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1. ..................................................................................................................
1.1 .....................................................................................
1.2 ...........................................................................................................
1.3 .................................................................
1.4 ..............................................
1.5 .........................................................
1.6 ............................................................................
1.7 ..................................................................................
1.8 ...............................................................................
2. ..................................
3. ......................................................................................
3.1 ...................................................
3.2 ,
..............................................................................................................
3.2.1 .......................................................................
3.2.2 ....................................................................................
3.2.3 .............................
3.3 ....................................................................................
3.3.1 ...........................................................
3.3.2 .........................................................
3.3.2.1 ...............................
3.3.2.2 .........................
3.3.2.3 ........
3.3.3 ................................
3.3.4 . . ..............
3.3.5 .......................................
3.4 ....................................
3.4.1 .................................................
3.4.2 .............................................................................
3.4.3 ............................................................
3.5 .............................................................................................
3.6 .........................................................................................
3.6.1 .................................................................................................................
3.6.2 ...............................
3.7 ...........
3.8 ......................................................
4. ............................................................................
4.1 ..............................................................
4.2 ........................................................................
4.3 ...............................................
4.4 .......................................
4.5 ..................................................................................................
4.6 ....................................................................
4.7 .................................................
4.8 ..............................................................................
4.9 ...................................................................

6
6
6
6
7
7
8
8
9
9
10
11
13
14
14
14
15
17
17
18
21
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23
24
26
27
28
28
31
34
35
35
35
36
37
40
43
43
46
49
49
50
51
53
53
53

5. ................................................................................................
5.1 ................................................................................................................
5.2 ................................................................................................
5.2.1 .......................................
5.2.2 ...................................................................
5.2.3 ...............................................................................
5.2.4 .....................................................................................................................
5.2.5 -
.........................................................................................................................
6. ...................................................................................................
6.1 ................................................................................................................
6.1.1 .............................................................
6.1.2 ..............................................
6.1.3 ...........................................................................................
6.2 ................................................................................................
6.2.1 ...................................................................
6.2.2 ......................................................................
6.2.3 ...................................................................................................
6.2.4 ....................................................................................
6.2.5 ...............................
6.2.6 ....................................................
6.2.7 ........................................................................
6.2.8 ........................................................................................
6.2.9 ........................................................
6.2.10 ...............................................
6.2.11 ........................
7. ...................
7.1
7.2 .......................................................................................................
7.3 ...............................................................................
7.4 .......................................................................................
7.5 ....................
8. ..............
8.1 ........................................................................
8.2 .....................................................
8.3 ..........................................
8.4 ......................
8.5 ....................
8.6 ..................
8.7 ...................................
8.8 ........................................
..............................................................................................................................
1. .............
2.
............................................................................................
3.
.........................................................................................
4. ......
5.
...........................................
......................................................................................................

55
55
57
57
57
58
60
60
61
61
61
62
63
64
64
66
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95
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99
101
102
102
105


.
, .

. . , . . . . . , , .
. , . . , . . , . . . . .
. . , . . ,
. . , . . , . . . . , -
. . . . .
. . , . . , . . , . . . . .





--

NYHA

New York Heart Associacion

1.
1.1
1932 , R-R [96]. 1965 . Hon Lee ,
[159].
1973 . Sayers . [189]. 80- Ewing . , , R-R-
[148]. , -

, 1978 . Wolf . [199]. 1981 . Acselrod . [129].



. . [48-52] ( ) . . ( , ) [8-17].
,
.
1996 . -
, , ,
[192].

-.
, . :
.
( ,
Q-T, . .) .
( ,
. .).
( , , . .).
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1996 , [192].
, heart rate variability
(HRV), () ().
, , R-R-,
. , , .
,
, . , RR : SDNN, SDRR, , CLV. 3. .
1.3

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X, Max, Min, . , D, , , As, Ex, V


, , , , , ,
TP, HF, LF, VLF, ULF, LF/HF, HF (%), LF (%),
VLF (%), ULF (%), HF n. u., LF n. u., ,
m 0, 1k
L, w, L/w, S,
RRNN, SDNN, rMSSD, NN50count, PNN50, HRV
W, WN1, WN5, WAM5, WAM10
m(RRM) (), m(), m() (%)

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10

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11


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.
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. 2, 2
, , .
. .
: , . 0,40-0,15 ,
(HF). , (LF), 0,15-0,04 [192].
: ,
, [96, 101]. - (-
, , .)
0,04-0,0033 , (VLF).




HF
LF
VLF
ULF

()
0,40-0,15
0,15-0,04
0,04-0,0033
0,0033

(.)
2,5-6,7
6,6-25
25-303
303

VLF .

[101]:
1. 0,15-0,40 - ;
2. 0,07-0,15 - ;
3. 0,01-0,07 - ;
4. 0,003-0,01 - .
, , R-R-
.

12

LF VLF

, II,

VLF

LF F
VLF ULF

HF

H ,
pO2, pCO2
LF VLF

13

3.
3.1
, :


. . .
:
. .
:




. .
:


:



:
1/f
(CGSA)

.
:


3.2 ,

3.2.1
.
( RR ).
:
. ( , , n, RRNN) RR
. .
, .
,
, .
: 0,940,03 , 0,770,06 .
R-R. ,
.
in R-R. .

14

,
, .
,
.
,
, , . . . . .
, , .
: 0,0060,00086.
( ) . RRNN.
( , , ), .
.
: 6090 1 .
( ) ( RR
, , SDNN, CLV, SDRR) ,
.
.
.
25 : 7010 ; 26-40 : 606 .,
605 ; 40 : 608 , 504 .
As ( ) , .
() () .
V (CV, )
, . /. 100%.
25 : 7,11,1%, 70,4%; 2640 :
5,60,5%, 6,10,4%; 40 : 6,40,7%,
6,10,4%.
,
. , , , .
3.2.2
: (Time Domain).
,
. , , .
:
;
;
.
.
.

