[1]董红生,刘青,林娟,等. 基于短时心率变异性信号两种熵测度的过速型室性心律失常的预测分析[J].中国医学物理学杂志,2019,36(10):1217-1227.[doi:DOI:10.3969/j.issn.1005-202X.2019.10.020]
　DONG Hongsheng,LIU Qing,LIN Juan,et al. Predictive analysis on ventricular tachyarrhythmia using two entropy measures of short-term heart rate variability signals[J].Chinese Journal of Medical Physics,2019,36(10):1217-1227.[doi:DOI:10.3969/j.issn.1005-202X.2019.10.020]
点击复制

  基于短时心率变异性信号两种熵测度的过速型室性心律失常的预测分析()
分享到：

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
36卷
期数:
2019年第10期
页码:
1217-1227
栏目:
医学信号处理与医学仪器
出版日期:
2019-10-29

文章信息/Info

Title:
 Predictive analysis on ventricular tachyarrhythmia using two entropy measures of short-term heart rate variability signals
文章编号:
1005-202X（2019）10-1217-11
作者:
 董红生; 刘青; 林娟; 苏芳
 兰州工业学院电气工程学院， 甘肃 兰州 730050
Author(s):
 DONG Hongsheng;  LIU Qing;  LIN Juan;  SU Fang
 Department of Electrical Engineering, Lanzhou Institute of Technology, Lanzhou 730050, China
关键词:
 ; 过速型室性心律失常; 心率变异性; 样本熵; 逐点多尺度熵; 复杂度
Keywords:
 ; ventricular tachyarrhythmia;  heart rate variability;  sample entropy;  point by point multi-scale entropy;  complexity
分类号:
R318
DOI:
DOI:10.3969/j.issn.1005-202X.2019.10.020
文献标志码:
A
摘要:
 目的：过速型室性心律失常［持续性室性心动过速或心室纤颤（VT/VF）］是心脏猝死的主要诱因，测试VT/VF发生前心率变异性信号是否有明显改变可作为VT和VF发生的提前预报信号。方法：以78名患者体内心脏复律除颤器记录的VT/VF事件发生前心率变异性信号（VT/VF序列）和来自同一患者的正常窦性节律（CON序列）组成的135个样本对作为实验序列。通过预处理消除实验序列的伪差、异位心搏等干扰，采用两种基于熵的非线性复杂度测度——样本熵和逐点多尺度熵（PPMSE），分析VT和VF发生前十几分钟的VT/VF序列，以及心率增加和减小的VT/VF序列复杂性，并采用PPMSE方法讨论了接近VT/VF发生时VT/VF序列复杂性变化。结果：与正常对照组CON序列相比，在一定匹配容差内，VT/VF发生前心率变异性信号的样本熵明显减小（r<0.25×SD, P<0.000 5），心率增加的VT/VF序列减小更显著（r<0.3×SD, P<0.000 1）；VT/VF序列的PPMSE在越接近VT/VF发生时刻减小越显著，提取的CI指数存在显著差异（如1~30尺度，N=986、500、250时，P=1.5×10-2、P=4.3×10-3、P=1.3×10-5），心率增加的VT/VF序列区分性能更好。结论：过速型心律失常的自然发作并不是突发现象，在其发作前或许存在某种生理预兆，两种熵测度可能是短时预报恶性室性心律失常事件的有效非线性参数。
Abstract:
Objective The ventricular tachyarrhythmia including sustained ventricular tachycardia (VT) and ventricular fibrillation (VF) is the major precipitating factor of sudden cardiac death. Whether there is significant change in the heart rate variability (HRV) preceding the onset of VT/VF events can be tested and the results can be served as the early warning signs of VT or VF. Methods A total of 135 samples consisted of heart rate variability signals preceding the onset of VT/VF events (VT/VF series) and normal sinus rhythm (CON series) from the same patient were taken as test series, and these samples were recorded by implantable cardioverter defibrillators (ICD) in 78 patients. The interferences such as artifacts and ectopic beats in test series were removed by signal pre-processing, and two nonlinear complexity measures based on sample entropy and point by point multi-scale entropy (PPMSE) were used for complexity analysis on VT/VF series with more than 10 minutes preceding the onset of VT/VF events, and VT/VF series of increased or decreased heart rates preceding the onset of VT/VF events. The complexity of VT/VF series when gradually approaching VT/VF occurrence was also discussed based on PPMSE multi-scale entropy method. Results Compared with that of CON series, in some range of matching tolerance, the sample entropy of HRV preceding the onset of VT/VF events was significantly decreased (r<0.25×SD, P<0.000 5), and the decrease was more obvious for VT or VF series of increased heart rate (r<0.3×SD, P<0.000 1). The decrease of PPMSE of VT/VF series were more significant when gradually approaching VT/VF occurrence, and there was significant difference for the extracted CI value (such as for scale range of 1-30 and N=986, 500, 250, the P value was 1.5×10-2, 4.3×10-3, 1.3×10-5, respectively), and the differentiation for VT/VF series of increased heart rates was even better. Conclusion The spontaneous occurrence of ventricular tachyarrhythmia is not a sudden phenomenon, and there may be some physiological signs before the onset. The two entropy measures might be the suitable nonlinear parameters for the short-term prediction of life-threatening ventricular tachyarrhythmia.

