CN1736324A - Detection/disposal method and apparatus for obtaining respiratory disturbance index information - Google Patents
Detection/disposal method and apparatus for obtaining respiratory disturbance index information Download PDFInfo
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Abstract
A detecting and dealing method and apparatus for getting respiratory disturbance index information. It is characteristic by: First, getting men's cardiac periodic sequence during sleeping and proceeding equispace resampling processing, and proceeding wave analysis and cardiac cycle extraction, and then separately digging out each apnea case and sleeping block diagram in the whole sleep using 'conformity in multi-means and on different levels' signal processing technology, the occasion of the apnea case and the total time of sleep separately forms the numerator and denominator of the respiratory disturbance index expression. The apparatus can intensify the function of the common cardioelectric Holter.
Description
Technical field
The present invention relates to a kind of detection processing method and device that is used to obtain clinical diagnosis information, be specifically related to a kind of detection processing method and device that obtains sleep disordered breathing medical diagnosis on disease information.
Background technology
Sleep apnea low syndrome (Sleep Apnea Hypopnea Syndrome, SAHS) be a kind of common sleep disordered breathing disease, has serious potential danger, have a strong impact on patient's sleep quality, and can cause multiple complications, data shows that China has 3,000 ten thousand people to suffer from SAHS approximately at present.Present methods for clinical diagnosis is to write down the whole night the multichannel physiological signal of sleep and analyze by polysomnogram instrument (PSG), to obtain patient's Sleep architecture the whole night and sleep-respiratory incident, and then obtain quantitative target such as the syndromic important diagnostic data-apnea hyponea index of sleep apnea low, and utilize these quantitative targets to carry out the state of an illness and judge.
The sleep apnea low index (Apnea Hypopnea Index, AHI), or be called apnea hyponea index (Respiratory Disturbance, RDI), the expression formula of AHI (RDI) is:
(sleep apnea number of times+low the whole night ventilation number of times the whole night)/sleep total time (hour)
Therefore, the acquisition of Sleep architecture and sleep-respiratory incident is the key of diagnosis SAHS.
The sleep stage standard that Brain Research Institute Rechtschaffen of California, USA university and Kales proposed in nineteen sixty-eight (is called for short R﹠amp; The K standard), accepted by Most scholars in the world, be widely used in clinical and scientific research at present.This standard judges that sleep stage needs three indexs: i.e. electroencephalogram (EEG), electrooculogram (EOG) and electromyogram (EMG).Up to the present, all adopt the method that detects above-mentioned three kinds of data for obtaining Sleep architecture and sleep-respiratory incident in clinical, this data detecting method is very loaded down with trivial details, the record of PSG parameter need be pasted nearly tens electrodes to patient, in order to obtain Sleep architecture, generally need measure 5 road signals simultaneously, i.e. two-way brain electricity, two-way eye movement electricity and one road mentalis signal of telecommunication; Need measure physiological signals such as patient's mouth and nose air-flow, breast breathing, abdominal respiration and blood oxygen saturation simultaneously in order to detect the sleep-respiratory incident, not only complicated operation, expense costliness, and influence patient's ortho sleep, bring inconvenience to patient, can not well reflect patient's the actual patient's condition.According to estimates, current only in severe obstructive apnea syndrome patient, just have the women of 93% male and 82% to can not get diagnosis.
Summary of the invention
The problem to be solved in the present invention provide a kind of easy to operate, expense is cheap, patient is disturbed detection processing method and the device be used to obtain respiratory disturbance index information for a short time.
For reaching above-mentioned purpose, the method that the present invention adopts is: obtain the cardiac cycle sequence between the whole sleep period of human body earlier, and carry out uniformly-spaced resampling and handle, carrying out waveform analysis and cardiac cycle extracts, pass through the signal processing technology of " by different level, multi-method is integrated " then, therefrom excavate the Hypnogram of each apnea and whole sleep procedure respectively, molecule and the denominator in the apnea hyponea index expression formula formed in apnea number of times and sleep total time respectively.
Further scheme is: obtain described cardiac cycle sequence by detecting Real-time and Dynamic electrocardiosignal and/or ballistocardiogram signal and/or pulsation ripple signal.
