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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
21
22
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
66
68
70
70
70
71
72
73
74
75
76
78
85
86
87
88
88
90
91
91
92
92
92
95
95
95
99
101
102
102
105
.
, .
. . , . . . . . , , .
. , . . , . . , . . . . .
. . , . . ,
. . , . . , . . . . , -
. . . . .
. . , . . , . . , . . . . .
--
NYHA
1.
1.1
1932 , R-R [96]. 1965 . Hon Lee ,
[159].
1973 . Sayers . [189]. 80- Ewing . , , R-R-
[148]. , -
- :
, ;
- , , , . .;
;
, ;
;
.
:
,
;
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, , , ;
.
:
;
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;
, , , ;
;
;
(, , . .);
- , - .
1.4
. . , ( ). :
;
(. ).
(, ) , ;
, , 20%.
1.5
:
, 1,5-2 ;
;
18-24 ;
, , ;
.
, ;
;
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.
( ).
1.6
5-10 . 20- .
.
(VLF ULF) ( 40 ).
.
:
, ;
;
.
.
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- :
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,
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.
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,
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. -
0,05 200 .
. , , . () -
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, , ,
.
1.8
.
. ,
.
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,
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;
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;
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;
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;
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;
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, . .
.
.
60-100 1 . , ,
.
.
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. ( ). . , , . ( ),
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,
.
,
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. . -
,
.
.
. . .
.
, ,
[105].
: ,
.
.
.
: ,
, , .
,
, , . , .
,
, .
. ,
. [96].
11
.
.
, .
. , ,
.
, .
. 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 . .
. . .
90- [95-96], :
1. 33 .
2. ( ).
3. , .
:
, (,
, )
, .
, , .
, ,
.
, ,
1-2% .
().
I IV .
() ( . . )
I
II
III
IV
1
7
15
23
43
1
5
13
18
39
2
8
27
38
73
m (),
.
600 .
650 .
550 .
575 .
750 .
925 .
, ,
. , . , .
3.3
, .
3 :
;
;
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. .
( ).
4. , .
, . .
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 .
:
:
- ; - ; - .
, :
- ; - .
:
- ; - ; - .
:
- ; - .
:
- ; - () .
:
- ; - .
:
- ; - .
:
- ; - ; - .
( ).
, .
, .
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
+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, )
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
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 :
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. ,
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(.).
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47
Z. Servit:
15
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5 .
Z. Servit:
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2. .
3. .
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; .
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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
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:
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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].
.
(, ).
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1. ,
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2. , , . 6-7 .
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4.6
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:
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51
. , 70-85% ( 70-85%
). . ,
, .
(
).
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[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
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5 .
:
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30 , 25 35 26, 35 45 23,
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52
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50%
4.7
.
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3 .
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:
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.
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3, 10, 20, 30 40 . 10 1,5 .
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.
[32]:
15- 1
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():
= 100 (
) 100
53
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(). 20
--
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:
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():
= 100 (
) 100
3 12. 12 16
. 16
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.
[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
- . ,
.
-- . .
, . , ,
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,
( , , , ), , ,
B6, - ().
WPW, I ,
( ), ,
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.
5.2.2
, , , , , .
.
57
(, ) , .
0,66-1,10 , 14-24%, 0,23-0,54 , 40 .
.
(2/1 3). ( 80 . .)
(2/1 0,7). ,
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, . ,
.
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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
,
.
. (
. . ).
.
. , .
,
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, , , , -
. .
-
( 30 . .). , , (
. 90 . .). .
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( 100 200 . .)
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60
.
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.
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6.
6.1
6.1.1
.
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:
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;
;
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(HF);
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30:15.
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30:15 .
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1,5
61
1
, .
6.1.2
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() :
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LF. .
2. 20% . (HF) (LF) , .
3. 10%,
HF LF. .
4. HF LF (
), . .
. (
).
: . , .
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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]:
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( 5 );
: ( 75% 83% ),
;
:
;
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- :
;
: ,
. .
.
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.
.
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.
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[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
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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
,
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].
.
, . , - - .
.
. ,
.
:
( ) ;
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;
;
.
( ,
. .). . (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). , -,
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,
.
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
. , / .
.
, .
, .
/ .
-
.
, , . . .
.
. ( ), , ,
.
. . . 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 .
.
, . .
R-R . -
76
, . : , .
.
, (SDNN) 25
.
:
( 80 1 ).
( 80 1 ).
, (, , III-IV NYHA).
, ,
,
.
( , ,
12- ).
(, -).
77
,
. , , ,
.
7.2
() () ,
,
, .
.
. . .
:
- (1 ); - (2 ); - (3 ).
:
:
- ; - ; - --;
:
- ; - ; - ; - .
:
- ; - .
1 :
- ( 5); - (6-15); - ( 15).
:
- ( );
- ( );
- ( U);
- ( U).
:
;
():
- ; - ; - . .
78
:
- ( );
- ;
- .
(Lawn-Wolff, 1971):
0
1
2
3
4
4
5
1-30 1
30 1
()
3 ( )
R T
, .
, , , . ( ),
.
79
. ,
R-R , , R-R .
( ) () R-R .
. , ,
R-R, , , .
. , .
. ,
R-R .
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