碘营养与胎儿宫内发育迟缓关系的研究

目的 探讨碘营养与胎儿宫内发育迟缓(IUGR)的关系。方法 对60例正常晚孕妇女(对照组)，27例妊娠合并胎儿官内发育迟缓(IUGR组)孕妇尿碘及其甲状腺功能和其新生儿甲状腺功能进行了测定并进行对照分析。结果 IUGR组尿硖均值低于对照组，缺碘率明显高于时照组，两组孕妇血清FT3、FT4无明显差异。但IUGR组TSH明显高于对照组。IUGR组新生儿血清FT3、FT4低于对照组，TSH高于对照组。差异有显著性；经相关分析，孕妇尿碘与其自身TSH水平呈负相关，与其新生儿TSH也呈负相关，而与血清FT3、FT4无明显相关性。结论 碘营养影响胎儿及新生儿的生长发育，碘营养可能与IUGR的发生有关。     

心率功率谱分析检测植物神经功能状态

本工作在ＡＰＰＬＥ－Ⅱ微机上建立了心率功率谱分析方法，观察了植物神经对心率功率谱各频峰的影响。结果表明：心率功率谱高频峰与迷走神经活动有关，迷走神经紧张性减弱时，高频峰密度降低，心率功率谱低频峰既与迷走神经有关，又与交感神经有关，交感神经紧张性增加时，低频峰密度增加。心率功率谱分析可无创客观定量地检测植物神经功能状态。     

Ewing试验对自主神经及心率变异性的影响

目前缺乏利用客观生理参数反映健康人进行Ewing试验时,Ewing试验状态对自主神经活动影响的研究。心率变异性(HRV)是自主神经系统对窦房结控制的生物反馈,能够反映自主神经系统活动。本研究利用HRV分析71例健康者在进行Ewing试验期间,静息、深呼吸、Valsalva动作和站立状态的参数变化规律。实验结果表明相比静息状态,深呼吸和Valsalva状态的部分时域参数与频域参数明显上升(P0.01);站立状态的低频功率、低频与高频功率比值明显上升,而心跳间期标准差、相邻心跳间期差值的均方根和高频功率无明显变化。HRV的部分参数随着Ewing试验状态的改变而发生显著改变,心跳间期标准差、相邻心跳间期差值的均方根和高频功率随副交感神经活性增强而上升,反映了副交感神经活性水平。     

中西医结合治疗胎儿宫内发育迟缓

目的 探讨胎儿宫内发育迟缓(IUGR)的治疗方法。方法 分别采用硫酸镁加中药治疗胎儿宫内发育迟缓67例,硫酸镁治疗61例,利用彩色超声多普勒对其临床疗效进行观察。结果 硫酸镁加中药的有效率高于硫酸镁,其差异具有显著性意义(P<0.05)。结论 硫酸镁加中药是治疗IUGR的有效方法之一。     

静脉营养用于重度子痫前期IUGR的临床研究

目的探讨通过静脉营养治疗重度子痫前期并发胎儿宫内生长迟缓(IUGR)的效果。方法将36例28~36周重度子痫前期并发IUGR的孕妇随机分为2组,每组18例,对照组仅用5%葡萄糖500m L+25%硫酸镁30ml静脉滴注。实验组在应用硫酸镁的基础上采用脂肪乳250m L,氨基酸500m L,维生素C 2g,多种微量元素6m L及10%葡萄糖500m L+三磷酸腺苷40mg、辅酶A 100u静脉滴注,10d为1个疗程。治疗后测量孕妇的宫高、腹围、体重及胎儿的双顶径、股骨长、头围、腹围、新生儿出生体重及胎盘重量。结果实验组各项指标均明显高于对照组,静脉营养治疗后总有效率为87%,2组比较有显著性差异(P0.05)。结论静脉营养治疗重度子痫前期并发IUGR能明显改善胎盘血流灌注,对促进胎儿生长发育,有一定疗效,且安全、价廉。     

