急性饮酒对青年心率变异的影响及性别差异研究

目的通过检测轻度急性饮酒前后心率变异性指标,评价酒精对于自主神经活动影响的性别差异。方法20例健康志愿者．其中男性10例．年龄（20．1±0．6）岁：女性10例．年龄（19．6±0．8）岁。根据受试者体质量计算乙醇溶液饮用量（0．27g／kg）。分别在饮酒前和饮酒后15min、45min共3次记录心电信号．提取RR间期时间序列,计算心率变异性（HRV）评价指标,包括时域参数RR间期的平均值（RRI）、全部RR间期标准差（SDRR）、全程相邻RR间期之差的均方根（RMSSD）、相邻RR间期之差大于50ms的心搏动数占总心搏动数的比例（pNN50）,频域参数低频频段（LF）、高频频段（HF）和LF／HF,Poincar6图参数宽度（短轴,SDl）、长度（长轴,SD2）和SDl／SD2。结果时域参数、频域参数和P0inca诺参数存急性饮酒后降低。对于RMSSD和SDRR参数．仅在女性受试者中观测到饮酒45min后降低．差异均具有统计学意义（P〈0．05）。对于LF和SDl参数在饮酒后15min即观测到在男性受试者中降低,差异均具有统计学意义（P〈0．05）。结论少量的急性饮酒降低了心率变异程度．酒精抑制了副交感神经的活动度．女性比男性对酒精的敏感程度更高．男性自主种经活动对酒精影响的响应时间更短。     

ACEI及ARB对寒冷所致的高血压病人循环系统反应的干预

目的 为了探讨血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体阻滞剂（ARB）对寒冷所致的高血压病人循环系统反应的影响。方法 111例血压控制稳定的高血压病人分成ACEI治疗、ARB治疗组及对照组3组，观察气温骤降前后血压和心率变化。结果 ①3组病人气温骤降前血压控制均达到目标血压；②气温骤降后，ARB治疗组收缩压、舒张压无明显上升，其余各组收缩压、舒张压均明显上升；心率3组均无明显变化；③与对照组比较，ARB组寒冷所致的收缩压上升幅度明显减少；④与对照组比较，ACEI及ARB组寒冷所致的舒张压上升均轻度减少（P＞0．05），但无统计差异，心率变化亦无差异。结论 ACEI未能有效地阻断高血压病人寒冷所致的循环系统反应，亦不比其它降压药优胜；但ARB能有效地阻断高血压病人寒冷所致的循环系统反应，且明显优胜于其它降压药。     

少量饮酒的心血管反应及其与性格特征的关系

本文研究了大学生饮酒前后心血管系统功能的变化,并观察了个性特征与饮酒后心血管系统反应之间的关系,结果表明:小量酒(约相当于个体血夜部量的0.1％的酒精量)饮入后部分被试的心输出量、心率、收缩压均比饮洒前显著增加,指容积脉搏皮的射血时间缩短,女性受试者压力脉搏由主动脉传到指尖小动咏所需时间亦减少。 不同性格的人对酒精的反应不同,外倾性格者饮酒后的反应比内倾性格者反应增强。 小剂量的酒精对人体的舒张压影响不明显。 上述结果对某些个体,尤其是外倾性格者的卫生保健提供某些参考依据。     

氦—氖激光血管内照射改善妊高征患者血液粘度的临床观察

目的：探讨低能量He－Ne激光血管内照射血液（ILIB）改善妊高征患者血粘度与临床疗效的关系。方法：对35例妊高征病例采用ILIB治疗，观察治疗前后血液流变学的改变，以及血压、头痛、头晕等症状的变化。结果：治疗后全血粘度均下降（P＜0．01或P＜0．05），收缩压，舒张压下降明显（P＜0．01），临床症状改善明显。结论：ILIB能显著降低妊高征患者的血粘度，同时降低血压，改善临床症状。     

