老年高血压患者的动态脉压与冠心病并发症及颈动脉粥样硬化的关系研究

目的:探讨老年高血压患者的动态脉压(PP)与冠心病并发症及颈动脉粥样硬化的关系。方法:选取2010年5月至2013年6月在我院就诊的老年性高血压病患者328例,168例单纯性老年高血压患者设为高血压组,160例合并有冠心病的老年性高血压患者设为高血压合并冠心病组。根据厚度(IMT)是否增大将高血压组分为IMT增厚组94例和IMT正常组74例。对动态血压及颈动脉IMT进行测定。结果:与高血压组相比,高血压合并冠心病组的24 hAPP、dPP、nPP等指标以及24 hASBP、nSBP等指标均显著提高;而24hADBP、dDBP、nDBP等指标则明显下降;高血压合并冠心病组24hA PP艹60 mm Hg的发生率为57.50%,明显高于高血压组的39.29%;IMT增厚组患者的24hA PP、dPP及nPP水平均明显高于IMT正常组;艹60 mmHg组共89例,IMT为1.14±0.23 mm,明显高于60 mmHg组79例的平均厚度0.93±0.12 mm(P0.05)。结论:老年高血压患者的动态脉压在冠心病并发症及颈动脉粥样硬化预测方面具有显著的优越性。     

老年高血压患者颈动脉内膜中膜厚度与动态血压参数的相关性

目的:探究老年高血压患者颈动脉内膜中膜厚度(IMT)与动态血压参数间的相关关系,为老年高血压患者的临床治疗提供理论基础。方法:选取2015年1月至2016年1月在我院接受治疗的老年高血压患者204例,根据超声检查结果分为A、B、C三组,每组68例。24 h无创检测患者动态血压参数,包括24h平均收缩压(24h SBP),24 h平均舒张压(24h DBP)、白天平均收缩压(d SBP)、白天平均舒张压(d DBP)、夜间平均收缩压(n SBP)、夜间平均舒张压(n DBP),24h脉压(24h PP)及白天脉压(d PP)、夜间脉压(n PP),记录冠心病的发生率、杓型与非杓型高血压比例,利用Person相关性分析IMT与冠心病发生率及动态血压参数的相关性。结果:收缩压和脉压比较差异均有统计学意义(P0.05),其中B组、C组高于A组,C组高于B组,差异具有统计学意义(P0.05)。非杓型高血压在A组占54.41%,B组占60.29%,C组占79.41%,各组间差异有统计学意义(P0.05);A组、B组、C组冠心病发病率分别为41.18%、54.41%和91.18%,组间比较差异有统计学意义(P0.05)。IMT同冠心病发生率和24h SBP、d SBP、n SBP、24h PP、d PP、n PP呈正相关(r=0.876,0.448,0.378,0.476,0.443,0.491,0.438,P0.05)。结论:老年高血压患者收缩压,脉压升高以及非杓型高血压是造成颈动脉内膜中膜厚度增加的主要原因,同时,IMT与冠心病发病率和动态血压参数间呈正相关关系。     

藏族原发性高血压患者血管内皮功能与糖脂代谢指标和血压变异性的关系

目的:研究藏族原发性高血压患者血管内皮功能与糖脂代谢指标和血压变异性的关系。方法:以2017年2月-2018年2月暨南大学医学院附属广州红十字会医院收治的200例藏族原发性高血压患者为研究对象。将所有患者按照肱动脉血流介导的血管舒张功能(FMD)值分为正常FMD组(FMD≥6%)48例与异常FMD组(FMD6%)152例。分别比较两组患者的基本资料、糖脂代谢指标以及血压变异性指标水平,并分析藏族原发性高血压患者FMD与糖脂代谢和血压变异性的相关性。结果:异常FMD组年龄、空腹血糖水平高于正常FMD组(P0.05),而两组总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平对比差异均无统计学意义(P0.05)。异常FMD组日间收缩压、日间舒张压、夜间收缩压、夜间舒张压、24h收缩压、24h舒张压水平均高于正常FMD组(P0.05)。经Preason相关性分析可得:藏族原发性高血压患者FMD值与空腹血糖、日间收缩压、日间舒张压、夜间收缩压、夜间舒张压、24h收缩压、24h舒张压均呈负相关关系(P0.05)。结论:藏族原发性高血压患者血管内皮功能受损越严重,其空腹血糖、血压就越高,临床工作中可通过联合检查上述指标水平,有助于评估藏族原发性高血压患者血管内皮功能。     