亚健康人群心率变异性特点的研究

目的 探讨亚健康状态人群自主神经功能的特点.方法 随机选取70例亚健康状态人员,75例健康状态人员分别接受短时(5分钟)心率变异性分析,以正常心动周期的标准差(SDNN)、总功率(TP)、低频功率(LF)、高频功率(HF)、低频功率与高频功率比值(LF/HF)为考察指标,记录并进行统计学分析.结果 亚健康状态人群正常心动周期的标准差和总功率都显著低于健康人群(t=-4.643,P=0.00;t=-3.492,P=0.002);同时与健康人群比较,亚健康状态人群的低频功率增高,但未达统计学意义(t=0.898,P=0.377);高频功率有所下降,亦未达到统计学水平(t=-0.899,P=0.376);亚健康状态人群的低频功率与高频功率比值(LF/HF)与健康人群没有差异(t=0.943,P=0.354).结论 亚健康状态人群心率变异性降低,自主神经系统功能减退.     

IUGR的胎盘病理改变及胎盘EGFR免疫组化分析

目的观察IUGR的胎盘病理改变及EGFR表达情况,探讨IUGR的发病机制.方法选取IUGR患者及正常妊娠妇女胎盘各18、25例,常规HE染色及EGFR免疫组化分析,观察胎盘形态学及EGFR表达情况.结果IUGR组绒毛间质纤维化及纤维素样坏死＞3%,合体滋养细胞结节＞30%,绒毛血管减少、闭塞的数量均明显高于对照组.IUGR者EGFR的表达比对照组高.结论IUGR的胎盘病理改变是造成IUGR胎盘功能减退的形态学基础.EGFR在胎儿胎盘的生长发育过程中及IUGR的病理过程中起重要作用.     

24小时HRV的压缩谱阵列:参数的增强和数据压缩

心率变化信号(HRV)是反映心脏生理和病理状态的重要定量指征,特别是HRV的谱分析可以用于检测各种功率与生理机制相关的主频分量,如呼吸,动脉血压控制和温度效应等。一般的功率谱是对顺序的RR间期离散序列进行谱分析得到的。本文介绍的是一种在24小时Holter记录的ECG中以速度图(tachogram)方式检测RR间隔的方法。首先对非混迭记录进行谱分析,用参量法将结果以压缩谱阵的形式进行显示,并给出低频和高频功率     

正常人心动周期信号（HPS）的混沌特征随年龄变化──HPS的功率谱分析

心动周期信号（ＨＰＳ）具有混沌特征，携带有自主神经功能信息。ＨＰＳ的功率谱分析可以定量地评价交感、副交感神经活动的强弱及其相互作用。这种方法是测试自主神经系统功能的现代方法。我们利用自行研制的计算机化心动周期信号混沌分析系统，对２１７例正常人的心动周期信号进行了功率谱分析。本文介绍了研究中采用的功率谱指标（Ｐｖｖ、Ｐｌｖ、Ｐｈｖ、Ｐｖｒ、ＰｌｒＰｈｒ、Ｒｖｈ、Ｒｌｈ、Ｔｆｐ），频率指标（Ｖｆｍ、Ｌｆｍ、Ｈｆｍ、ｆｍ、ｆｏ）和混沌度Ｌｏｃ的意义以及它们与年龄的关系。研究表明，随着年龄的增加，交感活动加强，副交感的活动减弱，心脏的混沌程度逐步降低。５０岁左右，有些指标的变化趋势与其它年龄段明显不同。     

孕妇被动吸烟与围产儿不良结局

为了解孕妇被动吸烟对转帐产儿健康影响的情况,对我院1995年10月－1996年6月住院待产妇进行了相关因素调查并追踪至产后7天,桉孕期有,无被动吸烟自然分为吸烟组（又根据吸烟量分为A,B两组）和对照组,观察各组新生儿出生体重,IUGR,早产,新生儿窒息,围产儿死亡等的发生率,结果显示,被动吸烟组的新生儿体重明显低于对照组：IUGR的发生率则明显高于对照组,差异显著（P＜0．01,P＜0．005）,并且吸烟量越多则新生儿体重越低,IUGR的发生率越高,吸烟A,B两组比较差异显著（P＜0．01）,另外,被动吸烟组的早产率（17．0％）,新生儿窒息率（12．9％）,围产儿死亡率（1．6％）亦高于对照组（3．0％,4．2％,0．6％）,经统计学处理除围产儿死亡率外,差异均有显著性（P＜0．005）,提示：孕妇被动吸烟可严重影响胎儿的生长发育及健康,对胎儿不利。     