运动疗法在脑梗死患者中后期康复中的应用效果

目的:研究运动疗法在脑梗死患者中后期康复中的应用效果。方法:收集2013年1月~2015年8月绵阳四O四医院收治脑梗死患者中后期80例,随机分为两组,各40例,观察组为有氧训练,对照组为抗阻训练,比较两组患者血压变化、美国国立卫生研究院卒中量表(NIHSS)评分变化、脑血肿消失时间、自主神经功能变化及生存质量。结果:两组患者运动前后收缩压和舒张压均明显下降,且差异具有统计学意义(P0.05),运动后观察组与对照组相比,收缩压下降幅度差异明显,有统计学意义(P0.05);运动后观察组NIHSS评分显著低于对照组,脑血肿消失时间短于对照组(P0.05);运动后观察组RR间期均值、每天RR间期标准差值、每5 min内RR间期平均值的标准差以及每5 min内RR间期标准差的均值均低于对照组,差异具有统计学意义(P0.05);运动后观察组生存质量各维度评分均显著高于对照组(P0.05)。结论:有氧运动相对抗阻运动,更能改善老年脑梗死患者中后期自主神经功能及生存质量,可在临床上加以推广应用。     

心率变异性生物反馈对高血压前期患者应激反应的干预效果

目的探讨心率变异性生物反馈（HRV BF）干预高血压前期患者心血管应激反应的效果。方法比较高血压前期者与正常血压者应激反应上血压变化的差异;将36位高血压前期受试者随机分为心率变异性生物反馈（HRV BF）组、慢腹式呼吸（SAB）组和空白对照组。干预组受试者接受每次30 min,每周2次,持续2个月共15次的训练;空白对照组不予干预。实验间隔期嘱受试者每天进行不少于20 min的家庭训练。所有受试者在实验开始前及实验结束后均接受连续2 d同一时间点进行的两种应激测试。结果高血压前期者较正常血压者在应对心算应激时收缩压和舒张压反应性更大。干预2个月后,HRV BF和SAB组收缩压和舒张压平均降压幅度分别为15.4/10.2 mmHg、11.6/7.4 mmHg;空白对照组干预后血压无明显变化。HRV BF能显著降低受试者心算应激时收缩压反应性,较SAB更为明显。结论高血压前期者应激反应性较高,HRV BF训练可以降低受试者应对心理应激时心血管的反应,并降低高血压前期者血压。     

体外反搏对血液流变性和血小板聚集性的影响

观察４０例心脑血管疾病患者体外反搏前后血液流变性和血小板聚集性变化。结果表明，反搏后全血比及还原比粘度、血浆粘度有不同程度的下降（Ｐ＜０．０５～０．０１）。反搏治疗后，１～５ｍｉｎ血小板聚集率、最大聚集率和最大聚集速度较反搏前均明显降低（Ｐ＜０．０５～０．０１），而５ｍｉｎ解聚率则明显增加（Ｐ＜０．０５）。提示体外反搏治疗不仅影响血液动力学，而且明显降低血液粘度，对血小板聚集功能有明显抑制作用。     

酒精所致精神障碍病人临床分析

随着人民生活水平的提高，因酒依赖、酒中毒住人精神科病人明显增多。不仅影响病人的躯体和精神健康，也给家庭和社会带来诸多问题．本文对酒精所致精神障碍者临床资料分析如下。1一扭资料48例均为汉族男性，年龄28～60岁；工人40例，农民4例，干部《例；小学文化IO例，初中33冽，高中5例；已婚36冽，未婚2例，离婚10例，夫妻不和28例。家庭文：父兄大量饮酒或有酒中毒史者8例，其它精神病史者2例。饮酒情况；饮酒史8～32年，口饮酒（白酒）量450～3000ml．诊断：酒依赖10例，各种酒精中毒性精神障碍38冽。住院次数1～12次。2临床表现人格…     

