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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 陳韻之(Yunn-Jy Chen) | |
dc.contributor.author | Cheng-An Chu | en |
dc.contributor.author | 朱振安 | zh_TW |
dc.date.accessioned | 2021-06-17T07:07:05Z | - |
dc.date.available | 2020-03-28 | |
dc.date.copyright | 2019-08-26 | |
dc.date.issued | 2019 | |
dc.date.submitted | 2019-07-24 | |
dc.identifier.citation | 1. Young, T., Palta, M., Dempsey, J., Skatrud, J., Weber, S., & Badr, S. (1993). The occurrence of sleep-disordered breathing among middle-aged adults. New England Journal of Medicine, 328(17), 1230-1235.
2. Somers, V. K., White, D. P., Amin, R., Abraham, W. T., Costa, F., Culebras, A., ... & Pickering, T. G. (2008). Sleep apnea and cardiovascular disease: An American heart association/American college of cardiology foundation scientific statement from the American heart association council for high blood pressure research professional education committee, council on clinical cardiology, stroke council, and council on cardiovascular nursing in collaboration with the national heart, lung, and blood institute national center on sleep disorders research (national institutes of health). Journal of the American College of Cardiology, 52(8), 686-717. 3. Drager, L. F., Togeiro, S. M., Polotsky, V. Y., & Lorenzi-Filho, G. (2013). Obstructive sleep apnea: a cardiometabolic risk in obesity and the metabolic syndrome. Journal of the American College of Cardiology, 62(7), 569-576. 4. Nieto, F. J., Young, T. B., Lind, B. K., Shahar, E., Samet, J. M., Redline, S., ... & Pickering, T. G. (2000). Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Jama, 283(14), 1829-1836. 5. Coughlin, S. R., Mawdsley, L., Mugarza, J. A., Calverley, P. M., & Wilding, J. P. (2004). Obstructive sleep apnoea is independently associated with an increased prevalence of metabolic syndrome. European heart journal, 25(9), 735-741. 6. Senaratna, C. V., Perret, J. L., Lodge, C. J., Lowe, A. J., Campbell, B. E., Matheson, M. C., Dharmage, S. C. (2017). Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep medicine reviews, 34, 70-81. 7. Kushida, C. A., Morgenthaler, T. I., Littner, M. R., Alessi, C. A., Bailey, D., Coleman Jr, J., ... & Lee-Chiong, T. (2006). Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances: an update for 2005. Sleep, 29(2), 240-243. 8. Minoguchi, K., Tazaki, T., Yokoe, T., Minoguchi, H., Watanabe, Y., Yamamoto, M., & Adachi, M. (2004). Elevated production of tumor necrosis factor-α by monocytes in patients with obstructive sleep apnea syndrome. Chest, 126(5), 1473-1479. 9. Brown, E. C., Cheng, S., McKenzie, D. K., Butler, J. E., Gandevia, S. C., & Bilston, L. E. (2015). Tongue stiffness is lower in patients with obstructive sleep apnea during wakefulness compared with matched control subjects. Sleep, 38(4), 537-544. 10. Mirrakhimov, A. E., Sooronbaev, T., & Mirrakhimov, E. M. (2013). Prevalence of obstructive sleep apnea in Asian adults: a systematic review of the literature. BMC pulmonary medicine, 13(1), 10. 11. Hui, D. S., Chan, J. K. W., Ko, F. W. S., Choy, D. K. L., Li, T. S. T., Chan, A. T., ... & Lai, C. K. W. (2002). Prevalence of snoring and sleep‐disordered breathing in a group of commercial bus drivers in Hong Kong. Internal medicine journal, 32(4), 149-157. 