JP3062474B2 - Circulatory system comprehensive evaluation device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an oscillometric sphygmomanometer using a manchette in an upper arm or a forearm, which simultaneously measures systolic blood pressure and diastolic blood pressure, detects an arterial pulse wave by a pressure sensor, and detects a cardiac cycle. The present invention relates to a circulatory system comprehensive evaluation device that obtains various types of circulatory system information such as blood pressure information and peripheral circulatory information by measuring left ventricular ejection time.

[0002]

2. Description of the Related Art Conventionally, an examination apparatus has been put to practical use in which an arterial pulse wave is detected by a pressure sensor and attention is paid to its amplitude and waveform to obtain blood pressure information, peripheral circulation information, and the like. An example of the latest technical information on such an inspection apparatus is disclosed in Japanese Patent Application Laid-Open No. 8-33615. It is known that the left ventricular ejection time (LVET) is in the relationship of Arnold Weissler's formula when the heart rate is HR, but it is known that the LVET is measured with the blood flowing.
Was strongly affected by peripheral resistance, and it was difficult to accurately measure LVET. Further, it has not been known that the slope of the straight line in the Arnold-Weissler equation means information on metabolism or cardiac output. It has not been elucidated because it is necessary to accurately measure the oxygen consumption of the subject in order to clarify the relationship with metabolism.

[0003] At present, it is possible to freely analyze waveforms like a waveform analyzer, but at the time there was no measurement method for measuring LVET with high accuracy, and a method for measuring compliance (hardening degree) in an artery of the arm. Also did not exist. For this reason,
In Arnold Weissler's formula, it cannot be said that the effects of LVET on peripheral resistance and the slope of the straight line have been sufficiently studied. Japanese Patent Application Laid-Open No. 8-33615 discloses a method of improving the above-mentioned points and easily measuring non-invasion without being affected by peripheral resistance by measuring in a state of hemostasis. The latest information on an arterial medical information inspection apparatus capable of obtaining medical information such as arm compliance and metabolism (thyroid machine sushi) is disclosed.

[0004] Specifically, a first pressure sensor, a second pressure sensor, and a second pressure sensor are located at three positions along the artery extending from the heart side to the peripheral side, respectively, at the cardiac side, at the intermediate position, and at the peripheral side. A blood flow restricting element is provided to gradually reduce the pressing force at the above three positions from the blood flow cutoff state, and to keep the pressing force just before the blood flow passage limit at which the detection pressure is obtained from the second pressure sensor. The heart rate cycle, the left ventricular ejection time and the time constant of the pressure change as the first medical information are calculated from the pressure change obtained from the first pressure sensor when the pressing force is controlled to be constant. Measuring, dividing the left ventricular ejection time by a time constant to calculate second medical information, and performing a predetermined calculation based on the cardiac cycle and the time constant to calculate third medical information. It is. JP-A-8-33615
The technique disclosed in Japanese Patent Application Laid-Open Publication No. H10-15064 easily measures non-invasion without being affected by peripheral resistance by measuring in a state of hemostasis, afterloading as first medical information (whole body impedance), In this case, medical information such as arm compliance as third medical information and metabolism (thyroid function) as third medical information is obtained.

[0005]

However, in the test apparatus disclosed in Japanese Patent Application Laid-Open No. 8-33615, which obtains blood pressure information, peripheral circulation information, and the like, accurate limited information can be obtained. , etc. due to the necessary control means for controlling several pressure sensors and blood pressure recovery constant,
Not only is the configuration of the device complicated and its cost increased, but also its operation becomes complicated, so it can be used only at the facilities and staff of specialized hospitals etc., and individuals can easily use blood pressure information. It was difficult to obtain information on peripheral circulation and the like. In order to solve such problems, the present invention provides a circulatory system comprehensive evaluation that enables an individual to easily obtain blood pressure information and more circulatory information with the same feeling as a widely used blood pressure monitor. To develop equipment.

[0006]

SUMMARY OF THE INVENTION The present invention relates to an oscillometric sphygmomanometer using a manchette in the upper arm or forearm, and a high input-resistant omnidirectional microphone for detecting the internal pressure of a central assist manchette or a manchette for measuring blood pressure. pressure oligopoly support, the provided (described in the example below omnidirectional microphones) air pressure sensor, such as a semiconductor sensor for manchette pressure, systolic and simultaneously performing the measurement of the diastolic blood pressure, systolic blood pressure more In the state where the compression was performed, the pulsation change of the internal pressure of the central assist manchette or the blood pressure measurement manchette was detected by the omnidirectional microphone, and the maximum amplitude of the central pressure pulse waveform obtained from the omnidirectional microphone was detected. By measuring the cardiac cycle and the left ventricular ejection time from the beat that exceeds a predetermined level, the systolic blood pressure and By implementing a comprehensive circulatory system evaluation device that obtains various types of circulatory system information such as blood pressure information and peripheral circulatory information from the diastolic blood pressure, the cardiac cycle, and the left ventricular ejection time, With this configuration, an individual can easily obtain blood pressure information, more peripheral circulation information, and the like.