不同海拔健康青年男性心率变异性对比分析

应用短程心率变异性（HRV）时域、频域和非线性分析法，对比进入三个不同海拔高度自主神经系统（ANS）调节功能的特点。发现：与进入海拔1856m相比．海拔2800m平均正常RR间期的标准差（SDNN）、相邻RR间期差的均方根（rMSSD）、相差〉50ms的相邻RR间期占RR间期总数的百分比（PNNS0）、低频成分（LF）、高频成分（HF）以及总功率（TP）均有轻度升高，但无统计学差异；与进入海拔1856m和海拔2800m相比．海拔3040mSDNN、rMSSD、LF和HF显著降低。这表明进入海拔3040m副交感神经活动显著减弱、自主神经系统调节功能显著受抑。自主神经的这种变化有助于进一步阐明进入高海拔机体发生的病理生理学改变。     

Platelet Serotonin Transporter Function and Heart Rate Variability in Patients with Panic Disorder

Many studies showed abnormal serotonin transporter (5-HTT) function and heart rate variability (HRV) in panic disorder patients. The present study investigated the relationship between HRV power spectral analysis findings and platelet serotonin uptake in panic disorder patients. Short-term HRV over 5 min and platelet serotonin transporter uptake parameters (V_max and K_m) were measured both in 45 patients with panic disorder and in 30 age-matched normal healthy control subjects. Low frequency power (LF) normalized unit (nu) and LF/high frequency power (HF) were significantly higher, whereas HF and HF nu were lower in the patient group than in the control group. V_max and K_m were all significantly lower (i.e., reflects decreased 5-HTT function) in patients with panic disorder than in normal controls. In the patient group, K_m was negatively correlated with LF/HF and LF nu whereas no such correlations between them were found in the control group. By multivariate analysis based on multiple hierarchical linear regression, a low K_m independently predicted an increased LF nu even after controlling for age, sex, and body mass index in the patient group. These results suggest that impaired 5-HTT function is closely related to dysregulation of autonomic nervous system in panic disorder.     

Autonomic function in adults with allergic rhinitis and its association with disease severity and duration

Background

The association between allergic rhinitis (AR) and the autonomic nervous system (ANS) has recently received substantial attention. However, no studies have assessed how the heart rate variability (HRV) parameters are associated with duration and disease severity in AR.

Rhythmic oscillations of blood pressure and R-R interval in patients with chronic renal failure

Rhythmic blood pressure (BP) and R-R interval (R-R) oscillations at low-mid and high-frequency bands (LF: 0·02–0·06 Hz; MF; 0·07–0·14 Hz; HF; 0·15–0·40 Hz) were compared between uraemic patients maintained on haemodialysis and control subjects. The LF and MF powere spectra of BP were attenuated more in patients than in controls. With subjects standing, the MF power spectrum of BP increased significantly in both groups. With subjects supine, the plasma norepinephrine concentration was higher, and its increment upon standing was greater in patients than in controls. Each R-R frequency power spectrum decreased more in patients than in control subjects. The HF power spectrum of R-R, i.e. a vagal tone index, systematically decreased upon standing in the control subjects but not in the patients. The linear coupling between BP and R-R oscillations was strongest in the HF band, decreasing in the MF and LF bands. Transfer function analysis indicated that, in uraemic patients, linear BP/R-R relationships were altered in the HF band but remained normal in the LF and MF bands. The present results suggest that, first, the decreased amplitude of Mayer waves, i.e. the MF power spectrum of BP, observed in uraemic patients can be attributed to low sensitivity of the vasculature to sympathetic stimuli, and, secondly, autonomic modulation of linear BP/R-R relationships is frequency-dependent.     

