- 學位論文
利用PVR波形評估動脈總順應性
Accessing Total Arterial Compliance Using Pulse Volume Recording Waveform
摘要
近年來由於血管硬化所直接或間接引起之心血管疾病患者日益增加。而臨床上常以脈波傳導速度（PWV）作為評估血管硬化程度之參考指標，但其使用上的便利性並不高。本研究以非直線函數之指數型壓力─體積關係與Windkessel model為理論基礎，利用血壓波形中舒張末期之衰減常數及血管阻抗（R）估算非侵入式連續搏動容積紀錄（PVR）之動脈順應性，評估其結果與侵入式主動脈血壓波形之動脈總順應性（TAC）之間關係。並以Zhaorong等學者利用直線函數之壓力─體積關係所估算之動脈順應性及上臂─腳踝脈波傳導速度（baPWV）兩者對本研究所估算之結果進行驗證。結果顯示本研究利用衰減常數與血管阻抗估算動脈順應性之方法可得到與Zhaorong等學者提出之方法所估算之動脈順應性結果呈高度相關的數值（評估侵入式主動脈、上臂動脈血壓波形，及非侵入式連續搏動容積紀錄三者動脈順應性的相關係數分別為0.9639、0.9641、0.9498）；本研究利用衰減常數與血管阻抗估算動脈順應性之方法可利用非侵入式連續搏動容積紀錄評估動脈總順應性，其數值與侵入式主動脈總順應性之間相關性為0.8828。由以上結果得知，利用非侵入式連續搏動容積紀錄之衰減常數可用來估算動脈順應性、評估血管硬化程度。
並列摘要
Recent studies have shown that patients who have atherosclerosis would increase the risk of cardiovascular disease directly or indirectly. Nowadays, the pulse wave velocity (PWV) was used as an index for assessing the level of atherosclerosis in clinical. However, the general practice was inconvenience enough for its purpose. A better assessing method was proposed to improve its clinical feasibility. This study was based on the exponential decay function of diastolic blood pressure waveform with the pressure-volume relationship and the two-elements Windkessel model. The compliance of non-invasive continuous pulse-volume recording (PVR) was estimated by the decay constant of diastolic blood pressure waveform and the resistant (R) of vessel. The relationships between the decay constant, the estimated compliance and the total arterial compliance (TAC) were assessed. The method of compliance calculation based on linear pressure-volume relationship by Zhaorong et al. and the result of brachial-ankle pulse wave velocity (baPWV) were employed to validate the result of this study. The correlation coefficients between the compliance estimated by different methods of invasive aortic blood pressure waveform, invasive brachial blood pressure waveform, and non-invasive continuous pulse-volume recording are 0.9639, 0.9641, and 0.9498 respectively. The result shows that the proposed method could be used to estimate arterial compliance accurately. The correlation coefficient between the compliance of non-invasive PVR and the total arterial compliance of aortic artery is 0.8828. This means that using the decay constant and the resistance of non-invasive pressure-volume recording could be used to estimate the total arterial compliance and assessed the level of atherosclerosis.