手传振动对外周循环功能的影响及其与植物神经功能关系的研究

为探讨手传振动对外周循环功能与植物神经功能的关系,对39名金矿岩工人进行冷水试验前后手部红外摄像及心率变异性的研究。结果表明,白指组、接振组SDNANN较对照组明显降低,LF／HF较对照组明显增高,且均以白指组变化最甚（P＜0．05,P＜0．01）;冷水试验前、后白指组、接振组皮肤温度较对照组明显下降,其中白指组降低最基（P＜0．05,P＜0．01）。提示手臂振动导致植物神经功能紊乱可能是作业工人外周循环功能异常的原因。     

手传振动对体感诱发电位的影响及其临床意义

手传振动对周围和中枢神经机能的影响,国内外已进行了若干研究。我们曾研究了手传振动对神经传导速度、心率变异性的影响,均获得了有意义的结果[1,2]。但应用短潜伏时体感诱发电位(ｓｈｏｒｔｌａｔｅｎｃｙｓｏｍａｔｏｓｅｎｓｏｒｙｅｖｏｋｅｄｐｏｔｅｎｔｉａｌ,ＳＬＳＥＰ)评价其对中枢神经机能的影响,目前报道较少。我们通过对振动性白指(ＶＷＦ)患者和无白指接振工人的上肢正中神经ＳＬＳＥＰ研究,探讨其在“振动性神经病”早期诊断中的意义。一、对象与方法1.对象:将研究对象分为3组。ＶＷＦ组:从事砂轮磨光作业1ａ以上,主诉手麻…     

77台手传振动工具振动频率浅析

77台手传振动工具振动测试结果表明:捣固机频谱呈水平分布;凿岩机、风铲机、铆钉机、水泥振动棒、链锯机及砂轮机等呈上升形式分布。各类工具振动强度差异甚大,频率计权加速度(ahW)3.3～30.2m·s~(-2)。本文还就频谱分析的必要性及材料硬度对频率分布的影响做了初步讨论。     

手传振动与噪声对工人健康影响的调查

手传振动与噪声对工人健康影响的调查浙江省劳动卫生职业病防治所（杭州３１０００９）黄德明杨锦蓉浙江省丽水地区卫生防疫站陈卫平长期接触手传振动与噪声不仅会引起局部振动病和噪声性耳聋，而且对人体心血管系统、神经系统产生不良影响。为了解上述职业因素对工人健康...     

手传振动与噪声对作业工人心电图影响的调查

手传振动与噪声对作业工人心电图影响的调查浙江省劳动卫生职业病防治所（杭州市老浙大直路，３１０００９）杨锦蓉高华玲黄德明盛琴琴浙江省绍兴市卫生防疫站曹婉娟振动作业环境常与噪声共存。有关振动与噪声对心血管系统的影响国内外已有不少研究和报道，但结论并非一致...     

磨光作业工人手传振动剂量分析

为了解工业生产中各种类型打磨工具的振动加速度 ,采用 1 2种打磨机的振动测试数据 ,分析比较各种打磨机的振动危害程度。结果表明 ,手持砂轮机和角向磨光机的频率计权振动加速度 (ahw)较高 ,波动较大 ;座式砂轮机ahw较稳定 ,棒砂轮机ahw最低。由于工人每日使用手持砂轮机的时间较长 ,其 4h等能量频率计权振动加速度 [ahw(4) ]最高 ,角向磨光机次之 ,使用这些工具的多数工人的ahw(4) 明显超过 5m/s2卫生限值 ;使用石英砂纸打磨机ahw(4) 在 5m/s2 上下波动 ;棒砂轮机的ahw(4) <5m/s2 。提示 ,减轻手传振动危害的关键是控制接振时间 ,打磨工具中尤其应控制手持砂轮机的使用时间     

手指皮温对检测手传振动职业危害的意义

目的 探讨手传振动对接触者早期职业损害的指标,避免发生手传振动牟不可逆改变。方法 对１２８名暴露于不同接振剂量的工人及对照者的手指皮温和一些有关的主客观症状进行调查。结果 与对照组相比,随接振剂量的增强和工龄的延长,手批皮温显著下降,对照组及不同接振组工人手指皮温的下降率分别为５．６０％、３０．９５％、５７．５８％和７５．００％,同时受试者的痛阈降低。结论 手指皮温下降是手传振动从业者末梢血循环功     