15

,
:
RRNN ( , , n, .) RR
. . .
18 : : 94030
, 77060 .
: 76096 .
SDNN ( RR , ,
, CLV, SDRR) ,
.
.
25 : 7010 ; 2640
: 606 , 605 ; 40 : 608 , 504
.
: 14139 .
rMSSD ( RR )
SDNN. .
25 : 49,9315,23 .
: 2712 .
NN50 count , , 50
. , . .
PNN50 , 50 . , , NN50 count.
25 : 29,419,55%.
: 1813%.
,
:
SDNN (SDNNi) NN-, 5- .
: 5415 .
SDANN NN-, 5 . , SDNN.
.
: 127 35 .
SDSD NN-.

(, 1000 10000 ) [139].
, [190].
20-99 [76]

()
20-29
30-39
40-49
50-59
60-69
70-79
80-99

16

( / )
7910
787
787
769
779
729
7310

SDNN
()
15344
14332
13230
12127
12132
12422
10623

SDANNi
()
13743
13033
11641
10627
11131
11420
9524

SDNNi
()
7222
6415
6013
5215
4213
4311
3712

RMSSD
()
4319
3511
3111
259
226
247
16

PNN50
(%)
1813
139
109
66
45
45
33

3.2.3 . .
. . .
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1. 33 .
2. ( ).
3. , .
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II
III
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15
23
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5
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18
39

2
8
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.


600 .
650 .

550 .
575 .

750 .
925 .

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17

.
3.3.1
.
60- .
.
. . [12].
, .
( ) 0,05 ., 0,4 . 1,3 ., 18 . 0,4 1,3 .
, , .
100 . :
h = (Xmax Xmin) / k, :
Xmax ,
Xmin ,
k , k = 1 + 3,322 Ig n.
1/128 (7, 8125 ).
:
1. , , .
2. , ,
. .
3. .
( ).
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, . .
5. . ,
,
. .

18

IV
NYHA


R-R . ,
0,7 ( 85 /) ( ), 0,7-1,0 . ( 85 60 /) (), , 1 ( 60 /)
( ).

19

:
() R-R .
( ).
18 : 0,90,03 ., 0,760,05 .
( , ,
) , , . .

.

.
25 : 353%, 38,51,5%; 26-40 :
473%, 432,1%; 40 : 323%, 432,1%.
( , ) ( R-R ).
. , , .
25 : 0,380,07 ., 0,290,02 .;
26-40 : 0,290,03 ., 0,290,03 .; 40 : 0,280,06
., 0,290,03 .
( )
. ,
. =1/ .
( ) (=/). .
( )
(=/). .
( , -) ,
(=/2 ). :
.
80-150 . .
,
. , (, ) .

20

3.3.2
3.3.2.1
(scatter - ), , , , .
Hoopen M. [160] . . . [33].
.
, R-R ,
, R-R .
:
:
- ; - ; - .
, :
- ; - .
:
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:
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:
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:
- ; - .
:
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:
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( ).
, .
, .

21

:
L (, ) . R-R.
25 : 0,380,07 , 0,290,02 ;
26-40 : 0,290,03 , 0,290,03 ; 40 : 0,280,06
, 0,290,03 .
w (b, ) , .
L/w (/b, ) . , L/w.
S ( ). : S = L w/4.
.
( ) . ,
.
R-R ,
,
.
3.3.2.2
, ,
,
[29].
:
:
- ;
- ;
- .
:
- ;
- ;
- .
:
- ; - .
. .

22


.
R-R
1,7 .

.


.

3.3.2.3

, [29]. , , ,
.
.
, .
, 10-15 ( 750 ).

23

45


10-40%.


10%-40%

:
:
- ; - ; - .
:
- ; - .
:
- ; - .
:
- ; - .
:
- ; - ; - .

, , . , -, , , .

, , [29].
3.3.3

( R-R ).
:
1. , ,
() .
2. ,
, , .
3. ,
, , .

().

24

, . , , , .
( ),
.

, , (
, ,
, ).
() , , , , .


( )

25

3.3.4 . .
,
.
, 7,8125
. , .
. . [74] :
W . ().
WN1 () WN5 () 1% 5% , .
WAM5() WAM10 () 5% 10% .

, () . , . . , , .
, W,
, , .
. . . . , (n=47 ).
(5 ).
,
, .
(W) , .

26


3.3.5
(St. George)
.
7,8125 . (b) : b=2A/h, h
, , . . R-R . .
St. George.


( St. George = 22,8)


( St. George = 18,4)

(HRV)
R-R , 7,8125 ,
. 3715 .
(INN), M. Malik et al. [174-177].
.
, . .
.
:
, , , .
RR-. -

27

RR- [192].
15-20 ( 24 ).
3.4
3.4.1
() R-R . , . . . .

()

(.)

HF
LF
VLF
ULF

0,40-0,15
0,15-0,04
0,04-0,0033
0,0033

2,5-6,7
6,6-25
25-303
303


. .
[51]
[25]
1, 2
1
3, 4
2
5
3
6
4

HF ( , , ) ,
.
LF ( , , ) ( ). ,
() .
VLF ( , , )
- . (, , . .).
ULF ( ) . .

. . 6 () [51].
1. HF. . . , , .
.
2. HF, . . . , . .
3. LF. .
, .
. -
.
4. LF,
(VLF) . . . , .
5. (VLF). . .

28

HF LF.
-.
.
6. (VLF ULF). . - . - ( , . .).
,
. .
.

1 . .

2 . .

3 . .

29

4 . .

5 . .

6 . .

(1 5 . . ),
HF VLF

30

3.4.2

. .
, :

() . . (),
(2/). , .
.
.

.
. .
(HF) , (LF) , , (VLF ULF)
.

31

(
)
.

( 10 )
.

