| Objectives:Cerebrovascular disease or stroke,defined as a sudden neurological deficit,can be attributed to focal vascular causes,which has become one of the major contributors to the morbidity and mortality of our population.Cerebral vascular disease easily damage the autonomic nervous center,causing a series of complications,such as malignant arrhythmia,severe cases can lead to sudden death of the brain.Patients with acute cerebrovascular disease are traditionally evaluated to determine their involvement in advanced neurological functions such as the cranial nerves,motor system,sensory system,extrapyramidal system,cerebellar function,and autonomic function.However,autonomous functional testing is often not given its due importance.This is due to the complexity of autonomous functional tests and the relative technical difficulty of testing them.Since it is not possible to usually perform other tests in some bedridden acute stroke patients,a simpler method of assessing autonomic dysfunction is of particular importance.The detection of HRV at rest and its noninvasive measurement can do this well.In this study,the relationship between cerebrovascular disease and cardiac autonomic nervous system was evaluated by Meta analysis system to provide a theoretical basis for its prevention and treatment.Methods:Pubmed database,Medline database,Conchrane library,Wanfang database,CNKI full-text database and CBM database were collected and collected until November 2017.Apply Review Manager 5.3.3 software for statistical analysis,draw the forest diagram and funnel chart.The inclusion of continuity variables was statistically analyzed using the MD and its 95% confidence interval.Subgroup analyzes were performed based on the heterogeneity that may arise.If the research data in each group are similar enough,we use the fixed effect model to analyze.If subgroups have heterogeneity,we use random effects model analysis.And apply Begg and Egger test to further evaluate publication bias.Results:According to the strict inclusion and exclusion criteria,10 Chinese and 6 English papers were finally included in the analysis.Analysis shows: Compared with the control group,the SDNN of cerebrovascular disease group(P<0.05),the difference was statistically significant;Compared with the control group,SDANN of cerebrovascular disease group had significant difference(P<0.05);The RMSSD of cerebrovascular disease group was significantly higher than that of the control group(P<0.05),and the difference was statistically significant;Left hemisphere autonomic nerve function after stroke compared with the control group(P <0.05),the difference was statistically significant;.Right hemisphere autonomic nervous function after stroke compared with the control group(P<0.05),the difference was statistically significant;The right hemisphere and left hemisphere autonomic nerve injury compared(P<0.05),the difference was statistically significant;Compared with the control group,autonomic nerve function after stroke in brainstem(P<0.05),the difference was statistically significant;The medulla oblongata autonomic nerve injury compared with the pituitary(P<0.05),the difference was statistically significant;Compared with the control group(P<0.05),the difference was statistically significant after the time of stroke> 1 month;Compared with the control group,autonomic nerve function at night after stroke was significantly different(P<0.05).Conclusions:After the autonomic nerve function of acute cerebrovascular disease is impaired,the sympathetic tone of the heart is increased and the parasympathetic tone is reduced.The degree of autonomic nerve damage is related to the location of lesions,and the damage to the right hemisphere is more serious,with the right insular is more severe;the damage to the brain stem is more severe with bulbar lesions.The impairment of cardiac autonomic function affects the normal circadian rhythm,thereby increasing the chance of heart damage.The recovery time required for the autonomic nervous system to be damaged is longer. |
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