手传振动对煤矿掘进工血浆内皮素、一氧化氮浓度的影响

以不同接振时间的64名煤矿掘进工进行了血浆内皮素、一氧化氮浓度的测定。结果表明,各个接振时间段内皮素浓度均高于对照组,并随接振时间的延长增高更明显（P＜0．05,P＜0．01）。在接振时间≤5000h时,一氧化氮浓度高于对照组,但无统计学意义（P＞0．05）;接振时间＞5000h,一氧化氮浓度低于对照组,且随接振时间延长,降低更明显（P＜0．05,P＜0．01）。表明手传振动可致煤矿掘进工血浆内皮素浓度的升高及一氧化氮浓度的下降,这种改变可能与振动性血管损伤有一定联系。     

6种接触振动岗位作业工人手传振动危害现况调查

目的了解接触手传振动(以下简称接振)作业工人的职业接触现况。方法通过问卷调查,了解接振工人作业及防护情况。使用丹麦B&K4447型人体振动分析仪,依据ISO 5349—1:2001,对7个不同行业15家工厂6种接振岗位共59个操作位进行了手传振动测量,计算8 h等能量频率计权加速度[ahv(eq,8h),记为A(8)],分析其危害程度。结果各接振岗位的A(8)中位数(M)为5.16 m/s2,四分位数间距(Q)为2.83 m/s2,最小值为1.53 m/s2,最大值为51.43m/s2。有39个点(66.10%)的A(8)值超过ISO 5349—1:2001限值(3.7 m/s2)。左右手以及手套内外加速度差异无统计学意义(P>0.05)。结论手传振动职业接触水平高,防护差,接振工人的职业健康危害风险较高。     

20名手传振动作业工人的神经肌电图分析

目的探讨手传振动对作业工人周围神经的损害情况。方法对20名从事手传振动作业工人和30名无接触职业危害的健康成人进行神经肌电图检查分析。结果①MCV检测结果显示正中神经运动传导远端潜伏期延长（占85．0％）、MCV减慢（占35．0％）（P〈0．01）;②SCV捡测结果显示正中神经SCV减慢（占40．0％）、尺神经SCV减慢（占30．0％）（P〈0．01）;③肌电图检查结果表现为小力收缩时多相电位增多（占42．5％）及安静时出现纤颤电位（占15．0％）（P〈0．05或P〈0．01）。结论振动对作业工人周围神经损伤明显,神经肌电图检查最早表现为正中神经运动传导远端潜伏期延长,随着损伤加重,进一步出现神经传导速度减慢,运动和感觉同时受累。     

Assessment of autonomic nervous activity in hand-arm vibration syndrome patients using time- and frequency-domain analyses of heart rate variation

Objectives: The aim of the present study was to non-invasively assess autonomic nervous activity, using time- and frequency-domain analyses of heart rate variation (HRV), and to investigate the relationship between indices of HRV and duration of exposure to vibration (DEV), time since retirement from work involving vibration (TR) and time undergoing treatment (TT) in a group of patients with hand-arm vibration syndrome (HAVS). Subjects and methods: Twenty one HAVS patients who were no longer exposed to vibration and were undergoing standard treatment for HAVS, and 10 healthy control subjects, similar to the patients in age, height, weight and number of current smokers and drinkers, volunteered for this study. Indices of HRV [time-domain indices (the mean of R-R intervals, standard deviation and coefficient of variation) and normalized units of frequency-domain indices [low frequency (LF) and high frequency (HF) components], indicating parasympathetic nervous activity, were calculated from 2 min electrocardiographic data recorded during spontaneous breathing by subjects in supine rest. Results: The LF and HF components of the patients were significantly lower than those of the healthy controls (P < 0.05). When Pearson correlation analysis was applied for the patient group, using indices of HRV with age, weight, height, DEV, TR and TT, the LF components positively related to TR and TT (P < 0.01). The patients were thus divided into three groups as follows, according to TR: group A (≤1 year), group B (>1 to <5 years) and group C (≥5 to ≤10  years), or according to TT: group X (≤1 year), group Y (>1 to <5 years) and group Z (≥5 to ≤10  years). The LF components of the groups A and X were significantly lower than that of the healthy controls (P < 0.01). The HF components of the groups A and X were also significantly lower than that of the healthy controls (P < 0.05). Conclusions: The findings of the present study indicate decreased cardiac parasympathetic activity in the HAVS patients in comparison to the healthy controls. The TT and TR significantly influenced the HRV results in these patients; however, the DEV did not. The findings also indicate that treatment and cessation of exposure to vibration might have a beneficial effect on the cardiac parasympathetic activity in HAVS patients. Received: 18 March 1999 / Accepted: 14 June 1999     

