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研究生:楊宗祥
研究生(外文):Tzung-Shiang Yang
論文名稱:三維心電圖應用於慢性阻塞性肺疾相關性研究
論文名稱(外文):The Application of Three Dimensional Electrocardiogram on Chronic Obstructive Pulmonary Diseases
指導教授:江惠華江惠華引用關係
指導教授(外文):Huihua Kenny Chiang
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:醫學工程研究所
學門:工程學門
學類:生醫工程學類
論文種類:學術論文
論文出版年:1999
畢業學年度:87
語文別:中文
論文頁數:60
中文關鍵詞:三維心電圖
外文關鍵詞:3D-ECG
相關次數:
  • 被引用被引用:1
  • 點閱點閱:680
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  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:1
三維心電圖顯示技術是將12導程心電圖置於三維直角座標系統中,提供心電訊號在額平面及橫平面上一個整體性的顯示方式。此種顯示方式擁有許多優點,包括方便學習及增加觀察的敏感度,並能夠進行個別波形的比較及定量化分析計算,提供醫師在診斷心臟疾病時做參考。本研究中,我們將三維心電圖顯示技術實際應用於臨床慢性阻塞性肺疾( Chronic Obstructive Pulmonary Disease )的研究。慢性阻塞性肺疾之主要病症為肺氣腫及慢性支氣管炎,它會造成呼吸道阻塞使得心臟作功增加。在傳統的12導程心電圖進行慢性阻塞性肺疾診斷時,常在導程 II, III及 aVF處觀察異常高且尖的P波,但卻無法更進一步提供心電圖與慢性阻塞性肺疾病情嚴重度的相關性。本研究中,我們利用P波體積積分方式研究三維心電圖與慢性阻塞性肺疾病情嚴重度兩者間的相關性。
我們總共量測87位慢性阻塞性肺疾病患,發現P波體積積分值與慢性阻塞性肺疾病情嚴重度兩者間,存在統計學上線性迴歸的負相關特性。因此,對於行動不便及無法順利完成肺功能檢查的患者,三維心電圖所具有的簡單與非侵入式量測等優點;進一步開發完成後,可以提供臨床診斷的參考。
A novel three-dimensional (3D) display method for 12-lead electrocardiogram(ECG) was developed to provide an integral view of the cardiac signals in a 3D rectangular coordinate system in the horizontal and frontal planes. This technique owns many favorable features including easy learning enhancement in visual perception, and providing quantitative analysis results. In this research, we study the application of 3D ECG for clinical diagnosis of Chronic Obstructive Pulmonary Disease (COPD). Emphysema and Chronic Bronchitis are two major symptoms of COPD. These diseases obstruct the outflow of pneogaster and increase work load on the heart. Therefore, COPD is a heart-pulmonary associated disease. When using the traditional 12 leads ECG diagnosis, we often discover unordinary high P-wave in lead II, III and aVF. However, the relationships between them is not clear. In this research, we quantitatively study the relationship between the P-wave volume integration and the degree of COPD.
We measured 87 COPD patients and observe the relationship between the P-wave volume integration. The 3D ECG has several advantages in easy application and quantitative analysis, and has the potential to become a new tool for clinical diagnosis for some disabled patients or patients who can not complete the spirometry after farther developments.
中文摘要……………………………………………………………I
英文摘要……………………………………………………………II
圖表目錄索引………………………………………………………V
第一章 緒論……………………………………….………………1
1-1 前言………………………………………………………1
1-2 研究動機與目的…………………………………………4
第二章 原理………………………………………………………6
2-1 心電訊號的產生與傳導…………………………………6
2-2 心電訊號的量測與應用………………………………..12
2-2-1 心電訊號的量測…………………………..……13
2-2-2 心電圖波形……………………………………..18
2-2-3 心電圖的應用…………………………………..20
2-3 心臟與肺臟的相關性………………………………….21
2-3-1 心臟幫浦………………………………………..21
2-3-2 慢性阻塞性肺疾……………………………….22
2-3-3 肺功能試驗…………………………………….25
2-4 肺性心臟病之心電圖相關性…………………………28
第三章 實驗方法………………………………………………30
3-1 三維心電圖顯示………………………………………30
3-2 三維心電圖系統………………………………………34
3-2-1 三維心電圖硬體系統…………………………34
3-2-2 三維心電圖軟體系統…………………………35
3-3 心電訊號資料量化分析………………………………37
3-3三維心電圖與慢性阻塞性肺疾相關性分析………….43
第四章 結果……………………………………………………44
4-1 三維彩色心電圖形顯示結果…………………………44
4-2 定量化波形分析結果…………………………………50
第五章 討論…………………………………………………54
第六章 結論…………………………………………………56
參考文獻………………………………………………………59
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2. ("Three- Dimensional Electrocardiogram Display Method"), US Patent 5782773.
3. R.M.Berne and M.N.Levy,Chapter(23),(24)and(25),Physiology 3rd edition, Mosby Year
4. Ary L. Goldberger and Emanuel Goldberger, Clinical Electrocardiography 5rd edition, Mosby Year Book, 1994
5. Julian R. Beckwith, Grant''s Clinical Electrocardiography 2rd edition, McGraw-Hill Book, 1970
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8. Andreas Antoniou, Digital Filter 2rd edition, McGraw-Hill Book, 1993
9. W John, Medical Instrument Application and Design 2nd ed.,John Wiley & Sons, 1995
10. Pulmonary Pathophysiology-the essentials, JohnB. West, PH.D.
11. New approach to the digital elimination of 50 Hz interference from the electrocardiogram, I.I.Christov I.A.Dotsinsky Med. &Biol. Eng. & Comput.1988.
12. Improvement of resolution in measurement of electrocardiogram RR intervals by interpolation, I.Daskalov and I. Christov, Med. Eng. Phy. 1997
13. D. Noble, "The surprising heart: A review of recent progress in cardiac electrophysiology," Journal of Physiology., vol.353, pp. 1-50, 1984.
14. D. Kilpatrick, et al, "Origin of the Electrocardiogram," IEEE Eng. in Medicine and Biology, vol.l3, no. 4, pp. 479-486, Aug/Sep, 1994.
15. C. P. Manmen and Bhaskar Ramamurthi, "Vector Quantization for Compression of Multi-channel ECG," IEEE Trans on BME, vol.37, no. 9, Sep, 1990.
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