CN101664307A - Acquisition and processing method for measuring kororkoff sound information of blood pressure with auscultatory method and device - Google Patents
Acquisition and processing method for measuring kororkoff sound information of blood pressure with auscultatory method and device Download PDFInfo
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Abstract
The invention relates to an acquisition and processing method for measuring kororkoff sound information of blood pressure with an auscultatory method and a device; the method comprises the following steps: a kororkoff sound signal is acquired by a stethoscope head, instantaneous sound pressure of the kororkoff sound signal acquired by the stethoscope head is acquired to a computer to be stored bya measurement microphone and an analog-digital converter, weighted sound pressure level of the kororkoff sound signal is calculated according to a sound-pressure-level measurement method specified inANSI S1.4 or IEC 61672-1 standard, the corresponding sound pressure level threshold value is set, the kororkoff sound above the threshold value is considered to be audible, the kororkoff sound below the threshold value is considered to be inaudible. The acquisition and processing information in the method is used for determining blood pressure value measured by the auscultatory method, thereby reducing effect of subjective factors of an auscultator on blood measuring results and realizing objective and scientific blood pressure auscultation measurement.
Description
Technical field
The invention belongs to a kind of method and apparatus of handling with the human body physiological parameter relevant information that obtains, be specifically related to a kind of be used for auscultation survey arteriotony Ke Shi message breath obtain processing method and device.
Background technology
Blood pressure is the important physiological parameter of reflection human health status.The accurate measurement of blood pressure is to preventing and curing diseases, find early disease, and is all significant.At present, the method for noninvasive blood pressure measurement mainly contains the auscultation based on the Ke Shi sound, oscillographic method, Palpation, ultrasonic method etc.Wherein, the standard method that non-invasive blood pressure was measured when auscultation was known as by international medical community has obtained using widely clinically.In the evaluation of the accuracy standard of current popular blood pressure measurement device in the world, also all be the pressure value that uses auscultation to obtain, as the reference value of blood pressure measurement.1905, the doctor Korotkoff of Russia found that to the upper arm artery pressurization, gradual slow venting more then in the stethoscope that is placed on the moving point of cuff below tremulous pulse arm, can be heard the beat sound synchronous with pulse by the cuff inflation.This beat sound is called the Ke Shi sound.Auscultation determines that the method for pressure value is, the beginning of the Ke Shi sound that can listen and the finish time correspondence cuff pressure be judged to be systolic pressure and diastolic pressure.Promptly first o'clock the Ke Shi sound is judged to be systolic pressure and diastolic pressure with the cuff pressure of the 5th o'clock initial sound correspondence mutually mutually.
Auscultation is that non-invasive blood pressure is measured " goldstandard ", yet also there are some problems in it.Auscultation relies on auscultator's audition to discern the Ke Shi sound fully, needs to concentrate one's energy to observe the hydrargyrum mercury column of continuous decline in the auscultation process, in time reads mercurypressure in the time can listening the Ke Shi sound to begin and finish.Therefore, auscultator's acouesthesia degree, subjective factorss such as the degree of concentrating one's energy influence the accuracy of auscultation blood pressure measurement unavoidably.The accuracy of auscultation is subjected to the considerable restraint of auscultator's error (observer error).Again for example, an auscultator who just from the noise environment, has come back, this moment, his acouesthesia degree will descend, and carried out the auscultation blood pressure measurement immediately if this is him, then his scope of the Ke Shi sound that can hear will reduce to some extent, thereby influences the auscultation blood pressure measurement.This illustrates that once more auscultator's subjective factors can influence the accuracy of auscultation blood pressure measurement.
Summary of the invention
What the technical problem to be solved in the present invention provided a kind of Ke Shi message breath that is used for the auscultation measuring blood pressure obtains processing method and device, the data that the inventive method and device are obtained are used for the measurement of auscultation arteriotony, can reduce in the auscultation process subjective factors influence of blood pressure measurement is realized auscultation blood pressure measurement more objective, more science.
Address the above problem method comprise following content
1, obtains Ke Shi sound acoustical signal with stethoscope head;
2, the instantaneous sound pressure of the Ke Shi sound acoustical signal that stethoscope head is obtained with measuring microphone and analog-digital converter collects computer and preserves;
3, calculate the weighted sound pressure level of Ke Shi tone signal according to the sound-pressure-level measurement method of stipulating in ANSI S1.4 or the IEC 61672-1 standard;
4, set corresponding sound pressure level threshold value, the Ke Shi sound on this threshold value is considered to and can hears, the Ke Shi sound of sound pressure level under this threshold value is considered to and can not hears.
