常规心电图缺血分级联合动态心电图心率变异性对急性脑梗死程度的预测价值

目的分析常规心电图缺血分级联合动态心电图心率变异性对急性脑梗死(ACI)程度的预测价值。方法回顾性分析2021年7月至2023年7月在我院治疗的154例ACI患者病历资料,根据美国国立卫生研究院卒中量表(NIHSS)评分将患者分为轻度组(NIHSS评分≤5分,36例)与中重度组(NIHSS评分>5分,118例),比较两组患者一般资料、常规心电图缺血分级、动态心电图心率变异性情况,采用Logistic回归分析ACI严重程度的独立危险因素,采用受试者工作特征(ROC)曲线评估常规心电图缺血分级、动态心电图心率变异性对ACI程度的预测价值。结果两组患者高血压、常规心电图缺血分级、动态心电图心率变异性[PNN50、rMSSD、SDNN]比较有统计学差异(P<0.05)。Logistic回归分析结果显示:常规心电图缺血分级、PNN50、rMSSD、SDNN是影响ACI严重程度的独立危险因素(P<0.05)。ROC曲线分析常规心电图缺血分级联合动态心电图心率变异性对ACI程度的AUC为0.995(95%CI:0.874-0.995),灵敏度为89.80%,特异度为99.20%优于常规心电图缺血分级、PNN50、rMSSD、SDNN各指标单独预测指标0.675(95%CI:0.573-0.778)、0.834(95%CI:0.726-0.942)、0.813(0.740-0.886)、0.608(95%CI:0.477-0.740)。结论常规心电图缺血分级、动态心电图心率变异性[PNN50、rMSSD、SDNN]水平是判断ACI病情严重程度的独立危险因素,常规心电图缺血分级、动态心电图心率变异性针对ACI程度均具有较高的预测价值,且将两者联合应用可有效提高各指标单独应用时的效能。

高频心电图和心率变异对小儿病毒性心肌炎的应用价值

目的 联合应用高频心电图和心率变异对小儿病毒性心肌炎进行检测用以探讨其应用价值。方法 选小儿病毒性心肌炎118例,对照组208例,两组按年龄分为学龄前组(1～6岁)、学龄期组(7～14岁)。分别统计其高频切迹总数、心率变异时域指标SDNN 、rMSSD、HRVI、PNN50和频域指数LF/HF进行对比分析,并对57例经过治疗的患儿复查观察各数值。结果 心肌炎组高频切迹明显增多,阳性率共95例占80.5%,对照组阳性率9例为5.4%,两者有非常显著性差异(p<0.01),心肌炎组与对照组的心率变异各指标比较显示, 学龄前心肌炎组的SDNN、 rMSSD、HRVI有显著性差异(p<0.01),而学龄期组除SDNN之外其余均有显著性差异(p<0.01),心肌炎组心电图异常共53例占44.9%,高频心电图阳性与心电图异常两者有非常显著性差异(p<0.01),而高频心电图阳性同时合并心率变异性低下(以SDNN、rMSSD、HRVI低于对照组计)共83例占70.3%,与心电图异常比较有非常显著性差异(p<0.01)。经治疗后的57例患儿有45例转为阴性,心率变异指标均有回升。结论 高频心电图对小儿病毒性心肌炎的诊断率优于常规心电图。高频心电图能反映心肌损害,而心率变异提供心脏自主神经调控信息,联合应用对于及早诊断小儿病毒性心肌炎及动态观察病情转归、指导治疗有很好的价值。

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.

Analysis of Heart Rate Variability in Chinese PLA Navy Global Visiting Task Group

Objective： To analyze the heart rate variability in Chinese PLA navy global visiting task group. Methods：We analyzed the heart rate variability in Holter in 77 men and 4 women for 5-15 days before voyage, and 65-75 and 115-125 days after voyage, and 29 men and 3 women for 5-15 days after having finished voyage. Results：NN50 and VLF were lower in 77 men and 4 women for 65-75 days after voyage than that was 5-15 days before voyage （P＆lt;0.01）. SDANN was lower in 77 men and 4 women for 115-125 days after voyage than that was 65-75 days after voyage （P＆lt;0.01）. SDNN, SDANN, SDNN index, RMSSD, NN50, PNN50,Triangular index, VLF, HLF, VAI and VLI were lower in 77 men and 4 women for 65-75 days after voyage than that was 5-15 days before voyage （P＆lt;0.01）.Conclusion： These findings suggest that voyage may reduce heart rate variability for a long time.