宫内发育迟缓胎鼠心率变异性功率谱分析

为了探讨将胎儿自主神经发育及其功能状况作为判断胎儿宫内发育迟缓(IUGR)的可行性,采用酒精灌胃加限食法建立IUGR动物模型,利用自回归(AR)模型法对IUGR胎鼠心率变异性(HRV)进行功率谱分析.结果表明,无论是低频功率、高频功率还是总功率,实验组均明显高于对照组,但标化后的高频功率实验组则明显低于对照组,标化后的低频功率实验组仍明显高于对照组.提示,利用FHRV谱分析评价胎儿自主神经发育及其功能状况,进而对IUGR进行产前诊断的方法是可行的.     

体位改变对Beagle犬心脏自主神经控制的影响

目的观察体位改变对Beagle犬心脏自主神经控制的影响。方法利用大动物无创生理遥测技术,监测清醒活动状态下雌性Beagle犬在静态姿势（lying、standing、sitting、hanging）和运动（walking）姿势下的心电图（ECG）,并用HRV功率谱分析其自主神经功能。结果在静态姿势下,Beagle犬RR间期（RRI）、RR间期的标准差SDNN（SDNN）、相邻RR间期差值平方和的均方根RMSSD（RMSSD）、相邻R-R间期差值〉50 ms的窦性个数占心搏总数的百分比pNNabs（50）（pNNabs（50））、TP总功率（TP）、VLF极低频功率（VLF）、标准化高频功率（HFnorm）均明显高于运动状态（P〈0.05,P〈0.01）,而心率（HR）、标准化低频功率（LFnorm）和低频功率/高频功率（LF/HF）平衡指数则明显低于运动状态（P〈0.05,P〈0.01）。结论不同体位姿势在静息状态下以迷走神经活动兴奋为主,相反,在运动状态下以交感神经活动兴奋为主;体位姿势改变能引起心率的变化,必然影响心脏自主神经控制能力,其主要取决于迷走神经活动强弱有关,且导致LF/HF均衡性的破坏。     

血管紧张素AT1受体抗体阳性孕鼠后代高盐饮食后血管功能障碍

血管紧张素AT1受体抗体(AT1-Ab)可损伤胎盘发育,进而导致胎儿宫内生长受限(intrauterine growth restriction,IUGR).根据胎儿源性成人疾病学说,IUGR会明显增加成人后患心血管疾病的几率.本研究旨在观察AT1-Ab阳性孕鼠后代生长至成年后血管功能有无异常.24只雌性Wistar大...     

创伤患者伤后自主神经功能的研究

目的:探讨创伤惠者伤后自主神经的功能改变。方法:应用HRV频域分析观察创伤患者伤后自主神经功能的变化情况。30例创伤患者依照ISS评分分为轻伤、重伤和严重伤三组,分别收集伤后第1天、第7天和第14天上午8点至10点间的心电图资料,选取其中5分钟的无干扰、无早搏的心电图数据,应用频域分析法进行短时程HRV分析。结果:创伤患者伤后早期HRV的低频功率(low-frequency,LF)、高频功率(high-frequency,HF)均明显降低;但LF/HF却明显升高。结论:伤后早期自主神经功能有明显改变,即交感神经兴奋性增高,迷走神经兴奋性降低。损伤越严重,这种改变越明显。随着病情的缓解,LF、HF逐渐升高,LF/HF逐渐降低,交感神经和副交感神经之间的平衡逐渐恢复。     

