研究生: |
劉人銘 Jen-Ming Liu |
---|---|
論文名稱: |
循環量測應用於服用高血壓藥物患者之研究 Study of noninvasive circulatory measurements by applying different anti-hypertensive drugs |
指導教授: |
許昕
Hsin Hsiu |
口試委員: |
廖愛禾
Ai-Ho Liao 鮑建國 JIAN-GUO BAU 劉如濟 Ju-Chi Liu 許儀彬 Yi-Ping Hsu |
學位類別: |
碩士 Master |
系所名稱: |
應用科技學院 - 醫學工程研究所 Graduate Institute of Biomedical Engineering |
論文出版年: | 2018 |
畢業學年度: | 106 |
語文別: | 中文 |
論文頁數: | 76 |
中文關鍵詞: | 高血壓 、高血壓藥物 、血管張力素轉化酶抑制劑 、Beta受體阻斷劑 、循環量測 、動脈血壓波形 、光血容積訊號儀 、雷射都卜勒血流儀 |
外文關鍵詞: | Hypertension, Anti-hypertensive drugs, Angiotensin converting enzyme inhibitor, Beta-blocker, Microcirculation, Blood Pressure waveform, Photoplethysmograph, Laser Doppler Flowmetry |
相關次數: | 點閱:213 下載:0 |
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高血壓是最普遍發生且最容易被忽略。在台灣地區,20 歲以上民眾,平均約每4個人就有一個人患有高血壓。而高血壓是許多心血管疾病的危險因子[3],例如中風、心肌梗塞、先天性心臟病、末期腎臟疾病等,若血壓控制不當,很可能引發心肌梗塞、中風及心臟衰竭等致命性疾病上身。因此研究高血壓及對於心血管疾病的關係是迫切需要,且濫用藥物,可能導致人體的肝腎功能損傷或增加副作用[4][5],所以用藥對於追蹤也是勢在必行。
雖然血壓機是很普遍的居家醫療儀器,只能反映血壓值的高低,無法反映生理上細微的變化,這可能減損量測於藥物效果偵測的實用性。醫師會藉由每半年檢查報告來觀察副作用的造成生理損傷,雖然詳細,但沒有即時監控的效果。本研究藥物選擇為A類藥物(Angiotensin-recepter blocker),與為B類藥物(β-blockers)做比較,驗證此本實驗室自行開發的系統對於高血壓藥物作用的解析能力,期望能即時監控藥物作用達到提升高血壓患者生活品質,醫生方面也能因應不同病患的做出用藥評估。
本實驗室所開發之微循環量測系統所包含的設備有心電圖訊號放大器(ECG)、動脈血壓波形模組(BPW)、光血容積訊號儀(PPG)、雷射都卜勒血流儀(LDF),分別可量測到心臟端、動脈端、動脈端與部分微循環端及微循環端。受測者分為A、B兩組:A組為A類藥物(Angiotensin-recepter blocker)、B組為B類藥物(β-blockers)。
LDF 時域分析、LDF 時域分析各項變異度、LDF頻域分析及BP、PPG諧波走勢皆能看出A組與B組的差異,代表此量測系統對高血壓藥物的作用有解析能力,可看出對周邊循環的副作用造成的傷害、藥物效果。不同的指標可以看到許多層面如:上、中、下游端、血流面、調控程度面、生理機制,從不同的角度去觀察,並提供醫師或達到療程即時監控的目的、客觀評估、治療方法的選擇等等的效益,患者對於不適的副作用,也能降低內心所產生的擔憂與恐懼。
Hypertension is one of the most common and most easily overlooked ailments. In Taiwan, on average, about one in four people over 20 years old suffers hypertension. Hypertension is a risk factor for many cardiovascular diseases [3], such as stroke, myocardial infarction, congenital heart disease, and terminal renal disease. If blood pressure is not properly controlled, it may cause fatal diseases such as myocardial infarction, stroke and heart failure. Therefore, it is urgent to study the relationship between hypertension and cardiovascular disease. At the same time, drug abuse may lead to liver and kidney function damage or increase the risk of side effects, so it is necessary to track drug uses.
Although the blood pressure machine is a very common home medical instrument, it can only reflect the level of blood pressure, and cannot reflect the subtle, physiological changes, which may reduce the practicality of measuring the effect of the drug. The physician will use the semi-annual examination report to observe the physiological damage caused by side effects, which is detailed, but there is no immediate monitoring effect. The study compared class A drugs (Angiotensin-recepter blocker) with class B drugs (β-blockers) to verify the analytical capability of the system self-developed by this laboratory for the effect of hypertension drugs. We expect to achieve immediate monitoring of drug effect to improve the quality of life of patients with hypertension. Doctors can also evaluate drugs for different patients.
The devices in the microcirculatory measurement system developed by our laboratory includes ECG, BP, PPG, and LDF, which can respectively measure the heart, arteries, arteries and some microcirculation, and microcirculation. Subjects were divided into 2 groups: the A group is with A drugs (Angiotensin-recepter blocker) while the patients in the B group with B drugs (β-blockers).
LDF time domain analysis, LDF time domain analysis variability, LDF frequency domain analysis and BP, and PPG harmonic wave trend can be used to tell the difference between group A and group B, implying this measurement system can analyze the effects of hypertension drugs, and can measure the damage on peripheral circulation caused by the side effects of high blood pressure drugs and the drug effects of high blood pressure drugs on peripheral circulation. Different indicators can reflect many levels such as: upper, middle and lower end, blood flow, degree of regulation, physiological mechanism so that it is possible to observe from different angles, providing benefits such as helping physicians achieve immediate monitoring of treatment, objective assessment, and selecting treatment method. The patients can have less concern and fear about discomforting side effects.
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