32

:
.
( 5-10%,
, , . .).
, , ,
10%.
, , 10
.
:
( , TF)
. , , , 16000 2 .
- ,
.
: 34461018 2.
HF ( 0,4 0,15 , P)
.
, , .
, , ( ).
: 975203 2.
LF ( 0,15 0,04 , P1) ( ). .
, , ( ).
: 1170416 2.
VLF ( 0,04 0,0033 , P2)
- .
: 765 410 2.
ULF ( 0,0033 0 ) . .
: .
LF/HF ( ) (LF) (HF).
.
.
: 0,7-1,5.
HF% ( , P%)
.
.
, , .
, , ( ).
: 35,7914,74%.
LF% ( , P1%)
( ).
, , .
, , .
: 33,689,04%.
VLF% ( , P2) -
.
, ,
, .

33

, .
: 28,6511,24%.
HF n. u. ( , ) . HF n. u. . : HF n. u. = HF/(TP-VLF) 100%.
, , .
, , ( ).
: 49,49,4%.
LF n. u. ( , ) ( ). : LF n. u. = LF/(TP-VLF)
100%.
, , .
, , .
: 50,69,4%.
( ) . (LF VLF)
(HF).
: 3.
( ) .

. .
3.4.3

. ,
1 .
, .
:
1k ( )
( ). , . ,
, 1k 1.
.
.
25 : 0,430,06; 26-40 : 0,480,05; 40 :
0,60,07.
M0 (0) ,
.
.
.
.
25 : 51; 26-40 : 102; 40 : 177.

34

.
3.5
,
, , . 1/f, , (CGSA). :
, , . D2 , . , , ,
, . [192].
3.6
3.6.1

. ,
. -

35

. . . (), , [12]. 1 10.


:
. ().
. - SDNN
( ).
. : , rMSSD, HF, .
. , ,
(LF).
. -
(VLF).
[8]:
1. , (=1-2).
2. , .
, (=3-4).
3. , , -
- (=4-6).
4. , - , .
(=6-8).
5. () ,
( )
.
(=8-10). (, 1979, , 1991, 1997).
. . : [76-77].
, SDNN, TINN, ( ), . , .
rMSSD, A St. George.
.
3.6.2
(), :

+2

+1

36

,
2

VLF ULF

5 8

LF

1000
1000
2248

-1

-2

2 5

1 2

(
)

HF F
30 50%

HF F
50%

22483366
33664484

4484

,
.
:
+10 +12. .
. .
. .
+7 +9. . - .
. .
.
+4 +6. .
- . , , .
- .
+3 3. . , . .
.
4 6. . . , , . - . -.
7 9. .
, .
10 12. . , . .
3.7
:
, .
, . . , , .
() , .
, ( , . .).
+ .
, 4 :

37

+ +
+

:
() + , , . .
.
() ,
, . . .
() + ,
+ .
()
.
() .
, .
,
II SDNN 50
( )
3 ( ).
, 1000 . 180 SDNN (+ ).
200 (+ ). 150 SDNN (+ , ). 50 (- + ). 180 ,
SDNN, 150 .
30 , SDNN, (+ - ).
770 (- , ).

30

, +
-

150

50

, +
,

, -
, +

770
38

, -
,


:
= 150/(150+50) 100% = 75%
= 770/(770+30) 100% = 96,25%
= 150/180 100% = 83,33%
= 800/820 100% = 97,56%

.

. Wolf .
[199].
G. Casolo . [141].


1

23

R. Kleiger . [167].
. demnuyiwa
. [180].

The Multicenter
Postinfarction Research Group
[195] .

113

T. Gripps .
[156].
X Copie .
[144].
L. Fei .
[152].
T. Facell .
[150].

, %

, %

SDNN<32

84

45

SDNN<50

100

69

SDNN<50

34

88

75

52

HRV<30
ULF<1600 2
VLF<180 2
ULF<1600
VLF<180 2

75
28
30

76
93
92

20

96

HRV<25

87

56

RRNN<700

45

85

SDNN<70

100

87

SDANN<55

88

87

SDNN<50

91,6

77,8

HRV<39

(SDNN<50 , HRV<15 .)
. SDNN 50100 HRV 15
20 . [192]. , SDNN 50 5,3 , SDNN 100
( 4 34% 9% ).
SDNN 50100
(14%)[195].
LF 3,5 pNN50 5,5%
3 [182].
NN50 ( 800) LF ( 35 2), 1
,
[136].
rMSSD 36 , 24
24 ,
( , ) 6 [187].
LF/HF, 2025
, -

39

, , 2 ( 2,7) [183].
,
. ()
, L. Fei . [153]. , ,
[153, 192].
SDNN 1520 . ,
4 SDNN 25 ,
24 , , 40 [130].
,
[82]. 6-8 -
.
. , , .
- :
1. ;
2. (..
SDNN ). (ULF, VLF .)
24 .
3. .

.
(SDNN<50 ) ()
()
(. . ).

, %
40
60
50
75
75
92
11
11

, %
40
50
71
76
86
95
73
80

, %
25
60
5
20
95
92
8
11

, %
43
50
98
97
50
95
80
80

0,6
1,2
2,3
8,0
1,9
17,5
0,4
0.6

3.8

[135, 164, 197].

, 5-6- [164]. (HRV, SDANN).
rMSSD. .

40

. . , ( 5 ,
6 ) [82]. , (HF) 600 2,
(LF VLF) 450 2.
LF VLF 900 400 2
.

. - , - . 15 15 . ,
32 , 2756 0 95
. . R-R
: X, Max,
Min, , D, , , As, Ex, V, , , , , , , , ,
, TP, HF, LF, VLF, LF/HF, HF (%), LF (%), VLF (%), HF n.u., LF n.u, m0,1k, L, w, L/w, S,
RRNN, SDNN, rMSSD, NN50count, PNN50.
21 26 69 c ( II-III , , ). 16 7 44 ,
- ( , ,
). 10 11 33 , , . 47 .
,
5 30 ( 15 21 ), , , .
- , 5 30 ( 15 21
), , .
Microsoft
Excel 2000.
, (, RRNN, R-R Max, R-R Min).
3,6% .
( 69,85% VLF 2,
21,81% LF n.u.). , , , .
,
(). I
1303,54 2 3248,83 2 ( 59,87%
), II 1801,5 2 3194,85 2 ( 43,61%), III
4550,84 2 5820,8 2 ( 21,82%).

