健康人心率变异性分析

心率变异性（ＨＲＶ）分析是一种无创性检测心脏自主神经张力的方法，对指导疾病的治疗及某些疾病的预后判断有重要价值，它受多种因素的影响。ＨＲＶ测定由于操作方法，仪器，指标不尽相同，缺乏可比性，目前国内缺乏统一的正常值，为此，中华心血管病杂志编委会ＨＲＶ专题对策组于１９９７年参考了欧美两会拟定的标准化方案制定了全国ＨＲＶ分析研究协作组研究方案，并几经修改完善。作为该协作成员之一，该研究进行了健康人的ＨＲ     

健康人心率变异性的初步探讨

心率变异性（ＨＲＶ）是指心电图中连续正常ＱＲＳ波群之间变化的变异数。ＨＲＶ分析是一种无创的，可定量检测心脏植物神经系统活性的方法［１］；是一项预测心原性猝死的独立、敏感的指标［２］。但是，目前尚缺乏ＨＲＶ正常值的大样本研究。本文拟对健康人２４ｈＨＲＶ正常值进行研究，并初步探讨年龄、性别、昼夜因素对ＨＲＶ的影响。１对象与方法１．１对象　健康人选自１９９２年１０月～１９９４年５月来我院进行体检及部分自愿者，共１０６例，其中男７２例，女３４例，年龄２２～６３岁，平均４２．２岁。其中青中年组（＜４５岁）…     

年龄因素对健康人心率变异性的影响

目的探讨年龄因素对健康人心率变异性（ＨＲＶ）的影响。材料与方法将２３６例健康人分为五个年龄组，使用美国先进医用设备公司５．０版本ＨＲＶ软件做短时时域及频域ＨＲＶ分析。结果年龄因素对健康人ＨＲＶ短时时域和频域分析的多项指标产生显著影响，随着年龄增大，时域指标中的ＨＲＳＤ、ＳＤＡＮＮ、ｒＭＳＳＤ及ＰＮＮ５０均逐渐降低；随着年龄增长，频域指标中各频段下的绝对面积，即：ＶＬＦ、ＬＦ、ＭＦ及ＨＦ均逐渐降低；而频域指标中各频段下的相对面积，即：ＶＬＦＰ、ＬＦＰ、ＭＦＰ、ＨＦＰ随着年龄增长呈不同的发展趋势。ＬＦ／ＨＦ随着年龄的增加而逐渐升高。结论ＨＲＶ随着年龄的增加而下降，尤以迷走神经活性下降为显著。频域指标中各频段的相对面积较绝对面积能更敏感地反映交感、迷走神经张力的消长。     

阻塞性睡眠呼吸暂停综合征者心率变异的分析

０　引　　言阻塞性睡眠呼吸暂停综合征（ｏｂｓｔｒｕｃｔｉｖｅｓｌｅｅｐａｐｎｅａｓｙｎｄｒｏｍｅ,ＯＳＡＳ）患者常可发生心律失常等心血管并发症,成为夜间猝死的主要原因［１］。其发生机制认为与ＯＳＡＳ患者夜间睡眠期心交感神经与副交感神经的张力紊乱有关［２］。心率变异性（ｈｅａｒｔｒａｔｅｖａｒｉａｂｉｌｉｔｙ,ＨＲＶ）是近年来发展起来的一项无创、定量、能反映心交感与副交感神经张力状况的重要指标,国外已有研究提示,ＯＳＡＳ患者死亡率增高与ＨＲＶ的降低有关［３］。本研究就国人ＯＳＡＳ患者的ＨＲＶ状况作…     

不同年龄冠心病患者心率变异分析

为了分析不同年龄冠心病患者及正常人心率变异特点，本文对５６例冠心病患者及７２例健康人按年龄进行分组检测ＨＲＶ参数，并进行对比分析，结果：（１）年龄组冠心病民同组健康人比较，ＨＲＶ各参数显著降低；（２）老年冠心病患者ＨＲＶ较年轻冠心病患者亦明显降低；（３）健康人随关年龄的增加ＨＲＶ降低。     

高血压患者心率变异性的临床分析

心率变异性（ＨＲＶ）分析作为反映植物神经系统对心脏和血管调节动态平衡的无创指标已被人们公认,许多临床研究已证实ＨＲＶ的改变与多种疾病有联系。本文对５１例高血压病（ＥＨ）患者和３６例正常人的ＨＲＶ分析,以探讨高血压对心脏植物神经活动的影响,期望对预防和...     

小儿心率变异性的研究进展

心率变异性 (ＨＲＶ)是指连续心动周期间的时间变异数 ,即分析连续出现的正常Ｒ Ｒ间期之间的细微的时间变化及其规律。作为一种无创性的检测方法 ,ＨＲＶ可定量地反映心脏自主神经功能。目前关于成人ＨＲＶ已做了大量工作 ,并已证明ＨＲＶ在心肌梗死、糖尿病性神经病变、心力衰竭、阵发性心律失常、血管神经性晕厥、心脏移植等方面有重要的临床价值。但ＨＲＶ在儿科领域的研究与应用很少。本文主要对小儿ＨＲＶ的研究进展作一综述。　　ＨＲＶ的测定一、线性分析法　可分为时域法与频域法。(一 )时域法常用的指标　①统计法指标 :包括正常…     

心律变异非线性动力学分析的随机因素研究

本文结合生理意义讨论了外部噪声对心律变异（ＨＲＶ）非线性动力学分析的影响和ＨＲＶ 的自身随机性。分析了采样率、平稳性、非均匀时间间隔等因素的影响和去除,提出一种针对心动周期信号的内插算法。实验表明这些措施能改善分析效果。文中还从替代数据、交互信息、非线性预测等非线性动力学角度研究了ＨＲＶ的自身随机性,指出ＨＲＶ 是确定性混沌与随机过程的综合体。     

急性心肌梗塞后不同时期心率变异分析及其临床意义

近年来，自主神经对急性心肌梗塞（ａｃｕｔｅｍｙｏｃａｒｄｉａｌｉｎｆａｒｃｔｉｏｎ，ＡＭＩ）、心源性猝死的影响愈来愈引起人们的关注，目前，心率变异（ｈｅａｒｔｒａｔｅｖａｒｉａｂｉｌｉｔｙ，ＨＲＶ）分析作为定量分析自主神经活性的方法已被公认［１］...     

非胰岛素依赖型糖尿病患者的心率变异分析

探讨非胰岛素依赖型糖尿病患者自主神经变化与心率变异性的关系。方法ＮＩＤＤＭ患者和健康人各３０例，进行ＨＢＲ分析。结果和对照组相比ＮＩＤＤＭ组ＨＲＶ各指标均明显降低，ＨＲＶ和病程无关。结论ＨＲＶ分析是一种为临床早期发现ＮＩＤＤＭ患者自主神经变化的较好方法。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.