以传统方法与散布图法分析发烧对心率变异性之影响.docVIP

以傳統方法與散佈圖法分析發燒對心率變異性之影響 Fever Effect on the Heart Rate Variability Using Traditional and Poincare Methods 王家鍾Jia-Jung Wang1 李欣芳Hsin-Fang Li1 陳鈞健Chun-Chien Chen1　 蔡彥碩Yen-Shuo Tsai2 林禮獎Li-Chiang Lin3 1義守大學生物醫學工程學系 Department of Biomedical Engineering, I-Shou University 2義大醫院急診部 Emergency Department, E-Da Hospital 3義大醫院醫工處 Department of Biomedical Engineering, E-Da Hospital 一、中文摘要 本研究的主要目的是在觀察人體於發燒溫度不同時，受測者的心率變異性是否有所變化。我們將發燒溫度由36.5 ℃起，按0.5 ℃增幅分成五個溫度間隔，並依16位急診室發燒病患之就醫許可，記錄每溫度區間五分鐘的單導程心電圖，並於事後進行R-R間期的變異分析。由統計結果顯示，在這16位受測者中，相較於36.5~37.0 ℃區間(1.27±0.50)，發燒體溫38.0~38.5 ℃及38.5~39.0℃區間之散佈圖的SD2 (0.58±0.400, 0.64±0.36)均有顯著地降低(p0.05)，但SD1則沒有明顯變化；時域分析顯示在38.5~39.0 ℃體溫時，其平均R-R間期(581±73 ms)比37.0~37.5 ℃的體溫(672±100 ms)時，具有顯著的降低 (p0.05)，而在38.5~39.0 ℃時R-R間期的平均標準誤差(11.4±6.7 ms) 顯著地比37.0~37.5 ℃的平均標準誤差(25.1±14.4 ms)來得低(p0.05)；我們同時也發現發燒溫度愈高，低頻段(Low frequency band: 0.04~0.15 Hz，LF)功率的平均值有愈低的現象。由以上結果可以推得，當身體發燒的溫度愈高時，心率變異性的程度反而會有下降的現象 關鍵詞：心率變異性、R-R間期、發燒、時域分析、頻域分析、散佈圖 Abstract The goal of the work was to study the effect of fever on the heart rate variability (HRV). The fever temperature ranging from 36.5~39 ℃was separated into four divisions with an increase of 0.5 ℃. The study included 16 patients with fever in the emergency department, I-Da Hospital, and their 5-minute ECGs were recorded for each temperature division, if the medical condition was allowed. The results showed that SD2 values computed at 38.0~38.5℃ (0.58±0.400) and 38.5~39.0℃ (0.64±0.36) were significantly declined as compared with that at 36.5~37.0℃(1.27±0.50) (p0.05), with no significant change in SD1 in the 16 patients. Time-domain analysis indicated that the average of the RR intervals was significantly declined from 581±73 ms at 37.0~37.5 ℃ to 672±100 ms at 38.5~39.0℃ (p0.05). Meanwhile, the average of the standard deviations was also significantly reduced from 11.4±6.7 ms at 37.0~37.5 ℃ to 25.1±14.4 ms at 38.5~39.0 ℃ (p0.05). It was found that the higher the fever temperature, the lower the average power in the low