臺灣博碩士論文加值系統

心率變異度的高低可以反應一個人的自律神經是否失調，可以反應心臟功能的健康，其低變異度代表著高心臟病危險性。本研究利用光體積變化描記法量測生理訊號，發展出可長期監控使用者之心率變異之心率監控系統，本研究之特徵在於耳戴式之PPG量測裝置及其訊號分析系統，加上同時播放音樂能消除使用者情緒的影響而取得自然心率及心率變異。
本系統的核心使用簡單可解調MP3資料之系統單晶片，能同時處理音訊播放和生理訊號之擷取與分析。生理資訊可以在系統裝置中儲存和即時顯示，也可以透過USB通訊傳輸介面把生理資訊傳至電腦，所得之時序脈搏資料及分析後之心率變異資料可經由Borland C++ Builder編輯視窗化軟體使用者介面程式，顯示系統平台的分析結果及儲存。
在實驗分析的辯證流程中，本研究分為無聽音樂ECG、無聽音樂PPG、有聽音樂ECG和有聽音樂PPG這四種類型，利用T-TEST分析四種類型的HRV參數，可以證明音樂和不同的量測方式對使用者是有影響的。把每種類型的時頻域頻譜做成圖像以影像處理之方法利用自相關分析，做交叉比對，分析統計量測心電圖與量測PPG方式之差異，辯證於耳機內裝設PPG量測系統，在受測者聆聽音樂時不自覺之狀況下使用PPG量測方式，可取得長期的自然心率變異資訊。

This innovation is related to measuring the heart rate under unawareness of subject to extract the true nature heart rate variability. The Heart Rate Variability (HRV) is an important index that could be used for long term monitor of cardiac function. The low variability of heart rate indicates that the cardiac rhythm could not be regulated by autonomic nerve system. It is not a healthy condition for regular daily activities. This innovation has devised a portable photo-plethysmo-graphy (PPG) through an ear plug appliance.
The PPG signal was acquired and analyzed using a simple microcontroller with a MP3 data decoder. In this way, the user of MP3 player could has option of monitoring and recording his or her heart rate and heart rate variability regularly and unaware. The prototype system was also including functions of data display with color LCD, data storage with CF card, data communication with USB. An off-line PC window program was also provided for reviewing the recorded PPG and analyzed HRV.
The system was used to assess the psychophysic effect of heart beat monitoring over four circumstances. That were the situation of monitoring the ECG without listening to music, assessing the PPG without listening to music, listening to music with monitoring the ECG, and listening to music with the assessment of PPG. Four types of HRV parameters were analysed among named four circumstances using Student’s T-TEST. It were to examine the impact of heart beat monitoring methods on users. While examining the HRV frequency spectrum against each testing situation, the parasympathetic tone was found activated much earlier using PPG to assessing heart beat than the using ECG. This result demonstrated that the subjects’s heat rate and their natural heart rate variability could be monitored unconsciously using PPG while listening to music.

中文摘要 I
ABSTRACT II
謝誌 III
目錄 IV
圖目錄 VII
表目錄 X
第一章 緒論……………………………………………………………………..1
1-1 前言………………………………………………………..………………1
1-2 文獻回顧……………………………………………………..……………2
1-2-1 心率變異和自主神經的關係………………………..…………2
1-2-2 PPG和ECG的相關性………………………………..………..3
1-2-3 心率變異度與情緒的關係……………………………..………4
1-2-4 音樂對情緒的影響………………………………………..……4
1-3 研究目的………………………………………………………………..…5
1-4 論文架構………………………………………………………………..…5
第二章 研究背景與原理………………………………………………………..6
2-1 音樂對人的影響……………………………………………………..……6
2-2 HRV與身心健康………………………………………..………………...7
2-2-1 心律不整......................................................................................7
2-2-2 糖尿病 (Diabetes)........................................................................8
2-2-3 憂鬱症 (Depression)……………………………..……………..8
2-3 光體積變化描記圖概論……………………………………..…………….8
2-3-1 光體積變化描記原理………………………………..………….9
2-3-2 PPG 量測方式與原理…………………………...……………..11
2-4 心電圖概論…………………………………………………...…………...13
2-4-1 心電圖原理…………………………………………...………...13
2-5 心率變異(Heart Rate Variability , HRV )………………………..………..16
2-6 心率變異度與自主神經系統……………………………………..………16
2-7 QRS特徵點的偵測………………………………………………..……...18
2-8 心跳間期重新取樣(Berger algorithm)……………………………..……..19
2-9 心率變異分析方法…………………………………………………..……21
2-10 心率變異頻譜意義……………………………………………………..…21
2-11 快速傅立葉轉換原理……………………………………………………..23
2-12 本章總結…………………………………………………………………..26
第三章 系統架構與實現方法 ……………………………………………….. 27
3-1 硬體架構與裝置概述……………………………………………………..27
3-2 A122系統單晶片…………………………………………………………28
3-2-1 RISC51………………………………………………………….29
3-2-2 ZSP……………………………………………………………...30
3-2-3 RISC51和ZSP的溝通………………………………………...31
3-2-4 同時處理音訊播放和FFT轉換機制………………………….33
3-3 PPG類比訊號模組………………………………………………………..34