41

6000

80
70

5000

60
4000

50
40

3000

30

2000

20

1000

10
0

0
1


(, 2)


(SDNN, )

. , I 244,6 2 1682,2 2 ( 85,45%).


957 2.

80

60

70

50

60
40

50
40

30

30

20

20

10
0

10
0
1

(,%)

(, /)
1
2
3


.
( ).
, , R-R .

,
.
, :
1.
.
2.
( 10-15 ).

42

3. , .
4. , 5
, ,
.
5. .
, , . , ,
, [5].
4.
4.1
-.
:
1. .
2. .
3. , .
4. .
:

, 5 . .
:
.
. , , 4 .
1. .
. 20 . 15- .
2. .
. 1-2 . 30- .
3. - . LF. 1-2
, , 5-10 .
4. -- . (VLF%).

(). 1-2 . ,

.
:
:

43

1. 30:15 ( 30:15) ().


2. .
3. .
1 . 30:15,
R-R, , R-R, .
. K 30:15 1,35.
1,35-1,2 , 1,2 .
:

(R-Rmax - R-Rmin) x 100%


R-Rmax

3
.



30%

44

0-30%
< 0
> 30%,

(=46.1%)

(=33%)

(=12,4%)

(=19,3%)

2 .
(HF LF). .
, .
LF .

= 2480 2

= 1256 2

4 .
. . . 1981 . 10
() . .

1
.

.

.
2
.

.
.
3 .
( ).

.
.
4
(
).
.
.

.
.

. .
.
.




.


.

. .

.

45

5 ( ). . 20-30% .
6 ( ). . 10-20% .
7 ( ). . 10% .
8 .

( ).

.
.
9 .

( ).

. , ( 30%)
.
10 .

( ).

. , ( 30%)
.



.
-
.


.
.


.
.
.

.
.
. .

. .

4.2
.
W. Birkmayer (1976) Z.
Servit (1948) [32].
W. Birkmayer:

, 10 .
.
5 .
1 .
W. Birkmayer:

46

6 :
: 20-40% 5-20 . . . 4- ,
. .
: , .
,
;
. .
:
. - . , ( - ). . .
: .
, ( , ).
: ( , ), 3-6
. ,
.
( , ). .
: , ,
.
.

(.).
(. . .), (/).

47

Z. Servit:
15
, 5 . .
5 .
Z. Servit:

. :
1. .
2. .
3. .
4. .
- . :
1. :
; .
2. :
; .
3. :
; .
4. .
.

48

4.3
. . .
:

10 . .
:
() : ( ) ,
30-90 . .; 30 . .; 90 160 . .; 160 . .
() (/).


< 30
3060
6090
90160
> 160

1,1
1,13
3
1
12,5
2,5
0,9
0,91,8
1,8
0,7
0,71,5
1,5
0,5
0,51,2
1,2

:
1. 48 . ., 92 . .; / = 1,92

2. 124 . ., 280 . .; / = 2,26



4.4
.
.
, Wheeler Watkins
Hilsted Jensen.
:
6 (5 , 5 ) .
4:6 . ,
. .
:

49

0,05-0,15 .
:

.
. . -
. (r-r) 1,4.
1,4-1,2 , 1,2 .
LF/HF [82].
6 , , (LF),
12 1 .
(HF)
0,15-0,25 . LF/HF .
, , . ,
.
,
Hilsted Jensen

:
4.5

50

.
:
.

II [96].
.
(, ).
:
15-20 , 40 . . . .
.
:
4 [96]:
1. ,
. 3- .
2. , , . 6-7 .
3. ,
,
, .
4.
, , . ,
.
:
(K), R-R R-R . K 1,7. 1,7-1,3 , 1,3 .

4.6

, . ( ).
:
. , - ( ), - (), , . . -

51

. , 70-85% ( 70-85%
). . ,
, .
(
).
1,5 , , , .
[67, 89]:
1,5

,

5-9
10-14
15-19

18-22
35
36
33

23-26
33
35
32

27-30
31
33
31

31-35
28
30
30

,
36-40 41-45
26
24
30
29
29
28

46-49
22
27
27

50-53
20
26
27

54-58
18
24
25

59-63
16
23
24


10-15 . 6
5 .
:

() .
:

6-7 .
:
, .
- .
.
( ), . . 25
30 , 25 35 26, 35 45 23,
45 20 . 3
, .
.
:
, , 1,5 10- 1
(). .
1 (). .
:
0 20%
20 30%
30 40%
40 50%

52

. .
,
.
.
.

50%

4.7
.
:
30%
3 .
. .
:
.
:
15 . . . 10-15 . . .
, 10 . . . .
4.8

.
:
, , 1,5 15- 1 (). 0,3 0,1% 0,15 /. , ,
3, 10, 20, 30 40 . 10 1,5 .
: 10 . . ., 10 ,
3 1 .
:
:
1. .
2. .
3. .
, . . .
. .
4.9
- ( -)
.
[32]:
15- 1
(). , 15-25 . 20
() 15 .
:
, .
:
():

= 100 (

) 100

53

3 8.
. 0 3 . .
( -)

.
:
.
.
.
[32]:
15- 1
(). 20
--
. 15 , 15 ().
:
.
:
():

= 100 (

) 100

3 12. 12 16
. 16
. 0 3 . .
( , -)
.
[32]:
15- 1
().
20-30 . 25
() 15 .
:

.
:
. . (1958) W. Birkmayer (1976). .
.
4-12 .
4 .
12 .

