Autonomic nervous function in Helicobacter pylori-infected patients with atypical chest pain studied by analysis of heart rate variability
Autonomic nervous function in Helicobacter pylori-infected patients with atypical chest pain studied by analysis of heart rate variability
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DOI：
10.1097/00042737-200405000-00003
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发表时间：
2004-05-01
影响因子：
2.1
通讯作者：
Sinkiewicz, W
中科院分区：
文献类型：
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作者：
Budzynski, J;Klopocka, M;Sinkiewicz, W
目的 通过心率变异性 (HRV) 分析估计的心血管自主神经系统 (ANS) 活动，在患有非典型胸痛的幽门螺杆菌阳性和幽门螺杆菌阴性男性患者中进行比较，以验证自主神经系统可能是慢性幽门螺杆菌感染与胃肠道疾病之间联系的假设。 方法 我们分析了从我们诊所检查的 101 名因非典型胸痛而没有严重心血管、呼吸道和消化道证据的男性患者获得的数据。或代谢性疾病。除了面谈和体格检查外，每位患者还进行了：胃镜检查及粘膜活检（尿素酶试验和组织学检查）、食管 pH 测定和测压、超声腹部检查、胸部 X 线检查、跑道运动试验、24 小时动态心电图动态心电图时域和频域 HRV 分析以及超声心动图。 结果 与幽门螺杆菌阴性相比，所有幽门螺杆菌感染患者 (n = 63) 明显更大的低频功率、交感神经活动指数和迷走神经张力参数的更高值[pNN50，大于 50 ms 的 RR 间隔之间的差异百分比；观察到HRV分析（HF）中的高频功率。多因素分析证实了幽门螺杆菌感染与HF值之间的关系。上述ANS活性差异还伴随着：H. pylori阳性患者的胃食管反流事件显着减少，胃酸度降低，食管蠕动更有效和完整。结论 H. pylori感染可能影响ANS活性，并通过这种方式也有助于胃食管和心血管病理。 Eur J Gastroenterol Hepatol 16:451-457 (C) 2004 Lippincott Williams Wilkins。
Objectives Cardiovascular autonomic neurous system (ANS) activity estimated by analysis of heart rate variability (HRV) was compared in Helicobacter pylori-positive and H. pylori-negative male patients suffering from atypical chest pain to verity the hypothesis that autonomic neural system might be the way linking chronic H. pylori infection with gastrointestinal tract disorders.Methods We have analysed data obtained from 101 male patients examined in our clinic due to atypical chest pain, without evidence of serious cardiovascular, respiratory and digestive tract or metabolic diseases. In each patient, besides interview and physical examination, were performed: gastroscopy with mucosa biopsy (for urease test and histology), oesophageal pH-metry and manometry, ultrasound abdomen examination, chest X-ray, exercise test on running track, 24-h ECG Holter monitoring with time-domain and frequency-domain HRV analysis, and echocardiography.Results In comparison with H. pylori-negative, in all H. pylori-infected patients (n = 63) a significantly greater low frequency power, an index of sympathetic activity, and higher values of vagal tone parameters [pNN50, percentage of differences between RR intervals that are greater than 50 ms; high-frequency power in HRV analysis (HF)] were observed. The relationship between H. pylori infection and the HF value was confirmed in multi-factorial analysis. The aforementioned ANS activity differences were accompanied by: significantly fewer gastro-oesophageal acid reflux episodes, lower gastric acidity and more effective and complete oesophageal peristalsis in H. pylori-positive patients.Conclusions H. pylori infection may affect ANS activity and via this way also contribute to gastro-oesophageal and cardiovascular pathology. Eur J Gastroenterol Hepatol 16:451-457 (C) 2004 Lippincott Williams Wilkins.