心率变异性生物反馈对高血压前期患者应激反应的干预效果

目的探讨心率变异性生物反馈（HRV BF）干预高血压前期患者心血管应激反应的效果。方法比较高血压前期者与正常血压者应激反应上血压变化的差异;将36位高血压前期受试者随机分为心率变异性生物反馈（HRV BF）组、慢腹式呼吸（SAB）组和空白对照组。干预组受试者接受每次30 min,每周2次,持续2个月共15次的训练;空白对照组不予干预。实验间隔期嘱受试者每天进行不少于20 min的家庭训练。所有受试者在实验开始前及实验结束后均接受连续2 d同一时间点进行的两种应激测试。结果高血压前期者较正常血压者在应对心算应激时收缩压和舒张压反应性更大。干预2个月后,HRV BF和SAB组收缩压和舒张压平均降压幅度分别为15.4/10.2 mmHg、11.6/7.4 mmHg;空白对照组干预后血压无明显变化。HRV BF能显著降低受试者心算应激时收缩压反应性,较SAB更为明显。结论高血压前期者应激反应性较高,HRV BF训练可以降低受试者应对心理应激时心血管的反应,并降低高血压前期者血压。     

肌电生物反馈中正常青年人心率变异性分析

目的应用心率变异性的频域指标探讨肌电生物反馈中的心脏自主神经系统功能活动的量化改变.方法借助多信号生物反馈分析系统同步记录生物反馈放松状态中的心电、脑电、肌电等信号,在心电信号的提取中引入了心率变异性的分析.取30名大二学生为被试,随机分为试验组和对照组各15名.结果肌电生物反馈中试验组第7-10次进入生物反馈状态后表征心脏交感神经兴奋程度的频域指标低频功率较对照组下降(3.55±0.32/3.98±0.21,3.51±0.29/3.82±0.15,3.39±0.26/3.93±0.16,3.41±0.28/3.91±0.23,t＝-4.35、-3.68、-6.85、-5.34,P＜0.05),表征心脏迷走神经兴奋程度的高频功率在8-10次生物反馈组较对照组升高(4.18±0.25/3.84±0.28,4.23±0.22/3.86±0.24,4.22±0.22/3.85±0.33,t＝2.94、3.58、3.61,P＜0.05),衡量交感迷走神经之间拮抗平衡的低频高频功率比值在7-10次生物反馈试验组较对照组下降(1.00±0.17/1.20±0.11,0.96±0.18/1.22±0.10,0.85±0.13/1.18±0.10,0.87±0.13/1.21±0.13,t＝-3.83、-4.89、-7.79、-7.16,P＜0.05).结论利用心率变异性频域指标可量化分析肌电生物反馈中心脏自主神经系统功能活动的变化,肌电生物反馈可以诱导健康受试者心率变异性升高,和安静状态相比,机体自主神经系统功能活动平衡性增加.     

生物反馈训练对疗养飞行员心理健康及心率变异性的影响

目的探讨生物反馈训练对飞行员心理健康及心率变异性的影响,为提高飞行员心理素质及心理生理储备能力提供依据。方法采用症状自评量表(SCL-90)进行心理测评,多参数生物反馈仪进行训练及心率变异性检测。结果飞行员生物反馈训练前后在SCL-90上的均值比较显示,除抑郁、敌对外,其余各因子得分均低于训练前(t=1.73~8.62,P0.01),有显著统计学意义。生物反馈训练前后HRV频域指标的比较结果显示,TP(总功率谱)及HF(高频)升高;LF/HF(低高比值)降低,训练前后比较有显著统计学意义(P0.01)。结论生物反馈训练能有效提高飞行员心理素质及心理生理储备能力。     

心率变异性作为植物神经功能检查方法的探讨

本文提出了规范化序列负荷心率变异性的诱发性检查法。通过三种不同负荷及生物反馈放松训练，既可揭示植物神经功能状态，也可获得生物反馈对植物神经功能的改善效能。作者还提出Ｌｏｒｅｎｚ散点图是综合评价植物神经功能状态的理想方法。它似“慧星”状，其长轴与交感神经兴奋有关，其尾部宽度与副交感神经张力有关。     