54

5.
5.1

[159].
, -
, .
, (T, LF, HF, m0,
), . 4-5 , ( T, LF, HF, m0). . -
(T, LF, m0, ), .
, , 6-8 (.. , ..
, .. , 2001).

1
(Mm)
118,01,7
119,51,7

2
(Mm)
123,92,3
124,72,2


3
4
5
(Mm)
(Mm)
(Mm)
121,62,8
128,83,2
124,83,2
123,32,8
131,23,6
129,43,5

69,86,36

90,628,18

111,615,7

115,415,6

94,29,9

99,311,6

125,93,6

34,43,03
10,61,37
14,40,99
17,11,11
0,510,01
0,510,01

45,873,73
10,991,02
14,81,15
17,11,17
0,490,01
0,480,01

51,675,8
15,322,12
19,51,8
14,51,58
0,490,01
0,490,01

49,45,06
16,32,44
17,62,2
13,41,81
0,470,01
0,460,01

48,74,71
14,51,71
14,21,3
11,41,38
0,480,01
0,480,01

50,74,71
14,31,67
19,01,7
15,41,69
0,450,01
0,450,01

60,77,60
13,62,24
17,32,5
18,73,24
0,460,02
0,450,02

T
(/2)
LF
HF
m0
m0
M

140
120
100
80

6
(Mm)
131,63,2
136,83,5

7
(Mm)
125,23,6
125,23,6


T
LF

60
40
20
0

HF
VLF + ULF
m0
1

55

(1-3 ) , . .
.
(4-6 ) :
. , HF, , .
7-10 , ( )
( , . .) . 7-8 . 9-10-
,
.
11-13 .
( ) 1415 [43].
[20]

(.)
(.)
(%)
(. .)

1-3
0,580,02
0,230,04
282,5
13417,7

4-7
0,620,03
0,230,05
271,0
9415,0

,
8-10
0,720,02
0,280,02
160,9
5711,0

11-13
0,730,02
0,270,02
231,5
8210,0

14-15
0,740,02
0,340,04
181,0
396,6

0-2 [76]

0-1 .
2-3 .
4-5 .
6-9 .
4 . 2

3-5

6-8

9-11

12-15

Xc. ()
39411
44926
45916
46122
47959
546,341,3
618,335,6
703,228,4
668,242,4
793,934,5
676,646,8
823,554,5
740,252,1

SDNN ()
485
648
6512
6513
7021
116,613,1
123,714,5
131,810,2
140,714,2
183,419,2
163,518,9
227,356,6
183,621,4

rMSSD ()
225
265
278
224

50,26,6
47,65,6
54,27,8
54,87,3
72,69,3
63,99,2
82,512,3
77,17,8

PNN50 (%)
0,980,3
2,62,1
2,72,4
1,71,6

13,45,3
15,14,3
21,34,2
19,73,8
33,48,5
24,48,6
42,76,8
39,96,8

,
. ,
, .
.
,
, .

56

5.2
5.2.1
( ) , .
, , , . : I , (
T ST I, II, V5, V6), , . . . .
, ,
( 14-20%, 0,71,1, 0,24-0,48 , HF%). - . , , ,
2/1,
. - .
, .
(0,5-0,62 ), (0,08-0,12 ), (38-52%) (120-400 . .).
- . . , 1/3
- . ,
.
-- . .
, . , ,
, (, , .). , .
,
( , , , ), , ,
B6, - ().
WPW, I ,
( ), ,
(, , ).
, .
.
5.2.2
, , , , , .
.

57

(, ) , .
0,66-1,10 , 14-24%, 0,23-0,54 , 40 .
.
(2/1 3). ( 80 . .)
(2/1 0,7). ,
, .
,
. , . . ,
, . ,
.
, , . , ( . .), , , .
5.2.3
. .
,
: SDNN rMSSD
: (T), LF HF. (LF/HF) . , ( ) , .
. ,
.

.
, , , , , rMSSD, SDNN
.
(HF) , ,
. LF/HF
. ,
. .

: , ( . ., . ., . .)

58

,
, . .
HF, 2
SDNN,
rMSSD,

0,410,02
41,132,59
3585435
0,0920,004
0,1030,006

0,360,01
49,991,64
1789154
0,0740,002
0,0760,003

0,4020,013
41,0542,393
2740371
0,0900,004
0,1070,007

ANOVA
<0,01
p>0,05
<0,01
<0,001
<0,001

, LF .

( ) , . .
(, SDNN, rMSSD) , .
:
( . ., . ., . .)
.,
., . .
Am ., %
LF ., 2
SDNN .,
RMSSD .,


0,1490,010
421,661,4
59,93,9
1357216
0,0310,002
0,0220,002

0,2270,019
218,534,9
46,72,8
1575117
0,0480,004
0,0340,005

ANOVA
p<0,01
p<0,01
p<0,05
p<0,05
p<0,01
p<0,05


, . , :
, : SDNN ,
.
.
:
( . ., . ., . .)
.,
., . .
A ., %
SDNN .,


0,1310,015
767,6124,9
68,94,2
0,0290,003

0,1600,010
377,743,5
55,82,8
0,0340,002

ANOVA
P<0,05
P<0,05
P<0,01
P<0,05

, .
. .
.

5.2.4

59


( , , ) : , ( 34%) ( 200
. .). , ( . . ). , , , .
, ( ).

:

, %

, . .

0,67-0,50
0,58-0,46
0,49-0,38
0,40-0,32

0,40-0,14
0,12-0,08
0,06-0,04
0,02

17-34
35-45
46-75
76-98

48-199
200-749
750-2999
3000-6805

,
.

. (
. . ).
.
. , .
,
, , , , .
5.2.5 -
, , , , -
. .
-
( 30 . .). , , (
. 90 . .). .
, , ,

( 100 200 . .)
, - . ( 100300 . .) ,

( 30 . .) .

