基于心血管信号分析识别血液透析期间易发生低血压的患者。

Identification of patients prone to hypotension during hemodialysis based on the analysis of cardiovascular signals.

作者信息

Hernando D, Sörnmo L, Sandberg F, Laguna P, Llamedo M, Bailón R

机构信息

Biomedical Signal Interpretation & Computational Simulation (BSICoS) Group, Aragón Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain.

Signal Processing Group, Department of Biomedical Engineering and Center for Integrative Electrocardiology, Lund University, Lund, Sweden.

出版信息

Med Eng Phys. 2015 Dec;37(12):1156-61. doi: 10.1016/j.medengphy.2015.10.003. Epub 2015 Oct 29.

DOI:10.1016/j.medengphy.2015.10.003

PMID:26525780

Abstract

Intradialytic hypotension (IDH) is a major complication during hemodialysis treatment, and therefore it is highly desirable to identify, at an early stage during treatment, whether the patient is prone to IDH. Heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS) were analyzed during the first 30 min of treatment to assess information on the autonomic nervous system. Using the sequential floating forward selection method and linear classification, the set of features with the best discriminative power was selected, resulting in an accuracy of 92.1%. Using a classifier based on the HRV features only, thereby avoiding that continuous blood pressure has to be recorded, accuracy decreased to 90.2%. The results suggest that an HRV-based classifier is useful for determining whether a patient is prone to IDH at the beginning of the treatment.

摘要

透析中低血压（IDH）是血液透析治疗期间的一种主要并发症，因此非常希望在治疗早期识别患者是否易于发生IDH。在治疗的前30分钟内分析心率变异性（HRV）、血压变异性（BPV）和压力反射敏感性（BRS），以评估自主神经系统的信息。使用顺序浮动前向选择方法和线性分类，选择具有最佳判别能力的特征集，准确率达到92.1%。仅使用基于HRV特征的分类器，从而避免必须记录连续血压，准确率降至90.2%。结果表明，基于HRV的分类器对于在治疗开始时确定患者是否易于发生IDH是有用的。