心率变异性研究进展

心率变异性指窦性心率的波动变化程度.其发生的主要机制是心脏节律直接受心交感和心述走神经的双重调节并相互制约.传统的心率变异性分析包括时域方法和频城方法,二类指标密切相关,非线性分析方法属近年来兴起的"新方法",目的在于描述RR间期的动态变化特征.心率变异性可用来预测心脏性猝死、评价心脏自主神经的活动性、均衡性有关的病理状态,因而具有重要临床价值.必须建立一种标准的测量分析方法,才能使心率变异性成为临床常规监测项目.     

睡眠中的心率变异性

睡眠中的心率变异性杨军俞梦孙苏琳陈蓓北京新兴生物医学工程研究发展中心（１０００３７）睡眠医学与研究觉醒和睡眠好像一个钟摆，是生命活动必需的两个互相转化的过程。对睡眠过程的研究无疑对我们了解人体生理机制有重要意义，还可以发现某些疾病的隐患或者致病因素，...     

海洛因成瘾者的心率变异性研究

利用功率谱估计的方法 ,对 15例海洛因成瘾者和 15例正常人的 HRV信号进行分析。分析结果表明 ,在海洛因成瘾者和正常人心率变异性信号功率谱间存在高频谱峰位置的显著差异 ,即海洛因成瘾者 HRV信号功率谱的高频谱峰位于 0 .437± 0 .0 6 4Hz,而正常人的 HRV信号功率谱的高频谱峰位于 0 .32 5± 0 .0 5 2 Hz     

军事飞行员心理训练效果的实证研究

目的:探讨两种不同的心理训练方法对飞行员缓解急性应激的效果,并对两种方法的有效性进行比较,为我军心理健康促进工作提供参考。方法:本研究选取116名飞行员参加本项研究,先通过"四任务测验"诱发应激,然后将飞行员随机分成漂浮舱训练组和腹式呼吸训练组,训练时间均为10分钟,分析两种心理训练方法对飞行员缓解应激情绪的影响。采用情绪的生理指标皮肤电作为心理训练效果的评价指标。结果:应用SPSS 16.0中一般线性模型(General linear model,GLM)的Repeated measures和multivariate过程对心理训练重复测量数据进行重复测量方差分析和多元方差分析,并进行不同时间点和不同组的两两比较。漂浮舱训练时,飞行员的皮肤电在静息、应激和漂浮舱训练3种状态均有显著差异(F=184.479,P0.05);腹式呼吸训练时,应激状态与静息和腹式呼吸训练间有显著差异,而静息和腹式呼吸训练两个状态间未见显著差异。结论:漂浮舱训练能有效缓解飞行员的急性应激,而腹式呼吸训练后的放松效果不明显。     

心率变异性慢性实验研究

心率变异性指标在心脏状态上作用已经有很多研究，除了反映心脏自身健康状况外，它尚对机体其他系统对心脏的调控能力有的映。我们利用动物模型设计了一系列特定的心脏状态，检测这一系列心脏状态下的心率变异性指标变化规律，发现心率变异性指标在实验过程中的动态变化规律，说明变异参数适用需要一定的限制，并且动态检测的方式明显优于静态检测。     

小儿心肌炎的心率变异性

目的:探讨小儿心肌炎的心率变异性。方法:采用ECG-LA2.OGold型心电综合分析系统,描记肢体导联采样5分钟,应用时域及功率谱分析法,通过计算机计算出全部R-R间期的标准差(sDNN),极低频(VLF)低频(LF)高频(HF)。结果:以SDNN<27ms为阳性诊断标准,将57例小儿心肌炎病儿分为两组,一组SDNN<27ms共17例,病情较重,另一组SDNN>27ms共41例,病情较轻。结论:病情较重的心肌炎患儿短程HRV降低SDNN<27ms。     

Effects of Multiple Sessions of True and Placebo Heart Rate Biofeedback Training on the Heart Rates and Anxiety Levels of Anxious Patients During and Following Treatment

