Department of Psychology and Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Lincoln, NE, United States of America.
PLoS One. 2021 Sep 3;16(9):e0257110. doi: 10.1371/journal.pone.0257110. eCollection 2021.
Although fingerstick is often favorably compared to venipuncture as a less invasive method of drawing blood for clinical labs, there is little empirical research that compares physical and psychological stress responses to fingerstick vs. venipuncture (blood draw using a needle in the arm) within the same person.
We assessed changes in cortisol (a stress hormone), heart rate variability (a marker of autonomic stress), and psychological stress in 40 healthy women who completed both venipuncture and fingerstick. Contrary to our predictions, there was a significant decline in cortisol across conditions, with greater decline from pre- to post-draw in response to venipuncture than fingerstick. There were similar patterns of rise and fall in heart rate variability in both types of blood draw, suggestive of mild vasovagal responses. Psychological measures of stress (such as negative emotion and perceived stress) were generally stronger predictors of participant's reported pain and blood draw preferences than physical stress measures.
These findings challenge the characterization of fingerstick as necessarily "less invasive" than venipuncture, as participant's stress responses to fingerstick were equivalent to (and for some measures greater than) their response to venipuncture. Heart rate variability response to fingerstick significantly predicted that individual's vasovagal-like responses to venipuncture, suggesting that measuring heart rate variability during pre-donation hemoglobin testing may identify donors at risk for adverse events during venipuncture.
虽然指尖采血通常被认为比静脉穿刺更具侵入性，是一种从临床实验室采集血液的较少侵入性方法，但很少有实证研究比较同一人指尖采血与静脉穿刺（在手臂上用针采血）的生理和心理应激反应。
我们评估了 40 名健康女性在接受静脉穿刺和指尖采血两种采血方式后，皮质醇（一种应激激素）、心率变异性（自主应激的标志物）和心理应激的变化。与我们的预测相反，两种采血方式下皮质醇都有显著下降，静脉穿刺后的下降幅度大于指尖采血。两种采血方式中心率变异性的波动模式相似，提示存在轻度血管迷走反应。心理应激指标（如负面情绪和感知压力）通常比生理应激指标更能预测参与者报告的疼痛和采血偏好。
这些发现挑战了指尖采血比静脉穿刺更具“侵入性小”的特征，因为参与者对指尖采血的应激反应与静脉穿刺相当（在某些指标上甚至大于静脉穿刺）。指尖采血的心率变异性反应显著预测了个体对静脉穿刺的类似血管迷走反应，这表明在献血前血红蛋白检测期间测量心率变异性可能可以识别在静脉穿刺期间发生不良事件的风险较高的献血者。