贝那普利联合氨氯地平对高血压患者降压效果、血压变异性及心功能的影响

目的:探讨贝那普利联合氨氯地平对高血压患者降压效果、血压变异性(BPV)及心功能的影响。方法:选取2015年2月～2018年12月期间西安交通大学医学院附属三二〇一医院收治的131例高血压患者,根据随机数字表法分为对照组(n=65)和研究组(n=66),对照组患者给予氨氯地平治疗,研究组在对照组基础上联合贝那普利治疗。比较两组患者治疗后的降压效果、BPV以及心功能指标,记录两组患者治疗期间不良反应情况。结果:两组患者治疗4个月后收缩压(SBP)、舒张压(DBP)均下降,且研究组低于对照组(P0.05)。两组患者治疗4个月后24 h收缩压变异性(24hSBPV)、白天收缩压变异性(dSBPV)、24h舒张压变异性(24hDBPV)、白天舒张压变异性(dDBPV)均下降,且研究组低于对照组(P0.05),而夜间收缩压变异性(nSBPV)、夜间舒张压变异性(nDBPV)比较差异无统计学意义(P0.05)。两组患者治疗4个月后A峰速度、A/E峰值均下降,且研究组低于对照组(P0.05)。两组患者治疗4个月后E峰速度、EF值均升高,且研究组高于对照组(P0.05)。两组不良反应发生率比较无差异(P0.05)。结论:贝那普利联合氨氯地平治疗高血压患者的降压效果确切,可有效改善患者BPV及心功能,且安全性较好。     

低钠透析联合血液透析滤过对终末期肾脏病合并顽固性高血压患者血压节律、钙磷代谢的影响

目的:探讨低钠血液透析(hemodialysis,HD)联合血液透析滤过(Hemodiafiltration,HDF)对终末期肾脏病合并顽固性高血压的透析患者血压节律、钙磷代谢的影响。方法:将62例终末期肾脏病合并顽固性高血压患者随机分为治疗组和对照组,对照组应用常规HD治疗,每周3次,每次4 h,治疗组低钠联合HDF治疗,每周1次,3个月后进行效果评价。比较两组治疗前后血压昼夜节律、钙磷代谢变化及不良反应的发生情况。结果:治疗后,治疗组24 h收缩压(systolic blood pressure,24h SBP)、24 h舒张压(diastolic blood pressure,24h DBP)、日间收缩压(day systolic blood pressure,dSBP)、日间舒张压(day diastolic blood pressure,dSBP)、夜间收缩压(night systolic blood pressure,nSBP)、夜间舒张压(night diastolic blood pressure,nSBP)均较治疗前明显下降,且明显低于对照组(P0.05);对照组除nSBP外,其余血压指标治疗前后比较差异均无统计学意义(P0.05)。治疗后,治疗组血Ca水平较治疗前明显升高,且显著高于对照组,而血P、PTH水平较治疗前明显降低,且均明显低于对照组(P0.05)。治疗组和对照组不良反应发生率分别为16.1%、12.9%,两组比较差异无统计学意义(P0.05)。结论:低钠HD联合HDF治疗终末期肾脏病合并顽固性高血压患者可有效改善钙磷代谢并促进血压节律恢复。     

