This may have future monitoring and therapeutic implications.

摘要

目的

心率变异性（HRV）测量的自主神经失衡与中风后预后不良有关。关于脑出血（ICH）中 HRV 变化的观察结果很少。在这里，我们旨在研究 ICH 中的 HRV 与对照组相比，并探讨与中风严重程度、出血体积和 ICH 后结局的相关性。

方法

我们在 ICH 的急性期和年龄及高血压匹配的健康对照组中使用 HRV 的频域分析来检查自主神经调节。血肿体积、脑室内延伸、初始中风严重程度以及基线人口统计学、临床参数以及死亡率和功能结局都包括在分析中。

结果

分析了 47 例 ICH 患者和 47 例年龄及高血压匹配的对照组。与对照组相比，ICH 患者的总高频带（HF）和低频带（LF）功率明显降低（p=0.01，p<0.001），归一化 HF 功率升高（p=0.03），LF/HF 比值降低（p<0.001）。自主神经参数与中风严重程度（p=0.004）和脑室内受累（p=0.01）相关，并独立预测不良结局（p=0.02）。