University hospital Osijek, Pediatric Clinic, J. Huttlera 4, 31000 Osijek, Croatia
Medical faculty Osijek, Osijek, Cara Hadrijana 10E, 31000 Osijek, Croatia.
J R Soc Interface. 2018 Sep 19;15(146):20180420. doi: 10.1098/rsif.2018.0420.
Heart rate variability (HRV) has been analysed using linear and nonlinear methods. In the framework of a controlled neonatal stress model, we applied tone-entropy (T-E) analysis at multiple lags to understand the influence of external stressors on healthy term neonates. Forty term neonates were included in the study. HRV was analysed using multi-lag T-E at two resting and two stress phases (heel stimulation and a heel stick blood drawing phase). Higher mean entropy values and lower mean tone values when stressed showed a reduction in randomness with increased sympathetic and reduced parasympathetic activity. A ROC analysis was used to estimate the diagnostic performances of tone and entropy and combining both features. Comparing the resting and simulation phase separately, the performance of tone outperformed entropy, but combining the two in a quadratic linear regression model, neonates in resting as compared to stress phases could be distinguished with high accuracy. This raises the possibility that when applied across short time segments, multi-lag T-E becomes an additional tool for more objective assessment of neonatal stress.
心率变异性（HRV）已通过线性和非线性方法进行了分析。在受控新生儿应激模型的框架内，我们应用多滞后期的音调熵（T-E）分析来了解外部应激源对健康足月新生儿的影响。本研究纳入了 40 名足月新生儿。使用多滞后期 T-E 在两个休息和两个应激阶段（足跟刺激和足跟采血阶段）分析 HRV。在应激状态下，平均熵值较高且平均音调值较低，表明随着交感神经活动增加和副交感神经活动减少，随机性降低。ROC 分析用于估计音调与熵值及其组合特征的诊断性能。分别比较休息和模拟阶段，音调的性能优于熵值，但在二次线性回归模型中结合两者，与应激阶段相比，在休息阶段的新生儿可以以高精度区分。这增加了这样一种可能性，即在短时间片段中应用时，多滞后期 T-E 成为更客观评估新生儿应激的附加工具。
