台灣自律神經疾患臨床分類之初探

自律神經疾患日益普遍，但迄未有廣被接受的分類類型，研究團隊自2007年11月起投入國人自律神經疾患類型的研究，利用心跳率變異度（heart rate variability, HRV）頻域分析的檢測結果，包含自律神經總體活性（LF）、交感神經活性（LF％）與副交感神經活性（HF），與同輩同性別標準平均值之差距（％），作為自律神經失調的分類原理，並與臨床症狀及醫學文獻進行對比分析，於2008年9月30日，首次提出自律神經疾患之臨床分類，為國內首度將國人自律神經疾患作分型的研究單位，共歸納五大類型失調：第一類型是交感神經活性增加合併副交感神經活性低下；第二類型是交感神經活性低下合併副交感神經活性增加；第三類型是總體活性、交感神經及副交感神經活性三者均低下；第四類型是總體活性、交感神經及副交感神經活性三者均增加；第五類型是總體活性、副交感活性明顯下降，但交感神經活性僅輕度下降。歷經5年研究資料累計與分析，研究團隊2013年5月1日提出第六類型自律神經疾患：第六A類型是單純性交感神經活性升高，第六B類型是單純性副交感神經活性升高。2017年8月30日，研究團隊再提出第七類型自律神經疾患：第七A類型是單純性交感神經活性下降，第七B類型是單純性副交感神經活性下降。歷經10年完整的研究，不斷修正各失調分類的門檻條件與計算公式，將「未分類」與「正常」之定義更明確地界定，如此可涵蓋國人自律神經檢測所有結果，有助於臨床治療與後續統計分析。

關鍵字

交感神經；副交感神經；自律神經疾患；心跳率變異度

並列摘要

Our research team had studied autonomic disorder classification in Taiwan since November 2007, comparing the frequency domain measurement of heart rate variability (HRV) to the standard means of total activities of autonomic, sympathetic and parasympathetic nervous systems and correlating the results with clinical symptoms. On September 30, 2008, our research team became the first to propose the following five autonomic imbalance categories: Type I category refers to increased activity of sympathetic nervous system and decreased activity of parasympathetic nervous system; Type II category refers to decreased activity of sympathetic nervous system and increased activity of parasympathetic nervous system; Type III category refers to decreased total activities of autonomic, sympathetic and parasympathetic nervous systems; Type IV category refers to increased total activities of autonomic, sympathetic and parasympathetic nervous systems; and Type V category refers to significantly decreased activity of autonomic and parasympathetic nervous systems and slightly decreased activity of sympathetic nervous systems. Five years later on May 1, 2013, our research team introduced the 6^(th) category of autonomic imbalance that incorporated two sub-categories: Type VIa category for isolated increased activity of sympathetic nervous system, and Type VIb category for isolated increased activity of parasympathetic nervous system. By August 30, 2017, our research team officially presented the classification of seven autonomic imbalance categories in Taiwan, adding Type VIIa category for isolated decreased activity of sympathetic nervous system and Type VIIb category for isolated decreased activity of parasympathetic nervous system. Over a course of a decade, our research team had dedicated ourselves to continuous modification of thresholds and calculation formulas for each type in order to reach more distinctively delineations of the ＂unclassified＂ and ＂normal＂ categories. The classification is accordingly believed to have covered most autonomic nervous system measurements beneficial to further evaluation and treatment of autonomic disorder in Taiwan.

並列關鍵字

sympathetic nervous system ； parasympathetic nervous system ； autonomic nervous system ； autonomic disorder ； heart rate variability

國際替代計量

台灣自律神經疾患臨床分類之初探

全文下載

主題瀏覽