Fifty-six adult males who were hospitalized with anxiety related problems were randomly assigned to the conditions formed by a 2 (instructions to increase heart rate, instructions to decrease heart rate) × 3 (true biofeedback, placebo biofeedback, no biofeedback) factorial plus 1 (no-treatment control) design. Subjects were seen for 4 heart rate training/recording sessions and 1 subsequent transfer-test session. Results indicated that: a) neither instructions alone nor the combinations of instructions and true or placebo biofeedback were more effective than simply sitting quietly (adaptation) for decreasing heart rate, b) instructions plus true biofeedback was more effective than instructions alone or instructions plus placebo biofeedback for increasing heart rate, c) multiple sessions of training did not enhance the level of control achieved early in the first session, d) the control achieved with biofeedback did not transfer to a subsequent no-biofeedback situation, and e) biofeedback training did not influence subjects' subjective anxiety levels.     

Utility of Voluntary Control of Respiration and Biofeedback for Increasing and Decreasing Heart Rate

Ninety-six subjects participated in an experiment conducted to determine the separate and combined effects of respiratory control and biofeedback on control of heart rate (HR). The results indicated, first, that controlling respiration enabled subjects to reliably (p < .001) increase HR but did not enable them to decrease HR, and second, that HR biofeedback did not enable subjects to change their HR more than they did when simply instructed to do so and not given biofeedback. These results are consistent with and add to previous findings concerning respiratory control, biofeedback and HR.     

Diastolic Blood Pressure and Heart Rate Biofeedback Training During Orthostatic Stress

Forty male college student volunteers were asked either to increase their diastolic pressure or their heart rate while sitting and during orthostatic stress (going from a sitting to a standing position), and half of them were also given second- to-second visual feedback for the target variable. Systolic blood pressure was also continuously recorded. Comparisons were made between baseline and voluntary control conditions, and test trials were included to examine immediate carry-over effects. With voluntary control instructions, substantial increases in tonic levels were obtained for the three cardiovascular variables in both sitting and postural change conditions. In general, the increases were significantly greater for feedback than for no-feedback conditions. Phasic effects of feedback were also observed during postural change conditions: the blood pressure troughs and the heart rate peak occurred earlier with feedback than for instructions only. Immediate transfer effects were obtained in feedback conditions only. The results were discussed in terms of concomitant effects of somatic and cognitive activities. The distinctive feedback effects on the time course of the responses suggest that a precise analysis of response patterns is needed in selecting appropriate feedback methods in the management of orthostatic hypotension.     

Systolic Blood Pressure and Heart Rate Changes During Three Sessions Involving Biofeedback or No Feedback

Two groups of normotensive human subjects of both sexes received contingent feedback for increases or decreases in systolic blood pressure, and two additional groups received random (non-contingent) feedback or no feedback. Subjects in all groups served fur three 1-hr sessions separated by intervals of 24 hrs. Reliable decreases in blood pressure, reaching a maximum of 9.5 mm Hg at the end of the third session, were observed in the decrease group. No systematic changes in blood pressure were observed in the increase, random, or no-feedback groups. Heart rate increased or decreased in the groups receiving contingent feedback for increasing or decreasing blood pressure, respectively. It is concluded that contingent feedback is effective in lowering blood pressure and that decreases are augmented by extended training. The covariance of heart rate and blood pressure is discussed with reference lo curlier experiments.     