脑卒中患者血管紧张素转换酶基因多态性与心率变异性的关联研究

目的　探讨脑卒中患者血管紧张素转换酶 (angiotensin- converting enzyme,ACE)基因多态性和心脏心率变异性的关系。方法　应用聚合酶链反应方法检测 4 3名正常人、4 6例脑梗塞患者、4 0例脑出血患者 ACE基因的插入 /缺失多态性 (insertion/deletion,I/D) ,并用心率变异性 (heart rate variability,HRV)分析方法观察其 HRV的时域、频域和混沌参数。结果　缺血性、出血性脑卒中患者的 ACE基因缺失型 (DD)及 D等位基因频率明显高于正常对照组 (P<0 .0 1) ,DD型患者的 HRV的参数值升高 ,即相邻心搏间期的均方根值、相邻心搏间期差大于 10 ms的心搏间期数占心搏间期总数的百分比、总功率谱、高功率谱、低频功率谱、混沌参数 ,明显高于 ACE基因插入型 (II)、ACE基因插入 /缺失混合型 (ID)患者 ,差异有显著性 (P<0 .0 5 )。结论　 HRV的相关参数和遗传相关 ,提示脑卒中患者有 ACE DD基因型的人 ,有脑源性心脏自主神经功能紊乱发生的危险性。     

The Autonomic Nervous Activity in Patients with Essential Hypertension who Showed Early Morning Rise of Blood Pressure

Autonomic nervous function was evaluated by means of power spectral analysis of heart rate variability in patients with essential hypertension who showed early morning rise of blood pressure (BP). We monitored ambulatory (BP) and physical activity in 80 untreated patients using TM 2425 (A&D Co.Ltd.). Early morning rise of BP was defined a patient's blood pressure obtained between 6:00 to 9:00am is 170mmHg or higher. Patients who showed early morning rise of BP were categorized into groups. Twenty patients, whose mean BP obtained between 6:00 to 9:00am were higher than those obtained between 3:00 to 600am by 30mmHg or more, were defined as a surge type. Sixty patients, in whom the difference in BP was less than 30mmHg, were defined as a sustained type. Power spectral analysis of hourly R-R intervals for 24 hours was performed to obtain the low frequency power (LF, 0.04 to 0.15 Hz) and high frequency power (HF, 0.15 to0.04 Hz). LFn and LF/HF ratio were considered to be indexes of sympathetic nervous activity, and HF parasympathetic nervous activity, respectively. Between 3:00 to 6:00am, LFn and LF/HF were significantly higher and HF was significantly lower in the sustained type patients than in the surge type patients. LF/HF and LFn in the surge type elevated significantly beween 6:00 to 9:00am. These results indicate that both the loss of nocturnal decline in BP in the sustained type and the morning rise in BP in the surge type to occurred in association with changes in autonomic nervous system.     

妊娠期糖尿病孕妇心率变异性变化

目的:探讨妊娠期糖尿病孕妇心率变异性变化.方法:选取阳春市妇幼保健院2018年1月至2020年4月收治的50例妊娠期糖尿病患者作为观察组,选取同期健康孕检孕妇50例作为对照组,年龄20～36岁,孕周24～40周.所有孕妇给予动态心电图监测,比较两组孕妇平均心率(AHR)、正常窦性RR间期的总体标准差(SDNN)、每5 ...     

