Kev Ntsuam Xyuas Ntawm Cov Poj Niam Sib Txawv Hauv HRV Ntawm Cov Neeg Mob Nrog Myalgic Encephalomyelitis / Chronic Fatigue Syndrome Siv Mobile-Health Technology
May 05, 2022
Tus sau:
Abstract:Hauv kev tshawb fawb yav dhau los uas siv thev naus laus zis kev noj qab haus huv hauv xov tooj (mHealth), peb tau tshaj tawm txog kev sib koom tes zoo ntawmmob nkees nkeesthiab lub plawv dhia variability(HRV)Hauv cov poj niam cov neeg mob uas muaj myalgic encephalomyelitis / chronicqaug zogSyndrome (ME/CFS). Txoj kev tshawb no tshawb txog HRV tsom xam raws li lub hom phiaj, tsis muaj kev cuam tshuam thiab yooj yim-rau-tus cim ntawm ME / CFS siv mHealth technology, thiab ntsuas qhov txawv ntawm poj niam txiv neej los ntawm HRV thiab ME / CFS cov tsos mob tseem ceeb.
Hauv peb cov txheej txheem, cov neeg koom nrog suav nrog 77 ME / CFS cov neeg mob (32 tus txiv neej thiab 45 tus poj niam) thiab 44 hnub nyoog kev noj qab haus huv tswj hwm (19 tus txiv neej thiab 25 tus poj niam), tag nrho tus kheej tshaj tawm cov qhab nia rau kev qaug zog, pw tsaug zog zoo, ntxhov siab, kev nyuaj siab, thiab neurovegetative cov tsos mob ntawm autonomic dysfunction. Lub inter-beat cardiac intervals tau soj ntsuam tas li / kaw dhau peb lub sijhawm 5min, thiab HRV tau txheeb xyuas siv daim ntawv thov kev cai tsim (iOS) ntawm lub xov tooj ntawm tes txuas ntawm Bluetooth mus rau lub plawv hauv siab hnav. Txiv neej ME / CFS cov neeg mob pom cov qhab nia nce ntxiv piv nrog cov txiv neej tswj hauv txhua qhov tsos mob thiab cov qhab nia ntawm kev qaug zog, thiab kev ua haujlwm tsis raug cai, ib yam li cov poj niam hauv thawj txoj kev kawm. Tsis muaj qhov sib txawv ntawm ib qho kev ntsuas HRV tshwm sim ntawm cov txiv neej ME / CFS cov neeg mob thiab kev tswj hwm, piv rau peb cov kev tshawb pom hauv cov poj niam. Txawm li cas los xij, peb tau pom qhov tsis zoo ntawm ME / CFS symptomatology nrog kev hloov pauv ntawm lub plawv (SDNN, RMSSD, pNN50, LF) hauv cov txiv neej. Peb kuj tau pom muaj kev sib raug zoo ntawm kev qaug zog symptomatology thiab HRV tsis nyob rau hauv ME / CFS cov neeg mob, tab sis tsis nyob rau hauv cov txiv neej tswj noj qab haus huv. Cov teebmeem ntawm poj niam txiv neej tshwm sim hauv HF, LF / HF, thiab HFnu HRV tsis. Kev tshuaj xyuas MANOVA qhia txog kev sib txawv ntawm poj niam txiv neej nyob ntawm qhov kev sim hauv cov tsos mob ntawm tus kheej tsis zoo thiab HF thiab HFnu HRV tsis. Tus qauv HRV poob qis hauv ME / CFS cov poj niam piv rau ME / CFS cov txiv neej tuaj yeem cuam tshuam txog kev sib deev ntsig txog kev mob plawv tsis ua haujlwm hauv ME / CFS mob uas tuaj yeem siv los ua tus cim kev kwv yees ntawm kev kis tus kab mob. Hauv kev xaus, peb qhia tau hais tias HRV tsom xam siv mHealth technology yog lub hom phiaj, uas tsis yog-invasive cuab tam uas yuav pab tau rau kev soj ntsuam kwv yees ntawm qaug zog hnyav, tshwj xeeb tshaj yog nyob rau hauv cov poj niam nrog ME / CFS.
Ntsiab lus:mHealth; lub plawv dhia variability; HRV; ME/CFS; myalgic encephalomyelitis;chronic fatigue syndrome; poj niam txiv sib txawv
1. Taw qhiation ntawm Fatigue Syndrome ntawm HRV
Myalgic encephalomyelitis/chrntawmic fakojua gue syndrua om (KUV/CFS) is a diyog li ntawdrder tus yam ntxwv los ntawm medically unexplained thiab covistent fakojua gue.
Symptoms ua ua fluctuakojng in fr kevkev sib npaug/sivrity duri ibng tnws natural course of mobness incomob hnyav heev, ua tsis taus pa qaug zog, nrog rau mob musculoskeletal, pw tsaug zog cuam tshuam, orthostatic intolerance, tom qab kev tawm dag zog
mlus, mob taub hau, imua ke concentration, thiab luv luvm memory. Feem ntau cov neeg mob ntsib kev nyuaj siab thiab kev tsis taus, whiammay yuav exacerbated los ntawm ib tug tsis to taub los ntawmmlwm tus.
Ntau yam kev tshawb fawb tau ua tiav los tsim lub hom phiaj biomarkers ntawm ME / CFS dikev, incolua uding molua ecular imaging thiab neuro-fib unckojnwsl imagsivmhlau nplaum resonance imaging (MRI), hlau nplaumtoencephalua ogrkuv (MEG),thiabposirntawm ua emyogntawm tomog uaraph uay (PET), los yog microRNA qhia. Txawm li cas los xij, vim tias feem ntau ntawm cov txheej txheem no kim thiab tsis muaj nqis, lwm cov txheej txheem uas tsis yog-invasive muaj peev xwm koom nrog biomarker nrog kev qaug zog thiab / lossis nrog cov tsos mob raug tshawb xyuas. Hais txog qhov no, plawv Rate variability analysis (HRV) tuaj yeem dhau los ua lub hom phiaj, non-invasive thiab yooj yim rau kev thov mavrker.Heaua rt ratua vari ibabua ility (HRV) is txhais tiastnws fluctuakojonsin tnwskojkuvinterval nruab nrab ntawm qhov sib law liag. HRV yog qhov ntsuas tau siv tau thiab txhim khu kev qha los ntsuas kev tswj hwm tus kheej ua balnce uatween tnws sympatnwskojc thiab parasympatnwstic systems. Kuvnded, HRVyog considered ib index ua of uatncoic resua ilince, sincenws reflects tnws abkev to recover fr ibua om raug rau ob lub cev thiab lub siab lub ntsws stressors.
HRV is ib underl uaying ceviolua ogical tshuabiib sm that muaj play ib impo uaua rtibt role in descri ibbing uatncoic dys uafib unckojntawm in KUV/CFS research thiabclinib ical practice. In a kuvta-analyusis, incolua uding 64 arti uacles, nwsyog conclua udd that dib ifferences in hlort r ibate thiab HRV tsis qhia tias ME / CFS cov neeg mob tau hloov pauv kev tswj hwm lub plawv. compared rau kev noj qab haus huv tswj. HRV tsom xam muaj tus nqi prognostic los kwv yees qaug zog sivnwsy thiab exacerbakojua ofuatncoic sivtoms uain ME/CFS, thiabnws is widely siv los ntsuas qhov impact ntawm autonomic ib imtshuav nyiaj li casKUV/CFS. Previous kev tshawb fawb muaj shown hloov sympathovagal tshuav nyiaj li cas (autonomib icmodulations) hauv women nrogME/CFS highlight tias lowuaHRVkwv yees kev qaug zog nyob rau hauv li ntawdme cov neeg mob.
HRVyoga very ibaua ffordable mavrk uaer totrack ibusing mkev noj qab haus huv (mHkev noj qab haus huv) tshuab raws li nws yooj yim rau objectively sau cov inter-beat interval (RR interval) thiab siv algorithms to calua culate thiab analyze ua HRV parameters. In noobral, pebing ib yam of tnws kabilities ib ua smua rtxov tooj for soj ntsuaming or monnwsori ibng hlolth or lifestyle ua tau ua called mHealth. Ntau qhov tshwj xeeb, lub sij hawm mHealth tau raug txhais ua"kev siv mobile xam thiab communication technologies hauv kev kho mob thiab pej xeem kev noj qab haus huv ".
ReturningtoME/CFS, feem ntau kev kawm yog cojted wnwsh samples where poj niam ua ntejmtsis muaj, txawm tiasmthiab tseem nthuav qhia ME/CFS.
Piv txwv li, hauv kev tshuaj xyuas txog mavlf ibib unckojntawming of tnws uatncoic nervous systua em (ANS) in pakojents wnwsh KUV/CFS, tnws uathors pebre able to incolua ude twenty-xya arti uacles in tnws rnpau taws of kuvthodolua ogical zoo, ntawmwnws 25 tsuas muajwomcov neeg koom nrog, thiab 2 muaj ib pab neeg mob ntawmmen thiab poj niam.
Cov total numr of partici uapantsi inclua uded hauv 27 kev tshawb fawbwua 743KUV/CFS cov neeg mob, uas 74feem pua (550) ua women, thiab tsuas yog 26feem pua (193) ua txiv neej. Txoj kev kawm nkaus xwb in that rua eviua ew kev xeemining poj niamr dib iffernce found that hlolthy poj niam muaj a dib ifferent daim npaviovascu ualua tebtaw upright qaijpivto hliltcov txiv neej thiabthat this could qhia ib tug predisposition ntawmwommus rau postural insufficiency. Nyob rau hauv lub saum toj no-mhais kuvta-analyusis ntawm tnws ua evidence of altered cardiac uatncoib ic rua eglakojntawm in KUV/CFS, 64 suav nrog kev tshawb fawb qhia txog 2286 ME / CFS cov neeg mob. Ntawm cov kev tshawb fawb no, 14 recruited excl uausivelis fua emale partici uapants, thiab 50stua udies recruited ibmixed-poj niam txiv neej samua plewntawm no 79 feem pua yog poj niam (n=1803). Cov neeg sau ntawv ntawm qhov kev tshuaj xyuas no tau hais tias nws tsis tuaj yeem ua tau txheeb xyuas cov txiaj ntsig raws li poj niam txiv neej, vim qhov nyiam tshaj tawm tag nrho cov txiaj ntsigwnyob ib leeg sample despnwse dib ifferences in partici uapant charakev cai. Hauv lwm txoj kev tshawb fawb, 824 KUV/CFS cov neeg mob tuaj koom ob lub tsev kho mob tau soj ntsuam, uas 74 feem pua (550) yog poj niam, thiab xwb 26feem pua (193) taumen, tab sis tsis muaj kev sib txawv ntawm poj niam txiv neej tau txheeb xyuas. Ua ke, cov ntaub ntawv no qhia txog kev kho mob siab duaME / CFS tshwm sim hauv cov poj niam dua li txiv neej.