冠心病患者心率变异性与冠状动脉病变狭窄范围及严重程度的关系研究

目的:探讨冠心病患者心率变异性(HRV)与冠状动脉病变狭窄范围及严重程度的关系。方法:选取上海市第十人民医院2015年1月至2018年7月期间收治的冠心病患者220例,所有患者均行冠脉造影及24 h动态心电图检查。按狭窄范围分为单支狭窄组(n=68)、双支狭窄组(n=82)、三支狭窄组(n=70),按狭窄严重程度分为轻度组(狭窄≤50%,n=62),中度组(50%狭窄70%,n=66),重度组(狭窄≥70%,n=92),另选取51例同期于我院体检的健康志愿者作为对照组。记录冠心病患者与对照组HRV各项指标,比较不同冠脉病变狭窄范围患者、不同狭窄严重程度患者正常平均N-N间期(SDNN)、正常相邻每5minR-R间期均数标准差(SDANN)、正常相邻正常N-N间期的均方根(RMSSD)、正常相邻间期差值高于50 ms心搏数占总心搏数的百分比(pNN50)、低频(LF)、高频(HF)及低频/高频比值(LF/HF)。结果:冠心病患者与对照组RMSSD、pNN50、LF、HF比较差异无统计学意义(P0.05),冠心病患者SDNN、SDANN低于对照组,LF/HF值高于对照组(P0.05)。不同冠脉狭窄范围、不同冠脉病变狭窄严重程度患者pNN50、LF、HF整体比较无统计学差异(P0.05),随着冠脉狭窄范围的增加或狭窄病变严重程度的加重SDDN、SDANN、RMSSD逐渐降低,LF/HF值逐渐升高(P0.05)。结论:HRV是评估心脏自主功能的良好指标,该指标中SDDN、SDANN、RMSSD、LF/HF值可作为评估冠心病患者冠状动脉的狭窄程度和狭窄范围的良好指标,具有重要的临床指导意义。     

肾小叶间动脉阻力指数变化在高血压患者中的临床意义

目的:分析原发性高血压患者小叶间肾动脉阻力指数(resistive index,RI)与临床指标的相关性,研究肾动脉阻力指数对高血压患者临床意义.方法:选择原发性高血压患者115例.用彩色多普勒超声仪测量肾小叶间动脉的RI,彩超检查的当天测量收缩压(SBP)和舒张压(DBP),计算脉压(PP)、平均血压(MBP);检测血清尿素氮(BUN)、血清肌酐(Scr)、血清尿酸(UA),估算内生肌酐清除率(Ccr);分析小叶间肾动脉RI与临床指标的相关性.结果:高血压患者小叶间肾动脉RI与Ccr、SBP、DBP、PP、年龄、高血压发病时间均有相关性.高血压分级、平均血压、BUN、Scr、UA与小叶间肾动脉RI无相关性.结论:原发性高血压患者的小叶间肾动脉RI与Ccr、SBP、DBP、PP、年龄、高血压发病时间相关,可以间接反映高血压对肾动脉的影响及全身动脉硬化的状况.     

特发性室性早搏与心率变异性的相关性分析

目的:探讨特发性室性早搏(IPVCs)与心率变异性(HRV)的相关性。方法:回顾性分析2016年2月～2018年2月我院心内科收治的150例IPVCs患者的临床资料,根据负荷量、心功能,将IPVCs患者分别分为低负荷组(1%～10%,n=51)、中负荷组(10%～20%,n=65)、高负荷组(20%,n=34)及LVEF50%组(n=106)、LVEF≤50%组(n=44)。另选取同期健康者50例作为对照组。检测和比较各组HRV相关指标变化,并分析IPVCs与HRV的相关性。结果:高负荷组RMMSD、PNN50明显低于对照组、低负荷组和中负荷组,中负荷组和高负荷组LF、HF明显低于对照组、低负荷组(P0.05),高负荷组LF、HF均明显低于中负荷组(P0.05)。LVEF≤50%组RMMSD、PNN50、LF、HF较对照组、LVEF50%组明显降低(P0.05)。IPVCs负荷与LVEDD、LVESD呈显著正相关,与LVEF呈显著负相关(P0.05)。IPVCs负荷与RMMSD、PNN50、LF、HF呈显著负相关(P0.05)。结论:IPVCs的发生与自主神经功能调节失衡有关,迷走神经张力减弱具有重要作用,从而诱发HRV异常。     

长期应用氨氯地平对老年高血压患者晨峰现象的影响

目的:分析长期应用氨氯地平治疗老年高血压患者的效果及对晨峰现象的影响。方法:选取2017年8月至2018年8月本院收治的老年高血压患者164例,按照患者入院顺序交替均分为两组(n=82)。观察组长期给予氨氯地平治疗,对照组给予非洛地平治疗,两组均连续治疗8周后,比较其降压效果及晨峰血压的变化。结果:治疗后,观察组的白昼平均收缩压(Day systolic blood pressure,dSBP)、白昼平均舒张压(Day diastolic blood pressure,dDBP)、夜间平均收缩压(Night systolic blood pressure,nSBP)、夜间平均舒张压(Night diastolic blood pressuren,DBP)、24 h平均收缩压(24 h systolic blood pressure,24hSBP)、24 h平均舒张压(24 h diastolic blood pressure,24hDBP)均低于对照组及治疗前(P0.05);观察组的晨峰值显著低于对照组及治疗前(P0.05);观察组患者的治疗前两组总胆固醇(Total cholesterol,TC)、甘油三酯(Triglyceride,TG)、低密度脂蛋白(Low density lipoprotein cholesterol,LDL-C)显著低于对照组及治疗前(P0.05),高密度脂蛋白(High density lipoprotein cholesterol,HDL-C)HDL-C显著高于对照组及治疗前(P0.05)。结论:对老年高血压患者长期应用氨氯地平不但降压安全、有效,且对控制血压晨峰现象具有积极的影响。     