3-3-1 555振盪方波…………………………………………………...35
3-3-2 光電晶體偵測電路……………………………………………..36
3-3-3 高通濾波器……………………………………………………..36
3-3-4 低通濾波器……………………………………………………..38
3-3-5 帶拒濾波器……………………………………………………..39
3-3-6 後極放大及減法器……………………………………………..40
3-4 心電圖類比訊號模組……………………………………………………..40
3-5 周邊硬體…………………………………………………………………..42
3-5-1 薄膜電晶體液晶顯示器（TFT-LCD）………………………..42
3-5-2 CF 卡（Compact Flash Card）………………………………...43
3-6 系統硬體實現……………………………………………………………..44
3-6-1 Bresenham’s line algorithm……………………………………..45
3-6-2 特徵化R波…………………………………………………….46
3-6-3 數位濾波器……………………………………………………..47
3-6-4 Qualify…………………………………………………………..49
3-6-5 Resampling……………………………………………………...49
3-6-6 Fast Fourier Transform ( FFT)………………………………….50
3-6-7 心率變異度和時頻域分析……………………………………..51
3-7 視窗化軟體撰寫…………………………………………………………..52
3-8 實驗流程…………………………………………………………………..52
3-9 本章總結…………………………………………………………………..53
第四章 研究結果與討論 54
4-1 PPG類比訊號擷取電路板………………………………………………..54
4-2 心電圖類比訊號擷取電路板……………………………………………..55
4-3 系統功能實現……………………………………………………………..56
4-3-1 硬體實現………………………………………………………..57
4-3-2 軟體實現………………………………………………………..57
4-3-3 訊號檢測及驗證………………………………………………..61
4-3-4 1024點FFT和128點FFT比較………………………………69
4-3-5 ECG和PPG相關性驗證………………………………………70
4-4 實際測量人體訊號結果與討論…………………………………………..72
4-4-1 T-TEST分析……………………………………………………73
4-4-2 自相關分析……………………………………………………..77
4-5 本章總結……………………………………………………………..........81
第五章 結論與未來展望 82
5-1 結論………………………………………………………………………..82
5-2 未來展望…………………………………………………………………..82
參考文獻 83
附錄一 1024點和128點FFT轉換的功率頻譜圖 86
附錄二 功率頻譜圖和時頻域分析圖 89
附錄三 四種類型的相關係數分佈圖 109
附錄四 四種類型的相關係數輪廓圖 119
附錄五 四種類型的相關係數比較表 129
作者簡介 139


圖目錄
圖 1-1 心電圖（ECG）與連續動脈壓波形（ABP） ..........................................................4
圖2-1 光體積描記圖直流及交流成分示意圖[22] ................................................................9
圖2-2 心臟收縮時手指末端量測之PPG（紅色波形）[23]..............................................10
圖2-3 心臟舒張時手指末端量測之PPG（紫色波形）[23]..............................................10
圖2-4 一個完整循環週期所量測之PPG（藍色虛線）[23] ............................................ 11
圖2-5 反射式血管管徑變化偵測示意圖 [24] ....................................................................12
圖2-6 穿透式血管管徑變化偵測示意圖 [24] ....................................................................12
圖2-7 血管徑的連續變化波形.............................................................................................12
圖2-8 心臟之傳導系統 [25] ................................................................................................14
圖2-9 正常人的單次心電圖 [26] ........................................................................................15
圖2-10 12 導程位置圖[27]。(A)肢導程、(B)胸導程。.....................................................15
圖2-11 (A)心率變異度頻譜主要的三個頻峰。(B) 副交感神經抑制時之頻譜[28].........16
圖 2-12 QRS 波特徵化處理程序流程圖.............................................................................19
圖 2-13 心電圖QRS 波偵測................................................................................................19
圖2-14 BERGER 演算法示意圖[32] .....................................................................................20
圖2-15 正常順序排序的樹狀圖[33] ....................................................................................25
圖2-16 反向位元排序的樹狀圖[33] ....................................................................................25
圖2-17 N=8 的FFT 流程圖[33]..........................................................................................26
圖 3-1 系統實現架構圖........................................................................................................28
圖 3-2 A122 系統架構[34]....................................................................................................29
圖 3-3 RISC51 系統架構[34]................................................................................................30
圖 3-4 ZSP 架構[35]..............................................................................................................31
圖 3-5 51 端的流程圖...........................................................................................................32
圖 3-6 ZSP 端的流程圖........................................................................................................33