Preferably, when calculating the weighted sound pressure level of Ke Shi tone signal, the frequency weighted of Ke Shi sound is selected the A weighted.
The device that the inventive method is used is: be provided with:
The cuff of the employed band aerating and exhaust device of auscultation measuring blood pressure is used to be strapped in the tested position of human body;
Stethoscope head is used to obtain the Ke Shi sound acoustical signal that produces in the inflation cuff;
Measure mike, be used to obtain the instantaneous sound pressure of auscultation Ke Shi sound acoustical signal in front;
Mould/number coverter is used for the simulation instantaneous sound pressure conversion of signals that the measurement mike obtains is become digital signal, and is input to computer;
It is characterized in that described measurement mike is a measuring microphone, also is provided with
Computer is used for preserving the instantaneous sound pressure digital signal of described analog-digital converter input and calculates the weighted sound pressure level of Ke Shi tone signal according to the sound-pressure-level measurement method that ANSI S1.4 or IEC 61672-1 standard are stipulated.
Described ANSI S1.4 standard and IEC 61672-1 standard are respectively to contain the American National Standard of sound-pressure-level measurement method standard and the standard that International Electrotechnical Commission formulates.
The information that the inventive method is obtained processing is used for determining that the method for the pressure value of auscultation measuring blood pressure is: obtaining Ke Shi message breath with the inventive method when, obtain the cuff pressure value that produces this Ke Shi tone signal synchronously, side of the present invention is considered to the Ke Shi sound of sound pressure level on setting threshold can hear, the Ke Shi sound of sound pressure level under threshold value is considered to and can not hears, the cuff pressure value of correspondence is a systolic arterial pressure when then beginning to hear the Ke Shi tone signal, and the cuff pressure value of correspondence was a diastolic pressure when Ke Shi sound acoustical signal finished.
It is to rely on the hearing ability of auscultator's individuality to discern the Ke Shi sound that the tradition auscultation is surveyed arteriotony, because the audition between the different auscultators there are differences, the audition of same auscultator under different time and environment also there are differences, this differentia influence the objectivity of auscultation blood pressure measurement.Distinguishing in the inventive method that listening of Ke Shi sound can not listen is to judge that with the sound pressure level threshold value of setting sound pressure level is objective, the physics characterising parameter of sound, and the weighted sound pressure level can well reflect people's ear " can listen " degree to sound to a certain extent.The inventive method is described listened to the degree of Ke Shi sound quantitatively using this physical parameter of weighted sound pressure level.This method comes down to Ke Shi sound " can listen " and " can not listen ", and the audition by the auscultator from traditional auscultation is distinguished, and converts to by the threshold value that whether surpasses of physical parameter sound pressure level quantitatively to distinguish.And the setting of threshold value can be set according to the meansigma methods of the pairing sound pressure level of the just perceived Ke Shi sound of the normal auscultator of several audition (environment noise is less than 30dBA) under quiet environment.Therefore can greatly eliminate different auscultators or same auscultator acoustically existing difference under different time, environment, reduce of the influence of auscultator's subjective factors, realize auscultation blood pressure measurement more objective, more science blood pressure measurement.
The device of existing Ke Shi sound measuring blood pressure adopts piezoelectric type sensor acquisition Ke Shi vibrations more, perhaps use common electric capacity or electret microphone to gather the Ke Shi sound, the requirement that the precision of the Ke Shi sound acoustic pressure information that it collects and frequency response curve all can not satisfy the inventive method, apparatus of the present invention adopt measuring microphone to gather the acoustic pressure of Ke Shi sound, so-called measuring microphone belongs to a kind of high accuracy mike that can reach IEC 61094-4 standard, it has extremely flat frequency response curve in free transmission range, has very high sensitivity, therefore, the data with the measuring microphone collection can satisfy the requirement of the inventive method according to ANSI S1.4 or IEC 61672-1 criterion calculation Ke Shi tone signal weighted sound pressure level.
Description of drawings
Fig. 1, apparatus of the present invention embodiment cooperate the structural representation of measuring blood pressure with traditional auscultation apparatus
Fig. 2, weighted sound pressure level computational methods block diagram
The A weighted wave filter amplitude-response curve that Fig. 3, the inventive method embodiment adopt
Fig. 4, the data of obtaining with the inventive method embodiment are carried out the sketch map that pressure value is determined
The specific embodiment
This routine Ke Shi message breath acquisition processing device is (referring to Fig. 1)
This device comprises air bag that is connected with automatic aerating and exhaust device that traditional auscultation measuring blood pressure is required and cuff, can obtain the stethoscope head of Ke Shi message breath from cuff, and the measuring microphone that is communicated with stethoscope head, the measuring microphone outfan is connected with the host computer input with 24 analog-digital converters and microcontroller by preamplifier, signal conditioning circuit successively.