12. Bixler, E. O., Vgontzas, A. N., Lin, H. M., Ten Have, T., Rein, J., Vela-Bueno, A., & Kales, A. (2001). Prevalence of sleep-disordered breathing in women: effects of gender. American journal of respiratory and critical care medicine, 163(3), 608-613. 13. Chuang, L., Hsu, S., Lin, S., Ko, W., Chen, N., & Tsai, Y. (2008). Prevalence of snoring and witnessed apnea in Taiwanese adults. Chang Gung medical journal, 31(2), 175. 14. Kim, J., In, K., Kim, J., You, S., Kang, K., Shim, J., ... & Shin, C. (2004). Prevalence of sleep-disordered breathing in middle-aged Korean men and women. American journal of respiratory and critical care medicine, 170(10), 1108-1113. 15. Reddy, E. V., Kadhiravan, T., Mishra, H. K., Sreenivas, V., Handa, K. K., Sinha, S., & Sharma, S. K. (2009). Prevalence and risk factors of obstructive sleep apnea among middle-aged urban Indians: a community-based study. Sleep medicine, 10(8), 913-918. 16. Ip, M. S., Lam, B., Lauder, I. J., Tsang, K. W., Chung, K. F., Mok, Y. W., & Lam, W. K. (2001). A community study of sleep-disordered breathing in middle-aged Chinese men in Hong Kong. Chest, 119(1), 62-69. 17. Ip, M. S., Lam, B., Tang, L. C., Lauder, I. J., Ip, T. Y., & Lam, W. K. (2004). A community study of sleep-disordered breathing in middle-aged Chinese women in Hong Kong: prevalence and gender differences. Chest, 125(1), 127-134. 18. Sharma, S. K., Kumpawat, S., Banga, A., & Goel, A. (2006). Prevalence and risk factors of obstructive sleep apnea syndrome in a population of Delhi, India. Chest, 130(1), 149-156. 19. Whyte, K. F., Allen, M. B., Jeffrey, A. A., Gould, G. A., & Douglas, N. J. (1989). Clinical features of the sleep apnoea/hypopnoea syndrome. QJM: An International Journal of Medicine, 72(1), 659-666. 20. Pedrosa, R. P., Drager, L. F., Gonzaga, C. C., Sousa, M. G., de Paula, L. K., Amaro, A. C., Lorenzi-Filho, G. (2011). Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension. Hypertension, 58(5), 811-817. 21. Bradley, T. D., & Floras, J. S. (2003). Sleep apnea and heart failure: Part I: obstructive sleep apnea. Circulation, 107(12), 1671-1678. 22. Millman, R. P., Redline, S., Carlisle, C. C., Assaf, A. R., & Levinson, P. D. (1991). Daytime hypertension in obstructive sleep apnea: prevalence and contributing risk factors. Chest, 99(4), 861-866. 23. Hla, K. M., Young, T. B., Bidwell, T., Palta, M., Skatrud, J. B., & Dempsey, J. (1994). Sleep apnea and hypertension: a population-based study. Annals of internal medicine, 120(5), 382-388. 24. Peppard, P. E., Young, T., Palta, M., & Skatrud, J. (2000). Prospective study of the association between sleep-disordered breathing and hypertension. New England Journal of Medicine, 342(19), 1378-1384. 25. Bradley, T. D., & Floras, J. S. (2009). Obstructive sleep apnoea and its cardiovascular consequences. The Lancet, 373(9657), 82-93. 26. Kanbay, A., Tutar, N., Kaya, E., Buyukoglan, H., Ozdogan, N., Oymak, F. S., ... & Demir, R. (2013). Mean platelet volume in patients with obstructive sleep apnea syndrome and its relationship with cardiovascular diseases. Blood Coagulation & Fibrinolysis, 24(5), 532-536. 