摘要：

目的 系统评价丘脑底核脑深部电刺激术对帕金森病患者心率变异性的影响。方法 以 subthalamic nucleus、deep brain stimulation、DBS、STN、electrical stimulation、Parkinson disease、heart rate variability 和帕金森病、脑深部电刺激、心率变异性等中英文检索词计算机检索2000 年1 月1 日-2017 年12 月1 日美国国立医学图书馆生物医学信息检索系统（PubMed）、荷兰医学文摘（EMBASE/SCOPUS）、Cochrane 图书馆、中国知网中国知识基础设施工程（CNKI）、万方数据库、维普数据库（VIP）等收录的关于帕金森病患者丘脑底核脑深部电刺激术后心率变异性变化的队列研究，采用心率变异性的高频部分（HF）、低频部分（LF）和低频部分/高频部分（LF/HF）作为评价指标，，采用Newcastle-Ottawa 量表（NOS）和RevMan 5.3 统计软件进行文献质量评价和Meta 分析。结果 共获得28 篇英文文献，经剔除重复和不符合纳入标准者，最终纳入6 项高质量（NOS 评分7 分）临床研究共101 例行丘脑底核脑深部电刺激术的帕金森病患者。Meta 分析显示，帕金森病患者丘脑底核脑深部电刺激术前后心率变异性之LF 值（SMD =0.050，95%CI：- 0.230 ~ 0.330；P = 0.740）、HF 值（SMD = 0.160，95%CI：- 0.120 ~ 0.430；P = 0.270）和LF/HF比值（SMD = 0.110，95%CI：- 0.220 ~ 0.440；P = 0.500）差异均无统计学意义。结论 丘脑底核脑深部电刺激术不影响帕金森病患者的心率变异性。

关键词: 帕金森病, 深部脑刺激法, 丘脑底核, 心率, Meta分析

Abstract:

Objective To evaluate the changes of heart rate variability (HRV) after subthalamic nucleus deep brain stimulation (STN-DBS) in patients with Parkinson's disease (PD). Methods Retrieve relevant cohort studies from online databases (January 1, 2000-December 1, 2017) in PubMed, EMBASE/SCOPUS, Cochrane Online Library, China National Knowledge Infrastructure (CNKI), Wanfang Data and VIP database with key words: subthalamic nucleus, deep brain stimulation, DBS, STN, electrical stimulation, Parkinson disease, heart rate variability. Low-frequency power (LF), high-frequency power (HF) and LF/HF of HRV were applied as evaluation indexes. Quality of studies was evaluated by using Newcastle-Ottawa Scale (NOS). All data were pooled by RevMan 5.3 software for Meta-analysis. Results We enrolled 28 English articles, from which 6 studies with NOS score 7 were chosen after excluding duplicates and those not meeting the inclusion criteria. A total of 101 PD patients undergoing STN-DBS were included. Meta-analysis showed that there were no significant differences in the LF of HRV (SMD = 0.050, 95%CI: -0.230-0.330; P = 0.740), HF of HRV (SMD = 0.160, 95%CI: - 0.120-0.430; P = 0.270), and LF/HF of HRV (SMD = 0.110, 95%CI: -0.220-0.440; P = 0.500) in patients with PD before and after the treatment of STN-DBS. Conclusions STN-DBS does not change HRV of patients with PD.

Key words: Parkinson disease, Deep brain stimulation, Subthalamic nucleus, Heart rate, Meta-analysis