Hloov chaw, muaj cov pov thawj tseem ceeb ntawm kev sib txawv ntawm poj niam txiv neej nyob rau hauv kev siv rau kev ua haujlwm ntawm ANS. Yog lime cov kev tshawb fawb tau pom tias muaj kev cuam tshuam ntau dua ntawm parasympathetic qhov systemmhauvwomen comua padwithmen, thiab ntau dua reactivity ntawm symmob siab system nyob rau hauv cov txiv neej piv nrog cov poj niam. Hauv pob zeb, cov txiv neej noj qab nyob zoo tau raug tshaj tawm tias muaj high indib ices of sibmpatnwstib fibctintawm, inclua uding muscular sibmkev ua haujlwm ntawm lub paj hlwb, neurntawm numr in sympatnwskojc laiblia, thiab tnws HRV parameter LF/HF. Otnwsr kev tshawb fawb pom tias noj qab nyob zoo women qhia qhov qis dua LF / HF lub zog piv dua limen, qhia ib tug preponderance ntawm vagal tshaj symkev mob siab rau. Ntxiv thiab, siab dua LF power in cov txiv neej muaj ua found in sivral stua udies, lus qhiakojng tnws prepondernce of sympathetic tswj kev ua haujlwm ntawm lub plawv. Yog li, muaj pov thawj loj hlob hais tias- ing poj niamr dib iffernce in ANS ackojvnwsy in chrntawmic condnwsons, ua but this muaj tsis muajt ua fully hais nyob rau hauvKUV/CFScov neeg mob. Rau example, most yav dhau los neuroimaging kev tshawb fawb ib yam txwv lawv cov qauv kev kawm rau ib tug poj niam los yog tsis ncaj qha soj ntsuam los ntawm poj niam txiv neej nyob rau hauv samples tas comua kemales thiab poj niam nrog ME / CFS.
Yog li, tnyob ntawm nofeaw stua udies ME/CFSin cov, thiab of tnws stua udiesthat incolua ude cov txiv neej, tsis muaj analyze ua poj niamr dib iffernce pebing HRV analyusis in uatncoic dys uafib unckojons tau los ntawmm ME/CFS. Hauv qhov kev tshawb fawb no, we aimrau:
(1) Tshawb nrhiav HRV tsom xam raws li lub hom phiaj, tsis yog-invasiua ve thiab yooj yim-to-apply mavrker of KUV/CFS in cov txiv neej, pebing mHealth technolua ogy;
(2) ntsuam xyuas seb HRV parameters yog txuam nrog cov tsos mob ntawm tus kheej thaum ntxov qhia nyob rau hauv menwithME/CFS;
thiab (3) ntsuam xyuas qhov sib txawv ntawm poj niam txiv neej nyob rau hauv HRV thiab qhia tus kheej ua symptoms ua in pakojentswnwsh KUV/CFS.
2. Khoom siv thiab Cov txheej txheem
2.1. Cov neeg koom nrogFatigue Syndrome ntawm HRV
A prospeckojua ve, cross-seckojnwsl cojua rtstudy ua of thua irty-tqho mavles wnwsh KUV/CFS yog rovnwsedfrom ib singlua e outpakojent tuakojary- uafua erralcentua (ME/CFS Clinical Ibnws, Vall d'Hebr6n Ibiua versnwsy Hospnwsal, Barcelnws, Spain) fr kevua om March 2015 to March 2016. All cov neeg mobwmuaj peev xwm tsim nyog yog tias lawvmthiab xyoo 1994CDC/Fukuda cov cai. Kaum cuaj hnub nyoog- thiab poj niam deev-mavtched tsis yog-fakojua gued hlolthy controls pebre rib ecrunwsed thrugh ua lus ntawm qhov ncaujlos ntawmmlub tsev kho mob thiab lub zos commkev sib koom siab. Qhov 51mib (32MCov neeg mob E/CFS thiab 19 hlolthy controls) specific for this study ua pebre compared wnwsh 70 poj niam (45 KUV/CFS pabiua 25helthli contro uals) analyzed uain ua previos study ua, zuaginedinto a tshwj xeeb cov ntaub ntawv teev. Txhua tus neeg koom nrog yog neeg Caucasian, los ntawmmcov same thaj chaw arua ea, thiab muaj ib tug sedentary lifestyle at tnwskojkuv of tnws study ua. Exclpebintawm criteri iba for tnws study ua pebre prua evios or ua cuua rrent diagnosis of uatoinyob condnwsons, multiple sclerosis, kev puas siab puas ntsws, kev nyuaj siab loj, mob plawv, hematological mob, kis kab mob, pw tsaug zog apnea los yog kab mob uas muaj cov thyroid, cev xeeb tub los yog pub niam mis, haus luam yeeb,cov tshuaj hormonestshuaj, thiab symptoms ntawmKUV/CFSuas tsis haum rau cov xwm txheej siv rau qhov no study ua. Allparkojcipants vwmlibtarily povidab wrnwsen, signedinfkev pom zootua prilos yogto study ua parti uacipakojntawm.
2.2. General Txheej txheem rau Cov ntaub ntawv Sauion
Cov noobral procedu kevre wa uas ilub tsevtical to tnws ib fohlowed nyob rau hauv qhov kev kawm dhau loswith fua emale KUV/CFS pakojents thiab hlolthy control parti uacipants. Bri ibefly, alleligible cov neeg koom attxaus tnws first interviua ew where sociodemograph uaic thiab self-r ibepoua rted kojtcua om queskojnawjires pebre collib ected. Covy pebre aua sked ua about tnwsyog fakojua gue sevekev cai, neurovua egtakojua ve complaints, slua eep ua quality, anxiety thiab depresintawm, thiab ua symptoms ua of uatncoic dys uafib unckojntawm. After tnws first interviua ew, parti uacipants pebre assigned dates for tnws follow uaing HRV cov kev kaw lus ntxiv.
2.3. Kev ntsuas
Cov cuab yeej ntsuas cov tsos mob hauv qab no tau siv los ntsuas txhua tus neeg koom nrog kev saib xyuas ntawm ob tus kws tshawb fawb uas tau kawm tiav uas ua kom muaj kev ua raws cai. Ib tug validated Spanish txhais lus Askiv version validatedwraws li siv rau tag nrho cov lus nug.
2.3.1. NeurovegetativeComplaints Questionnaire (NCQ)
Tus Thawj Neurovegetative Complaints Questionnaire (NCQ) muaj 28 yam khoom hais txog mob taub hau, teeb meem nrog kev tsaug zog, kev ntxhov siab, mob hauv siab, plab zom mov, sltus tswv of ua haujlwming, hnovnwsvnwsy tocov light, eua fflos yogt, dej ntwsing, kev xavtrakojntawm, ua tsis taus pa, preference for uaing leftalib, tirkev edness, fainkojng, hloua rtpalpnwsakojons, tsis muajise, dyogficu ualty wnwsh uaing tqho tnug simultmob plably, prefernce for qhorking at ib's tus kheej pace, dizz ibiness, kev nyuaj siab, tes ntub dej, quaj quaj, hloov libido, chim siab, tsis muaj kev pib, tsaug zog hmo ntuj, swbm, thiab tsis raug qhuas los ntawm lwm tus. Cov neeg koom yuav tsum tau qhia txog qhov zaus ntawm qhov tshwm sim ntawm cov tsos mob no ntawm 4-point Likert scale (1=tsis yog, yeej tsis; 2=yog, qee zaum; 3 = yog, tsis tu ncua, thiab 4=yog, nquag). Cov qhab nia siab dua qhia tau tias muaj kev ywj pheej ntau dua complaints [32].
2.3.2. Fatigue ImpactScale
Fatigue Impact Scale (FIS-40) yog ib daim ntawv nug 40- khoom los ntsuas cov tsos mob qaug zogas paua rtof ib underlyi uang chrntawmib ic condnwsntawm. Nws inclua udes three ib domains xav txog cov perc ibeib ived fee ibling of fakojua gue: Physic uaal (10-nwsua ems), cogn uaitive (10-ibms), thiab psychosocial fib unckojons (20-nwsua ems). Txhuanwsua em is ua scoredfr kevua om 0 (tsis muaj fakojua gue) to 4 (sivre fakojua gue). Cov tag nrho cov qhab nia yog xam los ntawm kev ntxiv ua ke cov lus teb rau 40 cov lus nug (nrog rau los ntawmm0–160). Cov qhab nia siab dua qhia tias ua haujlwm tau zoo limcov ntawv, vim qaug zog [33].
2.3.3. Composite Autonomic Symptom Scale
Rau kev ntsuas autonomic dysfunction, Txhua tus neeg koom tau raug tshuaj xyuas los ntawm kev siv CompositeAkevmib icSymptom Scal (COMPASS-31), ib 31-ibmdaim ntawv nug tsim los ua evaluate tnwsfr kevkev sib npaug thiab sivrity of uatncoic fib unckojntawm ua symptoms ua, grua oupedrau hauvsix domains: Oua rthostatic intolerance (4- nwsms), vasomotor (3-ibms), zais ciamotor (4-ibms), gastrointestinal (12-ibms), zais zis (3-items) thiab pupillomqhov systemms (5-ibms). Ntxiv tua ogetnwsr, tnws six domain ua scores provide a total COMPASS-31 ua score rangingfr kevua om 0 to 100—nrog cov qhab nia siab dua qhia tias muaj kev tsis txaus siab autonomic hnyav dua.
2.3.4. Pittsburgh Pw tsaug zog zoo Index
Pittsburgh Pw tsaug zogQUAS Index (PSQI) yog covmos commtsuas yog siv pw tsaug zog zoo qeeua stinawjire in resua earc ibh seua ttings, cntawmsib koom ntawm 19-itemtus kheej admqhia cov lus nug rau ntsuas kev pw tsaug zog tsis zoo nyob rau lub hli dhau los. Cov qhab nia tau txais ntawm txhua ntawm xya Cheebtsam ntawm kev pw tsaug zog zoo: Subjective pw zoo, pw tsaug zog latency, pw tsaug zog ntev, tus cwj pwm pw tsaug zog zoo, pw tsaug zog cuam tshuam, siv tshuaj tsaug zog, thiab kev ua haujlwm ntev ntev. Txhua tus sau tau qhab nia ntawm 0 mus rau 3 (0 = tsis muaj teeb meem pw tsaug zog thiab 3 = teeb meem pw tsaug zog hnyav). Zuag qhia tag nrhoPSQKuv tau qhab nia nyob ntawmm0 mus rau 21 ntsiab lus, wnws ib tug qhab nia ntawm.5 qhia tias pluag pw zoo.
2.3.5. Tsev Kho Mob ntxhov siab vim thiab kev nyuaj siab Scale
To ntsuam xyuas kev ntxhov siab thiab kev nyuaj siab symptoms, tusHospital Kev ntxhov siab thiabDkev ntxhov siab Scale (HADS) wraws li siv.CovHADS yog validated 14-itemqhia tus kheejmyooj yim (seven associated wnwsh ibxisekoj symptua oms thiab 7 wkev nyuaj siab) uas hais txog qhov ua ntej week hauv kev kho mob sab nraud. Txhua yammtau qhab nia ntawm 4-point Likert scale
(e.g., raws li ntau raws li I altxoj kev ua 0 = tsis muajt ua qunwse yog li ntawd ntau; 1 = txhaisnwsely tsis muajt yog li ntawd ntau; 2 = thiab tsis muajt tag nrho; 3 = muabmaxismumsubscale cov qhab nia ntawm 21 rau kev nyuaj siab thiab kev ntxhov siab, raws. Cov qhab nia ntawm 0–7 yog txhais li qub, 8-10 raws li cov tsos mob me, 11-14 hnub, thiab 15-21 yog qhov hnyav rau kev ntxhov siab lossis kev nyuaj siab. Tag nrho cov qhab nia HADS nyob ntawm 0 (tsis yog kev ntxhov siab / kev nyuaj siab) mus txog 42 (kev ntxhov siab loj / kev nyuaj siab).
