利用心電圖探討自主神經與細胞生理之關聯性

Exploration of Relation between Autonomic Nervous system and Cellular Physiology using Electrocardiogram

黃楚勛(Chu-Hsun Huang)

指導教授 ： 胡威志

中原大學/工學院/生物醫學工程研究所/碩士(2013年)

https://doi.org/10.6840/cycu201400064

摘要

心電圖Q-T間期的電位變化反應心室的去極化開始至心室再極化結束的間期電位變化，在臨床上的症候群有Q-T間期延長症候群(QT prolongation syndrome)，目前判斷Q-T間期是否有延長現象，為將Q-T間期利用心率進行校正，然而Q-T間期與心率兩者所受到的調控方式已有不同，所以利用心率進行Q-T間期校正之方法還有待商確。
本研究的目的是評估Q-T間期與R-R間期的相關性，進而建議評估Q-T間期延長症候群(QT prolongation syndrome)的可行方法，本研究利用特徵值演算法將本研究所需心電圖的R、Q、T等特徵點擷取出來，對其特徵點時間序列進行運算，分別於時域與頻域進行分析與討論，並將其Q-T與R-R間期重新取樣，利用快速傅立葉轉換，成為頻域訊號後討論其相關性。時域部分則討論其R-R間期與校正前後Q-T間期散佈圖的相關性，頻域部分則討論R-R間期與Q-T間期時頻圖交相關圖形兩者是否有共同特徵訊號，進而評估其Q-T間期與R-R間期的相關性。
利用正常人15組心電訊號與13組腦血管疾病之病患的心電訊號所計算出來的間期時間序列，進行時域與頻域的分析。時域分析結果顯示其正常人無顯著相關性，但病人的R-R間期與Q-T間期經過心率校正後的Q-T間期之相關性顯著提高，顯示出Q-T與R-R間期無相關性，利用R-R間期做Q-T間期正規化僅能顯示Q-T間期佔一個心跳時間的百分比。頻域分析結果表示R-R間期與Q-T間期時頻圖的交相關圖形兩者無顯著相關性。綜合以上分析結果提出Q-T間期與R-R間期由於調控方式不同，兩者無論在時域或是頻域皆無顯著相關性。

關鍵字

R-R間期 ； Q-T間期延長 ； Q-T間期 ； 心電圖

並列摘要

The electrical potential of QT interval at body surface ECG reflects the depolarization and repolarization processes of the ventricular myocardium. The QT duration will undergo subtle beat-to-beat fluctuations. The most commonly clinical symptom that associates with QT duration is QT prolongation syndrome. The method of diagnosis is to determine if the QTc is prolonged. However, the inflection of QT interval and heart rate are different. The mechanism of using heart rate to normalized QT interval is questionable. The objective of this study is to evaluate the relation of QT interval and RR interval, and then suggested the methodology to assess QT prolongation syndrome (QT prolongation syndrome).
In the present study, an eigenvalue algorithm was performed to capture characteristic points of R, Q, T, and of time series. The characteristic points of time series was resampled and performed fast Fourier Transform (FFT) to transform the signals into frequency-domain, and then discussed the relationships. In time domain, the relationships between R-R interval and QT interval were discussed and showed with scatter plots. In frequency domain, the same characteristic signals between RR interval and QT interval were discovered and evaluated the relationship.
The experiment used the time period sequence of ECG signals obtained from the fifteen health people and thirteen patients with cerebrovascular diseases. The result of time domain showed there was no obvious relationship between RR interval and QT interval with health people. However, there was highly relative between uncorrected RR interval and QT interval after correcting with the heart rate. Furthermore, corrected QT interval only showed a period in an entire heart beat. The result of frequency domain showed there was no relationship in the cross-correlation diagram between RR intervals and QT intervals. According to these results present above, the inflection of QT interval and heart rate are different so that there was no obvious relationship both in time domain and frequency domain.

並列關鍵字

ECG ； QT interval ； RR interval ； QT prolongation

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