心率变异性分析的新指标及其在航空医学中的应用

目的通过对２４ｈ心率变异性（ＨＲＶ）谱成分极低频（ＶＬＦ）、低频（ＬＦ）与高频（ＨＦ）功率之间的关系进行回归分析，探讨回归方程各参数的病理生理意义及其在飞行员心功能鉴定中的价值。方法对象为健康女飞行员３０名、年龄相当的男飞行员３０名、可疑冠心病飞行员８例、确诊的冠心病人２０例。采用２４ｈ全信息动态心电图仪。分析指标：ＶＬＦ（０．００３Ｈｚ～０．００４Ｈｚ）、ＬＦ（０．０４Ｈｚ～０．１５Ｈｚ）、ＨＦ（０．１５Ｈｚ～０．４０Ｈｚ）和总体平均功率（０．００３Ｈｚ～０．４０Ｈｚ，ＴＦ），回归分析各频率间的关系，并进行ｔ检验。结果①ＶＬＦ和ＬＦ与ＨＦ均呈显著负相关；ＶＬＦ与ＨＦ的相关系数值（ｒ）显著大于ＬＦ与ＨＦ的相关系数值。②ＶＬＦ和ＬＦ与ＨＦ回归方程的斜率（Ｂ）、相关系数（ｒ）以及ＨＦ值均表现为夜间大于白天，女性大于男性，健康飞行员大于冠心病人。结论ＶＬＦ可能反映交感神经系统活性；ＶＬＦ或ＬＦ与ＨＦ回归方程的斜率可反映交感神经系统与副交感神经系统的均衡性，相关系数可反映二者的拮抗性与协调性。女飞行员的夜间迷走神经活性高于男性飞行员；冠心病人可表现有交感神经系统与副交感神经系统的协调性降低，以及迷走神经活性受损

The new indexes for analysis of heart rate variability and its application in aviation medicine

Objective To explore new method for assesment of heart rate variability(HRV),and apply it in clinical aviation medicine. Methods Using 24 h Holter ECG monitoring and software for analysing HRV,the time domain parameters and frequency domain parameters including VLF,LF, and HF were obtained in 30 healthy female pilots, 30 healthy male pilots, 8 male pilots with suspected coronary heart disease(CHD),and 20 CHD patients. The relationship between lower frequency(VLF and LF) and high frequency(HF) components were determined by linear regression analysis. The t tests were used to assess the differences of the parameters of regression equations between each group. Results HF is significantly correlated negatively with VLF and LF. The correlation coefficient(r) of HF with VLF was significantly greater than that with LF. The slope of the linear regression equations in the healthy female pilots was significantly greater than that of the male pilots. The slope during the daytime was lower than those during the night in the healthy pilots. The slope was significantly lower in the patients with CHD as compared to the healthy pilots. Conclusion VLF of HRV was an index of sympathetic activity. The regression equations describing HF VLF relation as well as HF LF relation, appeared to provide a quantitative evaluation of the sympathovagal balance. The female pilots during the night had a greater vagal activity than the male. In CHD patients vegal activity was significantly attenuated.