帕金森病患者周期性肢体运动相关的心率变化研究

Heart rate fluctuation related to periodic limb movement during sleep in patients with Parkinson disease

  • 摘要: 目的 研究帕金森病(Parkinson' disease,PD)患者夜间周期性肢体运动障碍(periodic limb movement during sleep,PLMS)相关的心率变化模式。 方法 纳入2014年3月- 2015年9月在新疆军区总医院睡眠障碍诊治中心诊断为PD合并PLMS患者5例(病例组)及原发性PLMS患者11例(对照组)。全部样本均进行多导睡眠图(polysomnography,PSG)检查,测量每次腿动发生前、发生时、发生后共25个心脏周期的R-R间期(T-5 ~ T+19),并换算成心率;通过与基线心率比较,分析不同时间点的心率变化,比较两组间心率变化趋势及幅度。 结果 PD合并PLMS组未发生腿动时,心率无显著变化(P=0.231);原发性PLMS组心率在腿动发作前1个心脏周期开始升高(P< 0.001);腿动发作使两组心率均发生“先升高,后下降”的变化;两组心率变化在腿动发生后T+1 ~ T+5及T+12 ~ T+18等时间点均具有统计学差异(P< 0.05)。 结论 PD合并PLMS腿动相关的心率变化模式与原发性PLMS相似;PD合并PLMS患者PLMS相关的心率变化幅度低,但心动过速后心率回归基线时间延迟。

     

    Abstract: Objective To study the changes of heart rate (HR) related to periodic limb movement during sleep (PLMS) in patients with Parkinson's disease (PD). Methods Five patients with PD plus PLMS (case group) and another 11 patients with idiopathic PLMS (control group) who had undergone polysomnography (PSG) in Xinjiang Military Command General Hospital from March 2014 to September 2015 were enrolled in our study. Limb movement related HR was compared between the two groups. In detail, the R-R intervals of heart rate were measured before 5 beats (T-5-T-1), onset and after 19 beats (T+1-T+19) of each PLMS. HR at different time points and global HR change pattern were explored in each group. HR and HR variability amplitude were compared between two groups. Results HR didn't change significantly before PLMS onset in case group (P=0.231), while HR of control group elevated significantly at T-1 (P < 0.001). In both case and control groups, HR showed a significant change before and after PLMS onset. HR were significantly different between case and control groups at multiple time points including T+1-T+5 and T+12-T+18 (all P< 0.05). Conclusion Periodic limb movement related HR fluctuation demonstrates similar patterns in both patients with PD plus PLMS and idiopathic PLMS patients. However, patients with PD plus PLMS have smaller amplitude in HR change and greater duration of tachycardia than idiopathic PLMS patients.

     

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