摄食行为对小型猪心脏自主神经功能的影响

目的观察摄食行为对小型猪心脏自主神经功能的影响。方法利用大动物无创遥测技术观察清醒活动状态下小型猪摄食前（BI）、摄食过程中（IP）、摄食后（AI）、AI 2 h和AI 4h的心电图（ECG）和自主活动,并用HRV功率谱分析其自主神经功能。结果与摄食前比较,小型猪摄食过程中心率（HR）、自主活动和标准化低频成分（LFnu）明显增加,RR间期（RRI）、总功率（TP）、极低频成分（VLF）、高频成分（HF）明显减少,LF/HF比值明显升高;且随着摄食后恢复时间的延长,小型猪HR、自主活动、LFnu均有所降低,而RRI、TP、VLF、HF均有所升高,LF/HF比值逐渐降低,并在摄食后2 h、4 h时变化显著;相关分析显示摄食行为与TP、VLF、HF、LF和LF/HF密切相关,多元线性逐步回归分析亦显示摄食行为与VLF、LF/HF和TP密切相关,且VLF起主要作用。结论小型猪摄食行为不仅影响心脏活动;而且能引起小型猪心脏自主神经控制能力发生改变,其中VLF在摄食行为过程中占有重要作用。     

血管紧张素Ⅱ对家兔心率变异的影响

目的:研究血管紧张Ⅱ(AngⅡ)对家兔心率变异(HRV)影响的机制。方法:分别给家兔静脉输注生理盐水,AngⅡ,溴化六烃季胺(HEXB),HEXB+AngⅡ检测安静状态下连续5 min的心电图并进行HRV的时域和频域分析。结果:血管紧张素Ⅱ组的时域指标SDNN和RMSSD较对照组明显降低,频域指标低频(LF)升高,而高频(HF)和总功率(TP)明显降低;HEXB+AngⅡ组与HEXB组相比无明显区别。结论:交感神经阻断剂HEXB不能影响AngⅡ的作用,AngⅡ主要通过抑制中枢自主神经的传出,降低迷走神经张力来降低HRV。     

大鼠缺血性脑损伤引起学习记忆障碍及心率变异性改变

本研究通过建立高脂缺血性脑损伤大鼠模型,进行水迷宫实验和心率变异性（heart rate variability,HRV）的功率谱分析,探讨脑损伤前后大鼠学习记忆的变化及缺血对自主神经的影响。23只成年雄性Wistar大鼠随机分为对照组（n=10）、高脂组（n=6）和高脂缺血组（n=7）。高脂组和高脂缺血组大鼠均饲以高脂饲料制成高血脂大鼠模型。各组大鼠进行水迷宫实验后,高脂缺血组用双侧颈总动脉结扎（2-VO）法制作缺血再灌注模型,同时记录心电图。7d后各组大鼠再次进行水迷宫实验和记录心电图,对HRV序列进行基于快速傅立叶转换（fast Fourier transformation,FFT）的功率谱分析。结果：（1）第一次水迷宫测试,3组大鼠空间探索实验和定位航行实验结果无统计学差异;第二次水迷宫实验,高脂缺血组与其它两组相比,空间探索实验中平台所在象限的记忆频度明显下降（P〈0．01）,定位航行实验中平台所在象限的记忆频度显著下降（P〈0．01）,10圆环记忆得分显著下降（P〈0．001）,但高脂组与对照组相比无明显差异。（2）高脂缺血组缺血后心率持续下降;缺血时HRV中频段功率（0．2加．6Hz）呈现明显下降的趋势,高频段功率（0．6-2．5Hz）缓慢下降,中频／高频功率比值明显下降（P〈0．05）。（3）缺血7d后高脂缺血组与高脂组相比,心率明显加快,HRV的中频段功率无显著变化,高频段功率明显下降,中频／高频功率比值显著增高（P〈0．05）。结果表明,缺血过程中高脂缺血组大鼠的自主神经活动降低,交感神经活动相对于迷走神经活动减弱。缺血7d后,由于海马区神经元对缺血敏感易受损,造成高脂缺血组大鼠学习记忆障碍,同时引发迷走神经活动下降,大鼠交感．迷走神经系统平衡失调。     