[0007]

BEST MODE FOR CARRYING OUT THE INVENTION

FIG. 1 is an explanatory diagram showing the configuration of a circulatory system comprehensive evaluation apparatus according to the present invention. In FIG. 1, reference numeral 10 denotes a measurement control unit of the circulatory system comprehensive evaluation device. Reference numeral 20 denotes a manchette, and 30 denotes an air supply pipe for sending air for measurement from the measurement control unit 10 to the manchette 20. Measurement control unit 10
Is a blood pressure measurement start instruction button P1 for displaying a blood pressure measurement start and an automatic measurement value of the blood pressure, a heartbeat cycle display button P2 for displaying an automatic measurement value of the heartbeat cycle, and an automatic measurement value of the left ventricular ejection time. Left ventricular ejection time display button P to be displayed
It has an automatic measurement value display button such as 3 and a display section DS for displaying circulatory system comprehensive evaluation information such as various calculation results. In addition, the measurement control unit 10 includes therein air pressure control means for controlling the value of the pressure of air supplied to the manchette 20, measurement means for systolic blood pressure and diastolic blood pressure by an oscillometric method, and supply to the manchette 20. Omni-directional microphone that measures the fluctuations in air pressure, measurement means that measures the cardiac cycle and left ventricular ejection time based on changes in pressure measured by the omni-directional microphone, and blood pressure information and peripheral circulation from these measured data. Computing means for obtaining various information of the circulatory system such as information.

The manchette 20 includes an additional band 21 attached to the upper arm or forearm of the examinee and an air bag 22 that suppresses a detection site by injecting air. Air pressure for measurement is supplied from the measurement control unit 10 to the air bladder 22 of the manchette 20 by the air supply pipe 30. In the circulatory system comprehensive evaluation device shown in FIG. 1, the additional band 2 attached to the upper arm or forearm of the subject is examined.
Both ends are connected, and air is injected into the air bladder 22 to suppress the detection site of the upper arm or forearm of the examinee, thereby closing the artery via the skin tissue of the examinee.
In a state where the manchette 20 is attached to the arm of the examinee, air is injected into the air bag 22 provided on the additional band 21 by an air pump (not shown), and the upper arm or the upper arm of the examinee is examined. The artery such as the forearm artery is closed.

In order to measure blood pressure, when the blood pressure measurement start button P1 of the measurement control unit 10 is pressed while the manchette 20 is attached to the upper arm or forearm of the examinee, the air from the measurement control unit 10 is measured. Air is injected into the bag 22, the air pressure of the air bag 22 is gradually increased until the artery of the upper arm or forearm of the examinee is occluded, and when the artery is occluded, the air pressure of the air bag 22 is gradually increased thereafter. The supply pressure is controlled to decrease. In this process, the systolic blood pressure and the diastolic blood pressure are measured by the same method as a normal blood pressure monitor. The heart rate cycle and left ventricular ejection time are measured by pressing the blood pressure measurement start button P1 of the measurement control unit 10 with the manchette 20 attached to the upper arm or forearm of the examinee. Air is injected into the bag 22 and the artery is compressed above the systolic blood pressure to occlude the artery. In this state, at omnidirectional microphone equipped with a pressure sensor inside the measurement control unit 10 detects a beat change in the internal pressure of the central side auxiliary manchette or blood pressure measuring cuff, resulting from non-directional microphone The heartbeat cycle and the left ventricular ejection time are measured from the pulsation in which the maximum amplitude of the central pressure pulse waveform exceeds a predetermined level.

[0010] FIG. 2 is an explanatory view showing a configuration of a non-directional microphone and the arithmetic unit of the pressure sensor <br/> in the measurement control unit 10. In FIG. 2, PT is a pressure sensor, CPU is an arithmetic unit, and LN is a signal line. The pressure sensor PT is a signal line, as shown in FIG. Installed. The output signal of the pressure sensor PT is applied to an arithmetic unit CPU inside the measurement control unit 10 via a signal line LN. The arithmetic unit CPU performs various arithmetic operations on the signal of the pressure sensor PT in order to obtain various types of circulatory system information such as blood pressure information and partially circulating information. In the case of using a semiconductor sensor in <br/> pressure sensor, it is necessary to connect a differentiator in the range of the time constant 60~400msec in front of the arithmetic unit CPU.

