CN101365373A - Techniques for prediction and monitoring of clinical episodes - Google Patents
Techniques for prediction and monitoring of clinical episodes Download PDFInfo
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Abstract
A method is provided for predicting an onset of an asthma attack. The method includes sensing at least one parameter of a subject without contacting or viewing the subject or clothes the subject is wearing, and predicting the onset of the asthma attack at least in part responsively to the sensed parameter. Also provided is a method for predicting an onset of an episode associated with congestive heart failure (CHF), including sensing at least one parameter of a subject without contacting or viewing the subject or clothes the subject is wearing, and predicting the onset of the episode at least in part responsively to the sensed parameter. Other embodiments are also described.
Description
The cross reference of related application
The application requires the priority of following patent application: (a) people's such as Halperin that submitted on August 3rd, 2005 the U.S. Patent application 11/197 that is entitled as " Techniques for prediction and monitoringof clinical episodes ", 786, this patent requires following priority: (i) U.S. Provisional Patent Application of submitting on June 21st, 2,005 60/692,105, the (ii) U.S. Provisional Patent Application of submitting on April 25th, 2,005 60/674,382; (b) U.S. Provisional Patent Application of submitting on June 21st, 2,005 60/692,105.This paper is incorporated in all above-mentioned applications by reference into.
Technical field
Generality of the present invention relates to prediction and monitoring abnormal physiology state, particularly is used for by non-cpntact measurement and analyzes physiology and/or the method and apparatus of abnormal physiology state is predicted and monitored to the physical parameter feature.
Background technology
The occasionality that chronic disease often shows as clinical symptoms worsens.The prophylactic treatment of chronic disease reduces required whole dosage and relevant side effect, and reduces mortality rate and sickness rate.Generally speaking, should when monitor the earliest period clinical symptoms, begin or strengthen prophylactic treatment, so that the development and the deterioration of prevention clinical episodes, and stop and reversing pathophysiological process.Therefore, the ability of index had improved the effectiveness of prophylactic treatment chronic disease before accurately monitoring showed effect.
Many chronic diseases cause such as breathing and the general variation of the vital sign of heart beating pattern by various physiological mechanisms.For example, the common respiratory disorder such as asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF) directly changes breathing and heart beating pattern.Also known change heart of chronic disease and respiratory activity such as diabetes, epilepsy and some cardiac conditions (for example congestive heart failure (CHF)).Under some cardiopathic situation, this change normally produces owing to the pathophysiology relevant with general myovascular insufficiency with fluid retention.Also known have importance such as other signal of coughing and sleep restless under some clinical settings.
Many chronic diseases are brought out the general influence of vital sign.For example, some chronic diseases are disturbed normal the breathing and cardiac procedure between awakening and sleep period, cause breathing and heart beating pattern unusual.
Breathing and heart beating pattern can and change through various direct and indirect physiological mechanisms, produce and the relevant abnormal patterns of change reason.Directly change breathing such as some respiratory disorders of asthma with such as some heart diseases of CHF.Influence the active neuropathy of autonomic nervous system such as other Developmental and Metabolic Disorder of hypoglycemia and other and change breathing indirectly.
Asthma is the chronic disease that does not have known therapies.Symptoms of asthma be can significantly alleviate by preventative therapy, bronchodilator and antiinflammatory for example used.The purpose for the treatment of asthma is to improve the quality of life of asthma object.Treating asthma proposes stern challenge to patient and doctor, because prophylactic treatment needs the adaptability of long term monitoring pulmonary function and corresponding administration type and dosage.But the monitoring pulmonary function is remarkable, and needs complicated instrument and professional skill, and this generally can not provide under non-clinical or family's condition.
The monitoring pulmonary function is regarded as determining the principal element of correct treatment and patient's tracking.Preferred therapy usually based on aerosol pattern medicine to minimize systemic side effects.The curative effect of aerosol pattern therapy and compliance of patients height correlation, compliance of patients are difficult to estimate and keep, and this also helps the pulmonary function importance of monitoring.
As if asthma attack is several days time of development usually, although they occur sometimes unexpectedly.Beginning gradually of asthma attack for starting counter measure to stop and the inflammatory process of reversing provides chance.The early treatment of outbreak last stage can significantly reduce the clinical episodes symptom, and even can prevent to be transformed into clinical episodes fully from preclinical phase.
Two kinds of technology of the general use of asthma monitoring.First kind of technology is spirometry, utilizes spirometer to estimate pulmonary function, and spirometer is a kind of instrument of the volume of air of measuring the lung suction and breathing out.During carrying out strong collaborative suction and breathe out, the blowing nozzle that is connected to spirometer through pipe measures aerodynamics patient.The peak flow instrument is a kind of simpler apparatus that is similar to spirometer, and uses in a similar fashion.Second kind of technology estimated pulmonary function by utilizing special-purpose nitrogen oxide monitor to measure nitrous oxides concentration.Patient blows to the blowing nozzle that is connected to monitor through pipe.
Effectively treating asthma needs every day and monitors breathing function, and this is normally unpractical, especially in non-clinical or home environment.Peak flow instrument and nitrogen oxide monitor provide the general indication of pulmonary function situation.But these monitoring devices do not have predictive value, and are used as interparoxysmal sign.In addition, peak flow instrument and nitrogen oxide monitor need patient's active to participate in, and this is difficult to obtain from many children, and can not obtain from the baby substantially.
CHF be have a weak heart can not blood circulation to satisfy the disease of somagenic need.Body fluid in lower limb, kidney and lung accumulation subsequently makes disease show congested feature.Weak can be relevant with the left and right or both sides of heart, the different causes of disease is relevant with every kind of pattern with treatment.As a rule, the decline of the left side of heart can not pump into blood in the body circulation it effectively.Body fluid is full of pulmonary and causes respiratory variations subsequently, comprises the variation of frequency and/or mode, and follows dyspnea to increase and rapid breathing.