The model of above-mentioned measuring microphone is BSWA MPA201, and this measuring microphone can satisfy the requirement of IEC61672 to Class 1 type sound meter, can be used to have the acoustic measuring instrument of a type required precision.
Adopt said apparatus to realize that obtaining with processing method of Ke Shi message breath is:
Cuff is strapped on measured's arm, stethoscope head is clipped between cuff and the tested position, utilize automatic aerating and exhaust device that cuff is charged and discharged gas, obtain Ke Shi message breath from stethoscope head;
Obtain the instantaneous sound pressure of Ke Shi sound with the measuring microphone that is communicated with stethoscope head, be input to signal conditioning circuit by preamplifier;
Preamplifier is used for the impedance conversion.Because the output impedance of measuring microphone is higher, is unfavorable for the amplification of circuit thereafter, gather, therefore realize the impedance conversion with preamplifier, high output impedance is become lower output impedance.
This routine signal conditioning circuit is mainly used in to measuring microphone power supply with to sound pressure signal and nurses one's health, and the acoustic pressure that will handle number is input to 24 analog-digital converters again;
Behind the analog signal digital of 24 analog-digital converters handles input,, send to host computer through microcontroller.
Because acoustical signal has high dynamic range, therefore, analog-digital converter should adopt more than 16, and this example is used the instantaneous sound pressure of the analog-digital converter collection Ke Shi sound with 24 bit resolution precision, with the dynamic range of further raising acquisition system.Usually, be no less than the data that the analog-digital converter of 24 bit resolution precision obtains and more can well satisfy the needs that the inventive method is calculated.
Computer is used for preserving, and analyzes the data of gathering.
The process of the Ke Shi message breath of gathering being handled with computer comprises following content:
1, calculates the weighted sound pressure level of Ke Shi sound instantaneous sound pressure signal according to the sound-pressure-level measurement method of stipulating in ANSI S1.4 or the IEC 61672-1 standard;
The computational methods of Ke Shi sound instantaneous sound pressure are that the amplitude of usefulness measuring microphone output signal can obtain Ke Shi sound instantaneous sound pressure divided by the sensitivity of measuring microphone.
According to ANSI s.14 or the sound pressure level computational methods of stipulating in the IEC 61672-1 standard sound pressure level is calculated fully.
Fig. 2 is the method sketch map that calculates the weighted sound pressure level by instantaneous sound pressure, and instantaneous sound pressure by time weighted wave filter, obtains the weighted sound pressure level then at last at first by frequency weighted wave filter.Wherein, frequency weighted method has three kinds: A weighted (A-weighting), C weighted (C-weighting), no weighted (linear).The time weighted also has three kinds of methods: equivalence is weighted (equivalentcontinuous) continuously, fast weighted (Fast), slow weighted (Slow).
For better anthropomorphic dummy's ear is to the perception of listened to the degree of Ke Shi sound, the frequency weighted of this routine Ke Shi sound is selected the A weighted, this be because the Ke Shi sound near diastolic pressure the time sound pressure level lower.The time weighted is selected equivalence weighted continuously, and the integrating range length of time weighted is chosen as 200ms.This is because Ke Shi sound general persistence is no more than 200ms.Shown in Figure 3 is the amplitude-response curve of A weighted frequency filter.
People's ear is to the perception of the sonority of sound, and is relevant with the sound pressure level and the frequency of sound.As far back as 1933, Fletcher and Munson measured the equal loudness contour of whole person's ear, promptly on sound pressure level-frequency plane, people's ear were sounded that the coordinate points of equally ringing links together the curve of formation.A weighted frequency filter is exactly that the amplitude-response curve of A weighted frequency filter formally is the counter-rotating of 40 side's equal loudness contours of Fletcher and Munson for this frequency response of anthropomorphic dummy's ear should and design.Sound by A weighted wave filter after low frequency part decayed greatly, thereby anthropomorphic dummy's ear is insensitive to the low sound of frequency, and relatively more responsive to the high sound of frequency.
2, set corresponding sound pressure level threshold value, the Ke Shi sound on this threshold value is considered to and can hears, is considered to and can not listens at the Ke Shi sound of sound pressure level under this threshold value.
In theory, the above sound of 0dB just can be heard by people's ear.Yet this need could obtain in the anechoic chamber.In fact, through test of many times, be that A weighted, time weighted are to be the Ke Shi sound weighted sound pressure level of the continuous equivalent weighted of 200ms the persistent period for the frequency weighted, can set 40dB as threshold value, can listen and can not listen the Ke Shi sound in order to distinguish, effect is very good.