FIG. 3 is a waveform chart for explaining the operation of the circulatory system comprehensive evaluation device of the present invention. In FIG. 3, (1) shows a pressure pulse wave generated in an artery such as the brachial artery in a state where a compression equal to or higher than the systolic blood pressure is performed. (2) shows the output signal waveform detected the pressure pulse wave by the pressure sensor using a non-directional microphone.
Signal waveform (2) is in the form of being differentiated by the time constant of the pressure sensor the pulsating vibration (1).

[0012] Figure 4 is a block diagram showing the structure of an embodiment of a measurement circuit for measuring the cardiac cycle and the left ventricular ejection time. 4 is a part of the arithmetic unit CPU. In FIG. 4, PT is a pressure sensor, which uses a pressure-electric conversion element of an omnidirectional microphone using an FET and detects an arterial pulse wave as a pressure change. Pressure sensor PT
The impedance conversion of the omnidirectional microphone is performed by a self-biased FET to prevent the operating point drift at the time of excessive input, and the first-order differential time constant constituted by the input resistance of the self-biased FET is 60 to 400 ms.
It is set in the range of c.

Reference numeral LV denotes a level detection circuit, and a pressure sensor PT
Is detected when the pressure detection output exceeds a predetermined level, that is, when the aortic valve opening time point a shown in FIG.
The pulse A is output. TM1 and TM2 are timers that measure the time from when a signal is applied to the start terminal to when a signal is applied to the stop terminal, and output the result to the output terminal. The pulse A output from the level detection circuit LV is supplied as a timer start signal to the timers TM1 and TM2. Here, the pressure sensor PT
Is output as a predetermined time-constant differential signal of the pulse wave, as shown in (2) of FIG.

CN1 is a counter. Counter CN
1 outputs a pulse of a different polarity every time the pulse A output from the level detection circuit LV is received. When the first pulse is received from the level detection circuit LV (that is, (1) in FIG. 3). At the point a) of the first aortic valve opening,
Negative pulse (outputs, upon receiving the next pulse from the level detection circuit LV (i.e., the (1 point b of the aortic valve opens release of)) in FIG. 3, and outputs a positive pulse B, A preset counter that operates so as to output a negative pulse when receiving the next pulse from the level detection circuit LV.A positive pulse B output from the counter CN1 is transmitted to the timer TM1 as a timer stop signal. After receiving the pulse A from the level detection circuit LV, the timer TM1 outputs the pulse B from the counter CN1.
Time until the heart rate is received and the measured value D
Output as R.

The predetermined time constant differential signal which is a pressure detection output of the pressure sensor PT is connected to the minimum detector DT. Minimum detector DT outputs a positive pulse F every time of detecting the minimum value of the output signal of the pressure sensor PT. The positive pulse F output from the minimum value detector DT is supplied to the timer TM2 as a timer stop signal. Timer TM2 measures the time from receiving pulse A from level detection circuit LV to receiving pulse F from minimum value detector DT, and outputs the measured value G as left ventricular ejection time ET. Measured value D from timer TM1
The (heartbeat period RR) is supplied to a computing unit CL, which is also supplied with a measured value G (left ventricular ejection time ET) from a timer TM2, and the computing unit CL is supplied with a measured value D. (Heart cycle RR) and measured value G (left ventricular ejection time ET)
Is used to obtain various information of the circulatory system, such as blood pressure information and partial circulation information.

Next, the operation of the circuit of FIG. 4 configured as described above will be described. First, the measurement control unit 10 sends the manchette 20 through the air supply pipe 30.
By controlling the pressure of the air sent to the air bag 22, the suppression pressure at the position where the pressure sensor PT is provided is gradually reduced from the blood flow cutoff state. Then, in Oppland white-metric method, the range of systolic or determining the blood pressure suppression force, from the pressure sensor PT, as shown in (2) in FIG. 3, a predetermined time constant differential signal of pulse wave is output You. Level detection circuit LV
Detects a time point a when the pressure detection output of the pressure sensor PT exceeds a predetermined level, that is, a time point a when the first aortic valve is opened, and outputs a pulse A.
2 and the counter CN1. In response to this, their <br/> respectively, to start the measurement of the cardiac cycle and the left ventricular ejection time.

