The function of the heart is to contract and pump oxygenated blood to the body and deoxygenated blood to the lungs.To achieve this goal,a normal human heart must beat regularly and continuously for one's entire li...The function of the heart is to contract and pump oxygenated blood to the body and deoxygenated blood to the lungs.To achieve this goal,a normal human heart must beat regularly and continuously for one's entire life.Heartbeats originate from the rhythmic pacing discharge from the sinoatrial(SA) node within the heart itself.In the absence of extrinsic neural or hormonal influences,the SA node pacing rate would be about 100 beats per minute.Heart rate and cardiac output,however,must vary in response to the needs of the body's cells for oxygen and nutrients under varying conditions.In order to respond rapidly to the changing requirements of the body's tissues,the heart rate and contractility are regulated by the nervous system,hormones,and other factors.Here we review how the cardiovascular system is controlled and influenced by not only a unique intrinsic system,but is also heavily influenced by the autonomic nervous system as well as the endocrine system.展开更多
The influence of b-cell function on cardiovascular autonomic neuropathy(CAN), an important diabetesrelated complication, is still unclear. In this study, we aimed to investigate the association between residual b-cell...The influence of b-cell function on cardiovascular autonomic neuropathy(CAN), an important diabetesrelated complication, is still unclear. In this study, we aimed to investigate the association between residual b-cell function and CAN in patients newly diagnosed with type 2 diabetes. We enrolled 90 newly-diagnosed type 2 diabetic patients and 37 participants with normal glucose tolerance as controls. The patients were divided into a CAN? group(diabetic patients with CAN, n = 20) and a CAN-group(diabetic patients without CAN, n = 70) according to the standard Ewing battery of tests. Fasting and postprandial plasma glucose, insulin, and C-peptide were measured.Homeostasis model assessment-beta cells(HOMA-B) and HOMA-insulin resistance(IR) were calculated. The prevalence of CAN in this population was 22.2%. Compared with the CAN-group, the CAN? group had significantly lower fasting plasma insulin(6.60 ± 4.39 vs 10.45 ± 7.82 l/L, P = 0.029), fasting C-peptide(0.51 ± 0.20 vs0.82 ± 0.51 nmol/L, P = 0.004), and HOMA-B(21.44 ± 17.06 vs 44.17 ± 38.49, P = 0.002). Fasting C-peptide was correlated with the Valsalva ratio(r = 0.24, P = 0.043) and the 30:15 test(r = 0.26,P = 0.023). Further analysis showed that fasting C-peptide(OR: 0.041, 95% CI 0.003–0.501, P = 0.012) and HOMAB(OR: 0.965, 95% CI 0.934–0.996, P = 0.028) were independently associated with cardiovascular autonomic nerve function in this population. The patients with fasting C-peptide values \ 0.67 nmol/L were more likely to have CAN than those with C-peptide levels C0.67 nmol/L(OR:6.00, 95% CI 1.815–19.830, P = 0.003). A high prevalence of CAN was found in patients with newly-diagnosed type 2 diabetes. Decreased b-cell function was closely associated with CAN in this population.展开更多