ACEI及ARB对寒冷所致的高血压病人循环系统反应的干预

目的为了探讨血管紧张素转换酶抑制剂(ACEI)和血管紧张素受体阻滞剂(ARB)对寒冷所致的高血压病人循环系统反应的影响. 方法 111例血压控制稳定的高血压病人分成ACEI治疗、ARB治疗组及对照组3组,观察气温骤降前后血压和心率变化. 结果①3组病人气温骤降前血压控制均达到目标血压;②气温骤降后,ARB治疗组收缩压、舒张压无明显上升,其余各组收缩压、舒张压均明显上升;心率3组均无明显变化;③与对照组比较,ARB组寒冷所致的收缩压上升幅度明显减少;④与对照组比较,ACEI及ARB组寒冷所致的舒张压上升均轻度减少(p>0.05),但无统计差异,心率变化亦无差异. 结论 ACEI未能有效地阻断高血压病人寒冷所致的循环系统反应,亦不比其它降压药优胜;但ARB能有效地阻断高血压病人寒冷所致的循环系统反应,且明显优胜于其它降压药.     

老年高血压患者的心理护理

探求分析老年高血压患者实施心理护理能否降低血压、提高治疗效果。方法采取随机抽样的方法分成2组，每组45例，对照组按常规护理，观察2组病人血压差值有无差异。结果收缩压（P〈0．05）血压下降有差异，舒张压（P〈0．01）血压下降较对照组有明显差异．结论老年高血压患者实施心理护理后血压下降较对照组明显。     

Compression on trigger points in the leg muscle increases parasympathetic nervous activity based on heart rate variability

Massotherapy, the therapeutic use of massage, is used to treat various chronic pain syndromes. One type of massotherapy, pressure stimulus applied over trigger points (TPs), is reported to have excellent therapeutic effects. Its effect is possibly mediated through changes in the autonomic nervous system although little research has been conducted to assess autonomic activity during TP compression. We have investigated how compression applied over TPs affects the autonomic nervous system. Six healthy young adult females whose daily working routine was carried out predominantly in a standing position were enrolled in the study cohort. After a day's work, the subjects were asked to rest supine, and electrocardiograms (ECGs), instantaneous lung volume (ILV) and systolic and diastolic blood pressures (SBP, DBP) were measured before and after pressure application over the TPs in those lower limb muscles where the subjects felt muscle fatigue or discomfort. The subjects were also asked to coordinate breathing with the beeping sounds. The therapeutic effects of TP compression were assessed by a subjective fatigue scale. Parasympathetic nervous activity was also assessed by spectral analysis of heart rate (HR) variability. The transfer function from ILV to HR was evaluated using linear analysis. The results indicated that TP compression (1) decreased HR, SBP and DBP, (2) increased parasympathetic activity, (3) increased the gain from ILV to HR, and (4) improved the fatigue scores. These findings suggest that an increase in parasympathetic nervous activity after the TP compression induced a reduction of fatigue. The therapeutic mechanisms of TP compression to enhance parasympathetic nervous system are discussed.     

Achieving haemodynamic baseline values with Finapres in elderly subjects during supine rest.

BACKGROUND: Clear guidelines for the resting time necessary to achieve stable blood pressure (BP) levels are scant in gerontology research. Therefore, we aimed to determine the minimum period required for obtaining haemodynamic baseline values in elderly subjects during supine rest. In addition, we evaluated the effect of cardiovascular morbidity, such as diastolic heart failure, and the effect of complex comorbidity of geriatric patients, on haemodynamic changes during supine rest. METHODS: A total of 17 healthy subjects, 18 heart failure patients with normal systolic function and 24 geriatric patients, aged 70 years and more, participated. After an overnight fast, changes in systolic BP (SBP), diastolic BP (DBP), heart rate (HR), and stroke volume (SV) were determined by Finapres beat-to-beat non-invasive BP monitoring during a 20-min supine rest. The procedure was repeated in the healthy subjects and geriatric patients on a second day. RESULTS: Complete BP stabilization was reached in each group within 5 min of supine rest, as SBP remained essentially unchanged and DBP did not change significantly anymore after the fourth minute. In the heart failure patients, HR decreased and SV increased until the twelfth minute of rest. The SBP, DBP, HR, and SV changes during supine rest showed good reproducibility. CONCLUSIONS: A span of 5 min of supine rest ensured achievement of reliable and reproducible baseline BP values by Finapres in elderly subjects. However, we recommend at least 12 min of rest to obtain full haemodynamic stability in elderly patients with diminished cardiac compliance and diastolic function.     

