Predictive Value of Blood Pressure,Heart Rate,and Blood Pressure/Heart Rate Ratio in a Chinese Subpopulation with Vasovagal Syncope

Objective:The head-up tilt test(HUTT)is widely used but is time-consuming and not cost-effective to evaluate patients with vasovagal syncope(VVS).The present study aims to verify the hypothesis that ambulatory blood pressure(BP)monitoring(ABPM)and the simplistic tilt test may be potential alternatives to the HUTT.Methods:The study consecutively enrolled 360 patients who underwent the HUTT to evaluate VVS.BP),heart rate(HR),and BP/HR ratios derived from ABPM and the simplistic tilt test were evaluated to predict the presence,pattern,and stage of syncope during the HUTT.Results:Mixed response was the commonest pattern,and syncope occurred frequently with infusion of isoproterenol at a rate of 3μg/min.During the simplistic tilt test,the cardioinhibitory group had higher tilted BP/HR ratios than the vasodepressor group,while the vasodepressor group had a faster tilted HR and a larger HR difference than the cardioinhibitory group.The higher the BP/HR ratio in the tilted position,the higher the isoproterenol dosage needed to induce a positive response.During ABPM,BP/HR ratios were signifi cantly higher in the cardioinhibitory group than in the vasodepressor group.The higher the ABPM-derived BP,the higher the dosage of isoproterenol needed to induce syncope.There were signifi cant correlations in BP/HR ratios between ABPM and the supine position in the vasodepressor group,while signifi cant correlation was found only for the diastolic BP/HR ratio between ABPM and the tilted position in the cardioinhibitory group.The mixed pattern shared correlative features of the other two patterns.Conclusion:ABPM and the simplistic tilt test might be used as promising alternatives to the HUTT in VVS evaluation in clinical settings.

THE CENTRAL DISTRIBUTION OF ADRENOMEDULLIN AND ITS EFFECTS ON BLOOD PRESSURE AND HEART RATE IN RATS

ＴＨＥＣＥＮＴＲＡＬＤＩＳＴＲＩＢＵＴＩＯＮＯＦＡＤＲＥＮＯＭＥＤＵＬＬＩＮＡＮＤＩＴＳＥＦＦＥＣＴＳＯＮＢＬＯＯＤＰＲＥＳＳＵＲＥＡＮＤＨＥＡＲＴＲＡＴＥＩＮＲＡＴＳＷｅｉＹｉｎｇＪｉｅ魏英杰；ＬｉＱｉａｎｈｏｎｇ李倩虹；ＳｏｎｇＬｉａｎｇｗｅｎ宋...

Blood Pressure and Heart Rate Measurements Using Photoplethysmography with Modified LRCN

In this study,single-channel photoplethysmography(PPG)signals were used to estimate the heart rate(HR),diastolic blood pressure(DBP),and systolic blood pressure(SBP).A deep learning model was proposed using a long-term recurrent convolutional network(LRCN)modified from a deep learning algorithm,the convolutional neural network model of the modified inception deep learning module,and a long short-term memory network(LSTM)to improve the model’s accuracy of BP and HR measurements.The PPG data of 1,551 patients were obtained from the University of California Irvine Machine Learning Repository.How to design a filter of PPG signals and how to choose the loss functions for deep learning model were also discussed in the study.Finally,the stability of the proposed model was tested using a 10-fold cross-validation,with an MAE±SD of 2.942±5.076 mmHg for SBP,1.747±3.042 mmHg for DBP,and 1.137±2.463 bpm for the HR.Compared with its existing counterparts,the model entailed less computational load and was more accurate in estimating SBP,DBP,and HR.These results established the validity of the model.

Cardiovascular age of aviation personnel: based on the principal component analysis of heart rate and blood pressure variability