The development that is quantified as assessment CHF of this adnormal respiration provides the foundation.For example, Cheyne-Stokes respiration (Cheyne-Stokes Respiration (CSR)) is a kind of breathing pattern, it is characterized by with alternative asphyxia and breathe enhanced intermittence with morning and evening tides capacity of regular cycle period to vibrate.Though (encephalitis, big disturbance of cerebral circulation and medullary respiratory center pathological changes) can be observed CSR, the independent hazard factor that it has been considered to aggravate heart failure and has reduced CHF object survival rate in many different diseases.In CHF, CSR is relevant with the frequent awakening that interrupts sleep, and relevant with the sympathetic nerve activation of following, and both all can make CHF worsen.Other abnormal breathing pattern can relate to periodic breathing, expiration or air-breathing prolongation or cause Tachypneic breathing rate gradual change usually.
At whole phenolics, generally use several sensor devices to monitor the health of fetus, comprise as heredity and developmental defect screening implement and monitor the ultrasonic imaging of fetal growth, and the heart beating that utilizes doppler ultrasound sensor monitoring fetus.Have been found that healthy babies responds activity by increasing heart rate, similar to the adult in the mode of activity and the changes in heart rate of quiescent period.The heart rate of fetus changes between 80 to 250 beats/min usually, and quickens with the motion of normal health fetus.The shortage of this variation is relevant with the antenatal high fetal mortality that observes.In later stage of pregnancy, especially in the pregnancy of highly dangerous, monitoring baby heart beating is to monitor the healthy of baby and to discern the initialize signal that the baby gets into danger on the basis of routine usually, and this causes initiatively beginning urgent childbirth usually.The solution that monitors foetus health at present generally is not suitable for home environment.
Impact cardiotokography aroused in interest is to measure because the health recoil that blood circulation cardiac and blood motion cause.Can use the pick off of the health slight movement that the acceleration in the time of can detecting blood and move produces in blood circulation.For example, in the United States Patent (USP) 4,657,025 of the Orlando that incorporates this paper by reference into, put down in writing a kind of device that utilizes single-sensor sensing heart rate and breathing rate.This pick off is that a structure is used to strengthen because the electromagnetic transducer of the sensitivity of patient's heart beating and breathing function effect and the vertical vibration direction that produces on common bed, and the patient who is described as leaving standstill in bed and place under the situation that does not have physical connection between the pick off on the bed away from patient and to realize enough sensitivity.
Paradoxical pulse is the sign that exists in the outer disease of the various hearts and the heart, and it has valuable diagnosis and prediction significance.Paradoxical pulse is commonly defined as the contraction pressure drop that intake period is higher than 10mmHg.Paradoxical pulse and following disease association: cardiac tamponade, pericardial effusion, constrictive pericarditis, restrictive cardiomyopathy, pulmonary infarction, acute myocardial infarction, cardiogenic shock, bronchial asthma, tension pneumothorax, anaphylactic shock, gastric volvulus, diaphragmatocele, superior vena cava block.In bronchial asthma, paradoxical pulse is very important, because it is often relevant with slight obstruction, and therefore can be as the signal of warning in early days.Generally be difficult to assess the paradoxical pulse among the child, especially in emergency room (for example referring to " the The clinical presentation of acute asthmain adults and children " of Brenner BE etc., In Brenner, BE, ed.Emergency Asthma (New York:Marcel Dekker, 1999:201-232)).
Also may be interested in following patent and patent application gazette, they all incorporate this paper by reference into:
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The paper of undated being entitled as " Pedema TOR:Innovativemethod for detecting pulmonary edema at the pre-clinical stage " of Shochat M etc. can find on network address http://www.isramed.info/rsmm_rabinovich/pedemator.htm, and incorporate this paper by reference into, it has described a kind of clinical preceding impedance monitor that detects pulmonary edema that is used for.This impedance monitor is striden the breast impedance it is deducted and is measured " the intrathoracic impedance " that is substantially equal to the lung impedance by the impedance of automatic calculating skin electrode and from what measure.
Propose, the biology of breathing rate and heart rate change may prove to such as the chronic disease of asthma and CHF and for such as stress other state of an illness be useful (for example referring to the United States Patent (USP) 5,076,281,5 of Gavish, 800,337 and 6,090,037, the United States Patent (USP) 6 of Gavish etc., 662,032 and the US patent application publication 2004/0116784 of Gavish, they all incorporate this paper by reference into).Attempted utilizing based on the biofeedback technology of continuous measurement with provide the vision/auditory feedback relevant to carry out this biological the change with the value of monitoring parameter.
Some researcheres think, if individual in slight or REM sleep rather than awaken in deep sleep, best awakening then can occur.For example, aixs cylinder sleep study laboratory (Axon Sleep Research Laboratories, the Providence, Rhode Island,USA) developing a kind of intelligent alarm clock (being called " SleepSmart "), circulation of its monitoring sleep and the optimum of attempting in sleep cycle are waken user up.The headband that SleepSmart needs user to have on and measures physiological data is sleeping.Also propose, can from the breathing between sleep period and heart rate information obtain sleep stage (for example referring to people such as Shinar Z " Identificationof arousals using heart rate beat-to-beat variability; " Sleep 21 (3Suppl): 294 (1998), it incorporates this paper by reference into).
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The aforementioned reference that comprises in the background technology part does not also mean that they constitute prior art or the similar technique relevant with the present invention disclosed herein.
