高血压合并急性脑血管病的心率变异分析

目的：探讨急性脑组织损害对原发性高血压（ＥＨ）患者心率变异（ＨＲＶ）的影响。方法：对２６例ＥＨ并急性脑血管病（ＡＣＶＤ）患者进行２４ｈ动态心电图ＨＲＶ测定,并与２０例ＥＨ元ＡＣＶＤ患者进行对比。结果：ＥＨ并ＡＣＶＤ组最小心率及平均心率明显高于无ＡＣＶＤ组（Ｐ〈０．０１;Ｐ〈０．０１）;２４ｈ相邻Ｒ－Ｒ间期之差的均方根（ｒＭＳＳＤ）、相邻Ｒ－Ｒ间期之差大于５０ｍｓ的心搏数占心搏总数的百分比（ＰＮＮ５     

高血压性急性脑血管病的心率变异分析

目的：通过心率变异性（ＨＲＶ）分析,评估高血压性急性脑血管病（ＡＣＶＤ）患者的病情及预后。方法：对８０例原发性高血压患者并ＡＣＶＤ组４０例,无ＡＣＶＤ组４０例进行对比分析。结果：原发性高血压并ＡＣＶＤ组最小心率及平均心率高于无ＡＣＶＤ组,Ｐ〈０．０１。前者Ｒ－Ｒ间期标准差（ＡＤＮＮ）、心率变异系数（ＨＲＶ Ｉｎｄｅｘ）均低于后者,病灶部位越接受心血管中枢部位及自主神经调节中枢,其ＨＲＶ中ＳＤＮＮ及     

高血压性急性脑血管病的心率变异分析

目的：通过心率变异性（ＨＲＶ）分析，评估高血压性急性脑血管病（ＡＣＶＤ）患者的病情及预后。方法：对８０例原发性高血压患者并 ＡＣＶＤ组４０例，无 ＡＣＶＤ组４０例进行对比分析。结果：原发性高血压并 ＡＣＶＤ组最小心率及平均心率高于无 ＡＣＶＤ组，Ｐ＜０．０１，前者Ｒ－Ｒ间期标准差（ＡＤＮＮ）、心率变异指数（ＨＲＶ Ｉｎｄｅｘ）均低于后者，病灶部位越接近心血管中枢部位及自主神经调节中枢，其ＨＲＶ中ＳＤＮＮ及Ｉｎｄｅｘ越低。结论：ＨＲＶ是临床预防心衰、预测ＡＣＶＤ危险因素的重要指标。     

高血压合并急性脑血管病的心率变异性改变

对原发性高血压（ＥＨ）合并急性脑血管病（ＡＣＶＤ）患者３０例进行２４小时动态心电图心率变异性（ＨＲＶ）测定，并与３０例无ＡＣＶＤ的ＥＨ患者进行对比。结果显示，合并ＡＣＶＤ组最小心率及平均心率明显高于对照组（Ｐ＜０．０１、＜０．００１）；ＳＤＮＮ、ｒＭＳＳＤ、ＰＮＮ５０比对照组明显减低（Ｐ＜０．００１、＜０．０１、＜０．００１）。提示合并ＡＣＶＤ的ＥＨ患者ＨＲＶ减低，其主要原因可能是自主神经中枢损害。     

高血压患者心率变异的临床探讨

对84例高血压病人和50例正常人心率变异指数（HRVI）进行研究分析，结果显示高血压患者的事件组（包括死亡）比无事件组HRVI显著减低（P＜0．01），HRVI减低的阳性率显著增高（P＜0．001），最快心率与最慢心率差值缩小，死亡组更明显。HRVI≤25的高血压患者死亡率是HRVI＞25的5倍。提示用HRVI预测高血压患者的预后具有重要的临床意义。     

高血压患者心率变异的临床探讨

对８４例高血压病人和５０例正常人心率变异指数进行研究分析，结果显示高血压患者的事件组比无事件组ＨＲＶＩ显著减低，ＨＲＶＩ减低的阳性率显著增高，最快心率与最慢心率差值缩小，死亡组更明显。     