心率变异和RT变异频域分析的方法学研究

心率变异作为检测自主神经系统功能平衡状态的无创性指标，日益受到重视，已成为心电信号处理中的研究热点之一。ＱＴ是心室肌复极化时间，从另一方面来反映自主神经系统的平衡状态。ＱＴ变异分析在临床应用上与心率变异分析是否有互补作用，目前这方面研究工作开展得不多。由于ＱＴ间期检测困难，一般以ＲＴ间期代替ＱＴ间期。建立了心率变异和ＱＴ变异测定方法。在采集２４ｈ心电信号后，首先要完成标志点的检测。较好地实现了心电Ｒ波标志点的检测和异位心跳的剔除，并采用以相关系数为条件的模板匹配方法检测出Ｔ波标志点。频域分析方法分别通过快速傅里叶变换法（ＦＦＴ）和自回归谱估计法（ＡＲ）实现了２４ｈ三维频谱显示图以及２４ｈＨＦ／ＬＦ和高频能量变化趋势图。以不同的频率控制受试者的呼吸，采集其心电数据，从ＲＲ间期和ＲＴ间期谱分析的结果可以看到，高频峰受到呼吸频率的调制，高频峰可能与迷走神经活动有关。这一过程也检验了心电信号采集、检测和谱分析方法的可靠性。建立的方法为今后进一步深入研究打下了基础。随着心率变异和ＱＴ变异的检测和分析技术的日趋成熟，一定会在一些疾病的早期诊断、监护及预后评估等方面发挥更大的作用     

The Role of Feedback in Control of Heart Rate Variability

The effects of contingent feedback (CF), non-contingent feedback (NCF). and no feedback (NF) on heart rate (HR) variability control were studied. Nine matched trios of subjects were given (ruining in HR variability control on 3 consecutive days. CF and NCF subjects attempted HR, variability control while HR feedback was continuously presented, and NF subjects attempted HR variability control without feedback. During the training periods the CF group produced reliably-lower mean HR variance than the NF group, but the NCF group was not reliably different from either of those groups. There was no significant difference among groups in negative linear trend across training periods, and the CF group did not continue to produce decreasing HR variances over sessions. However, the CF and NCF groups showed reliable quadratic trends, indicating an initial drop in HR variance followed by a return to pretraining levels. Both CF and NCF groups showed rapid, reliable increases in respiration rate during training periods. The results pose serious problems for studies which have reported feedback-related control of HR variability.     

Heart Rate Biofeedback and Cold Pressor Pain

This study addressed the relative contributions of self-regulated heart rate change and belief that heart rate is changing in an instructed direction to the perception of cold pressor pain. Forty male volunteers were each assigned to one of four combinations of increase or decrease heart rate instructions and increase or decrease feedback conditions. Subjects were given an initial 45-sec cold pressor test, 25 feedback trials, and a final cold pressor in which they were told to change their heart rate in the instructed direction, but without the aid of feedback. Subjects were instructed specifically that increased heart rate was associated with increased pain and decreased heart rate with decreased pain. The veridical groups (consistent instructions and feedback) showed appropriate heart rate changes during biofeedback training and parallel changes in heart rate and pain perception during the final cold pressor. The non-veridical (reverse) feedback groups showed no heart rate change during biofeedback training and no relationship between heart rate and pain perception changes during the final cold pressor test. EMG, respiration, and skin conductance data are presented, and several mechanisms are proposed to explain the physiological and subjective changes.     

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.     

Biofeedback and Progressive Relaxation: Effects on Systolic and Diastolic Blood Pressure and Heart Rate

Two groups of subjects were pretrained in Jacobson's progressive relaxation, then instructed to lower their blood pressure while receiving contingent feedback or no feedback for two 1-hr sessions. A third group was pretrained in a control relaxation procedure, then instructed to lower blood pressure while receiving contingent feedback. All subjects returned for a Follow-up session in which they attempted to reduce blood pressure without feedback. The results indicated reliable decreases in systolic blood pressure for all three groups in the first two sessions. The group pretrained in progressive relaxation and given feedback achieved greater control than the other two groups which did not differ from each other. During the Follow-up session, blood pressure decreases were small but reliable in the two groups pretrained in progressive relaxation. Heart rate and diastolic blood pressure decreased in all groups, with the progressive relaxation groups achieving the lowest levels. It is concluded that progressive relaxation and blood pressure feedback in combination are highly compatible and that progressive relaxation allows for modest blood pressure control in the absence of feedback.     

糖尿病人心率变异的李雅普洛夫指数的计算

采用常规的李雅普洛夫指数定义的方法和长度演化法，面积演化法分别计算１０例正常人和１０例糖尿病人的李雅普洛夫指数，结果显示糖尿病人的李雅普洛夫指数明显低于正常人。它反映了植物神经功能受到损伤，同时还显示心电图数据不必大量采集便能说明问题。