Kliszczewicz Brian, Esco Michael R, E Bechke Emily, Feito Yuri, M Williamson Cassie, Brown Danielle, Price Brandi
Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA.
Department of Exercise Science, University of Alabama, Tuscaloosa, AL, USA.
Pacing Clin Electrophysiol. 2017 Oct;40(10):1080-1086. doi: 10.1111/pace.13181. Epub 2017 Sep 23.
Heart rate variability (HRV) has been shown to be influenced by several factors such as noise, sleep status, light, and emotional arousal; however, little evidence is available concerning autonomic responses to a venipuncture. The purpose of this study was to investigate changes of HRV indexes and heart rate (HR) during and following a venipuncture procedure among healthy individuals.
33 healthy individuals (22.8 ± 0.56 years, 167 ± 1.56 cm, 69.5 ± 2.61 kg) participated. Testing included 10-minute HRV analysis prior to the venipuncture, a 1-minute venipuncture procedure followed by a 10-minute analysis of HRV, and a total recording of 21 minutes. The first 5 minutes of the 21-minute recordings were discarded, and the remaining 5 minutes of the resting segment was analyzed (PRE), and the last 5 minutes of the 21-minute recording (POST). The log transformation of the time domain root mean squared of successive differences (lnRMSSD) and the frequency domains of high frequency (lnHF) and low frequency (lnLF) and LF/HF ratio (lnLF/HF) were used to quantify autonomic activity. HR was measured in 1-minute segments at 2 minutes prior (PRE), venipuncture (STICK), and post (P1-5).
HR significantly increased at STICK (P = 0.002), and fell below resting at P-5 (P < 0.001). lnRMSSD and lnHF increased significantly by POST (P < 0.001, P = 0.005). lnLF/HF ratio significantly decreased at POST (P = 0.047), while no significant changes occurred for lnLF (P = 0.590).
HRV and HR are influenced for 10 minutes following the venipuncture procedure. Practitioners and researchers who are interested in collecting blood and measuring HRV need to account for the influence of the venipuncture.
心率变异性（HRV）已被证明受多种因素影响，如噪音、睡眠状态、光线和情绪唤醒；然而，关于自主神经系统对静脉穿刺的反应，几乎没有相关证据。本研究的目的是调查健康个体在静脉穿刺过程中及之后HRV指标和心率（HR）的变化。
33名健康个体（年龄22.8±0.56岁，身高167±1.56厘米，体重69.5±2.61千克）参与研究。测试包括静脉穿刺前10分钟的HRV分析、1分钟的静脉穿刺操作，随后进行10分钟的HRV分析，共记录21分钟。21分钟记录中的前5分钟被舍弃，分析剩余5分钟的静息段（PRE）以及21分钟记录的最后5分钟（POST）。采用连续差值均方根的对数变换（lnRMSSD）以及高频（lnHF）、低频（lnLF）的频域和低频/高频比值（lnLF/HF）来量化自主神经活动。在静脉穿刺前2分钟（PRE）、静脉穿刺时（STICK）和穿刺后（P1 - 5），以1分钟为时间段测量心率。
静脉穿刺时心率显著升高（P = 0.002），在P - 5时降至静息水平以下（P < 0.001）。lnRMSSD和lnHF在穿刺后显著升高（P < 0.001，P = 0.005）。lnLF/HF比值在穿刺后显著降低（P = 0.047），而lnLF无显著变化（P = 0.590）。
静脉穿刺操作后10分钟内，HRV和HR会受到影响。对采血和测量HRV感兴趣的从业者和研究人员需要考虑静脉穿刺的影响。
