Heart rate variability monitoring in the detection of central nervous system complications in children with enterovirus infection
Heart rate variability monitoring in the detection of central nervous system complications in children with enterovirus infection
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DOI：
10.1016/j.jcrc.2006.02.005
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发表时间：
2006-09-01
影响因子：
3.7
通讯作者：
Wu, Mei-Hwan
中科院分区：
文献类型：
--
作者：
Lin, Ming-Tai;Wang, Jou-Kou;Wu, Mei-Hwan
目的：先前的研究表明复杂性手足口病(HFMD)和疱疹绞痛患者存在自主神经功能障碍的可能性。心率变异性(HRV)是自主神经系统的一项指标，可用于检测疾病的进展。材料和方法：从2001年到2002年，66例1-9岁的患者被前瞻性纳入对照组(20例)和疾病组(46例手足口病或疱疹心绞痛)。疾病组分为I期(仅发热)、11期(合并脑脊髓炎)和III期(合并脑脊髓炎以及心动过速、高血糖、呼吸急促和高血压或低血压)组。结果：病变组HRV参数普遍降低，低频(LF)/高频(HE)比值升高。疾病组11期患者的心率变异性参数(三角指数、总功率、低频功率和高频功率)显著低于疾病组I期患者，而低频/高频比值高于疾病组I期患者，且III期患者的HRV参数极低。以HRV(正常至正常间期的标准差17毫秒和高频功率24毫秒(2))来定义III期患者(敏感性为100%；特异性为71.4%)也有助于预测疾病的进展。结论：手足口病和疱疹心绞痛患者合并中枢神经系统损害和心肺衰竭时，HRV显著降低，很可能是由于自主神经功能障碍，可作为监测疾病进展的有用参数。(C)2006 Elsevier Inc.保留所有权利。
Purpose: Previous studies suggest the possibility of autonomic dysfunction in patients with complicated hand, foot, and mouth disease (HFMD) and herpangina. Heart rate variability (HRV), an index for autonomic nervous system, may be useful to detect disease progression.Materials and Methods: From 2001 to 2002, 66 patients (1-9 years old) were enrolled prospectively in either a control (20 patients) or disease (46 patients with HFMD or herpangina) group. The disease group was subdivided into stage I (fever only), stage 11 (with complications of encephalomyelitis), and stage III (with complications of encephalomyelitis as well as tachycardia, hyperglycemia, tachypnea, and hypertension or hypotension) groups. Data from electrocardiograms were transformed for HRV.Results: The HRV parameters generally decreased and the low frequency (LF)/high frequency ratio (HE) increased in the disease groups. Patients in disease group stage 11 had significantly lower parameters of HRV (triangular index, total power, LF power, and HF power) and higher LF/HF ratio than those in disease group stage I. With this trend, patients with stage III disease had extremely low HRV parameters. The inferred criteria of HRV (standard deviation of normal-to-normal interval < 17 milliseconds and HF power < 24 milliseconds(2)) to define stage III patients (sensitivity, 100%; specificity, 71.4%) were also useful to predict disease progression.Conclusions: The HRV markedly decreased, most likely because of autonomic dysfunction, in patients with,HFMD and herpangina when complicated with central nervous system involvement and cardiopulmonary failure and may be useful parameters to monitor disease progression. (c) 2006 Elsevier Inc. All rights reserved.