臺灣博碩士論文加值系統

脈聲儀系統是由血流動力學理論發展而來，利用微型麥克風偵測並記錄手腕橈動脈上的脈波訊號變化，此訊號包含了血流動力學中任何動態壓力變化的訊息，所以使用脈聲儀作為訊號蒐集裝置。睡眠障礙可能導致罹患心血管疾病。本研究使用能量頻譜密度及潘凱圖及分析三組有睡眠障礙的病人。第一組為13位慢性失眠病人及14位正常對照,能量頻譜密度圖顯示慢性失眠病人副交感神經活躍。潘凱圖顯示慢性失眠病人心跳變異率較低,圖形長軸與短軸比值接近1。第二、三組分別是18位睡眠呼吸中止症病人和15位夜間額葉癲癇病人,能量頻譜圖以及潘凱圖都顯示出有上述兩種病患呈現在有壓力的生理狀態,而導致無法有效睡眠。

The Audiocardiography system is developed from hemodynamics theory. It measuring and recording the pulse wave on the wrist artery which contains various cardiovascular system information. The sleep disorders can put people at risk for cardiovascular diseases. Poincare’ plot analysis is a powerful method to analyze non-linear dynamic system and to observe hidden characters. This research collects data through a non-invasive audiocardiography system proposed by Dr. Yu. In this thesis, data from three groups of participants are collected, and power spectral density (PSD) and Poincare’ plot are adopted to analyze the sleep disorder. Group one is a total of 13 non-medicated patients with chronic insomnia and 14 matched controls without insomnia. The analysis result shows that heart rate variability (HRV) is lower and parasympathetic nerves are activated in patients with chronic insomnia. The Poincaré plot index of SD2/SD1for patients with the chronic insomnia shows that it is much lower than which for the matched controls. This result reveals that adaptability of heart in patients with the chronic insomnia is not good enough during daytime. Group two and group three are 18 patients with sleep apnea and 15 patients with nocturnal frontal lobe epilepsy respectively. The results represent that their heart activity are highly alerted for their adaptivity and can not fall into sleep effectively due to the sleep disorder .

摘要 I
Abstract II
誌謝 IV
Contents V
Table Contents VIII
Figure contents IX
Symbols XI
中文主文題要 XIII
第一章 緒論 XIII
第二章 理論分析 XIV
第三章 實驗設備、方法與步驟 XV
第四章 結果與討論 XVI
第五章 結論與建議 XVII
Chapter 1 Introduction 1
1-1 Preface 1
1-2 Motivation 2
1-3 Introduction of HRV and Sleep Disorder 4
1-3-1 Heart rate variability 4
1-3-2 Sleep Disorder 6
Chapter 2 Theoretical Analysis 9
2-1 Fast Fourier Transform (FFT) 9
2-2 Heart physiological structure and its current conduction process 11
2-3 HRV analysis 13
2-3-1 Time domain analysis 13
2-3-2 Frequency domain analysis 15
2-3-3 Poincaré plot non-linear analysis 18
2-4 Window technique 19
Chapter 3 Experimental apparatus, Methods and Procedures 22
3-1 Experimental apparatus 22
3-2 Experimental methods and procedures 23
3-2-1 Chronic insomnia 25
3-2-2 Sleep apnea 25
3-2-2 Nocturnal frontal lobe epilepsy 26
3-3 Validation of condenser microphone 27
Chapter 4 Results and Discussion 29
4-1 Validation of microphone frequency response 29
4-2 Analysis of patients with the chronic insomnia 30
4-3 Analysis of patients with sleep apnea 32
4-4 Analysis of patients with the nocturnal frontal lobe epilepsy 34
Chapter 5 Conclusion and Suggestion 36
5-1 Conclusions 36
5-2 Suggestion 37
References 39
Vita 64

