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.

Analysis of heart rate variability based on singular value decomposition entropy

Assessing the dynamics of heart rate fluctuations can provide valuable information about heart status. In this study, regularity of heart rate variability （HRV） of heart failure patients and healthy persons using the concept of singular value decomposition entropy （SvdEn） is analyzed. SvdEn is calculated from the time series using normalized singular values. The advantage of this method is its simplicity and fast computation. It enables analysis of very short and non-stationary data sets. The results show that SvdEn of patients with congestive heart failure （CHF） shows a low value （SvdEn： 0.056±0.006, p 〈 0.01） which can be completely separated from healthy subjects. In addition, differences of SvdEn values between day and night are found for the healthy groups. SvdEn decreases with age. The lower the SvdEn values, the higher the risk of heart disease. Moreover, SvdEn is associated with the energy of heart rhythm. The results show that using SvdEn for discriminating HRV in different physiological states for clinical applications is feasible and simple.

Effects of Moxa (Artemisia Vulgaris) Smoke Inhalation on Heart Rate and Its Variability

Objective: To evaluate the changes of human heart rate (HR) and heart rate variability (HRV) during and after moxa smoke inhalation and to investigate the effects of moxa smoke on human autonomic nervous system. Methods: 24 healthy volunteers were exposed to moxa smoke with their HRV parameters measured before, during and after the moxa smoke inhalation. Results: The healthy volunteers exposed to moxa smoke had significant reductions in HR and also significant changes in HRV parameters. Conclusions: Moxa smoke can improve the autonomic nervous system activity. The inhalation of moxa smoke will induce a depressant effect on human body.

Relationship between hypothermia and heart rate yarialion in severe brain injury

AIM:To investigate effects of heart automatic nerve variations and hypothermia(HT) therapy on heart rate variation(HRV).METHODS:We studied the dynamic electrocardiagraph(ECG) of 41 cases of severe brain injury.The patients were devided into HT therapy group(n=21,body temprature 32-33℃),non-HT therapy group(n=20) and normal control(n=20).RESULTS:In group 1,the reduction of time domain indexes and frequency domain indexes were 3-6 folds and 30-50folds respectively compared with those of the control group,while the corresponding indexes reduction were 2-3 folds and 4-5folds in the group 2(P<0.05,P<0.01,respectively).The difference between groups were significant(P<0.05-0.01);the HRV reduction was more significant in the cerebrovascular accident patients than that of brain injured(P<0.05-0.01);the HRV indexes increased significantly in resuscitated patients than those in coma(P<0.01);the HRV in dead was much lower than that in survival(P=0.01).CONCLUSION:Injury of central nervous system can induce abnormal function of automatic nerve of heart and reduction of HRV.HT therapy can reduce HRV on a higher level;HRV examination can be applied into the prediction of prognosis of the brain injured.

An Intelligent Household Heart Rate Meter

The measuring instrument which uses Sunplus SPCE061A MCU as the controller is a practical intelligent household heart rate meter.It can serve all people timely and effectively to detect the heart rate.It rings some voice alarm if the HRV is abnormal.Then it is decided whether to see a doctor at a convenient time for further diagnosis.The instrument has a feature of voice guidance that can save keyboard steps,which extends the scope of use.All people,old and young,the blind and the deaf,can use it by themselves.

Clinical Teleacupuncture between China and Austria Using Heart Rate Variability in Patients with Depression

In previous studies by the same research group it has been shown in post-stroke patients that the autonomic system can be affected by acupuncture. Within this study, teleacupuncture between China and Austria is used for quantifying the effects of heart rate variability (HRV) in Chinese patients suffering from depression. In 22 Chinese depression patients (17 f, 5 m;mean age ± SD 52.3 ± 10.6 years;range 31 - 70 years) electrocardiographic signals before, during and after acupuncture at the acupoint Jianshi (PC 5) were recorded in Harbin and analyzed in Graz using teleacupuncture via internet. HRV data were analyzed in the time and frequency domain and a protocol from Austria was sent to the team in China immediately after the treatment and recording session. Mean heart rate decreased significantly (p < 0.001) during and after acupuncture, whereas total HRV increased significantly during (p < 0.034) and after (p < 0.001) acupuncture, always immediately following manual needle stimulation. Furthermore, there is a marked decrease in balance between sympathetic and parasympathetic activity (low frequency/high frequency HRV ratio) during treatment. This study shows that HRV could be a useful parameter for quantifying clinical effects of acupuncture on the autonomic nervous system. Teleacupuncture between China and Austria over a distance of more than 8,500 km has been successfully used.

