利用光體積描記法訊號與洗腎病患透析血管體積流速之關聯性來預測評估血液透析併發症之產生

Abstract

台灣目前的洗腎人口密度為全球最高，總洗腎人數高達七萬多人，主要是起因於不良的用藥習慣、濫用各式偏方、人口高齡化和糖尿病等因素，再加上台灣為已開發國家，在這樣多方的壓力下，生活習慣和飲食習慣都會受到影響，甚至會有濫用藥物的問題。在這樣可預期的惡性循環下，未來洗腎人數只會增加不會減少。因此，本研究目的是藉由非侵入式的光體積描記法感測器來即時監控接受自體動靜脈廔管或者是人工動靜脈廔管的末期腎臟病患的血管通路的血流狀態，研究光體積描記法感測器所收到的訊號與血流量之關聯性，進而透過血流變化早期偵測出血管通路失能（如血管狹窄及血管栓塞）。進而維持或改善末期腎臟病患的生活品質，未來希望能延伸應用於正常人身上來及早預防慢性腎臟病變。根據初步的臨床實驗結果，光體積描記法感測器三個波長下的血管體積流速已能與標準儀器的血管體積流速建立不錯的相關性，且其相關性有顯著性。未來會繼續優化演算法以達更高的相關性及顯著性，使得病患未來能夠自行居家監測，提高病患的生活品質。

The population of hemodialysis in Taiwan is the highest in the world. With a total number of more than 70,000 people, mainly due to poor medication habits, abuse of all kinds of remedies, population aging and diabetes and other factors, coupled with Taiwan has been a developed nation. Under such pressure, living habits and eating habits will be affect, and even abuse of drugs. In this predictable vicious cycle, the number of hemodialysis patients will only increase but not reduce. This study aims to study the correlation between photoplethysmography signal and blood flow of end- stage of the chronic kidney diseases patients with vascular access whether arteriovenous fistulas or arteriovenous grafts for early diagnosis of hemodialysis complications. Prevention of vascular access complications, such as vascular stenosis and vascular thrombosis, and thus to maintain or improve the quality of life of patients with end-stage chronic kidney diseases, I hope to extend the application to normal people for prevent chronic kidney disease in the future. According to the preliminary clinical results, the blood flow velocity of blood vessels at three wavelengths of the photoplethysmographic sensor has been able to establish a good correlation with the blood flow velocity of blood vessels measured by the standard instrument, and its relevance is significant. In the future we will continue to optimize the algorithm to achieve higher correlation and significance, making the patient in the future to self-home monitoring, improving the quality of life of patients.