Analysis of correlation between physical training and autonomic function by using multivariate analysis: establishing an indicator of health]

The purpose of this study is to assess the effects of physical training on autonomic nervous function. Twenty-two healthy subjects(12 males and 10 females) participated in this study. We inquired contents of the exercise for each subject. Continuous ECG was recorded during 320 seconds at supine resting. Respiratory rhythm was fixed at 0.25 Hz(15 time/min). On the basis of spectral analysis of heart rate variability, the autonomic nervous function was assessed by low frequency power(LF: 0.06-0.13 Hz) and high frequency power(HF: 0.16-0.50 Hz). The predominance of sympathetic nervous activity were indicated by the LF/HF and LF-HF. Relationship between physical training and autonomic function was analyzed by using multivariate analysis(partial correlation analysis). As the results, LF power and LF-HF negatively correlated with training time per day, energy expenditure per day, energy expenditure per week, and total energy expenditure, respectively(p < 0.05). HF power positively correlated with energy expenditure per day, energy expenditure per week, and total energy expenditure, respectively(p < 0.05). These results indicate not training time but energy expenditure alters the autonomic nervous function. This index may be useful for evaluating training effect on the promotion of health.     

AUTONOMIC BALANCE CHANGES DURING THE HUMAN MENSTRUAL CYCLE

Five female students were each tested 5 days a week throughout one menstrual cycle with a 3 day overlap into the next cycle. The autonomic variables reported are: sub-lingual temperature, heart period, diastolic blood pressure, palmar and volar conductance, salivary output, and log conductance change. These measures were taken in order to estimate autonomic factor scores (ā). Significant menstrual phase differences in ā scores and sub-lingual temperature were demonstrated. The ā score estimates an autonomic factor for an individual at a particular time; low scores represent relative sympathetic nervous system (SNS) dominance. During menses, the follicular, and the ovulatory phases, ā scores were higher; during the luteal phase the ā scores were lowest. It was concluded that high estrogen levels are accompanied by decreased SNS function.     

Autonomic nervous control of heart rate at altitude (5050 m)

To investigate possible changes in autonomic regulation of heart rate as a result of acclimatization to high altitude, indexes of autonomic nervous activity were obtained non invasively by spectrum analysis of heart rate variability on five healthy male subjects [age, 31 (SEM 2) years] during a postural change from supine to seated, both at sea level and after 1 month of exposure to an altitude of 5050 m. Heart rate fluctuations at the respiratory frequency (high frequency, HF) are mediated by the parasympathetic system whereas fluctuations at about 0.1 Hz (low frequency, LF) are due to both sympathetic and parasympathetic nervous systems. Maximal heart rate, as measured during an incremental exercise test, decreased from 184 (SEM 5) beats · min^–1 at sea level to 152 (SEM 2) beats · min^–1 at 5050 m. At sea level, the change in posture from supine to seated induced an increase in LF amplitude accompanied by an increase or a decrease in HF amplitude, whereas after 1 month at altitude the HF amplitude decreased in all subjects, with little or no change in LF amplitude. These results indicate a changed strategy of heart rate regulation after acclimatization to high altitude. At sea level, the postural change induced an increase in sympathetic activity in all subjects with different individual vagal responses, whereas at altitude the postural change induced a net decrease in vagal tone in all subjects, with little or no change in sympathetic activity. These results corroborate the reported reduced sensitivity of the heart to adrenergic drive in chronic hypoxia, which may, at least in part, explain the decreased maximal heart rate in altitude-acclimatized human subjects.     

