非线性检测心率变异初探

The Inquiry Into Non Linear Test on Heart Rate Variation

对１５例急性心肌梗塞（ＡＭＩ）、２４例健康成人的２４ｈ动态心电图进行心率变异（ＨＲＶ）的时域、频域和非线性检测。非线性检测包括构成散点图、计算散点图量化指标（ＰＬＯ）以及复杂度（ＣＯＭ）、预测度（ＰＲＥ）、李雅普诺夫指数（ＬＩ）、相关维（ＣＤ）等参数。正常组ＰＬＯ：ＳＤＳ（横座标）＞６５０且ＬＬ（纵座标）＜８０００；ＣＯＭ为１６０～３２０；ＰＲＥ提示正常组ｒ值开始较高，但随预测步数的增加而递减；ＬＩ为１．１２～２．０８；ＣＤ为１．４７～１．５６。结果还显示非线性参数与时域、频域参数间有一定的相关性。非线性参数能较好地反映ＡＭＩ时ＨＲＶ改变的特征及程度，且用于评价ＡＭＩ的预后优于线性参数，这主要缘于非线性参数更符合心动周期复杂的动力学特性。非线性ＨＲＶ检测方法值得在临床研究中作深入探讨。

Heart rate variability (HRV) test for 24 hours ambulatory eletrocardiographs of 15 cases of acute myocardial infarction (AMI) and 24 cases of normal adults is proceeded, which including three parts: time domain method, frequency domain method and non linear method. The parameters derived from the non liner test were index of Poincare graphics (PLO),complexity(COM),prediction(PRE),index of Lyapounov(LI), and correlation dimension (CD). The parameters ranged for normal adult were as following:PLO:SDS>650 & LL<8000, COM:160～320, PRE:the value decreases while the predicting step number increases, and the original value indicates a high prediction. LI:1.12～2.08, CD:1.47～1 56. Which lies in the result is that the non linear parameter, the time domain one and frequency domain one have some relations between them.The non linear parameter gets a good mirror of the influence which AMI applies on the HRV in levels and characteristics, of which the linear parameter lacks. It is resulted from the good accordance with the complicated dynamic charater of heart period. So more discussion about non liner test method is worth putting forward in clinical research.