CN112057058A - Method for evaluating autonomic nerve function and application - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/0205—Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/40—Detecting, measuring or recording for evaluating the nervous system
- A61B5/4029—Detecting, measuring or recording for evaluating the nervous system for evaluating the peripheral nervous systems
- A61B5/4035—Evaluating the autonomic nervous system
Abstract
The method adopts an electrocardio-blood pressure detector and a calculating unit to comprehensively detect the heart rate, the blood pressure, the breathing frequency and the like of a patient, and adopts an algorithm to evaluate 8 experimental results so as to evaluate whether an autonomic nervous system is abnormal. The method is rapid, simple to operate, free of drug mediation and safe.
Description
Technical Field
The invention relates to the field of medical treatment, in particular to a method for evaluating autonomic nerve function and application.
Background
If the autonomic nervous system changes in function due to the influence of drugs or the nervous system, many symptoms such as recurrent syncope, dizziness, palpitation, sweating, vomiting and night sweat and the like which are difficult to explain due to unknown reasons appear, and great troubles and burdens are brought to patients. Therefore, autonomic nervous function test has important clinical significance for clinical disease diagnosis and differential diagnosis, and the autonomic nervous function assessment method which is rapid, simple to operate, free of drug mediation and safe can greatly simplify the process.
Disclosure of Invention
In order to solve the technical problem, the invention provides a method for evaluating the autonomic nervous function, which comprises an electrocardio-blood pressure detector and a calculating unit, and comprises the following steps:
an electrocardio-blood pressure detector is adopted to collect the heart rate and blood pressure of the patient in the clinostatic position; the computer unit calculates the heart rate and the blood pressure of the upright position collected by the electrocardiogram and blood pressure detector according to a calculation rule and evaluates the positive result of the blood pressure of the upright position;
adopting an electrocardio-blood pressure detector to collect continuous strength training heart rate and blood pressure; the computer unit calculates the continuous strength training heart rate and blood pressure collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates a continuous strength induction positive result;
collecting the values of the deep respiration heart rate and the respiration frequency of a patient by adopting an electrocardio-blood pressure detector; the computer unit calculates the values of the deep respiration heart rate and the respiration frequency collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates a positive result of deep respiration induction;
adopting an electrocardio-blood pressure detector to collect the heart rate and the blood pressure of a patient in a mental calculation state; the computer unit calculates the heart rate and respiratory rate values of the patient in the mental calculation state collected by the electrocardiogram and blood pressure detector according to a calculation rule, and evaluates a positive result induced by the mental calculation;
an electrocardio-blood pressure detector is adopted to collect the heart rate, the respiratory rate and the blood pressure of a patient in a Valsalva Manual state; the computer unit calculates the heart rate, respiratory rate and blood pressure values of the patient in the Valsalva Manual state collected by the electrocardio-blood pressure detector according to a calculation rule, and evaluates a Valsalva Manual positive result;
an electrocardio-blood pressure detector is adopted to collect the heart rate and blood pressure of a patient in an ice bag icing state; the computer unit calculates the heart rate and blood pressure values of the patient in the ice bag icing state collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates an ice bag induction positive result;
collecting blood pressure of a patient in an over-ventilation state by using an electrocardio-blood pressure detector; the computer unit calculates the heart rate and blood pressure values of the patient in the over-ventilation state collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates an over-ventilation positive result;
an electrocardio-blood pressure detector is adopted to collect the heart rate and blood pressure of the patient in a long-range upright inclined state; the computer unit calculates the heart rate and blood pressure values of the patient in the long-range vertical inclination state collected by the electrocardiogram and blood pressure detector according to a calculation rule, and evaluates a positive result of the long-range vertical inclination test;
and the computer unit comprehensively evaluates the calculated vertical and horizontal blood pressure positive result, continuous strength induction positive result, deep respiration induction positive result, cardiac calculation induction positive result, Valsalva Manual positive result, ice bag induction positive result, over ventilation positive result and long-range vertical inclination test positive result, and gives an evaluation result of autonomic nervous dysfunction if one of the 8 evaluation results of the vertical and horizontal blood pressure positive result, the continuous strength induction positive result, the deep respiration induction positive result, the cardiac calculation induction positive result, the Valsalva Manual positive result, the ice bag induction positive result, the over ventilation positive result and the long-range vertical inclination test positive result is positive.
Further, the calculation rule of the computer unit for evaluating the positive result of the blood pressure in the lying position in the step (1) is that
The reduction range of the systolic pressure is vertical systolic pressure-horizontal systolic pressure;
the diastolic pressure decrease amplitude is vertical diastolic pressure-horizontal diastolic pressure;
the heart rate rising amplitude is vertical heart rate-horizontal heart rate;
if the reduction range of the systolic pressure is more than or equal to 20mmHg and/or the continuous reduction range of the diastolic pressure is more than or equal to 10mmHg, the blood pressure of the standing position and the lying position is positive;
if the heart rate is increased by more than or equal to 30 times/min compared with the horizontal position in the vertical position period and/or the maximum value of the heart rate is more than or equal to 125 times/min, the vertical position blood pressure result is positive;
the calculation rule for evaluating and evaluating the positive result of the continuous strength induction by the computer unit in the step (2) is
The reduction range of the contraction pressure is the contraction pressure after force is applied and the contraction pressure before force is applied;
the diastolic pressure reduction amplitude is equal to the diastolic pressure after force is applied and the diastolic pressure before force is applied;
the heart rate rise is the heart rate after exertion-the heart rate before exertion.
