脊髓損傷病患其心率變異與起坐性低血壓之關係

Heart Rate Variability and Orthostatic Hypotension of Spinal Cord Injury Treated by Tilt Table

呂雅婷(Ya-Ting Lu)

指導教授 ： 張恆雄

中原大學/工學院/醫學工程研究所/碩士(2001年)

https://doi.org/10.6840/cycu200100391

摘要

中 文 摘 要

脊髓損傷病患因自律神經傳導障礙，時常發生起坐性低血壓併發暈眩的狀況。故本研究以可量化之心率變異量測為基礎，探討脊髓損傷病患於傾斜床測試時，發生起坐性低血壓併發暈眩症狀與心率變異及血壓之關係，進而瞭解暈眩症狀之相關生理機轉及可能預測暈眩發生的指標。
心率變異訊號是藉床邊監視器之心電記錄模組來量測收集，所量測的參數包括心跳間期、心跳變異之低頻、高頻及高低頻功率比；血壓則以非侵入式血壓計量測收縮壓及舒張壓。以14名正常人(七位男性平均歲數24 ±3歲、七位女性平均歲數22 ±1歲)及9名脊髓損傷病患(七位Frankel A～B平均歲數30 ±14歲、兩位Frankel C～D平均歲數47 ±9歲)為對象。實驗中將傾斜床之傾斜角度設定在0°,30°,45°,60°,75°，每個角度均停留六分鐘並同時量測心電圖及血壓訊號。
本研究結果顯示病患於暈眩時期血壓會下降超過20mmHg，且其心率變異低頻訊號之能量變化會上升超過原來的50%以上。故本研究建議心率變異之低頻頻譜，可輔助血壓合併討論判斷起坐性低血壓暈眩狀況的最佳指標。

關鍵字：心率變異、傾斜床、姿勢性低血壓、脊髓損傷病患

關鍵字

傾斜床 ； 脊髓損傷病患 ； 姿勢性低血壓 ； 心率變異

並列摘要

Abstract
This research investigated the relationship between heart rate variability (HRV) and orthostatic hypotension of spinal cord injury patients at varied tilting angle controlled by tilting table. In order to clarify the mechanism of postural hypotension and to predict the timing of syncope, we monitored the changes of blood pressure and heart rate.
We studied 14 normal subjects (7 male :24 ±3 years, 7 female: 22 ±1 years) who have no history of either cerebrovascular or cardiovascular diseases and 9 patients (7 Frankel A～B :30 ±14 years , 2 Frankel C～D: 47 ±3 years) with spinal cord injury above T6. A 30-minute head-upright tilt test was conducted on all subjects. We set five tilting angle ( 0°、30°、45°、60°、75°) in our study , and each angle stayed 6 minutes. We analyzed the time and frequency (0.04 ~ 0.4Hz) domain of the heart rate variability in all subjects.
The results of our study suggested that the syncope would occur when the systolic or diastolic blood pressure decreased more than 20mmHg and the RR interval –LF (Low frequency) increased over 50% simultaneously in spinal cord injury patients with postural hypotension. Blood pressure plays a dominant role in evaluating syncope. We suggest that parameter of heart rate and RRI-LF index can also be the reasonable indicators to predict the syncope in our study.
Key Word: Heart rate variability、tilting table、Orthostatic hypotension、Spinal cord injury

並列關鍵字

Spinal cord injury ； Orthostatic hypotension ； tilting table ； Heart rate variability

參考文獻

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