60

.
, (, , , , ,
, .),
.
, , ,
, , , .
6.
6.1
6.1.1
.

, . ( ).
:
, ;
;
;
;
.
:
(),
(HF);
1 . . ;
,
(SDNN , , . .);
30:15.

, . , LF VLF
30:15 .
, 15 .

1,5

61

1
, .
6.1.2
. .
() :
1. 10-20%, HF
LF. .
2. 20% . (HF) (LF) , .
3. 10%,
HF LF. .
4. HF LF (
), . .
. (
).

: . , .
, , .
, . , .

62

50
45
40
35

30

25

20

15
10
5
0

6.1.3

, .
. . :
;
(LF% VLF%)
(HF%);
.

63

, . , , . , , .
6.2
6.2.1
() . , , [96]:
( 40 );
( 5 );
: ( 75% 83% ),
;
:
;
-: , ;
- :
;
: ,
. .
.
. ,
.
.

. - ,
. . , ,
.
, ,
. , , (. ).

[82].
1 , , .

64

2 . - .
3 ( VLF 60%).
400 2, .

( .)

, /
SDNN,
rMSSD,
PNN50, %

(n=9)
73,94,2
59,85,3
42,46,1
21,15,1

(n=25)
74,92,8
38,14,1
25,23,3
7,62,7

. ,
() 400 2, (SDNN) 20 , (LF/HF) 2,5,
(VLF%) -
-.
[81, 107].
.
,
. .

, %

VLF

,
/
60

( -
-II).
60-70
( -
-II). ().
70 ( -
-II). ().
70 - LF
. , , ,
, .
60-70
-.
50-60
. - .
.
50 .
- . .
60 ().
F
60 ().
, , , .

65

, .
6.2.2
, . ,
. 0,5%,
7-17%.
, , ( ). , , .
.
, , . .
, ,
.
.
:
;
(VLF VLF%)
;
(HF HF%);
(LF%).
, ,
, ,
.
6.2.3
.
.
, . , [22]. 1-3 77,4-81,3% 10%.
4 .
75,4%
: HF 18,5%, LF 21,5%, HF LF 35,4%
( 75,4%, 40,5%). [21]. (SDNN, rMSSD, NN50, 2, HF 2 ..).
. ,
SDNN 70
8,8 [82].
,
[22]

66


, .
1
2
3
4


HF,
LF, 2

2
0,04
0,06
0,20***
0,07
0,04
0,17**
0,13*
0,14*
0,21***
*
**
0,12
0,18
0,22***

0,14**
0,15**
0,09
0,16
*
**
0,13
0,15
0,10
0,12*
0,12*
0,13
0,10
0,10
0,11
0,12*
0,12
0,10

: . : * <0,05; ** <0,01; *** <0,001.



:
, (, , );
;
;
.
. . (
).

,
> 400 2, SDNN > 20-25

( )

< 400 2, SDNN < 20-25


,
HF, LF, VLF,

120 1 , ST 2 ;
ST 6 ; ST ;
ST Q;
;


HF, LF, VLF,
. ( , LF%) -. (
,
HF%) . . - (
,
LF%), , , -II.
6.2.4

67


.
: ,
. - . . Q , Q [167]. ,
[169].
.
, . , - - .

.
. ,
.
:
( ) ;
;
;
;
.
( ,
. .). . (SDNN , HRV .) (VLF 2, HF 2). , SDNN 15-20 . RRNN.
,
(SDNN) 50 (HRV) 15 . ( ).

: , ,
.
.
, .
. . [123]
().
= 5 ln(RRNN)-1,7 x -1,3 ln()-0,5 ln(VLF)
RRNN RR ( ),
( 0 , ),
- , VLF 2.
25,8 . 1,5%;
25,1-25,8 8,8% , 25,1 42,4%.
:

, . -

68

3-10 [26]. :
;
(TP 2), , (HF 2) ;
(LF% VLF%)
, .
3 , HF , . , , [135, 171, 172]. , ( ) .
, ()
() Bigger at al.

SDNN,
SDANNi,
SDNNi,
rMSSD,
PNN50, %
TP, 2
ULF, 2
VLF, 2
LF, 2
HF, 2
LF/HF

(n=274)
14138
12735
5415
2712
97
2122211663
1842010639
1782965
791563
229282
4,612,33

(n=278)
11240
9938
4618
2815
1011
143030353
121309241
14601090
511538
231324
3,602,43

(n=684)
8130
7027
3516
2312
79
73235720
60674861
850800
277335
129203
2,752,13

, -, 3
2-4
[124]. , 2-4 , 67 ,
.

RRNN
SDNN
SDNN / RRNN
100%
ln (TP, 2)
ln (VLF, 2)
ln (LF, 2)
ln (HF, 2)
LF / HF
LF, nu

2-4-
> 67
67
806,1
1051,5
18,0
34,0
2,2
3,2
5,8
5,0
4,4
4,3
1,3
53,9

7,2
6,3
5,9
5,8
1,1
52,4

3-
> 67
67
907,8
1071,0
33,0
38,0
3,5
3,5
6,8
5,9
5,4
5,3
1,3
53,3

7,3
6,3
6,1
5,9
1,2
54,4

1
> 67
67
896,9
969,7
28
36
3,4
3,6
6,9
6,2
5,7
5,2
1,6
61,4

7,2
6,4
5,9
5,5
1,3
58,2

, , .
, ( ).
6.2.5

69

():
( ,
);
;

;
;
.
.
, . , (LF%) (VLF%) . , .
: -II , . ,
, ().
. (TP 2) (HF 2)
(LF 2) . , (LF) .
[165].
(VLF 2) .
, .
SDNN SDANN 70 55 ,
6 ( 100% 88%
, 87% ) [152].
. . . , . ,

NYHA [95, 96].
6.2.6
, ,
. . , (LF) (RRNN). , . .
(1997) (TP) .
6.2.7
. , [155, 188]. (HF) (LF) . - (VLF).