医学院女大学生自主神经系统功能状况及其影响因素分析

目的通过对医学院女大学生心率变异性的测量,了解其自主神经系统功能状况,分析其影响因素,为改善女大学生自主神经功能,促进其身心健康提供科学依据。方法 2015年6-10月选取422名吉林省某综合大学医学院女大学生为研究对象,采取自填式问卷方法,对其心率变异性进行测查。结果医学院女大学生自主神经系统活性偏低的检出率为37.0%,自主神经系统均衡性异常的检出率为71.1%;多因素Logistic回归结果显示,压力大和睡眠质量差分别是医学院女大学生自主神经系统活性和自主神经系统均衡性的独立影响因素(P<0.05)。结论医学院女大学生自主神经功能异常问题突出,应及时采取缓解压力、改善睡眠质量、加强体育锻炼等措施提高自主神经功能,促进女大学生身心健康。     

Effects of occupational use of vibrating tools in the autonomic, central and peripheral nervous system

Objectives:The objective of this study was to clarify the autonomic, central and peripheral nervous effects of vibrating-tool operation. Methods: The ECG R-R interval variability (CV_RR), including the C-CV_HF, C-CV_LF (two component CVs of the CV_RR reflecting parasympathetic and sympathetic activities, respectively) and the power spectral densities (PSD_HF and PSD_LF) after autoregressive analysis, short-latency somatosensory evoked potentials (SSEP), distribution of nerve conduction velocities (DCV), and median and radial nerve conduction velocities (NCVs) were measured in 17 vibrating-tool operators and the same number of age-matched control subjects. Some of the operators complained of white finger even in summer as soon as they arrived at the cold workplace. Design: The significance of the differences in neurophysiological data between the exposed and unexposed groups and the associations between these data in the former were investigated. Results: The CV_RR, C-CV_HF and PSD_HF were significantly lower in the vibrating-tool operators than in the matched controls. The N9–N13 interpeak latency of the SSEP, i.e., conduction time of the cervico-spinobulbar pathway, in the operators was significantly prolonged as compared with the controls; the faster velocities of the DCV and the NCVs were significantly slowed in the operators. The N9–N13 interpeak latency in the operators was significantly correlated with the C-CV_HF. Conclusion: Complex stressors of local vibration, cold, noise and heavy work, seem to affect the cervico-spinobulbar, parasympathetic and peripheral nerve functions. Also, parasympathetic hypofunction may imply a consequence in brainstem pathology induced by cold exposure in addition to vibration. Received: 2 July 1996 / Accepted: 17 January 1997     

