RR间期和QT间期动力学特性联合分析用于心脏自主神经状态评估的研究

项目名称： RR间期和QT间期动力学特性联合分析用于心脏自主神经状态评估的研究

项目编号： No.81471746

项目类型： 面上项目

立项/批准年度： 2015

项目学科： 医药、卫生

项目作者： 彭屹

作者单位： 中国医学科学院基础医学研究所

项目金额： 72万元

中文摘要： 心脏自主神经失衡与心血管疾病的病死率密切相关，无创评估和监测心脏自主神经状态，具有迫切的临床需求。心率变异性（HRV）的作用虽得到公认，但其指标易受年龄和性别等个体差异的影响，在临床应用过程中受到很多限制。本研究拟利用公共数据库和自行设计实验数据，探讨弱化个体差异，突出自主神经病理因素影响的自主神经状态判别分析方法。提出采用短时序列分析以遵循心电图间期序列的非平稳性，并通过自行设计被动直立倾斜实验和应激实验，探讨不同自主神经平衡状态下以及交感神经和迷走神经的交互作用缺失时，短时序列分析指标的敏感性；然后通过长时序列中短时序列分析指标相关性分析，量化自主神经活动的昼夜节律，表征HRV与QT变异性（QTV）的关联性，进行以HRV为基础的，多视角和多层次的判别分析，并在典型病理状态验证所提出方法的有效性。为心脏安全中自主神经状态评估提供有临床应用前景的依据。

中文关键词： 自主神经；短时序列分析；QT-RR相互作用；动态心电图；心脏安全

英文摘要： The imbalance of cardiac autonomic nerve has close relationship to cardiac mortality. Noninvasive monitoring of cardiac autonomic nerve state is with great importance but there is no available method for clinical usage by now. Though heart rate variability (HRV) is widely used in reflecting cardiac autonomic activity, it is apt to be influenced by individual factors such as age, sex and so on. And surface body ECG (especially Holter data), as a noninvasive and continuous measure, is paramount in monitoring cardiac safety. Using the data from multi-source Holter database and our experiments, this project is aimed to establish a noninvasive method in evaluating the cardiac autonomic nerve state based on the analysis of ECG interval time series and having a joint analysis of HRV and QT variability (QTV). Through head-up tilt test and stress response test, the sensitivity of various indexes of short-term interval series is investigated. According to the nonstanarity of ECG interval time series, short-term analysis is to be performed on them, and the distribution of short-term indexes on long-term time series is to be charaterized for the quantitative analysis of circadian rhythm and correlation analysis of HRV and QTV. The proposed method is expected to have the advantage in weakening the influence of individual differences and highlighting the pathological influence, providing a basis for the application of noninvasive monitoring of the cardiac autonomic nerve stste for cardiac safty to clinical use.

英文关键词： autonomic nerve systerm;short-term analysis;QT-RR interactions;Holter;cardiac safety