Objective: To introduce a method to calculate cardiovascular age, a new, accurate and much simpler index for assessing cardiovascular autonomic regulatory function, based on statistical analysis of heart rate and blood pressure variability (HRV and BPV) and baroreflex sensitivity (BRS) data. Methods: Firstly, HRV and BPV of 89 healthy aviation personnel were analyzed by the conventional autoregressive (AR) spectral analysis and their spontaneous BRS was obtained by the sequence method. Secondly, principal component analysis was conducted over original and derived indices of HRV, BPV and BRS data and the relevant principal components, PCi orig and PCi deri (i=1, 2, 3,...) were obtained. Finally, the equation for calculating cardiovascular age was obtained by multiple regression with the chronological age being assigned as the dependent variable and the principal components significantly related to age as the regressors. Results: The first four principal components of original indices accounted for over 90% of total variance of the indices, so did the first three principal components of derived indices. So, these seven principal components could reflect the information of cardiovascular autonomic regulation which was embodied in the 17 indices of HRV, BPV and BRS exactly with a minimal loss of information. Of the seven principal components, PC2 orig , PC4 orig and PC2 deri were negatively correlated with the chronological age ( P <0 05), whereas the PC3 orig was positively correlated with the chronological age ( P <0 01). The cardiovascular age thus calculated from the regression equation was significantly correlated with the chronological age among the 89 aviation personnel ( r =0.73, P <0 01). Conclusion: The cardiovascular age calculated based on a multi variate analysis of HRV, BPV and BRS could be regarded as a comprehensive indicator reflecting the age dependency of autonomic regulation of cardiovascular system in healthy aviation personnel.

Effects of Impaired Glucose Metabolism on Heart Rate Variability and Blood Pessure Variability in Essential Hpertensive Patients

To investigate the effects of impaired glucose metabolism （IGM） on cardiovascular autonomic nervous systems in essential hypertensive （EH） patients by comparing heart rate variability （HRV） and blood pressure variability （BPV） in EH patients with or without type 2 diabetes mellitus （T2DM）. Simultaneous 24-h recordings of ambulatory ECG and blood pressure monitoring were performed in 36 male old patients with simple EH and 33 male old patients with EH combined with T2DM. HRV analysis included time domain parameters such as SDNN, SDANN, SDNNi, rMSSD and pNN50, and total spectral power （TP） of HRV, which mainly consists of VLF, LF and HF component along with LF/HF ratio, was also obtained. The value of ambulatory blood pressure was represented as the mean blood pressure （mean systolic/mSBP, diastolic/mDBP and pulse pressure/mPP） during different periods （24 h/24 h, day time/d and night time/n）. Standard deviation （SD） as well as coefficient of variance （CV） of blood pressure during each above-mentioned period were obtained to reflect the long-term BPV. Our result showed that SDNN, SDNNi, SDANN, rMSSD, PNN50, TP and HF of HRV in cases of EH with T2DM were all significantly lower than those in simple EH subjects （P〈0.05）. No significant differences in VLF or LF was found between the two groups （P〉0.05）, while LF/HF ratio was significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.01）. Moreover, dmSBP, 24 h-mPP and dmPP were all significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.05）, while nmSBP, 24 h-mSBP, 24 h-mDBP, dmDBP, nmDBP or nmPP showed no significant difference between this two groups of patients （P〉0.05）. And dSBPSD, dSBPCV and 24 h-SBPSD were all significantly higher in EH with T2DM patients than in simple EH subjects （P〈0.05）, while the other BPV indexes showed no significant difference between this two groups （P〉0.05）. It is concluded that the cardiovascular autonomic nervous systems in EH patients was further impaired by T2DM, displaying lowering of HRV and enlargement of BPV, which in turn induced abnormal structural and functional changes of cardiovascular systems. Therefore, improving cardiovascular autonomic nervous systems might reduce the occurrence of cardiovascular complications in the EH patients with IGM.

Blood pressure and stature in Helicobacter pylori positive and negative persons

To evaluate vital signs and body indices in Helicobacter pylori(H.pylori)positive and negative persons.A total of 22 centres entered the study.They were spread over the whole country,corresponding well to the geographical distribution of the Czech population.A total of 1818 subjects(aged 5-98 years)took part in the study,randomly selected out of 38147 subjects.H.pylori infection was investigated by means of a 13Curea breath test.Data on height,weight,systolic and diastolic blood pressure and heart rate were collected at the clinics of general practitioners.The overall prevalence of H.pylori infection was 30.4%(402/1321)in adults(≥18 year-old)and 5.2%(26/497)in children and adolescents(≤17 year-old).Once adjusted for age and gender,only a difference in body mass index remained statistically significant with H.pylori positive adults showing an increase of 0.6 kg/m2 in body mass index.Once adjusted for age and gender,we found a difference in height between H.pylori positive and H.pylori negative children and adolescents.On further adjustment for place of residence,this difference became statistically significant,with H.pylori positive children and adolescents being on average 3.5 cm shorter.H.pylori positive adults were significantly older compared to H.pylori negative subjects.Once adjusted for age and gender,H.pylori infection had no impact on body weight,body mass index and vital signs either in adults or children and adolescents.Chronic H.pylori infection appeared to be associated with short stature in children.H.pylori infection did not influence blood pressure,body weight and body mass index either in adults or children and adolescents.

