| Summary: | 碩士 === 國立東華大學 === 電機工程學系 === 103 === This thesis focuses on the application of Multiscale Entropy (MSE) in the waveform contour analysis of digital volume pulse using the Crest Time (CT) series and also the interpretation of electromyographic (EMG) signals in urodynamic study.
In Part One, the application of MSE in CT analysis was shown to successfully discriminate healthy individuals from those with diabetes mellitus type 2. Data on digital volume pulse were obtained from 93 individuals in three groups [Healthy young (Group 1, 20< age ≤40, n = 30), healthy upper-middle-aged (Group 2, age >40, n = 30), and diabetic (Group 3, n = 33) subjects]. Crest time, normalized crest time (NCT), crest time ratio (CTR), small and large-scale MSE on CT [MSESS(CT) and MSELS(CT), respectively] were computed and correlated with anthropometric (i.e., body weight/height, waist circumference), hemodynamic (i.e., blood pressure), and biochemical parameters (i.e., serum triglyceride, high-density lipoprotein, fasting blood sugar, and glycosylated hemoglobin). The results demonstrated higher variability in CT in healthy subjects (Groups 1 and 2) compared with that in diabetic patients (Group 3) as reflected in significantly elevated MSESS(CT) and MSELS(CT) in the former (p < 0.003 and p < 0.001, respectively). MSELS(CT) also showed significant association with waist circumference and fasting blood sugar as well as glycosylated hemoglobin concentration. In conclusion, using MSE analysis for assessing CT variation successfully distinguished diabetic patients from healthy subjects. MSESS(CT) and MSELS(CT) therefore may serve as noninvasive tools for identifying subjects with diabetes and those at risk.
Part Two of this thesis describes the application of MSE in the interpretation of EMG signals from the external urethral sphincter acquired during urodynamic study. In an attempt to explore the information hidden in the EMG signals that may be of prognostic significance for patients receiving surgeries for primary bladder neck dysfunction, 46 patients with voiding difficulty were divided into four groups: Patients with successful surgery (Group 1, n=18), patients with unsuccessful surgery (Group 2, n=9), patients with detrusor overactivity (Group 3, n=7), and those with detrusor external sphincter dyssynergia (Group 4, n=12). The results demonstrated the MSELS(EMG) of Group 1 is significantly higher than that of Group 2, whereas there was no significant difference between Group 1 and Group 3 (i.e., patients with normal external urethral sphincter function). Moreover, the MSELS(EMG) and MSESS(EMG) of Group 2 is significantly higher than those of Group 4. In conclusion, using MSE analysis for assessing EMG signals of the external urethral sphincter not only successfully distinguished patients with successful surgery from those with surgical failure, but also could serve as an indicator of the functional integrity of external urethral sphincter.
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