After receiving the pulse A from the level detection circuit LV, the timer TM1 outputs the pulse B from the counter CN1.
Is measured, that is, the heartbeat period RR of the pulse wave, and the measured value D is output to the calculator CL. The timer TM2 measures the time from when the pulse A is received from the level detection circuit LV to when the pulse F is received from the minimum value detector DT, that is, the left ventricular ejection time.
Is output to the arithmetic unit CL. In the arithmetic unit CL, the measured value D
(Heart cycle RR) and measured value G (left ventricular ejection time ET)
The following calculation formula is used to calculate various types of circulatory information such as blood pressure information and peripheral circulatory information, and the result is output as circulatory system comprehensive evaluation information.

The following calculations are performed using the systolic blood pressure BPS and the diastolic blood pressure BPD measured by the oscillometric blood pressure measurement, the cardiac cycle RR measured by the circuit of FIG. 4 and the left ventricular ejection time ET. An operation is performed using an expression. Arithmetic equation 1) The averaging measurement values of left ventricular ejection time (msec) = ET and cardiac cycle (msec) = RR are defined as ETav and RRav, respectively. 2) The measured systolic blood pressure is BPS, the diastolic blood pressure is BPD, and the average blood pressure calculation formula is BPM = BPD + K * (BPS-BPD). (However, K = 1/3, 0.43, 1/2) Systolic blood pressure BPS Diastolic blood pressure BPD Heart rate cycle RRav Heart rate HR = 60 * 1000 / RRav Left ventricular ejection time ETav

From the heartbeat period RR and the left ventricular ejection time ET, a heartbeat corrected left ventricle ejection time EI is obtained, and a minute cardiac output index corresponding to electrical current information is obtained. Arnold Whistler calculates heart rate corrected left ventricular ejection time EI as follows: male; ET (msec) =-1.7 × HR + 413 female; ET (msec) =-1.6 × HR + 418 From the relational expression of male; EI = ET + 102 × (1 / RR−1) female; EI = ET + 96 × (1 / RR−1)
The unit of RR is sec. In addition, how to find the heart rate correction left ventricular ejection time EI by Hazette

(Equation 1) EI = ET / √ (RR) The unit of RR is sec.

[0020] Cardiac output per minute Index

(Equation 2) El = ETav / √ (RRav * 1000) Total peripheral resistance lndex RE = BPM / El Total arterial compliance lndex CO = CR / RE Stroke output lndex SV = EI / HR Minute heart power lndex PV = BPM * El Arterial sinus time constant Index CR = (RRav-ETav) / ln (BPS / BPD) Pulse index Index PS = (BPS-BPD) / BPS Thus, systolic blood pressure, diastolic blood pressure, heart cycle,
By directly measuring the left ventricular ejection time, it is possible to determine the components of the Wind Kessle Classic model and various circulation indices, enabling a comprehensive evaluation of the whole body circulatory system. This comprehensive evaluation of the circulatory system is a synthetic evaluation of the physical condition that changes with time in the individual's essential constitution, and is effective as an index of self-health management and as a tool for examining the action and side effects of drugs.

[0021]

As is apparent from the above description, the present invention relates to an oscillometric sphygmomanometer using a manchette in the upper arm or the forearm, and an omnidirectional sensor for detecting the internal pressure of the central assist manchette or the manchette for measuring blood pressure. provided the pressure sensor, such as sexual microphone, simultaneously performing the measurement of systolic and diastolic blood pressure, in a state that was subjected to compression less than the systolic pressure, central side auxiliary manchette or blood pressure measured by the pressure sensor detecting a beat change in the internal pressure of the cuff, by the maximum amplitude of the central portion all pressure pulse waveform obtained from the pressure sensor measures the cardiac cycle and the left ventricular ejection time from becoming beats a predetermined level or higher, To obtain various information of the circulatory system such as blood pressure information and peripheral circulation information from systolic blood pressure, diastolic blood pressure, cardiac cycle and left ventricular ejection time. By implementing an overall rating device cardiovascular, with a simple structure, individuals can be easily obtained blood pressure information and Sue稍 circulation information. According to the present invention,
With the same feeling as a widely used blood pressure monitor, it is possible to realize a circulatory system comprehensive evaluation device that allows an individual to easily obtain blood pressure information, peripheral circulation information, and the like.

[Brief description of the drawings]

FIG. 1 is an explanatory diagram showing a configuration of a circulatory system comprehensive evaluation device of the present invention.

FIG. 2 is a measurement control unit 1 of the circulatory system comprehensive evaluation device of the present invention.
It is an explanatory view showing a configuration of a pressure sensor and the measurement circuit at 0.

FIG. 3 is a waveform chart for explaining the operation of the circulatory system comprehensive evaluation device of the present invention.