脑中风患者心率变异的初步分析

目的：探讨中风后植物神经的变化规律及其变化机制。方法：采用反映植物神经功能折心率变异指标，对其时域指标进行分析、应用方差分析及ｔ检验，比较了健康对照组与中风组的心率变异情况。结果：（１）中风组ＳＤＮＮ及ＨＲＶＩ均明显低于健康对照组。（２）中风组随病程的处长，其心率变异逐渐增高，到半年后基本恢复到对照组的水平。     

高血压合并急性离出血管病的心率变异性改变

对原发性高血压（ＥＨ）合并急性脑血管病（ＡＣＶＤ）患者３０例进行２４小时动态心电图心率变异性（ＨＲＶ）测定，并与３０例无ＡＣＶＤ的ＥＨ患者进行对比。结果显示，合并ＡＣＶＤ组最小心率及平均心率明显高于对照组（Ｐ〈０．０１、〈０．００１）；ＳＤＮＮ、ｒＭＳＳＤ、ＰＮＮ５０比对照组明显减低（Ｐ〈０．００１、〈０．０１、〈０．００１）。提示合并ＡＣＶＤ的ＥＨ患者ＨＲＶ减低，其主要原因可能是自主神经中枢损害     

急性脑血管病患者心率和QT间期的研究

目的了解急性脑血管病患者心率和QT间期的变化,为急性脑血管病的合理干预提供依据。方法检测246例急性脑出血(Ⅰ组)、251例急性脑梗死患者(Ⅱ组)和300例正常对照组的标准12导联心电图,观察心率和QT间期的变化。结果与正常对照组相比,Ⅰ组和Ⅱ组窦性心动过速的发生率显著增加,Ⅰ组增加更明显,而窦性心动过缓的发生率低于对照组;2组平均心室率明显增快,尤以急性脑出血组为甚。Ⅰ组和Ⅱ组平均QTc间期较对照组明显延长,且QTc间期延长的发生率显著增高。结论急性脑血管病患者平均心室率增快,QT间期延长。     

136例心神经官能症患者的心率变异分析

目的探讨心神经官能症心率变异。方法对2008-03-2011-03就诊的心神经官能症患者136例进行心率变异分析。结果心脏神经官能症患者HRV变化显示交感神经张力增加,而迷走神经张力不足。结论心神经官能症患者交感神经张力增加,治疗过程中应用β-受体阻滞剂,增大迷走神经张力,降低拟交感受体兴奋性[6],临床症状改善会更明显,有利于疾病控制。     

Orthostatic heart rate variability analysis in idiopathic Parkinson's disease

Objectives –  We evaluated time and spectral analyses of 24-h heart rate variability (HRV) and the heart rate responses to passive tilt in patients with idiopathic Parkinson's disease (IPD) in order to investigate cardiovascular autonomic functions.
Material and methods –  Twenty-three subjects with IPD without autonomic symptoms and 15 age-matched healthy controls were enrolled. Frequency- and time-domain HRV parameters were studied during resting and passive head-up tilt (HUT) test.
Results –  All time-domain parameters were found to be low in patients with IPD. In patients with IPD, both low frequency (LF) and high frequency (HF) decreased during HUT period and no significant change in LF to HF ratio was noted. Both time- and frequency-domain HRV indices showed no correlation with age, disease severity and duration, and with l -dopa medication.
Conclusion –  The results indicate that impairment of autonomic nervous system function in IPD without autonomic symptoms is frequent, and does not show clear association with clinical stage and the age of the patients.     

