Monge-Argilés J A, Palacios-Ortega F, Vila-Sobrino J A, Matias-Guiu J
Department of Neurology, Hospital S. M. Rosell, Cartagena, Murcia, Spain.
Acta Neurol Scand. 1998 Feb;97(2):86-92. doi: 10.1111/j.1600-0404.1998.tb00615.x.
Multiple sclerosis (MS) frequently causes disturbances of autonomic functions. Cardiovascular dysautonomia has been studied by classic autonomic tests and, recently, by heart rate variability analysis in some isolated periods. Multiple authors recommended performing heart rate variability analysis with a 24 h ECG recording to increase its sensitivity.
We analyzed the heart rate variability in time and frequency domains in 34 MS patients and 24 age and sex-matched healthy control subjects, in order to evaluate the effects of MS on sympathetic and parasympathetic cardiovascular regulatory functions measured from 24-h electrocardiogram.
Low frequency power (0.01) and low frequency/high frequency power (0.01) were significantly higher in multiple sclerosis patients independently, all together or in subgroups. Very low frequency (0.01) and high frequency (0.001) power were higher in less affected multiple sclerosis patients. Variability in time domain (0.05) were lower in most affected multiple sclerosis patients.
These results suggest that multiple sclerosis causes cardiovascular autonomic dysregulation manifesting as impaired heart rate variability. This illness seems to cause an increase in sympathetic cardiovascular tone; the parasympathetic tone is most variable and depends on clinical and paraclinical findings, but the illness progression seems to provoke a decrease in it.
多发性硬化症（MS）常导致自主神经功能紊乱。经典自主神经测试已对心血管自主神经功能障碍进行了研究，最近，在一些特定时间段也通过心率变异性分析进行了研究。多位作者建议通过24小时心电图记录进行心率变异性分析，以提高其敏感性。
我们分析了34例MS患者以及24例年龄和性别匹配的健康对照者的时域和频域心率变异性，以评估MS对通过24小时心电图测量的交感和副交感心血管调节功能的影响。
无论单独、综合还是分组来看，多发性硬化症患者的低频功率（0.01）和低频/高频功率（0.01）均显著更高。在病情较轻的多发性硬化症患者中，极低频（0.01）和高频（0.001）功率更高。在病情最严重的多发性硬化症患者中，时域变异性（0.05）更低。
这些结果表明，多发性硬化症会导致心血管自主神经调节异常，表现为心率变异性受损。这种疾病似乎会导致交感心血管张力增加；副交感神经张力变化最大，取决于临床和辅助检查结果，但疾病进展似乎会导致其降低。
