Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Brain Behav. 2024 Feb;14(2):e3391. doi: 10.1002/brb3.3391.
Our study was conducted aimed at investigating the potential correlation between cerebral microangiopathy and autonomic nervous dysfunction.
We initially included 164 hospitalized patients with cerebral microangiopathy at our hospital from November 2019 to January 2021. Based on the inclusion and exclusion criteria, a final total of 162 patients with cerebral microangiopathy were selected. According to the patient's Autonomic Symptom Profile (ASP) score, patients with a score greater than 22 were categorized into a group with concomitant autonomic dysfunction (71 cases, combined group), while those with a score below 22 were categorized into a group of isolated cerebral microangiopathy (83 cases, cerebral microangiopathy group). The general data and laboratory examination results of the two groups were analyzed, and Pearson correlation analysis was performed to evaluate the correlation between cerebral microangiopathy and autonomic dysfunction, as well as the influencing factors of cerebral microangiopathy patients combined with autonomic dysfunction.
There were no significant differences between the two groups in terms of sex, BMI, smoking, drinking, family dementia history, diabetes, hypothyroidism, carotid atherosclerosis, obstructive sleep apnea hypopnea syndrome, hyperuricemia, hyperlipidemia, chronic obstructive pulmonary disease, Hamilton Anxiety Scale score, Hamilton Depression Scale score, 24-h mean systolic blood pressure (SBP), 24-h mean diastolic blood pressure DBP, daytime mean systolic blood pressure (dSBP), daytime mean diastolic blood pressure, nighttime mean systolic blood pressure (nSBP), nighttime mean diastolic blood pressure, 24-h systolic blood pressure standard deviation (SBPSD), 24-h diastolic blood pressure standard deviation, daytime diastolic blood pressure standard deviation, nighttime diastolic blood pressure standard deviation (nDBPSD), nDBPSD (p > .05). However, significant differences were observed between the two groups regarding age, history of coronary heart disease, hypertension, leukoaraiosis, cognitive function, ASP score, SSR, 24-h SBPSD, daytime systolic blood pressure standard deviation (dSBPSD), nighttime systolic blood pressure standard deviation (nSBPSD), standard deviation of RR interval (SDNN), root mean square value of successive RR interval difference (RMSSD), high-frequency component (HF), and low-frequency component (LF) (p < .05). Moreover, the levels of TG, TC, HDL-C, and LDL-C did not show significant differences between the two groups (p > .05), but there were significant differences in blood uric acid and homocysteine (Hcy) levels (p < .05). Age, history of leukoaraiosis, cognitive function assessment, blood uric acid, Hcy levels, 24-h SBPSD, dSBPSD, and nSBPSD showed positive correlations with ASP scores and SSR in patients with cerebral microangiopathy (p < .001). In contrast, hypertension, SDNN, RMSSD, HF, and LF showed negative correlations with ASP scores and SSR (p < .001). Moreover, coronary heart disease was negatively correlated with ASP scores but positively correlated with SSR (p < .001). The independent variables included age, history of leukoaraiosis, cognitive function assessment, ASP score, SSR, blood uric acid, Hcy, bradykinin, coronary heart disease, hypertension, 24-h SBPSD, dSBPSD, nSBPSD, SDNN, RMSSD, HF, and LF, which were indicators with differences in general data and laboratory indicators. The dependent variable was patients with cerebral microangiopathy combined with autonomic nervous dysfunction. The analysis results showed that age, history of leukoaraiosis, ASP score, SSR, 24-h SBPSD, dSBPSD, nSBPSD, SDNN, RMSSD, HF, and LF were the influencing factors of patients with cerebral microangiopathy complicated with autonomic nervous dysfunction.
We demonstrates that age, history of leukoaraiosis, cognitive function assessment, blood uric acid, Hcy level, 24-h SBPSD, dSBPSD, nSBPSD, blood pressure, SDNN, RMSSD, HF, LF, and coronary heart disease were highly associated with cerebral microangiopathy with autonomic dysfunction. Furthermore, the influencing factors of cerebral microangiopathy with autonomic dysfunction are age, history of leukoaraiosis, ASP score, SSR, blood pressure variability, and HRV.
本研究旨在探讨脑微出血与自主神经功能障碍之间的潜在相关性。
我们最初纳入了我院 2019 年 11 月至 2021 年 1 月收治的 164 例脑微出血患者，根据纳入和排除标准，最终选择了 162 例脑微出血患者。根据患者的自主症状谱（ASP）评分，评分大于 22 分的患者分为合并自主神经功能障碍组（71 例，合并组），评分小于 22 分的患者分为单纯脑微出血组（83 例，脑微出血组）。分析两组的一般资料和实验室检查结果，并进行 Pearson 相关性分析，评估脑微出血与自主神经功能障碍的相关性，以及脑微出血合并自主神经功能障碍患者的影响因素。
两组患者在性别、BMI、吸烟、饮酒、家族痴呆史、糖尿病、甲状腺功能减退、颈动脉粥样硬化、阻塞性睡眠呼吸暂停低通气综合征、高尿酸血症、高脂血症、慢性阻塞性肺疾病、汉密尔顿焦虑量表评分、汉密尔顿抑郁量表评分、24 小时平均收缩压（SBP）、24 小时平均舒张压（DBP）、白天平均收缩压（dSBP）、白天平均舒张压、夜间平均收缩压（nSBP）、夜间平均舒张压、24 小时收缩压标准差（SBPSD）、24 小时舒张压标准差、白天舒张压标准差、夜间舒张压标准差（nDBPSD）方面差异无统计学意义（p>0.05）。但两组患者在年龄、冠心病史、高血压、脑白质病变、认知功能、ASP 评分、SSR、24 小时 SBPSD、dSBPSD、nSBPSD、RR 间期标准差（SDNN）、连续 RR 间期差值的均方根值（RMSSD）、高频成分（HF）和低频成分（LF）方面差异有统计学意义（p<0.05）。此外，两组患者的 TG、TC、HDL-C 和 LDL-C 水平差异无统计学意义（p>0.05），但血尿酸和同型半胱氨酸（Hcy）水平差异有统计学意义（p<0.05）。年龄、脑白质病变史、认知功能评估、血尿酸、Hcy 水平、24 小时 SBPSD、dSBPSD、nSBPSD 与脑微出血患者的 ASP 评分和 SSR 呈正相关（p<0.001），而高血压、SDNN、RMSSD、HF 和 LF 与 ASP 评分和 SSR 呈负相关（p<0.001）。此外，冠心病与 ASP 评分呈负相关，与 SSR 呈正相关（p<0.001）。纳入的自变量包括年龄、脑白质病变史、认知功能评估、ASP 评分、SSR、血尿酸、Hcy、缓激肽、冠心病、高血压、24 小时 SBPSD、dSBPSD、nSBPSD、SDNN、RMSSD、HF 和 LF，这些指标在一般资料和实验室指标上存在差异。因变量为脑微出血合并自主神经功能障碍患者。分析结果表明，年龄、脑白质病变史、ASP 评分、SSR、24 小时 SBPSD、dSBPSD、nSBPSD、SDNN、RMSSD、HF 和 LF 是脑微出血合并自主神经功能障碍患者的影响因素。
本研究表明，年龄、脑白质病变史、认知功能评估、血尿酸、Hcy 水平、24 小时 SBPSD、dSBPSD、nSBPSD、血压、SDNN、RMSSD、HF、LF 和冠心病与脑微出血伴自主神经功能障碍密切相关。此外，脑微出血伴自主神经功能障碍的影响因素为年龄、脑白质病变史、ASP 评分、SSR、血压变异性和 HRV。