Stochastic resonance whole body vibration increases perceived muscle relaxation but not cardiovascular activation:A randomized controlled trial

AIM To investigate the acute effects of stochastic resonance whole body vibration(SR-WBV), including muscle relaxation and cardiovascular activation.METHODS Sixty-four healthy students participated. The participants were randomly assigned to sham SR-WBV training at a low intensity(1.5 Hz) or a verum SR-WBV training at a higher intensity(5 Hz). Systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR) and selfreported muscle relaxation were assessed before and immediately after SR-WBV.RESULTS Two factorial analyses of variance(ANOVA) showed a significant interaction between pre- vs post-SR-WBVmeasurements and SR-WBV conditions for muscle relaxation in the neck and back [F(1,55) = 3.35, P = 0.048, η2 = 0.07]. Muscle relaxation in the neck and back increased in verum SR-WBV, but not in sham SR-WBV. No significant changes between pre- and post-training levels of SBD, DBD and HR were observed either in sham or verum SR-WBV conditions. With verum SR-WBV, improved muscle relaxation was the most significant in participants who reported the experience of back, neck or shoulder pain more than once a month(P < 0.05).CONCLUSION A single session of SR-WBV increased muscle relaxation in young healthy individuals, while cardiovascular load was low. An increase in musculoskeletal relaxation in the neck and back is a potential mediator of pain reduction in preventive worksite SR-WBV trials.

The Effect of Baroreflex Function on Blood Pressure Variability

Objective: The aim of this study was to assess the relationship of blood pressure variability (BPV) and heart rate variability (HRV) to investigate the effect of baroreflex function on blood pressure variability. Methods: This study consisted of 111 subjects, including 32 normotensives and 79 hypertensives. All the subjects were given two concurrent tests: 24-hour Holter ECG and ambulatory blood pressure monitoring. According to standard deviation of normal-to-normal sinus RR intervals (SDNN) derived from the Holter ECG, the hypertensives were divided into two groups: an HRV normal group with SDNN > 100 ms and an HRV abnormal group with

Power Spectral Analysis of Heart Rate Variability of Driver Fatigue

This investigation was to evaluate the driving fatigue based on power spectral analysis of heart rate variability (HRV) under vertical vibration. Forty healthy male subjects (29.7±3.5 years) were randomly divided into two groups, Group A (28.8±4.3 years) and Group B (30.6±2.7 years). Group A (experiment group) was required to perform the simulated driving and Group B (control group) kept calm for 90 min. The frequency domain indices of HRV such as low frequency (0.04 0.15 Hz, LF), high frequency (0.150.4 Hz, HF), LF/HF together with the indices of hemodynamics such as blood pressure (BP) and heart rate (HR) of the subjects between both groups were calculated and analyzed after the simulated driving. There were significances of the former indices between both groups (P<0.05). All the data collected after experiment of Group A was observed the remarkable linear correlation (P<0.05) and parameters and errors of their linear regression equation were stated (α=0.05, P<0.001) in this paper, respectively. The present study investigated that sympathetic activity of the subjects enhanced after the simulated driving while parasympathetic activities decreased. The sympathovagal balance was also improved. As autonomic function indictors of HRV reflected fatigue level, quantitative evaluation of driving mental fatigue from physiological reaction could be possible.