27. Kato, M., Roberts-Thomson, P., Phillips, B. G., Haynes, W. G., Winnicki, M., Accurso, V., & Somers, V. K. (2000). Impairment of endothelium-dependent vasodilation of resistance vessels in patients with obstructive sleep apnea. Circulation, 102(21), 2607-2610. 28. Ip, M. S., Tse, H. F., Lam, B., Tsang, K. W., & Lam, W. K. (2004). Endothelial function in obstructive sleep apnea and response to treatment. American journal of respiratory and critical care medicine, 169(3), 348-353. 29. Nadeem, R., Molnar, J., Madbouly, E. M., Nida, M., Aggarwal, S., Sajid, H., ... & Loomba, R. (2013). Serum inflammatory markers in obstructive sleep apnea: a meta-analysis. Journal of Clinical Sleep Medicine, 9(10), 1003-1012. 30. Teran-Santos, J., Jimenez-Gomez, A., Cordero-Guevara, J., & Cooperative Group Burgos–Santander. (1999). The association between sleep apnea and the risk of traffic accidents. New England Journal of Medicine, 340(11), 847-851. 31. Kales, A., Caldwell, A. B., Cadieux, R. J., Vela-Bueno, A., Ruch, L. G., & Mayes, S. D. (1985). Severe obstructive sleep apnea—II: Associated psychopathology and psychosocial consequences. Journal of chronic diseases, 38(5), 427-434. 32. Young, T., Evans, L., Finn, L., & Palta, M. (1997). Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep, 20(9), 705-706. 33. American Academy of Sleep Medicine. (2005). International classification of sleep disorders. Diagnostic and coding manual, 51-55. 34. Dempsey, J. A., Veasey, S. C., Morgan, B. J., & O'Donnell, C. P. (2010). Pathophysiology of sleep apnea. Physiological reviews, 90(1), 47-112. 35. Isono, S., Feroah, T. R., Hajduk, E. A., Brant, R., Whitelaw, W. A., & Remmers, J. E. (1997). Interaction of cross-sectional area, driving pressure, and airflow of passive velopharynx. Journal of Applied Physiology, 83(3), 851-859. 36. Schwartz, A. R., & Smith, P. L. (2013). CrossTalk proposal: the human upper airway does behave like a Starling resistor during sleep. The Journal of physiology, 591(9), 2229-2232. 37. Butler, J. P., Owens, R. L., Malhotra, A., & Wellman, A. (2013). CrossTalk opposing view: The human upper airway during sleep does not behave like a Starling resistor. The Journal of physiology, 591(9), 2233-2234. 38. Watanabe, T., Isono, S., Tanaka, A., Tanzawa, H., & Nishino, T. (2002). Contribution of body habitus and craniofacial characteristics to segmental closing pressures of the passive pharynx in patients with sleep-disordered breathing. American Journal of Respiratory and Critical Care Medicine, 165(2), 260-265. 39. Mathew, O. P., Abu-Osba, Y. K., & Thach, B. T. (1982). Influence of upper airway pressure changes on genioglossus muscle respiratory activity. Journal of Applied Physiology, 52(2), 438-444. 40. Van Lunteren, E. R. I. K., & Vafaie, H. E. L. E. N. (1993). Force potentiation in respiratory muscles: comparison of diaphragm and sternohyoid. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 264(6), R1095-R1100. 41. Svanborg, E. (2005). Impact of obstructive apnea syndrome on upper airway respiratory muscles. Respiratory physiology & neurobiology, 147(2-3), 263-272. 