第 46 筆
國家圖書館索書號: 系統編號: 82YM003521001
　　　　　研究生: 陳宗瀛 Chen, Chung-Yin
(以研究生姓名查詢國家圖書館索書號 ，未查獲者表國圖尚未典藏)
(以研究生姓名查詢國科會科資中心微片資料庫)
(連結至全國圖書聯合目錄)　 (連結至政大圖書館館藏目錄)
　　　　論文名稱: 急性心肌梗塞患者之橈動脈脈波頻譜研究
　　　　論文名稱: Spectral analysis of radial pulse wave in patients with
acute myocardial infarction
　　　　指導教授: 王唯工 Wang, Wei-Kong
金鏗年 Ching, King-Nien
　　　　學位類別: 博士
　　　　校院名稱: 國立陽明大學
　　　　系所名稱: 臨床醫學研究所
　　　　　學年度: 82
　　　　　語文別: 中文
　　　　　關鍵字: 醫學 MEDICINE
心肌梗塞
橈動脈
全文影像: (依著作權法相關規定，以下全文影像僅限國家圖書館館內下載)
封面
中文摘要
英文摘要
第一章緒論
第二章血管循環系統與共振理論--血液分配與灌注
第三章傅立葉轉換與動脈壓脈波頻譜研究之文獻回顧
第四章急性心肌梗塞與有效性腎血漿流量研究
第五章急性心肌梗塞患者橈動脈脈波頻譜研究
第六章結論
參考文獻
[摘要]
研究背景。根據我的指導老師王唯工教授觀察液體動態模型的運作及結果，(按：楊順聰老
師在小白鼠尾動脈所作的乃研究提供了此一液體動態模型確定的動物實驗證據 )，提出一
個理論：主動脈與相聯接的內臟器官之間可以形成相互共振。因此，理論上來看該系統與
心臟其實組成一個完整的共振迴路。我們十分想知道：這種理論與實際運作功能是否可在
臨床領域中證實？
初研究理念。本研究構思實來自於楊順聰老師的動物實驗結果。在他的動物實驗中，楊老
師發現即夾即放左側腎動脈或上腸繫膜動脈會改變小白鼠尾動脈脈波的頻譜分析。因此，
我們即思考在臨床上有那一種疾病或疾病狀態可能短暫的改變與主動脈相連的內臟器官的
血管阻力(或阻抗)與血 流。當然這部分血管阻力或血流的變化必須可用某一檢驗 室方法
來偵測得知。然後，我們期待就像在楊老師的動物 實驗一樣，某特定內臟之血管阻力或血
流量的改變，會反映 在患者橈動脈脈波的頻譜分析(藉離敬傅立葉轉換之助)。
研究方法。根據研究理念，我們分成兩階段來進行該研究。首先，我們藉用標記I-131的
iodo-ortho-hippurate 靜脈注射而在準44分鐘後自另一處抽血來測定有效性腎 血漿流量
的核子醫學檢查來研究急性但無併發症 (Killip 第一型)心肌梗塞後有效性腎血漿流量的
變化。再系列性測定心房利鈉激素或鏈胜以研究有效性腎血漿流量的變化是否與此相關。
其次，我們每日記錄急性但無併發症急性。、肌梗塞患者右手橈動脈脈波，並藉用離散傅
立葉轉換來分析是項動脈脈波之能量頻譜。這項動脈脈波能量頻譜分析更包括了三組無心
肌梗塞患者作為參考基準。
研究結果。從第一部分的研究過程，我們有下列三項結果：
(1)在12例無心肌梗塞而僅住院接受冠狀動脈攝影檢查之冠心症患者，我們證實藉用I-131
iodo-ortho-hippurate測定有效性腎血漿流量之再生性良好，係一有效且方便的檢測方法
。
(2)急性但無合併症之心肌梗塞發生後，患者都表現有短暫性有效性腎血漿流量增力加的現
象；
(3)上述這種短暫性有效性腎血漿流量增高，至少有一部份的原因是因於急性心肌梗塞後心
房利鈉激素或鏈胜升高的結果。
而在第二部分的研究中，我們有了以下的觀察結果：
(1)急性但無併發症之心肌梗塞後之當時，患者橈動脈脈波能量頻譜之諧頻CO會暫時降低(
雖然不具統計學有意義的降低 )，而逐漸隨心肌梗塞的恢復而回復與無心肌梗塞患者相匹
配的程度；
(2)在急性但無併發症之心肌梗塞後之當時，橈動脈波能量頻譜中諧頻C2與C3之百分比程
度(Percentag intntensity of co)會呈現短暫性的降低；而後隨急性心肌梗塞的逐日恢復
而回復其與無心肌梗塞患者相匹配的水準；
(3)急性心肌梗塞後，橈動脈脈波能量頻譜中諧頻C2與C3之百分比程度之短暫性降低與急性
心肌梗塞後有效性腎血漿流量之增加呈現有統計學意義的反向相關。
結論。Selwyn指出，局部組織或器官的血流量實在是判定該組織或器官功能正常或疾病的
重要指標。他曾藉正子閃爍電腦斷層掃描與標記C-12之人類自蛋白來偵測各重要器官，如
：腦.肝.心...等局部臟器血流。本研究可能是第一次提供數據證實急性但無併發症心肌梗
塞後有效性腎血漿流量會有短暫性升高而後逐漸降低的變化，可能是局部血管阻力減低的
結果。而心房利鈉鍊胜之短暫性升高可能是有效性腎血漿流量升高的主要因素或眾多因素
之一。而有效性腎血漿流量短暫性升高可能反映在動脈脈波能量頻譜中短暫性降低其百分
比強度之諧頻c2與c3。這個觀察事實上是首次有臨床數據顯示內臟血管阻力或血流的改變
可由往傅立葉轉換得到之動脈脈波能量頻譜分析中偵知。而這項觀察結果不但提供王老師
之液體動態模型有臨床證據，並支持王老師的理論：與主動脈相連的臟器可與主動脈形成
共振，而全一系統實乃一個共振迴路。臨床應用。本研究之臨床實用性有二：
(1)檢視動脈脈波能量頻譜分析中之諧頻C2與C3百分比強度，可作為監視急性但無併發症心
肌梗塞病程恢復順利與否之指標。
(2)急性但無併發症心肌梗塞發生後，腎血管叢對於交感神經興奮度增加的反應不同；而此
項相異的反應應與心肌梗塞後心房利鈉激素之增加相關。
Background. According to Wang et al's observation from the operation of their
dynamic fluid model, which has been further demonstrated by the Young et al's
animal study, that aorta and closely linked internal organ may cause coupled
oscillation and theoretically this integrated system together with the heart
is actually acting physiologically as a resonance circuit. We are wondering
whether this theoretical model and its function is really existing and can be
demonstrated clinically.
Rational.The idea of the study is actually from Young et al's animal
observation that briefly clamping the renal artery or the supramesentery
artery might change the power spectrum of tail arterial pulse of rat.
Therefore, we have to seek a disease condition or state which may alter the
vascular resistance or plasma flow of one internal organ which linked to
aorta, and certainly this alteration should be able to measure with existing
laboratory technique. Then, we hope we are able to see this alteration of
vascular resistance or plasma flow of this specific internal organ in the
power spectrum of patient's radial pulse derived from discrete Fourier's
transformation.