If the rising amplitude of the systolic pressure is more than or equal to 20mmHg and/or the rising amplitude of the diastolic pressure is more than or equal to 10mmHg continuously in the continuous strength process, or the heart rate rises more than or equal to 30 times/min and/or the maximum value of the heart rate is more than or equal to 120 times/min, the continuous strength induction result is positive
The calculation rule for evaluating and evaluating the positive result of deep respiration induction by the computer unit in the step (3) is
The heart rate difference before and after deep breathing is the inspiration phase heart rate-expiration phase heart rate;
the rise of the blood pressure and the heart rate before and after deep respiration indicates that the sympathetic function is possibly hyperfunction;
calculating respiratory sinus heart rate difference (RSA) by combining heart rate difference before and after deep respiration to evaluate whether vagus nerve hyperfunction exists, wherein the specific age and normal range are shown as Table 1;
Table 1.Normative values for deep breathing test.
calculating the respiratory sinus heart rate difference (the respiratory sinus arrythmia) by combining the heart rate difference before and after deep respiration, evaluating the positive result of deep respiration induction by RSA,
if the age is 10-29 and RSA is more than or equal to 14, the induction result of deep respiration is positive;
if the age is 30-39 and the RSA is more than or equal to 12, the induction result of deep respiration is positive;
if the age is 40-49 and the RSA is more than or equal to 10, the induction result of deep respiration is positive;
if the age is 50-59 and RSA is more than or equal to 9, the induction result of deep respiration is positive;
if the age is 60-69 and RSA is more than or equal to 7, the induction result of deep respiration is positive;
the calculation rule of the computer unit for evaluating the positive result of mental calculation induction is
The rising amplitude of the systolic pressure is the systolic pressure after the mental calculation-the systolic pressure before the mental calculation;
the diastolic pressure rise amplitude is the diastolic pressure after the mental calculation and the diastolic pressure before the mental calculation;
heart rate rise amplitude is heart rate after mental calculation-heart rate before mental calculation;
if the rising amplitude of the systolic pressure before and after the systolic pressure is more than or equal to 20mmHg and/or the continuous rising amplitude of the diastolic pressure is more than or equal to 10mmHg, or the heart rate rises more than or equal to 30 times/min and/or the maximum value of the heart rate is more than or equal to 120 times/min, the mental arithmetic induction result is positive;
the calculation rule for evaluating the positive result of the Valsalva Manuver by the computer unit in the step (5) is
The mean maximum value of blood pressure or pulse drop is the mean of the highest blood pressure or pulse minus the lowest blood pressure or pulse in each Valsalva Manuver period;
end mean blood pressure recovery phase ii and mean blood pressure overthrot phase iv: the mean value of the blood pressure at different stages of each Valsalva Manual cycle;
systolic pressure recovery time: the mean value of the time required for the systolic pressure to fall back to the starting point in each Valsalva Manual cycle;
the Valsalva ratio, VR, the maximum value/the minimum value of the heart rate in each Valsalva manager period, VR of each period is respectively calculated, and finally, the average value is calculated;
the blood pressure changes in a normal range, if the blood pressure exceeds the normal range, the result of Valsalva Manuver is positive;
Table 2.Normative values for Valsalva maneuver in blood pressure.
| variables of | Normal value |
| Mean maximum value of blood pressure drop | ≥20mmHg |
| II mean blood pressure at end of the term (convalescent period) | Not less than base line (m)mHg) |
| Mean blood pressure stage IV (OVERHOOT) | Baseline (mmHg) |
| Maximum pulse decline | Not less than 50% of base line |
| Systolic pressure recovery time | < 4 seconds |
Valsalva ratio, VR ═ heart rate maximum/heart rate minimum, normal range, if exceeding normal range, Valsalva Manuver result is positive;
Table 3.Normative values for Valsalva ratio.
the calculation rule for evaluating and evaluating the positive result of ice bag induction by the computer unit in the step (6) is
The rising amplitude of the systolic pressure is the systolic pressure after cold compress-systolic pressure before cold compress;
the diastolic pressure rise amplitude is the diastolic pressure after cold compress-the diastolic pressure before cold compress;
the heart rate rise is the heart rate after cold compress-the heart rate before cold compress.
If the rising amplitude of the systolic pressure is more than or equal to 20mmHg before and after the cold compress of the ice bag, or the continuous rising amplitude of the diastolic pressure is more than or equal to 10mmHg, or the heart rate rises more than or equal to 30 times/min, or the maximum value of the heart rate is more than or equal to 120 times/min, the induction result of the ice bag is positive;
step (7) the computer unit evaluates the calculation rule for evaluating the positive result of the hyperventilation to
The rise amplitude of the systolic pressure is the systolic pressure after over ventilation-systolic pressure before over ventilation;
the diastolic pressure rise amplitude is the diastolic pressure after hyperventilation-the diastolic pressure before hyperventilation;
heart rate rise is the post-hyperventilation heart rate-pre-hyperventilation heart rate;
if the rise amplitude of systolic pressure is more than or equal to 20mmHg before and after the over-ventilation and/or the continuous rise amplitude of diastolic pressure is more than or equal to 10mmHg, or the heart rate rises more than or equal to 30 times/min and/or the maximum value of heart rate is more than or equal to 120 times/min, the over-ventilation result is positive;
the computer unit evaluates and evaluates the positive result of the long-range upright inclination test according to the calculation rule
Vasovagal syncope positive reaction: the occurrence of syncope or syncope aura in the upright tilt test was positive with one of the following: firstly, the blood pressure is reduced; ② the heart rate is reduced less than 60 times/min; third, the intercross escape heart rate of sinus asystole is generated; sexual first degree or more atrioventricular block and cardiac arrest of up to 3 s;
positive reaction of postural tachycardia syndrome: the heart rate is increased by more than or equal to 30 times/min compared with the horizontal position within 10min of the vertical inclination test, and/or the maximum heart rate is more than or equal to 120 times/min; simultaneously, the reduction range of the systolic pressure is less than 20mmHg, and the reduction range of the diastolic pressure is less than 10 mmHg;
orthostatic hypotension positive reaction: within 3min of the vertical inclination test, the reduction range of the systolic pressure is more than or equal to 20mmHg and/or the continuous reduction range of the diastolic pressure is more than or equal to 10 mmHg;
orthostatic hypertension positive reaction: the increase of the systolic pressure is more than or equal to 20mmHg and/or the diastolic pressure is more than or equal to 20mmHg compared with the increase of the diastolic pressure at a horizontal position within 3min of the vertical inclination test; or the maximum value of the blood pressure is more than or equal to 140/90 mmHg.
Furthermore, the invention also provides an application of the method for evaluating the autonomic nervous function to the evaluation of autonomic nervous dysfunction.
Has the advantages that: the method adopts an electrocardio-blood pressure detector and a calculating unit to comprehensively detect the heart rate, the blood pressure, the breathing frequency and the like of a patient, and adopts an algorithm to evaluate 8 experimental results so as to evaluate whether an autonomic nervous system is abnormal. The method is rapid, simple to operate, free of drug mediation and safe.
Drawings
Fig. 1 is a graph showing the relationship between the common stages, the heart rate and the blood pressure when the Valsalva action evaluates the functions of the sympathetic system and the vagal system.