4 is a block diagram showing the structure of an embodiment of a measurement circuit for measuring the cardiac cycle and the left ventricular ejection time.

[Explanation of symbols]

10 ・ ・ ・ Measurement control unit of circulatory system comprehensive evaluation device,
Reference numeral 20: Manchette, 30: Air supply pipe for sending air for measurement from the measurement control unit 10 to the manchette 20, P1, P2, P3: Start of measurement, display button, 21: Additional band, air Bag 2
2, DS: display unit, PT: pressure sensor
Sa, CPU · · · computing device, LN · · · signal line, LV · · · level detection circuit, TM
1, TM2 ... timer, CN1 ... counter,
DT: minimum value detector, CL: arithmetic circuit

Claims (4)

(57) [Claims] 1. A Oppland white-metric method sphygmomanometer with cuff in the upper arm or forearm, and the air pressure sensor for detecting the internal pressure of the central side auxiliary manchette or blood pressure measurement cuff, the measurement of systolic and diastolic blood pressure the performed simultaneously, and means for detecting the beat change in the internal pressure of the central side auxiliary manchette or blood pressure measuring cuff by the air pressure sensor in the state they were subjected to pressure above systolic blood pressure, than the air pressure sensor Means for measuring a cardiac cycle and a left ventricular ejection time from a beat in which the maximum amplitude of the obtained central total pressure pulse waveform is equal to or more than a predetermined level, wherein the systolic blood pressure, the diastolic blood pressure, the cardiac cycle and the left A comprehensive circulatory system evaluation device that obtains various circulatory system information such as blood pressure information and partial circulation information from ventricular ejection time. 2. A brachial or Oppland white-metric method sphygmomanometer with cuff in forearm, and air pressure sensor for detecting the internal pressure of the central side auxiliary manchette or blood pressure measurement cuff, the measurement of systolic and diastolic blood pressure the performed simultaneously, in a state that was subjected to compression less than the systolic pressure, and means for detecting the beat change in the internal pressure of the central side auxiliary manchette or blood pressure measuring cuff by air pressure sensors, from the air pressure sensor The time interval between the rising point of the obtained central pressure pulse waveform and the minimum value point due to the notch is set to 24 to 27 of one pulsation cycle in order to exclude waveform distortion due to excessive compression.
% Or less, and when calculating a plurality of beats, means for calculating an average value and measuring it as a left ventricular ejection time, comprising: systolic blood pressure, diastolic blood pressure, heart cycle, and left ventricular ejection. A comprehensive circulatory system evaluation device that obtains various circulatory system information such as blood pressure information and peripheral circulatory information from time. 3. An oscillometric sphygmomanometer using a manchette in an upper arm or a forearm portion, wherein a self-bias type FET performs impedance conversion for detecting an internal pressure of a central side assist manchette or a manchette for measuring blood pressure. Time constant 60 to 40
And air pressure sensor in the range of 0 msec, at the same time as the systolic blood pressure when performing measurement of the diastolic blood pressure, in a state that was subjected to compression less than the systolic pressure, central side auxiliary manchette or blood pressure measured by窒気pressure sensor and means for detecting the internal pressure of use manchette, the rising point and the rising point of the next pulsation of the central portion all pressure pulse waveform obtained from the air pressure sensor 1 pulsation cycle, 1
When measuring multiple beats excluding 24-27% or less of one beat cycle in order to exclude the waveform distortion due to excessive compression in the time interval between the rising point between beats and the minimum value point due to the notch Is provided with means for calculating an average value and measuring it as a left ventricular ejection time, from the systolic blood pressure, the diastolic blood pressure, the cardiac cycle and the left ventricular ejection time, a circulatory organ such as blood pressure information or partial circulation information. Comprehensive circulatory system evaluation device that obtains various types of yarn information. 4. A sphygmomanometer using a manchette having a pressure sensor and a blood flow restricting element in an upper arm or a forearm portion, wherein the suppression of pressing by the blood flow restricting element is gradually reduced from a blood flow cutoff state. A suppression control means for controlling the suppression to be constant just before the blood flow passage limit at which a detection output is obtained from the pressure sensor; a heartbeat cycle measuring means for measuring a heartbeat cycle; and the suppression control means for keeping the suppression constant. A left ventricular ejection time measuring means for measuring a left ventricular ejection time from a pressure change obtained from the pressure sensor when controlling, a systolic blood pressure, a diastolic blood pressure, a heart cycle, a left ventricular ejection time, Circulatory system comprehensive evaluation device that obtains various information of the circulatory system such as blood pressure information and peripheral circulatory information from.