Becker K, Görlach I, Frieling T, Häussinger D
Department of Gastroenterology and Infectious Diseases, Heinrich Heine University Medical Centre, Dusseldorf, Germany.
AIDS. 1997 May;11(6):751-7. doi: 10.1097/00002030-199706000-00008.
To examine the degree, pattern, and natural history of cardiac autonomic nervous dysfunction in patients infected with HIV.
Cross-sectional and prospective longitudinal cohort study.
Primary care and tertiary referral university centre.
Thirty-five consecutive HIV-infected patients who had either not yet developed AIDS (15 pre-AIDS patients) or who were at the Centers for Disease Control and Prevention (CDC) AIDS stage (n = 20), and 29 healthy age- and sex-matched HIV-negative controls.
Computer-aided power spectral analysis of 15 standardized parameters of heart-rate variability (HRV).
Pre-AIDS patients as a group did not exhibit any HRV parameters to be significantly different from healthy controls (P > 0.017), whereas AIDS patients demonstrated reduced HRV in 14 parameters (93.3%) compared with healthy subjects (p > 0.017). Median proportion of abnormal HRV parameters (< 10th percentile of controls) per individual was 9.1% in pre-AIDS patients and 61.3% in AIDS patients (P = 0.0347). Progressive CDC stages inversely correlated to 10 HRV parameters (66.7%; -0.50 < or = r < or = -0.36; P < 0.05). Follow-up testing in 10 pre-AIDS and six AIDS patients after 6-16 months (median, 12.5 months) did not reveal deterioration of HRV (P < 0.05). A dysautonomia symptom score correlated to 10 HRV parameters (66.7%; -0.14 < r < -0.55; P < 0.05).
Cardiac autonomic nervous dysfunction is severe in AIDS patients, although not significant in pre-AIDS patients. Cardiac autonomic nervous dysfunction proceeds with HIV disease progression, although its individual course is slow.
研究感染人类免疫缺陷病毒（HIV）患者心脏自主神经功能障碍的程度、模式及自然病史。
横断面及前瞻性纵向队列研究。
初级保健及三级转诊大学中心。
35例连续的HIV感染患者，其中尚未发展为获得性免疫缺陷综合征（AIDS）的患者15例（AIDS前期患者），处于美国疾病控制与预防中心（CDC）AIDS阶段的患者20例，以及29名年龄和性别匹配的健康HIV阴性对照者。
对心率变异性（HRV）的15项标准化参数进行计算机辅助功率谱分析。
AIDS前期患者作为一个群体，其HRV各项参数与健康对照者相比均无显著差异（P>0.017），而AIDS患者与健康受试者相比，14项参数（93.3%）的HRV降低（P>0.017）。AIDS前期患者个体异常HRV参数（<对照组第10百分位数）的中位数比例为9.1%，AIDS患者为61.3%（P=0.0347）。CDC分期进展与10项HRV参数呈负相关（r=-0.50至-0.36，66.7%；P<0.05）。10例AIDS前期患者和6例AIDS患者在6至16个月（中位数12.5个月）后进行的随访检测未发现HRV恶化（P<0.05）。自主神经功能障碍症状评分与10项HRV参数相关（r=-0.14至-0.55，66.7%；P<0.05）。
AIDS患者存在严重的心脏自主神经功能障碍，而AIDS前期患者则不明显。心脏自主神经功能障碍随HIV疾病进展而加重，但其个体病程进展缓慢。