Detailed Description
Example 1:
the invention provides a method for evaluating autonomic nervous function, which comprises an electrocardio-blood pressure detector and a calculating unit, and comprises the following steps:
an electrocardio-blood pressure detector is adopted to collect the heart rate and blood pressure of the patient in the clinostatic position; the computer unit calculates the heart rate and the blood pressure of the upright position collected by the electrocardiogram and blood pressure detector according to a calculation rule and evaluates the positive result of the blood pressure of the upright position;
adopting an electrocardio-blood pressure detector to collect continuous strength training heart rate and blood pressure; the computer unit calculates the continuous strength training heart rate and blood pressure collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates a continuous strength induction positive result;
collecting the values of the deep respiration heart rate and the respiration frequency of a patient by adopting an electrocardio-blood pressure detector; the computer unit calculates the values of the deep respiration heart rate and the respiration frequency collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates a positive result of deep respiration induction;
adopting an electrocardio-blood pressure detector to collect the heart rate and the blood pressure of a patient in a mental calculation state; the computer unit calculates the heart rate and respiratory rate values of the patient in the mental calculation state collected by the electrocardiogram and blood pressure detector according to a calculation rule, and evaluates a positive result induced by the mental calculation;
an electrocardio-blood pressure detector is adopted to collect the heart rate, the respiratory rate and the blood pressure of a patient in a Valsalva Manual state; the computer unit calculates the heart rate, respiratory rate and blood pressure values of the patient in the Valsalva Manual state collected by the electrocardio-blood pressure detector according to a calculation rule, and evaluates a Valsalva Manual positive result;
an electrocardio-blood pressure detector is adopted to collect the heart rate and blood pressure of a patient in an ice bag icing state; the computer unit calculates the heart rate and blood pressure values of the patient in the ice bag icing state collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates an ice bag induction positive result;
collecting blood pressure of a patient in an over-ventilation state by using an electrocardio-blood pressure detector; the computer unit calculates the heart rate and blood pressure values of the patient in the over-ventilation state collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates an over-ventilation positive result;
an electrocardio-blood pressure detector is adopted to collect the heart rate and blood pressure of the patient in a long-range upright inclined state; the computer unit calculates the heart rate and blood pressure values of the patient in the long-range vertical inclination state collected by the electrocardiogram and blood pressure detector according to a calculation rule, and evaluates a positive result of the long-range vertical inclination test;
and the computer unit comprehensively evaluates the calculated vertical and horizontal blood pressure positive result, continuous strength induction positive result, deep respiration induction positive result, cardiac calculation induction positive result, Valsalva Manual positive result, ice bag induction positive result, over ventilation positive result and long-range vertical inclination test positive result, and gives an evaluation result of autonomic nervous dysfunction if one of the 8 evaluation results of the vertical and horizontal blood pressure positive result, the continuous strength induction positive result, the deep respiration induction positive result, the cardiac calculation induction positive result, the Valsalva Manual positive result, the ice bag induction positive result, the over ventilation positive result and the long-range vertical inclination test positive result is positive.
Further, the calculation rule of the computer unit for evaluating the positive result of the blood pressure in the lying position in the step (1) is that
The reduction range of the systolic pressure is vertical systolic pressure-horizontal systolic pressure;
the diastolic pressure decrease amplitude is vertical diastolic pressure-horizontal diastolic pressure;
the heart rate rising amplitude is vertical heart rate-horizontal heart rate;
if the reduction range of the systolic pressure is more than or equal to 20mmHg and/or the continuous reduction range of the diastolic pressure is more than or equal to 10mmHg, the blood pressure of the standing position and the lying position is positive;
if the heart rate is increased by more than or equal to 30 times/min compared with the horizontal position in the vertical position period and/or the maximum value of the heart rate is more than or equal to 125 times/min, the vertical position blood pressure result is positive;
the calculation rule for evaluating and evaluating the positive result of the continuous strength induction by the computer unit in the step (2) is
The reduction range of the contraction pressure is the contraction pressure after force is applied and the contraction pressure before force is applied;
the diastolic pressure reduction amplitude is equal to the diastolic pressure after force is applied and the diastolic pressure before force is applied;
the heart rate rise is the heart rate after exertion-the heart rate before exertion.
If the rising amplitude of the systolic pressure is more than or equal to 20mmHg and/or the rising amplitude of the diastolic pressure is more than or equal to 10mmHg continuously in the continuous strength process, or the heart rate rises more than or equal to 30 times/min and/or the maximum value of the heart rate is more than or equal to 120 times/min, the continuous strength induction result is positive
The calculation rule for evaluating and evaluating the positive result of deep respiration induction by the computer unit in the step (3) is
The heart rate difference before and after deep breathing is the inspiration phase heart rate-expiration phase heart rate;
the rise of the blood pressure and the heart rate before and after deep respiration indicates that the sympathetic function is possibly hyperfunction;
calculating respiratory sinus heart rate difference (RSA) by combining heart rate difference before and after deep respiration to evaluate whether vagus nerve hyperfunction exists, wherein the specific age and normal range are shown as Table 1;
Table 1.Normative values for deep breathing test.
calculating the respiratory sinus heart rate difference (the respiratory sinus arrythmia) by combining the heart rate difference before and after deep respiration, evaluating the positive result of deep respiration induction by RSA,
if the age is 10-29 and RSA is more than or equal to 14, the induction result of deep respiration is positive;
if the age is 30-39 and the RSA is more than or equal to 12, the induction result of deep respiration is positive;
if the age is 40-49 and the RSA is more than or equal to 10, the induction result of deep respiration is positive;
if the age is 50-59 and RSA is more than or equal to 9, the induction result of deep respiration is positive;
if the age is 60-69 and RSA is more than or equal to 7, the induction result of deep respiration is positive;
the calculation rule of the computer unit for evaluating the positive result of mental calculation induction is
The rising amplitude of the systolic pressure is the systolic pressure after the mental calculation-the systolic pressure before the mental calculation;
the diastolic pressure rise amplitude is the diastolic pressure after the mental calculation and the diastolic pressure before the mental calculation;
heart rate rise amplitude is heart rate after mental calculation-heart rate before mental calculation;
if the rising amplitude of the systolic pressure before and after the systolic pressure is more than or equal to 20mmHg and/or the continuous rising amplitude of the diastolic pressure is more than or equal to 10mmHg, or the heart rate rises more than or equal to 30 times/min and/or the maximum value of the heart rate is more than or equal to 120 times/min, the mental arithmetic induction result is positive;
the calculation rule for evaluating the positive result of the Valsalva Manuver by the computer unit in the step (5) is
The mean maximum value of blood pressure or pulse drop is the mean of the highest blood pressure or pulse minus the lowest blood pressure or pulse in each Valsalva Manuver period;
end mean blood pressure recovery phase II and mean blood pressure overshot phase IV: the mean value of the blood pressure at different stages of each Valsalva Manual cycle;
systolic pressure recovery time: the mean value of the time required for the systolic pressure to fall back to the starting point in each Valsalva Manual cycle;
the Valsalva ratio, VR, the maximum value/the minimum value of the heart rate in each Valsalva manager period, VR of each period is respectively calculated, and finally, the average value is calculated;
the blood pressure changes in a normal range, if the blood pressure exceeds the normal range, the result of Valsalva Manuver is positive;
Table 2.Normative values for Valsalva maneuver in blood pressure.
