4.2.2.

Cc phng php phn tch Cc phng php phn tch trong phn mm c chia ra lm 3 phn gm: + Min thi gian + Min tn s + Phng php phi tuyn tnh. Cc phng php ny c tng hp trong bng 4.1.
4.2.2.1. Phng php min thi gian

Phng php min thi gian l phng php n gin nht, phng php ny da trn vic o cc khong RR lin tip. lch tiu chun ca cc on RR (SDNN) c xc nh nh sau:

(4.1) Trong RRj biu th gi tr ca on RR v N l tng s cc on lin tip. SDNN phn nh ton b s bin i (c k ngn v k di) trong chui RR, tri li lch tiu chun phn nh s khc nhau on RR lin tip (SDSD), theo cng thc: (4.2) SDSD c th c s dng nh mt php o s thay i ca s bin i k ngn. i vi chui RR c nh E{RRj} = E{RRj+1} E{RRj} = 0 v SDSD tng ng bnh phng gi tr trung bnh ca cc s khc nhau lin tip (RMSSD), theo cng thc:

(4.3) Php o khc c tnh ton t s khc nhau ca cc on RR lin tip l NN50, thng s ny l s lng cc on lin tip khc nhau ln hn 50ms hay s lng lin quan tng ng:

(4.4)

Ngoi ra l cc php o thng k, l mt s php o hnh hc c tnh ton t th on RR. Ch s tam gic HRV thu c khi ton b th c chia ra thnh chiu cao ca th-ph thuc vo chiu rng bin c la chn. Theo kt qu so snh thu c, chiu rng bin l 1/128 giy. Php o hnh hc khc l TINN, n l chiu rng ng gc ca th RR c nh gi thng qua php ni suy tam gic.
4.2.2.2. Phng php min tn s

Trong phng php min tn s, nh gi mt nng lng ph (PSD) c tnh ton trn chui RR. Phng thc nh gi PSD thng thng bng vic ly mu cch u, v vy, chui RR c chuyn i thnh chui c ly mu cch u bng phng php ni suy trc khi nh gi PSD. Trong phn mm ny php ni suy bc 3 c s dng. Trong phn tch HRV, nh gi PSD c thc hin s dng phng php da trn FFT hay phng php da trn s m hnh ha tham s AR. Li ch ca phng php da trn FFT l n gin trong thc hin, trong khi li ch ca ph AR l ci thin phn gii c bit i vi cc mu ngn. c tnh khc ca ph AR l lm cho cc mu c thy r hn trong phn tch HRV, v th n c th tm ra cc thnh phn ph ring l. S bt li ca ph AR l s phc tp ca la chn th t model v s ngu nhin ca cc thnh phn khng tt trong vic tm ra tha s (factorization) ph. Tuy nhin, ta c th tnh ton ph bng c 2 phng php c cc kt qu so snh. T kt qu sau khi phn tch c chnh xc hn. Trong phn mm ny, ph HRV c tnh ton vi phng php chu k Welch da trn FFT v AR. Tm tha s (factorization) ph trong phng php AR l ty chn. Trong phng php chu k Welch, mu HRV c chia ra thnh cc on chng ln nhau. Ph sau khi thu c s ly trung bnh hnh nh ph ca cc on ny. Phng php ny lm gim s khc bit ca ph FFT. Bng tn ph bin trong trng hp ghi HRV thi gian ngn l tn s rt thp (VLF, 00.04 Hz), tn s thp (LF, 0.040.15 Hz), v tn s cao (HF, 0.150.4 Hz). Tiu chun nh gi min tn s c rt ra t s nh gi PSD cho mi bng tn bao gm nng lng tng i v tuyt i ca bng tn VLF, LF, v HF, nng lng bng tn LF v HF trong cc thnh phn tiu chun ha, t l nng lng

LF/HF, v cc tn s nh i vi mi bng tn (xem bng 4.1). Trong trng hp ph FFT, gi tr nng lng tuyt i i vi mi di bng tn thu c bng cch hp nht ph trn cc gii hn bng tn. Trong trng hp ph AR, ni theo cch khc, nu s tm ra tha s (factorization) l cho php phn bit cc thnh phn ph i vi mi bng tn vi s la chn thch hp th t cc model v gi tr nng lng tuyt i thu c trc tip nh cc nng lng ca thnh phn ny. Nu khng th tm ra tha s, nng lng ph AR c tnh ton nh ph FFT. Di nng lng trong thnh phn tng i v tiu chun ha thu c t cc gi tr tuyt i a ra trong bng 4.1.
4.2.2.3. Phng php phi tuyn tnh

Thy rng h thng iu khin tim rt phc tp, l hp l tha nhn c ch phi tuyn tnh l phc tp trong s hnh thnh HRV. c trng ca phng php phi tuyn trong phn tch HRV l php o s dng phn tch nh v s Poincar, entropy mu v entropy xp x, phn tch s bt thng trn th, kch thc tng quan, v v th ti din. Nhiu nm gn y, i tng nghin cu s dng phng php ny tng ng k. Ri ro ca phng php ny l vn c, tuy nhin , kh c th gii thch ti sao li c cc kt qu vy.