42. Nishino, T. (2000). Physiological and pathophysiological implications of upper airway reflexes in humans. The Japanese journal of physiology, 50(1), 3-14. 43. Tangel, D. J., Mezzanotte, W. S., & White, D. P. (1991). Influence of sleep on tensor palatini EMG and upper airway resistance in normal men. Journal of Applied Physiology, 70(6), 2574-2581. 44. Wheatley, J. R., Tangel, D. J., Mezzanotte, W. S., & White, D. P. (1993). Influence of sleep on response to negative airway pressure of tensor palatini muscle and retropalatal airway. J Appl Physiol, 75(5), 2117-2124. 45. Van de Graaff, W. B. (1988). Thoracic influence on upper airway patency. Journal of Applied Physiology, 65(5), 2124-2131. 46. Ballard, R. D., Irvin, C. G., Martin, R. J., Pak, J. U. N. O., Pandey, R. A. M. E. S. H., & White, D. P. (1990). Influence of sleep on lung volume in asthmatic patients and normal subjects. Journal of applied physiology, 68(5), 2034-2041. 47. Fouke, J. M., & Strohl, K. P. (1987). Effect of position and lung volume on upper airway geometry. Journal of Applied Physiology, 63(1), 375-380. 48. Bacon, W. H., Turlot, J. C., Krieger, J., & Stierle, J. L. (1990). Cephalometric evaluation of pharyngeal obstructive factors in patients with sleep apneas syndrome. The Angle orthodontist, 60(2), 115-122. 49. Mathur, R., & Douglas, N. J. (1995). Family studies in patients with the sleep apnea-hypopnea syndrome. Annals of Internal Medicine, 122(3), 174-178. 50. Schwab, R. J., Pasirstein, M., Pierson, R., Mackley, A., Hachadoorian, R., Arens, R., ... & Pack, A. I. (2003). Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging. American journal of respiratory and critical care medicine, 168(5), 522-530. 51. Strobel, R. J., & Rosen, R. C. (1996). Obesity and weight loss in obstructive sleep apnea: a critical review. Sleep, 19(2), 104-115. 52. Yu, X., Fujimoto, K., Urushibata, K., Matsuzawa, Y., & Kubo, K. (2003). Cephalometric analysis in obese and nonobese patients with obstructive sleep apnea syndrome. Chest, 124(1), 212-218. 53. Stauffer, J. L., Buick, M. K., Bixler, E. O., Sharkey, F. E., Abt, A. B., Manders, E. K., Zwillich, C. W. (1989). Morphology of the uvula in obstructive sleep apnea1-3. Am Rev Respir Dis, 140(3), 724. 54. Van de Graaff, W. B. (1988). Thoracic influence on upper airway patency. Journal of Applied Physiology, 65(5), 2124-2131. 55. Schwartz, A. R., Patil, S. P., Laffan, A. M., Polotsky, V., Schneider, H., & Smith, P. L. (2008). Obesity and obstructive sleep apnea: pathogenic mechanisms and therapeutic approaches. Proceedings of the American Thoracic Society, 5(2), 185-192. 56. Boyd, J. H., Petrof, B. J., Hamid, Q., Fraser, R., & Kimoff, R. J. (2004). Upper airway muscle inflammation and denervation changes in obstructive sleep apnea. American journal of respiratory and critical care medicine, 170(5), 541-546. 57. Tsai, H. H., Ho, C. Y., Lee, P. L., & Tan, C. T. (2009). Sex differences in anthropometric and cephalometric characteristics in the severity of obstructive sleep apnea syndrome. American Journal of Orthodontics and Dentofacial Orthopedics, 135(2), 155-164. 