| variables of | Normal value |
| Mean maximum value of blood pressure drop | ≥20mmHg |
| II mean blood pressure at end of the term (convalescent period) | Not less than baseline (mmHg) |
| Mean blood pressure stage IV (OVERHOOT) | Baseline (mmHg) |
| Maximum pulse decline | Not less than 50% of base line |
| Several compression recovery times | < 4 seconds |
Valsalva ratio, VR ═ heart rate maximum/heart rate minimum, normal range, if exceeding normal range, Valsalva Manuver result is positive;
Table 3.Normative values for Valsalva ratio.
the calculation rule for evaluating and evaluating the positive result of ice bag induction by the computer unit in the step (6) is
The rising amplitude of the systolic pressure is the systolic pressure after cold compress-systolic pressure before cold compress;
the diastolic pressure rise amplitude is the diastolic pressure after cold compress-the diastolic pressure before cold compress;
the heart rate rise is the heart rate after cold compress-the heart rate before cold compress.
If the rising amplitude of the systolic pressure is more than or equal to 20mmHg before and after the cold compress of the ice bag, or the continuous rising amplitude of the diastolic pressure is more than or equal to 10mmHg, or the heart rate rises more than or equal to 30 times/min, or the maximum value of the heart rate is more than or equal to 120 times/min, the induction result of the ice bag is positive;
step (7) the computer unit evaluates the calculation rule for evaluating the positive result of the hyperventilation to
The rise amplitude of the systolic pressure is the systolic pressure after over ventilation-systolic pressure before over ventilation;
the diastolic pressure rise amplitude is the diastolic pressure after hyperventilation-the diastolic pressure before hyperventilation;
heart rate rise is the post-hyperventilation heart rate-pre-hyperventilation heart rate;
if the rise amplitude of systolic pressure is more than or equal to 20mmHg before and after the over-ventilation and/or the continuous rise amplitude of diastolic pressure is more than or equal to 10mmHg, or the heart rate rises more than or equal to 30 times/min and/or the maximum value of heart rate is more than or equal to 120 times/min, the over-ventilation result is positive;
the computer unit evaluates and evaluates the positive result of the long-range upright inclination test according to the calculation rule
Vasovagal syncope positive reaction: the occurrence of syncope or syncope aura in the upright tilt test was positive with one of the following: firstly, the blood pressure is reduced; ② the heart rate is reduced less than 60 times/min; third, the intercross escape heart rate of sinus asystole is generated; sexual first degree or more atrioventricular block and cardiac arrest of up to 3 s;
positive reaction of postural tachycardia syndrome: the heart rate is increased by more than or equal to 30 times/min compared with the horizontal position within 10min of the vertical inclination test, and/or the maximum heart rate is more than or equal to 120 times/min; simultaneously, the reduction range of the systolic pressure is less than 20mmHg, and the reduction range of the diastolic pressure is less than 10 mmHg;
orthostatic hypotension positive reaction: within 3min of the vertical inclination test, the reduction range of the systolic pressure is more than or equal to 20mmHg and/or the continuous reduction range of the diastolic pressure is more than or equal to 10 mmHg;
orthostatic hypertension positive reaction: the increase of the systolic pressure is more than or equal to 20mmHg and/or the diastolic pressure is more than or equal to 20mmHg compared with the increase of the diastolic pressure at a horizontal position within 3min of the vertical inclination test; or the maximum value of the blood pressure is more than or equal to 140/90 mmHg.
Furthermore, the invention also provides an application of the method for evaluating the autonomic nervous function to the evaluation of autonomic nervous dysfunction.
The method adopts an electrocardio-blood pressure detector and a calculating unit to comprehensively detect the heart rate, the blood pressure, the breathing frequency and the like of a patient, and adopts an algorithm to evaluate 8 experimental results so as to evaluate whether an autonomic nervous system is abnormal. The method is rapid, simple to operate, free of drug mediation and safe.
Example 2:
an application of the method of the invention for screening autonomic nerve function.
1. Technical problem to be solved by the embodiment
The autonomic nerve function is screened rapidly, comprehensively and safely. If the result is positive, it indicates that the autonomic nerve function is abnormal, and further specialized diagnosis and treatment of the primary disease are necessary.
2. Operating environment and basic requirements:
empty stomach for 4 h. If the patient has a history of diabetes, the patient should be ordered to have a small amount of sugar or chocolate.
Establishing a venous access, keeping the environment of the examination room quiet, soft light and proper temperature (20-25℃)
Age 18-75 years, require normal cognitive function, complete coordination and complete detection.
Contraindications: severe coronary stenosis, severe aortic stenosis, severe left ventricular outflow obstruction, severe mitral stenosis, severe cerebrovascular stenosis, pregnancy.
Standing facilities: central oxygen supply equipment, suction equipment, simple respirator, ECG blood pressure and blood oxygen monitoring, and emergency medicine (adrenaline hydrochloride, noradrenaline, dopamine, cillan, lidocaine, 50% glucose, finasteride, atropine, dexamethasone, furosemide, aminophylline, 10% calcium gluconate, isoshuji)
3 detailed operation procedure
3.1 lying position blood pressure
Equipment: integrated computer, ECG and blood pressure monitor (12 lead wire, cuff, ECG module, blood pressure module, blood oxygen module, power line, network cable)
Collecting information: heart rate and blood pressure were recorded 5 minutes after lying down (before standing), 1, 3, 5 minutes after standing.
l the patient lies down and then rests for 5 minutes, then measures the heart rate and blood pressure (rest for 5min), opens the venous channel, draws blood for the first time, and checks the catecholamine concentration.
l measuring heart rate and blood pressure after standing (1, 3, 5min)
If the patient is unstable in standing, the patient can hold a cane or other articles in balance and can stand with the assistance of other people.