Impact of metabolism-related mutations on the heart rate of gastric cancer patients after peritoneal lavage

BACKGROUND During surgery for gastric cancer,peritoneal lavage using warm distilled water can cause temporary hemodynamic changes.AIM To examine the associations between changes in heart rate and single nucleotide polymorphisms(SNPs).METHODS This was a prospective observational study of patients with gastric cancer who underwent gastrectomy and peritoneal hypotonic lavage at the Third Af
liated Hospital of Soochow University from March 2018 to March 2019.Related SNPs were selected,and the verified exons were analyzed.Heart rate and blood pressure(BP)were measured before and after lavage.The patients were grouped as heart rate change≥30%vs<30%.Comparison and regression analyses of the selected SNPs were performed between the two groups.RESULTS According to the inclusion/exclusion criteria,194 patients were included in the analysis.Of these patients,138 were male,with a mean age of 65.9±0.8 years,and 56 were female,with a mean age of 65.0±1.3 years.Heart rate dropped by 0%-10%in 65 participants,by 10%-15%in 29,by 15%-20%in 23,by 20%-50%in 39,by 50%-100%in four,six had a cardiac arrest,and 28 had an increase in heart rate.Considering the possible impact of exonic SNPs on the phenotypes,TEP1(rs938886),TEP1(rs1713449),and RECQL5(rs820196)were analyzed.The haplotype analysis suggested that the haplotypes CTT[odds ratio(OR)=2.018,95%confidence interval(CI):1.012-4.025,P=0.0430]and GCC(OR=2.293,95%CI:1.174-4.477,P=0.0131)of TEP1(rs938886),TEP1(rs1713449),and RECQL5(rs820196)increased the risk of a drop in heart rate>30%.CONCLUSION The TEP1(rs938886),TEP1(rs1713449),and RECQL5(rs820196)SNPs were associated with changes in heart rate≥30%during intraperitoneal lavage using distilled water after gastrectomy for gastric cancer.

Efectsofmoxonidineinjectedintorostralventrolateralmedulaonbloodpressure,heartrate,andrenalsympatheticnerveactivityinrats

目的：观察延髓腹外侧头端（ＲＶＬＭ）注射莫索尼定（Ｍｏｘ）对麻醉大鼠血压（ＢＰ）、心率（ＨＲ）及肾交感神经放电（ＲＳＮＡ）的影响．方法：麻醉大鼠ＲＶＬＭ注射１μＬＭｏｘ１，１０，１００μｍｏｌ·Ｌ－１，同步记录ＢＰ，ＨＲ及ＲＳＮＡ．结果：Ｍｏｘ１，１０，１００μｍｏｌ·Ｌ－１分别使ＢＰ从１３９±１０ｋＰａ降至１３０±１７ｋＰａ（Ｐ＜００５），１３８±１８ｋＰａ至１１４±１５ｋＰａ（Ｐ＜００１），ａｎｄ１３９±１９ｋＰａ至９４±１７ｋＰａ（Ｐ＜００１）．Ｍｏｘ不影响ＨＲ．Ｍｏｘ１μｍｏｌ·Ｌ－１增加ＲＳＮＡ５０％（Ｐ＜００５），１０μｍｏｌ·Ｌ－１对ＲＳＮＡ无影响（Ｐ＞００５），１００μｍｏｌ·Ｌ－１则降低ＲＳＮＡ２３％（Ｐ＜００５）．在缓冲神经切断大鼠，Ｍｏｘ１０μｍｏｌ·Ｌ－１抑制ＲＳＮＡ５０％（Ｐ＜００５），明显不同于缓冲神经完整的动物（Ｐ＜００１）．结论：麻醉大鼠ＲＶＬＭ注射Ｍｏｘ可降低ＢＰ，但不影响ＨＲ。

High frequency heart rate variability evoked by repetitive transcranial magnetic stimulation over the medial prefrontal cortex: A preliminary investigation on brain processing of acute stressor-evoked cardiovascular reactivity

