Laganà B, Gentile R, Vella C, Giovani A, Tubani L, Mastrocola C, Baratta L, Bonomo L
Dipartimento di Medicina Clinica, Università La Sapienza, Roma.
Recenti Prog Med. 1997 Dec;88(12):579-84.
Heart rate variability (HRV) is a suitable diagnostic tool in identifying patients with autonomic nervous system (ANS) disorders even in pre-clinical stage. We have enrolled in this study all patients with large variety of connective tissue disorders, given the possibility of an involvement of ANS in these diseases. The study population consisted in eighty-five patients (68 females and 17 males), 35 of whom affected by systemic lupus erythematosus, 16 by rheumatoid arthritis, 14 by Sjögren syndrome, 12 by progressive systemic sclerosis, 3 by Behçet syndrome and 5 by antiphospholipid antibodies syndrome. The mean age ranged between 33.7 of patients with lupus erythematosus and 51.8 of those with Sjögren syndrome. As control, we enrolled healthy subjects of different age, divided into two groups, to rule out the aging as potential source of considered parameters alteration. The autonomic function has been evaluated by 24 hours ambulatory monitoring, using a Zymed 1210 Scanner with Zymed 3.74-PC 1990 software. We have considered: in the time domain, the standard deviation of the RR intervals average (SDNN) and the percentage of RR adjacent intervals differing each other more than 50 msec (pNN50); in the frequency domain, the low (LF) and high (HF) frequencies, the LF/HF ratio, and the total power (RT). The HRV parameters resulted abnormal in every type of the connective tissue diseases considered: particularly SDNN, pNN50, LF, HF and RT (p < or = 0.01).
the results of our study suggest that autonomic neuropathy may be present in any kind of connective tissue disorders even in preclinical stage.
心率变异性(HRV)是一种适用于识别自主神经系统(ANS)紊乱患者的诊断工具,即使在临床前期也是如此。鉴于ANS可能参与这些疾病,我们招募了患有各种结缔组织疾病的所有患者参与本研究。研究人群包括85名患者(68名女性和17名男性),其中35名患有系统性红斑狼疮,16名患有类风湿性关节炎,14名患有干燥综合征,12名患有进行性系统性硬化症,3名患有白塞综合征,5名患有抗磷脂抗体综合征。平均年龄在红斑狼疮患者的33.7岁至干燥综合征患者的51.8岁之间。作为对照,我们招募了不同年龄的健康受试者,分为两组,以排除衰老作为所考虑参数改变的潜在来源。使用配备Zymed 3.74-PC 1990软件的Zymed 1210扫描仪,通过24小时动态监测评估自主神经功能。我们考虑了:在时域中,RR间期平均值的标准差(SDNN)和RR相邻间期相差超过50毫秒的百分比(pNN50);在频域中,低频(LF)和高频(HF)频率、LF/HF比值以及总功率(RT)。在所考虑的每种结缔组织疾病类型中,HRV参数均异常:特别是SDNN、pNN50、LF、HF和RT(p≤0.01)。
我们的研究结果表明,即使在临床前期,任何类型的结缔组织疾病中都可能存在自主神经病变。