摘要
目的 通过心率变异性分析,观察献血者在献血过程中的自主神经的调节情况,探讨献血相关迷走神经性献血反应的可能性发生机制。方法 用便携式心电记录仪对90例献血者采用FontaineⅠ导联监测献血全过程的心电图,分别对献血前、中、后各阶段进行5 min短时心率变异分析。结果 在献血全过程中,反映交感神经的HRV指标(LF nu)上升,反映迷走神经指标(pNN50、RMSSD、HFnu)下降,交感和迷走神经平衡能力指标(LF/HF)呈上升变化,心率总体变异性指标(SDNN、Total power)下降;不同献血者(初次和重复、男性和女性、18~24岁和≥25岁、献血量<400 mL和献血量400 mL组)在献血前的心率变异性基线水平比较,低年龄(18~24岁)献血者的pNN50、RMSSD、Total power较高,其余各指标差异无统计学意义;不同类型献血者献血中较献血前的HRV指标变化:重复献血者较初次献血者pNN50、HF nu下降幅度更大、LF/HF上升更多;男性献血者比女性献血者RMSSD下降幅度更大;≥25岁献血者较低年龄(18~24岁)献血者LF/HF变化幅度大;400 mL和<400 mL献血者HRV指标变化差异无统计学意义。结论 献血引起了献血者心脏自主神经调节,在献血过程中交感神经兴奋,而迷走神经被抑制,初次献血、女性、低年龄(18~24岁)献血者对献血应激的心脏自主神经功能调节不够充分,献血相关血管迷走神经反应的发生可能与献血者的自主神经调节功能有关。
Objective To observe the regulation of autonomic nerves in blood donors during blood donation by heart rate variability analysis and explore the possible mechanism of donation related vasovagal reaction. Methods Electrocardiogram(ECG) of 90 blood donors was monitored by Fontaine Ⅰlead during the whole process of blood donation, and the 5-min heart rate variation before, during and after blood donation was analyzed. Results During the whole process of blood donation, the sympathetic HRV index(LF nu) and the sympathetic and vagal balance ability index(LF/HF) increased, whereas the vagal nerve index(pNN50, RMSSD, HFnu) and heart rate variability index(SDNN, Total power) decreased. For baseline heart rate variability of different blood donors(first-time vs. repeated, male vs. female, 18-24 years old vs. ≥25 years old, <400 mL vs. 400 mL) before blood donation, the pNN50, RMSSD and Total power of 18-24 years old blood donors were higher, but other indicators showed no significant difference. There were differences in HRV indexes of different types of blood donors during blood donation compared with before blood donation. The decrease of pNN50 and HFnu and the increase of LF/HF were larger in experienced blood donors than in first-time blood donors. The decrease of RMSSD was larger in male blood donors than in female blood donors;the change of LF/HF was larger in blood donors aged≥25 years than in blood donors aged 18-24 years;other indicators had no significant difference. Conclusion Blood donation leads to reflex readjustment of the cardiac autonomic tone: the sympathetic nerve is excited while the vagal nerve is suppressed. The cardiac autonomic nerve function of first-time blood donors, female donors and low-age(18-24 years old) donors to blood donation stress is not fully regulated. Donation related vasovagal reaction may be related to the autonomic nerve regulation function of blood donors.
作者
李鹏
袁玉荣
张敏
卢伟
张莉
扬丽
李玲
LI Peng;YUAN Yurong;ZHAGN Min;LU Wei;ZHANG Li;YANG Li;LI Ling(Yichang Central Blood Station,Yichang 443005,China;Institute of Blood Transfusion,Chinese Academy of Medical Sciences&Peking Union Medical College;Key Laboratory of Transfusion Adverse Reactions,CAMS)
出处
《中国输血杂志》
CAS
2023年第1期75-79,共5页
Chinese Journal of Blood Transfusion
基金
中国医学科学院医学与健康科技创新工程(2021-1-I2M-060)。
关键词
献血反应
心率变异性
献血者
献血相关血管迷走神经反应
adverse reaction to blood donation
heart rate variability
blood donors
donation related vasovagal reaction
