| 摘要: | 傳統檢測交感神經系統(sympathetic nervous system)的方法為心率變異度分析(Heart Rate Variability, HRV)，或是使用微神經造影技術(Microneurography)，將探針插入皮膚下交感神經末梢來檢測其變化。前者雖然在臨床上使用較普遍，但是分析心電圖(Electrocardiography, ECG)所需紀錄時間較長，且分析上不易得到交感神經之活性變化。後者雖然為臨床上交感神經量測標準之一，但是由於探針為侵入式的方法，會造成量測者一定的痛苦，並無法普遍的使用。
先前研究已提出即時且非侵入式量測交感神經活性的方法，透過量測體表上的心電圖，經由高通濾波器濾波後即可得到皮膚交感神經活性(Skin Sympathetic Nerve Activity, SKNA)。本論文提出一個有效分析SKNA訊號的方法，多尺度波動分析法(Multi Scale Fluctuation Analysis, MSFA)，以多尺度動態趨勢法為基礎，可以分析SKNA訊號在不同尺度上波動的變化。此方法利用台大醫院加護病房(Intensive Care Unit, ICU)所蒐集術後病人的ECG資料，利用Matlab 數學軟體進行分析SKNA訊號的波動變化，可以驗證術後病人在交感神經調控的差異。另外本論文也提出利用不同量測儀器來蒐集ECG資料，利用先前研究提出的實驗方法，期望能以不同儀器量測SKNA訊號。
;Traditionally, sympathetic nervous system can be measured in two ways. The gold standard is highly invasive, which is well-known as Microneurography, utilizing the tungsten microelectrode to insert percutaneously into a sympathetic nerve to detect its electric activity. Since it will cause certain pain to the subject, it is not commonly applied for clinical diagnostic. On the other hand, the analysis of Heart Rate Variability (HRV), which measures the variation of the heart beat intervals, is more commonly used. However, it requires electrocardiograph (ECG) records of a long period of time, and the indexes are less related with sympathetic activities.
Previous studies have proposed a technique for simultaneous and non-invasive measurement of sympathetic activity. By measuring the electrocardiogram (ECG) on the body surface, the sympathetic nerve activity can be obtained by filtering ECG through a high-pass filter, which is called Skin Sympathetic Nerve Activity (SKNA). The thesis proposes a novel nonstationary approach to SKNA signal investigation, referred to as Multi Scale Fluctuation Analysis (MSFA). This method, based on the Multi Dynamic Trend Analysis (MDTA), can be applied by means of analyzing the fluctuation of SKNA signal under different scales. By using the Matlab mathematical software, MSFA validates the differences in sympathetic nerve regulation of postoperative patients. On the other hand, this thesis also attempted to use different instrument to measure ECG signal in order to detect SKNA signal, other than previous studies. |