If the patient can not stand, the heart rate and the blood pressure of the sitting position can be detected and marked.
3.2 Isometric Exercise (continuous Strength training)
Equipment: an integrated computer, an electrocardio-blood pressure detector (12 lead wire, cuff, electrocardio module, blood pressure module, respiration module, power line, network cable), and a pressure gauge;
collecting information: the dominant hand continuously grips the manometer air bag, and the heart rate and the blood pressure before and after 1 and 3 minutes of continuous gripping.
l grip strength 60mmHg for 1, 3min
l, the patient lies in the lying position, holds the pressure gauge air bag, keeps the pressure gauge reading at 60mmHg, and detects the heart rate and the blood pressure again after lasting for 1 and 3 min.
The patient is required to do this with their own dominant hand.
Patients with hemiplegia were completed with a healthy lateral hand.
3.3 deep breathing: breath (5s) for 1min
Equipment: an integrated computer and an electrocardio-blood pressure detector (12 lead wire, cuff, electrocardio module, blood pressure module, respiration module, power line and network cable);
collecting information: the heart rate and respiratory rate values were recorded continuously for 1 minute and plotted. Blood pressure was recorded before and after 1 minute of deep breathing.
The doctor guides the patient to complete a deep breath in seconds, such as: hu, 1, 2, 3, 4; suction, 1, 2, 3, 4 … …
The deep breathing action lasts for one minute, the heart rate and the blood pressure are measured, and the whole measurement process requires synchronous continuous deep breathing action.
3.4 mental calculation: 400-7/100-72 min
Equipment: an integrated computer and an electrocardio-blood pressure detector (12 lead wire, cuff, electrocardio module, blood pressure module, respiration module, power line and network cable);
collecting information: heart rate and blood pressure were recorded before and after 2 minutes of mental arithmetic.
And l, selecting to allow the patient to continuously perform mental calculation according to the age, the education condition, the intelligence level and the like of the patient, requiring the patient to concentrate on completing the calculation and not requiring whether the answer is correct or not. The doctor can prompt appropriately or correct the disease.
And l, starting to measure the blood pressure after the mental calculation lasts for 2 minutes, and requiring synchronous continuous mental calculation in the whole measuring process.
3.5 Valsalva Manual, tilt 20 degree blowing 30-40mmHg 12-15s
Equipment: an integrated computer, an electrocardio-blood pressure detector (12 lead wire, cuff, electrocardio module, blood pressure module, respiration module, power line, network cable), a point-to-point blood pressure detection module, and an upright bed.
Collecting information: the heart rate, respiratory rate, blood pressure values were recorded continuously for 1 minute and plotted. After the examination, the recumbent position is restored, and the heart rate and the blood pressure are recorded after 1, 3 and 5 minutes.
The patient is tilted 20 degrees to ensure that the patient can see the manometer reading.
A disposable 1ML needle tube is connected with a pressure gauge, and the patient is ordered to blow air into the needle tube, and the pressure is maintained at about 30-40mmHg for 10-15 seconds according to the specific situation of the patient.
l to help the patient complete the Valsalva Manuver in a manner that helps the patient read the second. The heart rate change value in the Valsalva manager process is noted and recorded, and the blood pressure is detected after 4-5 cycles are completed.
And l, recovering to the horizontal position, and detecting the heart rate and the blood pressure again after 1, 3 and 5 minutes.
If a point-to-point blood pressure recording system exists, the lowest value in the second stage in the Valsalva process needs to be recorded at the same time, and the blood pressure peak values in the second stage and the IV stage need to be recorded.
3.6 ice bag: 4-5 ℃ for 1, 3min
Equipment: an integrated computer, an electrocardiogram and blood pressure detector (12 lead wire, cuff, electrocardiogram module, blood pressure module, respiration module, power line, network cable), an ice bag (the size of which can completely cover the hand and forearm of the patient);
collecting information: and recording the heart rate and the blood pressure before cold compress of the ice bag and after 1 minute and 3 minutes after cold compress.
The ice bag should be placed in the cold storage layer of the refrigerator in advance.
l, cold compress on forearm of patient after taking out from refrigerator, covering whole hand. A single layer towel or sheet can be padded to protect skin.
If the patient can not tolerate the ice bag, the blood pressure can be measured in advance after 1 minute and the cold compress is finished.
3.7 hyperventilation
Equipment: an integrated computer and an electrocardio-blood pressure detector (12 lead wire, cuff, electrocardio module, blood pressure module, respiration module, power line and network cable);
collecting information: the heart rate and respiratory rate values were recorded continuously for 1 minute and plotted. Blood pressure was recorded before and after 1 minute of hyperventilation.
The physician directs the patient to complete the hyperventilation in the form of instructions such as: the frequency of breathe, … … is required to be more than 30 times/minute.
One minute later, the blood pressure measurement is started, and the whole measurement process requires synchronous continuous over-ventilation action.
3.8 Long Range vertical Tilt test
Equipment: an integrated computer, an electrocardiogram and blood pressure detector (12 lead wire, cuff, electrocardiogram module, blood pressure module, respiration module, power line and network cable), and a vertical bed;
collecting information: the patient is rested for more than 5 minutes, and the heart rate and the blood pressure are recorded at 0, 1, 3, 5, 10, 15, 20, 30, 40 and 45 minutes.
l rest for 5min, wait for the blood pressure heart rate to return to baseline.
The inclining time is determined according to the condition of the patient, and the patient can stop at any time if the patient is obviously in panic and chest distress or the other symptoms can not be adhered to.
Heart rate and blood pressure were recorded at 1, 3, 5, 10, 15, 20, 30, 40, 45 minutes, respectively.
4 data interpretation
4.1 interpretation of positive results for lying position:
the reduction range of the systolic pressure is vertical systolic pressure-horizontal systolic pressure;
the diastolic pressure decrease amplitude is vertical diastolic pressure-horizontal diastolic pressure;
the heart rate rise amplitude is vertical heart rate-horizontal heart rate.
4.1.1, the systolic pressure drop is more than or equal to 20mmHg and/or the diastolic pressure drop is more than or equal to 10mmHg, and the heart rate does not change obviously or slightly rises, thus indicating the possibility of an upright low blood pressure.