Summary of the invention
In some embodiments of the present invention, a kind of method of monitoring chronic internal disease comprises at least a breathing pattern and/or at least a heart beating pattern of non-intruding monitor object during nighttime sleep usually.These patterns are analyzed, so that (a) the imminent clinical episodes that worsens of prediction such as asthma attack or congestive heart failure, and/or (b) when clinical episodes takes place, monitored its seriousness and development.Analyzing these patterns generally includes these patterns and separately baseline mode is compared.Predict that imminent clinical episodes helps the early prevention treatment, this reduces needed dosage usually.Use for some, this method also comprises other potential index of monitoring imminent clinical episodes, and for example body temperature, cough, sleep is restless and/or blood pressure.Use for some, the prediction of clinical episodes or monitoring be one or more based in these other the potential index only.
In some embodiments of the present invention, monitor and breathe and the heart beating pattern by obtaining body motion data relevant with heart beating between sleep period substantially continuously (for example night of at least 80% between sleep period) between the All Through The Night sleep period usually with the breathing of object.Handle exercise data producing at least one motor pattern relevant and therefrom to draw breathing pattern with periodic breathing, and/or at least one motor pattern relevant with periodic heartbeat and therefrom draw the heart beating pattern.For some application, utilize not contact or the object of observation or the habited pick off of object obtain this exercise data.For example, this pick off can comprise piezometer or strain gauge, and it is generally suitable for being installed in mattress, bedding pad, mattress cover or sheet below or inner that object is slept, and is suitable for detecting and breathes and mechanical perturbation that Herzschlag causes.Use for some, also from exercise data, obtain other such as the cough and the restless potential index of sleeping.Because it is non-intrusion type (and not discernable usually) that data are obtained, so it generally is suitable for monitoring child and adult in home environment.
Use the technology of describing generally can before object is awared outbreak, detect imminent clinical episodes herein.For example, before awaring any perceptible signal of warning in early days that increases such as breathing rate, object predicts asthma attack usually.Usually, before the substantive increase of the breathing rate of object, for example before increasing by 20%, for example 10% or 5% than baseline (i.e. normal respiratory rate when object does not have symptoms of asthma substantially), breathing rate predicts asthma attack.And, before comparing baseline reduction by 10%, the forced expiratory volume in 1 second (FEV1) of object predicts asthma attack usually.Usually at least one hour, at least 4 hours prediction clinical episodes for example before clinical episodes outbreak.
Detection technology described in the literary composition does not need the compliance of object or another person (for example father and mother of object or health care worker) usually." compliance " comprises that in this article the active that should be understood to be in people when measuring the one or more physiological parameter be used to predict or monitor clinical episodes in the claims participates in, for example by manually or test the physiological parameter that (for example deserving to be called by standing in) checks object.Carry out the action carried out otherwise merely, it is sleeping for example to lie on a bed at night, does not then drop in the scope of " compliance ".Similarly, beginning, place tram (for example below mattress or the intravital implantation position of patient) with pick off is disposable, or carry out also not being considered as dropping in the scope of " compliance " that help ongoing measurement such as the periodicmaintenance of changing battery.Similarly, be not regarded as dropping in the scope of " compliance " by people's physiological parameter that on-the-spot or long-range explanation is measured behind sensing.
The effectiveness of described technology part is disturbed eupnea and cardiac cycle and is caused the abnormal breathing of disease specific and the check result of heart beating pattern between sleep period and during awakening based on some chronic internal medicine diseases herein.Various physiological mechanisms change to be breathed and the heart beating pattern, produces and the relevant special pattern of change reason.Such as the respiratory disorder of asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF) and physically different change breathing and the heart beating pattern relevant with some diseases.For example, these change the physically different of breathing pattern and comprise: (a) congestive heart failure (CHF), it produces the abnormal breathing pattern such as Cheyne-Stokes respiration (CSR) or periodic breathing sometimes, (b) hypoglycemia, that for example caused by diabetes and (c) unusual autonomic nervous system activity is for example caused by some sacred diseases.
Fluid retention is relevant with the variation of Herzschlag and breathing pattern in the lung tissue that occurs during the cardiopathic periodicity of being everlasting worsens.In some embodiments of the present invention, provide a kind of method that is used for monitoring usually the chronic heart failure object at home.In other embodiments of the present invention, provide a kind of and predict method with the evaluation object heart by breathing between non-intruding monitor sleep period at night and heart beating pattern.In other embodiment, a kind of method of warning in early days that produces imminent heart disease clinical deterioration rates when lung liquid accumulates in early days is provided, help thus to become and treat before even more serious in clinical symptoms.
In some embodiments of the present invention, the relevant coughing fit of clinical episodes of monitoring and/or evaluation and generation soon or appearance.In asthma, tussiculaing usually is the preceding sign of important early onset thereof that the clinical asthma attack of indication is about to begin.In congestive heart failure (CHF), cough can provide because heart failure worsens or the myovascular insufficiency development causes fluid retention warning in early days in lung.
In some embodiments of the present invention, provide a kind of and comprise that monitoring shows as the too much restless method of body kinematics between sleep period.Quantize to provide night restless objective measurement restless.Usually, utilization does not contact or checks that object or the habited pick off of object obtain body kinematics.For some application, periodic limb movement (PLMS) in the identification sleep.The generation of this syndrome and level are used as such as the chronic disease outbreak of CHF, diabetes, anemia, nephropathy and asthma or the index that worsens.
In some embodiments of the present invention, the parameter of monitoring such as breathing, heart rate and/or cough between the night sleep period.Successive analysis or after sleep finishes, for example analyze these parameters in the morning to predict imminent clinical episodes.In the morning or warn the imminent clinical episodes of object daytime later on.These imminent clinical episodes generally to arrive predict them arriving after at least several hrs just can take place.Therefore, notice is deferred to is generally object later on morning or daytime and provides the competent time before the outbreak clinical manifestation, beginning prophylactic treatment, and do not need the sleep of interrupt object.Use for some, seriousness and/or the urgency of analytical parameters to estimate imminent clinical episodes, and determine whether to wake up object according to seriousness and/or urgency.