Hardware unit used in the present invention is: be provided with real time record system and playback analytical system, described real time record system is provided with the line that leads, line one end that leads is provided with EGC sensor and/or heart shock transducer and/or pulsation wave sensor, the other end is connected with the recorder of the transducing signal that can the real-time continuous synchronous recording leads, the recorder outfan is connected with the playback analytical system, described playback analytical system is for supporting the computer or the electro cardio signal workstation of the operation of ambulatory electrocardiogram analysis software, and described computer or electro cardio signal workstation are provided with mouse or finger-impu system, display screen and printing equipment.
The preferred version of above-mentioned hardware unit is electrocardio Holter.
The present invention is by analyzing diagnostic message one apnea that obtains the sleep disordered breathing disease and the Sleep architecture of whole sleep procedure to the cardiac cycle sequence of the whole Sleep stages of human body, be based on to the discovery Journal of Sex Research of heart rate variability Changing Pattern in all kinds of apnea generating processes and to healthy people or patient SAS the various dynamic feature coefficients of cardiac cycle in sleep procedure and Sleep architecture (use R﹠amp; The result of study of correlation analysis K expert's result of determination), this is discovered: containing the relevant information of extracting AHI in the cardiac cycle, so can be by analysis and processing to corresponding data, therefrom obtain Hypnogram and sleep apnea number of times, further obtain apnea hyponea index AHI (AHI=asphyxia number of times/sleep total time) by these two then.
The inventive method is by the cardiac cycle sequence chart of the whole Sleep stages of human body, can obtain Hypnogram and sleep apnea number of times, and then the acquisition breathing rate points several AHI (AHI=asphyxia number of times/sleep total time), compare with traditional detection method, very high dependency is arranged, respiration case recall rate of the present invention is compared with typical PSG, correlation coefficient 〉=0.98, the Hypnogram that is provided is compared with typical PSG analysis expert result, coincidence rate is more than 0.8, and have easy to operate, expense is cheap, patient is disturbed little advantage, can obtain the required data of the inventive method from existing electrocardiogram in addition, therefore strengthen Electrocardiographic function.
The device that the inventive method adopted has reduced detecting electrode quantity, the inspection means of SAHS have been simplified, reduced inspection fee, and physiology, mental workload when patient checks have been reduced, because the device that the inventive method adopted can directly utilize existing electrocardio Holter, thereby increased the function of common electrocardio Holter, made it not only can be used for electrocardio and detect, also can be used for obtaining of respiratory disturbance index information.
Description of drawings
Fig. 1, the inventive method embodiment block diagram
Fig. 2, embodiment of the invention respiration case method for detecting block diagram
Fig. 3, the embodiment of the invention are obtained the block diagram of Sleep architecture method
Specific embodiments:
This example adopts electrocardio Holter to implement the inventive method, described electrocardio Holter recording system is provided with lead line and recorder, the line sensing element end that leads is provided with EGC sensor, pulsation wave sensor, and described recorder can be in real time, a plurality of transducing signals that lead of continuous synchronization record exactly.
The implementation process of the inventive method is:
One, obtaining of ambulatory ecg signal is referring to Fig. 1
1, by EGC sensor and the pulsation wave sensor of electrocardio Holter, obtains human body the Real-time and Dynamic electrocardiosignal and the pulsation ripple signal of sleep procedure the whole night, and be input to recorder by the line that leads;
2, recorder carries out the A/D data transaction with the transducing signal amplification, the filtering that receive;
3, will deposit memorizer through the sample information of A/D data transaction;
This recorder can be in real time, continuous synchronization writes down the electrocardiosignal of leading at least one road exactly, and electrocardiosignal is led or led more to two of continuous 24 hours or longer time to obtain and write down human body under natural animation with it.
Two, the playback analytical system of utilizing electrocardio Holter is carried out the extraction of waveform analysis and cardiac cycle to the ambulatory ecg signal of recorder storage:
1, according to ambulatory electrocardiogram each QRS ripple position is cut and forms heartbeat time domain spectrogram; The extraction step of described QRS ripple is:
(1), the ECG signal is done difference, ask for first derivative;
(2), initial 18 seconds data are divided into six sections, the addition of every section interior derivative maximum multiply by 0.5 as initial derivative detection threshold after average;
(3), in first front and back 70ms scope, look for the extreme point of ECG signal amplitude maximum greater than the point of detection threshold, be the R crest value point of this QRS wave group;
(4), upgrade thresholding: as EACH_PREAMBLE_NUM_FRACs detection threshold=preceding 2 seconds data segment interior derivative maximums of last derivative detection threshold * 0.9+ * 0.5*0.1;
(5), from then on R crest value point moves 200ms backward, continues next QRS wave group of search and R crest value point thereof;
Repeating step (3)-(5) are up to having detected all data.