4.1.2 in the standing period, the heart rate is increased by more than or equal to 30 times/min compared with the horizontal position and/or the maximum heart rate is more than or equal to 125 times/min, and no obvious standing low blood pressure is found, which indicates that the postural tachycardia is possible.
4.2 sustained force induced positive result interpretation:
the reduction range of the contraction pressure is the contraction pressure after force is applied and the contraction pressure before force is applied;
the diastolic pressure reduction amplitude is equal to the diastolic pressure after force is applied and the diastolic pressure before force is applied;
the heart rate rise is the heart rate after exertion-the heart rate before exertion.
In the process of continuous strength, the continuous rising amplitude of systolic pressure is more than or equal to 20mmHg and (or) the continuous rising amplitude of diastolic pressure is more than or equal to 10mmHg, or the heart rate rises more than or equal to 30 times/min and (or) the maximum value of heart rate is more than or equal to 120 times/min, which indicates that the sympathetic hyperactivity is possible.
4.3 deep breath induced positive result interpretation:
heart rate difference before and after deep breathing ═ inspiratory phase heart rate (average value after direct reading) -expiratory phase heart rate (average value after direct reading)
The rise of blood pressure and heart rate before and after deep respiration suggests possible hyperfunction of sympathetic function.
Calculating respiratory sinus heart rate difference (RSA) in combination with heart rate difference before and after deep respiration to assess whether there is vagal hyperfunction, and specific age and normal range are shown in the following figure.
Table 1. Normatic values phantom deep breaking test.
| Age range (lyears) | Minimum for nonnal RSA(beats/min) |
| 10-29 | ≥14 |
| 30-39 | ≥12 |
| 40-49 | ≥10 |
| 50-59 | ≥9 |
| 60-69 | ≥7 |
4.4 mental induced Positive result interpretation2：
The rising amplitude of the systolic pressure is the systolic pressure after the mental calculation-the systolic pressure before the mental calculation;
the diastolic pressure rise amplitude is the diastolic pressure after the mental calculation and the diastolic pressure before the mental calculation;
heart rate rise amplitude is the heart rate after mental calculation-the heart rate before mental calculation.
Mental arithmetic requires the patient to be full of attention to complete calculation, and can effectively induce the excitation of the sympathetic system. The possibility of sympathetic hyperactivity is suggested by the increase range of the systolic pressure before and after being more than or equal to 20mmHg and (or) the continuous increase range of the diastolic pressure being more than or equal to 10mmHg, or the increase of the heart rate being more than or equal to 30 times/min and (or) the maximum value of the heart rate being more than or equal to 120 times/min.
4.5 Valsalva Manuver positive results interpretation:
blood pressure (or pulse) decrease average maximum-the average of the highest blood pressure (or pulse) minus the lowest blood pressure (or pulse) per Valsalva manger cycle (averaged after direct reading);
end-stage mean blood pressure (convalescent period) and stage iv mean blood pressure fovershoot): averaging the blood pressure at different stages of each Valsalva Manual cycle (averaging after direct reading);
systolic pressure recovery time: the mean value of the time required for the systolic pressure to fall back to the starting point in each Valsalva Manual cycle;
valsalva Ratio (VR) ═ heart rate maximum/minimum in each Valsalva manager cycle (VR is calculated for each cycle and averaged last)
The Valsalva maneuver can assess the function of both the sympathetic and vagal systems simultaneously: the function of the sympathetic system is reflected by detecting the change of the blood pressure, and the function of the vagal (parasympathetic) system is prompted by the change of the heart rate. The relationship between the common stages and the heart rate and the blood pressure is shown in the following figure 1,
fig. 1, Valsalva movements are illustrated in stages, the upper curve is blood pressure change, and the middle curve is heart rate change. The lowest curve indicates the pressure change when the patient is blowing.
4.5.1 normal range of blood pressure change (if exceeding the normal range, indicating abnormal sympathetic reflex function),
Table 2.Normative values fbr Valsalva maneuver in blood pressure.
| variables of | Normal value |
| Mean decrease in blood pressureHigh value | ≥20mmHg |
| Mean blood pressure at end of phase II (recovery phase) | Not less than baseline (mmHg) |
| Mean blood pressure (OVERSHOT) in stage IV | Baseline (mmHg) |
| Maximum pulse decline | Not less than 50% of base line |
| Systolic pressure recovery time | < 4 seconds |
Need to complete point-to-point blood pressure monitoring
4.5.2 Valsalva ratio (VR maximum heart rate/minimum heart rate) Normal Range (if it exceeds Normal Range, it indicates fan is hyperfunction)
Table 3.Normative values for Valsalva ratio.
4.6 Ice pack Induction interpretation2：
The rising amplitude of the systolic pressure is the systolic pressure after cold compress-systolic pressure before cold compress;
the diastolic pressure rise amplitude is the diastolic pressure after cold compress-the diastolic pressure before cold compress;
the heart rate rise is the heart rate after cold compress-the heart rate before cold compress.
The ice bag cold compress can excite the temperature receptors and cause local vasoconstriction, the rising amplitude of the systolic pressure is more than or equal to 20mmHg before and after the ice bag cold compress, and (or) the continuous rising amplitude of the diastolic pressure is more than or equal to 10mmHg, or the rising amplitude of the heart rate is more than or equal to 30 times/min and (or) the maximum value of the heart rate is more than or equal to 120 times/min, which indicates that the sympathetic hyperfunction of the temperature receptor dependence is possible.
4.7 interpretation of hyperventilation results
The rise amplitude of the systolic pressure is the systolic pressure after over ventilation-systolic pressure before over ventilation;
the diastolic pressure rise amplitude is the diastolic pressure after hyperventilation-the diastolic pressure before hyperventilation;
heart rate rise amplitude-post-hyperventilation heart rate-pre-hyperventilation heart rate.
Over-ventilation increases the respiration, which results in a decrease in the partial pressure of carbon dioxide from arterial blood, and stimulates the sympathetic system, increasing heart rate and blood pressure. The possibility of chemoreceptor-dependent sympathetic hyperactivity is suggested by the fact that the rise amplitude of systolic pressure is more than or equal to 20mmHg and/or the continuous rise amplitude of diastolic pressure is more than or equal to 10mmHg before and after hyperventilation, or the rise of heart rate is more than or equal to 30 times/min and/or the maximum value of heart rate is more than or equal to 120 times/min.