In some embodiments of the present invention, predict or monitor clinical episodes by the relevant report information of the medical treatment that deviation is also considered and present object is being accepted of assessment measurement parameter and baseline parameter such as medicine and dosage information.For some application, directly receive medication information, and, manually provide information by object or health care worker for other application from doser.
In some embodiments of the present invention, provide a kind of method, this method be included in object when sleep do not contact or the habited situation of the object of observation or object institute under sensed object motion relevant parameter and analyze this parameter.Analysis is responded to small part, determine drug dose that object is used, and send dosage to object used doser.Usually, the clinical effectiveness of monitoring medicine and feedback offered doser to keep or to upgrade drug dose.
In some embodiments of the present invention, provide a kind of method that is used for monitoring conceived object fetus.This method be included in do not contact or the object of observation or object the motion relevant parameter of sensed object under the habited situation.Use for some, the inside on the dependence surface (for example common bed) of lying by measuring object, above or below pressure come the sense movement relevant parameter.Analyze this motion relevant parameter with heart beating that obtains fetus and/or the motion of measuring fetus.
In some embodiments of the present invention, provide a kind of method, this method be included in do not contact or the object of observation or object the motion relevant parameter of sensed object under the habited situation.By this motion relevant parameter acquisition and heart beating or the relevant signal of breathing.Utilize the breathing coherent signal to come rectification heart beating coherent signal, for example the heart beating coherent signal be multiply by the breathing coherent signal.
In some embodiments of the present invention, provide a kind of method that is used to predict clinical episodes.This method comprises the relevant body kinematics time-domain signal of the breathing that obtains object, and converts this time-domain signal to frequency-region signal.Determine the breathing rate of object by the peak value in the breathing correlated frequency scope of identification frequency-region signal.Discern the harmonic wave of one or more crest frequencies.Calculate the energy level of one or more harmonic waves and the one or more ratios between the energy level between the crest frequency and compare with one or more corresponding baseline ratios.This is relatively responded the beginning of predicting outbreak to small part.
In some embodiments of the present invention, provide a kind of and discern the early signal of hypoglycemia outbreak in the diabetes object by the tremble increase of level of identification physiology.Usually, by monitor about 4Hz between about 18Hz, for example detect physiology to the body kinematics between about 12Hz and tremble at about 8Hz.Perhaps, the physiology level increase of trembling is regarded as indicating outbreak or the development that is selected from the following state of an illness: parkinson disease, Alzheimer, apoplexy, essential tremor, epilepsy, stress, fibrillation and anaphylactic shock.In some embodiments, discern hypoglycemia by analysis of cardiac signal identification cardiopalmus.
In some embodiments of the present invention, a kind of system that is used to monitor chronic internal disease comprises and breathes relevant motion acquisition module, breathing pattern analysis module and output module.
Therefore, according to embodiments more of the present invention, provide a kind of method of predicting that clinical episodes begins of being used to, it comprises:
The breathing of sensed object;
Determine at least a breathing pattern of object according to the breathing of sensing;
Breathing pattern and baseline breathing pattern are compared; With
Relatively predict the beginning of outbreak according to this to small part.
Use for some, breathing pattern comprises the breathing rate pattern of object, and the baseline breathing pattern comprises baseline breathing rate pattern, comprises breathing rate pattern and baseline breathing rate pattern are compared and breathing pattern and baseline breathing pattern compared.
Use for some, relatively comprise by the breathing of analytic target during at least one non-symptom and determine the baseline breathing pattern.For some application, relatively comprise according to the average breathing pattern of colony and set the baseline breathing pattern.
Some are used, and the prediction outbreak begins to comprise according to the prolongation inspiratory duration of object and/or the prolongation expiratory duration of object predicts the outbreak beginning.For some application, breathing pattern comprises the successive air-breathing and section of exhaling, and the prediction outbreak begins to comprise according to the trend of the more long duration of at least one in air-breathing section and the section of exhaling and predicts the outbreak beginning.
In one embodiment, clinical episodes comprises and the outbreak that is selected from following disease association: asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), CHF, diabetes and epilepsy.
In one embodiment, breathing pattern comprises respiratory work cycle (breathingduty-cycle) pattern, and prediction outbreak begins to comprise according to the increase in respiratory work cycle of object and predicts the outbreak beginning.
Use for some, the breathing of sensed object comprises that sensing is selected from following at least a breathing related sound: whoop and cough sound, and the prediction outbreak begins to comprise according to an aspect of breathing related sound and predicts the outbreak beginning.
For some application, the breathing of sensed object comprises that sensing is selected from following at least one and breathes associated mechanical vibration: the mechanical vibration that the pant mechanical vibration that cause and cough cause, and the prediction outbreak begins to comprise according to an aspect of breathing the associated mechanical vibration and predicts the outbreak beginning.
In one embodiment, breathing pattern comprises the breathing rate changing pattern, the baseline breathing pattern comprises baseline breathing rate changing pattern, and the prediction outbreak begins to comprise according to the breathing rate variation predicts the outbreak beginning with respect to the minimizing of baseline breathing rate changing pattern in time.For some application, determine that at least one breathing pattern comprises definite breathing rate changing pattern and slow trend breathing rate pattern, relatively breathing pattern and baseline breathing pattern comprise comparison breathing rate changing pattern and baseline breathing rate changing pattern and slow trend breathing rate pattern and the slow trend breathing rate of baseline pattern, and the prediction outbreak begins to comprise according to above two relatively predicts the outbreak beginning.For some application, sensing respiration comprises below the sensing one at least: the breathing sound of object and the respiratory air flow of object.For some application, clinical episodes comprises asthma attack, and prediction outbreak begin to comprise the beginning of predicting asthma attack.