圖 3-7 同時處理音訊播放和FFT 轉換的機制時序圖.......................................................34
圖 3-8 PPG 量測線路方塊圖................................................................................................34
圖 3-9 無穩態震盪器............................................................................................................35
圖 3-10 555 所產生500HZ 的方波......................................................................................35
圖 3-11 光電晶體偵測電路..................................................................................................36
圖 3-12 二階高通的基本電路..............................................................................................37
圖 3-13 實現之二階BUTTERWORTH 高通濾波器之電路圖(截止頻率0.5HZ)...................38
圖 3-14 四階BUTTERWORTH 濾波器的參數值....................................................................38
圖 3-15 四階低通的基本電路..............................................................................................38
圖 3-16 實現之四階BUTTERWORTH 低通濾波器之電路圖（截止頻率為10HZ） ..........39
圖 3-17 T 型60HZ 帶拒濾波器............................................................................................39
圖 3-18 實現之正向放大及減法器線路..............................................................................40
圖 3-19 心電圖量測線路方塊圖..........................................................................................41
圖 3-20 心電圖肢導程電極配置圖......................................................................................41
圖 3-21 心電圖電極..............................................................................................................41
圖3-22 TFT-LCD 方塊圖 [36] .............................................................................................42
圖3-23 CF 卡方塊圖 [37].....................................................................................................43
圖 3-24 硬體即時分析流程圖..............................................................................................44
圖 3-25 BRESENHAM’S LINE ALGORITHM 流程圖..................................................................45
圖 3-26 經過BRESENHAM’S LINE ALGORITHM 得到的結果.................................................45
圖 3-27 經過200HZ 取樣所得到心電圖.............................................................................46
圖 3-28 經過BRESENHAM LINE ALGORITHM 後的心跳訊號.................................................46
圖 3-29 心電圖作微分取絕對值的訊號..............................................................................46
圖 3-30 做MOVING-AVERAGE 的訊號...................................................................................47
圖 3-31 FDATOOL 的數位濾波器規格介面.........................................................................48
圖 3-32 振福的頻率響應圖..................................................................................................48
圖 3-33 濾波係數..................................................................................................................49
圖 3-34 MATLAB 做FFT 運算之HRV 功率頻譜圖............................................................50
圖 3-35 ZSP 實現FFT 演算之HRV 功率頻譜...................................................................51
圖 3-36 經過SMOOTH 的HRV 時頻域圖（低頻成分的變動較大，值比較大，所對應的
顏色會偏向紅色；高頻成分的變動較小，值比較小，所對應的顏色會偏向藍色。）
.........................................................................................................................................52
圖 4-1 PPG 前端探頭............................................................................................................55
圖 4-2 PPG 類比訊號模組外觀圖........................................................................................55
圖 4-3 心電圖電極................................................................................................................55
圖 4-4 心電圖類比訊號擷取電路板....................................................................................56
圖 4-5 實驗工版包含電源系統、A122 晶片、USB 模組、SDRAM、CF CARD、BUTTON、
TFT LCD 和音源輸出。.................................................................................................56
圖 4-6 LCD 顯示介面分成三個部份1.即時顯示的PPG 訊號，取樣頻率為200HZ 2.
