基于Poincaré散点图的5s心率变异性分析方法用于实时监测自主神经功能的研究

Application of 5-second Heart Rate Variability Parameter Based on Poincaré Plot in Real-time Monitoring of the Autonomic Nervous System Activity

本研究拟应用基于Poincaré散点图的5 s心率变异性(HRV)分析方法,探索一种短时表征心电(ECG)信号特点的动力学参数(本文命名为5SSD1),用于实时监测自主神经功能的变化。实验方法为对20例择期行口腔颌面部手术患者清醒和麻醉两种状态下的ECG信号进行HRV分析,对分析所得的5SSD1分别与5 min HRV指标中的时域、频域及散点图的定量指标进行相关性分析。实验结果表明,5SSD1与5 min HRV指标时域中的rMSSD(r=0.995,P<0.01)、频域中的HF(r=0.895,P<0.01)、散点图的SD1(r=0.996,P<0.01)均显著相关,而与其他指标的相关性相对较差。由此可见,5 s HRV分析方法可即时反映自主神经功能的变化,其结果稳定可靠,使HRV分析不仅可用于临床诊断,还可作为一种连续实时监测的工具,从而大大拓展了其临床应用范围。

This study designed one index of HRV from Poincaré plot named 5SSD1 by the present authors,which can describe the characteristics of the heart rate dynamics with 5-second data.We also investigated the feasibility of its clinical application in real-time monitoring of the activity of autonomic nervous system.We studied 20 patients scheduled for oral maxillofacial surgery.ECG recording was obtained when kept awake and anesthetic states,respectively.We calculated the correlation coefficients between the 5SSD1 and the other quantitative indicators,such as 5-minute HRV in the time domain,the frequency domain,and the Poincaré plot families.The correlation between 5SSD1 and indicators,such as rMSSD, HF and SD1 of 5-minute HRV was significantly high,with r=0.995,0.895,0.996,respectively,at P0.01 for all.However,the correlation between 5SSD1 and the other indicators of 5-minute HRV was relatively poor.It was proved that 5SSD1 could be used to assess the activities of the autonomic nervous system in real-time,and the stable and reliable results might play more roles in the clinical applications.