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[目的]探讨急性重症脑卒中患者预后与早期心率变异的关系。[方法]大脑半球部位脑卒中患者33例,根据格拉斯哥昏迷评分(GCS)分为急性重症组(GCS≤8分15例)和非重症组(GCS﹥8分18例)。所有患者发病5d内进行Hoher连续记录。[结果]动态监测发现正常RR间期标准差(SDNN)≤60ms、总频谱(TF)≤1500ms/Hz、高频谱(HF)≤600ms/Hz、低频谱(LF)≤1000ms/Hz是预测预后的界限值;上述指标低于界限值提示病情恶化,预后不良;高于界限值则提示病情向好的方向发展,预后良好,其动态变化早于传统的GCS。[结论]监测HRV不仅可以反映植物神经平衡破坏情况,而且可以预测急性重症脑卒中患者预后的一个独立、定量的指标。
[Objective] To investigate the relationship between prognosis and early heart rate variability in patients with acute severe stroke. [Methods] Thirty-three patients with cerebral hemisphere stroke were divided into acute severe group (GCS≤8 points and 15 cases) and non-severe group (GCS> 8 points and 18 cases) according to Glasgow Coma Scale (GCS). All patients were recorded within 5 days of onset of Hoher. [Results] The results of dynamic monitoring showed that the standard deviation of normal RR interval (SDNN) ≤60 ms, total frequency ≤1500 ms / Hz, high frequency ≤600 ms / Hz and low frequency ≤1000 ms / Hz were prognostic factors Of the threshold value; the above indicators below the threshold prompted the deterioration of the disease, the prognosis is poor; higher than the threshold value is prompted to better the direction of disease development, the prognosis is good, the dynamic changes earlier than the traditional GCS. [Conclusion] Monitoring HRV can not only reflect the balance damage of autonomic nerves, but also predict an independent and quantitative index of the prognosis of patients with acute severe stroke.