經過FFT 轉換後所得到即時的HRV 資訊 3.將所得到HRV 資訊對應COLOR BAR
即時轉成時頻域圖，這是測量25 分鐘所得到的結果。............................................57
圖 4-7 使用者程式介面-訊號讀取顯示...............................................................................59
圖 4-8 HRV 功率頻譜圖.....................................................................................................59
圖 4-9 時頻域分析圖..........................................................................................................59
圖 4-10 ECG 和PPG 顯示圖................................................................................................60
圖 4-11 ECG 和PPG 峰對峰值的區間................................................................................60
圖 4-12 訊號檢測模擬圖(1) .................................................................................................61
圖 4-13 由硬體端所得到的功率頻譜圖和時頻域圖(1) .....................................................62
圖 4-14 由軟體端所顯示的功率頻譜圖(1) .........................................................................62
圖 4-15 由軟體端所顯示的時頻域圖(1) .............................................................................62
圖 4-16 訊號檢測模擬圖(2) .................................................................................................63
圖 4-17 由硬體端所得到的功率頻譜圖和時頻域圖(2) .....................................................64
圖 4-18 由軟體端所顯示的功率頻譜圖(2) .........................................................................64
圖 4-19 由軟體端所顯示的時頻域圖(2) .............................................................................64
圖 4-20 訊號檢測模擬圖(3) .................................................................................................65
圖 4-21 由硬體端所得到的功率頻譜圖和時頻域圖(3) .....................................................66
圖 4-22 由軟體端所顯示的功率頻譜圖(3) .........................................................................66
圖 4-23 由軟體端所顯示的時頻域圖(3) .............................................................................66
圖 4-24 訊號檢測模擬圖(4) .................................................................................................67
圖 4-25 由硬體端所得到的功率頻譜圖和時頻域圖(4) .....................................................68
圖 4-26 由軟體端所顯示的功率頻譜圖(4) .........................................................................68
圖 4-27 由軟體端所顯示的時頻域圖(4) .............................................................................68
圖 4-28 SUBJECT5 做1024 點FFT 所得到的功率頻譜......................................................70
圖 4-29 SUBJECT5 做128 點FFT 所得到的功率頻譜........................................................70
圖 4-30 SUBJECTA 的ECG 和PPG 峰對峰值區間圖.........................................................71
圖 4-31 SUBJECTB 的ECG 和PPG 峰對峰值區間圖.........................................................72
圖 4-32 SUBJECTC 的ECG 和PPG 峰對峰值區間圖.........................................................72
圖 4-33 左右圖分別為SUBJECT1 的無聽音樂ECG 和PPG 的相關係數分布圖.............78
圖 4-34 左右圖分別為SUBJECT1 的無聽音樂ECG 和PPG 的相關係數輪廓圖.............78

表目錄
表格 2-1 心律變異頻譜意義................................................................................................22
表格 3-1 不同形式ZSP 的規格[36].....................................................................................31
表格 3-2 BUTTERWORTH FILTER Q(品質因子)參數表..........................................................37
表格 4-1 1024 點和128 點FFT 轉換在功率頻譜上的差異..............................................69
表格 4-2 測量ECG 和PPG 所得到的心跳區間相關性分析.............................................71
表格 4-3 20 位受測者在無聽音樂下由ECG 和PPG 得到的正規化後高、低頻成分....73
表格 4-4 20 位受測者在有聽音樂下由ECG 和PPG 得到的正規化後高、低頻成分....74
表格 4-5 20 位受測者在有、無聽音樂這兩種情況下由ECG 和PPG 得到的低高頻比75
表格 4-6 在有、無聽音樂的環境下，用T-TEST 分析ECG 和PPG 高低頻成分的差異
(N=20)..............................................................................................................................76
表格 4-7 在ECG 和PPG 這兩種量測方式得到的高低頻成分，用T-TEST 分析有、無
聽音樂的差異(N=20).......................................................................................................76
表格 4-8 用T-TEST 分析有、無聽音樂和ECG、PPG這兩種方式低高頻比的差異(N=20)
.........................................................................................................................................77
表格 4-9 所有受測者相關係數比較表，●代表PPG 優於ECG，★代表ECG 優於PPG，
空白代表不符合研究所定的標準條件內......................................................................79
表格 4-10 所有受測者在這四種類型中能符合標準條件的統計表..................................81

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