生理律動分析系統之研發與應用

The Development and Application of an Analysis System for Physiological Rhythms

郭博昭(Terry Bo-Jau Kuo)

《慈濟醫學雜誌》 13卷2期 (2001/06) Pp. 113-129

https://doi.org/10.6440/TZUCMJ.200106.0113

摘要

十年前，全世界醫學界對於生理訊號的短期律動仍然陌生。這些律動約3秒至10秒發生一次，普遍存在於血壓和心跳內，但由於分析方法尚未成熟，只有少數實驗室能以特殊的電腦程式進行研究。當時這些律動的重要性很難受到學界和一般大眾的認同。作者1990年開始研究生理訊號短期律動，同時設計分析系統。系統之軟體架構分為四大部份，包括基礎輸入輸出、訊號處理、圖形數值輸出與時程控制四部份，雛形在1990年已大致確定，之後十年針對特定功能加入程式碼。首先在1991年完成頻譜分析程式，它能分離並定量藏於血壓、心率、肌電波、腦電波，甚至神經放電中的規律變動。1997年後作者進行雙生理律動轉換函數的程式設計，並剛成了可程式化電刺激器之軟體與硬體、類比數位轉換器和可程式化呼吸控制器等。經由這些軟硬體的應用，完成了多項動物實驗探討兩特定生理訊號在頻率領域的相關性。1996年設計了腦血流律動分析程式，並在臨床學者協助下完成人體實驗，研究非侵體評估腦血管自調節功能的可行性。同時期本系統也於公共衛生研究，作者設計了一個心電收集器，以此測量了三千餘人的心電圖進行心率變異性分析，探討性別和年齡對自主神經功能的影響。本系統發展至今超過十年，作者撰寫了四萬行以上的程式碼並製造了數十種電子線路，相關的應用已衍生了超過四十篇的學術論文。更重要的是研究夥伴和作者將原本大家都陌生的知識和技術，在十年間成功的引生物醫學領域並善盡其用。目前本系統已能分析多種生理律動下列種種應用，包括：(1)麻醉深度偵測。(2)感壓反射評估。(3)自主神經活性之測量。(4)腦死判定。(5)重症預後判定。(6)換心排斥偵測。(7)神經老化評估。(8)腦血管功能評估。(9)高血壓病因探索等。相關機轉與潛在應用仍在持續研究。

關鍵字

波動 ； 變異性 ； 時域 ； 頻域

並列摘要

Ten years ago, little was known about short-term rhythms of physiological signals. These rhythms had a period of around 3 to 10 seconds, and were broadly found in blood pressure and heart rate signals. Because of a lock of analytical tools, only a small fraction of physiological laboratories could study them with specially designed computer programs. It was difficult for investigators, as well as the general population, to appreciate the importance of these rhythms. I started research on physiological rhythms in 1990, and designed an analytical system for the computer. The program was constructed in four parts, basic input-output, signal processing, graphical and numerical output and timing control subsystems. The prototype was finished in 1990, and was frequently revised to offer specific features. Power spectral analysis was first incorporated. It separated and quantified periodical variations in arterial pressure, heart rate, electromyogram, electroencephalogram and even neuronal activity. I designed a computer program for transfer function analysis of paired physiological signals and constructed programmable electric stimulators, analog-digital converters and programmable ventilators since 1994. With the applications of the hardware and software, a number of animal experiments were done to explore the frequency-domain relationship of two specific biological signals. In 1996, I started to design a cerebral blood flow analysis program. With the cooperation of clinical investigators, we performed human experiments to test a new protocol to detect the cerebral autoregulation function non-invasively. At the same time, the analysis system was applied in the field of public health. I designed an electrocardiogram (ECG) acquisition device by which ECG signals of 3,000 more people were collected to analyze heart rate variability. Since ten years ago, I had written more than 40,000 lines of program codes, and constructed tens of electric circuits. More than 40 research papers have been derived from this system. More important, my colleagues and I have successfully generalized the knowledge and techniques of physiological rhythms into various fields of biomedical sciences. The analyses of physiological rhythms have provided the following applications: (1) detecting depth of general anesthesia. (2) detecting baroreflex sensitivity. (3) detecting autonomic activities. (4) diagnosis of brain death. (5) outcome prediction of critical illness. (6) detection of rejection of transplanted hearts. (7) evaluation of aging. (8) evaluation of cerebrovascular functions.(9) study of essential hypertension. The underlying mechanisms and potential applications warrant further invstigation.

並列關鍵字

fluctuation ； variability ； time domain ； frequency domain