めまい患者の自律神経機能 心電図ＲＲ間隔の動的評価について

Abstract

The function of the autonomic nervous system in patients with vertigo was examined, and several parameters of the RR interval were analyzed quantitatively in the supine and upright positions. Fifty-five patients with vertigo associated with autonomic nerve dysfunction were examined, and were analyzed by computer. Patients with normal autonomic function (Group 1: n=26) and those with autonomic dysfunction (Group 2: n=25) were compared statistically. Group 2 contained four subgroups: Group 2a: 15 patients with sympathetic hyperfunction; Group 2b: 9 patients with sympathetic hypofunction; Group 2c: 2 patients with parasympathetic hyperfunction; and Group 2d: 6 patients with parasympathetic hypofunction). Six patients had double dysfunctions.The parameters examined were:1. Heart Rate (HR).2. Coefficient of variation of RR interval (RRcv).3. Relation between RRcv and age.4. Power spectrum of RR interval.HR and RRcv were recorded in the supine and upright positions. RR intervals of 20 seconds were computed with FFT, and 2 major components (low frequency; 0.1Hz (P1): high frequency; 0.3Hz (P2)) of the power spectrum were analyzed. HR of Group 2a was significantly higher than that of Group 1 in both the supine and upright positions. RRcv of Group 2b was lower than that of Group 1. RRcv of Group 2c was reduced in the upright position. RRcv of Group 2d was lower than that of Group 1 and tended to rise in the upright position. RRcv of Group 1 in the upright position was related to age (r=-0.62), but that of Group 2 showed no significant relation. The power spectrum of Group 1 showed a dominant P2 in the supine position and a dominant P1 in the upright position, but the power spectrum of Group 2a revealed a dominant P1 in both the supine and upright positions and that of Group 2b showed no marked P1 and P2 components.