70

:
( LF), ,
, ( HF) [151].
(HF LF)
.
,
. -, .
6.2.8
:
(
), ();
- ;
.
,
.
5 50%.
:
:
(HF 2);
(LF 2) [132, 181];
( 2)
(LF) (HF) LF/HF;
;
;
.
:
LF- ;
30/15 ( 30/15) 1,2 ;
(r-r) 1,1 .

[32]:
;
( );
;
;
;
;
;
;
;
( );
.
, . .
56 II 18 73 .
8 I-II . .

71


, /
SDNN
rMSSD
HF2
LF 2
, . .


(n=48)
73,41,4
22,01,4
13,71,1
577
12022
54579


(n=8)
80,62,3
16,72,0
7,71,1
286
5516
745227

II , .
, II , .
, ,
. () (SDNN).
, .
6.2.9
[110].
. ,
(220 , 95 86 )
:
( )
LF HF. VLF
.
- , , ,
VLF ( )
(HF% LF%). ,
(VLF) .
, , VLF,
. VLF
( 5 ) (4- 2,5 ), , VLF-.
- , , (TP
2) ,
. : LF VLF,
HF VLF.
.
: LF , , - ,
VLF - .
.

72

, , VLF, .

LF ( ) .
.
[101]:
, 0,1 0,25 ( HF LF), . , . ( -)
.
, .
, , .
-
.
(HF 2). , -,
, - .
,
.
6.2.10

(). ,
.
[12]:
1. .
2. , .
3. .
: , ,
.
[12].
, , .

( ) ,
, . , [99].

73

(./.)
75,42,4
103,52,8

(.)

(%)

SDNN ()

322,1
351,8

(. .)
17810,2
36424,1

0,780,02
0,580,01

109,62,6
120,63,1
90,21,2

0,550,01
0,50,008
0,680,01

39,32,04
51,22,6
44,82,1

57629,3
93535,7
48721,4

16,80,8
10,70,2
18,31,02

110,11,4

0,550,01

48,21,8

62020,5

16,80,8

73,61,04

0,80,02

26,41,2

164,712,1

23,11,04

24,11,6
19,11,1

, (. . . . ).
6.2.11
-:
;
( (LF 2) 50%,
LF-) [192];
(
(HF%) 145%,
(LF/HF), ) [62];
;
- 60 [54];
(, .);
-
[81].
2+ (,
.):
;
( (LF));
( (HF), (LF/HF),
).
:
1 ;
3 (, .) : , ;
( (HF) ).
-II:
;
- (
(VLF));

74

(
(HF%), ) [61];
(VLF%) [81, 107].
:
;
(
(HF%), ).
- (, , ):
;
( (LF));
( (HF),
(LF/HF), ) [61].
-:
;
( (HF), (LF/HF),
);
( (LF%));
.
, :
(,
) ;
(, ) ;
(, ) ;
() .
.
. [192]:
;
( (HF),
).
:
[62].
7.

()
(R. Kleiger ., 1987):

, . . ,
, .
, . , 30/15 .
,
,
-

75

. , / .
.
, .
, .
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.
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.
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.

. . . El-Bedawi . (1994), , R-R ( ).
.
, ,
, .
7.1

, . :
I, II, aVF, V2-V6 ;
-Q -R;
( R-R).
, . .
, ( , HF). , , . .
[74] . .

.
.

40 100 1 . 60 90 , 50 60 , 40 50 ,
40 . 90-100 / , 100 .
.
, . .
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76

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.
, (SDNN) 25
.
:
( 80 1 ).
( 80 1 ).

, (, , III-IV NYHA).
, ,
,
.

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12- ).
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77

,
. , , ,
.
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.
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:
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:
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:
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:
;
():
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78

:
- ( );
- ;
- .

(Lawn-Wolff, 1971):

0
1
2
3
4
4
5


1-30 1
30 1
()

3 ( )
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, .
, , , . ( ),
.

79


. ,
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( ) () R-R .
. , ,
R-R, , , .
. , .
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1
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().
, (1:1 ; 2:1 ; 3:1 . .).

, RR .

80


, , .
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81


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82


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83

1
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:
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;
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).
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:
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84

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, , , . . ( ).
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);
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. (). .
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., 4

85


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86


[73]:





[57, 58]



-
-
-
-
- ,
- ()
- (HF)
- (100-150
/)
- (50-75
/)
-
-

,
- (LF
VLF)
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2
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/)

. ,
.
7.5
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, . , , , .
, . .
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87

, .

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(LF) .
8.

, , :
;
;
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:
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. .);
;
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8.1
. , -

88

. , 60 R-R
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R-R . ,
.
( ). 5 . .

., 5

., 10

., 2,5
, , 5-10% ,
.

89


(. 3.4.1. ).
, R-R .


8.2
, , Max (), Min (), , V (%).
60 90 1 . Max () Min () . (, ),
, .
X (), R-R , .
,
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40 (0,040 ).

90

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, ,
.
SDNN () () RRNN () X ()
.
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SDNN ().
NN50count PNN50 (%)
, 50 . PNN50 (%)
10-15%.
rMSSD ()
pNN50 (%) NN50count, .
8.4
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1%. 50%
.
/2 . , - . ()
.
,
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435. .

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91

(%) = 15; () = 0,67

(%) = 10,3; () = 0,669

8.5
.
0,4 1,4 . . .

0,4-1,4 .

0,7-1,1 .

8.6
.
1k , M0. M0 , .
.
M0 25 : 51; 26-40 : 102; 40 : 177.
8.7
, : (2), HF (%), LF
(%), VLF (%), LF/HF .
,
.

92

(2) , . .
, , 2
( ) :

., 20

93

HF (2) HF (%) . .
LF (2) LF (%) . VLF (2) VLF (%) - . VLF (%) .
,
.
. , HF (%) (2) .