In one embodiment, breathing pattern and baseline breathing pattern comprise slow trend breathing rate pattern separately, and relatively breathing pattern and baseline breathing pattern comprise slow trend breathing rate pattern and the slow trend breathing rate of baseline pattern.For some application, the slow trend breathing rate of baseline pattern comprises breathing rate dull decline at least 1 hour, and the prediction outbreak begins to comprise that the difference of the dullness according to slow trend breathing rate pattern and breathing rate between descending predict the outbreak beginning.
In one embodiment, sensing respiration comprises the relevant body motion data of the breathing of obtaining object.Use for some, obtain and obtain body motion data when exercise data is included in the object sleep.For some application, determine that breathing pattern comprises that analyzing body motion data breathes relevant motor pattern with definite, and determine breathing pattern according to breathing relevant motor pattern.Use for some, determine that breathing pattern comprises from body motion data, to remove and breathe irrelevant exercise data.For example, from body motion data, remove and breathe the analytical technology that irrelevant exercise data comprises application such as frequency domain spectra analysis or time domain regression analysis.
In one embodiment, obtaining body motion data is not included under the habited situation of contact object or object institute and obtains body motion data.For some application, clinical episodes comprises asthma attack, prediction outbreak begin to comprise the beginning of predicting asthma attack.For some application, obtain the relevant body motion data of breathing and comprise gaging pressure.Use for some, gaging pressure comprises the pressure on the mattress that measuring object lies.As selecting or extraly, gaging pressure comprises mattress below or the pressure inside that measuring object is lain.Be further used as and select or extraly, gaging pressure comprises mattress cover below or pressure inside, for example sheet, bedding pad or the bedding cover that measuring object is lain.
For some application, breathing pattern comprises the breathing rate changing pattern, and baseline breathing rate pattern comprises baseline breathing rate changing pattern, and the prediction outbreak begins to comprise according to the breathing rate variation predicts the outbreak beginning with respect to the minimizing of baseline breathing rate changing pattern in time.For some application, determine that at least one breathing pattern comprises definite breathing rate changing pattern and slow trend breathing rate pattern; Relatively breathing pattern and baseline breathing pattern comprise comparison breathing rate changing pattern and baseline breathing rate changing pattern and slow trend breathing rate pattern and the slow trend breathing rate of baseline pattern; The prediction outbreak begins to comprise according to above two relatively predicts the outbreak beginning.
According to one embodiment of the invention, a kind of method also is provided, it comprises:
The breathing of sensed object during clinical episodes;
Determine at least a breathing pattern of object according to the breathing of sensing;
Compare breathing pattern and baseline breathing pattern; With
To small part according to the described development of relatively assessing outbreak.
Use for some, breathing pattern comprises the breathing rate pattern of object, and the baseline breathing pattern comprises baseline breathing rate pattern, and comparison breathing pattern and baseline breathing pattern comprise comparison breathing rate pattern and baseline breathing rate pattern.
Use for some, the assessment development comprises according to the prolongation inspiratory duration of object and/or the prolongation expiratory duration of object assesses development.
For some application, breathing pattern comprises the successive air-breathing and section of exhaling, and the assessment development comprises according to the trend of the more long duration of at least one in air-breathing section and the section of exhaling and assesses development.
In one embodiment, clinical episodes comprises and the outbreak that is selected from following disease association: asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), CHF, diabetes and epilepsy.
In one embodiment, breathing pattern comprises the respiratory work cyclic pattern, and assessment development comprises according to the increase in respiratory work cycle of object and assesses development.
Use for some, the breathing of sensed object comprises that sensing is selected from following at least a breathing related sound: whoop and cough sound, and the assessment development comprises according to an aspect of breathing related sound and assesses development.For some application, clinical episodes comprises asthma attack, and the assessment development comprises the development of assessing asthma attack according to this aspect.
For some application, the breathing of sensed object comprises that sensing is selected from following at least one and breathes associated mechanical vibration: the mechanical vibration that the pant mechanical vibration that cause and cough cause, and the assessment development comprises according to an aspect of breathing the associated mechanical vibration and assesses development.For some application, clinical episodes comprises asthma attack, and the assessment development comprises the development of assessing asthma attack according to this aspect.
In one embodiment, breathing pattern comprises the breathing rate changing pattern, and the baseline breathing pattern comprises baseline breathing rate changing pattern, and the assessment development comprises that variation is assessed development with respect to the minimizing of baseline breathing rate changing pattern in time according to breathing rate.For some application, determine that at least one breathing pattern comprises definite breathing rate changing pattern and slow trend breathing rate pattern, relatively breathing pattern and baseline breathing pattern comprise comparison breathing rate changing pattern and baseline breathing rate changing pattern and slow trend breathing rate pattern and the slow trend breathing rate of baseline pattern, and the assessment development comprises according to above two relatively assesses development.For some application, clinical episodes comprises asthma attack, and the assessment development comprises the order of severity of assessing asthma attack.
In one embodiment, breathing pattern and baseline breathing pattern comprise slow trend breathing rate pattern separately, and comparison breathing pattern and baseline breathing pattern comprise slow trend breathing rate pattern and the slow trend breathing rate of baseline pattern.For some application, the slow trend breathing rate of baseline pattern comprises breathing rate dull decline at least 1 hour, and assesses the difference that develops between the dullness decline that comprises slow trend breathing rate pattern of basis and breathing rate and assess development.
In one embodiment, sensing respiration comprises the relevant body motion data of the breathing of obtaining object.For some application, determine that breathing pattern comprises that analyzing body motion data breathes relevant motor pattern with definite, and determine breathing pattern according to breathing relevant motor pattern.