老年高血压患者的动态脉压与冠心病并发症及颈动脉粥样硬化的关系研究

目的：探讨老年高血压患者的动态脉压fPP）与冠心病并发症及颈动脉粥样硬化的关系。方法：选取2010年5月至2013年6月在我院就诊的老年性高血压病患者328例,168例单纯性老年高血压患者设为高血压组,160例合并有冠心病的老年性高血压患者设为高血压合并冠心病组。根据厚度（IMT）是否增大将高血压组分为IMT增厚组94例和IMT正常组74例。对动态血压及颈动脉IMT进行测定。结果：与高血压组相比,高血压合并冠心病组的24hAPP、dPP、IlPP等指标以及24hASBP、nSBP等指标均显著提高;而24hADBP、dDBP、nDBP等指标则明显下降;高血压合并冠心病组24hAPP≥60mmHg的发生率为57．50％,明显高于高血压组的39．29％;IMT增厚组患者的24hAPP、dPP及nPP水平均明显高于IMT正常组;≥60mmHg组共89例,IMT为1．14±0．23mm,明显高于〈60mmHg组79例的平均厚度0．93±0．12mm（P〈0．05）。结论：老年高血压患者的动态脉压在冠心病并发症及颈动脉粥样硬化预测方面具有显著的优越性。     

Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation.

Cardiovascular autonomic modulation during 36 h of total sleep deprivation (SD) was assessed in 18 normal subjects (16 men, 2 women, 26.0 +/- 4.6 yr old). ECG and continuous blood pressure (BP) from radial artery tonometry were obtained at 2100 on the first study night (baseline) and every subsequent 12 h of SD. Each measurement period included resting supine, seated, and seated performing computerized tasks and measured vigilance and executive function. Subjects were not supine in the periods between measurements. Spectral analysis of heart rate variability (HRV) and BP variability (BPV) was computed for cardiac parasympathetic modulation [high-frequency power (HF)], sympathetic modulation [low-frequency power (LF)], sympathovagal balance (LF/HF power of R-R variability), and BPV sympathetic modulation (at LF). All spectral data were expressed in normalized units [(total power of the components/total power-very LF) x 100]. Spontaneous baroreflex sensitivity (BRS), based on systolic BP and pulse interval powers, was also measured. Supine and sitting, BPV LF was significantly increased from baseline at 12, 24, and 36 h of SD. Sitting, HRV LF was increased at 12 and 24 h of SD, HRV HF was decreased at 12 h SD, and HRV LF/HF power of R-R variability was increased at 12 h of SD. BRS was decreased at 24 h of SD supine and seated. During the simple reaction time task (vigilance testing), the significantly increased sympathetic and decreased parasympathetic cardiac modulation and BRS extended through 36 h of SD. In summary, acute SD was associated with increased sympathetic and decreased parasympathetic cardiovascular modulation and decreased BRS, most consistently in the seated position and during simple reaction-time testing.     