If adopt other frequency weighted or time weighted, then threshold value then can be unsteady to some extent, when for example adopting " soon " time weighted, can set 38dB and can listen and the threshold value that can not listen the Ke Shi sound as distinguishing.
Apparatus of the present invention are cooperated with traditional auscultation measuring blood pressure device, can realize determining of auscultation pressure value, referring to Fig. 1, this blood pressure measuring device comprises that traditional auscultation carries out the required armamentarium of auscultation blood pressure measurement: the air bag that is provided with cuff, the mercury gauge that is communicated with air bag, inflatable ball, be used to realize the automatic aerating and exhaust device of at the uniform velocity exitting, be provided with pressure transducer in addition in cuff, pressure transducer is connected with the computer input with 24 analog-digital converters and microcontroller by signal conditioning circuit successively.
Wherein cuff air bag input is provided with multiple-connector A, and the gas circuit of this joint and mercury gauge, inflatable ball, automatic aerating and exhaust device and pressure transducer is interconnected, and constitutes the cuff pressure gas passage, and its gas pressure equals cuff pressure.Establish multiple-connector B between stethoscope device head and receiver gas circuit, the gas circuit of this joint and stethoscope head, receiver gas and measuring microphone input is interconnected, and constitutes Ke Shi sound gas passage.
The present invention can obtain the Ke Shi tone signal by above-mentioned Ke Shi sound gas passage, and the cuff pressure that cooperates the cuff pressure path to obtain can realize determining of auscultation pressure value.
Definite method of pressure value remain the beginning that can listen the Ke Shi sound and the finish time correspondence cuff press respectively as systolic pressure and diastolic pressure.
Fig. 4 has shown with the weighted sound pressure level (b) that charges and discharge the cuff pressure curve (a) and the Ke Shi sound of a deflation course of gas automatically.40dB horizontal linear among Fig. 4 (b) is a threshold line, and the above Ke Shi sound of 40dB is considered to and can be heard by people's ear, and the following Ke Shi sound of 40dB is considered to and can not be heard by people's ear.Can listen for first the Ke Shi sound to appear at the 14s place, this corresponding constantly cuff is pressed and is 115mmHg, and this force value is judged as systolic pressure.Last sound can listen the Ke Shi sound to appear at the 31s place, and this corresponding constantly cuff is pressed and is 70mmHg, and this force value is judged as diastolic pressure.
The above; it only is preferred embodiment of the present invention; be not that the present invention is done any pro forma restriction, every foundation technical spirit of the present invention all still belongs to the protection domain of technical solution of the present invention to any simple modification, equivalent variations and modification that above embodiment did.
Claims (7)
1, a kind of Ke Shi message breath that is used for the auscultation measuring blood pressure obtain processing method, comprise following content:
(1), obtains Ke Shi sound acoustical signal with stethoscope head;
It is characterized in that,
(2), the instantaneous sound pressure of the Ke Shi sound acoustical signal that stethoscope head is obtained with measuring microphone and analog-digital converter collects computer and preserves;
(3), calculate the weighted sound pressure level of Ke Shi tone signal according to the sound-pressure-level measurement method of stipulating in ANSI S1.4 or the IEC 61672-1 standard;
(4), set corresponding sound pressure level threshold value, the Ke Shi sound on this threshold value is considered to and can hears, the Ke Shi sound of sound pressure level under this threshold value is considered to and can not hears.
2, the Ke Shi message breath that is used for the auscultation measuring blood pressure according to claim 1 obtain processing method, it is characterized in that when calculating the weighted sound pressure level of Ke Shi tone signal, the frequency weighted of Ke Shi sound is selected the A weighted.
3, the Ke Shi message breath that is used for the auscultation measuring blood pressure according to claim 2 obtain processing method, it is characterized in that when calculating the weighted sound pressure level of Ke Shi tone signal, the time weighted of Ke Shi sound is selected equivalence weighted continuously.
4, the Ke Shi message breath that is used for the auscultation measuring blood pressure according to claim 3 obtain processing method, it is characterized in that, adopt 40dB can listen and the sound pressure level threshold value that can not listen the Ke Shi sound as distinguishing.