In one embodiment, obtaining body motion data is not included under the habited situation of contact object or object institute and obtains body motion data.For some application, clinical episodes comprises asthma attack, and the development of assessment outbreak comprises the order of severity of assessing asthma attack.For some application, obtain the relevant body motion data of breathing and comprise gaging pressure.Use for some, gaging pressure comprises the pressure on the mattress that measuring object lies.As selecting or extraly, gaging pressure comprises mattress below or the pressure inside that measuring object is lain.Be further used as and select or extraly, gaging pressure comprises mattress cover below or pressure inside, for example sheet, bedding pad or the bedding cover that measuring object is lain.
For some application, breathing pattern comprises the breathing rate changing pattern, and baseline breathing rate pattern comprises baseline breathing rate changing pattern, and the assessment development comprises according to the breathing rate variation in time than assessing development with respect to the minimizing of baseline breathing rate changing pattern.For some application, determine that at least one breathing pattern comprises definite breathing rate changing pattern and slow trend breathing rate pattern; And relatively breathing pattern and baseline breathing pattern comprise comparison breathing rate changing pattern and baseline breathing rate changing pattern and slow trend breathing rate pattern and the slow trend breathing rate of baseline pattern; And the assessment development comprises according to above two relatively assesses development.
According to one embodiment of the invention, a kind of method also is provided, it comprises:
The breathing of sensed object;
Determine at least a breathing pattern of object according to the breathing of sensing;
Compare breathing pattern and baseline breathing pattern; With
Relatively detect the abnormal breathing pattern relevant according to described to small part with congestive heart failure (CHF).
Use for some, determine that breathing pattern comprises the breathing rate pattern of determining object, relatively breathing pattern and baseline breathing pattern comprise comparison breathing rate pattern and baseline breathing rate pattern.
For some application, detect the abnormal breathing pattern and comprise detection Cheyne-Stokes respiration (CSR), sense cycle breathing and/or detect rapid breathing.
In one embodiment, sensing respiration comprises the relevant body motion data of the breathing of obtaining object.For some application, obtain and obtain body motion data when body motion data is included in the object sleep.
In one embodiment, obtaining body motion data is not included under the habited situation of contact object or object institute and obtains body motion data.For some application, detect the abnormal breathing pattern and comprise detection Cheyne-Stokes respiration (CSR), sense cycle breathing and/or detect rapid breathing.
For some application, obtain the relevant body motion data of breathing and comprise gaging pressure.Use for some, gaging pressure comprises the pressure on the mattress that measuring object lies.As selecting or extraly, gaging pressure comprises mattress below or the pressure inside that measuring object is lain.Be further used as and select or extraly, gaging pressure comprises mattress cover below or pressure inside, for example sheet, bedding pad or the bedding cover that measuring object is lain.
According to one embodiment of the invention, a kind of method also is provided, it comprises:
The breathing of sensed object;
Determine at least a breathing pattern of object according to the breathing of sensing;
Compare breathing pattern and baseline breathing pattern; With
Relatively detect the abnormal breathing pattern relevant with the disease of object according to described to small part, described disease is selected from: chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), diabetes and epilepsy.
Use for some, determine that breathing pattern comprises the breathing rate pattern of determining object, and comparison breathing pattern and baseline breathing pattern comprise comparison breathing rate pattern and baseline breathing rate pattern.
In one embodiment, sensing respiration comprises the relevant body motion data of the breathing of obtaining object.For some application, obtain and obtain body motion data when body motion data is included in the object sleep.
In one embodiment, obtaining body motion data is not included under the habited situation of contact object or object institute and obtains body motion data.
For some application, obtain the relevant body motion data of breathing and comprise gaging pressure.Use for some, gaging pressure comprises the pressure on the mattress that measuring object lies.As selecting or extraly, gaging pressure comprises mattress below or the pressure inside that measuring object is lain.Be further used as and select or extraly, gaging pressure comprises mattress cover below or pressure inside, for example sheet, bedding pad or the bedding cover that measuring object is lain.
According to one embodiment of the invention, a kind of equipment of predicting that clinical episodes begins of being used to still also is provided, this equipment comprises:
Respiration pickup, it is suitable for the breathing of sensed object and produces signal according to described sensing; With
Control unit, it is suitable for:
Received signal,
Determine at least a breathing pattern of object according to described signal;
Compare breathing pattern and baseline breathing pattern; With
To small part according to the described beginning of relatively predicting outbreak.
According to one embodiment of the invention, a kind of equipment also is provided, this equipment comprises:
Respiration pickup, it is suitable for the breathing of object during the sensing clinical episodes and produces signal according to described sensing; With
Control unit, it is suitable for:
Received signal,
Determine at least a breathing pattern of object according to described signal;
Compare breathing pattern and baseline breathing pattern; With
To small part according to the described development of relatively predicting outbreak.
According to one embodiment of the invention, a kind of equipment also is provided, this equipment comprises:
Respiration pickup, it is suitable for the breathing of object during the sensing clinical episodes and produces signal according to described sensing; With
Control unit, it is suitable for:
Received signal,
Determine at least a breathing pattern of object according to described signal;
Compare breathing pattern and baseline breathing pattern; With
Relatively detect the abnormal breathing pattern relevant according to described to small part with congestive heart failure (CHF).
According to one embodiment of the invention, a kind of equipment also is provided, this equipment comprises:
Respiration pickup, it is suitable for the breathing of object during the sensing clinical episodes and responds described sensing producing signal; With
Control unit, it is suitable for:
Received signal,
Determine at least a breathing pattern of object according to described signal;
Compare breathing pattern and baseline breathing pattern; With
Relatively detect the abnormal breathing pattern relevant with the disease of object according to described to small part, described disease is selected from: chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), diabetes and epilepsy.
According to one embodiment of the invention, a kind of method that is used for clinical episodes prediction and assessment also is provided, this method comprises:
In sleep period measurements breathing rate changing pattern at night;
More described breathing rate changing pattern and normal breathing rate changing pattern; With
Determine near the probability of clinical episodes or the development or the seriousness of ongoing outbreak.