Introduction: Transcranial Magnetic Stimulation (TMS) is a non-invasive technique for brain stimulation. Repetitive TMS (rTMS) over the medial Prefrontal Cortex (mPFC), Broadman Area 10 (BA10) may stimulate transynaptically perigenual Anterior Cingulate Cortex (pACC, BA 33), insula, amigdala, hypothalamus and connected branches of the Autonomic Nervous System (ANS) involved in stressorevoked cardiovascular reactivity. Stressors are associated with an increase in sympathetic cardiac control, a decrease in parasympathetic control, or both, and, consequently, an increase in systolic/stroke volume, total vascular impedance/resistance and heart rate, a decrease of baroreflex sensitivity, i.e., an increase in blood pressure/arterial tension. Objectives and Aims: The present work aims, using TMS and accordingly to Gianaros modeling, based on functional neuroimaging studies and previous neuroanatomical data from animal models, to probe the connectivity of brain systems involved in stressor-evoked cardiovascular reactivity and to explore TMS potential as a tool for detection and stratification of individual differences concerning this reactivity and hemorreological risk factors correlated with the development of Coronary Heart Disease (CHD). Methods: Both subjects, a 52 years old male and a 40 years old female with previous increased Low Frequency (LF)/High Frequency (HF) Heart Rate Variability (HRV) ratios (respectively, 4.209/3.028) without decompensated cardiorespiratory symptoms, gave informed consent, and ethico-legal issues have been observed. Electroencephalographic (EEG) monitoring has been performed for safety purposes. Immediately after administration, over the mPFC, of 15 pulses of rTMS, during 60 second, with an inductive electrical current, at the stimulating coil, of 85.9 Ampère per μsecond and 66 Ampère per μsecond, respectively, for male and female subjects (a “figure-of-eight” coil and magnetic stimulator MagLite, Dantec/Medtronic, have been used), HRV spectrum analysis (cStress software) has been performed (during 5 minutes, in supine position). Results: In both subjects, LF power, HF power and LF/HF ratio results, before and after rTMS administration, pointed towards sympathetic attenuation and parasympathetic augmentation (respectively, in male/female subject: decreased LF power—65.1 nu/69.3 nu, before rTMS;56.1 nu/41.6 nu, after rTMS;increased HF power—15.5 nu/22.9 nu, before rTMS;30.9 nu/45.5 nu, after rTMS). Conclusions: In this preliminary investigation, the existence of a link between “mind” and heart’s function has been put in evidence, through a reversible “virtual” lesion, of brain systems involved in cardiovascular control, caused by TMS. Repetitive TMS over mPFC decreased brain function involved in stressorevoked cardiovascular reactivity, suggesting the importance of TMS in the management of stress-related cardiovascular disorders.

收缩压变异性和心率变异性对维持性血液透析患者MACE发生风险的预测价值

目的 探讨收缩压变异性(SBPV)和心率变异性(HRV)对维持性血液透析(MHD)患者主要不良心血管事件(MACE)发生风险的预测价值。方法 纳入2017年3月—2018年3月在宜昌市中心人民医院肾病内科血液净化中心接受规律治疗的MHD患者120例,根据是否发生MACE分为MACE组(n=59)与无MACE组(n=61)。在患者行血液透析前佩戴Holter,收集24 h心电活动信息,计算均值(MEAN)、RR间期总体标准差(SDNN)、RR间期平均值的标准差(SDANN)和相邻RR间期差值的均方根(r-MSSD)。采用自动血压监测系统记录24 h血压变化,计算白昼收缩压变异性(dSBPV)、夜间收缩压变异性(nSBPV)和24 h收缩压变异性(24 h SBPV)。Logistic回归分析MHD患者MACE发生的危险因素。调整混杂因素后,采用Cox比例风险模型回归分析24 h SBPV和SDNN与MHD患者MACE发生的关系。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)、灵敏度、特异度,分析SDNN和收缩压变异性单独及联合对维持性MHD患者发生MACE的预测价值。根据SDNN和24 h SBPV水平将患者分成3组,绘制Kaplan-Meier生存曲线评价不同SDNN和收缩压变异性的MHD患者MACE发生情况。结果 与无MACE组相比,MACE组年龄较大,24 h SBPV、dSBPV、nSBPV较高,SDNN、SDANN较低,差异具有统计学意义(P<0.05)。Logistic回归分析显示,年龄、Kt/V、24 h SBPV、dSBPV、nSBPV、SDNN、SDANN是MHD患者MACE发生的独立危险因素(P<0.05)。调整混杂因素后,多因素COX比例风险模型回归分析,24 h SBPV为MHD患者发生MACE的危险因素,而SDNN为MHD患者发生MACE的保护性因素(P<0.05)。SDNN与收缩压变异性联合预测MHD患者发生MACE的AUC为0.879,预测效能高于单项检测(P<0.05)。组1随访期间累积MACE发生率显著低于组2和组3(19.15%vs 65.12%vs 73.33%,P<0.001)。结论 MHD不良预后患者中24 h SBPV升高,SDNN降低,24 h SBPV和SDNN单独预测MACE的具体价值尚可,两者联合预测效果更佳,可为临床上及早识别及干预MHD患者MACE发生提供参考依据。

