指端容积血流脉动波形特征量化分析评估士兵应激损伤

摘要

目的 探讨基于指端容积血流脉动波形特征量化分析技术评估士兵应激反应的可行性.方法 分层随机抽取58名新兵与57名老兵,以负性情绪图片作为刺激材料,采用HC2180-D型指夹式无创血流参数检测系统,对图片刺激前后指端容积血流脉动波形(VBF)特征量化参数进行组内和组间比较,将主观应激报告(简明心境量表)和客观应激参数(唾液皮质醇水平)作为效标.结果 在负性情绪图片刺激条件下,两组特异性指标回缩充盈分数(CDF)与血管回缩期面积重心纵坐标(Y2)值明显升高(CDF:F新兵=7.44,P<0.01,F老兵=4.77,P<0.01;Y2:F新兵=3.60,P<0.05,F老兵=4.98,P<0.01);组间差异比较新兵组大于老兵组(CDF:93.89±10.50/89.83±9.32,t=2.18,P<0.05;Y2:36.39±6.31/34.05±6.07,t=2.00,P<0.05).CDF值与BPOMS总分呈中度正相关(r新兵=0.51,r老兵=0.49,P<0.05);Y2值与BPOMS总分呈中度正相关(r新兵=0.48,r老兵=0.45,P<0.05).结论 基于指端容积血流脉动波形特征的量化分析,对士兵应激状态评估具有较高的敏感性和可操作性.%Objective To discuss the feasibility of quantitative analysis for reviewing soldiers' stress reactions based on pulsation waveform features of fingertip volumetric blood flow (VBF).Methods Recruits (n=58) and veterans (n=57) were randomly and hierarchically chosen, and given stimulation by using pictures with negative emotion. The quantization parameters of pulsation waveform features of fingertip VBF were compared within groups and between groups by using HC2180-D finger-clip noninvasive detection system before and after picture stimulation, taken subjective stress report [Grade of Brief Profile of Mood State (BPOMS)] and objective stress parameters (salivary cortisol level) as criteria.Results Under the stimulation of pictures with negative emotion, constriction-dilation fraction (CDF) and value of barycenter ordinate (Y2) of vasoconstriction phase area increased significantly in 2 groups (CDF:Frecruit=7.44,P<0.01,Fveteran=4.77,P<0.01;Y2:Frecruit=3.60,P<0.05,Fveteran=4.98, P<0.01). The comparison between 2 groups showed CDF and Y2 were higher in recruit group than those in veteran group (CDF: 93.89±10.50/89.83±9.32,t=2.18,P<0.05; Y2: 36.39±6.31/34.05±6.07,t=2.00,P<0.05). CDF and total BPOMS score showed a moderate positive correlation (rrecruit=0.51,rveteran=0.49,P<0.05). Y2 and total BPOMS score showed a moderate positive correlation (rrecruit=0.48,rveteran=0.45,P<0.05).Conclusion The quantitative analysis based on pulsation waveform features of fingertip VBF has higher sensitivity and operability in review of soldiers' stress status.