健康人不同睡眠时相心率变异性的差异  

Differences of Heart Rate Variability between Different Sleeping Stages in Healthy Subjects

作　　者：胡敏[1] 江成璠[1] 王素霞[1] 汪飞[2] 邢智慧[2] 

机构地区：[1]安徽省黄山市人民医院功能科,245000 [2]安徽省黄山市人民医院神经内科,245000

出　　处：《中国全科医学》2015年第2期205-207,210,共4页Chinese General Practice

摘　　要：目的比较健康人不同睡眠时相心率变异性(HRV)的差异。方法试验数据取自Sleep Heart Rate and Stroke Volume Data Bank,包含45例健康人睡眠期窦性心率RR间期序列(RRI)和睡眠时相数据。RRI序列从采样率为500 Hz的心电数据中提取,睡眠时相数据分为醒觉期(WAKE)、快速动眼期(REM)及非快速动眼期(NREM)3个睡眠时相。将每一位受试者睡眠期RRI序列分成以5 min为单位的时间片,计算各单位时间片的HRV指标,其中频域法指标包括极低频能量(VLF)、低频能量(LF)、高频能量(HF)、总能量(TP)及低频与高频能量比(LF/HF);时域法指标包括5 min平均心率(HR)、正常-正常RR间期标准差(SDNN)、相邻RR间期差值均方根(RMSSD)、相邻RR间期差值大于50 ms的百分数(pNN50)及RR间期变化率(RRIV)。将睡眠时相数据序列分成同步的单位时间片,并标记各单位时间片内包含的睡眠时相数。结果研究对象共包含3 952个单位时间片,共纳入符合条件的单位时间片1 477个,其中,WAKE期240个(16.2%),REM期233个(15.8%),NREM期1 004个(68.0%)。不同睡眠时相频域法HRV指标比较,差异均有统计学意义(P<0.05);其中NREM期VLF、LF、TP、LF/HF与WAKE期比较,差异均有统计学意义(P<0.05);NREM期VLF、LF、HF、TP、LF/HF与REM期比较,差异均有统计学意义(P<0.05);REM期HF与WAKE期比较,差异有统计学意义(P<0.05)。不同睡眠时相时域法HRV指标比较,差异均有统计学意义(P<0.05);其中NREM期HR、SDNN、RRIV与WAKE期比较,差异均有统计学意义(P<0.05);NREM期HR、SDNN、RRIV、RMSSD、pNN50与REM期比较,差异均有统计学意义(P<0.05);REM期RMSSD、pNN50与WAKE期比较,差异均有统计学意义(P<0.05)。Spearman秩相关分析结果显示,RMSSD、pNN50与HF呈正相关(rs=0.95、0.94,P<0.001);RRIV与LF呈正相关(rs=0.79,P<0.001);SDNN与TP呈正相关(rs=0.98,P<0.001);RMSSD与pNN50呈正相关(rs=0.98,P<0.001)。结论 NREM期副交感神经兴奋性高,REM期交感神经兴奋性占�Objective To investigate the differences of heart rate variability（HRV）between different sleeping stages in healthy subjects. Methods The test data were taken from Sleep Heart Rate and Stroke Volume Data Bank including the sleep sinus rhythm RR interval（RRI）sequence and sleep phase data of 45 healthy subjects. RRI sequence was extracted from the ECG data whose sampling rate was 500 Hz. Sleep phase data were divided into 3 time phases：WAKE,rapid eye movement （REM）,non - rapid eye movement（ NREM）. The sleep RRI sequence was separated into time slices（5 min as a unit）. HRV indictors of each unit were calculated. The indicators of frequency domain method（ FDM） included very low frequency （VLF）,low frequency（LF）,high frequency（HF）,total energy（TP）and LF and HF ratio（LF/ HF）. The time domain method（TDM）indicators included 5 min mean HR,standard deviation of all normal - to - normal intervals（ SDNN）,root mean square of successive differences（RMSSD）,percentage of differences exceeding 50 ms between adjacent normal number of intervals（pNN50）and R - R interval variation（RRIV）. The sleep time phase number contained in time slices were recorded.Results A total of 3 952 units of time slices,1 477 eligible were enrolled including 240（16. 2% ）in WAKE,233（15. 8% ） in REM,1 004（68. 0% ） in NREM. There was significant difference in HRV indicators between varying sleep time phase FDMs（P 〈 0. 05）,there into NREM was different from WAKE in VLF,LF,TP,LF/ HF（P 〈 0. 05）;NREM different from REM in VLF,LF,HF,TP,LF/ HF（P 〈 0. 05）,REM different from WAKE in HF（P 〈 0. 05）. There was difference in HRV indicators between varying sleep time phase TDMs（ P 〈 0. 05）,there into NREM was different from WAKE in HR, SDNN,RRIV（P 〈 0. 05）,NREM from REM in HR,SDNN,RRIV,RMSSD,pNN50（P 〈 0. 05）,REM from WAKE in RMSSD,pNN50（P 〈 0. 05）. By Spearman rank correlation analysis,RMSSD,pNN50 were positively correlated with HF（rs= 0. 95,0.

关 键 词：心率变异性 睡眠时相 快速眼动期 健康人 

分 类 号：R338.63[医药卫生—人体生理学]