The Effect of Breathing Route on Heart Rate Variability—A within Subject Comparative Study

Background: The effect of traffic related emissions on Heart Rate Variability (HRV) has been previously demonstrated. However, the results of different studies on the relationship between ambient pollutants and specifically carbon monoxide (CO) on HRV are inconclusive and appear to reflect personal differences. The differences in methodology including breathing style and participants under study can possibly attribute to this variability. The aim of the present study is to assess the effect of the breathing route (Nasal/Oral) on the relationship between CO concentration and HRV. Methodology: Forty healthy participants (25 females, 15 males) between the ages of 15 - 50 years were included in the study. The participants strolled in a central bus station, staying for 10 minutes in three designated locations alternating nasal and oral breathing. CO concentration and HRV were continuously monitored. Frequency (LnLF, LnHF, LnLF/HF) and time domain (LnSDNN, LnRMSSD) HRV indices were computed. Analysis: MANCOVA, with HRV indices being the dependent variables and CO, gender and age being the independent variables was employed. Results: Significant interaction effects between breathing route and CO, and breathing route and gender on HRV (LnLF/HF) were found (p = 0.04 and 0.01 respectively). Both CO and age were found to affect LnSDNN and LnRMSSD. Conclusion: Breathing route emerges as a possible modifier of the relationship between air pollution and HRV and thus contributes to interpersonal differences obtained in studies investigating the effect of environmental pollution and HRV.

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.

HGI联合基于Ewing的HRV诊断预测T2DM患者心脏自主神经病变的价值

目的探讨糖化血红蛋白变异指数(HGI)联合基于Ewing的心率变异性(HRV)诊断预测2型糖尿病(T2DM)患者心脏自主神经病变(DCAN)的价值。方法选取2020年1月至2022年2月在郑州市第九人民医院治疗的T2DM患者140例。以Ewing试验为诊断金标准,分析DCAN和非DCAN患者临床资料、Ewing-HRV诊断参数差异,同时分析发生DCAN的影响因素。结果DCAN发生率为47.14%。DCAN患者糖尿病病程、空腹血糖、糖化血红蛋白(HbA1c)和胰岛素抵抗指数(HOMA-IR)分别为(5.40±1.02)年、(12.01±1.18)mmol/L、(11.43±1.82)%和(6.20±1.02)显著高于非DCAN患者(P<0.05)。HGI为(-0.44±0.19)显著低于非DCAN患者(P<0.05)。伴有DCAN、伴有微血管病变和DCAN患者HGI明显低于单纯T2DM、伴有微血管病变患者(P<0.05);伴有微血管病变患者HGI明显低于单纯T2DM患者(P<0.05)。DCAN患者握力试验时高频功率(HF)、静息状态时LF/HF、Valsalva动作时低频功率(LF)分别为(119.20±12.01)ms^(2)、(3.12±0.83)和(210.10±22.43)ms^(2),显著低于非DCAN患者(P<0.05)。空腹血糖、HbA1c、HOMA-IR、HGI、握力试验时HF、静息状态时LF/HF、Valsalva动作时LF是患者发生DCAN的影响因素(P<0.05)。HGI预测DCAN的ROC曲线下面积为0.882(P<0.05)。HGI联合Ewing-HRV诊断预测DCAN的灵敏性和阴性预测值分别为96.97%和96.92%,明显高于单独应用Ewing-HRV诊断(P<0.05)。结论HGI联合Ewing-HRV诊断预测T2DM患者DCAN有一定应用价值,值得临床使用。

基于调频连续波雷达的人体生命体征检测算法

针对现有雷达非接触生命体征检测精度低、实时性差等问题,提出一种基于调频连续波(FMCW)雷达的人体生命体征检测算法。首先,通过毫米波雷达获取生命体征信号;其次,利用改进的经验小波变换(EWT)算法,实现生命体征信号的自适应分解和重构,通过引入麻雀搜索算法(SSA)和模糊熵(FE)寻找频谱分割线的最优值;最后,通过改进频率插值的估计算法计算心率和呼吸频率。通过与医用重症监护仪进行对比实验验证所提算法的优越性和鲁棒性。实验结果表明,所提算法相较于小波变换(WT)算法、CEEMD(Complementary Ensemble Empirical Mode Decomposition)算法和VMD(Variational Mode Decomposition)算法,均方误差(MSE)分别减小了77.65、27.25和21.05,平均绝对百分比(MAPE)分别减小了7.33、4.33和3.42个百分点,实时性分别提高了0.72 s, 16.74 s和1.87 s。同时,利用所提算法也实现了对心率变异性(HRV)的检测。