In order to improve processing accuracy, this example adopts floating number to calculate when obtaining whenever to fight heart rate, after heart rate is whenever fought in acquisition, removes two kinds of irrelevant hearts rate: a kind of is because the influence of factors such as noise, the heart rate that misjudgement QRS ripple causes, another kind is the heart rate that is caused by premature beat; The place to go of premature beat wherein needs to detect earlier the premature beat point, and then removes the heart rate value at premature beat point two ends, and the removal method of the misjudgement heart rate that is caused by factors such as noises is as follows:
Getting length of window is 41, remove window center point C and window center rate value less than 30 or greater than 125 value, the heart rate addition M that averages to residue, if the heart rate value that C is ordered is less than 30 or greater than 125 or above 20% of meansigma methods, think that then the C point is to disturb and remove, otherwise then keep C point heart rate, so the heart rate value of whenever fighting is the whole night done smothing filtering.
The heart rate value of whenever fighting the whole night to after handling through above-mentioned steps utilizes approach based on linear interpolation to carry out interpolation, obtains the whole night the uniformly-spaced heart rate sequence of per second, and sample frequency is 1Hz.
Said method can reduce the influence of error and all kinds of non-sinus rates.
2, according to above-mentioned each QRS ripple position is cut formed heartbeat time domain spectrogram,, excavate each apnea by heart rate variability HRV (Heart Rate Variability) is analyzed;
The rule that this example changes according to heart rate variability in all kinds of apnea generating processes, the variation of heart rate variability in all kinds of apnea is divided into four types, i.e. rising type, leveling style, four kinds of decline type and mixed types, and according to no matter which kind of respiration case generally all has the process that short time (in 15 seconds) heart rate accelerates when finishing at every turn, when being defined as the respiration time-out, be applied in and judge whether to exist respiratory hole arrhythmia (RSA) relevant in the heart rate variability linearity curve, then belong to the obstructive respiration incident as existing, as disappearing, then belong to the central respiration case;
Fig. 2 is the process of appliance computer operation said method.
Adopt the respiration case recall rate of said method to compare correlation coefficient 〉=0.98 with typical PSG.
3, according to aforementioned each QRS ripple position is cut formed heartbeat time domain spectrogram,, obtain the Sleep architecture of whole sleep procedure by heart rate variability HRV (Heart Rate Variability) is analyzed;
This example according to healthy people or patient SAS the various dynamic feature coefficients of cardiac cycle in sleep procedure and Sleep architecture (use R﹠amp; The analysis result of relation K expert's result of determination), utilize cardiac cycle signal to obtain following dynamic feature coefficient:
(1), cardiac cycle meansigma methods in time;
(2), extremely low frequency composition energy
(3), low-frequency component energy
(4), radio-frequency component energy
(5), asphyxia composition energy
(6), extremely low frequency composition energy accounts for the ratio of gross energy
(7), the low-frequency component energy accounts for the ratio of gross energy
(8), the radio-frequency component energy accounts for the ratio of gross energy
(9), the ratio of asphyxia composition energy and gross energy
(10), the ratio of extremely low frequency composition energy and radio-frequency component energy
(11), the ratio of low-frequency component energy and radio-frequency component energy
With the relation of above-mentioned 11 kinds of main dynamic feature coefficients and sleep stage, to waking up in the sleep procedure, shallowly sleep, sound sleep, rapid eye movement phase four kinds of sleep stages classify, and reaches obtaining of Sleep architecture in the whole sleep procedure.
Fig. 3 is the process of appliance computer operation said method.
The Hypnogram that adopts said method to obtain is compared with typical PSG analysis expert result, and coincidence rate is more than 0.8.
4, by 2,3 gained data, further obtain breathing rate and point several AHI (AHI=asphyxia number of times/sleep total time).
Claims (7)
1, is used to obtain the detection processing method of respiratory disturbance index information, it is characterized in that: obtain the cardiac cycle sequence between the whole sleep period of human body earlier, carry out uniformly-spaced resampling processing, carrying out waveform analysis and cardiac cycle again extracts, pass through the signal processing technology of " by different level, multi-method is integrated " then, therefrom excavate the Hypnogram of each apnea and whole sleep procedure respectively, molecule and the denominator in the apnea hyponea index expression formula formed in apnea number of times and sleep total time respectively.