4.8 Long Range upright Tilt test
Heart rate and blood pressure changes after incline-before incline (either up or down can appear)
The long range upright tilt is used to assess hemodynamic changes following postural changes. The rapid posture change causes the perfusion of blood to the pelvic cavity and abdominal organs due to the influence of gravity, the venous return blood volume is rapidly reduced (500-1000ML), the central venous pressure is reduced, the cardiac filling state is influenced, and the arterial pressure is reduced. At this time, the human body activates the neurovascular system and the muscular venous system to maintain blood pressure. The data are interpreted as follows:
4.8.1 Positive reaction of vasovagal syncope: the occurrence of syncope or syncope aura in the upright tilt test was positive with one of the following: firstly, the blood pressure is reduced; ② the heart rate is reduced less than 60 times/min; third, the intercross escape heart rate of sinus asystole is generated; sexual second degree or more atrioventricular block and cardiac arrest of up to 3 s.
4.8.2 positive reaction of postural tachycardia syndrome: the heart rate is increased by more than or equal to 30 times/min compared with the horizontal position within 10min of the vertical inclination test and (or) the maximum heart rate is more than or equal to 120 times/min); meanwhile, the reduction range of the systolic pressure is less than 20mmHg, and the reduction range of the diastolic pressure is less than 10 mmHg.
4.8.3 orthostatic hypotension Positive reaction: within 3min of the vertical inclination test, the reduction range of the systolic pressure is more than or equal to 20mmHg and/or the continuous reduction range of the diastolic pressure is more than or equal to 10mmHg, and the heart rate has no obvious change.
4.8.4 upright hypertension positive reaction: the increase of the systolic pressure is more than or equal to 20mmHg and (or) the diastolic pressure is more than or equal to 20mmHg compared with the horizontal position within 3min of the vertical inclination test; or the maximum value of the blood pressure is more than or equal to 140/90 mmHg.
5 attention to
5.1 it is noted that the induction results should be interpreted systematically and no conclusion should be drawn from a certain test rate. It should be noted that the evaluation of the sympathetic function should be combined with the Valsalva action, the vertical inclination test result and other sympathetic induction modes, and the evaluation of the vagal system function should be combined with the Valsalva action, the deep breathing and other induction modes.
5.2 pay attention to the guiding significance of each result, the results should be analyzed specifically, and the life style guidance is given by combining the characteristics of the patient, such as the existence of disability, the existence of special medication, and the like, and the basic diseases, and the medication is adjusted if necessary.
Claims (3)
1. A method for evaluating autonomic nerve function is characterized by comprising an electrocardio-blood pressure detector and a calculating unit, and comprises the following steps:
an electrocardio-blood pressure detector is adopted to collect the heart rate and blood pressure of the patient in the clinostatic position; the computer unit calculates the heart rate and the blood pressure of the upright position collected by the electrocardiogram and blood pressure detector according to a calculation rule and evaluates the positive result of the blood pressure of the upright position;
adopting an electrocardio-blood pressure detector to collect continuous strength training heart rate and blood pressure; the computer unit calculates the continuous strength training heart rate and blood pressure collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates a continuous strength induction positive result;
collecting the values of the deep respiration heart rate and the respiration frequency of a patient by adopting an electrocardio-blood pressure detector; the computer unit calculates the values of the deep respiration heart rate and the respiration frequency collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates a positive result of deep respiration induction;
adopting an electrocardio-blood pressure detector to collect the heart rate and the blood pressure of a patient in a mental calculation state; the computer unit calculates the heart rate and respiratory rate values of the patient in the mental calculation state collected by the electrocardiogram and blood pressure detector according to a calculation rule, and evaluates a positive result induced by the mental calculation;
an electrocardio-blood pressure detector is adopted to collect the heart rate, the respiratory rate and the blood pressure of a patient in a Valsalva Manual state; the computer unit calculates the heart rate, respiratory rate and blood pressure values of the patient in the Valsalva Manual state collected by the electrocardio-blood pressure detector according to a calculation rule, and evaluates a Valsalva Manual positive result;
an electrocardio-blood pressure detector is adopted to collect the heart rate and blood pressure of a patient in an ice bag icing state; the computer unit calculates the heart rate and blood pressure values of the patient in the ice bag icing state collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates an ice bag induction positive result;
collecting blood pressure of a patient in an over-ventilation state by using an electrocardio-blood pressure detector; the computer unit calculates the heart rate and blood pressure values of the patient in the over-ventilation state collected by the electrocardio-blood pressure detector according to a calculation rule and evaluates an over-ventilation positive result;
an electrocardio-blood pressure detector is adopted to collect the heart rate and blood pressure of the patient in a long-range upright inclined state; the computer unit calculates the heart rate and blood pressure values of the patient in the long-range vertical inclination state collected by the electrocardiogram and blood pressure detector according to a calculation rule, and evaluates a positive result of the long-range vertical inclination test;
and the computer unit comprehensively evaluates the calculated vertical and horizontal blood pressure positive result, continuous strength induction positive result, deep respiration induction positive result, cardiac calculation induction positive result, Valsalva Manual positive result, ice bag induction positive result, over ventilation positive result and long-range vertical inclination test positive result, and gives an evaluation result of autonomic nervous dysfunction if one of the 8 evaluation results of the vertical and horizontal blood pressure positive result, the continuous strength induction positive result, the deep respiration induction positive result, the cardiac calculation induction positive result, the Valsalva Manual positive result, the ice bag induction positive result, the over ventilation positive result and the long-range vertical inclination test positive result is positive.
2. The method of claim 1, wherein:
the calculation rule of the computer unit for evaluating the positive result of the blood pressure of the lying position is
The reduction range of the systolic pressure is vertical systolic pressure-horizontal systolic pressure;
the diastolic pressure decrease amplitude is vertical diastolic pressure-horizontal diastolic pressure;
the heart rate rising amplitude is vertical heart rate-horizontal heart rate;
if the reduction range of the systolic pressure is more than or equal to 20mmHg and/or the continuous reduction range of the diastolic pressure is more than or equal to 10mmHg, the blood pressure of the standing position and the lying position is positive;
if the heart rate is increased by more than or equal to 30 times/min compared with the horizontal position in the vertical position period and/or the maximum value of the heart rate is more than or equal to 125 times/min, the vertical position blood pressure result is positive;
the calculation rule for evaluating and evaluating the positive result of the continuous strength induction by the computer unit in the step (2) is
The reduction range of the contraction pressure is the contraction pressure after force is applied and the contraction pressure before force is applied;
the diastolic pressure reduction amplitude is equal to the diastolic pressure after force is applied and the diastolic pressure before force is applied;
the heart rate rise amplitude is the heart rate after exertion-the heart rate before exertion;
if the rising amplitude of the systolic pressure is more than or equal to 20mmHg and/or the rising amplitude of the diastolic pressure is more than or equal to 10mmHg in the process of continuous strength, or the heart rate rises more than or equal to 30 times/min and/or the maximum value of the heart rate is more than or equal to 120 times/min, the result of continuous strength induction is positive;
the calculation rule for evaluating and evaluating the positive result of deep respiration induction by the computer unit in the step (3) is
The heart rate difference before and after deep breathing is the inspiration phase heart rate-expiration phase heart rate;
the rise of the blood pressure and the heart rate before and after deep respiration indicates that the sympathetic function is possibly hyperfunction;
calculating respiratory sinus heart rate difference (RSA) by combining heart rate difference before and after deep respiration to evaluate whether vagus nerve hyperfunction exists, wherein specific age and normal range are shown as able 1;
Table 1.Normative values for deep breathing test.
