整合心音及心電圖訊號於心臟衰竭之評估

Integration of Heart Sound and Electrocardiogram in the Evaluation of Heart Failure

陳冠瑋(Kuan-Wei Chen)

指導教授 ： 翁清松

中原大學/工學院/生物醫學工程研究所/碩士(2010年)

https://doi.org/10.6840/cycu201000836

摘要

本研究之目的為開發一套心音心電量測系統，擷取人體之心音及心電圖訊號，以輔助診斷心臟衰竭。以兩種Framingham心臟衰竭診斷之主要標準，分別為心音奔馬律及左心室肥大作為判別準則。
本研究心音利用電容式麥克風擷取，並利用演算公式來推算是否有心音奔馬律；心電圖採胸導程方式擷取V1、V5及V6之訊號，根據Sokolow標準來推算是否有左心室肥大。兩者訊號截取皆為非侵入性，進而節省時間及醫療成本，來有效的輔助診斷是否有心臟衰竭跡象。
系統裝置部分，心音及心電之類比電路皆進行放大及濾波，再結合TI MSP430微控制器進行12 bit ADC及UART。最後使用資訊傳輸控制晶片PL-2303HXD，以USB傳輸將數位訊號送至電腦做訊號處理。實驗部分，各蒐集15位心臟衰竭病患和健康成年人，藉由本系統擷取所需之特徵參數，而後透過t-test分析找出病患與正常人之差異性。
結果顯示，本系統可有效擷取出心音與心電之參數值。臨床方面，在參數統計上病患與正常人相比有較高R波與S波之振幅，與心音奔馬律之發生，進可推得受測者罹病與否。證實整合心音及心電圖訊號量測，在醫用輔助診斷及居家自我監測方面之應用是具有可行性的。

關鍵字

心音奔馬律 ； 左心室肥大 ； 心音 ； 心電圖 ； 心臟衰竭

並列摘要

The purpose of this research was to develop a Phonocardiogram(PCG) and Electrocardiogram(ECG) measurement and analysis system, and we could measure PCG and ECG singnals to diagnose heart failure. We used two major of Framingham criteria which are gallop rhythm and left ventricular hypertrophy(LVH).
In this study, we used electret condenser microphone to measure heart sound, and we examined LVH by using V1, V5 and V6 according to Sokolow criteria. With non-invasive examination through PCG and ECG, we could save time and medical cost, and auxiliary diagnosis of heart failure in effect.
Regarding to hardware, PCG and ECG signals were proceeded amplification and filtering, and we use TI MSP430 to proceed 12 bit analog-to-digital converter and Universal Asynchronous Receive/Transmit. Finally, we used PL-2303HXD data communication controller to transfer digital signal to computer. In the clinical experiment, fifteen heart failure patients and fifteen healthy adults without cardiovascular disease were recruited, we measured subjects PCG signal and ECG signal by the PCG and ECG parameters measuring instrument, and used the signal analysis interface to get the characteristic parameters. The study used t-test analysis to find the difference between heart failure patients and healthy adults.
The results showed that the PCG and ECG parameters could be obtained effectively from human bodies by the instrument and signal analysis. In clinical observation about ECG parameters, we found that the heart failure patients had higher values in Sv1, Rv5 and Rv6; In clinical observation about PCG parameters, we found that the heart failure patients had occurrence gallop rhythm. Therefore, it was feasible to apply the combination of Phonocardiogram and Electrocardiogram measurement for auxiliary diagnosis and self-monitoring of heart failure.

並列關鍵字

left ventricular hypertrophy ； Phonocardiogram ； Electrocardiogram ； gallop rhythm ； Heard failure

參考文獻

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