1.http://www.thoracicandsleep.com.au, Thoracic ＆ Sleep Group Queensland.
2.謝長倭, “自主神經功能研究用脈搏波形諧波分析系統之設計, 國立成功大學電機工程研究所博士論文, 2003。
3.林佳鈺, “脈搏波中有關心血管之訊號分析, 國立成功大學航空太空工程學系碩士論文, 2009。
4.林桓永,“心跳變異律應用於脈聲儀量測數據之分析研究, 國立成功大學航空太空工程學系碩士論文, 2011。
5.楊哲嘉, “由脈聲儀數據利用逆歸圖示分析法探討人體疲勞狀態,國立成功大學航空太空工程學系碩士論文, 2012。
6.Hon, E. H. and Lee, S. T., “Electronic evaluations of the fetal heart rate patterns preceding fetal death, further observations, American journal of obstetrics and gynecology, Vol.87, pp.814–26, 1963.
7.Sayers, B. M., “Analysis of heart rate variability (Blood pressure and
body temperature dynamic control systems and respiration relationship to heart rate variability), Ergonomics, Vol.16, pp.17-32, 1973.
8.http://www.biocomtech.com, Biocom Technologies.
9.Marek, M., “Heart rate variability, European heart journal, pp.354-381, 1996.
10.Ewing,D.J.,Martin,C.N.,Young,R.J.,Clarke,B.F., The value of cardiovascular autonomic function tests: 10 years experience in diabetes, Diabetic Care,Vol.8,No.5,pp.491-498, 1985.
11.Karim, N., Hasan, J. A., and Ali, S. S., “Heart rate variability – a
review, Journal of Basic and Applied Sciences, Vol.7, No.1, pp.71-77, 2011.
12.Schutte-Rodin, S., Broch, L., Buysse, D., “Clinical guideline for the evaluation and management of chronic insomnia in adults, Journal of Clinical Sleep Medicine, Vol.15, pp.487-504, 2008.
13.Ford, D.E., Kamerow, D.B., “Epidemiologic study of sleep disturbances and psychiatric disorders: an opportunity for prevention? Japan Automobile Manufacturers Association , Vol.262, pp.1479–1484, 1989.
14.Yang, A.C., Tsai, S.J., Yang, C.H., Kuo , C.H., Chen, T.J., Hong, C.J., “Reduced physiologic complexity is associated with poor sleep in patients with major depression and primary insomnia, Journal of Affective Disorders, Vol.131, pp.179-185, 2010
15.Chen, C.W., Yang, C.M., “Etiological model of insomnia and therapeutic factors of cognitive-behavioral therapy for insomnia: The correspondence of theories and practices, Archives of Clinical Psychology, Vol.3, No.1, pp.1-12, 2006.
16.Richardson, G.S., “The human circadian system in normal and disordered sleep , Journal of Clinical Psychiatry, Vol.66, pp.3-9, 2005.
17.Bonnft, M.H., Arand D.L., “Heart rate variability in insomniacs and matched normal sleepers, Psychosomatic Medicine, Vol.60,pp.610-615, 1998.
18.Park, D.H., Shin, C.J., Hong, S.C., Yu, J., Ryu, S.H., Kim, E.J., Shin, H.B., Shin, B.H., “Correlation between the Severity of Obstructive Sleep Apnea and Heart Rate Variability Indices, Korean Academy of Medical Sciences,Vol.23,No.2,pp.226-231, 2008.
19.Maslen, D. K. and Rockmore, D. N., “The cooley–tukey fft and group theory, Notices of the American Mathematical Society, Vol.48, No.10, pp.1151-1161, 2001.
20.Gough, B., “FFT algorithms, GNU Scientific Library Documentation, 1997.
21.http://www.ntsec.gov.tw/, 國立台灣科學教育館。
22.https://en.wikipedia.org/wiki/Electrical_conduction_system_of_the_heart, Wikipedia.
23.Yan, G.X., Lankipalli, R.S., Burke, J.F., Musco, S., Kowey, P.R., “Ventricular repolarization components on the electrocardiogram, Journal of the American college of cardiology, Vol. 42, No. 3,pp.401-409, 2003.
24.唐善美, “探討接受心導管檢查病人心率變異與焦慮之關係, 國立成功大醫學院護理學系碩士論文, 2004。
25.Cowan, M. J, “Measurement of heart rate variability, Western Journal Research, Vol.17, No.1, pp.32-48, 1995.
26.Mulppo, M. P., Makikallio, H. T., Takala, T. E. S., Seppanen, T., Huikuri,H. V., “Quantitative beat-to-beat analysis of heart rate dynamics during exercise, American Physiological Society, vol.271, No.1, pp. 244-252, 1996.
27.Salivahanan, S., Digital signal processing, McGraw-Hill Education, 2002.
28.http://physionet.org/physiobank/database/apnea-ecg/, physionet.
29.http://physionet.org/physiobank/database/capslpdb/, physionet.
30.蕭桂榮, “輪班護理人員的睡眠品質、壓力、疲勞與相關生理指標之探討, 長榮大學, 職業安全與衛生學系論文, 2009。
31.Bilan, A., Witczak, A., Palusin´ski, R., Mys´lin´ski, W., Hanzlik, J., “Circadian rhythm of spectral indices of heart rate variability in healthy subjects , Journal of Electrocardiology, Vol.38, pp.239-243, 2005.
32.Roche, F., Gaspoz, J. M., Court, F. I., Minini, P., Pichot, V., Duverney, D., Costes, F., Lacour, J. R., Barthelemy, J. C., “Screening of obstructive sleep apnea syndrome by heart rate variability analysis , Circulation, pp.1411-1415, 1999.
33.林慧慈, 徐榮隆, 蕭百勝, 邱泓文, “失眠的腦波與心律變異性, 台灣國際醫學資訊聯合研討會, 2008.
34.BUŠEK, P., VAŇKOVÁ, J., OPAVSKÝ1, J., SALINGER1, J., NEVŠÍMALOVÁ, S., “Spectral analysis of heart rate variability in sleep, Physiological Research, vol.54, pp. 369-376, 2005.
35.Marco, Z., “Nocturnal frontal lobe epilepsy – An Update on Differential Diagnosis with Non-rapid Eye Movement Parasomnia, T O U C H B R I E F I N G S, 2007.
36.https://ufhealth.org/electrocardiogram#prettyPhoto, UFHealth.
37.http://training.seer.cancer.gov/anatomy/cardiovascular/heart/structure.html, National Cancer Institute.
38.http://mrescience.com/life_slides_32.php#, MR. E Science.
39.http://vprd.ku.edu.tr/kusrp/analyzing-heart-signals, Analyzing Heart Signals with ECG Circuit and MATLAB Optimization
40.尤芳忞, 周銘霆, “脈聲儀系統之設計於心血管疾病檢測之應用, 台灣生物力學研討會暨國科會醫學工程學門成果發表論文集, 國立成功大學機械工程學系, 2006。