Blood pressure and heart rate variability in patients with essential hyperhidrosis

Introduction Essential hyperhidrosis (EH) is often considered to be related to an increased activity of sympathetic nervous system (SNS). However, there is a lack of studies comparing autonomic nervous system (ANS) activity in controls and in EH patients. The aim of the present study was to simultaneously investigate in patients with severe EH, blood pressure, heart rate variability and plasma catecholamine levels in comparison with controls.Methods 19 EH patients and 20 controls with normal ANS function assessed by clinical testing were included. Blood pressure (BP) and heart rate (HR) were measured using a Finapres beat-to-beat monitor. BP and HR variabilities (Fast Fourier transformation) and plasma catecholamine levels (HPLC) were obtained at rest and during a 15 min 70° head-up tilt test.Results At rest, a significantly higher relative energy of low frequency band (LF) of systolic BP was observed in EH in comparison with controls contrasting with the lack of difference in BP, HR, plasma catecholamine levels and in other spectral parameters. During tilt, all changes were comparable in EH and in control subjects excepting relative energy of LF of SBP which remained unchanged when compared to the resting condition in EH group.Conclusions In EH, SNS is not overreactive even if resting overactivity cannot be excluded.     

Twenty-four-hour heart rate variability to assess autonomic function in Parkinson's disease

OBJECTIVES: To evaluate the autonomic dysfunction in Parkinson's disease patients by means of a 24-h heart rate variability (HRV) method. MATERIAL AND METHODS: Thirteen patients with a diagnosis of Parkinson's disease were compared with 13 age-matched healthy persons (control group). The 13 patients had a mean age of 70.5 years, and mean disease duration of 10.9 years. The autonomic function was evaluated by HRV analysis using a continuous 24-h ECG. The parameters of SDNN (standard deviation of the normal-to-normal intervals between adjacent QRS complexes), of LF (power in low frequency) and of HF (power in high frequency) were studied during the following 3 periods: 24 h, night and day. RESULTS: The data show a statistically significant difference between groups for SDNN and LF in all the periods, while for HF parameters the difference is statistically significant only in the night period. CONCLUSION: The use of the 24-h HRV method can provide more accurate and reproducible data than other conventional cardiovascular tests.     

Reproducibility of heart rate and blood pressure variability in patients with chronic obstructive pulmonary disease

Abstract. Wide variations in respiratory rate and hypoxic stimulation of chemoreceptors may produce unreliable autonomic results in patients with COPD. We studied the reproducibility of two consecutive measurements of heart rate variability (HRV) and blood pressure variability (BPV) by time frequency analysis in patients with COPD while controlling respiratory rate and oxygen hemoglobin saturation (SaO₂). Reproducibility was assessed by paired t-tests and correlation analyses between repeated measures. Correlation analyses of the log transformed low (LF) and high frequency (HF) HRV were 11.5 ± 1.1 in measurement A and 11.5 ± 1.0 in measurement B (r = 0.89, p < 0.0001), and 10.5 ± 1.1 in measurement A and 10.6 ± 1.1 in measurement B (r = 0.89, p < 0.0001) respectively. The log transformed LF and HF BPV were 4.9 ± 1.3 in measurement A and 5.3 ± 0.9 in measurement B (r = 0.70, p < 0.0002), and 6.4 ± 1.3 in measurement A and 6.6 ± 1.2 in measurement B (R = 0.71 p < 0.0001) respectively. In conclusion, time frequency analysis of HRV and BPV is reproducible and reliable in patients with COPD while controlling their respiratory rate and oxygen hemoglobin saturation. Reproducibility of these measurements may allow for a non-invasive evaluation of autonomic tone in response to treatments in COPD patients.     

Heart rate variability in patients with untreated Parkinson's disease

The aim of this study was to evaluate cardiovascular responses as a marker of autonomic nervous system (ANS) disturbances in patients with untreated Parkinson's disease (PD) and to assess the relationship between them and the clinical characteristics of PD. The ANS functions were investigated in 50 patients with PD and 55 healthy subjects by measuring standard cardiovascular autonomic reflexes and heart rate variability (HRV) at rest using spectral analysis (the autoregressive model and the fast Fourier transformation), the percentage of the counts of beat-to-beat variation greater than 50 ms and the fractal dimension. Significantly attenuated HRV and deficient blood pressure reaction to tilting were found in the PD patient group. The patients with hypokinesia/rigidity as the initial symptom of PD had a more pronounced HRV deficit than those with tremor onset. Untreated PD patients suffer significant failure in cardiovascular nervous system regulation, and in patients with hypokinesia/rigidity as their initial disease manifestation the risk of this ANS dysfunction is high. However, in the early stages of PD these changes did not reach significance at individual level.     

