心率变异性与献血前心理评估的相关性研究

Relationship between heart rate variability and psychological evaluation before blood donation

目的探讨献血者心率变异性(HRV)与献血前紧张程度之间是否存在关联。方法用心理焦虑自评量表(SAS)和紧张程度评估253名献血者献血前心理状态并分析其HRV时域和频域参数,分析SAS评分、紧张程度、HRV参数3者之间的相关性,比较不同类型献血者的差异性,并进行多元线性回归分析。结果247名献血者纳入分析,18~24岁献血者的HRV参数中有5项高于25岁以上献血者(P均<0.05),女性献血者焦虑程度(SAS评分41~46)高于男性(SAS评分35~43)(P<0.001);献血前SAS评分与紧张程度评估结果高度一致(r=0.970,P<0.001);献血前紧张程度、SAS评分均与HRV参数中的极低频(VLF)呈显著负相关(r=0.179,P=0.005),且关联独立于年龄、身体质量指数、性别等混杂因素(P<0.05)。结论HRV作为1种献血前心理评估工具,相对SAS和紧张程度评估,展现出更高的客观性,将HRV列入献血者常规筛查,可以评估献血前献血者焦虑程度,识别潜在的献血相关血管迷走神经反应(DRVR)风险人群,进而提升献血安全。

Objective To investigate the correlation between heart rate variability(HRV)and the degree of nervousness before blood donation.Methods The psychological state of 253 blood donors before blood donation was assessed by the self-rating anxiety scale(SAS)and the degree of nervousness and their HRV were measured.The correlation between the SAS score,the degree of nervousness and the HRV parameters was analyzed,and the differences were compared among different types of donors,and analyzed by multivariate linear regression.Results A total of 247 blood donors were included in the study.Five HRV parameters in blood donors aged 18-24 were higher than in those aged 25 years and above(all P<0.05),and the anxiety level was higher in female donors(SAS score 41-46)than in males(SAS score 35-43)(P<0.001);the pre-donation SAS score was consistent with the assessment of the tension level(r=0.970,P<0.001);the pre-donation tension level and the SAS score were all significantly negatively correlated with VLF in HRV parameters(r=0.179,P=0.005),and the associations were independent of confounders such as age,body mass index and gender(P<0.05).Conclusion Compared with SAS and tension assessment,HRV is more objective,and can be used as one of the tests for assessing the tension level of blood donors in the actual work of voluntary blood donation.The inclusion of HRV in the routine screening of blood donors deserves further study for its application in assessing the anxiety level of blood donors before blood donation,identifying people prone to blood donation-related vasovagal reaction(DRVR),preventing and reducing the risk of DRVR,and improving the safety of blood donation.