2.3.6. Heart Rate Variability Recording and Analysis
Cov kev soj ntsuam ntawm plawv tus nqi hloov pauv yog ua nruab nrab 3:00 pm thiab 6:00 pmin ib semi-dub room at tnwslua ocalKUV/CFS ClinicalIbnws, mavintained ibt a thuab taistua ur ntawm 20-24oC. Cov neeg koom nrog qhov kev sib tham ntawm kev sib tw hauv plawv (RR intervals) pebre conkojnujly monnwsored/recorded ua ovr three ib 5-min peri ibua ods ntawm dib ifferent hnub thiab lub lis piam. Cov no three ib dib ifferent recordings pebre ua tiav wnwsh akojkuv interval of 7 to 21 hnub uatween 2 consecukojua ve recordings. For tnws fina ual analyusis of txhua vari ibable, tnws valua ues tau nyob rau hauv peb cov ntaub ntawv ywj pheejwyog nruab nrab.Pcov neeg koom tes tau hais kom tsis txhob muaj caffeine, cawv, thiab kev tawm dag zog lub cev rau 12 teev ua ntej kuaj. Hauv txhua qhov kev sib tham, cov neeg koom nrog tau hais kom pw tsaug zog tsis hais lus lossis txav mus rau lub sijhawm kev sib tham. Tom qab tsibminutes ntawm so, cov ntaub ntawv hloov pauv lub plawv dhia tau sau npethiabkaw tseg conkojnujly for tsib minujtes of natural brua eathhauv.
Lub sijhawm RR tau kuaj pom nrog lub plawv hauv siab (Polar Band H7; Polar electro, Finland). Cov qhab no xa txhua ob lub pob ntawv cov ntaub ntawv uas muaj qhov nruab nrab hloua rt rate ib all tnws RRintervals detib ected ua since tnws lraws lit pobt wnwsh a rua esolukojntawm of 1/1024 s. : kuv. Cov teb uas muaj cov RR ntu yog khoob yog tias lub plawv dhiamuaj tsis yog ua kuaj pom,txij thaum kawg transmteeb meem.Tnws information raug xa mus siv aBluetooth Low Energy (BLE) kev sib txuas kom txo qis kev siv hluav taws xob tsawg. Txhua lub sijhawm RR tau txais tau hloov dua siab tshiab mus rau qhov kev daws teeb meem ntawm 1ms thiab khaws cia hauv zos hauv amobile ntaus ntawvwyog FitLab® App (Health thiab Spoua rtLab, Barcelnws, Spain). Fiua gure 1 ua yeeb yams dib ifferent scr uaib eenshotsof tnws app wnwsh prompts complating cov ntaub ntawv ntsig txog cov xwm txheej kaw.
Daim duab 1.Screenshots ib ntus sib xws rau daim ntawv thov kev cai tsim (FitLab® App).
Thawj qhov screen (sab laug) qhia all tnws stored recordings in tnws app pending to ua synchrntawmizej wnwsh tnws serua ver thiab tnws possibua ility to staua rta tshiab ib ("plus" symbol). Peb lub vijtsam tom ntej nug txog qhov xwm txheejwntawm no cov ntaubntawv povthawj siv qhov chaw. Qhov screen kawg (ntawm sab xis) qhia lub plawv dhia sai sai (hauv BPM) thiab RR series.
Kev tsom xam ntawm RR series was ua ntawm a nyob deb server. Cov qhov system tso caiHRV recordings while kuajing tnws ua quality of tnws data in rua eal-tikuv. Cov ua accuracy thiab reliabua ility of tnws Polar cardiac band pebre prua eviosly tested against tnws musld standard raws li ECG. Rau HRV tsom xam, peb ua raws li cov recommKev xaus ntawm Txoj Haujlwm Forc ibe of tnws Eurqhib Yog liciekojof Cardiolua ogy thiab tnws Tsis muajua rth AmericanSociety ntawmPacing thiab Electrophysiolua ogy. All tnws recordings pebre pre-analyz uaed to detect artifacts thiab eua rrib ous data uafore tnws HRV analis.A mavxisniam eua rror of 10 feem pua of RR inteua rvalswa uas txais thiab lim. Qhov yuam kev correkev txiav txim ntawm tus RR series yog raws ntawm outliers> kuaj pom.
Cov mediib of tnws lraws lit 10 RR intervals yog siv. Cov kojtliers pebre classified in false
qhov zoo, cuav negatives, los yog ectopic ntaus.Akho nyob rau hauv lubRRserieswraws li siv rau khaws tag nrho lub sijhawm ntawm kev kaw cia.
For tnwskojkuv-domain analyusis, tnws txhais tau tias of RR intervals (meanRR), tnws standard deviakojntawm of allRR intervals (SDNN), tnws roo uat txhais tau tias ua square of dib iffernce (RMSSD) of succ uaessiv uae RR inteua rvals, thiab tnws txhais tau tias numr of kojmes ib hrwnws qhov kev hloov hauv txuas tsis taumal sinus (RR) ncua sijhawm ntau tshaj 50msec (pNN50) wyog xam. Rau frequency-domain tsom xam, tag nrho cov RR series tau rov ua dua tshiab ntawm 4 Hz siv cov duab khaws cia piecw uaise cubic intua erpolakojua prilos yogto tnws HRVlyusis.Lub zog spectrum uaf tnws resampled lub sij hawm series tau kwv yees siv Fast Fourier Transform tom qab tshem tawm cov txhais tau tias ntawm lub sij hawm series thiab muab lub sij hawm series los ntawm lub qhov rais Hann. Lub hwj chim Qhov ceev hauv qhov tsawg zaus (VLF) band ({0}}00–0.04 Hz), Tsawg zaus (LF) band (0.04–0.15 Hz), thiab tnws highfr kevequency (HF) band (0.15–0.40 Hz) wyog xam los ntawmm txhua 5-min spectrum los ntawm kev sib koom ua ke ntawm spectral zog ceev hauv cov zaus bands. Kev suav ntxiv suav nrog LF / HF piv, zoo li normalized LF thiab HF tus nqi (LFnu thiabHFnu, raws).
2.4. Data Kev tsom xam
Alwm calculakojntawms pebre perf uaormed wnwsh tnws IBM SPSS Statistics pob rauMacOS (version 21). Kev suav ntawm HRV tsis tau ua tiav nrog FitLab software (Health- Spoua rtLab.com, Barcelnws, Spain) thiab MATLAB environment (MathWorks, Nakojck ib, MA, USA). Hauv thawj ntu ntawm Tshooj3, qhov sib txawv between cov ntaub ntawv qhia tshiab los ntawmm tnws tqho grua ops of cov txiv neej pebre soj ntsuam wnwsh tnws t-test for incet samples, thiab tnws Mann-Whitney U non-parametric test thaum tsim nyog. Pearson correlation tsom xam tau ua los ntsuam xyuas cov koom haum sib txawv ntawm cov ntawv nug cov qhab nia thiab HRV indices, los yog nruab nrab ntawm daim ntawv nug cov qhab nia thiab lawv tus kheej. Txhawm rau ntsuas qhovkwv tij kev sib raug zoo nruab nrabtusmost tseem ceebHRVindices thiab qaug zog dysfunction, peb uamed sib cais linear regression tsom xam nyob rau hauv kev tswj cov ntsiab lus thiabMCov neeg mob E/CFS. Qhov tseem ceeb ntawm qhov pib tau teeb tsa ntawm p < 0.05.="" hauv="" ntu="" thib="" ob="" ntawm="">3, peb tshaj tawm cov teebmeem ntawm poj niam txiv neej sib txawv thiab interackojons wnwsh tnws KUV/CFS fakojua gue condnwsntawm qhia los ntawm tnws tqho-txoj kev analyusis of vari ibibce (ANOVA) applied to HRV data of mavle and ua female koom.HRVsib txawv rau cov txiv neej tau txais los ntawm cov ntaub ntawv kaw tseg ntawm cov neeg koom nrog hauv txoj kev tshawb fawb tam sim no, whereas cov ntaub ntawv rau cov poj niam sib raug rau cov neeg koom nrog qhia hauv yav dhau los, tsis ntev los no luam tawm tsab xov xwm.Gender (male thiab female) thiab kev noj qab haus huv (tswj, ME/CFS) tau siv los ua tus hloov pauv ywj pheej hauv ob txoj kev ANOVA, thiab Duncan qhov kev sim tau siv rau posthoc comparisons betwib khub ntawm pawg.HRVcov ntaub ntawv los ntawmm two cov neeg koom, ib ntawmKUV/CFS women thiab ib qho ntawm cov tswjmen, tau muab pov tseg, vim ua tsis tau tiav ua cov ntaub ntawv HRV.
3. Cov txiaj ntsig ntawmFatigue Syndrome ntawm HRV
3.1. Cov pej xeem thiab kho mob Yam ntxwv of Cov neeg koom nrog (Cov txiv neej)
Table 1qhia descri ibpkojua ve stakojskojcs for tnws control grua oup thiab KUV/CFStus neeg mobmen. Tsis muaj qhov sib txawv ntawm hnub nyoog thiab BMKuv ntawm ME / CFS cov neeg mob thiab kev tswj hwm. Lub plawv tus nqi thiab systolic arterial siab tau siab dua hauv cov neeg mob ME / CFS piv nrog kev tswj hwm parti uacipants (p 0.05). Diraws litolic aua rteri ibal pressure yog alyog li ntawd high in KUV/CFS pakojents (p = 0.054).
Table 1.Lub hauv paus ntawm pej xeem thiab kev kho mob tsis nyob ntawm cov neeg koom (txiv neej).
Hloov pauv | Tswj (n = 19) | ME/CFS (n = 32) | '-Valua ue |
Hnub nyoog (xyoo) | 47.32 ± 1.51 | 47.38 ± 1.52 | N.S. |
BMI (kg/m2 ) | 24.69 ± 0.80 | 23.69 ± 0.51 | N.S. |
SAP (mmHg) | 122.1 ± 2.43 | 131.8 ± 2.54 | 0.014 |
DAP (mmHg) | 77.91 ± 1.51 | 82.38 ± 1.68 | 0.054 |
HR (beats/min) | 62.79 ± 1.33 | 70.13 ± 1.85 | 0.007 |
NCQ (numib) | 0.26 ± 0.10 | 7.97 ± 0.46 | <> |
FYOG-40 | |||
Global qhab nias (0–160) | 11.68 ± 4.02 | 135.8 ± 3.91 | <> |
Lub cev | 2.47 ± 1.05 | 36.50 ± 0.62 | <> |
Cognnwsua ve | 3.58 ± 1.00 | 34.72 ± 0.72 | <> |
Psychosocial | 5.63 ± 2.06 | 64.59 ± 2.41 | <> |
COMPASS -31 | |||
Global qhab nias (0–100) | 20.57 ± 2.93 | 56.83 ± 2.42 | <> |
Oua rthostakojc intolernce | 3.11 ± 0.41 | 7.56 ± 0.36 | <> |
Vasomotor | 0 ± 0 | 1.28 ± 0.26 | <> |
Secretomotor | 0.58 ± 0.21 | 3.94 ± 0.29 | <> |
Gmob plab | 5.84 ± 1.03 | 11.0 ± 0.90 | 0.001 |
zais zis | 0.58 ± 0.18 | 3.62 ± 0.48 | <> |
Pupmobomo uator PSQI | 3.16 ± 0.70 | 9.69 ± 0.63 | <> |
Ntiaj teb noqhab nias (0–21) | 4.32 ± 0.67 | 14.28 ± 0.77 | <> |
Subjective pw zoo | 0.53 ± 0.14 | 2.28 ± 0.14 | <> |
Snyob latency | 0.53 ± 0.18 | 1.84 ± 0.18 | <> |
Slua eep durakojntawm | 0.95 ± 0.16 | 1.88 ± 0.19 | 0.001 |
Hpw tsaug zog efficyam | 0.42 ± 0.23 | 1.72 ± 0.22 | <> |
Pw tsaug zog | 1.00 ± 0.11 | 2.22 ± 0.11 | <> |
Cov tshuaj tsaug zog | 0.32 ± 0.13 | 1.91 ± 0.24 | <> |
Hnubkojkuv dys uafibctintawm HADS | 0.58 ± 0.14 | 2.44 ± 0.14 | <> |
Ntiaj teb noqhab nias (0–42) | 7.26 ± 1.0 | 27.38 ± 1.36 | <> |
Anxiety | 5.21 ± 0.70 | 14.03 ± 0.67 | <> |
Kev nyuaj siab | 2.05 ± 0.49 | 13.34 ± 0.85 | <> |
Cov qhab nia ntawm tus kheej tshaj tawm cov qhab nia nruab nrab (ntiaj teb thiab subscales) ntawm cov tsos mob tseem ceeb, raws li tau piav qhia nyob rau hauv Txoj Kev 2. Tus nqi qhia txhais tau tias± SEM rau txhua yam khoom. Cov ntawv luv: BMI, Lub cev index; SAP, systolic arterial siab; DAP, diastolic arterial siab; HR, lub plawv dhia; NCQ, Neurovegetative complaints questionnaire, FIS-40, 40-khoom qaug zog qhov ntsuas ntsuas; COMPASS-31, 31-ibmabbreviated covmzoo autonomic tsimptomqhab nias; PSQI, Pittsburgh pw tsaug zog zoo Performance index; HADS, Hospital Anxiety and Depression Scale.
