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[直立激发对健康受试者心率变异性频谱模式的影响]

[The effect of orthostatic provocation on the spectral pattern of heart rate variability in healthy subjects].

作者信息

Rozentryt P, Trzos G, Strłojewski D, Kozlowski J W, Maciejewski M

机构信息

1Z Pracowni Elektrokardiografil Szpitala Klinicznego nr 1 w Lodzi.

出版信息

Przegl Lek. 1996;53(7):534-9.

PMID:8975288
Abstract

Investigations were carried out in 74 persons (32 female and 42 male, mean age: 39.7 +/- 10.0 years, range: 16 to 68 years) free of diseases known to affect autonomic function. After a quarter of rest in quite, air conditioned room, while on voluntary breathing in supine, and later on in vertical position, time-series of a few minutes of successive R-R intervals were collected in each person and than stored for further off line analysis. Multivariate autoregressive modeling approach with parametric decomposition of peaks has given a basis for computation of spectral power of heart rate variability. In each body position 150 seconds long, stationary epoch of R-R intervals free of ectopy and artifacts were selected, and spectral power were calculated in three frequency bands: very low frequency (VLF): below 0.03 Hz (rejected from further analysis), low frequency (LF): from 0.03 to 0.15 Hz, and high frequency (HF): 0.15 to 0.35 Hz. Than, computed powers were expressed in either absolute units, or as normalized values, that is as percentages of total power less VLF. Breathing was also monitored in each case and spectral characteristics of its frequency also given in ranges defined for heart rate variability. In vertical, as compared to supine position, mean R-R interval decreased: 856 +/- 119 ms vs. 695 +/- 111 ms (p < 0.0005). The power of LF increased: 8.1 +/- 7.3 BPM2 vs. 19.2 +/- 14.6 BPM2, (p < 0,005), and simultaneously the power of HF dropped: 4.7 +/- 3.6 BPM2 vs. 2.7 +/- 2.5 BPM2, (p < 0.0005). In normalized units LF power enhanced: 63 +/- 385 vs. 87 +/- 42%, (p < 0.0005), and HF dropped: 36.7 +/- 32% vs. 12.3 +/- 12%, (p < 0.0005). Autonomic balance expressed as LF/HF ratio was higher in vertical position: 2.0 +/- 1.6 vs. 11.0 +/- 8.7, (p < 0.0005). In 73 out of 74 subjects (98.6%) the power of LF increased, and in 71 (95.9%)-decreased. In one person who had lower power of LF in vertical than supine position, the increase of HF power was noticed. Mean percentage increase of LF in the whole group was 209.4 +/- 243%, but after rejection of the result mention above the mean value increased to 218 +/- 22.1%. Mean percentage decrease of HF power in the whole group was 34.7 +/- 37.7%, and increased to 39.5 +/- 26.9% after rejection of three results with changes in opposite direction. Mean values of respiratory power did not change with switching of posture neither in LF:14.4 +/- 6.6% vs. 17.8 +/- 7.1%, (NS), nor in HF: 77.7 +/- 9.2% vs. 73.6 +/- 12.1%, (NS).

摘要

对74名(32名女性和42名男性,平均年龄:39.7±10.0岁,范围:16至68岁)无已知影响自主神经功能疾病的人进行了调查。在安静、有空调的房间休息一刻钟后,当他们仰卧自主呼吸时,随后处于直立位时,收集每个人几分钟连续的R-R间期的时间序列,然后存储以便进一步离线分析。采用具有峰值参数分解的多变量自回归建模方法为计算心率变异性的频谱功率提供了基础。在每个体位下,选择150秒长的无异位搏动和伪迹的R-R间期稳定段,并在三个频段计算频谱功率:极低频(VLF):低于0.03Hz(从进一步分析中排除),低频(LF):0.03至0.15Hz,高频(HF):0.15至0.35Hz。然后,计算出的功率以绝对单位或归一化值表示,即占总功率减去VLF后的百分比。每种情况下还监测呼吸情况,并给出其频率的频谱特征,其范围与心率变异性定义的范围相同。与仰卧位相比,直立位时平均R-R间期缩短:856±119ms对695±111ms(p<0.0005)。LF功率增加:8.1±7.3BPM2对19.2±14.6BPM2,(p<0.005),同时HF功率下降:4.7±3.6BPM2对2.7±2.5BPM2,(p<0.0005)。以归一化单位表示,LF功率增强:63±385对87±42%,(p<0.0005),HF功率下降:36.7±32%对12.3±12%,(p<0.0005)。以LF/HF比值表示的自主神经平衡在直立位时更高:2.0±1.6对11.0±8.7,(p<0.0005)。74名受试者中有73名(98.6%)LF功率增加,71名(95.9%)HF功率下降。在一名直立位LF功率低于仰卧位的受试者中,注意到HF功率增加。整个组中LF的平均百分比增加为209.4±243%,但在排除上述结果后,平均值增加到218±22.1%。整个组中HF功率的平均百分比下降为34.7±37.7%,在排除三个方向相反变化的结果后增加到39.5±26.9%。呼吸功率的平均值在体位转换时在LF方面没有变化:14.4±6.6%对17.8±7.1%,(无显著性差异),在HF方面也没有变化:77.7±9.2%对73.6±12.1%,(无显著性差异)。

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