Smith Anne-Louise, Reynolds Karen J, Owen Harry
Flinders Biomedical Engineering, Flinders Medical Centre, Adelaide, Australia.
Australas Phys Eng Sci Med. 2007 Dec;30(4):336-41.
Poincaré indices are usually applied to HRV to summarise long data sets collected over 24 hrs. Many applications of HRV are interested in dynamic, short term changes (<1 min). This study uses Poincaré indices published through the 1990's to the present, to determine which of them are correlated over the short term (25 beats). Dynamic changes were observed in 12 subjects pre-operatively receiving fentanyl and midazolam sedation with ECG collected for 5 mins before and 5 mins after fentanyl administration. Poincaré indices with a strong correlation (r>0.85) between the indices for each of the 12 subjects (p<0.001) (particularly with the common measures SDNN, RMSSD, pNN50 and meanRR) were identified. These indices will not be used for further investigation of dynamic effects of fentanyl and midazolam, two sedative drugs used in anaesthesia and intensive care. Indices that proved less suitable for short term analysis (eg. presence of outliers, inability to produce a valid index with smaller number of beats) were also identified. A shortlist of Poincaré indices that do not correlate strongly with commonly used measures may prove interesting in determining dynamic characteristics of the effect of sedative drugs on autonomic nervous system activity.
庞加莱指数通常应用于心率变异性（HRV），以总结24小时内收集的长数据集。HRV的许多应用都关注动态的短期变化（<1分钟）。本研究使用从20世纪90年代至今发表的庞加莱指数，来确定其中哪些在短期内（25次心跳）具有相关性。在12名术前接受芬太尼和咪达唑仑镇静的受试者中观察到动态变化，在给予芬太尼前5分钟和后5分钟收集心电图。确定了12名受试者中每个受试者的指数之间具有强相关性（r>0.85）（p<0.001）的庞加莱指数（特别是与常用指标标准差（SDNN）、平方根连续差值的均方根（RMSSD）、相邻RR间期差值大于50ms的心搏数占总心搏数的百分比（pNN50）和平均RR间期）。这些指数将不会用于进一步研究芬太尼和咪达唑仑这两种麻醉和重症监护中使用的镇静药物的动态效应。还确定了不太适合短期分析的指数（例如存在异常值、无法用较少心跳数产生有效指数）。与常用指标相关性不强的庞加莱指数候选清单可能在确定镇静药物对自主神经系统活动影响的动态特征方面很有趣。
