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目的 测定甲状腺功能减退 (甲减 )患者心率变异 (HRV)及观察甲状腺素替代治疗后的变化。方法 记录 38例甲减患者与 2 1例正常者 2 4小时动态心电图 ,并进行HRV分析。 18例甲减患者治疗 3月后重复HRV测定。结果 甲减时 ,HRV的时阈指标较对照组明显降低 ;频阈指标中 ,高频功率 (HF)较对照组明显增高 ,而低频 (LF)与HF比值较对照组显著减低。甲减患者经甲状腺素替代治疗后 ,HRV时阈指标和频阈指标均明显改善 ,且与FT3和FT4 的恢复程度相一致。结论 甲减时 ,自主神经活动明显改变 ,且以迷走神经兴奋性增加占优势。这种自主神经异常在甲状腺素替代治疗后可部分改善。
Objective To determine the heart rate variability (HRV) in patients with hypothyroidism (Hypothyroidism) and observe the changes after thyroid hormone replacement therapy. Methods Thirty-eight patients with hypothyroidism and 21 normal controls were enrolled in the study. HRV analysis was performed in 24 hours. 18 cases of hypothyroidism patients after treatment for 3 months repeated HRV determination. Results When hypothyroidism, the threshold of HRV was significantly lower than that of the control group. In the frequency threshold, HF was significantly higher than that of the control group, while the ratio of LF to HF was significantly lower than that of the control group. Thyroid hormone replacement therapy in patients with hypothyroidism, HRV threshold and frequency threshold indicators were significantly improved, and with the recovery of FT3 and FT4 consistent. Conclusions Hypothyroidism, autonomic activity significantly changed, and vagus nerve excitability increased predominance. This autonomic abnormalities can be partially improved after thyroid hormone replacement therapy.