| 摘要: | 根據世界衛生組織(World Health Organization, WHO)公布心血管疾病是位居全球最大死因之一，由於其症狀驟然發生且不可預期，因此居家醫療器材的輔助可以降低對生命造成的威脅。心電圖(Electrocardiogram, ECG)和心臟超音波(Echocardiography)是目前診斷心臟病理的兩種主要非侵入式方法，心電圖利用心臟電位變化找出心臟傳導異常或缺血區域，雖然心電圖已有許多便攜式的機型產生，但心臟結構異常，如：心室中隔缺損(Ventricular Septal Defect, VSD)或心臟瓣膜閉鎖不全(Valvular Heart Disease)等疾病還是需心臟超音波方可判別，且心臟超音波仰賴專業人員操作難以普及化，而反觀心音圖(Phonocardiogram, PCG)可透過數位記錄心臟收縮時，血流經過或撞擊不同心臟區域的聲音，在結構異常時會產生異常雜音，因此若能搭配訊號分析，有潛力做為心臟結構異常的篩檢工具。本研究提出一款可攜式非侵入性並整合十二導程心電圖及聲學雙系統之設計，藉由兩種系統的整合與居家檢測(Point-of-care, POC)的概念，將更容易且有效提前預防心臟是否衰竭及各項心臟疾病。在未來應用不僅僅只限於大型醫院或加護病房等，也可推展於小型醫療機構、戶外急救單位及普遍家庭，實現即時且普及的生理訊號監測系統。
本系統架構分為兩大部分，第一部分是量測十二導程心電圖電路，由類比數位轉換器(Analog／Digital Convertor, ADC)、微處理器(Microprocessor, MCU)及電源供應端(Power Supply)組成。第二部分為心音類比電路之設計，經類比電路端解析訊號後由微處理器之類比數位轉換器收錄，利用通用非同步收發傳輸器(Universal Asynchronous Receiver/Transmitter, UART)、藍芽(Bluetooth, BT)與外掛安全數位卡模組(Secure Digital Memory Card, SD Card)傳送或儲存到電腦進行分析及計算，搭配Python、Matlab等程式收錄原始訊號進行處理，分別即時顯示並同步分析得到心電圖及心音圖訊號，進行比對及系統設計驗證。;According to the World Health Organization (WHO), cardiovascular diseases are still one of the leading causes of death worldwide. Although, we can reduce this rate with the assistance of portable diagnostic devices. Electrocardiogram (ECG) and Echocardiography are currently the two non-invasive methods of diagnosing cardiac disease. ECG uses heart potential changes to find out the defective part of the atrium and ischemia. Although ECG have been produced by many portable products, but abnormal cardiac structures such as ventricular septal defect (VSD) or valvular heart disease still need Echocardiography to determine. Owing to Echocardiography depends on the operation of professionals. In contrast, Phonocardiogram (PCG) can digitally record the sound of blood flow or hitting different heart regions when the heart contracts. Abnormal noise heart sound will be generated, so if it can be combined with signal analysis, it has the potential to be used as a screening for abnormal heart structure tool. This study proposes a portable non-invasive device that integrates 12-Lead ECG and PCG into one system. Integration of the two systems and point-of-care (POC) conception can provide an easier and effective way of detecting various heart diseases.
This system is divided into two major parts. The measurement of the signal using a 12-Lead Electrocardiogram circuit and the design of an analog circuit of the heart sound. After the signal is analyzed by an analog circuit, it is recorded by an analog-to-digital converter. Universal Asynchronous Receiver/Transmitter (UART), Bluetooth (BT), and Secure Digital Memory Card (SD Card) are used to send or store the recorded signal for further analysis and calculation. The raw data are collected and processed using programming software to real-time display ECG and PCG signals for comparison and system design verification. |
