頸橈動脈與心電圖量測演算法系統之驗證

Abstract

心腦血管阻塞所造成的疾病是常見的死亡原因，而治療後也造成嚴重的生活不便且容易再次復發。頸動脈為供給大腦血液之主要血管，若在其血管分叉處產生動脈硬化狹窄，容易因內頸動脈或外頸動脈阻塞造成缺血性腦中風與臉部麻痺失控的症狀; 在心臟方面亦有許多疾病，如：心肌缺氧、心律不整、心肌梗塞、傳導障礙…等，但由於心臟疾病沒有特異性的早期症狀，常被誤以為老化而受到忽略而錯過治療時間。 頸動脈超音波為腦中風罹患篩檢的重要工具之一，但檢查方式須仰賴許多臨床人員執行，而超音波檢查也常因為有人為操作與經驗問題，其結果因環境因素與操作者而有差異。在心臟疾病方面，心電圖為評估之重要工具，但檢查需要在靜止狀態執行，於動作狀態下的心臟症狀，則不易察覺。 本研究整合了不同的訊號來源而建立評估的演算法，可以分別對腦血管與心臟功能進行評估。在腦部血管檢查方面，利用非侵襲性的雙頸動脈壓力感測器所測量之訊號，透過所撰寫之峰值擷取演算法分析基礎血液動力學之參數與進階阻力指標與彈性係數，並與臨床常規頸動脈超音波檢查進行比對。而為了評估心臟方面的狀況，本研究計算心電圖訊號與橈動脈訊號的尖峰時間差距，以分析更多心臟收縮等資訊 。 在結果方面，經過演算法計算的結果與臨床超音波比對，在血液動力學部分，如：心跳次數、血管收縮加速度、阻力係數其相關性皆呈現高度相關，另外也可以輔助計算出心電圖與橈動脈之波形差異時間。 透過壓力感測器整合峰值擷取演算法，可以自動化且有效計算出許多臨床上重要意義的血液動力學參數，透過更多的臨床試驗與數據收集分析後，將可以更有效的運用於臨床與普及檢查方式，達到輔助臨床診斷的重要功能。

Obstructions of cerebrovascular or cardiovascular are the common cause of death. Although receiving treatment, it also causes serious inconvenience in daily and it is possible to recurrent. Carotid artery is the main vessel supplying blood to brain. When the arteriosclerotic stenosis occurred in the carotid bifurcation, including internal carotid artery or external carotid artery, some symptoms were observed as ischemic stroke or facial paralysis. In addition, there are many cardiovascular diseases, such as: myocardial hypoxia, arrhythmia, myocardial infarction, conduction disorders, etc. will result in sudden cardiac death. However, lack of specific early symptoms of cardiovascular disease, often mistaken for aging and neglected to miss treatment time. Carotid ultrasound is one of the important tools for the cerebrovascular accident screening, whereas, the examination must rely on clinical professional performed. Furthermore, the results are easily affected by operator dependent and environmental factors. Besides, to evaluate cardiac disease, electrocardiogram is the essential tool for evaluating. However, procedure needed to be done at rest state that some patterns under movement are not noticeable easily. In this study, we integrated different signals and built up the system with algorithm for automatic peak detection. Hemodynamic of cerebrovascular and cardiac functions can be evaluated respectively. Noninvasive duel pressure sensor used for measuring the signals from common carotid artery. After collecting the waveform, basic information from hemodynamic and advanced parameters, including heart rate, resistance index and acceleration time were calculated. To find the correlation between this system and standard sonography, we compared the results with clinical carotid ultrasound examination for each subject. For evaluating heart functions, the peak time region between the collecting ECG signal and the radial artery signal were calculated. Based on the results, hemodynamic parameters, such as heart rate, acceleration time of vasoconstriction, and the resistance index are highly correlated with the examination by ultrasound. In addition, the peak tine region between electrocardiogram and radial artery waveform can also be calculated automatically. With more clinical trials recruited and data analyzed, it is possible to provide physician aiding clinical diagnosis.