台灣婦女停經前後心跳變異率之變化

The Relationship between Menopause and Heart Rate Variability in Taiwan

10.3966/168232812015092503003

黃姿菡(Tzu-Han Huang)；沈葭蔚(Chia-Wei Shen)；林晴筠(Ching-Yun Lin)；曾愉芳(Yu-Fang Tseng)；林憶婷(Yi-Ting Lin)；林宜美(I-Mei Lin)；杜鴻賓(Hung-Pin Tu)；張家禎(Chai-Jan Chang)

心跳變異率 ； 停經 ； heart rate variability ； menopause

台灣家庭醫學雜誌

25卷3期（2015 / 09 / 01）

186 - 195

繁體中文

背景及目的：女性在停經後心血管疾病發生率有快速上升現象。自律神經不平衡是心血管疾病的危險因子，分析心跳變異率可評估女性在不同經期狀態，其自律神經系統的變化情形。本研究目的在探討心跳變異率和女性的停經狀態的關係。方法：本研究從台北市和高雄市二家社區中心共收集61位40至60歲女性（16位停經前期、21位停經中期和24位停經後期）的基本資料（包含身高、體重、血壓、年齡、家族史、過去病史等）、七日運動量回顧問卷（7-day Recall Physical Activity Questionnaire）和10分鐘的心電圖儀器記錄心跳訊號。心跳訊號加以分析後得心跳變異率中時域部份的正常心跳間的標準差（SDNN）；正常心跳間期差值平方和的均方根(RMSSD)；正常心跳間期差值超過50毫秒的個數(NN50)；和頻域部份代表副交感神經活性的高頻波（HF：在0.15-0.40Hz間的生理電波）；代表交感神經活性的低頻波（LF：在0.04-0.15 Hz間的生理電波）；LF/HF：代表交感和副交感神經平衡的指標。結果：研究發現舒張壓在停經前期、停經中期和停經後期三組間有明顯差異；SDNN值雖然隨著停經前期至停經7年以上，有逐漸降低趨勢，但在統計上並無顯著差異。其他心跳變異率檢測的各個數值在三組間也並無統計上顯著差異。因此本研究未發現停經時間和心跳變異率的各數值有明顯相關。結論：本研究顯示婦女的停經狀態與心跳變異率並無統計上的顯著相關。

Background and Purpose: The incidence of cardiovascular disease has been found to rise sharply after menopause, and autonomic dysfunction is identified as an important risk factor of cardiovascular events. Analysis of heart rate variability (HRV) can be used to assess the adaptation of the autonomic nervous system in women experiencing a decline in the beneficial effects of natural estrogen on the heart. The aim of the study is to assess the correlation between HRV and menopause status. Methods: The study surveyed 61 women (16 premonopause, 21 perimenopause, and 24 postmenopause women) aged 40-60 at two community centers respectively in Taipei and Kaohsiung. The data collected included height, body weight, blood pressure, age, family history, past history, and 7-day Recall Physical Activity Questionnaire. HRV was analyzed in the time domain (the standard deviation of all normal to normal beats, SDNN; the square root of the mean of the sum of the squares of differences between adjacent NN interval, RMSSD; the number of pairs of adjacent NN intervals differing by more than 50 ms in the entire recording, NN50) and frequency domain (high frequency HF; low frequency, LF; LF/HF ratio) using the heart rate signals obtained from electrocardiogram and recorded within 10 minutes. Results: The diastolic blood pressure was significantly different in pre-, peri- and postmenopause women. Although a tendency of decline was observed in SDNN from premenopause to postmenopause over 7 years, the difference failed to reach statistical significance. The autonomic indices were similar among these three groups. No significant association between HRV indices and menopause status was observed in this study. Conclusion: The findings of the study indicate the absence of a significant correlation between heart rate variability and menopause status in Taiwanese women.

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