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肠易激综合征青少年的心率变异性与躯体化

Heart Rate Variability and Somatization in Adolescents With Irritable Bowel Syndrome.

作者信息

Semen Marta, Lychkovska Olena, Kaminskyy Danylo, Yavorskyi Ostap, Semen Khrystyna O, Yelisyeyeva Olha

机构信息

Departments of Propedeutics of Pediatrics and Medical Genetics, Cytology and Embryology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.

Departments of Pharmaceutical, Organic and Bioorganic Chemistry, Cytology and Embryology, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.

出版信息

J Neurogastroenterol Motil. 2023 Apr 30;29(2):208-217. doi: 10.5056/jnm22019.

Abstract

BACKGROUND/AIMS: Changes in autonomic regulation and psychological distress play an important role in the pathobiology of irritable bowel syndrome (IBS). The aim of the current study is to evaluate the autonomic function and to link it to the levels of somatization in adolescents with IBS.

METHODS

We enrolled 30 adolescents with various types of IBS and 35 healthy controls. Time and frequency domain indexes of heart rate variability (HRV) were measured in supine (baseline) and standing (orthostasis) positions using short-term electrocardiographic recordings. The somatic symptoms index was assessed with the modified Screening for Somatoform Symptoms questionnaire.

RESULTS

Adolescents with IBS showed no differences of HRV parameters in the supine position compared to healthy control. In orthostasis, a decrease in the standard deviation of normal RR intervals as well as main spectral index total power (TP) were observed. The reduction of TP was attributed to the reduced activities of the high- and low frequency components. Increased somatic symptoms index in IBS patients negatively correlated with TP in orthostasis ( = -0.485, = 0.007). A subgroup analysis revealed that adolescents with IBS with TP values either < 2500 msec or > 5500 msec in the supine position demonstrated significantly reduced activity of the low frequency component.

CONCLUSIONS

Adolescents with IBS showed signs of autonomic dysfunction only during the orthostatic test, which were associated with increased somatization scores. Further research is needed to establish the links between emotional wellbeing and autonomic function in this population.

摘要

背景/目的:自主神经调节变化和心理困扰在肠易激综合征(IBS)的病理生物学中起重要作用。本研究的目的是评估青少年IBS患者的自主神经功能,并将其与躯体化水平联系起来。

方法

我们招募了30名患有各种类型IBS的青少年和35名健康对照者。使用短期心电图记录,在仰卧位(基线)和站立位(直立位)测量心率变异性(HRV)的时域和频域指标。用改良的躯体形式症状筛查问卷评估躯体症状指数。

结果

与健康对照相比,IBS青少年在仰卧位时HRV参数无差异。在直立位时,观察到正常RR间期标准差以及主要频谱指数总功率(TP)降低。TP的降低归因于高频和低频成分的活动减少。IBS患者躯体症状指数增加与直立位时的TP呈负相关(r = -0.485,P = 0.007)。亚组分析显示,仰卧位时TP值<2500毫秒或>5500毫秒的IBS青少年低频成分活动显著降低。

结论

IBS青少年仅在直立试验期间表现出自主神经功能障碍的迹象,这与躯体化评分增加有关。需要进一步研究以确定该人群中情绪健康与自主神经功能之间的联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/057f/10083117/5eb30ce0a373/jnm-29-2-208-f1.jpg

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