老年肥胖型正常高值血压患者24h-动态血压变异特点及与动脉僵硬度的相关性研究

摘要 目的：探讨老年肥胖型正常高值血压患者24h-动态血压变异特点及与动脉僵硬度的相关性。方法：选择2018年1月~2020年5月期间在我院住院的老年正常高值血压患者174例作为研究对象,根据腰围分为腹型肥胖组（n=85）和非腹型肥胖组（n=89）。所有受试者监测24h-动态血压[包括24h平均收缩压（24h-SBP）、白昼平均舒张压（dDBP）、24h平均舒张压（24h-DBP）、夜间平均收缩压（nSBP）、白昼平均收缩压（dSBP）、夜间平均收缩压（nDBP）、血压变异系数（CV）]和颈-桡动脉脉搏传导速度（crPWV）,分析24h-动态血压变异性、节律性特点和crPWV的影响因素。结果：腹型肥胖组患者非杓型血压、24h-SBP-CV、24h-DBP-CV、dSBP-CV、nSBP-CV、夜间SBP下降率以及crPWV均高于非腹型肥胖组（P<0.05）,腹型肥胖组患者动脉僵硬度增高发生率高于非腹型肥胖组患者（P<0.05）。控制混杂因素后,腹型肥胖组患者腰围与夜间SBP下降率（r=0.338）、24h-SBP-CV（r=0.279）、24h-DBP-CV（r=0.259）、dSBP-CV（r=0.208）、nSBP-CV（r=0.317）、crPWV（r=0.543）呈正相关性（P<0.05）。经多元线性回归分析结果显示,腰围、LDL-C、夜间SBP下降率、24h-SBP-CV和nSBP-CV是crPWV的重要影响因素（P<0.05）。结论：腹部脂肪沉积对老年正常高值血压患者24h动态血压变异性和动脉僵硬度有显著影响,部分24h-动态血压参数与动脉僵硬度有关,控制腰围对预防动脉硬化有着重要的意义。     

Sex differences in baroreflex sensitivity, heart rate variability, and end organ damage in the TGR(mRen2)27 rat

The aim of this investigation was to evaluate sex differences in baroreflex and heart rate variability (HRV) dysfunction and indexes of end-organ damage in the TG(mRen2)27 (Ren2) rat, a model of renin overexpression and tissue renin-angiotensin-aldosterone system overactivation. Blood pressure (via telemetric monitoring), blood pressure variability [BPV; SD of systolic blood pressure (SBP)], spontaneous baroreflex sensitivity, HRV [HRV Triangular Index (HRV-TI), standard deviation of the average NN interval (SDNN), low and high frequency power (LF and HF, respectively), and Poincaré plot analysis (SD1, SD2)], and cardiovascular function (pressure-volume loop analysis and proteinuria) were evaluated in male and female 10-wk-old Ren2 and Sprague Dawley rats. The severity of hypertension was greater in Ren2 males (R2-M) than in Ren2 females (R2-F). Increased BPV, suppression of baroreflex gain, decreased HRV, and associated end-organ damage manifested as cardiac dysfunction, myocardial remodeling, elevated proteinuria, and tissue oxidative stress were more pronounced in R2-M compared with R2-F. During the dark cycle, HRV-TI and SDNN were negatively correlated with SBP within R2-M and positively correlated within R2-F; within R2-M, these indexes were also negatively correlated with end-organ damage [left ventricular hypertrophy (LVH)]. Furthermore, within R2-M only, LVH was strongly correlated with indexes of HRV representing predominantly vagal (HF, SD1), but not sympathetic (LF, SD2), variability. These data demonstrated relative protection in females from autonomic dysfunction and end-organ damage associated with elevated blood pressure in the Ren2 model of hypertension.     

先天性心脏病患儿介入封堵术治疗前后CRP、NT-proBNP、心率变异性的变化及与术后心功能的关系研究

摘要 目的：探讨先天性心脏病（CHD）患儿介入封堵术治疗前后C-反应蛋白（CRP）、N末端B型利钠肽原（NT-proBNP）、心率变异性（HRV）的变化及与术后心功能的关系。方法：选择2020年10月至2021年6月在本院行介入封堵术治疗的95例CHD患儿为研究对象,采用化学发光法检测血清CRP水平,采用电化学发光免疫技术检测血清NT-proBNP水平,采用24 h动态心电图及12导联同步心电图分析HRV指标,观察手术前后患儿的血清CRP、NT-proBNP水平及HRV指标变化,比较术后不同NYHA心功能分级患儿的血清CRP、NT-proBNP水平和HRV指标,分析患儿术前血清CRP水平、血清NT-proBNP水平、HRV指标与术后NYHA心功能分级的相关性。结果：介入封堵术后患儿血清CRP、NT-proBNP、LF/HF水平逐渐降低,术后3 d、术后1个月时均低于术前,术后1个月时均低于术后3 d时（P<0.025）;而TP、HF、LF、R-R、PNN50%、ASDNN、SDANN、SDNN、rMSSD水平逐渐升高,术后3 d、术后1个月时均高于术前,术后1个月时均高于术后3 d 时（P<0.025）。患儿术后3 d的血清CRP、NT-proBNP水平及LF/HF水平随着NYHA心功能分级的升高而升高,TP、HF、LF、R-R、PNN50%、ASDNN、SDANN、SDNN、rMSSD水平随着NYHA心功能分级的升高而降低（多有P＜0.05）。患儿术后3 d的NYHA心功能分级与治疗前血清CRP、NT-proBNP及LF/HF水平呈负相关,与TP、HF、LF、R-R、PNN50%、ASDNN、SDANN、SDNN、rMSSD水平呈正相关（P＜0.05）。结论：CHD患儿经介入封堵术治疗后,血清CRP、NT-proBNP及HRV指标变化明显,与术后NYHA心功能分级显著相关,血清CRP、NT-proBNP及HRV指标有望成为评估CHD患儿介入封堵术后预后的较敏感性指标。     