脾功能亢进患者行脾切除术与部分脾动脉栓塞术前后免疫功能的对比研究

目的:研究脾切除术与部分脾动脉栓塞术对脾功能亢进患者的影响。方法:选取我院外科确诊为乙型病毒性肝炎后肝硬化伴脾功能亢进症患者38例,通过随机数表法将所有患者平分为观察组和对照组,观察组给予部分脾动脉栓塞术,对照组给予脾切除术。检测术前术后血细胞计数、细胞免疫指标和体液免疫指标。结果:术后7天,对照组的红细胞略低于实验组(X~2=0.118,P=0.906);对照组的白细胞高于实验组(X~2=6.095,P0.001);对照组的血小板显著低于实验组(X~2=17.263,P0.001);术后28天,对照组的红细胞显著低于实验组(X~2=7.981,P0.001);对照组的白细胞明显高于实验组,差异有统计学意义(X~2=4.862,P0.001);对照组的血小板低于实验组(X~2=2.165,P=0.037);术后7天,对照组的CD3略低于实验组(t=0.606,P=0.548),对照组的CD4明显低于实验组,CD8显著高于实验组,CD4/CD8低于实验组,差异均有统计学意义(P0.001);术后28天,对照组的CD3略低于实验组(t=0.948,P=0.349);对照组的CD4略低于实验组(t=2.742,P=0.009);对照组的CD8显著高于实验组,CD4/CD8低于实验组,差异均无统计学意义(P0.05);术后7天,对照组的IgM高于实验组,对照组的IgG略高于实验组,IgA低于对照组,但差异无统计学意义(P0.05);术后28天,对照组的IgM高于实验组,对照组的IgG略高于实验组,但差异无统计学意义(P0.05);对照组的IgA为(2.76±1.37)g/L,明显低于实验组的(3.79±1.69)g/L(t=2.063,P=0.046)。结论:部分脾动脉栓塞术能有效改善脾亢症状,调节脾脏功能,提升全身性免疫功能,值得在临床中推广。     

关节置换法与内固定法治疗老年骨质疏松合并股骨粗隆间骨折的临床对比分析

目的:探讨关节置换法和内固定法对老年骨质疏松合并股骨粗隆间骨折患者的治疗效果。方法:选择2011年12月到2014年12月在我院收治的96例老年骨质疏松合并股骨粗隆间骨折患者,随机分为对照组和实验组,分别采用内固定法和关节置换法进行治疗,对比两组临床疗效、并发症发生率和骨密度值。结果:实验组患者下地时间和并发症发生率均明显小于对照组(P0.05)。实验组的优良率(95.83%)明显高于对照组(70.83%),具有显著性差异(P0.05)。治疗后,两组患者骨密度值均明显高于治疗前(P0.05),实验组骨密度值明显高于对照组(P0.05)。结论:关节置换法治疗老年骨质疏松合并股骨粗隆间骨折的临床效果优于内固定法,能明显降低并发症发生率,增强骨密度,改善患者预后。     

长期练习太极拳对老年人自主神经系统调节功能的影响

目的:研究长期练习太极拳运动对老年人自主神经系统调节功能的影响。方法:本文以辽宁省老干部大学太极拳练习班的18人为研究对象,将受试者分为两组。长期锻炼组10人,初学者8人。实验采用具有一个重复测量的两因素设计。利用ME6000生理电信号采集器、Pro Comp Infiniti呼吸感应器、水银血压计采集受试者练习太极拳前安静时,练习太极拳运动后30 min、60 min的心电、呼吸以及血压数据。结果:安静状态下,长期锻炼者心率变异性(HRV)的RR间期、正常RR间期的标准差(SDNN)、总功率(TP)、低频功率(LFP)、高频功率(HFP)、标准化高频功率(n HFP)频率显著高于初学者组,而低频/高频功率(LFP/HFP)、收缩压和舒张压、安静心率显著低于初学者。安静状态下,长期锻炼组受试者呼吸频率显著低于初学者。练习太极拳运动后,TP、n HFP、LFP/HFP以及HR和收缩压指标均有显著变化,同时发现长期锻炼组这些指标受太极拳运动影响的效应尺度要大于初学者。结论:长期坚持太极拳运动能够显著提高老年人迷走神经的调节作用同时减弱交感神经的调节作用。     

Power spectral analysis of heart rate variability for assessment of diurnal variation of autonomic nervous activity in guinea pigs.