58. Palmer, L. J., Buxbaum, S. G., Larkin, E. K., Patel, S. R., Elston, R. C., Tishler, P. V., & Redline, S. (2004). Whole genome scan for obstructive sleep apnea and obesity in African-American families. American journal of respiratory and critical care medicine, 169(12), 1314-1321. 59. Li, K. K., Kushida, C., Powell, N. B., Riley, R. W., & Guilleminault, C. (2000). Obstructive sleep apnea syndrome: a comparison between Far‐East Asian and white men. The Laryngoscope, 110(10), 1689-1693. 60. Kim, A. M., Keenan, B. T., Jackson, N., Chan, E. L., Staley, B., Poptani, H., ... & Schwab, R. J. (2014). Tongue fat and its relationship to obstructive sleep apnea. Sleep, 37(10), 1639-1648. 61. Cavaliere, M., Russo, F., & Iemma, M. (2013). Awake versus drug‐induced sleep endoscopy: evaluation of airway obstruction in obstructive sleep apnea/hypopnoea syndrome. The Laryngoscope, 123(9), 2315-2318. 62. Kwan, B. C., Butler, J. E., Hudson, A. L., McKenzie, D. K., Bilston, L. E., & Gandevia, S. C. (2014). A novel ultrasound technique to measure genioglossus movement in vivo. Journal of Applied Physiology, 117(5), 556-562. 63. Gennisson, J. L., Deffieux, T., Fink, M., & Tanter, M. (2013). Ultrasound elastography: principles and techniques. Diagnostic and interventional imaging, 94(5), 487-495. 64. Kamaya, A., Machtaler, S., Sanjani, S. S., Nikoozadeh, A., Sommer, F. G., Khuri-Yakub, B. T. P., Desser, T. S. (2013, July). New technologies in clinical ultrasound. In Seminars in roentgenology (Vol. 48, No. 3, pp. 214-223). Elsevier. 65. Shiina, T., Nightingale, K. R., Palmeri, M. L., Hall, T. J., Bamber, J. C., Barr, R. G., ... & Dietrich, C. F. (2015). WFUMB guidelines and recommendations for clinical use of ultrasound elastography: Part 1: basic principles and terminology. Ultrasound in medicine & biology, 41(5), 1126-1147. 66. Bamber, J., Cosgrove, D., Dietrich, C. F., Fromageau, J., Bojunga, J., Calliada, F., ... & Fink, M. (2013). EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall in der Medizin-European Journal of Ultrasound, 34(02), 169-184. 67. Sigrist, R. M., Liau, J., El Kaffas, A., Chammas, M. C., & Willmann, J. K. (2017). Ultrasound elastography: review of techniques and clinical applications. Theranostics, 7(5), 1303. 68. Lahav, Y., Rosenzweig, E., Heyman, Z., Doljansky, J., Green, A., & Dagan, Y. (2009). Tongue base ultrasound: a diagnostic tool for predicting obstructive sleep apnea. Annals of Otology, Rhinology & Laryngology, 118(3), 179-184. 69. Shu, C. C., Lee, P., Lin, J. W., Huang, C. T., Chang, Y. C., Yu, C. J., & Wang, H. C. (2013). The use of sub-mental ultrasonography for identifying patients with severe obstructive sleep apnea. PloS one, 8(5), e62848. 70. Chen, J. W., Chang, C. H., Wang, S. J., Chang, Y. T., & Huang, C. C. (2014). Submental ultrasound measurement of dynamic tongue base thickness in patients with obstructive sleep apnea. Ultrasound in medicine & biology, 40(11), 2590-2598. 71. Liao, L. J., Cho, T. Y., Cheng, P. W., Wang, C. T., Lo, W. C., & Huang, T. W. (2016). Submental ultrasonography in diagnosing severe obstructive sleep apnea syndrome. Journal of Medical Ultrasound, 24(3), 107-111. 72. Brown, E. C., Cheng, S., McKenzie, D. K., Butler, J. E., Gandevia, S. C., & Bilston, L. E. (2013). Respiratory movement of upper airway tissue in obstructive sleep apnea. Sleep, 36(7), 1069-1076. 