目的探究Ⅰ期心脏运动康复对冠心病监护病房(coronary care unit,CCU)内经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者心功能及心血管...目的探究Ⅰ期心脏运动康复对冠心病监护病房(coronary care unit,CCU)内经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者心功能及心血管不良事件(major adverse cardiovascular events,MACE)发生率的影响。方法选取2021年5月—2022年10月厦门大学附属第一医院CCU收治的需行PCI术治疗的138例急性STEMI患者为研究对象,采用随机数字表法将其分为观察组(PCI术后常规护理与Ⅰ期心脏运动康复干预,69例)及对照组(PCI术后常规护理,69例)。比较两组术前及出院时的心功能、心脏自主神经功能、抗氧化能力指标;记录两组术后1个月MACE发生率。结果出院时两组左室射血分数(left ventricular ejection fraction,LVEF)较术前明显提高,心肌肌钙蛋白(cardiac troponini,cTnI)、N末端脑钠肽前体(N-terminal-pro brain natriuretic peptide,NT-proBNP)水平较术前明显降低;观察组LVEF、NT-proBNP水平明显优于对照组,比较差异有统计学意义(P<0.05),两组cTnI水平比较差异无统计学意义(P>0.05)。两组出院时的相邻RR间期差值均方根(root mean square of successive differences,RMSSD)、相邻NN差>50 ms个数占总心跳的百分数(the percentage of adjacent NN difference>50 ms in total heartbeat,pNN50)、窦性RR间期标准差(standard deviation of NN intervals,SDNN)水平较术前明显升高,且观察组均高于对照组,比较差异有统计学意义(P<0.05)。两组出院时的血清超氧化物歧化酶(superoxide dismutase,SOD)、总抗氧化能力(total antioxidant capacity,T-AOC)水平较术前明显升高,丙二醛(malonic dialdehyde,MAD)水平明显降低,且观察组SOD、T-AOC水平明显高于对照组,MAD水平明显低于对照组,比较差异均有统计学意义(P<0.05)。观察组术后1个月MACE发生率为7.25%,对照组为11.59%,比较差异无统计学意义(P>0.05)。结论CCU内急性STEMI患者行PCI术后进行Ⅰ期心脏运动康复干预可改善其心功能及心脏自主神经功能,提高机体抗氧化能力,不增加MACE发生风险。展开更多
目的:探讨肠易激综合征(irritable bowel syndrome,IBS)患者心血管自主神经功能变化与心率变异性的相互关系.方法:选取海南省海口市第三人民医院2011-01/2012-12的78例I B S患者为研究组对象,对其进行心血管自主神经功能测试,依据结果...目的:探讨肠易激综合征(irritable bowel syndrome,IBS)患者心血管自主神经功能变化与心率变异性的相互关系.方法:选取海南省海口市第三人民医院2011-01/2012-12的78例I B S患者为研究组对象,对其进行心血管自主神经功能测试,依据结果分为阳性组和阴性组两个亚组,并且选取同期50名健康对象为对照组,观察3组心率变异性的变化.结果:研究组自主神经功能异常率与对照组比较,差异有统计学意义(71.8%vs 28.0%,P<0.05);阳性组正常RR间期标准差(standard diviation of NN intervals,SDNN)、每5 min平均RR间期标准差(self-developing artificial neural network,S D A N N)、相邻R R之差>50 m s所占总窦性心搏百分值(percentage of differences between adjacent normal RR intervals exceeding 50 milliseconds,PNN50)、相邻R R之差均方根(root means quare successive difference,RMSSD)、RR间期标准差平均值(average standard deviation of 5min NN intervals,SDNN index)、高频(high frequency,H F)、低频/高频(L F/H F)与对照组比较,差异有统计意义(104.6 ms±23.6 ms vs 151.6 ms±23.7 ms,99.5 ms±18.9 ms vs128.5 m s±18.9 m s,15.6±3.6 v s 10.5±2.8,38.9 ms±9.8 ms vs 25.5 ms±6.7 ms,36.7 ms±8.5 ms vs 105.5 ms±21.2 ms,412.6 ms2±88.9 ms2 v s 299.6 m s2±77.8 ms2,0.9±0.2 v s 1.3±0.3)(P<0.05);阴性组R M S S D、P N N50、HF、LF/HF与对照组比较,差异有统计学意义(39.4 ms±9.6 ms vs 25.5 ms±6.7ms,15.7±3.8 vs 10.5±2.8,408.6 ms2±90.6ms2 vs 299.6 ms2±77.8 ms2,0.9±0.3 vs 1.3±0.3)(P<0.05).结论:临床中可以通过监测心率变异性的变化能够尽早的发现IBS患者心血管自主神经功能异常情况,二者存在紧密的联系.展开更多
目的探讨舍曲林治疗冠心病合并抑郁的临床疗效。方法本研究观察对象为河北省第七人民医院2020年4月~2022年10月86例合并抑郁症的冠心病患者,数字表法随机分为两组,对照组给予常规心内科治疗以及心理护理,观察组在对照组基础上给予舍曲...目的探讨舍曲林治疗冠心病合并抑郁的临床疗效。方法本研究观察对象为河北省第七人民医院2020年4月~2022年10月86例合并抑郁症的冠心病患者,数字表法随机分为两组,对照组给予常规心内科治疗以及心理护理,观察组在对照组基础上给予舍曲林治疗。比较两组患者治疗前后汉密尔顿焦虑、抑郁评分(Hamilton anxiety and depression scores,HAMA,HAMD),心率变异性,左心室射血分数以及心血管不良事件发生率。结果治疗后两组患者HAMA评分,HAMD评分均显著降低,且治疗后观察组两项评分均显著低于对照组(P<0.05);治疗后两组正常窦性R-R间期标准差,高频功率,左心室射血分数升高,低频功率降低,且治疗后观察组各项指标均优于对照组(P<0.05);观察组心血管不良事件发生率显著低于对照组(P<0.05)。结论舍曲林治用于冠心病合并抑郁能够有效减轻负性情绪,改善自主神经功能以及心脏功能。展开更多
文摘The function of the heart is to contract and pump oxygenated blood to the body and deoxygenated blood to the lungs.To achieve this goal,a normal human heart must beat regularly and continuously for one's entire life.Heartbeats originate from the rhythmic pacing discharge from the sinoatrial(SA) node within the heart itself.In the absence of extrinsic neural or hormonal influences,the SA node pacing rate would be about 100 beats per minute.Heart rate and cardiac output,however,must vary in response to the needs of the body's cells for oxygen and nutrients under varying conditions.In order to respond rapidly to the changing requirements of the body's tissues,the heart rate and contractility are regulated by the nervous system,hormones,and other factors.Here we review how the cardiovascular system is controlled and influenced by not only a unique intrinsic system,but is also heavily influenced by the autonomic nervous system as well as the endocrine system.