甲状腺功能亢进症患者植物神经功能的昼夜周期改变

目的 研究甲状腺功能亢进症(甲亢)患者植物神经功能的昼夜周期改变.方法 记录33例初发甲亢患者(甲亢组)和35例健康体检者(对照组)的24 h动态心电图,并通过心率变异性的时域和频域分析来评价心脏植物神经功能状态.结果 甲亢组所有NN间期的标准差(SDNN);以5 min为间隔将24 h连续记录分为288段,先计算每段的平均NN间期,然后计算288个NN间期平均值的标准差(SDANN);以5 min为间隔将24 h连续记录分为288段,先计算每段的NN间期标准差,然后计算288个NN间期标准差的平均值(ASDNN);所有相邻NN间期差值的均方根(rMSSD)显著低于对照组[(82.3±29.0)ms比(139.4±40.2)ms;(75.0±27.4)ms比(130.3±43.9)ms;(29.9±14.9)ms比(57.3±14.4)ms;(19.8±10.9)ms比(29.5±9.4)ms](P＜0.01或＜0.05).甲亢组总功率(TP)、高频功率(HF)、低频功率(LF)和极低频功率(VLF)显著低于对照组[(566.1±573.2)ms2/Hz比(1894.2±984.3)ms2/Hz、(68.1±88.9)ms2/Hz比(232.7±155.5)ms2/Hz、(127.4±163.0)ms2/Hz比(551.3±390.6)ms2/Hz、(330.3±300.6)ms2/Hz比(1073.2±570.2)ms2/Hz](P＜0.01).短时频域分析甲亢组VLF在全天大多数时间均显著高于对照组(P＜0.05),LF主要在白天显著高于对照组(P＜0.05),HF在全天散在时间高于对照组(P＜0.05);两组LF/HF在全天绝大多数时间差异无统计学意义(P＞0.05).结论 甲亢患者心脏变时性低,交感神经张力在全天均增高,而迷走神经张力虽有相应增高,但以白天增高为主,夜间接近正常水平.

Abstract：

Objective To investigate the circadian change of autonomic nervous system in hyperthyroidism (HT) patients. Methods Recording 24 h dynamic electrocardiography from 33 HT patients( HT group) and 35 controls (control group). The cardiac autonomic nervous function was evaluated by the time domain and frequency domain analysis of heart rate variability( HRV). Results Comparing with control group, the SDNN, SDANN, ASDNN and rMSSD were significantly lower in HT group[ (82.3 ± 29.0)ms vs. (139.4±40.2 ) ms, ( 75.0 ± 27.4) ms vs. ( 130.3 ± 43.9) ms, (29.9 ± 14.9 ) ms vs. (57.3 ± 14.4) ms,( 19.8 ± 10.9 ) ms vs. (29.5 ± 9.4) ms ] (P ＜ 0.01 or ＜ 0.05 ), the long term total power (TP), high frequency (HF), low frequency (LF) and very low frequency (VLF) were significantly lower in HT group [ (566.1±573.2) ms2/Hz vs. ( 1894.2 ± 984.3)ms2/Hz, (68.1 ± 88.9 ) ms2/Hz vs. (232.7 ± 155.5 ) ms2/Hz, ( 127.4 ±163.0) ms2/Hz vs. (551.3 ± 390.6) ms2/Hz, (330.3 ± 300.6) ms2/Hz vs. (1073.2 ± 570.2) ms2/Hz] (P ＜0.01 ). Comparing with control group, short term VLF was higher in HT group during most time in 24 hours (P＜ 0.05 ). Short term LF was higher in HT group mainly in day time (P＜ 0.05 ). Short term HF was higher in HT group occasionally in the whole day (P＜0.05). Short term LF/HF didn't show significant difference between HT group and control group at most time points (P＞0.05).Conclusion In HT patients, cardiac chronotropic property is impaired, sympathetic activity increases in whole day, vagal activity increases correspondently but the increase in day is more marked than that in night.     

自主神经功能障碍对丘脑出血患者并发应激性溃疡的作用

目的探讨丘脑出血患者自主神经功能的变化以及这种变化在应激性溃疡发生中的可能作用。方法2008年1月～2009年12月间发病24h内人住笔者所在医院神经内科的急性丘脑出血患者50例为研究对象，同期因其他疾病住院的患者50例为对照组。对以下指标进行了比较：（1）丘脑出血患者第1天，第2天和第15天后的血清儿茶酚胺浓度；（2）丘脑出血患者急性期和慢性期并发应激性溃疡的比率；（3）丘脑出血患者急性期、慢性期和对照组之间的心率变异法各频域指标。结果丘脑出血患者急性期共有20％发生应激性溃疡，血清儿茶酚胺浓度明显升高，心率变异法分析显示丘脑出血急性期HF频域成分明显升高，提示迷走神经活动增强。结论在丘脑出血急性期交感神经系统活性有所增强，而迷走神经系统活性的增强更为显著，且可能占主导地位，这种自主神经系统功能障碍在应激性溃疡的发生中可能起到一定作用。     

