2型糖尿病合并高血压和冠心病患者心率变异性分析

目的:探讨糖尿病合并高血压和冠心病患者心率变异性的临床意义.方法:选择佛山市南海区人民医院2型糖尿病患者105例,分为单纯糖尿病组、合并高血压组和合并冠心病组,每组35例,同时选择健康体检者35例作为对照组.所有研究对象进行动态心电图检查,分析各组心率变异性,包括24 h正常RR间期的标准差(SDNN),每5分钟平均R...     

冠心病合并糖尿病患者心率变异性时域指标及散点图分析

目的:探讨冠心病合并糖尿病患者的心率变异性特点,明确自主神经功能的变化,为临床治疗提供指导依据。方法:选择56例冠心病患者(A组)、48例冠心病合并糖尿病患者(B组)、35例健康体检者(C组)的心率变异性进行线性及非线性分析。结果:A组、B组与C组比较,心率变异性线性时域参数下降,B组下降更加明显(P0.05),非线性散点图正常"棒球拍状"图形减少,异常的其他图形增多,以短"棒状"多见。结论:冠心病合并糖尿病患者的自主神经功能受损严重,应尽早检测心率变异性,早期识别高危患者,防止恶性心律失常及猝死的发生。     

24h动态心电图检查在病态窦房结综合征的临床应用价值研究

目的:探究24 h动态心电图检查在病态窦房结综合征的临床应用价值.方法:回顾性分析2019年11月至2021年5月期间我院收治的66例病态窦房结综合征患者为此次研究对象,将其设为研究组;另选取62例同时间进行健康体检者,作为对照组.两组均进行常规心电图及24 h动态心电图检查,对比不同检查对病态窦房结综合征的检出率,比较两组24 h平均心率、平均总心搏数、最高心率、窦性心动过缓、心律失常以及动态心电图最长R-R间期分布情况.结果:24 h动态心电图检查对病态窦房结综合征的检出率高于常规心电图(P<0.05).对照组24 h平均心率、平均总心搏数、最高心率指标均显著优于研究组,且具有明显差异(P<0.05).主要以显著窦性心动过缓、偶发房性期前收缩、偶发室性期前收缩、短阵房性心动过速、房室交接区性逸搏心律为主.I型严重持续性窦性心动过缓15例占22.73％、Ⅱ型窦性心动过缓伴窦房阻滞或者窦性停搏26例占39.40％、Ⅲ型慢快综合征12例占18.18％、Ⅳ型双结病变13例占19.70％.结论:采用24h动态心电图对SSS患者进行检查,可有效记录患者24h完整心电图表现,以此评估患者心动图分型,为临床诊疗提高可靠参考资料.     

外伤性脑梗死患者早期心率变异性的动态研究

目的 研究外伤性脑梗死患者早期心率变异性(HRV)的动态变化.方法 2009年8月到2011年5月本院收治的脑外伤患者50例(对照组)和外伤性脑梗死患者46例(研究组),对两组患者于外伤后第1天及第3天进行2次24 h连续动态心电图监测.比较分析两组第1天及第3天HRV指标和2次HRV动态变化的指标.结果 外伤性脑梗死患者第1天及第3天的HRV与对照组差异有统计学意义(P＜0.05),且HRV的动态变化也与对照组差异有统计学意义(P＜0.05).HRV出现明显异常早于头颅CT检查发现梗死病灶.结论 通过监测脑外伤患者早期HRV指标动态变化,能早期提示脑外伤患者出现脑梗死的风险.     

慢性肾衰患者心率变异性改变

目的　通过心率变异性 (HRV)变化测定 ,探讨慢性肾功能衰竭 (CRF)患者的自主神经活动状况。方法　用2 4小时动态心电图分析系统 ,对 2 0例健康者 ,77例CRF患者 (其中 30例氮质血症 ,4 7例尿毒症 )心率变异性的时域指标进行对比研究。结果　CRF患者心率变异性的测定结果为 :SDNN 85 .2 8± 19.96 ,SDANN 75 .5 5± 2 2 .4 7,r-MSSD19.2 2± 11.82 ,PNN50 6 .7± 14 .79,各项指标均明显低于健康者 (P <0 .0 1)。氮质血症期与尿毒症期心率变异性无明显差别。结论　通过HRV时域分析发现 ,CRF患者有自主神经调节功能紊乱。CRF氮质血症期患者已出现HRV下降 ,提示CRF患者早期就存在自主神经功能损害。     

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 ...     

