臺灣博碩士論文加值系統

心臟將血液輸出必須先克服血管系統給予心臟的壓力始能將血液輸送至身體各部位，血管系統的阻抗可以由體外量取，再者動脈有效抗彈性力（Effective Arterial Elastance, Ea）為動脈血管系統給予心臟的阻抗，因此討論Ea與心臟在不同狀況下變化的關係可以了解Ea是否可以當作評估心臟功能的參數。本研究開發血壓容積迴圈（Pressure-Volume Loop, PV-Loop）的分析程式，分析回流血量改變時的血壓與容積關係。藉由分析16位患有冠狀動脈阻塞的患者之血壓與容積關係，由Pacing Maker改變心跳速率，分析在不同心跳速率時血壓容積迴圈的相關參數變化。結果顯示在手術前後，心臟的舒張末期容積與收縮末期血壓的變化量不大，但手術前因為心臟搏出血量低落，會使得Ea的數值跟隨著舒張末期容積與收縮末期血壓兩者的變化而產生變動，手術後Ea因為心臟搏出血量提升而減少與舒張末期容積的配合，此結果說明心臟會因疾病而無法提供人體正常所需的血量時，動脈系統會調整給予心臟的壓力，讓心臟可以藉由調整收縮力道與心室容積提升血液供應量，所以Ea可以當成由體外評估心臟功能的參數。

Before the heart ejects blood from the left ventricular, it must overcome the pressure from the vascular system first. Since the pressure of the vascular system comes from the pressurization of human body, the cardio resistance (which is given by the vascular system) is measurable. The effective arterial elastance (Ea) is referred to the cardio resistance given by the arteries. Therefore, we are able to discuss Ea and can be using Ea as a reference to evaluate the cardiac functions, by discussing the relationship between Ea and different cardiac changes. The Pressure-Volume Loops (PV-Loops) analysis program was developed using the Borland C++ Builder 6. The PV data of 16 acute myocardial infracted (AMI) patients with coronary arterial occlusion acquired using the inferior Vena Cava balloon occlusion treatment (IVCBO) procedure was examined. The result shows that the average relevance of Ea and the end-diastolic volume, and the average relevance of Ea and the end-systolic pressure are below 0.6. The Ea would change before the treatment due to the blood regurgitation reduces; however, the same situation will not happen after treatment. In other words, the arteries will abstractly adjust pressure towards cardio output, letting body obtain sufficient blood, while the heart cannot perform its function well.

摘要 I
Abstract II
謝誌 III
目錄 IV
圖索引 VI
表索引 VII
第一章　緒論 1
1.1　研究背景 1
1.2　文獻回顧 6
1.3　研究目的 10
1.4　論文架構 11
第二章　基本理論 13
2.1　PV-Loop簡介 13
2.2　生理數據量測系統 19
2.2.1　左心室血壓量測系統 20
2.2.2　左心室容積量取系統 21
2.2.3　心電圖量測 22
2.3　生理參數簡介 23
2.4　心臟能力的評估 31
2.5　本章總結 33
第三章　研究設備與架構 34
3.1　資料擷取流程 34
3.2　病患資料 35
3.3　生理訊號擷取硬體 37
3.4　生理訊號分析系統程式架構 38
3.4.1　程式架構 39
3.4.2　讀取校正檔案 41
3.4.3　讀取原始檔案 42
3.4.4　選擇區間 43
3.4.5　計算R波 44
3.4.6　計算特徵點 44
3.4.7　迴圈挑選 53
3.4.8　計算生理參數 54
3.4.9　檔案儲存 55
3.4.10 特殊情況 56
3.5　本章總結 57
第四章　結果與討論 58
第五章　結論與未來展望 73
參考文獻 75
作者簡介 77

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