严重多发伤患者心率变异性分析及其临床意义(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2008年第6期
- 页码:
- 766-768
- 栏目:
- 临床研究
- 出版日期:
- 2008-12-25
文章信息/Info
- Title:
- Analysis of heart rate variability in patients with multiple traumas
- Author(s):
- LIU Jinliang; LI Keyao
- Department of Thoracic Surgery, PLA First Hospital, Lanzhou 730030, Gansu, China
- 分类号:
- R 541.7
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 探讨严重多发伤患者心率变异性（HRV）测定的意义。方法 对46例严重多发伤患者于创伤后1、3、7 d监测HRV短程频域分析的变化及测定外周血去甲肾上腺素、皮质醇水平（放免法）。设正常对照组10例。结果 以损伤严重度评分（ISS）≤16分为分组界限，伤后24 h内，各组低频标化功率（LFnm）、高频标化功率（HFnm）、LF/HF明显升高；随后，各组LFnm、HFnm、LF/HF显著降低并低于正常对照组。ISS>16分组的LFnm、HFnm、LF/HF在各个时相点与ISS≤16组相比存在显著性差异(P<0.01)。结论 创伤患者HRV发生了显著变化，反映出自主神经功能受损和失衡，并与创伤应激程度密切相关。
- Abstract:
- AIM To study the significance of measuring heart rate variability (HRV) in multipleinjury patients. METHODS Changes of HRV in the frequency domain were observed, and norepinephrine（NE） and cortisol（Cor） were measured on the 1st, 3 rd and 7 th day posttrauma in fortysix patients with multipletraumas and in control of 10 health subjects. RESULTS The patients were divided into two groups according to ISS≤16 and >16. Within 24 hour after trauma, LFnm, HFnm and LF/HF increased obviously in both groups. Subsequently, LF, HF and LF/HF of the two groups decreased obviously and were lower remarkably than those of the control group. Compared with those in the ISS≤16 group, LF, HF and LF/HF in the ISS>16 group were remarkably different at every time points after trauma. CONCLUSION Significant changes of HRV occur after trauma, which reflect injuries and imbalance of autonomous nervous function in severe traumatic patients and are closely correlated with the degrees of injury stress.
参考文献/References
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［5］ 翟惠敏，李亚洁. 应激反应评估的研究进展［J］. 护理研究， 2005, 19(13):1131-1133.
［6］ Winchell RJ, Hoyt DB. Spectral analysis of heart rate variability in the ICU: a measure of autonomic function［J］. J Surg Ress, 1996, 63(1)：11-16.
［7］ Grogan EL, Morris JA Jr, Norris PR, et al. Reduced heart rate volatility： an early predictor of death in trauma patients［J］. Ann Surg, 2004, 240(3):547-554.
备注/Memo
- 备注/Memo:
- 收稿日期：2007-11-28.作者简介：刘晋梁，主治医师，硕士Email：ljl.lz@163.com
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更新日期/Last Update: 2009-03-24