卡维地洛对心绞痛患者心率变异性的影响

目的评价卡维地洛对冠心病心绞痛型患者心率变异性（HRV）的影响。方法冠心病心绞痛型患者120例随机分为卡维地洛组（62例）和对照组（58例）,用药前后2周分别记录24h动态心电图,评价患者心率变异性指标的变化。结果两组治疗后心率变异性各参数较治疗前均显著改善（P〈0．01）,治疗后卡维地洛组较对照组改善更为显著（P〈0．01）。结论卡维地洛可以显著提高冠心病心绞痛型患者的心率变异性。     

老年患者心电图异常分析探讨

目的 探讨老年患者动态心电图异常的规律及其临床变化特点.方法 对本院心电室2006年1月～2008年12月住院,经24 h动态心电图检查的273例老年患者心率变异结果 进行分析.结果 55～90岁患者中,以70～80岁年龄的患者心电图异常者为多.结论 老年患者心电图具有增龄性的改变特点,进人老年期后异常心电图明显增多.在老年患者查体中心电是一个必要的检查项目,有必要每年至少做一次心电图检查.     

康复训练辅助益气强心参脉饮治疗代偿期心力衰竭恢复期的效果

目的:研究康复训练辅助益气强心参脉饮治疗代偿期心力衰竭恢复期的效果.方法:以2020年1月至2022年2月我院收治的108例代偿期心力衰竭恢复期患者为研究对象,采用随机数字表法将患者分为对照组和研究组(n=54).对照组采用益气强心参脉饮治疗,研究组采用康复训练结合益气强心参脉饮治疗8 w.分别于治疗前、治疗8 w后进行6 min步行试验(6 min walking test,6MWT),采用超声心动图显像仪和24 h动态心电图仪测定心肌功能、心率变异性参数,并进行匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、明尼苏达心力衰竭生活质量问卷(Minnesota heart failure quality of life questionnaire,MLHFQ)评分.结果:治疗8 w后研究组6MWT、心肌功能指标改善幅度以及心率变异性参数均明显高于对照组(P<0.05),PSQI、MLHFQ评分均明显低于对照组(P<0.05).结论:康复训练辅助治疗代偿期心力衰竭恢复期患者可有效改善患者心肌功能,增加运动耐受力,调节心率,提高生活质量改善睡眠.     

注射用红花黄色素对不稳定型心绞痛患者血流变和心率变异性的影响

目的 观察注射用红花黄色素对不稳定型心绞痛患者血流变和心率变异性﹙HRV﹚的影响.方法 随机选择60例不稳定型心绞痛患者,均用注射用红花黄色素(浙江永宁药业股份有限公司)100mg加入0.9%氯化钠注射液250ml中静点每日一次,以二周为一疗程.于治疗前后分别测定空腹血流变、,及记录24h动态心电图,评价患者心率变异性指标及血流变的变化.结果 治疗后HRV参数较治疗前差异有显著性,具有统计学意义(P<0.05),治疗后较治疗前血流变学指标均有显著改善,差异有统计学意义(P<0.05).结论 注射用红花黄色素可增加不稳定型心绞痛患者冠脉血流,改善缺血,同时可提高心率变异性,降低血粘度.     

低体温与心率变异性和血压变异性的关系

目的: 研究低体温与自主神经功能变化的关系。方法: 采用体表物理降温法逐步降低直肠温度,直肠温度变化范围为19-37 ℃。分别记录不同直肠温度下大鼠动态心电和血压信号。应用心率变异性和血压变异性分析系统评价低体温对心率变异性和收缩压变异性的影响。结果: 心率变异分析表明，直肠温度下降到29 ℃以下,R-R间期均延长（P<0.01）,提示心率明显降低;当直肠温度下降到19-21 ℃时,心率变异归一化低频功率降低（P<0.05）和归一化高频功率增加（P<0.05），而且自主神经的平衡向心迷走神经张力增强的方向发生了转移（P<0.05）。血压变异性分析表明，体温下降到31℃时与呼吸有关的归一化高频功率开始增加（P<0.01）；直肠温度下降到29 ℃以下(除27 ℃外),与呼吸有关的归一化高频功率增加（P<0.05或P<0.01），同时自主神经的平衡也发生了改变（P<0.05）。结论： 随着体温的降低，心血管迷走神经活性增加，自主神经的平衡向迷走神经张力增强的方向转移。低体温对血压变异性的影响敏感于心率变异性。     

Heart rate variability and its determinants in patients with severe or mild essential hypertension.