Use for some, measure described breathing rate changing pattern with the relevant motor message of breathing of extracting cycle from described compound body kinematics signal by measuring compound body kinematics signal.Perhaps, by measuring described breathing rate changing pattern from mouth and/or nose measurement respiratory air flow.Also or, by measuring described breathing rate changing pattern from breast, the back of the body, neck and/or facial acoustic measurement air flue sound and lungs sound.
Use for some, described normal respiratory rate changing pattern derives from the patient during the non-symptom.Use for some, the normal respiratory rate changing pattern derive from the age, highly, the average mode of the similar normal health object of weight and/or sex characteristics.
For some application, described breathing rate changing pattern: (1) cyclic pattern, its common persistent period be several seconds to a few minutes, and/or the slow trend of (2) sectional dull decline breathing rate continues several hrs usually.
Use for some, described comparison departs from the calculating of the degree of described normal respiratory rate changing pattern based on described breathing rate changing pattern.
In one embodiment, described clinical episodes is clinical asthma attack.
Use for some, described clinical episodes relates to any chronic disease that influences the breathing rate pattern, for example diabetes, heart disease, nervous system disease or epilepsy.
According to one embodiment of the invention, a kind of equipment that is used for clinical episodes assessment and prediction also is provided, this equipment comprises:
Measure the respiration pickup of breathing;
Amplify the amplifier of the output signal of respiration pickup;
The A/D card of the described amplifier output of digitized;
Processor, it extracts breathing rate pattern and more described pattern and normal mode; With
Be presented at the result on numeral, text or the pictorial displays or the result sent to the output device at clinical trail center.
Use for some, respiration pickup is used as the movement sensitive sensors that is installed in mattress below or inside.Perhaps, respiration pickup is used as the pneumatic detector of aiming at the object face.Again or, respiration pickup can also be as the acoustic detector of aiming at or being attached to object's face, breast or the back of the body.
According to one embodiment of the invention, a kind of method also is provided, this method comprises:
Do not contact or the object of observation or object the motion relevant parameter of sensed object under the habited situation;
From acquisition of motion relevant parameter and the heart beating signal relevant with breathing; With
Utilize and breathe coherent signal rectification heart beating coherent signal.
For some application, rectification heart beating coherent signal comprises the breathing coherent signal be multiply by the heart beating coherent signal.Use for some, the signal that acquisition is relevant with breathing with heart beating comprises respectively at the frequency range inner filtration motion coherent signal relevant with breathing with heart beating.For some application, heart beating correlated frequency scope is between 0.8 to 5Hz.For some application, breathing the correlated frequency scope is between 0.05 to 0.8Hz.
According to one embodiment of the invention, a kind of method that is used for measuring conceived object fetal heartbeat also is provided, this method comprises:
Do not contact or the habited situation of the object of observation or object institute under detect conceived motion of objects relevant parameter; With
Obtain the heart beating of fetus from the motion relevant parameter.
In one embodiment, the sense movement relevant parameter comprise in the dependence surface that measuring object lies, on or below pressure.
In one embodiment, this method comprises that the sound that produces by the simulation fetal monitor produces the acoustical signal of the fetal heartbeat that obtains.
Use for some, this method comprises by analyzing the measured value that the fetal heartbeat that is obtained determines that fetal heart frequency changes.Use for some, obtain fetal heartbeat and comprise from the motion relevant parameter of indication fetal heartbeat and mother's heart beating and obtain first signal and obtain the indication fetal heartbeat from first heart beating but do not indicate the secondary signal of mother's heart beating.
For some application, obtain fetal heartbeat and comprise from the motion relevant parameter and obtaining: (a) breath of mother coherent signal and (b) the heart beating coherent signal of fetus; With the heart beating coherent signal that utilizes breath of mother coherent signal rectification fetus.
According to one embodiment of the invention, a kind of method that is used for monitoring conceived object fetal movements also is provided, this method comprises:
Do not contact or the habited situation of the object of observation or object institute under detect conceived motion of objects relevant parameter; With
From the measurement of motion relevant parameter acquisition to fetal movements.
In one embodiment, detect in the dependence surface that the motion relevant parameter comprises that measuring object lies, on or below pressure.
According to one embodiment of the invention, a kind of method also is provided, this method comprises:
At least one parameter of detected object between the object sleep period;
Analyze this parameter;
Predict the beginning of clinical episodes according to described analysis to small part; With
The only beginning of being predicted to the object warning in object awakening back.
According to one embodiment of the invention, a kind of method of predicting that clinical episodes begins of being used to also is provided, this method comprises:
Obtain the relevant time-domain signal of breathing of object;
Convert time-domain signal to frequency-region signal;
Determine the breathing rate of object by the peak in the breathing correlated frequency scope of identification frequency-region signal;
Determine one or more harmonic waves of peak frequency;
Determine following relation between the two:
(a) first energy level is selected from: with relevant energy level in one or more harmonic waves and with the energy level of peak frequency dependence and
(b) second energy level, its with one or more harmonic waves in one relevant;
Relatively should concern and be somebody's turn to do the baseline values of relation; With
To small part according to the described beginning of relatively predicting outbreak.
According to one embodiment of the invention, a kind of method that is used to monitor blood pressure also is provided, it comprises:
Do not contact or the object of observation or object the motion relevant parameter of sensed object under the habited situation; With
Analyze this parameter to determine the blood pressure measurement of object.
Use for some, the sense movement relevant parameter be included in do not contact or the habited situation of the object of observation or object institute under respectively near first position of object with the first and second motion relevant parameters of the second position proximity sensing object.
