心率变化参数在急性缺血性中风患者进行静脉血栓溶解的变化
Yang Qu1, Ying-Ying Sun1, Reziya Abuduxukuer1
1Stroke Center, Department of Neurology The First Hospital of Jilin University Chang Chun China.
Journal of the American Heart Association
|May 26, 2023
概括
静脉内血栓溶解 (IVT) 改善了急性缺血性中风患者的自主神经系统功能,通过心率变化 (HRV) 来衡量. 在IVT后更好的自主功能与90天后改善的临床结果有关.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 自主神经科学 自主神经科学
背景情况:
- 自主功能障碍在急性缺血性中风中很常见,并且与预后不佳有关.
- 静脉血栓溶解 (IVT) 对自主神经系统 (ANS) 功能的影响,通过心率变化 (HRV) 评估,在中风患者中以前是未知的.
研究的目的:
- 在急性缺血性中风患者中使用HRV调查IVT对ANS功能的影响.
- 确定HRV评估的自主功能与IVT患者的临床结果之间的关联.
主要方法:
- 预计在2016年9月至2021年8月期间招募466名急性缺血性中风患者 (224人接受IVT,242人没有).
- 在中风后1-3天和7-10天测量HRV以评估ANS功能.
- 评估90天的临床结果使用修改的兰金度量表 (mRS),mRS≥2被定义为不利.
主要成果:
- 在中风后7-10天,IVT与1至3天的副交感HRV参数以及7至10天的同情和副交感HRV参数正相关.
- 在中风后1-10天内,HRV和自主功能与IVT患者的90天不良结果独立相关.
- 整合HRV参数显著改善了90天结果的预测,使ROC曲线下的面积从0.784增加到0.855.
结论:
- 在急性缺血性中风中,IVT积极影响HRV和自主神经系统活动.
- 在急性阶段通过HRV评估的自主功能是IVT治疗患者不良结果的独立预测因素.
- HRV评估可以提高接受IVT的急性中风患者临床结果的预测.
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