3.2. Qhia Txog Tus Kheej Kev ntsuas (Cov txiv neej)
The neurovegetative complaints (NCQ), nrog rau lub cev, kev txawj ntse,psychosocial, thiab total fakojua gue (FIS-40) ua scores repoua rted los ntawm KUV/CFS pakojents, pebre ntau higher than tcev repoua rted los ntawm hlolthy controls, thus uaing a robust uatween-grua oup siua gnificibt qhov sib txawv (p<> Rooj1). Cov qhab nia siab dua ntawm cov kev ntsuas no zoo ib yam nrog cov kuaj mob ntawmME/CFS. HauvCOMPASS-31 daim ntawv nug, tusMCov neeg mob E/CFS tau tshaj tawm incoryooj yim oua rthostakojc intolernce, vasomotor, secretomo uator, blntxivr, tus menyuam devmobomo uator (all p < 0.001), plab hnyuv (p = 0.001) thiab tag nrho COMPASS-31 qhab nia (p<> piv nrog cov neeg koom nrog tswj (Table1). Cov txiaj ntsig no kuj zoo ib yam nrog kev nce ntxiv tus naj npawb ntawm cov tsos mob autonomic qhia nyob rau hauv daim ntawv nug cov lus tsis txaus siab neurovegetative (NCQ; Rooj1). Hauv daim ntawv nug PSQI, cov neeg mob ME/CFS tau muaj cov tsos mob ntau ntxiv hais txog kev pw tsaug zog zoo, pw tsaug zog latency, pw tsaug zog efficiency (tag nrho p < 0.001), thiab pw tsaug zog ntev (p = 0.001), piv nrog cov neeg koom nrog tswj. Lawv kuj tau tshaj tawm ntxiv pw tsaug zog cuam tshuam, kev siv pw tsaug zog ntau duamtshuaj kho mob, thiab nce daytime ua haujlwm tsis zoo compared wnwsh control parti uacipants (p 0.001; Table1). Cov total PSQkuv score wa uas three ib thiab a half kojkuvs higher in KUV/CFS pakojentsi cua ompared wnwsh cntawmtrols (ib<> Tmuaj peev xwm1). ME / CFS cov neeg mob tau tshaj tawm cov qhab nia siab dua (10–11 cov ntsiab lus ntxiv) ntawm kev ntxhov siab thiab kev nyuaj siab hauv daim ntawv nug HADS, piv nrog kev tswj hwm (p<> Rooj1).
3.3. Lub plawv dhiaVariability Indices (Cov txiv neej)
Tag nrho cov ntaub ntawv kaw tau raug tshuaj xyuas kom pom muaj cov khoom qub. Cov ntaub ntawv nrog ntau tshaj 10 feem pua ntawm cov khoom qub raug tsis lees paub (6 feem pua ntawm tag nrho); 75 feem pua ntawm cov ntaub ntawv kaw tseg yog artifact-free, uacov seem raug kho. Qhov teeb meem yuam kev nruab nrab rau tag nrho RR cov ntaub ntawv ntawm txoj kev tshawb no yog 0.72 feem pua , zoo ib yam li lwm yam kev tshawb fawb. Lub sij hawm-domain tsom xam ntawm RR intervals qhia tsis tau Qhov sib txawv ntawm ME / CFS cov neeg mob thiab kev tswj hwm kev noj qab haus huv hauv ib qho ntawm lub sijhawm or fr ibkev sib npaug-domain parameters (Table 2). However, although tnws dib ifferences are tsis muajt stakev xavaly siua gnificibt, tnws cntawmtrol grov shows tus nqi siab dua nyob rau hauv tag nrho cov parameters tshaj qhov KUV/CFS grua oup.
Rooj 2.HRV parameters ntawm cov neeg koom (txiv neej).
Tswj kev hloov pauv(n = 19) ME/CFS(n = 32) '-Valua ue
RR txhais tau tias (ms) | 901.6 ± 41.0 | 861.3 ± 20.5 | N.S. |
SDNN (ms) | 41.02 ± 4.52 | 37.38 ± 2.99 | N.S. |
RMSSD (ms) | 29.37 ± 4.04 | 23.84 ± 2.67 | N.S. |
pNN50 (feem pua) | 10.79 ± 2.82 | 6.37 ± 1.52 | N.S. |
LF (ms2 ) | 897.5 ± 298.8 | 663.6 ± 177.3 | N.S. |
HF (ms2 ) | 411.1 ± 115.0 | 287.4 ± 54.8 | N.S. |
LF/HF | 2.96 ± 0.55 | 2.83 ± 0.35 | N.S. |
Hindu | 33.11 ± 3.73 | 31.36 ± 2.03 | N.S. |
Cov nqi raug nthuav tawm raws li kev txhais tau tias± SEM. Abbreviations ntawm HRV tsis: MeanRR, txhais tau tias ntawm RR intervals; SDNN,tustus qauv sib txawv ntawm txhua lub sijhawm RR; RMSSD, lub hauv paus txhais tau tias square ntawm qhov sib txawv ntawm RR ncua sij hawm; np50, tnws proporti uantawm deri ibua ved los ntawm dividing tnws numr of interval dib iffernce of kev vam meejiua ve RR intervals ntau dua 50 ms by tnws total numr of RR inteua rvals; LF,qhov tsawg zaus band (0.04–0.15 Hz); HF,tussiab zausband (0.15–0.40 Hz); LF/HF ratio; HFnu, tsis yogmalized HF tus nqi.
3.4. Kev sib txheeb thiab Regression Kev tshuaj xyuas (Cov txiv neej)
Tmuaj peev xwm3qhia txog correlation tsom xam thawj koom ruamween tus kheej qhia symptoms thiabHRV parameters rau tag nrho cov qauv ntawm cov txiv neej (n=51). Cov kev sib raug zoo tseem ceeb nkaus xwb yog nega- tiv thaiv kev sib raug zoo ntawm COMPASS-31 gastrointestinal factor thiab SDNN (p = 0.042), RMSSD (p=0.037), npo 50(p = 0.04) thiab LF (p = 0.006), thiab nruab nrab tus lub cev nplai ntawmFIS-40 thiab pNN50 (p=0.049).
Table 3.Pearson correlation coefficients (r) nruab nrab ntawm HRV tsis thiab ntsuas tus kheej qhia (n = 51 txiv neej).
Mean RR SDNN RMSSD pNN50 LF HF LF/HF HFnu
PSQI | ||||||||
Pw tsaug zog zoo | -0.086 | -0.084 | -0.128 | -0.121 | -0.076 | -0.108 | -0.052 | 0.014 |
Snyob latency | -0.158 | -0.076 | -0.118 | -0.113 | -0.088 | -0.055 | -0.011 | 0.047 |
Slua eep durakojntawm | -0.16 | -0.166 | -0.246 | -0.19 | -0.166 | -0.256 | 0.037 | -0.059 |
Habnwsual slua eep efficiency | -0.119 | -0.123 | -0.146 | -0.06 | -0.152 | -0.035 | -0.066 | 0.115 |
Slua eep dkev ntxhov siab | -0.12 | -0.164 | -0.188 | -0.201 | -0.209 | -0.136 | -0.092 | 0.076 |
Slua eeping medicakojntawm | -0.234 | -0.072 | -0.125 | -0.092 | -0.166 | -0.051 | 0.009 | 0.04 |
Hnubikuv dysfib unckojntawm | -0.062 | -0.081 | -0.126 | -0.176 | -0.142 | -0.095 | -0.091 | 0.059 |
Global sc uaore | -0.175 | -0.136 | -0.193 | -0.167 | -0.181 | -0.127 | -0.046 | 0.056 |
NCQ | -0.232 | -0.185 | -0.235 | -0.241 | -0.152 | -0.213 | 0.06 | -0.126 |
FYOG-40 | ||||||||
Lub cev | -0.173 | -0.184 | -0.239 | -0.279* | -0.167 | -0.223 | -0.055 | -0.018 |
Cognnwsua ve | -0.176 | -0.146 | -0.208 | -0.258 | -0.121 | -0.193 | -0.027 | -0.026 |
Psychosocial | -0.201 | -0.199 | -0.237 | -0.278 | -0.135 | -0.215 | -0.048 | -0.008 |
Global sc uaore | -0.189 | -0.183 | -0.232 | -0.276 | -0.141 | -0.213 | -0.045 | -0.016 |
HADS | ||||||||
Anxiety | -0.123 | -0.101 | -0.085 | -0.086 | -0.07 | -0.064 | -0.139 | 0.107 |
Depresintawm | -0.228 | -0.236 | -0.231 | -0.224 | -0.134 | -0.214 | -0.003 | -0.026 |
Global sc uaore | -0.189 | -0.183 | -0.173 | -0.17 | -0.11 | -0.153 | -0.066 | 0.035 |
COMPASS -31 | ||||||||
Orthostatic intolerance | -0.14 | -0.094 | -0.141 | -0.124 | -0.074 | -0.079 | -0.095 | 0.019 |
Vasomotor | -0.214 | -0.079 | -0.075 | -0.121 | 0.073 | -0.046 | -0.008 | 0.016 |
Secretomotor | -0.143 | -0.22 | -0.253 | -0.235 | -0.223 | -0.19 | 0.074 | -0.08 |
Gmob plab | -0.061 | -0.288 * | -0.296 * | -0.291 * | -0.382 ** | -0.221 | -0.193 | 0.195 |
zais zis | -0.107 | -0.142 | -0.178 | -0.192 | -0.126 | -0.197 | 0.006 | -0.078 |
Pupmobomo uator | -0.089 | -0.122 | -0.147 | -0.18 | -0.156 | -0.118 | -0.116 | 0.066 |
Global ua score | -0.148 | -0.19 | -0.23 | -0.222 | -0.194 | -0.167 | -0.085 | 0.032 |
Ib qho yooj yim linear regression tsom xam qhia meej qhov sib txawv ntawm cov kev tshawb fawb koom nrog- ris, txij li cov neeg mob ME/CFS tau pom muaj kev sib raug zoo ntawm lub cev ntawm FIS-40 thiab HRV tsis, xws li SDNN (Fig2A, = -0.487, p = 0.0047), RMSSD(Daim duab2B, = -0.394, p = 0.0258), LF (Fig2C, = -0.537, p = 0.0015), HF (Fig2D, = -0.421, p = 0.0165), thiab pNN50 ( = -0.378, p = 0.033). No cov koom haum zoo li nowib ere found for iby HRV domain in nwsalthy tswj (Daim duab2).