We established characteristics of power spectral analysis of heart rate variability, and assessed the diurnal variations of autonomic nervous function in guinea pigs. For this purpose, an electrocardiogram (ECG) was recorded for 24 hr from conscious and unrestrained guinea pigs using a telemetry system. There were two major spectral components, at low frequency (LF) and high frequency (HF) bands, in the power spectrum of HR variability. On the basis of these data, we defined two frequency bands of interest: LF (0.07-0.7 Hz) and HF (0.7-3.0 Hz). The power of LF was higher than that of HF in the normal guinea pigs. Atropine significantly reduced power at HF. Propranolol also significantly reduced power at LF. Furthermore, the decrease in the parasympathetic mechanism produced by atropine was reflected in a slight increase in the LF/HF ratio. The LF/HF ratio appeared to follow the reductions of sympathetic activity produced by propranolol. Autonomic blockade studies indicated that the HF component reflected parasympathetic activity and the LF/HF ratio seemed to be a convenient index of autonomic balance. Nocturnal patterns, in which the values of heart rate in the dark phase (20:00-06:00) were higher than those in the light phase (06:00-20:00), were observed. However, the HF, LF and the LF/HF ratio showed no daily pattern. These results suggest that the autonomic nervous function in guinea pigs has no clear circadian rhythmicity. Therefore, this information may be useful for future studies concerning the autonomic nervous function in this species.     

Heart Rate Variability and Skin Conductance During Repetitive TMS Course in Children with Autism

Autism spectrum disorder (ASD) is a developmental disorder marked by difficulty in social interactions and communication. ASD also often present symptoms of autonomic nervous system (ANS) functioning abnormalities. In individuals with autism the sympathetic branch of the ANS presents an over-activation on a background of the parasympathetic activity deficits, creating an autonomic imbalance, evidenced by a faster heart rate with little variation and increased tonic electrodermal activity. The objective of this study was to explore the effect of 12 sessions of 0.5 Hz repetitive transcranial magnetic stimulation (rTMS) over dorsolateral prefrontal cortex (DLPFC) on autonomic activity in children with ASD. Electrocardiogram and skin conductance level (SCL) were recorded and analyzed during each session of rTMS. The measures of interest were time domain (i.e., R–R intervals, standard deviation of cardiac intervals, NN50-cardio-intervals >50 ms different from preceding interval) and frequency domain heart rate variability (HRV) indices [i.e., power of high frequency (HF) and low frequency (LF) components of HRV spectrum, LF/HF ratio]. Based on our prior pilot studies it was proposed that the course of 12 weekly inhibitory low-frequency rTMS bilaterally applied to the DLPFC will improve autonomic balance probably through improved frontal inhibition of the ANS activity, and will be manifested in an increased length of cardiointervals and their variability, and in higher frequency-domain HRV in a form of increased HF power, decreased LF power, resulting in decreased LF/HF ratio, and in decreased SCL. Our post-12 TMS results showed significant increases in cardiac intervals variability measures and decrease of tonic SCL indicative of increased cardiac vagal control and reduced sympathetic arousal. Behavioral evaluations showed decreased irritability, hyperactivity, stereotype behavior and compulsive behavior ratings that correlated with several autonomic variables.     

Identification of development and autonomic nerve activity from heart rate variability in preterm infants

Heartbeat intervals, which are determined basically by regular excitations of the sinoatrial node, show significant fluctuation referred to as the heart rate variability (HRV). The HRV is mostly due to nerve activities through the sympathetic and parasympathetic branches of the autonomic nervous system (ANS). In recent years, it has been recognized that the HRV shows a greater complexity than ever expected, suggesting that it includes much information about ANS activities. In this study, we investigated relationship between HRV and development in preterm infants. To this end, heartbeat intervals were continuously recorded from 11 preterm infants in NICU. The recording periods were ranging from several days to weeks depending on the individuals. The HRV at various ages was then characterized by several indices. They include power spectrum as well as the mean and standard deviation of the series. For the power spectrum, the low-frequency band power (LF), high-frequency band power (HF), LF/HF (the ratio between LF and HF), beta (scaling exponent of the spectrum) were estimated. The detrended fluctuation analysis (DFA) was also employed to obtain short- and long-range scaling exponents. Each of these indices showed a correlation with the age. We showed that the long-range scaling exponent, derived from the DFA, was most significantly correlated with the age, suggesting that it could be a robust index to characterize the development of preterm infants.     