一种基于云端的老人摔倒告警系统

老人摔倒可能导致严重后果。鉴于此,开发一种基于云端的老人摔倒检测和告警系统或可避免此类问题。该系统采用STM32F103C8T6单片机作为主控,用传感器MAX30100采集老人的心率和血压值,传感器MPU6050采集老人摔倒的角度及加速度,A/D转换器转化为数字量,借助I2C总线把数字量送至微控制器,用ATK-1218-BD模块实现老人定位,ESP8266-01模块将采集的数据上传至云端,通过手机APP显示。系统可以监测老人当前状态,快速辨别其身姿,获取位置信息,满足实时监测和摔倒报警的要求。测试结果表明:系统总体布局合理,方案可行,运行稳定,误差不超过1%,实现了较精准的身姿识别,达到摔倒报警及远程监测的目的。

基于家庭远程血压/心率监测系统的医院外心衰管理效果观察

目的分析家庭远程血压/心率监测在左心力衰竭(心衰)合并高血压患者中的医院外应用效果。方法前瞻性选取2020年7月至2021年6月粤北人民医院心血管内科住院确诊为左心衰合并高血压患者420例,根据患者出院后是否同意进行家庭远程血压/心率监测分为远程监测组(112例)和常规随诊组(278例)。远程监测组每天早、晚进行血压和心率测量并上传数据至医护终端,医护团队根据测量结果及时指导患者生活方式、用药及进一步治疗;常规随访组自行测量血压和心率并登记,定期门诊随诊。记录2组患者出院后第1、3、6、12个月血压和心率控制值,非计划再次入院率及时间间距,全因死亡和心血管疾病死亡情况。结果远程监测组患者出院后第1、3、6、12个月收缩压,以及出院后第6、12个月心率均明显低于常规随访组,非计划再次入院率明显低于常规随访组,再入院时间间距明显长于常规随访组,差异均有统计学意义(P<0.05);2组患者全因死亡率、心血管疾病死亡率比较,差异均无统计学意义(P>0.05)。结论家庭远程血压/心率监测有利于平稳控制心衰合并高血压患者出院后的血压和心率,延迟患者再入院时间间距,降低患者再住院率。

关于北京市科技工作者精神压力与心脏损伤的研究

为研究北京市科技工作者精神压力与心脏损伤的关系,以155名北京市科技工作者为研究对象,测量相关指标。结果表明,样本群体中心血管疾病占比20.6%,抑郁占比35.9%,焦虑占比24.8%,失眠占比38.8%。在应对精神压力应激时,科技工作者血压、心率均较静息时明显升高,心率变异性指标中SDNN(Standard deviation of NN intervals,RR间期标准差)下降、LF/HF(low frequency/high frequency,低高频比值)升高,反映样本群体在精神压力应激时心脏交感副交感神经失衡。通过远程心电监测,发现科技工作者在居家时存在异常心电活动,包括各类心律失常、心电图ST-T改变(ST为心室肌除极过程,T为心室肌复极过程)等。基于以上结果,建议定期给科技工作者提供心脏心理的检测,必要时提供远程的心电监测,及时发现科技工作者的心脏心理问题,对有必要进行干预的人员,及早提供干预措施,以保障科技工作者的心脏心理健康。

大气碳颗粒暴露对成人心脏自主神经功能和血压的影响

目的 评估大气碳颗粒物暴露对成人心脏自主神经功能和血压的影响。方法 采用定组研究设计,从2014年11月24日到2016年1月18日,对在北京大学校园内招募的73例健康成人进行4次随访,每次随访收集研究对象调查问卷、空腹静脉血和尿样样本,以及24 h动态心电图和动态血压。采用广义线性混合模型分析黑炭、紫外线吸收颗粒物(ultraviolet absorbing particulate matter,UVPM)及不同排放源黑炭暴露与心率变异性和血压的关联。结果 急性暴露于黑炭、UVPM与心率变异性降低和血压升高具有显著正向关联。累积暴露12 h,黑炭和UVPM每升高1个四分位间距浓度,高频功率(high frequency,HF)、低频功率(low frequency,LF)和极低频功率(very low frequency,VLF)下降5.2%(95%CI:-6.8~-3.5)~11.7%(95%CI:-14.9~-8.3),LF/HF上升7.4%(95%CI:5.6~9.2)~10.2%(95%CI:8.0~12.4),血压水平升高0.8%(95%CI:0.3~1.3)~1.9%(95%CI:1.1~2.7)。不同来源黑炭与心率变异性和血压指标的关联分析显示,生物质燃烧和交通来源的黑炭均与心率变异性降低和血压升高有显著关联,其中交通源黑炭的不良心血管效应更大。结论 碳颗粒物,特别是交通源碳颗粒物,可引起成年人心率变异性降低和血压升高。