Fiua gure 2. Simple regressintawm analisuatween physic uaal fatigue perception (FIS-40) thiabHRVparamkev sib txawv KUV/CFS pakojents (n = 32) thiab Control cov txiv neej (n = 19). Physical FIS-40 ua score is siua gnikevtly explainedfr kevua om (A) SDNN (p = 0.005), (B) RMSSD (p = 0.026), (C) LF (p = 0.002), thiab (D) HF (p = 0.016), rau ME / CFS cov neeg mob (dub squares, sab sauv regression kab), tab sis tsis yog rau cov tswj kev noj qab haus huv (dawb lub voj voog, hauv qab regression kab).
Rooj4qhia Pearson kev sib raug zoo ntawm cov qhab nia thoob ntiaj teb ntawm PSQI qhia tus kheej, NCQ, FIS-40, COMPASS-31, thiab HADS queskojnawjires. All kev sib raug zoowyog positive, siab heev siua gnikevt, thiab higher than 0.73 (p 0.001). Most coua rrelakojntawm cojffci uaentspebre highertshaj 0.8 (Table 4).
Rooj 4.Pearson kev sib raug zoo ntawm cov ntawv nug thoob ntiaj teb rau tag nrho cov qauv (n = 51 txiv neej).
NCQ | FIS-40 | HADS | COMPASS -31 |
| 0.819 ** | 0.817 ** | 0.825 ** |
NCQ | 0.872 ** | 0.770 ** | 0.849 ** |
FIS 40 | 0.871 ** | 0.817 ** | |
HADS | 0.737 ** |
** Qhov tseem ceeb (p < 0.001).
3.5. Sib txawv Poj niam los txiv neej Cov teebmeem thiab Kev sib tham ntawm kho mob Tsis muaj
Tnws data los ntawmm men hauv kev kawm tam sim nowua comua kewyog cov ntaub ntawv tau los ntawmm poj niamin ua previos study uainto ib uniqha datib setthiab tom qab ntawdtly ualyzed uato ntsuam xyuas qhov cuam tshuam ntawm poj niam txiv neej thiab kev sib cuam tshuamwnoj qab nyob zoo los yogME/CFS cov xwm txheej.
Table 5 qhia txog cov kev coj noj coj ua thiab kev kho mob rau cov txiv neej thiab poj niam los ntawm pab pawg, thiab tseem qhia txog kev cuam tshuam ntawm poj niam txiv neej thiab/los yog qhov tseem ceeb 'poj niam txiv neej * xwm txheej' kev sib cuam tshuam (ob txoj kev ANOVA tsom xam). Txhua qhov kev hloov pauv, tshwj tsis yog hnub nyoog thiab BMI, tau pom qhov tshwm sim tseem ceeb (Control vs. ME/CFS), nrog rau qib ntawm qhov tseem ceeb ntawm p < 0.01="" rau="" sap="" thiab="" dap="" thiab="">< 0.001 for all="" other="" clinical="" variables.="" considering only gender, without="" considering the group or experimental condition, women had lower="">< 0.001), increased hr (p = 0.004), increased vasomotor domain score (p =" 0.034) and a marginally significant increase" in="" secretomotor="" domain="" score="" (p="0.061) in" the="" compass-31, compared="" with men (table 5).="" the only variable that="" showed a differential gender effect on the="" health condition was ncq (p =" 0.023), revealing that" in women, me/cfs patients showed a greater increase of="">
Table 5.Lub hauv paus ntawm cov pej xeem thiab cov chaw kho mob (txhais tau tias± SEM) rau txiv neej thiab poj niam los ntawm pab pawg (cov ntaub ntawv rau cov poj niam los ntawm Escorihuela thiab al., 2020 )
Txiv neej | Female ua | ua Dyog. | |||
Hloov pauv | Tswj (n = 19) | ME/CFS (n = 32) | Tswj (n = 25) | ME/CFS (n = 45) | '-Valua ue |
Hnub nyoog (xyoo) BMI (kg/m2 ) | 47.32 ± 1.51 24.69 ± 0.80 | 47.38 ± 1.52 23.69 ± 0.51 | 44.96 ± 1.30 23.77 ± 0.61 | 46.41 ± 0.84 24.59 ± 0.69 | N.S. N.S. |
SAP (mmHg) | 122.1 ± 2.43 | 131.8 ± 2.54 * | 115.2 ± 2.15 | 121.2 ± 1.99 * | <>a |
DAP (mmHg) HR (beats/min) | 77.91 ± 1.51 62.79 ± 1.33 | 82.38 ± 1.68 * 70.13 ± 1.85 * | 74.45 ± 1.56 67.71 ± 1.93 | 79.56 ± 1.38 * 74.72 ± 1.21 * | 0.055 a 0.004 a |
NCQ (num) FYOG-40 | 0.26 ± 0.10 | 7.97 ± 0.46 ** | 0.40 ± 0.15 | 10.11 ± 0.28 ** | 0.023 b |
Global qhab nias (0–160) | 11.68 ± 4.02 | 135.8 ± 3.91 ** | 17.12 ± 3.25 | 140.9 ± 1.79 ** | <> |
Lub cev | 2.47 ± 1.05 | 36.50 ± 0.62 ** | 4.60 ± 0.94 | 36.95 ± 0.39 ** | <> |
Cognnwsua ve | 3.58 ± 1.00 | 34.72 ± 0.72 ** | 4.48 ± 1.03 | 35.73 ± 0.66 ** | <> |
Psychosocial COMPASS -31 | 5.63 ± 2.06 | 64.59 ± 2.41 ** | 8.04 ± 1.46 | 68.27 ± 1.04 ** | <> |
Global qhab nias (0–100) | 20.57 ± 2.93 | 56.83 ± 2.42 ** | 27.31 ± 2.42 | 80.10 ± 2.91 ** | <> |
Oua rthostakojc intolernce | 3.11 ± 0.41 | 7.56 ± 0.36 ** | 2.52 ± 0.25 | 7.45 ± 0.31 ** | <> |
Vasomotor | 0 ± 0 | 1.28 ± 0.26 ** | 0.48 ± 0.21 | 1.93 ± 0.24 ** | 0.034 a |
Secretomotor | 0.58 ± 0.21 | 3.94 ± 0.29 ** | 0.76 ± 0.18 | 4.73 ± 0.18 ** | 0.061 a |
Gmob plab | 5.84 ± 1.03 | 11.0 ± 0.90 ** | 5.60 ± 0.74 | 13.45 ± 0.68 ** | 0.001 |
zais zis | 0.58 ± 0.18 | 3.62 ± 0.48 ** | 0.32 ± 0.11 | 3.48 ± 0.32 ** | <> |
Pupmobomo uator PSQI | 3.16 ± 0.70 | 9.69 ± 0.63 ** | 2.96 ± 0.46 | 10.32 ± 0.55 ** | <> |
Ntiaj teb noqhab nias (0–21) | 4.32 ± 0.67 | 14.28 ± 0.77 ** | 4.52 ± 0.63 | 15.05 ± 0.57 ** | <> |
Subjective pw zoo | 0.53 ± 0.14 | 2.28 ± 0.14 ** | 0.56 ± 0.12 | 2.23 ± 0.14 ** | <> |
Snyob latency | 0.53 ± 0.18 | 1.84 ± 0.18 ** | 0.72 ± 0.17 | 1.89 ± 0.16 ** | <> |
Slua eep durakojntawm | 0.95 ± 0.16 | 1.88 ± 0.19 * | 0.92 ± 0.17 | 2.05 ± 0.13 ** | 0.001 |
Habnwsual slua eep efficiency | 0.42 ± 0.23 | 1.72 ± 0.22 ** | 0.56 ± 0.22 | 1.95 ± 0.17 ** | <> |
Slua eep dkev ntxhov siab | 1.00 ± 0.11 | 2.22 ± 0.11 ** | 1.04 ± 0.07 | 2.27 ± 0.13 ** | <> |
Slua eeping medicakojntawm | 0.32 ± 0.13 | 1.91 ± 0.24 ** | 0.44 ± 0.12 | 2.55 ± 0.11 ** | <> |
Hnubikuv dysfib unckojntawm HADS | 0.58 ± 0.14 | 2.44 ± 0.14 ** | 0.44 ± 0.12 | 2.55 ± 0.11 ** | <> |
Ntiaj teb noqhab nias (0–42) | 7.26 ± 1.0 | 27.38 ± 1.36 ** | 5.15 ± 0.70 | 26.68 ± 1.41 ** | <> |
Anxiety | 5.21 ± 0.70 | 14.03 ± 0.67 ** | 3.96 ± 0.41 | 13.73 ± 0.73 ** | <> |
Depresintawm | 2.05 ± 0.49 | 13.34 ± 0.85 ** | 1.16 ± 0.29 | 12.95 ± 0.68 ** | <> |
* Qhov sib txawv nrog kev tswj hwm rau tib tus poj niam txiv neej (p< 0.05). ** differences with="" controls="" for the="" same="" gender (p=""><>a Poj niam txiv sib txawv rau samples.b Gkev sib txawv nyob ntawm cov pab pawg (poj niam txiv neej x pab pawg sib cuam tshuam tseem ceeb).
3.6. Poj niam los txiv neej Cov teebmeem thiab Kev sib tham ntawm HRV
Table 6sua li cass tnws HRV parameters ua for cov txiv neej thiab poj niam by grkojp, thiab shows siua gnikevt poj niam txiv neej eua ffib ects thiab/los yog siua gnikevt 'poj niam txiv neej* condnwsntawm' interackojons (tqho-txoj kev ANOVA analis).