73. Bearpark, H., Elliott, L., Grunstein, R., Cullen, S., Schneider, H., Althaus, W., & Sullivan, C. (1995). Snoring and sleep apnea. A population study in Australian men. American journal of respiratory and critical care medicine, 151(5), 1459-1465. 74. Udwadia, Z. F., Doshi, A. V., Lonkar, S. G., & Singh, C. I. (2004). Prevalence of sleep-disordered breathing and sleep apnea in middle-aged urban Indian men. American journal of respiratory and critical care medicine, 169(2), 168-173. 75. Younes, M. (2003). Contributions of upper airway mechanics and control mechanisms to severity of obstructive apnea. American journal of respiratory and critical care medicine, 168(6), 645-658. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/72818 | - |
dc.description.abstract | 研究目的 : 阻塞性睡眠呼吸障礙是指發生在睡眠過程中呼吸道塌陷導致呼吸不 順暢的問題。依文獻回顧所知,舌體的厚度增加以及彈性係數降低,可能會影響 患病的機率。而過去對上呼吸道的研究常以醫學影像例如核磁共振影像、電腦斷 層以及側顱影像觀察上呼吸周邊結構特徵為主,但是受限於輻射曝射、攝影成 本、耗時等缺點,限制其在臨床上的廣泛利用。而使用超音波作為影像工具則無 上述缺點。本篇研究目的,將建立可信賴之頦下彈性超音波,以進行上呼吸道結 構的測量,並分析上呼吸道體積及彈性係數與阻塞性睡眠呼吸中止症之對應關係。
研究方法 : 首先先針對本團隊發展的臨床測量方法,進行信賴度測試。以評估 是否可以作為本臨床研究的檢查工具。本實驗納入共頦下超音波的受試者共 69 人,其中健康受試者為 37 人;阻塞性睡眠呼吸中止症患者 32 人。以頦下彈性超 音波測量矢狀面及冠狀面之舌體厚度以及彈性係數,進行分析與評估。 結果 : 阻塞性睡眠呼吸中止症患者上呼吸道的矢狀面舌體厚度、冠狀面舌體厚 度皆顯著大於健康組(矢狀面舌體厚度 65.38±0.93mm VS 60.99±0.99mm, Odds ratio=1.150, p=0.0045;冠狀面舌體厚度 63.70±0.98mm VS 57.72±0.96mm, Odds ratio=1.205, p=0.0005),而冠狀面彈性係數平均值則是顯著小於健康組(13.24±0.36 kPa VS 15.87±0.63 kPa, Odds ratio=0.701, p=0.0029)。組內比較部分,患病組之上 呼吸道結構及彈性係數與呼吸中止指數(AHI)皆無顯著差別(p>0.05)。 結論 : 頦下彈性超音波可作為觀察上呼吸道結構特性之理想工具。阻塞性睡眠 呼吸中止症患者表現出較健康組別厚的舌體以及彈性係數較低的舌體剛性。但舌體彈性係數以及厚度並無法作為患病組嚴重程度之評估標準。 | zh_TW |
dc.description.abstract | Purpose: Obstructive Sleep Apnea syndrome (OSAs) is a sleep breathing disorders of upper airway collapsing during sleep. It mostly caused by the upper airway structure abnormality. According to the previously studies, volume enlargement and low elasticity of upper airway structure may correlate to the occurrence of OSAs. The medical imaging tools of evaluating upper airway included computed tomography (CT), Magnetic resonance imaging (MRI) and Cephalometric x-ray. However, their application was limited by the drawback such as radiation exposure, high cost and time consuming. Ultrasound imaging may benefit the observation of upper airway. The aim of this study was to establish a reliable submental ultrasound elastography protocol. And identified the upper airway structure characteristic of OSAs patients.
Methods: We used ultrasound as a tool to verified the reliability of clinical submental in our study. Then total sixty-nine adults, with thirty-seven healthy adults and thirty-two OSAs patients, were included for submental ultrasound elastography. The tongue height and tongue elasticity of both sagittal and coronal view were measured to estimate the upper airway characteristic of OSAs patient. Results: Both Sagittal Tongue Height and Coronal Tongue Height shows significant increase in OSAs patient (Sagittal Tongue Height : 65.38±0.93mm VS 60.99±0.99mm, Odds ratio=1.150, p=0.0045;Coronal Tongue Height 63.70±0.98mm VS 57.72±0.96mm, Odds ratio=1.205, p=0.0005). And the Coronal Tongue Elasticity was lower compared