How cardiac autonomic nervous control is related to the severity of essential hypertension in patients receiving long-term antihypertensive therapy is not well known. The aim of this study was to examine heart rate variability (HRV), a non-invasive measure of cardiac autonomic function, in patients with long-term and medically treated mild and severe essential hypertension and healthy control subjects, and to assess the clinical determinants of HRV in these patients. Thirty-four patients with severe essential hypertension (SEHT) and 29 with mild essential hypertension (MEHT) as well as healthy age- and sex-matched control subjects were studied. HRV was assessed from 10 min ECG-recordings during paced (0.2 Hz) breathing at rest and expressed as time and frequency domain measures. In the SEHT group time (SDNN, RMSSD) and frequency domain measures (total power, low-frequency (LF) power and high-frequency (HF) power of HRV in absolute units, and LF and HF power of HRV in normalized units) of HRV were significantly lower when compared with those of the control group. The MEHT and control groups did not differ from each other with respect to time or frequency domain measures of HRV. Comparison between the hypertensive groups showed that SDNN, total power, LF power and HF power were lower in the SEHT group compared with the MEHT group (P<0.05 for all). Among hypertensive patients RR-interval, age, gender, systolic finger blood pressure and diastolic office blood pressure as well as 24-h blood pressure were significant determinants of HRV. In conclusion, we found that the severity of chronic essential hypertension seems to be related to the severity of impairment of cardiac autonomic control.     

Nonlinear analysis of heart rate variability of healthy subjects and patients with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is one of the causes of mortality worldwide with an increasing prevalence. Heart rate variability (HRV) reflects the regulation mechanism of the cardiac activity by the autonomic nervous system. The assessment of HRV by using nonlinear methods is more sensitive for the detection of complexity when compared to linear methods. This study aims to get information about the autonomic dysfunction occurred in patients with COPD by analysing the complexity of HRV. Electrocardiogram signals recorded from healthy subjects, patients with moderate COPD and severe COPD (eight subjects per group) were analysed. The HRV signals were acquired from ECG signals. Signals were reconstructed in the phase space and largest Lyapunov exponent (LLE), correlation dimension, Hurst exponent and approximate entropy (ApEn) values were calculated. It has seen that for the patients with COPD LLE, correlation dimension, Hurst exponent and ApEn values were less than control group. According to this, HRV complexity decreases in the presence of COPD. However, there is no significant difference between COPD groups and the severity of COPD has no effect on the chaoticity of the system. The results revealed that autonomic dysfunction occurred in patients with COPD is associated with reduced HRV complexity.     

基于心率变异性谱分析的经穴磁刺激效应分析

目的：应用心率变异性（HRV）功率谱分析，探讨疲劳状态下，经穴磁刺激对自主神经功能的调整作用。方法：健康志愿人员20名，执行警惕操作任务90分钟后，施加经穴磁刺激15分钟。同时，时实记录实验者心电信号。结果：实验人员疲劳状态下，施加经穴磁刺激后，心率变异性发生显著性变化，表现为交感神经张力降低，迷走神经张力提高，主观评估疲劳程度降低。结论：经穴磁刺激有利于改善心率变异性，可一定程度上缓解精神疲劳。     

Predicting depressed patients with suicidal ideation from ECG recordings

Globally suicidal behavior is the third most common cause of death among patients with major depressive disorder (MDD). This study presents multi-lag tone–entropy (T–E) analysis of heart rate variability (HRV) as a screening tool for identifying MDD patients with suicidal ideation. Sixty-one ECG recordings (10 min) were acquired and analyzed from control subjects (29 CONT), 16 MDD subjects with (MDDSI+) and 16 without suicidal ideation (MDDSI?). After ECG preprocessing, tone and entropy values were calculated for multiple lags (m: 1–10). The MDDSI+ group was found to have a higher mean tone value compared to that of the MDDSI? group for lags 1–8, whereas the mean entropy value was lower in MDDSI+ than that in CONT group at all lags (1–10). Leave-one-out cross-validation tests, using a classification and regression tree (CART), obtained 94.83 % accuracy in predicting MDDSI+ subjects by using a combination of tone and entropy values at all lags and including demographic factors (age, BMI and waist circumference) compared to results with time and frequency domain HRV analysis. The results of this pilot study demonstrate the usefulness of multi-lag T–E analysis in identifying MDD patients with suicidal ideation and highlight the change in autonomic nervous system modulation of the heart rate associated with depression and suicidal ideation.     

