较短耐多药结核病治疗方案药物对三级医院耐多药结核病患者心率变异性的影响

Disha Patel, Chetankumar R. Acharya
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摘要

背景:结核病是印度的主要死亡原因。心率变异性分析是评估自主神经系统最常用的方法之一。较短的耐多药结核病方案药物既影响中枢神经系统,也影响周围神经系统。现有研究表明,活动性肺结核可引起ANS功能障碍。因此,通过HRV测量,可以关联耐多药结核病短方案药物对自主神经功能障碍的影响。本研究的目的是评价耐多药结核病短方案药物对耐多药结核病患者心脏自主调节的影响,以心率变异性为参数。方法:50例新诊断的MDR-TB患者,不论性别,均接受较短的MDR-TB治疗方案。休息20分钟后,用“physiopac数字测谎仪”软件测心电图5分钟。在治疗第2个月和第4或6个月进行两次HRV随访评估。HRV采用相邻RR区间连续差值(RMSSD)与低频高频比的均方根偏差计算。结果:重复测量方差分析显示,基线组、2个月组和6个月组HRV参数无统计学差异。因此,在使用较短的耐多药结核病方案药物治疗耐多药结核病期间,交感神经和副交感神经调节在HRV方面保持不变。结论:较短的耐多药结核病治疗方案药物对耐多药结核病患者HRV无显著影响,耐多药结核病患者HRV与心率无相关性。
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Impact of shorter MDR tuberculosis regimen drugs on heart rate variability in MDR tuberculosis patients at tertiary care hospital
Background: Tuberculosis is major cause of death in India. Analysis of heart rate variability is one of the most popular methods of autonomic nervous system evaluation. Shorter MDR-TB regimen drugs affect both central nervous system as well as peripheral nervous system. Existing research suggests that active pulmonary tuberculosis causes ANS dysfunction. So, by HRV measurement impact of shorter MDR-TB regimen drugs on autonomic dysfunction can be correlated. Aim of the current investigation was to evaluate effect of shorter MDR-TB regimen drugs on cardiac autonomic regulation in MDR-TB patients with respect to heart rate variability as a parameter.Methods: Fifty newly diagnosed MDR-TB patients of either gender on shorter MDR- TB regimen were enrolled in this study after taking consent. After 20 minutes rest, ECG was taken by “physiopac digital polygraph” software for 5 minutes. Two follow-up HRV assessments were done on 2nd month and 4th or 6th month of treatment. HRV was calculated by root mean square deviation of successive differences between adjacent RR intervals (RMSSD) and low frequency and high frequency ratio.Results: Repeated measures ANOVA showed no statistically significant difference in HRV parameters between baseline, 2 months and 6 months groups. So, sympathetic and parasympathetic modulation in terms of HRV remains unchanged during treatment of MDR-TB with shorter MDR-TB regimen drugs.Conclusions: Shorter MDR-TB regimen drugs don’t have any significant impact on HRV in MDR- TB patients, No correlation was observed between HRV and heart rate in MDR-TB patients.
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