PPG 2차 미분을 이용한정상인과 당뇨병 환자의 말초혈관 탄성도 비교 = Comparison of peripheral vascular compliance between normal and diabetic groups using the second derivative of photoplethysmogram

다국어 초록 (Multilingual Abstract)

Recently, the prevalence rate of diabetes in Korea has been increasing rapidly due to high growth of economy and changes in dietary lifestyle. Vascular complication is one of diabetic complications which have frequently occurred by obesity, hyperglycemia and impaired glucose metabolism. Photoplethysmogram(PPG) measured from finger and toe is very useful for evaluation of vascular aging and sclerosis level since the PPG signal represents characteristics of peripheral vascular. Several researchers have reported that second derivative of the finger PPG waveform was useful to evaluate vascular compliance and developed various analysis methods for vascular compliance. However, peripheral vascular compliance study for diabetic patient was never evaluated by using second derivative of PPG. Therefore, we aimed to objectively compare and to assess normal(n=50) and diabetic(n=50) groups vascular compliance using the second derivative of PPG waveform in this study. The evaluated factors of the second derivative of PPG are 'a', 'b', 'c', 'd', 'e' and b/a represents vascular compliance. This study found out that when vascular compliance is decreased, the absolute value of b/a is decreased. The average vascular compliance of 50 diabetic patients with neuropathy, -1.09±0.14, is statistically lower than the normal group, -0.81±0.09 (p<0.05). In conclusion, we suggest an objective evaluation of peripheral vascular compliance for diabetic patients and prevention of vascular complication.

국문 초록 (Abstract)

현재, 우리나라 당뇨병의 유병률은 빠른 속도로 증가하고 있으며 당뇨병의 유병기간이 길수록 각종 합병증이 발생하여 더욱 심각한 증상을 나타는데, 그 중 비만 및 고혈당, 당대사장애로 인한 당뇨병성 혈관합병증과 말초 혈관 경화증이 많이 발병하고 있는 실정이다. 따라서 본 연구에서는 광혈류량 측정법(Photoplethysmography)으로 손가락 및 발가락에서 얻어진 맥파의 2차 미분분석을 통해 연령이 비슷한 정상인 50명과 당뇨병으로 확진된 50명의 말초 혈관 탄성도를 객관적으로 비교하고자 하였다. PPG 파형의 2차 미분 분석에 사용되는 평가 인자는 a, b, c, d, e 이고, b/a는 혈관의 탄성도를 의미하며 탄성도가 떨어질수록 b/a의 절대 값은 감소하게 된다. 정상인 50명의 PPG 2차 미분 b/a값은 -1.09±0.14, 당뇨병 환자 50명의 PPG 2차 미분 b/a값은 -0.81±0.09로 정상인에 비해 당뇨병 환자의 말초혈관 탄성도가 감소하였으며, Independent t-test 검정 결과 통계적으로 유의한 차이를 보였다(p<0.05). 본 연구에서는 PPG 파형의 2차 미분 분석을 통하여 정상인과 혈관합병증 발병율이 높은 당뇨병 환자의 말초혈관 탄성도를 비교하였으며, 향후 비침습적이고 간단한 방법으로 당뇨병 환자의 말초혈관 탄성도와 혈관 경화정도를 객관적으로 평가하고 진단함으로써 당뇨병 환자들의 심혈관계질환 사전예방과 치료효과 판정에 도움을 줄 것으로 기대한다.

참고문헌 (Reference)

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