Hnh 4. 1. Phn tch v th Poincar vi chc nng iu chnh ellipse. SD1 v SD2 l lch chun trong phng hng x1 v x2, vi x2 l trc ng nht vi RRj = RRj+1.

4.2.2.3.1. V th Poincar

Mt trong cc phng php phi tuyn c s dng l v th Poincar. l biu din th s tng quan gia cc cc on RR lin tip, v d, v th ca on RRj+1 nh chc nng ca RRj c m t trong hnh 4.3. Hnh dng ca th c v l rt c trng. Phng php xp x biu din bng tham s hnh dng th, lm ph hp hnh elip, v th c ch ra trong hnh 4.3. Hnh elip c nh hng theo ng k ng nht (RRj = RRj+1). lch tiu chun ca cc im trc giao n ng k ng nht c biu th bi SD1 th hin s bin thin trong k ngn, RSA l nguyn nhn chnh gy ra s bin i . c th ch ra rng SD1 lin quan n php o min thi gian SDSD theo cng thc:

(4.5) lch tiu chun theo ng k ng nht biu din bi SD2, ni cch khc, n th hin s thay i trong k di v c ch ra l lin quan n min thi gian o SDNN v SDSD: (4.6) V th Poincar tiu chun c th xt n th t u tin. Th hai v th s l 3 kch thc v th khc trong cc gi tr (RRj ,RRj+1,RRj+2). Thm na, tr c th ln hn 1, v d: v th (RRj, RRj+2).
4.2.2.3.2 Entropy xp x

Entropy xp x (ApEn) o tn hiu phc tp hay bt thng. Gi tr ApEn ln l mt gi tr bt thng v tn hiu nh hn tn hiu bnh thng. ApEn c tnh ton nh sau. u tin ci t di ca vector uj: Uj = (RRj ,RRj+1, . . . ,RRj+m1), j = 1, 2, . . .N m+ 1 (4.7) Trong , m c gi l kch thc ghi nh v N l s on RR c o. Khong cch gia cc vector ny c nh ngha nh s khc nhau tuyt i ln nht gia cc yu t tng ng. v d: (3.8)

Tip, vi mi uj, s vector uk lin quan i vi d(uj, uk) r c tnh ton. Ch s ny ch r vi Cjm (r) v c th c tnh nh sau.

(4.9) Do tiu chun ha, gi tr ca Cjm (r) l lun lun nh hn hay tng ng 1. Ch rng Cjm (r) l nh vy, tuy nhin, gi tr nh nht l 1/(N m+ 1) khi bao gm c uj. Sau loga t nhin mi Cjm (r) v ly trung bnh cng chy t j n (N-m+1)

(4.10) Cui cng, entropy xp x thu c: (4.11) Nh vy, gi tr ca nh gi ApEn ph thuc vo 3 thng s, di m ca vector uj, gi tr dung sai r, v di d liu N. Trong phn mm ny gi tr ca m c chn m=2. Chiu di N ca d liu cng nh hng n ApEn. Khi N tng ApEn s xp x gi tr tim cn ca n. Dung sai r c tc ng r rt ln ApEn v n nn c chn nh thnh phn ca lch tiu chun ca d liu (SDNN). La chn ny cho php so snh cc loi d liu khc nhau. Mt la chn mc nh cho r l r = 0.2SDNN, c s dng trong phn mm ny.
4.2.2.3.3 Entropy mu

Entropy mu (SampEn) l tng t ApEn, nhng l 2 thng s khc nhau trong tnh ton. i vi ApEn, trong tnh ton s lng vector uk khi d(uj,uk) r, bao gm c vector uj. m bo rng Cjm (r) lun ln hn 0 v loga c th c p dng, nhng cng thi im lm cho ApEn b lch. Trong Entropy mu t so snh, uj c nh gi bng cch tnh Cjm (r) nh sau:

(4.12) By gi gi tr ca Cjm (r) s gia 0 v 1. Gi tr Cjm (r) l c ly trung bnh:

