特发性性早熟女童心脏自主神经功能分析

An analysis of cardiac autonomic nerve function in girls with idiopathic central precocious puberty

摘要:

目的 研究特发性性早熟（ICPP）女童的心脏自主神经功能状态。方法 选取ICPP女童66例，其中合并肥胖36例，非肥胖30例；另选年龄相匹配的健康女童68例（正常对照）及单纯肥胖女童51例为对照。对所有受试者行24 h动态心电图检查，比较组间的心率减速力（DC）、心率加速力（AC）、心率变异性（HRV）及体重指数（BMI）。结果 ICPP组的DC、RR间期总体标准差（SDNN）、RR间期平均值的标准差（SDANN）、相邻RR间期差值的均方根（RMSSD）和高频功率（HF）均低于正常对照组，AC和BMI高于正常对照组；ICPP组的RMSSD、BMI均低于单纯肥胖组（P < 0.05）。ICPP女童中合并肥胖组的DC、RMSSD及HF均低于非肥胖组，AC和BMI高于非肥胖组（P < 0.05）。结论 ICPP女童的心脏自主神经功能紊乱，其中合并肥胖者尤为突出，以迷走神经张力降低为主。

Abstract:

Objective To investigate the cardiac autonomic nerve function in girls with idiopathic central precocious puberty (ICPP). Methods A total of 66 girls with ICPP were enrolled, among whom 36 were obese and 30 were not obese. A total of 68 age-matched healthy girls (normal controls) and 51 girls with simple obesity were enrolled as controls. All the subjects underwent 24-hour ambulatory electrocardiography, and deceleration capacity of heart rate (DC), acceleration capacity of heart rate (AC), and heart rate variability (HRV), and body mass index (BMI) were compared between groups. Results Compared with the normal control group, the ICPP group had significantly lower DC, standard deviation of normal-to-normal R-R intervals (SDNN), standard deviation of the average normal-to-normal intervals (SDANN), root mean square of successive differences (RMSSD), and high-frequency power (HF) and significantly higher AC and BMI. The ICPP group had significantly lower RMSSD and BMI than the simple obesity group (P < 0.05). Compared with the ICPP girls without obesity, those with obesity had significantly lower DC, RMSSD, and HF and significantly higher AC and BMI (P < 0.05). Conclusions Cardiac autonomic dysfunction is seen in girls with ICPP, especially those with obesity, mainly presenting with reduced vagal tone.