探討最佳個人化周邊至中心血壓轉換函式

中心主動脈血壓波型包含了心臟功能及周邊血管系統的相關資訊，可以做為評估心臟功能的指標，在生理上也有許多反應機制皆會影響血壓及血壓波型的變化，所以中心主動脈血壓值常被當作全身心血管健康的重要指標。在一般臨床應用上，侵入性血壓量測裝置可提供連續血壓訊號，雖然精密且準確但卻不方便在一般例行性檢查中進行。非侵入性血壓量測方法可應用於一般檢查或居家環境中，卻僅能提供收縮壓與舒張壓兩個特徵值，無法呈現完整血壓訊號的資訊。本研究之目的是藉由頻率相關的轉換函式(frequency dependent transfer function)以及自回歸外生模型(auto-regressive exogenous model, ARX)方式，分別建構出周邊血管轉換函式(transfer function, TF)，並利用周邊血管模型估算出中心主動脈血壓波型訊號。本研究可分為兩部分來實現，第一部分藉由實驗室現有的周邊非侵入性低壓力氣囊連續血壓量測系統，量測得到肱動脈和橈動脈的周邊連續血壓波形訊號，再利用系統識別方法建構出周邊血壓的數學轉換函式模型。第二部分將建構出周邊血管的數學轉換函式模型，藉由臨床的主動脈血壓波形來相互驗證，用以推展至建構周邊與中心主動脈之間關係，並進一步驗證調整周邊血壓模型來估算出中心主動脈血壓，以探討出最佳個人化周邊至中心血壓轉換函式。本研究已經成功建構出周邊血管模型，並可以藉由最佳個人化周邊至中心血壓轉換函式估算出中心主動脈血壓。然而，本研究在建構出最佳個人化周邊-中心血管模型的轉換函式，是由臨床頸動脈血壓波型訊號來評估驗證，對於實際的中心主動脈血壓波型有可能會有些許差異，未來或許可以藉由侵入性的量測方法取得中心主動脈血壓波型來做進一步的驗證。

關鍵字

周邊血管轉換函式模型；自回歸外生模型；頻率相關的轉換函式

並列摘要

The central aortic pressure waveform contains the information about cardiac function and peripheral vascular system is an indicator for clinical evaluation of heart functions. Many of the physiological response mechanisms also affect the blood pressure and waveform, thus, so the central aortic blood pressure is frequently used as an important indicator of cardiovascular health. In clinical practice, invasive blood pressure measurement devices can provide continual blood pressure signal. Although these invasive devices are precise and accurate, they cannot be used in routine inspection. On the other hand, the non-invasive blood pressure measurement method can be applied in routine healthcare examination. However, most of these noninvasive devices can only provide the systole and diastole blood pressure readings. The purpose of this study is to construct peripheral vessel transfer function by frequency dependent transfer function and auto-regressive exogenous model (ARX model).The peripheral vascular model, is used to estimate the central aortic blood pressure waveform. This research can be divided into two parts: The first part is, to measure the brachial and radial artery pressure waveforms, using the non-invasive continuous blood pressure device, to construct peripheral transfer function by system identification method. The second part is to construct and valid the mathematical model of peripheral vascular transfer function using the aortic pressure waveform obtained by clinical devices. The result is extended to establish the relationship between peripheral and central aorta waveform. Furthermore, this study verifies the adjustment of peripheral vascular mathematical model to estimate the central aortic blood pressure. Finally, the optimal personal peripheral to central blood pressure transfer function is found. This study has successfully established a peripheral vascular model, and estimated the central aortic blood pressure using the optimal personal peripheral to central blood pressure transfer function. However, the optimal personal peripheral to central blood pressure transfer function is established using clinical carotid artery blood pressure waveform during evaluation. It is possible that there is a little difference between actual central aortic blood pressure and carotid artery blood pressure waveform. Nevertheless, in the future, it is possible to validate the result using invasive central aortic pressure waveform.

並列關鍵字

frequency dependent transfer function ； peripheral vascular transfer function ； auto-regressive exogenous model (ARX model)

參考文獻

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探討最佳個人化周邊至中心血壓轉換函式

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