(4.13) v entropy mu thu c: (4.14) Cc gi tr c chn i vi kch thc gn vo m v i vi thng s dung sai r trong phn mm l tng t nh cc thng s ny i vi s tnh ton entropy xp x. C ApEn v SampEn c nh gi i vi loga t nhin m ca xc sut c iu kin, l d liu ca chiu di N, lp li chnh n bn trong dung sai r i vi im m, cng s lp li chnh n i vi im m+1. SampEn c thit k lm gim chnh lch ca ApEn v ph hp vi l thuyt i vi d liu vi xc xut bit.
4.2.2.3.4. Phn tch s bt thng ca d th

Phn tch s bt thng ca th (DFA) o s tng quan trong tn hiu. S tng quan c rt ra t phm vi thi gian khc nhau nh theo [36]. u tin, chui thi gian on RR c hp nht:

(4.15) Trong : RR - gi tr trung bnh on RR. Tip theo, chui hp nht c chia thnh cc on chiu di tng ng n. Trong mi on, phng php bnh phng ti thiu c lm ph hp vi d liu. yn(k) th hin phng php hi quy. Tip theo chui hp nht y(k) c v th bng cch chia khuynh hng cc b trong mi on v s bt thng gi tr trung bnh bnh phng ca chui thi gian hp nht v v th c tnh ton:

(4.16) S tnh ton c lp li trn chiu di cc on khc nhau xc nh ch s F(n) nh mt hm ca chiu di on n. c trng F(n) lm tng chiu di on. Quan h phi tuyn tnh trn th log kp ch ra s c mt ca t l phn dng v

cc s bt thng c th c m t c im bng thnh phn t l ( nghing ca ng hi qui lin quan log F(n) n log n. Cc gi tr ch ra nh sau: = 1.5: nhiu nu (hp nht ca nhiu trng) 1 < < 1.5: Cc loi nhiu khc nhau. = 1: 1/f nhiu = 0.5: nhiu trng c trng, trong s tng quan DFA c chia ra trong cc bt thng k ngn v k di. Trong phn mm ny, s bt thng k ngn c biu th c im bi nghing 1 thu c t th ((log n,log F(n)) trong phm vi 4 n16. Tng ng, nghing 2 thu c t phm vi 16 n 64 biu th c im cc s bt thng k di, ch ra trong hnh 4.4

Hnh 4. 2. Phn tch s bt thng v th. th log kp ca ch s F(n) nh l hm ca chiu di on n. 1 v 2 nghing s bt thng k di v k ngn, tng ng.
4.2.2.3.5. Kch thc tng quan

Mt phng php khc o phc tp v s bt thng ca chui thi gian l kch thc tng quan. Kch thc tung quan a ra thng tin s nh nht ca bin s linh ng cn m hnh ha h thng c bn v n c th thu c nh sau. Tng t nh tnh ton entropy xp x v entropy mu, to thnh chiu di m ca vecto uj:

(4.17) v tnh ton s lng vecto uk vi d(uj, uk) r, l:

(4.18) trong hm khong cch d(uj, uk) c xc nh nh sau:

(4.19) Tip n, gi tr trung bnh ca Cjm(r) c tnh nh sau:

(4.20)

Hnh 4. 3. s xp x kch thc tng quan D2 t th (log r, log Cm(r)) y c gi l tch phn tng quan. Kch thc tng quan D2 c xc nh nh l gi tr gii hn:

(4.21) Thc t, gi tr gii hn l xp x vi nghing ca ng cong hi quy (log r, logCm(r)). nghing c tnh ton t phn tuyn tnh ca th log-log, ch ra trong hnh 4.5. nghing ca ng cong hi quy c khuynh hng lm

bo ha cc gi tr gii hn ca D2 khi m tng. Trong phn mm ny, gi tr mc nh m=10.

4.2.2.3.6. Phn tch th hi quy

Phn mm bao gm php tnh gn ng phn tch s phc tp ca chui thi gian c gi l phn tch th hi quy (RP). Trong php tnh gn ng, vector: (4.22) Trong m l kch thc a vo v l thi gian tr. Vector uj th hin cho chui thi gian on RR nh mt qu o trong khng gian kch thc. th hi qui l mt ma trn i xng [N (m 1)] [N (m 1)] ca 0 v 1. Thnh phn trong dng th j v ct th k ca ma trn RP, v d: RP(j,k), l 1 nu im uj trn qu o l gn st im uk. l:

(4.23) Trong d(uj, uk) l khong cch Euclidean a ra trong (4.19) v r l ngng c nh. Cu trc ca ma trn RP thng c ch ra trong on dng ngn ca ng song song ca ma trn n ng cho chnh. Chiu di ca ng cho chnh c m t khong thi gian m 2 im gn nhau. Mt v d RP i vi chui thi gian HRV c ch ra trong hnh 4.6

