Higher order crossings-based analysis to assess the effects of diabetic autonomic neuropathy on dynamic cerebral autoregulation

基於高階交越分析法評估糖尿病神經病變對動態腦血流調控之影響

葉守正(Shoou-Jeng Yeh) ； 邱創乾(Chuang-Chien Chiu) ； 廖本義(Ben-Yi Liau) ； André Diedrich ； André Diedrich

《弘光學報》 64期 (2011/09) Pp. 154-174

https://doi.org/10.6615/HAR.201109.64.12

摘要

本研究以頻譜及高階交越法分析平均血壓及平均腦血流之關係，藉以評估糖尿病神經病變對於腦血流調控之影響。結果顯示正常人平均血壓之低頻能量(LF_(MABP): 6.54±2.06 mmHg^2)及平均腦血流(LF_(MCBFV): 4.79±5.73 (cm/s)^2)在統計上確實高於糖尿病神經病變患者(p＜0.05)，此亦可能代表糖尿病患者交感神經系統之作用較為不良。藉由高階交越法評估平均血壓及平均腦血流推導出另一新的評估指標，CUMUDIFF_(HOC)，可分辨出糖尿病神經病變的嚴重程度，且具統計上之意義。（正常人:13.44±3.59 vs.糖尿病嚴重神經病變: 9.68±3.57, p＜0.05）。此一新的指標可顯示腦血流調控所受到的擾動外，並可以依新的方式評估神經病變對腦血流調控之影響。

關鍵字

腦血流調控 ； 糖尿病 ； 高階交越 ； 平均血壓 ； 平均腦血流

並列摘要

Spectral and higher order crossings (HOC) analysis of mean arterial blood pressure (MABP) and mean cerebral blood flow velocity (MCBFV) signals have been applied to evaluate the relation between diabetic autonomic neuropathy (AN) and cerebral autoregulation (CA). Results revealed low frequency (LF) power of MABP (LF_(MABP): 6.54±2.06 mmHg^2) and MCBFV (LF_(MCBFV): 4.79±5.73 (cm/s)^2) were significantly higher in healthy subjects (p＜0.05). Reduced L_(FMABP) in diabetics indicates that the sympathetic nerve modulation was impaired. A novel index, CUMUDIFF_(HOC), derived from HOC estimated by MABP and MCBFV could classify severity of diabetic AN (healthy :13.44±3.59 vs. diabetics (severe autonomic neuropathy): 9.68±3.57, p＜0.05). Index difference reveals disturbance in CA and provides a new insight into the effect of AN on CA.

並列關鍵字

Cerebral autoregulation ； diabetes ； higher order crossings (HOC) ； mean arterial blood pressure (MABP) ； mean cerebral blood flow velocity (MCBFV).

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