睡眠剥夺对矿工风险感知的影响研究:基于生理试验

为探究睡眠剥夺对矿工风险感知的影响机理及作用效果,将72名矿工被试分为控制组和睡眠剥夺组,通过2种睡眠状况(正常、睡眠剥夺)×2种任务片段(基线段、逃生任务片段)的试验设计,分别记录分析不同任务片段下皮肤电活动(Electrodermal Activity,EDA)和心率变异性(Heart Rate Variability,HRV)的部分指标的变化特征。试验结果表明:逃生任务可以有效激活矿工的风险感知,在执行逃生任务时,矿工的C_(S)、L_(SC)和F_(L)/F_(H)显著上升,I_(BI)和P_(NN20)显著下降;睡眠剥夺会损害矿工的风险感知能力,研究发现,控制组被试逃生任务片段唤醒情绪和打破交感神经平衡的程度更大。研究结果可为睡眠剥夺相关的生理研究提供证据和参考,有助于提高煤矿的安全生产水平。

基于HRV的北方林区冰雪道路驾驶疲劳分析

为提高林区冰雪道路行车安全性,探讨林区冰雪道路驾驶员心理与生理疲劳状态,针对东北林区冰雪道路环境特殊性,通过实驾试验采集驾驶员的心电信号,基于心率变异性(HRV)指标的有效定量评价,结合指标间的灰色关联度分析,研究东北林区冰雪道路环境下驾驶员的心率(HR)、R-R间期标准偏差(SDNN)、低频与高频比值(LF/HF)及相关维数(D2)4个指标值间的变化规律及其随时间的变化规律。结果表明,驾驶员在林区冰雪道路驾驶过程中,HRV指标与HR关联次序为SDNN,D2,LF/HF,驾驶员在林区冰雪道路行车初期驾驶员紧张程度大;连续行车驾驶员精神负荷与体力负荷都会增大,出现疲劳累积效应。

肥胖合并重度阻塞性睡眠呼吸暂停低通气综合征患者的心率变异性分析

目的探讨肥胖合并重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者的心率变异性(heart rate variability,HRV)特征。方法回顾性分析2018年4月至2022年5月在西安交通大学第二附属医院行多导睡眠(polysomnography,PSG)监测确诊为重度OSAHS的78例患者,根据身体质量(body mass index,BMI)将患者分为肥胖并重度OSAHS组(n=43)和非肥胖并重度OSAHS组(n=35)。所有患者行PSG监测同时接受24 h动态心电图监测,进行HRV指标的组间差异分析及与临床指标的相关性分析。结果基础指标及PSG指标分析结果显示,与非肥胖并重度OSAHS组相比,肥胖并重度OSAHS组体质量、BMI、颈围、腰围、呼吸暂停低通气指数(apnea hypopnea index,AHI)显著升高。组间HRV分析结果显示,与非肥胖并重度OSAHS组相比,肥胖并重度OSAHS组的24 h正常R-R间期标准差(standard deviation of R-R interval,SDNN)、5 min R-R间期均值标准差(standard deviation of the averages of 5-minute R-R intervals,SDANN)、三角指数(triangle index,TI)、心率减速力(deceleration capacity of heart rate,DC)、清醒期SDNN及睡眠高频功率明显降低(P<0.05)。相关性结果显示肥胖并重度OSAHS患者中相邻R-R间期差值均方根(root mean square of the difference of adjacent R-R interval,rMSSD)与高血压病程呈负相关,TI、DC与AHI呈负相关。经校正颈围和腰围后的线性回归分析显示SDNN、SDANN、rMSSD与收缩压相关(P<0.05)。结论肥胖并重度OSAHS患者存在HRV指标下降,自主神经功能受到损害,心血管疾病的发生风险增加。

公路线形复杂程度对驾驶员HRV的影响研究

通过检测驾驶员心理、生理指标,观察公路线形复杂程度对驾驶员心率变异性(HRV)的影响,研究不合理公路线形对驾驶员行车安全的影响。对内蒙古境内6条公路的线形资料进行调查统计,利用赋值打分法确定各自的复杂程度;选取典型路段进行实驾试验,通过二列相关系数的计算及相应检验,得到心率变异分析的敏感指标;进而分析公路线形复杂程度对驾驶员心理、生理的影响。结果表明,HRV指标间期均值(MRR)、低高频比值(LF/HF)、样本熵(Samp En)对公路线形复杂程度响应敏感;即复杂程度过低会导致驾驶员由于驾驶任务简单出现反应迟缓、注意力难以集中等现象,影响行车安全;复杂程度过高会使驾驶员时刻保持精神高度集中状态,容易提前产生疲劳,从而威胁行车安全。