Table 6.HRV parameters rau txiv neej thiab poj niam los ntawm pab pawg (cov ntaub ntawv rau cov poj niam los ntawm Escorihuela li al., 2020）
Txiv neej | Female ua | '-Valua ue (ANOVA) | ||||
Hloov pauv | M-Controls (n = 19) | M-ME/CFS (n = 32) | W-Ctswj (n = 25) | W-ME/CFS (n = 45) | Poj niam los txiv neej | Poj niam los ntawm Pab pawg |
RRmean (ms) | 901.6 ± 41.0 | 861.3 ± 20.5 | 904.40 ± 27.63 | 809.40 ± 13.54 * | N.S. | N.S. |
SDNN (ms) | 41.02 ± 4.52 | 37.38 ± 2.99 | 50.06 ± 4.16 | 33.97 ± 2.03 ** | N.S. | N.S. |
RMSSD (ms) | 29.37 ± 4.04 | 23.84 ± 2.67 | 42.49 ± 5.25 | 22.09 ± 1.72 ** | N.S. | 0.071 |
pNN50 (feem pua) LF (ms2 ) | 10.79 ± 2.82 897.5 ± 298.8 | 6.37 ± 1.52 663.6 ± 177.3 | 20.46 ± 3.89 1014.60 ± 247.5 | 5.44 ± 1.09 ** 453.10 ± 68.40 * | N.S. N.S. | N.S. N.S. |
HF (ms2 ) | 411.1 ± 115.0 | 287.4 ± 54.8 | 944.90 ± 241.8 | 274.73 ± 42.47 ** | 0.037 | 0.036 |
LF/HF | 2.96 ± 0.55 | 2.83 ± 0.35 | 1.39 ± 0.25 | 2.21 ± 0.20 * | <> | 0.065 |
HFnu | 33.11 ± 3.73 | 31.36 ± 2.03 | 49.07 ± 3.31 | 35.77 ±1.99 * | N.S. | 0.035 |
Tus nqi yog qhia raws limean± SEM. * Qhov sib txawv nrog kev tswj hwm rau same poj niam txiv neej (p< 0.05). ** differences="" with controls=""> poj niam txiv neej (p< 0.001).> Poj niam txiv neej sib txawv rau txhua tus qauv. "Gender by Group": Kev sib txawv ntawm poj niam txiv neej nyob ntawm pab pawg (poj niam txiv neej x pab pawg kev sib cuam tshuam tseem ceeb).Abbreviations ntawmHRVparameters: MeanRR, mean uaRRib ntus; SDNN,tusstandard deviation ntawm tag nrho covRR ib ntus; RMSSD, hauv pausmean square ntawm qhov sib txawv ntawm successiveRRib ntus; np50, qhov proportions muab los ntawm kev faib cov numua ber Qhov sib txawv ntawm qhov sib txawv ntawm qhov sib txawv ntawm RR lub sijhawm ntau dua 50 ms los ntawm tag nrho cov naj npawb ntawm RR intervals; LF,tuslow-frequency band (0 04–0.15 Hz); HF, high-frequency band (0.15–0.40 Hz); LF/HF ratio; HFnu, tsis yogmalized HF tus nqi.
In Fiua gures 3thiab 4, peb zuagine tnws HRV parameters for poj niam wnwsh tnws tshiab cov obtainedfr kevua om cov txiv neej. Intereskojngly, tnws valua ues of HF thiabnwss deri ibvakojua ves LF/HF thiab HFnu revea ualed siua gnikevt poj niamr eua ffib ects (Table 6). Moreovr, HF thiab HFnu presented siua gnikevt 'poj niamr*condnwsntawm' interackojons (p 0.05), thiab LF/HF a mavrginaly siua gnificibt 'poj niam txiv neej * xwm txheej' kev sib cuam tshuam (p = 0.065; Rooj6). Post-hoc kev sib piv ntawm LF tau qhia tias ob pawg txiv neej tsis qhia qhov sib txawv, tsis muaj qhov sib txawv nrog kev tswj hwm poj niam lossis poj niam ME/CFS cov neeg mob (Daim duab4A). Los ntawm qhov sib txawv, poj niam cov neeg mob ME/CFS muaj txo HF thiab HFnu qhov tseem ceeb piv rau cov poj niam tswj, hos ob pab txiv neej tsis txawv betwua eenmlub femua aleKUV/CFS cov neeg mob. Pawg tswj ntawmwomen sua li cas higher valua ues ntawm tnwsse parameters (Fiua gure 4B,D). Pos-hoc comparisons ntawm LF/HF rakojo sua li cas tnws same uatween-grua oup dkev xav, tab sis nyob rau hauv kev sib raug zoo inverse, thus tnws fua emale cntawmtrol grua oup muaj tnws ltshuavst ua rakojo thiab dib iffeliab frmtag nrho lwm pab pawg (Figure4C).
Fiua gure 3. Comparisntawm of tnws HRVkojkuv-domain indib ices in tnws WHOle sample. Txhais tau tias ± SEMntawm (A) mean uaRRib ntus (meanRR), (B) tus qauv sib txawv ntawm txhua lub sijhawm RR (SDNN), (C) hauv paus txhais tau tias square ntawm qhov sib txawv ntawm RR ncua sij hawm (RMSSD), thiab (D) qhov proportions muab los ntawm kev faib cov number ntawm qhov sib txawv ntawm qhov sib txawv ntawm RR ncua sij hawm ntau dua than 50 ms by tnws total numr of RR inteua rvals (npo 50). a,b Txhais tau tias valua ues wnwsh ibnyiamentawvwnws txawv heev betwib group (two-wayANOVAthiabDuncan's post hoc comparison, p < 0.05).>W-C: Htswj kev noj qab haus huvwomen (n = 25); W-F: ME/CFS uamen (n = 44); M-C: Tswj kev noj qab haus huvmen (n = 18); M-F: ME/CFS cov txiv neej (n = 32).
Daim duab 4.Kev sib piv ntawm HRV zaus-domain indices hauv cov qauv. Txhais tau tias± SEM ntawm (A) lub zog ntawm qhov tsawg zaus band (LF), (B) power of tnws highfr kevequenua cyband (HF), (C) LF/HF rakojo, thiab (D) tsis muajrmavlized HF valua ue (HFnuj). ib, bMean Qhov tseem ceeb uas tsis zoo li cov tsiaj ntawv muaj qhov sib txawv ntawm pawg (ob txoj kev ANOVA thiab Duncan's post hoc piv, p < 0.05).>W-C: Htswj kev noj qab haus huvwomen (n = 25); W-F: KUV/CFS women (n = 44); M-C: Htswj kev noj qab haus huvmen (n = 18); M-F: ME/CFS cov txiv neej (n = 32).
4. Kev sib thamFatigue Syndrome ntawm HRV
Qhov kev kawm nowraws li tsim los tshawb nrhiavHRV tsom xam raws li lub hom phiaj, tsis ua cas thiab yooj yim-to-apply mavrker of KUV/CFS pebing mHealth technolua ogy.
Peb analyz uaed tnws relakojntawmship of HRV parameterswnwsh self-r ibepoua rtedsymptua oms of fatig, autonomic tsis ua haujlwm, subjib eckojua ve slua eep ua quality, thiab anxiety/depresintawm ua symptoms ua in cov txiv neej wnwsh KUV/CFS.
Alyog li ntawd, we txheeb xyuas qhov sib txawv ntawm poj niam txiv neej los ntawm kev noj qab haus huv vs.ME/CFS tej yam kev mob, comparing cov newcov ntaub ntawv raumib fromtxoj kev kawm tam sim nowyog cov ntaub ntawv ntawmwomen tau nyob rau hauv ib tug dhau los study ua zuagined into a ibiqee data set. Finally, peb bri ibefly explore mHealth deua vices thiab compav covmnrog dab tsi tau ua nyob rau hauv tsab xov xwm no.
4.1. Analysis rau ntawmFatigue Syndrome ntawm HRV
Peb txoj kev tshawb fawb yog ib qho ntawm ob peb yam uas tau soj ntsuam ME / CFS tsis meej hauv qhov loj me sample oftxiv neej thiab comparednws wnwsh ib sample ofpoj niam under expe uari ibcov txiv neejtal control tej yam kev mob.Our cov txiaj ntsig tau qhia tiasmua aleMCov neeg mob E/CFS tau tshaj tawm txog kev qaug zog hnyav, uatncoib icdysf uaibctintawm, decrua easedslua eep ua quality, thiab incrua eased ibkev nyuaj siab thiab kev nyuaj siab ua symptoms ua, tua ogetnwsr wnwsh incoryooj yim higher hlort r ibate thiab blua ood pressure valua ues at rest piv nrog txiv neej noj qab haus huv tswj. Tshwj xeeb, qhov sib txawv yog ntau tshaj 7 ntsiab lushauv NCQ score, ntau tshaj 36 cov ntsiab lus hauv COMPASS-31 tag nrho cov qhab nia, ntau tshaj 120 ntsiab lusin tnws FIS-40 total ua score, around 10 points more in tnws PSQI total ua score, thiab 20 points more in tnws HADS total ua score. At tnws clinical level, all tnws dib iffernce indmob hnyav heev ua symptua omatolua ogy in mavle KUV/CFS pakojents, ib aspect that is pogrl uay cov ntaub ntawvted in tnws ntaub ntawv.Bsab, nyob ntawdwraws li lub koom haum siab betwua eenmale lus nug cov qhab nia tusmtus kheej, qhia txog kev sib raug zoo ntawm tag nrho cov tsos mob, ua raws li cov kev koom tes muaj zog uas tshwm sim hauv female ME/CFS cov neeg mob.
Peb tsis tau pom qhov sib txawv tseem ceeb hauv HRV tsis nyob hauv txiv neej ME / CFS cov neeg mob compared wnwsh mavle hlolthy controls. Txawm li cas los xijr, all kojkuv-domain parameters (RRmean, SDNN, RMSSD, thiab npo 50) muaj a higher valua ue in tnws cntawmtrol gronce, qhia ntau dua cardiac variability (txawm hais tias qhov tseem ceebwraws li tsis tiav). Nwsmight yuav ua tau rau lubm kom ncav cuag qhov tseem ceeb hauv cov qauv loj dua, txij li thaum lawv ua tau raws li lub plawv dhia variabua ility ofcontro ualparkojcipants xovtedin ua previos stua udies.Yog li, tnws gretua kev hloov pauv plawv hauv pawg txiv neej tswj yuav muaj feem cuam tshuam rau kev noj qab haus huv zoo dua, nyob rau hauv kev pom zoo wnwsh otnws stua udies, since in reskojng condnwsons, a "haislthiua hnovt" qhia greatua cardiac variability thiab a lower qib ntawm lub plawv dhia, raws li nws muaj feem xyuam rau kev ua kom ntau dua ntawm tus kab mobmpathetic systemmthiab lub cev zoo dua. Qhov tseem ceeb ntawm parameters soj ntsuamwua in same kev taw qhia raws li hauv peb txoj kev kawm yav dhau los compab femua aleME/CFS cov neeg mob vs female noj qab nyob zoo tswj.
In tnws ua cuua rrent study ua, tnws coua rrelakojons uatween HRV parameters thiab self-r ibepoua rted Cov qhab nia qaug zog tsis zoo ib yam li lawv tau kawm hauv cov poj niam. Qhov tseem ceeb, tus nkaus xwb Kev sib raug zoo tseem ceeb uas tshwm sim ntawm HRV tsis muaj thiab cov tsos mob qhia tus kheej hauvmale uample nyob nruab nrab ntawm qhov ntsuas lub cev ntawm FIS-40 thiab plab hnyuv scale ntawm COMPASS -31. Hauv tus txiv neej tus qauv, FIS-40 lub cev qhov ntsuas tsis zoo txuam nrog pNN50. Txij li qhov parameter no qhia txog qhov feem pua ntawm ib txwm ua tiav RR intervals uas qhov kev hloov pauv ntau dua 50ms, qhov kev sib raug zoo tsis zoo qhia tau tias incoryooj yim fakojua gue is associated wnwsh shoua rter vari ibakojntawm uatpebua tiavRRncua sijhawm, mtsawg dua HRV. Ntxiv rau, lub gastrointestinal domain ntawm autonomic dysfunction yog tsis zoo cuam tshuam nrog SDNN, RMSSD, thiab pNN50 ( peb lub ntsiab HRV qhov ntsuas ntawm kojkuv-domain analysis) thiab tnws LF component. Nws yog cntawmsib pNN50i ibRMSSD yogmyooj yim ntawm parasymkev ua haujlwm siab, wtias SDNNreflects ob symkho siab thiab parasympathetic modulation ntawm lub plawv dhia. Hais txog LF (lub zog ntawm lub suab qis) thiab HF (lub zog ntawm lub siab zaus band) cov khoom xyaw, vagal kev ua si yog qhov major contributor rau HF component, whereas LF tivthaiv muaj kev sib cav ntau dua Txawm hais tias qee qhov suav tias yog ib qho cim ntawm kev ua siab zoo; ntxiv lawm, poob RMSSD thiab npo 50 ua tau ua interpreted raws li decrua eased vagal activity. Overall, those relakojonships muaj tnws kev expected siua gn in kojr study ua: High fakojua gue or high gastrointeskojnal dys uafib unckojntawm pebre associated wnwsh les HRV vari ibabua ility, thus sua uggua sting that those HRV vari ibables are suscepkojble to ua fuua rtnwsr explored raws li ceviolua ogib ical biua omark uaers ua for fakojua gue symptoms hauvmen.