, , HF (%)

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94

8.8
.
, . , , (, , W . .) :

W,
.


. .
.
1

: 03.05.2002

: 17
:
. 4.9 (291 .). QRS : 282.

X ()

1.034

Max ()

1.140

Min ()
. ()
D
(/)

0.891
0.006
0.0025
59.0


()
(%)
()

1.050
33.3

0.627

0.360
2

TP ( )

2457.7
2

0.250

HF (P) ( )

3.813

63.543

1510.2

LF (P1) ( )

404.1
2

VLF (P2) ( )

543.4

95

()

0.050

As

-0.248

Ex

-0.412

V (%)

4.9


RRNN ()

1034.3

SDNN ()

50.4

133.440

31.746


()

ULF (2)

0.0

LF/HF

0.3

HF (%)

61.4

LF (%)

16.4

L (c)

0.284

VLF (%)

22.1

w (c)

0.191

ULF (%)

0.0

L/w

1.488

HF n.u. (%)

78.9
21.1

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55.9

S ( )

0.043

LF n.u. (%)

NN50count

121

()

1.539

PNN50 (%)

42.9

HRV ()

13.4


m(RRM) ()


m0

1k

0.622

m()
m() (%)

1.034
1544.2
0.0

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195.3

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7.8

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210.9

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195.3

96


1. .
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(++)

97


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:
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0 .

: _____________________

98

: 03.05.2002

: 17

30/15

1.449

1.35

(%)

31.0

30 %

(/)

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7 18


(c)

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80.0

80.0

0.0025

0.0039

0.0016

X ()

1.034

0.756

0.750

Max ()

1.140

0.896

0.872

Min ()

0.891

0.619

0.672

0.0025

0.0039

0.0016

0.050

0.063

0.040

4.9

8.3

5.4

. ()
()
V (%)


()

1.050

0.750

0.700

AMo (%)

33.3

37.3

53.7

()

0.250

0.278

0.200

3.813

4.804

7.158

63.543

89.485

192.173

133.440

134.228

269.042

0.627

13.740

10.935

0.360

11.746

7.597

2457.7

3869.3

1615.9

1510.2

262.5

135.4

TP ( )
HF ( )
2

LF ( )

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523.3

451.9

543.4

3083.4

1028.6

0.0

0.0

0.0

LF/HF

0.268

1.994

3.337

HF (%)

61.4

6.8

8.4

LF (%)

16.4

13.5

28.0

VLF (%)

22.1

79.7

63.7

ULF (%)

0.0

0.0

0.0

HF n.u. (%)

78.9

33.4

23.1

LF n.u. (%)

21.1

66.6

76.9

VLF ( )
ULF ( )

99


m0

1k

0.622

0.083

0.113

()
L (c)

0.284

0.346

0.275

w (c)

0.191

0.121

0.084

L_W

1.488

2.869

3.251

S (c )

0.043

0.033

0.018

()

1.539

2.170

2.439


RRNN ()

1034.3

756.3

750.1

SDNN ()

50.4

62.8

40.4

rMSSD ()

55.9

22.1

19.0

NN50count

121

PNN50 (%)

42.9

2.9

1.0



. .

4 - ( ). .

.

.
, .
.

.


. 3
.

: . . - .
: _____________________

100

: 16.04.2002

: 28

Krr

2.492

1.062

0.975

0.615

0.811

3326.2

23255.1

1373.9

11775.1

TP ( )
HF ( )
2

LF ( )

615.3

1928.9

844.5

9551.0

ULF ( )

492.6

0.0

LF/HF

0.448

0.164

HF (%)

41.3

50.6

LF (%)

18.5

8.3

VLF (%)

25.4

41.1

ULF (%)

14.8

0.0

HF n.u. (%)

69.1

85.9

LF n.u. (%)

30.9

14.1

VLF ( )



:

:
:

: _____________________

101

: 10.02.2002

: 37


1.533


:
:

: _____________________

,
[192]

102

Guzetti, 1991,
40 ,
30
Langewiz, 1994
41 ,
34 ,
54
Saul, 1988
25 III-IV .
NYHA,
21

LF
. LF.
.
, ().
, LF HF
. , .

Casolo, 1989 [140]


20 II-IV .
NYHA,
20
Binkley, 1991
10
14-40%,
20
Kienzle, 1992 [165]
23 II-IV .
NYHA
Townend, 1992
12 III-IV .
NYHA
Binkley, 1993
13 II-III .
NYHA

Woo, 1994
21 III .
NYHA

Axelopoulos, 1988
19 ,
10


(>0.01 ) /.
.


(24-48 .)


(24 )


,
(24 )

(24 )

Sands, 1989 [188]


17 ,
6

Stein,1993
38


(24 )

Marangoni, 1993
39 ,
24

Counhilan, 1993
104

(24 )

Dougherty, 1992
16
, 5
,
5
Huikuri, 1992
22
,
22
Algra, 1993 [130]
193 ,
230


(24 )

12 HF.

.
.

: .
0,02 1,0 90%.
.
, ULF 2 SDANN
( ,
. .).
HF.

LF SDNN 1 .

1


(24 )

HF .
LF


(24 )

(0,05-0,50
)
2,6 ,
(0,02-0,5 ) - 2

103

Myers, 1986
12
(6 ),
6
Martin, 1988
5
,
20
Vybrial, 1993
24 ,
19


(24 )

.
HF (0,35-0,5 )


(24 )

SDNN .


(24 )

Huikuri, 1992
18


(24 )

Holnloser, 1994
14
,
14


(24 )

Kocovic, 1993
64


(24 )


,
. .

. . ,
,
/
, .

: ; ,
; ; ;
; ; ; ; .

104


1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.

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. , 1968, I:751.
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28.11.84 ( 7-83;2-85)
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25780-83. ( 3652-82) . .
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.
.. . .
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