基于时变滤波经验模态分解的非接触式心率变异性估计方法

民航从业人员的身体健康状况是影响航空安全的重要因素,其中呼吸和心跳是极其重要的健康状况表征。为解决接触式或穿戴式测量系统对人员工作时的局限与影响,可采用线性调频连续波(Frequency-modulated continuous wave,FMCW)雷达达到非接触式测量的目的。由于生命体征信号具有时变、非平稳的特点,针对经验模态分解(Empirical mode decomposition,EMD)在信号分解中存在模态混叠现象的问题,使用时变滤波经验模态分解(Time varying filtering based on EMD,TVF-EMD)自适应信号的局部截止频率,可有效提高信号分离性能,解决模态混叠问题。利用TVF-EMD分解出的本征模态函数(Intrinsic mode functions,IMF)分量重构心跳对应的时域信号,估计心跳信号的频率和心跳节拍间隔(Inter-beat interval,IBI),进一步对心率变异性(Heart rate variability,HRV)相关指标进行估计。仿真实验与实测数据处理结果表明,TVF-EMD可从毫米波雷达测量信号中有效分离出呼吸与心跳信号。同时,从模态混叠程度及信号分离性能两方面对TVF-EMD与EMD方法分解效果进行了仿真分析,结果表明TVF-EMD能够有效解决模态混叠问题。因此,TVF-EMD方法能够准确有效地从毫米波雷达测量信号中提取生命体征信息,为IBI估计和HRV分析提供准确的时域信息,具有广阔的应用前景。

曲美他嗪对于陈旧性心肌梗塞病人心率变异性/HRV干预影响的随机交叉研究

目的:研究曲美他嗪（Trimetazidine）对于处于常规治疗中的心肌梗塞后病人的心率变异性（heart rate variability,HRV）的影响。方法:冠心病陈旧心 肌梗塞病人（OMI）,共59对;男性55对,女性4对。配对主要条件为:性别、 年龄、梗塞部位、梗塞后心功能、梗塞后时间、高血压病史及分级、糖尿病史。 采用病例配对、随机、交叉、单盲的试验设计。HRV参数为:全部正常窦性心 搏间期标准差（SDNN）;全程5min时间段NN均值标准差（SDANN）;全部相邻NN间期之差的均方根值（RMSSD）;三角指数:NN间期的总个数除以NN间期直方图的高度（横坐标时间单位为1/128秒）。结果分析:组间差别分析采用方差分析（ANOVA检验）;两组样本均数差别分析采用t’检验。结果:综合总的交叉试验结果（上述4个HRV分析参数）显示:曲美他嗪处理组心率变异性（HRV）改变不十分确切（PSDNN<0.05,PSDANN>0.05,P RMSSD>0.05、P三角指数>0.05）。但对于陈旧性心肌梗塞后左室射血分数/LVEF≤40％病人组与>40％组的心率变异性（HRV）差别的分析结果显示:曲美他嗪组心率变异性值增加具有明显差别（P<0.05）。对于陈旧性心肌梗塞合并Ⅱ型糖尿病病人组与非合并组的分析结果显示:曲美他嗪处理组心率变异性值增加具有显著意义（P<0.05）。结论:应用曲美?

基于Teager算子的短时HRV样本熵算法

在心率变异性(HRV)数据的短时非线性分析中,单纯的样本熵算法不能有效提取健康人和充血性心衰(CHF)患者的信号特征差异。为此,提出一种基于Teager能量算子的样本熵分析算法。采用Teager算子的预处理捕获心脏动力学活动中的异常节律变化,以强化样本熵分析效果。对MIT BIH数据库中样本的实验结果表明,该算法可反映健康人与CHF患者的短时HRV信号非线性复杂性的差异,为计算机分析诊断心衰等疾病提供新的辅助依据。

HRV的最大李雅普诺夫指数估计

对心率变异性(HRV)进行了研究,比较了心率正常者与心率失常者HRV之间的最大李雅普诺夫指数上的差别。人在正常状态和病理状态下的HRV信号最大李雅普诺夫指数是不同的,当出现病理心血管事件时,指数α减少,因此李雅普诺夫指数可作为人体是否异常或处于何种异常状态的特征刻画指标,本文心率正常者HRV信号的最大李雅普诺夫指数为0.45907,心率不齐者的最大李雅普诺夫指数是0.41472。它们均为混沌信号,但是处于心率不齐状态的节律混沌程度明显比处于心率正常状态的节律混沌程度低。

