Sympathetic Skin Response and R-R Interval Variation in Cerebral Infarctions

腦梗塞的皮膚交感神經反應及R-R間隔心律變異性

馮清世(Chin-Shih Fong)

《慈濟醫學雜誌》 15卷3期 (2003/06) Pp. 149-154

https://doi.org/10.6440/TZUCMJ.200306.0149

摘要

目的:腦中風後經常伴隨有自律神經系統失調等症狀，然而很少對腦中風病人施行自律神經系統功能檢查。本研究藉由皮膚交感神經反應與R-R間隔心律變異性兩種檢查來評估腦梗塞後的自律神經系統功能。病人與方法:收集56位腦梗塞的病人組與52位年齡相配對的對照組。以皮膚交感神經的反應來檢查交感神經汗腺運動的功能，以R-R間隔心律的變異性來檢查心臟復交感神經的功能。結果56位腦梗塞的病人中39位病人的皮膚繳感神經有反應，腦梗塞病人的皮膚交感神經反應的平均震幅比控制組有意義降低 ，尤期腦梗塞的早期振福降低的較明顯，且左大腦半球中風的病人皮膚交感神經反應的異常比右大腦半球中風的病人來的明顯。同樣的腦梗塞病人的R-R間隔心律變異性比控制組低，且腦梗塞的早期心律變異性降低的較明顯。又右大腦半球中風病人的R-R間隔心律變異性比控制組低，左大腦半球中風病人與控制組相比，心律變異性無差異。結論:交感神經的活性在左側腦梗塞的病人降低的較明顯，而右側腦梗塞對副交感神經活性有較大的抑制作用。(慈濟醫學 2003; 15:149-154)

關鍵字

腦中風 ； 皮膚交感神經反應 ； R-R間隔心律變異性

並列摘要

Objective: Autonomic dysfunctions are frequently encountered manifestations in patients with cerebrovascular diseases, however, few autonomic tests have been developed to evaluate strokes patients. The purpose of the present study was to assess the autonomic nervous system function after cerebral infarction by measuring both sympathetic skin response (SSR) and R-R interval variation (RRIV). Patients and Methods: Fifty-six patients with cerebral infarctions and 52 age-matched control subjects were enrolled in this study. We performed SSR for the assessment of sympathetic sudomotor function and RRIV for cardiac parasympathetic function. Results: The SSRs were obtainable in 39 patients. The mean SSR amplitude values had significantly decreased in patients with cerebral infarctions compared with the control subjects. The SSR amplitudes were more diminished during the early phase of the infarction. The SSR abnormalities were more marked in those with left hemispheric stroke than in those with right hemispheric stroke. Similarly, RRIV had decreased in stroke patients when compared with controls and greater decreases were noticed during the early phase of infarction. Decreased RRIV values were found in patients with right hemispheric strokes compared with control subjects. No such differences were found in patients with left hemispheric strokes. Conclusions: Suppression of sympathetic sudomotor activity was more apparent in patients with left cerebral infarctions. Patients with right cerebral infarctions had greater inhibitory effects upon cardiac parasympathetic activity. (Tzu Chi Med J 2003; 15:149-154)

並列關鍵字

cerebral infarction ； sympathetic slin response ； R-R interval variation