Hnh 4. 4. ma trn th hi qui i vi chui thi gian HRV (en=1 v trng=0). Phng php th hi qui xc nh s lng: Trong phn mm ny, cc la chn sau y c thc hin. Kch thc a vo v tr c chn ring l l m = 10 v = 1. Khong cch ngng r c chn l mSD, trong SD l lch tiu chun ca chui RR. o s lng u tin ca RP l tc hi qui (REC), n gin l t l ca 1 v 0 trong ma trn RP. S lng cc thnh phn trong ma trn RP i vi = 1 tng ng N m + 1 v tc hi qui c a ra:

(4.24) Tc hi qui c th cng c tnh ton tch ring ra i vi mi ng cho song song n ng ng nht thc (ng cho chnh). Khuyng hng ca REC nh mt hm ca khong cch thi gian gia cc ng cho v ng ng nht thc m t s tt dn ca s hi qui i vi cc im xa hn. Khong dng ca vic o RP da vo chiu di ca ng cho. Ngng Lmin=2 c s dng loi tr cc ng cho to ra bi s chuyn ng tip tuyn ca qu o. Chiu di ng ln nht l Lmax v nghch o ca n, s phn k

(4.25) c ch ra tng quan vi thnh phn Lyapunov xc thc ln nht. Chiu di ng cho trung bnh, thu c nh sau:

(4.26) Trong Nl l s lng ng c chiu di l. Thuyt quyt nh ca chui thi gian c o bi bin s:

(4.27) Cui cng, entropy thng tin Shannon ca s phn b chiu di ng ny c xc nh nh sau:

(4.28) trong nl l s lng ng c chiu di l phn chia bi tng s cc ng, l:

(4.29)
4.2.2.4. Tm tt cc thng s phn tch HRV

Php o HRV trong min thi gian, min tn s v phi tuyn tnh c tnh ton vi phn mm c tm tt trong bng 4.1. Vi mi php o a ra n v c u tin v miu t ngn. Thm na, s tham kho n phng trnh trong php o c th c xc nh. Bng 4. 1: Tm tt cc php o HRV c tnh ton bi phn mm Min thi gian RR [ms] - gi tr trung bnh ca cc on RR STD RR (SDNN) [ms] - lch tiu chun ca cc on RR [Eq. (4.1)] HR [1/min] - nhp tim trung bnh STD HR [1/min] - lch tiu chun ca gi tr nhp tim intantaneous

RMSSD [ms] - cn ca gi tr trung bnh bnh phng khc nhau gia cc on RR lin tip [Eq. (4.3)] NN50 - S lng cc cp RR lin tip sai khc hn 50 ms pNN50 [%] - NN50 phn chia bi tng s cc on RR [Eq. (4.4)] Ch s tam gic HRV Ton b th ca on RR c chia thnh chiu cao ca th TINN [ms] - chiu rng ng gc ca th on RR Min tn s Tn s nh [Hz] - tn s nh di VLF, LF, v HF Nng lng tuyt i [ms2] - nng lng tuyt i ca di tn VLF, LF, v HF Nng lng tng i [%] - nng lng tng i ca di bng tn VLF, LF v HF. VLF [%] = VLF [ms2]/total power [ms2] 100% LF [%] = LF [ms2]/total power [ms2] 100% HF [%] = HF [ms2]/total power [ms2] 100% Nng lng tiu chun ha [n.u]. Nng lng ca di tn LF v HF vi n v bnh thng ha LF [n.u.] = LF [ms2]/(total power [ms2] VLF [ms2]) HF [n.u.] = HF [ms2]/(total power [ms2] VLF [ms2]) LF/HF - t l gia nng lng bng tn LF v HF Phi tuyn tnh SD1, SD2 [ms] - lch tiu chun ca ng trc giao th Poincar n (SD1) v theo chiu di (SD2) ng ng nht thc Entropy xp x ApEn [Eq. (4.11)] Entropy mu SampEn [Eq. (4.14)] Kch thc tng quan D2 [Eq. (4.21)] Phn tch bt thng th DFA 1 - dc bt thng ca k ngn 2 - dc bt thng ca k di Phn tch th hi qui RPA

Lmean [nhp] - chiu di ng trung bnh [Eq. (4.26)] Lmax [nhp] - chiu di ng ln nht REC [%] - tc hi quy [Eq. (4.24)] DET [%] - tt nh lun vt l [Eq. (4.27)]