頁籤選單縮合
題 名 | Application of Digital Volume Pulse Analysis in Patients with Spinal Cord Injury=手指容積脈波測量在脊髓損傷患者的應用 |
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作 者 | 蔡維倫; 黃美涓; 裴育晟; 林育如; 廖昱昕; 黃書群; | 書刊名 | 臺灣復健醫學雜誌 |
卷 期 | 40:4 2012.12[民101.12] |
頁 次 | 頁189-196 |
分類號 | 416.292 |
關鍵詞 | 脈波; 姿態型低血壓; 心跳變異數; 脊髓損傷; Photoplethysmography; Orthostatic hypotension; Heart rate variability; Spinal cord injuries; |
語 文 | 英文(English) |
中文摘要 | 姿態性低血壓在脊髓損傷病人中,是相當常見的後遺症。然而,目前臨床上並沒有一個簡單的評估工具能夠用來量化受傷部位以下的小動脈功能損傷程度。我們假設保有不同程度交感神經功能的脊髓損傷病人,在休息平躺或頭部身體傾斜時,會表現出不同的手指容積脈波波型。本研究收集了三十一名高位慢性脊髓損傷(神經受傷節段高於胸髓第六節)及二十八名低位脊髓損傷病人(神經受傷節段低於等於胸髓第六節)。另收集了三十二名年齡及身體質量指數相似的健康受試者為對照組。所有受試者都在傾斜床上進行平躺休息、頭部身體傾斜抬高六十度、及回復平躺休息三種姿勢各五分鐘。同時測量手指容積脈波、心跳變異率及血壓。反射係數為反射波振福除以直接傳導波振福。反射係數比值為身體傾斜五分鐘時之反射係數除以平躺休息時的反射係數。心跳變異數方面,我們紀錄了低頻功率對高頻功率比值、高頻功率、標準化低頻功率以及標準化高頻功率。結果顯示,高位脊髓損傷病人有明顯的姿勢性低血壓,且手指容積脈波之反射波振福從平躺變換到頭部身體抬高傾斜六十度時有明顯下降的情形,而此下降比率和神經受傷節段顯著有關,高位最多、其次低位、再其次為健康控制組。此外,相較於低位慢性脊髓損傷病人和健康控制組,高位病人從平躺變換到頭部身體抬高傾斜六十度時,其低頻對高頻功率比值增加的幅度較少,但其高頻功率減少的幅度並無不同。綜合以上,姿勢變換重力影響下,手指容積脈波的反射波減少,而且神經受傷節段越高位,則減少越多。反射係數比值可以用來在臨床上,量化脊髓損傷病人的交感神經對小動脈控制異常的程度。 |
英文摘要 | Orthostatic hypotension is a common complication following spinal cord injury (SCI). However, an easy method to quantify the degree of vasomotor impairment below the level of injury is lacking. We postulated that SCI patients with different sympathetic reserves exhibited different digital volume pulse contours. Thirty-one patients with high chronic SCI (above the T6 neurologic level) and 28 low-level SCI patients (below T6) were recruited. Thirty-two age- and BMI-matched healthy participants were enrolled in the control group. All participants were positioned on a tilting table for five minutes in each of the following: supine rest (SR), 60-degree head-up tilt (HUT), and recovery to supine position. Digital volume pulse (DVP), heart rate variability (HRV), and blood pressure were measured. The reflection index (RI) was calculated as the amplitude of reflection wave divided by directly-transmitted wave. The RI ratio is the RI value in the fifth minute during the HUT position divided by RI in SR. Low frequency to high frequency power ratio (LF/HF), high frequency power (HFP), normalized low frequency power (LFn) and high frequency power (HFn) were recorded in HRV analysis. Our results revealed that patients with a higher level of injury had a reduced reflection wave of DVP in SR and HUT. High-level SCI patients also had a smaller RI ratio. Additionally, the increase of LF/HF during the transition from SR to HUT was attenuated in high SCI patients. However, the decrease of HF power was normally preserved in high SCI patients. We concluded that posture change alters the contour of the pulse wave, which is related to the level of injury. The RI ratio could be used to quantify the degree of vasoconstriction impairment below the injury level in SCI patients. |
本系統中英文摘要資訊取自各篇刊載內容。