用HRV观察麝香保心丸对家兔急性心肌缺血的影响

实验在３２只戊巴比妥纳麻醉的新西兰兔上进行,记录心率、呼吸心电图和ＨＲＶ（心率变异性）频谱分析,以ＨＲＶ频谱成分指标分别记录正常时,正常加药对照组,急性心肌缺血时,缺血后加麝香保心丸时总变异性（ＴＶ）,低频成分（ＬＦ）,高频成分（ＨＦ）,低频成分和高频成分比值（ＬＦ／ＨＦ）,结果显示正常时与加药对照时的ＨＲＶＰ值均＞０．０５,其它除急性缺血时ＬＦ／ＨＦＰ值＞０．０５外,所有Ｐ值均＜０．００１,因而本实验提示,麝香保心丸能调整急性心肌缺血时自主神经功能,尤其是调整交感神经和迷走神经兴奋的适当比例,有益于心功能恢复,改善心肌缺血状态。     

Alpha-adrenoceptor gene variants and autonomic nervous system function in a young healthy Japanese population

α_1A-adrenergic receptor (α_1A-AR) regulates the cardiac and peripheral vascular system through sympathetic activation, and α_2A-AR and α_2C-AR subtypes are essential for presynaptic feedback regulation of catecholamine release from the central and peripheral sympathetic nerve. Genetic variations in each human α-AR subtype gene have been identified and have been implicated in hypertension and cardiovascular disease. It is not yet clear whether these genetic variations actually have an effect on sympatho-vagal modulation. The aim of the present study was to evaluate the relation between the five representative genetic polymorphisms of α-AR subtypes (Arg347Cys of α_1A-AR; C-1291G, Asn251Lys, and DraI RFLP of α_2A-AR; and Del322–325 of α_2C-AR) and autonomic nervous system (ANS) function in young and healthy Japanese males. One hundred forty-nine subjects were genotyped for each α-AR polymorphism, and underwent evaluation of ANS function by power spectral analysis of heart rate variability (HRV) during supine rest and in a standing position. In a supine position, the α_1A-AR 347Cys allele was significantly associated with lower HRV sympathetic index (normalized low frequency power [LF(%)] and LF:HF ratio) and higher HRV parasympathetic index [HF(%)]. Meanwhile, subjects with the α_2C-AR Del322–325 allele had markedly higher LF(%) and LF:HF ratio and lower HF(%) than noncarriers. Thus, the α_1A-AR and α_2C-AR genetic variations influence sympatho-vagal balance even in young and healthy normotensive states, which could be postulated to constitute an intermediate phenotype for future pathological episodes of various ANS dysfunction-related diseases.     

Effects of high altitude acclimatization on heart rate variability in resting humans

The sympatho-vagal nerve interaction at the heart was studied by means of power spectrum analysis of heart rate variability in seven Caucasians (aged 27–35 years) in resting supine and sitting positions before and during 35 days of a sojourn at 5050 m above sea level (asl) and in six Sherpas (aged 22–30 years) at high altitude only. A high frequency peak (HF)-central frequency between 0.20 and 0.33 Hz, a low frequency peak (LF)-central frequency between 0.08 and 0.14 Hz, and a very low frequency component ( < 0.05 Hz), no peak observed, were found in the power spectrum in both positions and independent of altitude. The peak powers, as a percentage of the total power, were affected by both body position and altitude. At sea level the change from a supine to a sitting position yielded a decrease in percentage HF from 25 (SEM 1.9)% to 6.2 (SEM 1.5) % (P < 0.05) and a significant increase in the ratio between LF and HF powers (LF : HF) from 1.7 (SEM 0.4) to 6.9 (SEM 1.6). At altitude compared to sea level in the supine position, percentage HF decreased from 25% to 10.9 (SEM 1.0)% (P < 0.05) and the LF:HF ratio increased from 1.7 to 4.8 (SEM 0.7) (P < 0.05). No changes occurred at altitude in the sitting position either in the peak powers or in the LF:HF ratio, but the central frequency of HF peak increased significantly from 0.25 (SEM 0.02) Hz to 0.32 (SEM 0.01) Hz. In the Sherpas comparable results to the Caucasians were found in both body positions. The high LF:HF ratios observed at altitude in both body positions and groups would suggest that hypoxia caused a shift of sympatho-vagal nerve interaction at rest toward a dominance of the sympathetic system, which was found at sea level only in the sitting position. An acclimatization period of 10 days higher than 2850 m asl and 1 month at 5050 m asl did not modify the interactions of the autonomic systems.