原发性高血压患者伴左心室肥厚与室性早搏的心率变异性及可达龙干预的探讨

目的 探讨原发性高血压(EH)患者伴左心室肥厚(LVH)与室性早搏(VPBS)的心率变异性(HRV)特点及可达龙对其治疗效果.方法 对108例EH患者伴或不伴LVH及室性早搏和80例正常人24h动态心电图(Holter)和心脏超声资料进行对比分析;频发VPBS组服用可达龙治疗6周后复查HRV,并与治疗前相比较.结果 EH患者伴LVH组的室性早搏发生率明显高于非LVH组与对照组(P＜0.05);非LVH组与对照组室性早搏的发生率无显著性差异(P＞0.05);2组患者心率变异性各指标差异无统计学意义(P＞0.05),但均明显低于对照组(P＜0.05);服用可达龙8周后HRV较治疗前明显改善(P＜0.05).结论 EH患者心率变异性与左心室肥厚的程度呈负相关,与心律失常的发生呈正相关;可达龙治疗可改善高血压伴室性早搏的HRV,改善其预后.     

躯体化症状为主的抑郁症心率变异性对照研究

目的：探讨躯体化症状为主的抑郁症患者自主神经系统的特点及抑郁症躯体化表现的发生机制。方法：对30例躯体化症状为主的患者（A组）和30例情绪症状为主的患者（B组）及30例健康正常者（C组）分别进行汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评定及短时（10min）心率变异性（HRV）分析。结果：A、B、C3组HRV分析指标RR间期标准差（SDNN）分别为（50.84±19.92）ms、（94.93±28.80）ms、（105.77±22.05）ms,A组显著低于C组（t=5.68,P〈0.01）,较B组低（t=3.73,P〈0.05）;3组LF/HF分别为（6.26±2.11）ms、（3.51±2.44）ms、（1.80±1.07）ms,A组显著高于C组（t=6.35,P〈0.01）,较B组高（t=2.50,P〈0.05）;A组HAMD评分（28.30±6.26）分高于B组（24.35±6.69）分,二者差异有显著性（t=3.14,P〈0.05）;A组HAMA评分（22.70±4.92）分显著高于B组（13.05±4.71）分,二者差异有显著性（t=6.17,P〈0.01）;HAMD焦虑/躯体化因子分与HRV指标SDNN、LF、HF、VLF和LF/HF均呈中度相关（r分别为0.49、0.61、0.58、0.50、0.63）（P〈0.05或P〈0.01）。结论：躯体化症状表现为主的抑郁症患者多伴有焦虑,自主神经功能紊乱。     

癫癎患者发作间期心血管自主神经功能与心率变异性

目的　探讨癫　患者发作间期心血管自主神经功能与心率变异性（ＨＲＶ）的变化。方法　５１例癫　患者根据标准心血管自主神经功能试验结果分为阳性（ＡＮＦＴ＋）组及阴性（ＡＮＦＴ－）组,与正常对照组３６例对比,进行ＨＲＶ分析。结果　癫　患者发作间期心血管自主神经功能异常率为４５．１％,且病程越长异常率越高。癫　患者在ＨＲＶ时域分析及非线性定量分析指标上均较对照组降低,且以　ＡＮＦＴ＋组患者最明显。ＨＲＶ直方图、散点图亦有特征性改变,以ＡＮＦＴ＋组患者最为显著。结论　癫　患者发作间期心血管自主神经功能存在紊乱现象,这种现象可能与癫　患者的猝死发生有关,ＨＲＶ是测定这一变化的敏感方法。