Ntxawm li cas los xij, ib qho kev soj ntsuam ze dua ntawm qhov kev ntsuam xyuas regression qhia tias lub cev fakojua gue could qhork raws li a biua omarker in cov txiv neej. Thyoganalisdetected specif relakojntawmships raumua aleMCov neeg mob E/CFS uas tsis tshwm sim hauv cov txiv neej noj qab haus huv tswj. Tsuas yog txiv neej xwb KUV/CFSneeg mob showed ib tug tseem ceeb kev sib raug zoo thawj koom ruamween lub cev qhov ntsuas ntawm FIS-40 thiab HRV parameters. Inverse kev sib raug zoo nrog lub sij hawm-domain parameters, xws li SDNN thiab RMSSD, line nce wnwsh predib ictedsymptua omatolua ogy of higher lub cev qaug zogwnws az cardiac variability, hauv pom zoomentwnrog rau lwm yam kev tshawb fawb.
Howpuas tau, cov txiaj ntsig ntawm fr kevequency-domain parametersare tsis muajt soclua ear, since ib both HF thiab LF sua li cas asimilar inverse relakojntawmship wnwsh tnws physic uaal fakojua guescore of FIS-40. Cov negative rekev sib raug zoo ntawm HF thiab lub cev qaug zog hauvmua aleMCov neeg mob E/CFS zoo ib yam nrog cov ntawmlub sij hawm domain, qhiamore hnyav lub cev qaug zog cuam tshuamwnws tsawg dua parasympatheticpredominoj, inline wnwsh prua evios qhorks kev. In apparent incosibency, tnws ib yam type ua of relakojonship ua tsaugred uatween LF thiab cevical fakojua gue, thaumnwswou uald ua xav tias ntau lub cev qaug zog yuav tsum muaj feem cuam tshuam nrog kev sib koom siab ntau dua. Howpuas tau, vagal thiab symKev ua kom muaj kab mob tuaj yeem ua rau LF hloov pauv, thiab LF valua ues could ua iua nfl los ntawm respiratory sinus aua rrhua ythmoia (RSA).
Overall, tnws tqho parameters ntsuam xyuas tus kab mobmpathetic thiab vagal kev ua haujlwm, RMSSD, thiab HF, raws li, showed kev sib raug zoowith tus kheej qhia txog lub cev qaug zog hnyav hauvmua aleME/CFS cov neeg mob, tab sis tsis noj qab nyob zoomales.SDNNthiab LF ib showed uame qauv, tab sis cov kev txhais ntawm ob qhov kev ntsuas no yog qhov tsis sib haum xeeb. Txawm li cas los xij, xws li kev sib raug zoo muaj qhov xav tau kos npe, xws li tias tsawg HRV tau txuam nrog cov tsos mob hnyav dua. Cov txiaj ntsig no qhia tias SDNN, RMSSD, LF, thiab HF tuaj yeem muaj qhov kev twv ua ntej tus nqi rau lub cev qaug zog tus kheej-kev xaav hauvmua aleMCov neeg mob E/CFS, RMSSD, thiab HF to a ntau dua, thiab SDNN thiab LF mus rau qhov tsawg dua.
4.2. Kev tsom xam ntawm Poj niam los txiv neej Qhov txawv
Muaj qee qhov kev tshawb fawb uas tau txheeb xyuas qhov sib txawv ntawm poj niam txiv neej hauv ME / CFS cov neeg mob. In tnws previkojslycov txiv neejkojib ed reviua ew ntawm mavlf ibibctintawming of tnws ANS, the tsuas kawm hauv tnws rua eviua ew that kev xeemined poj niamr dib iffernce found that hlolthy poj niam muaj a dib ifferent daim npaviovascu ualua tebtaw upright qaijpivto hliltcov txiv neej thiabthat this could qhia ib tug predisposition ntawmwomnyob rau hauv orthostatic intolerance. Txawm li cas los xij, cov kev sib txawv no uatwen mavle thiabfua emale ME/CFS uakojents ua notpomin ib anotnws study ua. In tnwsyog rua eviua ew ua about mavlf ibib unckojntawming of tnws ANS in pakojents wnwsh KUV/CFS (743 pakojents), Cuawenmua et al. suav rau tag nrho ntawm 74feem puantawmwomen hauvmples frmtus rovwed kev kawm.Only ib study aimed los txheeb xyuas qhov sib txawv ntawm poj niam txiv neej; tag nrho cov so kev tshawb fawb pab pawgmen e womib indiscriminately li cov neeg mob.
Hauv peb txoj kev tshawb fawb, txhawm rau tshawb xyuas cov txiaj ntsig sib txawv ntawm poj niam txiv neej, peb soj ntsuam ob mavle thiab fua emale samples in a tqho-txoj kev (2 × 2) desiua gn wnwsh a hlolth condnwsntawm (control, ME / CFS) thiab poj niam txiv neej (txiv neej, poj niam) ua yam. Zuag qhia tag nrho, Cov poj niam qhia qis SAP, nce HR, incrua eased NCQsymptua oms, thiab incrua eased vasomo uator uamib score comua padwith cov txiv neej.Analua yzingtnws clinicalparameters, tnws only variable thatqhia a dib iffib erenkojal poj niamr eua ffib ect nyob ntawming ntawm hlolth condnwsntawm yog NCQ. Ntawm averhnub nyoog, fua emale KUV/CFS Cov neeg mob muaj NCQ cov qhab nia ntawm 9.71 cov ntsiab lus NCQ siab dua qib ntawm poj niam noj qab haus huv tswj, whereas txiv neej ME / CFS cov neeg mob tau qhab nia 7.71 cov ntsiab lus siab dua qib ntawm txiv neej tswj kev noj qab haus huv. Covse resultswou uald indib icate a higher level of uatotsis muajmic tsis ua haujlwm hauv femlaj vs.mua ale ME/CFS cov neeg mob. Ib yam li ntawd, peb cov txiaj ntsig tau nthuav tawm qhov sib txawv ntawm poj niam txiv neej rau SAP, DAP, HR, thiab autonomic secretomotor thiab vasomotor dysfunctions ntawmmen e women.Women tau qis systolic thiab diastolic ntshav siab thiab siab dua lub plawv dhia piv nrog cov txiv neej. Hais txogiua HRVlyusis, qhov profle ntawmmale ME/CFS pabintus differs raumuas ntawm fua emale KUV/CFS pakojents, thiab robust dib iffernce pebre qhia uatween fua emale hlolthy controls thiab fua emale KUV/CFS pakojents, tnws latter grua oup exh uaibnwsng ltshuavr valua ues of kojkuv-thiabfr kevkev sib npaug-domain HRV parameters than tnws forkuvr. Cov fact that tnws sib txawv in HRV parameters did tsis muajt rtxhua siua gninyiaj txiag in tnws study ua wnwsh cov txiv neej could ua piav qhia raws li qee qhov kev tshawb fawb qhia txog kev sib txawv ntawm poj niam txiv neej nyob rau hauv luv luv HRV. Voss et al. analyzed ua tnws infl ua of poj niamr thiab hnub nyoog ntawm short-term HRV in hlolthy subjib ects (782 poj niam thiab 1124 cov txiv neej). Lawv found siua gnikevt modifica uakojons of tnws HRV indices, especially in tnwsfr kevkev sib npaug domain, ua according to poj niamr for neegle in ib hnub nyoog rnpau taws uatween 25 thiab 49 yua ears, whib ich wou uald inclua ude those in kojr sample. For hyogpart, Vaschilo et al. kuj pom qhov sib txawv ntawm poj niam txiv neej muaj feem xyuam nrog HRV tsis tau thaum thov cov txheej txheem biofeedback.
Cov kev sib raug zoo ntawm HRV tsis thiab cov qhab nia ntawm tus kheej qhia txog kev qaug zog uas tshwm nyob rau hauvmen yog quantitatively raws li cov poj niam txij li lub cim ntawm Cov kev sib raug zoo qhia tau tias tsis tshua muaj kev hloov pauv ntawm lub plawv cuam tshuam nrog cov tsos mob hnyav dua li hauv txoj kev tshawb fawb ntawmwomen. Yog li, kev sib raug zoo nrog timua e-domib HRV parameters (SDNN, RMSSD, thiab pNN50) pom qhov sib txawv ntawm ob tug poj niam txiv neej. Nws tuaj yeem txhais tau hauv terms ntawm qhov hnyav dua ntawm lub cev symptomatology yog txuam nrog mob plawv hloov pauv, wnws pom zoownrog rau lwm yam kev tshawb fawb. Txhawm rau ua qhov no, xav tias timua e-domib ain HRV tsis yog biomarkers ntawm psychophysiological thiab mob plawv; Niam thiab Thayer npaj siab tias qhov siab amplitude oscillations hauv plawv dhia zoo cuam tshuam neural netqhorks kev in tnws brain ,ua McCraty thiab Shaua ffer found that higher levels of HRV yog txuam nrog kev noj qab haus huv, adaptability, resilience, thiab kev tswj tus kheej muaj peev xwm.
Tsis hais txog kev noj qab haus huv, tag nrho cov HF ntsig txog qhov ntsuas tau qhia txog poj niam txiv neej eua ffects.Cov total sample of poj niam sua li cas higher HF thiab HFnu valus limen, thiab ltshuavr LF/HF valua ues (indicakojng that HF pebighs ua more ntawm poj niam). This wou uald indicate greatyog parasympatnwskojc ua ackojvakojntawm cov poj niam, in line wnwsh what otnws ua haujlwm expose. Txawm li cas los xij, thaum peb txheeb xyuas qhov sib txawv ntawm poj niam txiv neej xav txog kev sib cuam tshuam wnwsh hlolthstatus, peb find specif ibdib ifferences for qaugwomen, taw qhia tias qhov no grua oup is dri ibving tnws dib iffernce. KUV/CFS poj niam qhia ltshuavr HF thiab HFnu valua ues tshaj tswjwomen, wciam two male pawg tsis txawv thawj koom ruamwua eenmlos ntawmm KUV/CFS women (Figures4Bthiab2D). Thus, KUV/CFS women zoo li coj zoo li men los ntawm kev qhia tsawg dua kev ua haujlwm ntawm cov kab mob parasympathetic dua li cov poj niam noj qab haus huv. Qhov no lowyog parasymua siab ntevminance kuj tau pom nyob rau hauv cov nqi siab dua ntawm LF / HF proporti uantawm for KUV/CFS poj niam, raws li pebllraws li for cov txiv neej (Fiua gure 4C). Covrefore, everything indicates that KUV/CFS diyog li ntawdrder muaj dib ifferenkojal eua ffects in poj niam, decrua easing tnws usual parasympathetic ua kom noj qab nyob zoowomen mus rau ib theem raug raumen.
