心率变异性作为儿童炎症性肠病疾病恶化的预测指标。
Heart rate variability as a predictor of disease exacerbation in pediatric inflammatory bowel disease.
机构信息
Pediatric Gastroenterology Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Pediatrics, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
出版信息
J Psychosom Res. 2022 Jul;158:110911. doi: 10.1016/j.jpsychores.2022.110911. Epub 2022 Apr 12.
OBJECTIVES
Heart rate variability (HRV), a marker of the parasympathetic vagal activity, was reportedly significantly lower in patients with inflammatory bowel disease (IBD) compared to healthy controls. The aim of this study was to evaluate HRV as a predictor of clinical outcomes in pediatric IBD.
METHODS
This was a prospective study. Children (12-18 years of age) with IBD were prospectively recruited. Each patient underwent two 10-min HRV measurements by means of a photoplethysmograph finger sensor. The square root of the mean squared differences of successive R-R pulse intervals (RMSSD), an indirect index of vagal activity, was calculated. Clinical data, including demographic variables, disease activity and course, medications, and laboratory results were collected during a follow-up of 12 months. The relation between RMSSD and clinical outcomes was examined, adjusting for confounders.
RESULTS
A total of 34 children with IBD were included. Patients in clinical remission had a significantly higher RMSSD compared to patients with active disease (67.72 ± 27.81 versus 45.76 ± 22.04, respectively, P = 0.022). A multivariate analysis revealed that a higher RMSSD was a significant and independent predictor of lower risk of IBD exacerbation (odds ratio = 0.941, 95% confidence interval 0.887-0.998, p = 0.044).
CONCLUSION
HRV correlates with IBD activity and may also serve as an independent predictor of disease exacerbation in pediatric IBD.
目的
心率变异性（HRV）是迷走神经活动的副交感神经活性的标志物，据报道，炎症性肠病（IBD）患者的 HRV 明显低于健康对照组。本研究旨在评估 HRV 作为儿童 IBD 临床结局的预测指标。
方法
这是一项前瞻性研究。前瞻性招募了患有 IBD 的儿童（12-18 岁）。每位患者均通过光电容积脉搏传感器进行两次 10 分钟的 HRV 测量。计算出相邻 R-R 脉搏间隔的均方根差（RMSSD）的平方根，这是迷走神经活动的间接指标。在 12 个月的随访期间收集了临床数据，包括人口统计学变量、疾病活动和病程、药物和实验室结果。在校正混杂因素后，检查了 RMSSD 与临床结局之间的关系。
结果
共纳入 34 名患有 IBD 的儿童。处于临床缓解期的患者 RMSSD 明显高于处于活动期的患者（分别为 67.72±27.81 和 45.76±22.04，P=0.022）。多变量分析显示，较高的 RMSSD 是 IBD 恶化风险降低的显著且独立的预测指标（比值比=0.941，95%置信区间 0.887-0.998，p=0.044）。
结论
HRV 与 IBD 活动相关，也可作为儿童 IBD 疾病恶化的独立预测指标。
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