Adebiyi Adewole Adesoji, Oyebowale Olaniyi Mabayomije, Olaniyi Ayodele John, Falase Ayodele Olawale
Department of Medicine, College of Medicine, University of Ibadan; Department of Medicine, University College Hospital, Ibadan, Nigeria.
Department of Medicine, University College Hospital, Ibadan; Department of Medicine, State Hospital, Abeokuta, Nigeria.
Niger Postgrad Med J. 2019 Jan-Mar;26(1):8-12. doi: 10.4103/npmj.npmj_186_18.
Autonomic nervous system (ANS) dysfunction assessed by abnormalities in heart rate variability (HRV) is thought to play a role in the pathophysiology of sickle cell disease (SCD). There is suggestion that changes in ANS may occur in SCD subjects during episodes of vaso-occlusive crises (VOC).
The aim of this study was to evaluate the ANS by determining the HRV in patients with SCD during VOC.
This was a cross-sectional observational study.
HRV studies were carried out in 76 participants with SCD during episodes of VOC. Eighty-two SCD participants in steady state served as controls.
Comparison of two independent groups with Student's t-test and Mann-Whitney's test, and multiple linear regressions were also carried out.
Participants with SCD and VOC had significant reductions in the time-domain HRV parameters of standard deviation of RR intervals (45.8 [59.36] ms vs. 66.3 [129.2] ms, P = 0.0073) and root mean square of successive differences of RR intervals (48.3 [87.66] ms vs. 74.2 [174.5] ms, P = 0.0015). The frequency-domain HRV indices of low frequency (145.8 [81.62] ms 157.5 [68.9] ms, P = 0.1442) and high frequency (145.0 [118.40] ms vs. 146.3 [90.3] ms, P = 0.3683) were similar between the two groups. Age and the heart rate were the major independent relations of the HRV parameters.
Time-domain HRV parameters were impaired during crises in participants with SCD. This finding suggests further impairment of ANS activity in SCD patients during crises. Further studies are needed to clarify the prognostic implication of these findings.
通过心率变异性（HRV）异常评估的自主神经系统（ANS）功能障碍被认为在镰状细胞病（SCD）的病理生理学中起作用。有迹象表明，在血管闭塞性危机（VOC）发作期间，SCD患者的ANS可能会发生变化。
本研究的目的是通过测定VOC期间SCD患者的HRV来评估ANS。
这是一项横断面观察性研究。
对76例VOC发作期间的SCD参与者进行了HRV研究。82例处于稳定状态的SCD参与者作为对照。
采用Student t检验和Mann-Whitney检验对两个独立组进行比较，并进行多元线性回归分析。
患有SCD和VOC的参与者RR间期标准差的时域HRV参数显著降低（45.8[59.36]ms对66.3[129.2]ms，P = 0.0073），RR间期连续差值的均方根也显著降低（48.3[87.66]ms对74.2[174.5]ms，P = 0.0015）。两组之间低频（145.8[81.62]ms对157.5[68.9]ms，P = 0.1442）和高频（145.0[118.40]ms对146.3[90.3]ms，P = 0.3683）的频域HRV指数相似。年龄和心率是HRV参数的主要独立相关因素。
SCD参与者在危机期间时域HRV参数受损。这一发现表明，SCD患者在危机期间ANS活动进一步受损。需要进一步研究来阐明这些发现的预后意义。