5, a kind of Ke Shi message breath that is used for the auscultation measuring blood pressure obtain blood processor, be provided with:
The cuff of the employed band aerating and exhaust device of auscultation measuring blood pressure is used to be strapped in the tested position of human body;
Stethoscope head is used to obtain the Ke Shi sound acoustical signal that produces in the inflation cuff;
Measure mike, be used to obtain the instantaneous sound pressure of the Ke Shi sound acoustical signal in the stethoscope head;
Mould/number coverter is used for the simulation instantaneous sound pressure conversion of signals that the measurement mike obtains is become digital signal, and is input to computer;
It is characterized in that described measurement mike is a measuring microphone, also is provided with
Computer is used for preserving the instantaneous sound pressure digital signal of described analog-digital converter input and calculates the weighted sound pressure level of Ke Shi tone signal according to the sound-pressure-level measurement method that ANSIS1.4 or IEC 61672-1 standard are stipulated.
6, the Ke Shi message breath that is used for the auscultation measuring blood pressure according to claim 5 obtain blood processor, it is characterized in that: described A/D converter precision is no less than 24.
7, the Ke Shi message breath that is used for the auscultation measuring blood pressure according to claim 5 obtain blood processor, it is characterized in that: described measuring microphone outfan is connected with the computer input with analog-digital converter and microcontroller by preamplifier, signal conditioning circuit successively.
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Cited By (8)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN102800231A (en) * | 2011-05-24 | 2012-11-28 | 天津市天堰医教科技开发有限公司 | Korotkoff sound simulation method |
| CN105615859A (en) * | 2014-08-29 | 2016-06-01 | 周嘉璐 | Auxiliary device for blood pressure measurement, blood pressure measurement equipment and design method of blood pressure measurement equipment |
| WO2017000385A1 (en) * | 2015-07-02 | 2017-01-05 | 赵俊峰 | Auxiliary device for blood pressure measurement and blood pressure measuring equipment |
| WO2017193925A1 (en) * | 2016-05-12 | 2017-11-16 | 京东方科技集团股份有限公司 | Blood pressure measurement instrument, and korotkoff's sound recognition method and device |
| CN108309274A (en) * | 2018-03-09 | 2018-07-24 | 上海由泰医疗器械科技有限公司 | A kind of method that automatic detection obtains blood pressure Korotkoff's Sound |
| CN110680298A (en) * | 2019-11-01 | 2020-01-14 | 徐州市双惠医疗设备有限公司 | Korotkoff sound electronic blood pressure measuring instrument and active noise reduction and pickup device, system and method thereof |
| CN111657900A (en) * | 2020-04-28 | 2020-09-15 | 四川大学 | Korotkoff sound time phase classification and identification method and system |
| CN115486826A (en) * | 2022-10-11 | 2022-12-20 | 广东省妇幼保健院 | Korotkoff sound blood pressure measuring method, measuring instrument and multi-data fusion blood pressure measuring method |
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Cited By (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102800231A (en) * | 2011-05-24 | 2012-11-28 | 天津市天堰医教科技开发有限公司 | Korotkoff sound simulation method |
| CN105615859A (en) * | 2014-08-29 | 2016-06-01 | 周嘉璐 | Auxiliary device for blood pressure measurement, blood pressure measurement equipment and design method of blood pressure measurement equipment |
| WO2017000385A1 (en) * | 2015-07-02 | 2017-01-05 | 赵俊峰 | Auxiliary device for blood pressure measurement and blood pressure measuring equipment |
| JP2018525184A (en) * | 2015-07-02 | 2018-09-06 | ジャオ，ジュンフェン | Auxiliary device for measuring blood pressure and blood pressure measuring apparatus |
| WO2017193925A1 (en) * | 2016-05-12 | 2017-11-16 | 京东方科技集团股份有限公司 | Blood pressure measurement instrument, and korotkoff's sound recognition method and device |
| CN108309274A (en) * | 2018-03-09 | 2018-07-24 | 上海由泰医疗器械科技有限公司 | A kind of method that automatic detection obtains blood pressure Korotkoff's Sound |
| CN110680298A (en) * | 2019-11-01 | 2020-01-14 | 徐州市双惠医疗设备有限公司 | Korotkoff sound electronic blood pressure measuring instrument and active noise reduction and pickup device, system and method thereof |
| CN111657900A (en) * | 2020-04-28 | 2020-09-15 | 四川大学 | Korotkoff sound time phase classification and identification method and system |
| CN115486826A (en) * | 2022-10-11 | 2022-12-20 | 广东省妇幼保健院 | Korotkoff sound blood pressure measuring method, measuring instrument and multi-data fusion blood pressure measuring method |
| CN115486826B (en) * | 2022-10-11 | 2023-09-08 | 广东省妇幼保健院 | Korotkoff sound blood pressure measuring instrument |
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Application publication date: 20100310 |