沙库巴曲缬沙坦钠联合常规对症治疗射血分数保留心力衰竭患者的临床疗效及安全性研究

目的 观察沙库巴曲缬沙坦钠联合常规对症治疗射血分数保留心力衰竭(HFpEF)的临床疗效,并探讨其对患者心功能、心率变异、炎性因子、血管内皮功能和再住院率的影响。方法 选取2021年1月至2022年12月许昌医院收治的108例HFpEF患者作为研究对象,按随机数表法分为联合组和对照组各54例。对照组患者行常规的利尿药物、β受体阻滞剂、血管紧张素转换酶抑制剂等对症支持治疗,联合组患者则在对照组治疗的基础上联合沙库巴曲缬沙坦钠治疗。治疗8周后,比较两组患者的临床疗效,以及治疗前后的心功能指标[左心室射的血分数(LVEF)、左心室的收缩末期内径(LVESD)、左心室的舒张末期内径(LVEDD)]、心率变异性指标[24 h窦性心律R-R间期标准差(SDNN)、24 h相邻正常R-R间期差值>50 ms百分比(RNN50)]、炎性因子[血清白细胞介素(IL)-1β、IL-8]、血管内皮功能[一氧化氮(NO)、内皮素-1 (ET-1)]水平,同时比较两组患者治疗期间的不良反应发生率和治疗结束后随访3个月的再住院率。结果 治疗8周后,联合组患者的治疗总有效率为92.59%,明显高于对照组的70.37%,差异有统计学意义(P<0.05);治疗8周后,联合组患者的LVEF、RNN50、SDNN分别为(61.11±5.03)%、(12.01±2.24)%、(112.20±12.23) ms,明显高于对照组的(58.85±4.72)%、(10.31±1.89)%、(103.34±10.18) ms,而LVESD、LVEDD分别为(40.37±4.12) mm、(47.71±4.55) mm,明显低于对照组的(45.17±4.38) mm、(50.52±4.67) mm,差异均有统计学意义(P<0.05);治疗8周后,联合组患者的血清IL-1β、IL-8、ET-1水平分别为(9.94±1.25) ng/L、(53.53±5.04) ng/L、(82.26±7.05) ng/L,明显低于对照组的(15.76±2.21) ng/L、(76.67±7.11) ng/L、(88.18±8.24) ng/L,血清NO水平为(89.65±7.53)μmol/L,明显高于对照组的(70.52±6.61)μmol/L,差异均有统计学意义(P<0.05);治疗期间,联合组患者的并发症总发生率为12.96%,略高于对照组的9.26%,但差异无统计学意义(P>0.05);治疗结束后随访3个月,联合组患者因心衰再住院率为3.70%,明显低于对照组的16.67%,差异有统计学意义(P<0.05)。结论 沙库巴曲缬沙坦钠联合常规对症治疗HFpEF可进一步改善患者的心功能、心率变异及血管内皮功能,减轻炎性状态,降低再住院率,其临床疗效确切且具有较高的安全性。

心悸寒证与热证心率变异性(HRV)与自主神经张力(交感和迷走)相关分析

[目的]观察心悸寒/热证心率变异性(heart rate variability,HRV)与自主神经张力(交感和迷走)相关性。[方法]使用前瞻性设计,平行对照方法,将141例住院及门诊患者按寒热证候归入实热、实寒、虚热、虚寒4组。观测HRV指标,时域指标SDNN、SDANN、RMSSD,频域指标TP、LF、HF、LF/HF。使用DMS动态分析软件,人工修正、去除伪差,自动分析24h连续心电信号(动态心电图)后,获得HRV各项指标。[结果]寒热辨证分组:热证82例(58.2%,82/141),其中实热32例,虚热50例;寒证59例(41.8%,59/141),均为虚寒证。SDNN、SDANN、RMSSD热证与寒证组间均无显著差异(P>0.05),虚寒组均大于虚热组(P<0.05)。TP、LF、HF热证与寒证组间均无显著差异(P>0.05),LF/HF热证组高于寒证(P<0.05);频域指标TP、HF、LF/HF虚热与虚寒均有显著差异(P<0.05),TP、HF虚寒大于虚热(P<0.05),LF/HF虚热组大于虚寒组(P<0.05),LF组间无显著差异(P>0.05),[结论]虚实与自主神经总张力相关,寒热与自主神经功能交感和迷走神经的张力平衡相关,热证与寒证自主神经总体能量无显著差异(P>0.05),热证组交感活动相对增强。