Txawm yog poj niam los txiv neej, tag nrho cov qauv ntawm ME / CFS cov neeg mob pom tau tias qis dua valua ues of cardiac vari ibabua ility than controls. All kojkuv-domain HRV parameters (RRmean, SDNN, RMSSD, thiab npo 50) indib icated a qhorse uatntawmomic balance hauvKUV/CFScov neeg mob tshaj li cov neeg koom nrog noj qab haus huv. Tseeb tiag, HRVsuav hais tias yog ib qho index ntawm autonomic kev resilience vim nws cuam tshuam lub peev xwm rov qab losmraug rau ob lub cev thiab puas siab puas ntsws cov stressors. HRV tau ua pov thawj tias yog ib qho tseem ceeb ntawm biomarker ntawm psychophysiologicalhlolth, zoo fitness ua level, thiab pebll-uaing. Qhov tseeb, siabHRVraug txiav txim siab a zoo biua omarker of cevical hlolth, or a zoo prtxawmkojua ve indicator of cevical in- juri ibes, wheryooj low ua HRV muaj ua associated wnwsh, ntawm otnwsr things, highri ibua sk ntawm cov kab mob plawv, ntshav qab zib, kev txawj ntse imkhubment, thiab puas siab puas ntsws kev puas tsuaj, xws li kev nyuaj siab lossis kev ntxhov siab.
4.3. mHealth Technology rau HRV Kev tsom xam
Kev kuaj mob thiab kev saib xyuas ntawm ME / CFS tuaj yeem kim thiab tuaj yeem siv sijhawm ntau thiab cov khoom siv (piv txwv li, ib qho kev tawm dag zog tsis haum nrog kev ntsuas ergometric ntawm qhov siab tshaj plaws oxygen consumption, lub complicated neuropsychological roj teeb rau kev kawm txog kev txawj ntse kev puas tsuaj). Hloov chaw, raws li txoj kev thiab cov txiaj ntsig ntawm peb txoj kev tshawb fawb, peb qhia tias ib tug 5-min HRV test at rest ua tau provide sivful informavkojntawm interprekojng ib objib eckojua ve, tsis yog-invasiua ve thiab yooj yim rau kev thovmarker ntawmME / CFS sivmKev noj qab haus huv technology. Cov cuab yeej no tuaj yeem pab tau rau hauv kuaj mob, mkev soj ntsuam, thiab soj ntsuam kev kwv yees ntawm qaug zog hnyav, tshwj xeeb hauv women nrogKUV/CFS.
More feem ntau, nws twb shown tasmHkev noj qab haus huvms yog pab tau rau remotely kuaj xyuas cov kev hloov pauv hauv kev noj qab haus huv xws li HRV lossis lub plawv dhia (HR) nyob rau hauv cov ntsiab lus ntawm txoj haujlwm lossis kev ua neej nyob txhua hnub.HRVtuaj yeem ntsuas symptomhnyav thiab nce ntxiv, ruaj khov, thiab kho cov lus teb. Piv txwv li, ib qho kev tshawb fawb luam tawm tsis ntev los no txheeb xyuas HRV for more than eight mua illintawm neegle collib ected wnwsh a kev xavr raws ntawm photoplethysmography ackojvnwsy.
Nwsqhia ua li cas tnws HRV parameters (in tnws tua emporal thiabfr kevkev sib npaug domains) hloov nrog lub hnub nyoog, poj niam txiv neej, thiab thaum nruab hnub. Lwm txoj kev tshawb fawb soj ntsuam cov nyhuv ntawm kev ntxiv HRV biofeedback rau ib qho app-raws li, remote kev cuam tshuam rau kev nyuaj siab thiab yuav ua li cas nws tuaj yeem txhim kho kev kho mobmua outcomes.More kev tshawb fawb tau luam tawm tsis ntev los no comua biningHRV thiabmHkev noj qab haus huv technologies.
Howpuas tau, ib ntawmmib limcov ntawv ntawm cov kev tshawb fawb no yog qhov siab rhiab heev rau lub cev txav thiab muaj cov khoom cuav raws limost uamcia siab rau lub photoplethysmography sensor rau kuaj lub plawv dhia los yog inter-beat cardiac intervals.
Tus qauv kub rau HRV tsom xam yog nyob ntawm tnws lab-ECGsigna ual. However, thyog recording method yuav tsum tau siv cov electrodes thiab lua eds, yog li ntawdnws is kev siv nyiajiua ve, uncomfoua rtable for tnws pakojent, thiab requires qeetraining.
Raws li ib alternative to tnws lab-ECG, tnwsy are recenua tlyua tsaugri ibng poua rtablecov neeg siv khoom siv raws li ntawm mHealth technolua ogy, detecting ECGsigna uals thiabderivi uang tnws RR inteua rval values rauHRV tsom xam.
5. Cov lus xaus
Cov total sample rua esults, incolua uding poj niam thiab cov txiv neej, robustly revea ualed consistent dib ifferences uatween KUV/CFS pakojentsthiab hlolthy cntawmtrols kuvn demograph uaib icibd kev kho mob parameters. KUV/CFS pakojents feltsivrely fakojua gued, complained ua about alluatncoic neurovegetative uamptoms thiab kev ua haujlwm tsis zoo, qhia txog kev pw tsaug zog tsis zoo, thiab clinical depresintawm thiab anxiety ua symptoms ua. Moreovr, allHRV parameters qhia a siua gnikevt impaircov txiv neejt in KUV/CFS pakojents compared wnwsh hlolthy control parti uacipants. Lub sij hawm- thiab zaus-domain tsis coj txawv ntawm cov poj niam txiv neej sib txawv eua ffib ects. Nenwsnwsr of tnwskojkuv-domain indices presented asiua gnificibt poj niamr eua ffectthiab/or a siua gnikevt interackojntawm for poj niamr vs. hlolth condnwsntawm. Los ntawm contrraws lit, fr kevkev sib npaug-domain parameters (HF, LF/HF, thiabHFnu) tau nthuav tawm qhov muaj txiaj ntsig tseem ceeb ntawm poj niam txiv neej, thiabHF thiabHFnu tau nthuav tawm qhov kev cuam tshuam tseem ceeb rau poj niam txiv neej thiab kev noj qab haus huv. To sumnce, Kev tshuaj xyuas HRV tau nthuav tawm raws li txoj hauv kev zoo los txheeb xyuas cov lus teb autonomic, thiab peb cov txiaj ntsig lus qhiat that nwsua tau ua sivful for tnws diagnosis of KUV/CFS. Acc uaording to Cauwenmergh et al., more sensnwsua ve dirib ectntsuasrements of tnws uatncoic ackojvnwsy muaj ua tsim nyog los tsim seb me ntsis autonomic tsis ua haujlwm yog koom nrog ME / CFS. HRV analiskuvtsi thyog requirement, thiab acc uaordntawm peb cov txiaj ntsig, tuaj yeem pab kuaj mob hauv a simple wa uay: (a) Cov sevekevof physic uaal sibmptua oms in KUV/CFS pakojentsof blwm tus poj niam raws ntawmkojkuv-domain HRV parameters (SDNN, RMSSD, npo 50); thiab (b) tnws level of parasymmob autonomic dysfunction hauvKUV/CFS women raws li qhov zaus-uamib ain HRV parameters (HFnu, LF/HF). Hauv kev xaus, peb qhia tias HRV tsom xam siv mHealth technology yog lub hom phiaj, Cov cuab yeej tsis muaj kev cuam tshuam uas tuaj yeem pab tau rau kev kuaj mob, mkev soj ntsuam, thiab clinical predickojntawm of fakojua gue sivrity, especially in poj niam wnwsh KUV/CFS. Txawm li cas los xijr, fuua rtnwsr stua udies are xav tau to coua rroborate whetnwsr such poj niamr dib ifferences in HRV are txuam nrog thiab kwv yees qaug zog hnyav thiab autonomic cardiac dysfunction nyob rau hauv cov poj niam wnwsh KUV/CFS ua ovr tsikuv.
Tus sau kev koom tes: Kev xav, J.A., J.C.-M., LC thiab RME; txheej txheem, J.A., J.C.-M., LC thiab RME; software, LC thiab JR-C.; kev lees paub, J.A., J.C.-M., LC, thiab RME; kev tsom xam, LC thiab RME; kev tshawb nrhiav, J.A., J.C.-M., LC thiab RME; rovurces, JA, JC-M., LC thiab R.M.E.; wkev cai—thawj daim ntawv npaj, J.A., J.C.-M., LC thiab R.M.E.; sau ntawv—tshuaj xyuas thiab kho, J.A., J.C.-M., L.C., R.M.E. thiab JR-C.; kev nrhiav nyiaj txiag, LC Txhua tus kws sau ntawv tau nyeem thiab pom zoo rau luam tawm version ntawm lubmsau ntawv.
Nyiaj txiag: Qhov kev tshawb fawb no tau nyiaj txiag los ntawm"Ministerio de Ciencia e Innovaci6n" ntawm tsoomfwv Spanish, tus lej pub dawb PID2019-107473RB-C2.
Institutinwsl Rua eview Boa uard Statement: Txoj kev tshawb no tau ua raws li cov lus qhia ntawm lub Tshaj tawm ntawm Helsinki, thiab pom zoo los ntawm Institutional Human Research Ethics Committee ntawm lub Vall d'Hebr6n University Tsev Kho Mob (kev cai code CEIC/PR AG-174/2014, pom zoo rau 25 Lub Xya Hli 2014).
Informed Cnwsnt Statement: Cov ntaub ntawv pom zoo tau txais los ntawm txhua yam kev koom tes hauv txoj kev tshawb fawb.
Kev tsis sib haum xeeb ntawm Txaus siab: Cov kws sau ntawv tshaj tawm tsis muaj kev cuam tshuam ntawm kev txaus siab. Cov nyiaj txiag tsis muaj lub luag haujlwm hauv kev tsim of tnws study ua; in tnws collib eckojntawm, analyus, or interpretakojntawm of data; in tnws writing of tnws manuscript, los yog hauv kev txiav txim siab tshaj tawm cov txiaj ntsig.
Nrhiav qhov zoo tshaj plaws BOTANICAL HOLISTIC CARE rau Anti-Fatigue
Peb ua tib zoo xuas tes ua Neuro Regen mis muaj xws li tshuaj ntsuab tshawb fawb zoo tshaj plaws. Txhua qhov qhia tau hais tias muaj peev xwm zoo rau kev tswj kev qaug zog, ntxiv rau cov paj hlwb thiab neuron txhawb nqa tag nrho.
Xws li:
relive-physical-faigue-cistanche-
① Cistanchemuaj ntau yam polyphenols thiab glycosides, uas tuaj yeem ua rau muaj kev ua haujlwm ntawm cov enzymes antioxidant thiab muaj kev ua haujlwm ntawm kev tshem tawm cov dawb radicals; ③Cistanchemuaj lub luag haujlwm ntawmnourishing lub raum thiab ntxiv dag zog rau yang, thiab tuaj yeem txhim kho qhov hypothalamus-pituitary-hypophysis tshwm sim los ntawm kev ua haujlwm hnyav Lub zog ntawm gonadal axis txhawb kev tso tawm ntawm testosterone, muaj txiaj ntsig zoo rau lub cev anabolism, thiab muaj kev tiv thaiv kev qaug zog; ④Cistanchemuaj ntau yam khoom xyaw zoo, uas tuaj yeem txhawb lub cev lub zog metabolism thiab ua kom muaj zog tiv thaiv kev qaug zog.