2, the detection processing method that is used to obtain respiratory disturbance index information according to claim 1 is characterized in that: by detected Real-time and Dynamic electrocardiosignal, and/or the ballistocardiogram signal, and/or pulsation ripple signal obtains the cardiac cycle sequence.
3, the detection processing method that is used to obtain respiratory disturbance index information according to claim 1 and 2, it is characterized in that, the method for detecting of described apnea is: according to the rule of heart rate variability variation in all kinds of apnea generating processes, the variation of heart rate variability in all kinds of apnea is divided into four types, i.e. rising type, leveling style, four kinds of decline type and mixed types, and according to no matter which kind of respiration case generally all has the process that the short time heart rate accelerates when finishing at every turn, when being defined as the respiration time-out, be applied in and judge whether to exist respiratory hole arrhythmia relevant in the heart rate variability linearity curve, then belong to the obstructive respiration incident as existing, as disappearing, then belong to the central respiration case.
4, the detection processing method that is used to obtain respiratory disturbance index information according to claim 1 and 2, it is characterized in that, the acquisition methods of the Hypnogram of described whole sleep procedure is: the analysis result according to the relation of various dynamic feature coefficients of cardiac cycle in the sleep procedure and Sleep architecture, utilize cardiac cycle signal to obtain following dynamic feature coefficient:
(1), cardiac cycle meansigma methods in time;
(2), extremely low frequency composition energy
(3), low-frequency component energy
(4), radio-frequency component energy
(5), asphyxia composition energy
(6), extremely low frequency composition energy accounts for the ratio of gross energy
(7), the low-frequency component energy accounts for the ratio of gross energy
(8), the radio-frequency component energy accounts for the ratio of gross energy
(9), the ratio of asphyxia composition energy and gross energy
(10), the ratio of extremely low frequency composition energy and radio-frequency component energy
(11), the ratio of low-frequency component energy and radio-frequency component energy;
With the relation of above-mentioned 11 kinds of main dynamic feature coefficients and sleep stage, to waking up in the sleep procedure, shallowly sleep, sound sleep, rapid eye movement phase four kinds of sleep stages classify, and reaches obtaining of Sleep architecture in the whole sleep procedure.
5, the detection processing method that is used to obtain respiratory disturbance index information according to claim 3, it is characterized in that, the acquisition methods of the Hypnogram of described whole sleep procedure is: the analysis result according to the relation of various dynamic feature coefficients of cardiac cycle in the sleep procedure and Sleep architecture, utilize cardiac cycle signal to obtain following dynamic feature coefficient:
(1), cardiac cycle meansigma methods in time;
(2), extremely low frequency composition energy
(3), low-frequency component energy
(4), radio-frequency component energy
(5), asphyxia composition energy
(6), extremely low frequency composition energy accounts for the ratio of gross energy
(7), the low-frequency component energy accounts for the ratio of gross energy
(8), the radio-frequency component energy accounts for the ratio of gross energy
(9), the ratio of asphyxia composition energy and gross energy
(10), the ratio of extremely low frequency composition energy and radio-frequency component energy
(11), the ratio of low-frequency component energy and radio-frequency component energy;
With the relation of above-mentioned 11 kinds of main dynamic feature coefficients and sleep stage, to waking up in the sleep procedure, shallowly sleep, sound sleep, rapid eye movement phase four kinds of sleep stages classify, and reaches obtaining of Sleep architecture in the whole sleep procedure.
6, be used to obtain the detection blood processor of respiratory disturbance index information, it is characterized in that: be provided with real time record system and playback analytical system, described real time record system is provided with the line that leads, line one end that leads is provided with EGC sensor and/or heart shock transducer and/or pulsation wave sensor, the other end is connected with the recorder of the transducing signal that can the real-time continuous synchronous recording leads, the recorder outfan is connected with the playback analytical system, described playback analytical system is for supporting the computer or the electro cardio signal workstation of the operation of ambulatory electrocardiogram analysis software, and described computer or electro cardio signal workstation are provided with mouse or finger-impu system, display screen and printing equipment.
7, the detection blood processor that is used to obtain respiratory disturbance index information according to claim 6, it is characterized in that: described device is electrocardio Holter.
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