Very low-frequency blood pressure variability depends on voltage-gated L-type Ca2+ channels in conscious rats

The mechanisms generating high- frequency (HF) and low-frequency (LF) blood pressure variability (BPV) are reasonably well understood. However, little is known about the origin of very low-frequency (VLF) BPV. We tested the hypothesis that VLF BPV is generated by L-type Ca(2+) channel-dependent mechanisms. In conscious rats, arterial blood pressure was recorded during control conditions (n = 8) and ganglionic blockade (n = 7) while increasing doses (0.01-5.0 mg.100 micro l(-1).h(-1)) of the L-type Ca(2+) channel blocker nifedipine were infused intravenously. VLF (0.02-0.2 Hz), LF (0.2-0.6 Hz), and HF (0.6-3.0 Hz) BPV were assessed by spectral analysis of systolic blood pressure. During control conditions, nifedipine caused dose-dependent declines in VLF and LF BPV, whereas HF BPV was not affected. At the highest dose of nifedipine, VLF BPV was reduced by 86% compared with baseline, indicating that VLF BPV is largely mediated by L-type Ca(2+) channel-dependent mechanisms. VLF BPV appeared to be relatively more dependent on L-type Ca(2+) channels than LF BPV because lower doses of nifedipine were required to significantly reduce VLF BPV than to reduce LF BPV. Ganglionic blockade markedly reduced VLF and LF BPV and abolished the nifedipine-induced dose-dependent declines in VLF and LF BPV, suggesting that VLF and LF BPV require sympathetic activity to be evident. In conclusion, VLF BPV is largely mediated by L-type Ca(2+) channel-dependent mechanisms. We speculate that VLF BPV is generated by myogenic vascular responses to spontaneously occurring perturbations of blood pressure. Other factors, such as sympathetic nervous system activity, may elicit a permissive effect on VLF BPV by increasing vascular myogenic responsiveness.     

Heart Rate Variability During 24 Hours in Asthmatic Children

The autonomic circadian rhythm plays an important role in asthma. In recent years it has become possible to evaluate autonomic nervous function (ANF) using analysis of heart rate variability (HRV). We analyzed the HRV in the 24h period following the state without an asthma attack in order to study the relationship between asthma and ANF. The HRV was analyzed in 94 asthmatic children (ages 5–15 years). These subjects were divided into groups according to the severity of their asthma. After recording a 24h ambulatory electrocardiograph (AECG), the HRV was analyzed by a computer. Evaluation of the HRV was carried out using time-domain and frequency-domain analyses. The ANF of asthma subjects was decreased in comparison to the normal group. The severity of asthma had a significant effect on the %RR50 (the proportion of cycles during which the difference is > 50 ms), the SD (standard deviation; mean of standard deviation of all normal RR intervals for all 5-minute periods), the low-frequency (LF) band (0.04 to 0.15 Hz), and the high-frequency (HF) band (0.15 to 0.4 Hz) (%RR50: F = 4.31, p = 0.01; SD: F=3.48, p = 0.03; LF: F=3.67, p = 0.02; HF: F=3.41, p = 0.03). These values were lowest in the severe asthma group. With regard to the therapy grouping, the index that exhibited a significant difference was the NNA (mean of normal-to-normal RR intervals over 24h) (F = 4.43, p = 0.01) In conclusion, even in the normal condition in which the patient is free of an asthma attack, the ANF of asthma sufferers differs from that of normal children. It is possible that the different ANF of asthma sufferers is related to the severity of the asthma. (Chronobiology International, 14(6), 597–606, 1997)