含糖透析液对合并糖尿病的维持性血液透析患者血糖、血压和心率变异性的影响

目前研究提示含糖透析液可有效稳定血糖水平,显著减少透析低血糖事件发生,同时有助于稳定血压和改善心率变异性,对心脑血管风险较高的糖尿病患者尤为重要。这些发现揭示了含糖透析液在提升糖尿病患者透析治疗质量中的潜在价值。然而,针对其长期应用的安全性和有效性,仍需进一步的研究探讨。本文就含糖透析液对合并糖尿病的维持性血液透析患者在透析期间对血糖、血压及心率变异性的影响进行综述,旨在探究含糖透析液在糖尿病维持血液透析治疗中的临床应用价值,为临床决策提供科学依据及研究方向。

改良动态ROX指数对急性呼吸衰竭患者HFNC治疗失败的预测价值

目的 分析改良动态ROX指数对急性呼吸衰竭患者高流量鼻导管(HFNC)治疗失败的预测价值。方法 选取2021年3月至2023年3月的急性呼吸衰竭患者102例,HFNC成功66例,失败36例,改良ROX指数为PaO_(2)/FIO_(2)与RR×HR的比值×100,动态指数定义为HFNC前与HFNC 2 h指数的差值,分析不同指数对HFNC失败的预测效能及相关因素。结果 HFNC失败组年龄、APACHE II评分高于HFNC成功组。HFNC 2 h时,HFNC成功组HR、RR和FiO_(2)低于HFNC失败组,SpO_(2)、PaO_(2)、PaCO_(2)、SpO_(2)/FIO_(2)和PaO_(2)/FIO_(2)高于HFNC失败组。HFNC成功组HFNC持续时间、HFNC 2 h ROX,动态ROX,HFNC 2 h改良ROX和改良动态ROX指数均高于HFNC失败组。动态ROX、HFNC 2 h改良ROX和改良动态ROX的AUC(95%CI)分别为0.703(0.590~0.790)、0.726(0.622~0.829)和0.811(0.717~0.902),临界值分别为0.97、6.78和0.12。对混杂因素进行调整后,动态ROX>0.97、HFNC 2 h改良ROX>6.78和改良动态ROX>0.12是HFNC失败风险降低的影响因素。结论 改良动态ROX指数可早期预测HFNC预后,改良动态ROX>0.12和HFNC 2 h改良ROX>6.78在预测急性呼吸衰竭患者HFNC失败风险方面表现良好。

探讨参松养心胶囊联合美托洛尔缓释片治疗老年冠心病室性期前收缩的临床疗效

目的探究老年冠状动脉粥样硬化性心脏病(简称冠心病)室性期前收缩采取参松养心胶囊联合美托洛尔缓释片的治疗效果。方法随机选取2021年6月-2023年6月淄博市中医医院收治的100例冠心病室性期前收缩患者为研究对象,按照不同治疗药物分成单一组与联合组,每组50例。单一组的患者采取美托洛尔缓释片进行治疗,联合组的患者采取美托洛尔缓释片联合参松养心胶囊进行治疗。比较两组患者不同用药之后的治疗效果、血压、不良反应等情况。结果联合组患者的治疗总有效率为88.00%,高于单一组的72.00%,差异有统计学意义(χ^(2)=4.000,P<0.05)。治疗后,联合组患者的心率、血压水平、室性期前收缩次数低于单一组,差异有统计学意义(P均<0.05)。两组不良反应比较,差异无统计学意义(P>0.05)。结论采取参松养心胶囊联合美托洛尔缓释片能够有效地提高患者的治疗效果,改善患者的心率以及血压水平,降低室性期前收缩次数,且联合用药方式安全性较高。