迷走神经在心率变异性中的作用

采用功率谱和近似熵 (approximateentropy ,ApEn)的方法 ,分析清醒家兔在双侧迷走神经保留 ,右、左侧迷走神经切断以及双侧迷走神经同时切断时心搏间期 (RRI)的变化。结果显示 :双侧迷走神经保留时功率谱中高频功率 (HF)、低频功率 (LF)及ApEn值均高于双侧及单侧迷走神经切断时 (P <0 0 5 ) ,LF/HF比值最小 ;切断单侧迷走神经 ,ApEn变小 ,LF/HF比值在右侧迷走神经切断时增大 ,而切断左侧迷走时LF/HF比值无明显变化 ;双侧迷走神经切断后LF/HF比值最大 ,ApEn最低。结果表明 :心率变异主要由迷走神经调节 ,右侧迷走神经起主要作用 ;传统心率变异性测量方法与非线性方法所得结果一致     

Capsaicin increases modulation of sympathetic nerve activity in rats: measurement using power spectral analysis of heart rate fluctuations

We assessed the sympatho-vagal activities of the heart after administration of capsaicin by measuring the power spectral analysis in rats. There were major two frequency components of heart rate variability, which we defined as high (1.0 Hz <, HF) and low (LF, < 1.0 Hz) frequency components. Vagal blockade by atropine abolished the high frequency component, and lowered the amplitude of the low frequency component. On the other hand, under conditions of sympathetic blockade by propranolol, the low frequency component was reduced. Combined vagal and sympathetic blockade abolished all heart rate fluctuations. We analyzed the low and high frequency components by integrating the spectrum for the respective band width. The rats administered capsaicin had a higher heart rate and sympathetic nervous system index (LF/HF) than the control group of rats. These results suggest that power spectral analysis is an effective and noninvasive method for detecting subtle changes in autonomic activity in response to the intake of foods or drugs.     

Acute Moderate Exercise Does Not Further Alter the Autonomic Nervous System Activity in Patients with Sickle Cell Anemia

A decreased global autonomic nervous system (ANS) activity and increased sympathetic activation in patients with sickle cell anemia (SCA) seem to worsen the clinical severity and could play a role in the pathophysiology of the disease, notably by triggering vaso-occlusive crises. Because exercise challenges the ANS activity in the general population, we sought to determine whether a short (<15 min) and progressive moderate exercise session conducted until the first ventilatory threshold had an effect on the ANS activity of a group of SCA patients and a group of healthy individuals (CONT group). Temporal and spectral analyses of the nocturnal heart rate variability were performed before and on the 3 nights following the exercise session. Standard deviation of all normal RR intervals (SDNN), total power, low frequencies (LF) and high frequencies powers (HF) were lower but LF/HF was higher in SCA patients than in the CONT group. Moderate exercise did not modify ANS activity in both groups. In addition, no adverse clinical events occurred during the entire protocol. These results imply that this kind of short and moderate exercise is not detrimental for SCA patients.     

Capsaicin Increases Modulation of Sympathetic Nerve Activity in Rats: Measurement Using Power Spectral Analysis of Heart Rate Fluctuations

We assessed the sympatho-vagal activities of the heart after administration of capsaicin by measuring the power spectral analysis in rats. There were major two frequency components of heart rate variability, which we defined as high (1.0 Hz<, HF) and low (LF, <1.0 Hz) frequency components. Vagal blockade by atropine abolished the high frequency component, and lowered the amplitude of the low frequency component. On the other hand, under conditions of sympathetic blockade by propranolol, the low frequency component was reduced. Combined vagal and sympathetic blockade abolished all heart rate fluctuations. We analyzed the low and high frequency components by integrating the spectrum for the respective band width. The rats administered capsaicin had a higher heart rate and sympathetic nervous system index (LF/HF) than the control group of rats. These results suggest that power spectral analysis is an effective and noninvasive method for detecting subtle changes in autonomic activity in response to the intake of foods or drugs.     

