- 學位論文
使用橈動脈之彈性常數以作為分析動脈粥狀硬化病人血管彈性之研究
A Study of Using the Spring Constant of Radial Artery to Analyze the Arterial Elasticity of Atherosclerosis Patients
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摘要
動脈粥狀硬化是必須早期發現早期治療的疾患，才能夠提早預防心血管病變的發生，尤以此疾患又特別好發於頸動脈，若能早期發現將有助於降低疾病的嚴重程度，這些併發症也是導致成年人死亡的頭號殺手之一，因此研發能早期診斷的新技術已是當前首要之事。 本研究為以非侵入式的壓力感測器測量橈動脈之振動，並分析橈動脈壓力波波形計算其彈性常數(Spring Constant)，並將此彈性常數與醫院檢測之頸動脈超音波檢查參數及易引起粥狀動脈的危險因子(年齡、血糖、血脂肪、糖尿病、抽菸)等指標作分析。 我們共蒐集60位個案，使用二元分類之ROC (Region Of Convergence) 曲線分析圖來分析彈性常數與頸動脈參數異常者之關係，對右側頸動脈而言，進行其橈動脈之彈性常數與收縮時內頸動脈與總頸動脈之峰值血流速度比(ICA/CCA; ICA: Internal Carotid Artery; CCA: Common Carotid Artery)異常者之ROC分析，其中ROC曲線下面積(AUC: Area Under Convergence = 0.605 ± 0.077) > 0.5，顯示此工具所測得之彈性係數對右側ICA/CCA異常者具有鑑別力；對左側ICA/CCA指標而言，ROC曲線下面積(AUC=0.504 ± 0.079)為0.504 > 0.5，顯示此工具所測得之彈性係數對左側 ICA/CCA指標異常者也具有初步鑑別能力。對於彈性常數與收縮時兩側總頸動脈之峰值血流速度比(CCA)之ROC曲線分析，結果AUC為0.727 ± 0.076 (> 0.5)， 顯示彈性常數對兩側總頸動脈異常者是具有鑑別能力的。 結果顯示此彈性常數具有作為檢測頸動脈異常的可行性，並可進一步作為評估動脈粥狀硬化病人其動脈硬化的指標，能達成快速、有效檢查出動脈血管硬化，此研究結果希望可提供臨床醫療人員一項新技術，進而對非侵入式診斷動脈粥狀硬化有新的突破及提升相關醫療品質。
並列摘要
Arteriosclerosis must be detected and treated in its early stage to prevent the occurrence of cardiovascular disease. Particularly, this disease is prone to befall the carotid and coronary arteries. Early detection will help reduce the severity of the disease as the complications have caused a high mortality, so it is the prime task to develop the new technology for early diagnosis or new technique for examination at this moment. This study adopted the non-invasive pressure sensor to measure the radial artery of atherosclerosis patients, analyze the radial artery pressure waveform, and calculate the spring constant. Furthermore, the spring constant, the carotid ultrasound index detected in the hospital and atherothrombotic risk factors (age, blood pressure, blood lipids, diabetes, and smoking) were analyzed. We collected sixty cases. The binary classification of ROC curve analysis was used to analyze the relationship between the spring constant and the abnormality of carotid artery index. The area under ROC curve up to 0.605 > 0.5 (AUC= 0.605 ± 0.077) indicates that the detected spring constant is a good determinant against right ICA/CCA index. The area under the ROC curve up to 0.504 > 0.5 (AUC=0.504 ± 0.079) indicates that the detected spring constant is a preliminary determinant against left ICA/CCA index. Regarding CCA index, the area under the ROC curve increases up to 0.727 > 0.5 (AUC = 0.727 ± 0.076), and that indicates the spring constant a good discernment for carotid abnormality. The verification of such spring constant can be applied for the patients with carotid disorder. Furthermore, the spring constant can be an indicator for atherosclerosis patients. Because the spring constant is a fast as well as effective method, it is hoped that the result can be of use to medical professionals and sheds some light to non-invasive arteriosclerosis diagnosis as well as lift medical quality.
參考文獻
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