calculating the respiratory sinus heart rate difference (the respiratory sinus arrythmia) by combining the heart rate difference before and after deep respiration, evaluating the positive result of deep respiration induction by RSA,
if the age is 10-29 and RSA is more than or equal to 14, the induction result of deep respiration is positive;
if the age is 30-39 and the RSA is more than or equal to 12, the induction result of deep respiration is positive;
if the age is 40-49 and the RSA is more than or equal to 10, the induction result of deep respiration is positive;
if the age is 50-59 and RSA is more than or equal to 9, the induction result of deep respiration is positive;
if the age is 60-69 and RSA is more than or equal to 7, the induction result of deep respiration is positive;
the calculation rule of the computer unit for evaluating the positive result of mental calculation induction is
The rising amplitude of the systolic pressure is the systolic pressure after the mental calculation-the systolic pressure before the mental calculation;
the diastolic pressure rise amplitude is the diastolic pressure after the mental calculation and the diastolic pressure before the mental calculation;
heart rate rise amplitude is heart rate after mental calculation-heart rate before mental calculation;
if the rising amplitude of the systolic pressure before and after the systolic pressure is more than or equal to 20mmHg and/or the continuous rising amplitude of the diastolic pressure is more than or equal to 10mmHg, or the heart rate rises more than or equal to 30 times/min and/or the maximum value of the heart rate is more than or equal to 120 times/min, the mental arithmetic induction result is positive;
the calculation rule for evaluating the positive result of the Valsalva Manuver by the computer unit in the step (5) is
The mean maximum value of blood pressure or pulse drop is the mean of the highest blood pressure or pulse minus the lowest blood pressure or pulse in each Valsalva Manuver period;
end mean blood pressure recovery phase ii and mean blood pressure overthrot phase iv: the mean value of the blood pressure at different stages of each Valsalva Manual cycle;
systolic pressure recovery time: the mean value of the time required for the systolic pressure to fall back to the starting point in each Valsalva Manual cycle;
the Valsalva ratio VR, VR is the maximum value/minimum value of the heart rate in each Valsalva manager period, VR of each period is calculated respectively, and finally, the average value is calculated
The blood pressure changes in a normal range, if the blood pressure exceeds the normal range, the result of Valsalva Manuver is positive;
Table 2.Normative values for Valsalva maneuver in blood pressure.
valsalva ratio, VR ═ heart rate maximum/heart rate minimum, normal range, if exceeding normal range, Valsalva Manuver result is positive;
Table 3.Normative values for Valsalva ratio.
the calculation rule for evaluating and evaluating the positive result of ice bag induction by the computer unit in the step (6) is
The rising amplitude of the systolic pressure is the systolic pressure after cold compress-systolic pressure before cold compress;
the diastolic pressure rise amplitude is the diastolic pressure after cold compress-the diastolic pressure before cold compress;
heart rate rise is the heart rate after cold compress-the heart rate before cold compress;
if the rising amplitude of the systolic pressure is more than or equal to 20mmHg before and after the cold compress of the ice bag, or the continuous rising amplitude of the diastolic pressure is more than or equal to 10mmHg, or the heart rate rises more than or equal to 30 times/min, or the maximum value of the heart rate is more than or equal to 120 times/min, the induction result of the ice bag is positive;
step (7) the computer unit evaluates the calculation rule for evaluating the positive result of the hyperventilation to
The rise amplitude of the systolic pressure is the systolic pressure after over ventilation-systolic pressure before over ventilation;
the diastolic pressure rise amplitude is the diastolic pressure after hyperventilation-the diastolic pressure before hyperventilation;
heart rate rise is the post-hyperventilation heart rate-pre-hyperventilation heart rate;
if the rise amplitude of systolic pressure is more than or equal to 20mmHg before and after the over-ventilation and/or the continuous rise amplitude of diastolic pressure is more than or equal to 10mmHg, or the heart rate rises more than or equal to 30 times/min and/or the maximum value of heart rate is more than or equal to 120 times/min, the over-ventilation result is positive;
the computer unit evaluates and evaluates the positive result of the long-range upright inclination test according to the calculation rule
Vasovagal syncope positive reaction: the occurrence of syncope or syncope aura in the upright tilt test was positive with one of the following: firstly, the blood pressure is reduced; ② the heart rate is reduced less than 60 times/min; third, the intercross escape heart rate of sinus asystole is generated; sexual first degree or more atrioventricular block and cardiac arrest of up to 3 s;
positive reaction of postural tachycardia syndrome: the heart rate is increased by more than or equal to 30 times/min compared with the horizontal position within 10min of the vertical inclination test, and/or the maximum heart rate is more than or equal to 120 times/min; simultaneously, the reduction range of the systolic pressure is less than 20mmHg, and the reduction range of the diastolic pressure is less than 10 mmHg;
orthostatic hypotension positive reaction: within 3min of the vertical inclination test, the reduction range of the systolic pressure is more than or equal to 20mmHg and/or the continuous reduction range of the diastolic pressure is more than or equal to 10 mmHg;
orthostatic hypertension positive reaction: the increase of the systolic pressure is more than or equal to 20mmHg and/or the diastolic pressure is more than or equal to 20mmHg compared with the increase of the diastolic pressure at a horizontal position within 3min of the vertical inclination test; or the maximum value of the blood pressure is more than or equal to 140/90 mmHg.
3. Use of the method of assessing autonomic nerve function of claim 1 to assess autonomic nerve dysfunction.
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