心室复极化时程与自主神经系统关系的研究

目前,随着心血管疾病日益增多,国外有少量研究者开始分析心室极化时程变异（Ｒｅｐｏｌａｒｉｚｔｉｏｎ ｄｕｒａｔｉｏｎ ｖａｒｉａｂｉｌｉｔｙ,ＲＤＶ）某些心脏疾病会在心室复极化时程上会有所表现。我们用乌拉坦麻醉大白鼠,研究用阿托品阻断迷走神经前后,ＲＤＶ的变化规律。通过正常人体位变化来改变人体自主神经系统的平衡状态,以研究心室复极化时程与自主神经系统的关系,发现大白鼠的ＨＲＶ和ＲＤＶ的谱分析的峰值     

围产期母亲和胎儿心动周期信号分析

同时分析围产期胎儿和孕妇心动周期信号的数字特征(混沌和谱特征)以评价自主神经系统功能。用可视化程序设计的方法实现提取和分析围产期母亲和胎儿心动周期信号。受试者取仰卧位，心电信号从置于腹壁下部耻骨联合导联获得。胎儿心电信号用小波分解进行信号预处理。采用本实验室已经完成开发的技术实现心动周期信号数字特征的分析。该系统可以评价胎儿和孕妇的自主神经系统功能，特别是分别定量评价交感和副交感神经系统功能；该系统还可用以预测胎儿窘迫。胎儿和其它年龄段的心动周期信号数字特征随年龄的变化提示了自主神经系统的发育、成熟和衰老的生理过程，基于这一点我们可以寻找抗衰老的方法；胎儿的心动周期信号数字特征介于新生儿和成人之间，提示胎儿的自主神经系统的调节可能受母体神经内分泌系统的影响。     

Verylow frequency variability in arterial blood pressure and blood volume pulse

Several parameters of the cardiovascular system fluctuate spontaenously owing to the activity of the autonomic nervous system. In the study, the simultaneous very low frequency (VLF) fluctuations of the arterial blood pressure, the tissue blood content and the tissue blood volume pulse are investigated. The latter two parameters are derived from the baseline BL and the amplitude AM of the photoplethysmographic (PPG) signal, measured on the fingertips of 20 healthy male subjects: the changes in the PPG parameters AM and BV, defined by BV=const.-BL, are related to the change in the tissue blood volume pulse and the total tissue blood volume, respectively. The VLF fluctuations in BV and AM are directly correlated, those of AM preceding those of BV by 4–13 heart-beats. The VLF fluctuations in the systolic (SBP) and the diastolic (DBP) blood pressure are inversely correlated to those of AM and BV, those of AM preceding those of SBP and lagging behing those of DBP by about one heart-beat. For most subjects, the period P of the PPG pulse, which is equal to the cardiac cycle period, directly correlates with AM and BV and inversely correlates with DBP and SBP. On average, the fluctuations fluctuations in tissue blood volume, systolic blood volume pulse, diastolic and systolic blood pressure, and heart period, together with their interrelationship, can provide a better understanding of the autonomic nervous control of the peripheral circulation and a potential tool for the evaluation of its function.     

A non-invasive approach to cardiac autonomic neuropathy in patients with diabetes mellitus

The purpose of this study was to obtain information regarding the participation of the sympathetic nervous system in cardiac autonomic neuropathy in patients suffering from diabetes mellitus employing spectral analysis of heart rate variability in the supine and standing posture. Ten insulin-dependent diabetic patients (29 +/- 2 years) with a short to moderately long duration of diabetes (11 +/- 1 years) and cardiac vagal neuropathy based on measurements of respiratory sinus arrhythmia were compared to 10 healthy volunteers (27 +/- 1 years) before and after the administration of atropine and atropine plus propranolol. In diabetic patients the reactivity in total power (delta TP) from supine to upright position was significantly lower compared to control subjects before and after atropine. There was no significant difference in delta TP between diabetics and controls after atropine plus propranolol. The magnitude of TP increase is essentially due to the increase of blood pressure related heart rate fluctuations (delta MF) from lying to standing and dependent on beta-adrenergical efferent activity to the heart. In diabetic patients as well as in normal subjects under the influence of atropine plus propranolol the delta MF power was significantly lower compared to the unmedicated control and atropine group. There was no significant difference between diabetics and controls after combined autonomic blockade. It was concluded that delta MF heart rate spectral power could serve as an indirect, non-invasive, quantitative and sensitive marker of early cardiac sympathetic damage.