急性心肌梗死患者PCI治疗后抑郁对心率变异性、内皮功能及不良心血管事件发生率的影响

目的:探讨急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)治疗后抑郁对心率变异性(HRV)、内皮功能及不良心血管事件(MACE)发生率的影响。方法:选择2017年1月-2018年12月期间在本院接受PCI治疗的AMI患者117例作为研究对象,根据PCI术后出院当日的抑郁自评量表(SDS)评分值将其分为抑郁组(评分值≥53分)41例、非抑郁组(评分值<53分)76例。对比两组患者HRV相关指标[正常RR间期标准差(SDNN)、5 min内正常RR间期平均值标准差(SDANN)、相邻正常RR间期差值均方的平方根(RMSSD)、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)]、内皮功能指标[内皮依赖性血管舒张功能(FMD)、非内皮依赖性血管舒张功能(NMD)]水平差异,记录两组随访期内MACE发生情况。结果:PCI术后出院当日,抑郁组患者的HRV时域指标SDNN、SDANN、RMSSD水平低于非抑郁组患者;频域指标中LF、LF/HF的水平高于非抑郁组,HF的水平低于非抑郁组(P<0.05),两组患者TP水平的差异无统计学意义(P>0.05)。抑郁组患者的FMD、NMD水平均低于非抑郁组患者,差异有统计学意义(P<0.05)。随访期内,抑郁组患者的MACE总发生率、再发心肌梗死发生率高于非抑郁组,差异有统计学意义(P<0.05)。两组患者顽固性心绞痛、新发心肌梗死、心力衰竭、心源性死亡发生率的差异无统计学意义(P>0.05)。结论:AMI患者PCI后合并抑郁可能对心血管系统造成负面影响并最终增加MACE的发生风险。     

Impact of gender on the cardiac autonomic response to angiotensin II in healthy humans

Premenopausal women have a lower risk of cardiovascular disease (CVD) compared with men of a similar age. Furthermore, the regulation of factors that influence CVD appears to differ between the sexes, including control of the autonomic nervous system (ANS) and the renin-angiotensin system. We examined the cardiac ANS response to angiotensin II (Ang II) challenge in healthy subjects to determine whether differences in women and men exist. Thirty-six healthy subjects (21 women, 15 men, age 38 ± 2 years) were studied in a high-salt balance. Heart-rate variability (HRV) was calculated by spectral power analysis [low-frequency (LF) sympathetic modulation, high-frequency (HF) parasympathetic/vagal modulation, and LF:HF as a measure of overall ANS balance]. HRV was assessed at baseline and in response to graded Ang II infusions (3 ng·kg(-1)·min(-1) × 30 min; 6 ng·kg(-1)·min(-1) × 30 min). Cardiac ANS tone did not change significantly in women after each Ang II dose [3 ng·kg(-1)·min(-1) mean change (Δ)LF:HF (mean ± SE) 0.5 ± 0.3, P = 0.8, vs. baseline; 6 ng·kg(-1)·min(-1) ΔLF:HF (mean ± SE) 0.5 ± 0.4, P = 0.4, vs. baseline], whereas men exhibited an unfavorable shift in overall cardiac ANS activity in response to Ang II (ΔLF:HF 2.6 ± 0.2, P = 0.01, vs. baseline; P = 0.02 vs. female response). This imbalance in sympathovagal tone appeared to be largely driven by a withdrawal in cardioprotective vagal activity in response to Ang II challenge [ΔHF normalized units (nu), -5.8 ± 2.9, P = 0.01, vs. baseline; P = 0.006 vs. women] rather than an increase in sympathetic activity (ΔLF nu, -4.5 ± 5.7, P = 0.3, vs. baseline; P = 0.5 vs. women). Premenopausal women maintain cardiac ANS tone in response to Ang II challenge, whereas similarly aged men exhibit an unfavorable shift in cardiovagal activity. Understanding the role of gender in ANS modulation may help guide risk-reduction strategies in high-risk CVD populations.