相似文献/References:

[1]王遥,霍万里,熊壮,等.TACE手术中不同站姿下铅眼镜和铅面罩对医生眼晶状体防护效果的蒙特卡洛模拟比较[J].中国医学物理学杂志,2016,33(6):553.[doi:DOI:10.3969/j.issn.1005-202X.2016.06.003]
　[J].Chinese Journal of Medical Physics,2016,33(10):553.[doi:DOI:10.3969/j.issn.1005-202X.2016.06.003]
[2]张新,谷晓芳,王培臣,等.轻离子束治疗设备注册检验关键技术问题[J].中国医学物理学杂志,2016,33(6):559.[doi:10.3969/j.issn.1005-202X.2016.06.004]
　[J].Chinese Journal of Medical Physics,2016,33(10):559.[doi:10.3969/j.issn.1005-202X.2016.06.004]
[3]江芬芬,王培,康盛伟,等. 热释光剂量片测量肺部肿瘤放疗剂量的方法[J].中国医学物理学杂志,2016,33(6):564.[doi:10.3969/j.issn.1005-202X.2016.06.005]
　[J].Chinese Journal of Medical Physics,2016,33(10):564.[doi:10.3969/j.issn.1005-202X.2016.06.005]
[4]刘洪源,彭威,杨锐,等. 锥形束CT离线校正肺癌摆位误差[J].中国医学物理学杂志,2016,33(6):573.[doi:10.3969/j.issn.1005-202X.2016.06.007]
　[J].Chinese Journal of Medical Physics,2016,33(10):573.[doi:10.3969/j.issn.1005-202X.2016.06.007]
[5]赵彪,潘香,杨毅,等. 右乳癌保乳术后瘤床同步X线和后程电子线补量调强放疗剂量学比较[J].中国医学物理学杂志,2016,33(6):576.[doi:10.3969/j.issn.1005-202X.2016.06.008]
　[J].Chinese Journal of Medical Physics,2016,33(10):576.[doi:10.3969/j.issn.1005-202X.2016.06.008]
[6]邓南,钱建庭,刁现芬,等. 基于宽带检测放疗X-光光声效应仿体实验[J].中国医学物理学杂志,2016,33(9):865.[doi:DOI:10.3969/j.issn.1005-202X.2016.09.001]
　[J].Chinese Journal of Medical Physics,2016,33(10):865.[doi:DOI:10.3969/j.issn.1005-202X.2016.09.001]
[7]张先稳,李军,张西志,等. 宫颈癌术后5野调强放疗4个变量组合的最佳治疗模式的剂量学[J].中国医学物理学杂志,2016,33(9):872.[doi:10.3969/j.issn.1005-202X.2016.09.002]
　[J].Chinese Journal of Medical Physics,2016,33(10):872.[doi:10.3969/j.issn.1005-202X.2016.09.002]
[8]胡健,李承军,徐利明,等. 床面倾斜对剂量验证通过率的影响[J].中国医学物理学杂志,2016,33(9):881.[doi:10.3969/j.issn.1005-202X.2016.09.003]
　[J].Chinese Journal of Medical Physics,2016,33(10):881.[doi:10.3969/j.issn.1005-202X.2016.09.003]
[9]陈亚正,肖明勇,孙春堂,等. 准直器角度对宫颈癌术后VMAT计划的影响[J].中国医学物理学杂志,2016,33(9):885.[doi:10.3969/j.issn.1005-202X.2016.09.004]
　[J].Chinese Journal of Medical Physics,2016,33(10):885.[doi:10.3969/j.issn.1005-202X.2016.09.004]
[10]李毅,唐丰文,张晓智. 基于四维CT和锥形束CT确定非小细胞肺癌放疗靶区外放边界[J].中国医学物理学杂志,2016,33(9):892.[doi:10.3969/j.issn.1005-202X.2016.09.005]
　[J].Chinese Journal of Medical Physics,2016,33(10):892.[doi:10.3969/j.issn.1005-202X.2016.09.005]

备注/Memo

备注/Memo:
 【收稿日期】2019-03-18
【基金项目】甘肃省自然科学基金（1506RJZA060）；兰州市科技计划项目（2015-3-121）
【作者简介】董红生，博士，教授，研究方向：信号处理与模式识别，E-mail: shdong712@163.com
更新日期/Last Update: 2019-10-30