冠心病患者心率变异性分析

目的研究冠心病患者心率变异（HRV）的变化规律及临床意义。方法选择50例无心律失常冠心病患者（冠心病组）、30例伴心律失常冠心病患者（心率失常组）与52例正常成人自愿者（正常组）进行24h动态心电图HRV指标比较研究。结果与正常组比较,冠心病患者SDNN、SDANN、RMSSD、PNN50和HF指标均降低,LF指标升高,具有显著差异。伴心律失常与无心律失常冠心病患者比较,HRV指标异常变化趋于恶化。结论冠心病患者心脏自主神经调节功能受到损害,迷走神经活性减弱,交感神经活动占优势。     

心肌缺血中心率变异性的符号动力学分析

目的基于心率变异性（HRV）研究,分析心肌缺血发生过程中心率的动态变化特性以探讨自主神经活动的变化和影响。方法从长时ST段一T波终点（Long．term ST-T）数据库中,选取13个记录中共193个心肌缺血时段及其前后各5min的对照时段。选用符号动力学方法分析不同时段的RR间期序列,利用重复测量的方差分析对缺血前和缺血中以及缺血后结果进行检验;以线性拟合的方式,分析心肌缺血时自主神经响应模式随缺血持续时间的分布。结果较之心肌缺血前后,心肌缺血过程中0v％的显著增加和2UV％的显著减小反映了交感神经活性的增加和迷走神经活性的减弱,但这种自主神经平衡向交感神经更占优移动的趋势随着缺血持续时间的延长而减小,提示可能存在的对心脏的保护作用。结论符号动力学分析为研究心肌缺血中自主神经的调制提供了一个敏感的工具。     

正常家兔心率变异特点

目的:记录测定正常家兔在体和离体短程心率变异情况,探讨心脏自主神经功能的变化情况,为进一步研究家兔冠状动脉粥样硬化、冠脉痉挛时自主神经变化反映在心率变异性上的特点提供基础数据.方法:在体组用正交法记录胸前心电;离体组,采用兰氏(Langendorff)心脏灌流系统基础上,用正交悬浮电极法记录心电.采用Powerlab/8sp多道生理仪采集心电波.利用Chart模块对电信号进行短程心率变异分析.结果:正常家兔在体和离体组,短程心率变异分析结果值有明显不同.结论:正常家兔短程HRV特征较人体有明显区别,其频段取值范围有明显差异;在体与离体组HRV差异与神经体液调节因素有关.     

Holter ECG monitoring in patients with perceived electrical hypersensitivity.

Earlier studies have indicated that patients claiming to be sensitive to electromagnetic fields, so-called electrical hypersensitivity (EHS), have a dysbalance of the autonomic nervous system (ANS) regulation. This paper focuses on a possible dysbalance in the ANS among EHS patients by the use of long-term monitoring of electrocardiogram (ECG) in both a patient and a matched control group. At the same time, the environmental power frequency magnetic field was recorded for both groups in order to see if there was any difference in exposure between the groups. ECG, heart rate (HR) and heart rate variability (HRV) as well as the magnetic field exposure were monitored for 24 h. Fourteen patients with perceived EHS symptoms were selected from the University Hospital, Ume?, Sweden. Symptoms indicating autonomic nervous dysregulation were not part of the inclusion criteria of the patient group. Age and sex matched healthy subjects were used as controls. No differences were found between the groups regarding magnetic field exposure or the mean HR for 24 h. The HRV analyses showed that the high-frequency (HF) component did not have the expected increase with sleep onset and during nighttime in the EHS group. When separating the sleeping and awake time even less differences between the two conditions in the EHS patients, both for the low-frequency and HF components in the HRV spectrum, were seen. EHS patients had a disturbed pattern of circadian rhythms of HRV and showed a relatively 'flat' representation of hourly-recorded spectral power of the HF component of HRV.     

The influence of major depression and its treatment on heart rate variability and pupillary light reflex parameters

BACKGROUND: The link between depression and autonomic dysfunction has attracted more attention since epidemiological studies have revealed that depressed patients have an augmented risk of cardiovascular morbidity and mortality. Former studies of autonomic dysfunction in major depression have shown inconclusive results. AIMS: To further elucidate the effect of depression and medication on autonomic function, 18 patients and 18 matched control subjects were comprehensively assessed once medicated and once non-medicated as well as after full clinical recovery. METHODS: Cardiac autonomic function was evaluated by measuring heart rate variability (HRV) parameters, and central autonomic tone was investigated by obtaining parameters of the pupillary light reflex (PLR). RESULTS: Acutely depressed patients who had not taken antidepressant medication for 8 weeks prior to the investigation differed significantly neither in heart rate parameters nor in parameters of the PLR from their controls. However, after 2 days of antidepressant treatment (SSRI and NaSSRI), parameters of heart rate analysis and PLR (except relative amplitude) changed significantly and remained significantly different after clinical recovery. LIMITATIONS: The study needs to be repeated using larger patient groups. Long-term studies are absolutely essential. CONCLUSION: The state of depression did not influence autonomic parameters significantly. In fact, treatment influenced autonomic function far more than the disease itself. Other branches of the autonomic nervous system (ANS), as well as new techniques should be applied to elucidate whether small changes in autonomic function exist. This might clarify whether disease or treatment might influence cardiac mortality in depression.