肥胖儿童心脏自主神经变化特征及有氧运动的干预作用

目的:了解单纯性肥胖儿童心率的变化特征,探讨有氧运动对心率变异的影响机制。方法:选择单纯性肥胖男性儿童30名作为实验组,年龄(10.40±0.30)岁,身高(155.20±3.80)cm。配对选择体重正常健康儿童30名作为对照组,年龄(10.50±0.51)岁,身高(154.40±3.50)cm。实验组儿童进行12周有氧运动,采用12导联Superscan TM动态心电图分析系统记录运动前后安静状态心电图,并进行心率变异性的时域和频域分析。结果:①频域指标:实验组LF、HF和LF/HF均低于对照组(P<0.01或P<0.05);实验组运动后LF和HF与运动前比较明显增加(P<0.05)。②时域指标:实验组SDNN和LPNN50低于对照组(P<0.01);实验组运动后SDNN和LPNN50与运动前比较明显增加(P<0.05)。结论:单纯性肥胖儿童与正常儿童比较存在心率变异,主要表现为迷走神经活性降低;有氧运动能够改善单纯性肥胖儿童的自主神经活动。     

The mechanism of a human reaction to vibration stress by palmar sweating in relation to autonomic nerve tone

Objectives: To clarify the mechanism of a human reaction to vibration stress by palmar sweating in relation to the autonomic nerve tone. Methods: The autonomic nerve tone was divided into four types by using digital photoelectroplethysmography (PTG) with auditory stimuli: normal (N), hyperreactive (I and D), and hyporeactive (P) types. Palmar sweating and digital PTG were simultaneously measured on the right palm and middle finger, respectively, in 20 healthy men. The left hand gripping the handle with a grasp strength of 49 N was exposed to vibration at a frequency of 125 Hz and acceleration magnitudes of 0 m/s² (as a control), 30 m/s², or 50 m/s² for 3 min. The volume of palmar sweating was recorded before, during, and 30 min after vibration load. Three kinds of drugs related to the autonomic nervous system were orally administered to the subjects. Then 80 min after administration, the experiments were repeated. Results: Of 20 subjects, 17 showed normal autonomic nerve tone (N type), and 3 hyperreactive (I type). The palmar sweating reaction to vibration in I-type subjects was greater and lasted longer than that in N-type subjects. Vibration with an acceleration of 50 m/s² produced the greatest reaction which was about 7 times larger than that at 0 m/s² and 2.5 times that at 30 m/s² (P < 0.01). Sulpiride decreased palmar sweating during vibration, while prazosin and scopolamine inhibited it. Conclusions: The palmar sweating reaction to vibration stress was related to the background level of the autonomic nerve tone. The sweating volume was in direct proportion to the acceleration magnitude of vibration. The reaction of palmar sweating to vibration stress may be mediated through both the adrenergic and cholinergic fibers of the autonomic nervous system. Received: 18 September 1998 / Accepted: 10 July 1999     

体育运动对心率变异性的影响

[目的]心率变异性(heart rate variability,HRV)是临床上用于评价自主神经功能的主要方法。自主神经功能紊乱与一些常见慢性病(高血压、冠心病、糖尿病和肥胖等)存在紧密联系。长期运动健身可以改善机体的自主神经功能紊乱,对上述疾病具有防治作用。为进一步开展"运动与自主神经功能"领域的研究,撰写本综述。[方法]采用文献综述法对心率变异性的原理、分析方法以及急性和慢性运动对心率变异性的影响进行了描述。[结果]大量研究证实急性运动过程中,由于运动强度、运动方式以及运动者机能状态的不同,HRV各参数也呈现不同的特征;慢性运动可以改善自主神经平衡状态,表现为HRV各参数的良好改变。[结论]HRV在疾病的运动防治领域有广泛的应用前景。