Objective assessment of exhausted conditions by using the parameters of pupil size and its variability

考察了瞳孔大小参数及其随耗竭变化的关系。使用红外摄像机（IRIS C7364, Hamamatsu, F2D, AMTech）连续记录瞳孔大小变化和黑暗变化660-720秒。计算平均瞳孔直径（PD）、瞳孔缓慢振荡<1.0Hz （FFT振幅）、瞳孔疲劳比（PFR，平均瞳孔直径/瞳孔直径标准差）、瞳孔动荡指数（PUI，基于连续数据序列平均值的瞳孔大小累积变化）作为瞳孔活动的参数。采用生命衰竭量表、主观疲劳问卷、斯坦福嗜睡量表、嗜睡视觉模拟量表和CES-D量表评估受试者的疲劳、嗜睡和主观症状。同时评估心率变异性、唾液Ig-A和皮质醇、血清皮质醇和DHEA-S。采用横断面分析的方法，对17名夜班三班制的医院护士（27.0岁）和38名到诊所进行健康检查的男性员工（43.4岁）进行了调查。对13名健康男学生（0.21.7岁）进行了体检。限制睡眠5小时7天的实验条件。结果：护士FFT振幅与疲劳（p<0.01）、困倦（p=0.05）相关，PFR与困倦相关（p=0.04）。PD与唾液、血清皮质醇水平相关（p<0.05）。在工人中，PUI与抑郁症状呈负相关（p<0.05）。睡眠受限状态下PD较小，FFT幅值较大（p=0.03）， PFR较小（p=0.02）。结论：瞳孔大小计算的参数与疲劳症状相关

The relationships of parameters in pupil size and its variability with exhaustionwas examined. Changes of pupil size and its variation in darkness were recorded continuously for 660-720 seconds using infrared video cameras (IRIS C7364, Hamamatsu, and F2D, AMTech). Average pupillary diameter (PD), slow pupillary oscillations<1.0Hz (FFT amplitude), the pupillary fatigue ratio (PFR, average pupillary diameter/papillary diameter standard deviation), the pupillary unrest index (PUI, cumulative changes in pupil size based on mean values of consecutive data sequences) were calculated as parameters of pupillary activity. Fatigue, sleepiness, subjective symptoms of the subjects were assessed by Vital Exhaustion Scale, Subjective Tiredness Questionnaire, the Stanford Sleepiness Scale, Visual Analog Scale of Sleepiness, and CES-D. Heart rate variability, salivary Ig-A and cortisol, serum cortisol and DHEA-S were simultaneously assessed. Cross-sectional analysis was conducted in 17 hospital nurses (27.0 yrs) working on 3-shift system including night duty, and 38 male workers (43.4 yrs) visiting a clinic for their health check-ups. 13 healthy male students (.21.7 yrs) were examined in an. experimental conditions with 5-hour sleep restriction for 7 days.Results : In nurses, FFT amplitude correlated with fatigue (p<0.01) and sleepiness (p=0.05), and PFR correlated with sleepiness (p=0.04). PD was correlated with salivary and serum cortisol level (p<0.05). In workers, PUI was inversely correlated with depressive symptoms (p<0.05). PD was smaller, FFT amplitude was larger (p=0.03), and PFR was smaller (p=0.02) in sleep-restricted states in the students. Conclusions : Parameters calculated from pupil size correlated with symptoms of exhaustion