Method.The whole study is now dividing into two steps. Firstly, we are using
intravenous injection of 1-131-iodo-ortho-hippurate to measure the effective
renal plasma flow immediately after and one week after acute but uncomplicated
myocardial infarction in 17 patients. Serial measurement ofatrinatriuretic
peptide of these patients was also carried out to demonstrate whether or not
it is attributing to the alteration of effective renal plasma flow after
myocardial infarction. Secondly, we recorded the radial pulse of all these
patients with acute but uncomplicated myocardial infarction non-invasively
everyday for ten days , and studied the power spectrum of pulsewaves derived
by discrete Fourier's transformation. Three more groups of patients who are
not having myocardial infarction were as control for comparison.
Results. In the first part of the clinical study we demonstrated followings:
(1) the good reproducibility of effective renal plasma flow by using I-131-
iodo-ortho-hippurate isotopes in 12 control patients, and proved this
technique is useful and effective;
(2) the initial elevation of effective renal plasma flow immediately after
acute but uncomplicated myocardial infarction, reduced a week later; and
(3) the early elevation of atrinatriuretic peptide after myocardial infarction
may, at least partly, contribute to the initial elevation of effective renal
plasma flow.
In the second part of this clinical study we have the following observations:
(1) immediately after acute but uncomplicated myocardial infarction, the
patient may show lower intensity of harmonics CO of the power spectrum of
radial pulse, although statistically insignificant, and the intensity may
gradually return to the level compatible to those patients who did not have
acute myocardial infarction;
(2) immediately after myocardial infarction, both the harmonic C2 and C3 show
lower (statistically significant) in percentage intensity of the average
intensity of radial pulse, the CO, and gradually increased along with the
recovery of the disease in a few days;
(3) the initial drop or reduction of the percentage intensity of both harmonic
C2 and C3 of the average intensity of radial pulse, the CO, reversely
correlates with the initial elevation of the effective renal plasma flow with
statistically significant p value;
Conclusion. As Selwyn pointed out in his study of regional blood flow
distribution after acute myocardial infarction, using ll-C labeled human
albumin microsphere and PET scanning technique, that blood flow in regional
tissue is a critical determinant of function in health and disease. We are
probably the first to demonstrate that the effective renal plasma flow does
transiently increase after acute but uncornplicated myocardial infarction (
most likely due to the reduction of regional vascular resistance). The
transient elevation of atrinatriuretic peptide may play an important role for
this transient increase of effective renal plasma flow but does not alter
renal function, urine and plasma electrolytes or the urine amount. And this
transient increase of effective renal plasma flow can reflect on to the power
spectrum --reduction of the percentage intensity of both harmonic C2 and C3 --
of radial pulse, using discrete Fourier's transformation. These clinical
observations provide further related evidence in support of the finding of
dynamic fluid model and Wang's theory that aorta and closely organs may cause
coupled oscillation, and the structure is equivalent to a resonance circuit.