to the healthy group (13.24±0.36 kPa VS 15.87±0.63 kPa, Odds ratio=0.701, p=0.0029). When compared within the OSAs group, Neither Tongue height or Elasticity were correlated to Apnea-Hypopnea Index (AHI) (p>0.05). Conclusion: Submental ultrasound elastography could be a reliable tool for upper airway structure evaluation. The OSAs patients showed larger Tongue Height and lower Tongue Elasticity when compared to healthy group. But Tongue height and Tongue elasticity could not be the parameter for severity determination in OSAs patients. | en |
dc.description.provenance | Made available in DSpace on 2021-06-17T07:07:05Z (GMT). No. of bitstreams: 1 ntu-108-R05422019-1.pdf: 2543805 bytes, checksum: 74c074c32389e36385d2b5955d74cb9e (MD5) Previous issue date: 2019 | en |
dc.description.tableofcontents | 誌謝 I
中文摘要 II ABSTRACT III 目錄 V 表目錄 VII 圖目錄 VIII 第一章 背景 1 第二章 文獻回顧 3 第一節 阻塞性睡眠呼吸中止症之盛行率 3 第二節 阻塞性睡眠呼吸中止症之臨床特徵 4 第三節 阻塞性睡眠呼吸中止症之診斷 5 第四節 與阻塞性睡眠呼吸中止症相關之生理機轉 6 第五節 易發生阻塞性睡眠呼吸中止症之的生理特徵 8 第六節 評估上呼吸道周邊組織結構特性之工具回顧 9 第七節 超音波基本原理 12 第八節 超音波於影像醫學的應用 12 第九節 超音波之彈性成像 13 第十節 利用超音波作為阻塞性睡眠呼吸中止症診斷工具之相關研究方法回顧 14 第十一節 研究目的 15 第二章 實驗材料與方法 16 第一節 前導實驗 : 頦下超音波彈性影像之信賴度研究 16 1.1 實驗對象 16 1.2 實驗流程及所需的儀器與設備 16 1.3 影像數據化與測量 18 1.3 實驗資料處理及分析 19 第二節 主實驗 : 頦下超音波彈性影像分析阻塞性睡眠呼吸中止症患者之上呼吸道結構特性 20 2.1 實驗對象 20 2.2 實驗流程及所需的儀器與設備 21 2.3 影像數據化與測量 22 2.1 實驗資料處理及分析 24 第三章 實驗結果 25 第一節 頦下超音波信賴度測試 25 第二節 實驗對象之基本資料分析 25 第三節 阻塞性睡眠呼吸中止症患者與一般受試者之生理結構差異 26 第四節 健康受試者在不同年齡層之結構差異 26 第五節 阻塞性睡眠呼吸中止症嚴重度相關因子分析 27 第四章 討論 28 第一節 頦下超音波於上呼吸道結構測量之可行性 28 第二節 阻塞性睡眠呼吸中止症患者之生理特質 29 第三節 患病組在頦下超音波影像下的上呼吸道特性 29 第四節 影響呼吸睡眠中止指數嚴重性的因子 30 第五節 超音波作為上呼吸道檢查工具的成效與展望 31 參考文獻 33 附錄一 健康受試者招募文宣 44 附錄二 表格與圖片 45 表目錄 表一、有關睡眠呼吸中止症盛行率的研究列表 45 表二、睡眠呼吸障礙對心血管的影響 46 表三、超音波於常見組織中的傳導速度 47 表四、利用超音波進行阻塞性睡眠呼吸中止症之研究列表 48 表五、頦下超音波之施測者間信度(Inter-Rater Reliability) 49 表六、頦下超音波之施測者內信度(Intra-Rater Reliability) 50 表七、患病組與健康組之基本資料比較 51 表七之一、患病受試者基本資料表 52 表七之二、健康受試者基本資料表 53 表八、阻塞性睡眠呼吸中止症之風險因子評估 54 表九、健康受試者在結構上的差異 55 表十、各項測量值之Spearman相關係數 56 圖目錄 圖 1 、睡眠時發生呼吸道塌陷的示意圖 57 圖2、多功能睡眠生理監測儀的監測項目和位置 58 圖3-1、本實驗使用之超音波儀器Toshiba Aplio 300 Platinum Platform 59 圖3-2、本實驗使用之環狀探頭PVT-375sc Convex Transducer 60 圖4-1、頦下超音波矢狀面(sagittal view)的測量 61 圖4-2、頦下超音波B mode下的舌體矢狀面測量 62 圖4-3、頦下超音波舌體矢狀面之彈性成像 63 圖4-4、頦下超音波舌體矢狀面之彈性成像取樣 64 圖5-1、頦下超音波冠狀面(coronal view)的測量 65 圖5-2、頦下超音波B mode下的舌體冠狀面 66 圖5-3、頦下超音波舌體冠狀面之彈性成像 67 圖5-4、頦下超音波舌體冠狀面之彈性成像取樣 68 圖6、同受試者彈性超音波矢狀面與冠狀面均質程度的差異 69 | |
dc.language.iso | zh-TW | |
dc.title | 利用頦下超音波及彈性影像觀察阻塞性睡眠呼吸中止症患者之上呼吸道結構特性 | zh_TW |
dc.title | Identifying the Upper Airway Characteristic of Obstructive Sleep Apnea patient with Submental Ultrasound Imaging and Shear Wave Elastography | en |
dc.type | Thesis | |
dc.date.schoolyear | 107-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 施庭芳,張凱閔 | |
dc.subject.keyword | 阻塞性睡眠呼吸中止症,頦下超音波,彈性超音波,彈性係數,舌頭,上呼吸道, | zh_TW |
dc.subject.keyword | Obstructive Sleep Apnea,Submental Ultrasound,Ultrasound Elastography,Elasticity,Tongue,Upper Airway, | en |
dc.relation.page | 69 | |
dc.identifier.doi | 10.6342/NTU201901937 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2019-07-25 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床牙醫學研究所 | zh_TW |
顯示於系所單位: | 臨床牙醫學研究所 |
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