基金supported by the Medical Scientific Research Foundation of Guangdong Province of China(A2018286)the Key Projects of Clinical Disciplines of Hospitals Affiliated to Ministry of Health from Ministry of Health of China(A1781)
文摘The influence of b-cell function on cardiovascular autonomic neuropathy(CAN), an important diabetesrelated complication, is still unclear. In this study, we aimed to investigate the association between residual b-cell function and CAN in patients newly diagnosed with type 2 diabetes. We enrolled 90 newly-diagnosed type 2 diabetic patients and 37 participants with normal glucose tolerance as controls. The patients were divided into a CAN? group(diabetic patients with CAN, n = 20) and a CAN-group(diabetic patients without CAN, n = 70) according to the standard Ewing battery of tests. Fasting and postprandial plasma glucose, insulin, and C-peptide were measured.Homeostasis model assessment-beta cells(HOMA-B) and HOMA-insulin resistance(IR) were calculated. The prevalence of CAN in this population was 22.2%. Compared with the CAN-group, the CAN? group had significantly lower fasting plasma insulin(6.60 ± 4.39 vs 10.45 ± 7.82 l/L, P = 0.029), fasting C-peptide(0.51 ± 0.20 vs0.82 ± 0.51 nmol/L, P = 0.004), and HOMA-B(21.44 ± 17.06 vs 44.17 ± 38.49, P = 0.002). Fasting C-peptide was correlated with the Valsalva ratio(r = 0.24, P = 0.043) and the 30:15 test(r = 0.26,P = 0.023). Further analysis showed that fasting C-peptide(OR: 0.041, 95% CI 0.003–0.501, P = 0.012) and HOMAB(OR: 0.965, 95% CI 0.934–0.996, P = 0.028) were independently associated with cardiovascular autonomic nerve function in this population. The patients with fasting C-peptide values \ 0.67 nmol/L were more likely to have CAN than those with C-peptide levels C0.67 nmol/L(OR:6.00, 95% CI 1.815–19.830, P = 0.003). A high prevalence of CAN was found in patients with newly-diagnosed type 2 diabetes. Decreased b-cell function was closely associated with CAN in this population.