Clinical Implication.The clinical implication of this clinical study at this
moment can be twofold:
(1) non-invasive recording of radial pulse may be useful to monitor the
recovery of acute but uncomplicated myocardial infarction by checking the
percentage intensity of harmonic C2 and C3;
(2) vascular bed of kidneys may respond differently to the enhanced sympathetic
activity after acute myocardial　infarction; and this unusual response may be
related to the release of atrinatriuretic peptides.

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第 47 筆
國家圖書館索書號: 410.35 010M 82-13 系統編號: 81YM003530003
　　　　　研究生: 林慶波 Lin, Ching-Po
(以研究生姓名查詢國家圖書館索書號 ，未查獲者表國圖尚未典藏)
(以研究生姓名查詢國科會科資中心微片資料庫)
(連結至全國圖書聯合目錄)　 (連結至政大圖書館館藏目錄)
　　　　論文名稱: 直流電壓在溶液中緩慢電流反應的機制
　　　　論文名稱: The mechanism of the slow current changing induced by the
DC voltage in the solution
　　　　指導教授: 王唯工 Wang, Wei-Kung
　　　　學位類別: 碩士
　　　　校院名稱: 國立陽明大學
　　　　系所名稱: 醫學工程研究所
　　　　　學年度: 81
　　　　　語文別: 中文
　　　　　關鍵字: 醫學工程 MEDICAL-ENGINEERING
直流電壓在溶液中
緩慢電流
反應的機制
[摘要]
當一個直流電壓通過含有極性分子(polar molecCule)的溶液時，溶液中會引起何種變化?
尤其是電流如何變化，這是本文探討的重心．
溶液中影響電流反應的因子很多，我們從其中選擇了三個比較重要的項目﹕溶液中polar
molecule的濃度(考量生理的因素，選擇了lactic acid)．溫度以及離子數量的多寡(選用
體內較多的離子NaCl)，以此三項作為實驗控制變因，量取電流變化的圖形，並比較分析，
以從其中得到一些訊息，來瞭解溶液中發生之變化．
結果發現，溫度對電流的變化有些微影響，離子造成的反應很大但在極短時間內便迅速衰
減，而 polar mole-cule在溶液中確實主導了某一時間內的電流反應，這在生理上是否有
意義呢?當這直流電壓加在人體上時是否也有相類似的現象?此反應是否有其生理意義?是否
與低頻電磁波能量之吸收有關?尚有待追一步的努力.
What will happen when we put a DC voltage electrode into a　solution with
polar molecule, especially the changing　of current ? This is the main point
of the article.
There are　many　factors　will　affect　the current changing in solution .
Three important factors , the concentration of the polar molecule, temperature
and the amount of the ions were manipulated. The current changing　graphs　
were analyzed to get some informa- tions about the changing of the solution.
We found that temperature has little effect on currents . The ions induced
very great but quickly decayed response . What we really interested is the the
current changing induced by polar molecule which keeps for a long time and
changes very slowly. Is it meaningful to human body ? Is there a similar
pheno- menon when we add the voltage to human body ? Does this response have
its physiological meaning ? Is this concerned with the energy absorbed of
EMF ? More studies need to be done to answer all this questions.

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第 48 筆
國家圖書館索書號: 448 001M 81-112 系統編號: 80NTU02442112
　　　　　研究生: 廖世舉 LIAO, SHIH-CHU
(以研究生姓名查詢國家圖書館索書號 ，未查獲者表國圖尚未典藏)
(以研究生姓名查詢國科會科資中心微片資料庫)
(連結至全國圖書聯合目錄)　 (連結至政大圖書館館藏目錄)
　　　　論文名稱: 共振對血壓波與血流波影響之模擬
　　　　論文名稱: The simulation of the resonance effect on blood pressure
and flow
　　　　指導教授: 王唯工 WANG, WEI-KUNG
　　　　學位類別: 碩士
　　　　校院名稱: 國立台灣大學
　　　　系所名稱: 電機工程研究所
　　　　　學年度: 80
　　　　　語文別: 中文
　　　　論文頁數: 52
　　　　　關鍵字: 血壓波
血流波
心臟血管系統
共振耦合
[摘要]
心臟血管系統的運作非常奧妙；心臟打出血液時，面對這麼多臟器，要怎麼有效的分
配到各器官呢？整個血管系統是否有一較有利的條件來配合心臟呢？
本實驗設計，將心臟血管系統簡化至心臟和一個器官的簡單系統，臟器分別用汽球，
正常的樹狀分枝管，不正常的樹狀分枝管模擬，以觀察各種不同型態 (Pattern)的器
官，各心臟提供了什麼訊息。
實驗結果顯示，在心臟血管系統間的共振耦合下，各模擬器官對心臟輸出的血液壓力
波有選擇性，且在模擬正常的樹狀分枝血管叢時，有著最明顯的頻率選擇特性；其表
現不僅在頻域的能量大小分配上，也在其相位的變換上。
共振耦合的觀念為王唯工教授所提出，而共振耦合也是心臟血管系統有效分配血液至
各器官的答案。