多发性硬化症患者的心率变化:系统性审查和元分析
Omid Mirmosayyeb1,2, Mohammad Yazdan Panah3, Mohammadreza Alinejadfard4
1Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. omid.mirmosayyeb@gmail.com.
Acta neurologica Belgica
|June 30, 2025
概括
患有多发性硬化症 (MS) 的人表现出心脏自主功能受损,这表明心率变化 (HRV) 发生变化. 这种功能障碍表明,与健康个体相比,MS患者的交感神经系统占主导地位更大.
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:
- 多发性硬化症 (MS) 是一种影响自主神经系统的神经退行性疾病.
- 在多发性硬化中,自主功能障碍得到了充分的证据,但它对对同情与对共情活动的具体影响仍在争论中.
- 心率变化 (HRV) 作为心脏自主功能的关键非侵入性指标.
研究的目的:
- 与健康对照组 (HCs) 相比,系统地审查和元分析MS (PwMS) 患者的心率变化 (HRV) 参数,与健康对照组 (HCs) 相比.
- 在PwMS中使用HRV阐明心脏自主功能障碍的性质和程度.
- 为了确定MS中自主功能障碍是否主要影响交感或副交感活动.
主要方法:
- 在PubMed/MEDLINE,Web of Science,Embase和Scopus数据库中进行了系统的文献搜索,直到2024年8月.
- 包括观察性研究,比较PwMS和HC之间的HRV参数.
- 进行了随机效应的元分析,以估计各组之间HRV参数的标准平均差异 (SMD).
主要成果:
- 综合了43项涉及1518名PwMS和1062名HC的研究数据.
- 普华永道显示时间域HRV指标显著减少,包括RMSSD (SMD = -0.81) 和pNN50 (SMD = -0.63).
- 频域分析显示,与HC相比,PwMS的高频 (HF) 功率 (SMD = -0.51) 和低频 (LF) 功率 (SMD = -0.44) 在PwMS显著降低.
结论:
- 与健康个体相比,患有多发性硬化症的人表现出显著改变的心脏自主功能, HRV.
- 观察到的HRV模式表明,在PwMS中,交感神经系统占主导地位更大.
- 需要进一步的研究来调查不同MS严重程度,亚型和治疗方案的HRV,以更好地了解自主功能障碍.
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