文摘目的探究Ⅰ期心脏运动康复对冠心病监护病房(coronary care unit,CCU)内经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者心功能及心血管不良事件(major adverse cardiovascular events,MACE)发生率的影响。方法选取2021年5月—2022年10月厦门大学附属第一医院CCU收治的需行PCI术治疗的138例急性STEMI患者为研究对象,采用随机数字表法将其分为观察组(PCI术后常规护理与Ⅰ期心脏运动康复干预,69例)及对照组(PCI术后常规护理,69例)。比较两组术前及出院时的心功能、心脏自主神经功能、抗氧化能力指标;记录两组术后1个月MACE发生率。结果出院时两组左室射血分数(left ventricular ejection fraction,LVEF)较术前明显提高,心肌肌钙蛋白(cardiac troponini,cTnI)、N末端脑钠肽前体(N-terminal-pro brain natriuretic peptide,NT-proBNP)水平较术前明显降低;观察组LVEF、NT-proBNP水平明显优于对照组,比较差异有统计学意义(P<0.05),两组cTnI水平比较差异无统计学意义(P>0.05)。两组出院时的相邻RR间期差值均方根(root mean square of successive differences,RMSSD)、相邻NN差>50 ms个数占总心跳的百分数(the percentage of adjacent NN difference>50 ms in total heartbeat,pNN50)、窦性RR间期标准差(standard deviation of NN intervals,SDNN)水平较术前明显升高,且观察组均高于对照组,比较差异有统计学意义(P<0.05)。两组出院时的血清超氧化物歧化酶(superoxide dismutase,SOD)、总抗氧化能力(total antioxidant capacity,T-AOC)水平较术前明显升高,丙二醛(malonic dialdehyde,MAD)水平明显降低,且观察组SOD、T-AOC水平明显高于对照组,MAD水平明显低于对照组,比较差异均有统计学意义(P<0.05)。观察组术后1个月MACE发生率为7.25%,对照组为11.59%,比较差异无统计学意义(P>0.05)。结论CCU内急性STEMI患者行PCI术后进行Ⅰ期心脏运动康复干预可改善其心功能及心脏自主神经功能,提高机体抗氧化能力,不增加MACE发生风险。
文摘目的:探讨肠易激综合征(irritable bowel syndrome,IBS)患者心血管自主神经功能变化与心率变异性的相互关系.方法:选取海南省海口市第三人民医院2011-01/2012-12的78例I B S患者为研究组对象,对其进行心血管自主神经功能测试,依据结果分为阳性组和阴性组两个亚组,并且选取同期50名健康对象为对照组,观察3组心率变异性的变化.结果:研究组自主神经功能异常率与对照组比较,差异有统计学意义(71.8%vs 28.0%,P<0.05);阳性组正常RR间期标准差(standard diviation of NN intervals,SDNN)、每5 min平均RR间期标准差(self-developing artificial neural network,S D A N N)、相邻R R之差>50 m s所占总窦性心搏百分值(percentage of differences between adjacent normal RR intervals exceeding 50 milliseconds,PNN50)、相邻R R之差均方根(root means quare successive difference,RMSSD)、RR间期标准差平均值(average standard deviation of 5min NN intervals,SDNN index)、高频(high frequency,H F)、低频/高频(L F/H F)与对照组比较,差异有统计意义(104.6 ms±23.6 ms vs 151.6 ms±23.7 ms,99.5 ms±18.9 ms vs128.5 m s±18.9 m s,15.6±3.6 v s 10.5±2.8,38.9 ms±9.8 ms vs 25.5 ms±6.7 ms,36.7 ms±8.5 ms vs 105.5 ms±21.2 ms,412.6 ms2±88.9 ms2 v s 299.6 m s2±77.8 ms2,0.9±0.2 v s 1.3±0.3)(P<0.05);阴性组R M S S D、P N N50、HF、LF/HF与对照组比较,差异有统计学意义(39.4 ms±9.6 ms vs 25.5 ms±6.7ms,15.7±3.8 vs 10.5±2.8,408.6 ms2±90.6ms2 vs 299.6 ms2±77.8 ms2,0.9±0.3 vs 1.3±0.3)(P<0.05).结论:临床中可以通过监测心率变异性的变化能够尽早的发现IBS患者心血管自主神经功能异常情况,二者存在紧密的联系.
文摘目的探讨舍曲林治疗冠心病合并抑郁的临床疗效。方法本研究观察对象为河北省第七人民医院2020年4月~2022年10月86例合并抑郁症的冠心病患者,数字表法随机分为两组,对照组给予常规心内科治疗以及心理护理,观察组在对照组基础上给予舍曲林治疗。比较两组患者治疗前后汉密尔顿焦虑、抑郁评分(Hamilton anxiety and depression scores,HAMA,HAMD),心率变异性,左心室射血分数以及心血管不良事件发生率。结果治疗后两组患者HAMA评分,HAMD评分均显著降低,且治疗后观察组两项评分均显著低于对照组(P<0.05);治疗后两组正常窦性R-R间期标准差,高频功率,左心室射血分数升高,低频功率降低,且治疗后观察组各项指标均优于对照组(P<0.05);观察组心血管不良事件发生率显著低于对照组(P<0.05)。结论舍曲林治用于冠心病合并抑郁能够有效减轻负性情绪,改善自主神经功能以及心脏功能。