According to one embodiment of the invention, a kind of method that is used for the treatment of object also is provided, it comprises:
Do not contact or the habited situation of the object of observation or object institute under the sense movement relevant parameter;
Analyze this parameter;
Determine to be administered to the predose of the medicine of object according to described analysis to small part; With
Send predose to object used doser.
For some application, analytical parameters comprises:
Analyze the clinical effectiveness of the medicine that doser uses with the predose that is transmitted;
Determine the renewal drug dose different according to analyzing with predose; With
More new dosage sends doser to.
According to one embodiment of the invention, a kind of method of predicting that clinical episodes begins of being used to also is provided, it comprises:
At least one parameter of detected object;
Analyze this parameter;
Receive the data relevant with the medicine that is administered to object; With
Predict the beginning of clinical episodes according to the combination of described analysis and administration data to small part.
Use for some, receive the administration data and comprise the doser reception administration data of giving object from dispenser.Use for some, the administration data comprise the dosage of medicine.For some application, at least one parameter of sensing when at least one parameter of sensing is included in the object sleep.
According to one embodiment of the invention, a kind of method that clinical episodes begins that is used for the treatment of also is provided, it comprises:
Do not contact or the object of observation or object at least one parameter of sensed object under the habited situation;
Analyze this parameter;
Analyze according to this to small part and to detect clinical episodes; With
According to the clinical episodes that detects, utilize the device of implanting object to treat clinical episodes.
According to one embodiment of the invention, a kind of method also is provided, it comprises:
Do not contact or the habited situation of the object of observation or object institute under, at least one parameter of sensed object when object is slept;
Analyze described parameter to determine the restless measured value of object.
In one embodiment, described at least one parameter comprises at least one motion relevant parameter of object, and at least one parameter of sensing comprises at least one motion relevant parameter of sensing.
According to one embodiment of the invention, a kind of method also is provided, it comprises:
Do not contact or the habited situation of the object of observation or object institute under, at least one parameter of sensed object when object is slept; With
Come periodic limb movement in the sleep of detected object (PLMS) by analyzing described parameter.
In one embodiment, described at least one parameter comprises at least one motion relevant parameter of object, and at least one parameter of sensing comprises at least one motion relevant parameter of sensing.
According to one embodiment of the invention, a kind of method also is provided, it comprises:
Utilization places in the dependence surface that object lies or just what a pick off of below comes at least one parameter of sensed object, and this pick off is the clothes worn of contact object or object not; With
Come the cough of detected object by analyzing this parameter.
In one embodiment, described at least one parameter comprises at least one motion relevant parameter of object, and at least one parameter of sensing comprises at least one motion relevant parameter of sensing.
According to one embodiment of the invention, a kind of method of predicting asthma attack also is provided, it comprises:
The breathing of sensed object;
The heart beating of sensed object;
Determine at least one breathing pattern of object and determine at least one heart beating pattern of object according to the heart beating of sensing according to the breathing of sensing;
Compare breathing pattern and baseline breathing pattern, and compare heart beating pattern and baseline heart beating pattern; With
To small part according to the described beginning of relatively predicting asthma attack.
In one embodiment, determine that at least one breathing pattern and at least one heart beating pattern comprise at least one breathing rate pattern of determining object respectively and at least one heart of object; Relatively breathing pattern and baseline breathing pattern comprise comparison breathing rate pattern and baseline breathing rate pattern; Relatively heart beating pattern and baseline heart beating pattern comprise comparison cardiac rate pattern and baseline cardiac rate pattern.
In one embodiment, sensing respiration and heart beating comprise at least one motion relevant parameter of sensed object, and obtain to breathe and heart beating from the motion relevant parameter.Use for some, this method comprises from the motion relevant parameter and obtains at least one extra physiological parameter, and the prediction outbreak begins to comprise to small part and predicts the outbreak beginning according to described comparison and described extra physiological parameter.Use for some, extra physiological parameter is selected from: the measured value that the measured value of object cough, object are exhaled and the blood pressure of air-breathing time ratio, object, object are awakened between sleep period at measured value restless between sleep period and object.
According to one embodiment of the invention, a kind of method of predicting that asthma attack begins of being used to also is provided, it comprises:
The breathing of sensed object;
Determine at least one breathing pattern of object according to the breathing of sensing;
Compare breathing pattern and baseline breathing pattern;
Determine the measured value of object cough; With
Predict the beginning of asthma attack according to the measured value of described comparison and cough to small part.
According to one embodiment of the invention, a kind of method that is used for the beginning of the prediction outbreak relevant with congestive heart failure (CHF) also is provided, it comprises:
The breathing of sensed object;
The blood pressure of sensed object;
Determine at least one breathing pattern of object according to the breathing of sensing;
Compare breathing pattern and baseline breathing pattern; With
Predict the beginning of outbreak according to described comparison and blood pressure to small part.
According to one embodiment of the invention, a kind of method that is used for the determination object heart rate also is provided, it comprises:
Under the habited situation of not contact object or object institute, near first pulse signal the primary importance of sensed object in being selected from column position down: the chest of object and the abdominal part of object;
Under the habited situation of not contact object or object institute, near second pulse signal the following second position of the anatomy waist of sensed object; With
Determine heart rate according to first and second pulse signals.
Use for some, determine that heart rate comprises the cross-correlated signal of calculating first and second pulse signals, and definite heart rate is the frequency of cross-correlated signal.Use for some, the second position of object comprises near the position of lower limb of object.
In one embodiment, sensing first and second pulse signals be included in do not contact or the habited situation of the object of observation or object institute under sensing first and second pulse signals.
For some application, sensing first pulse signal comprises near the first motion relevant parameter of sensed object primary importance, with obtain first pulse signal from the first motion relevant parameter, and sensing second pulse signal comprise sensed object near the second position the second motion relevant parameter and obtain second pulse signal from the second motion relevant parameter.
Use for some, this method comprises the beginning according to heart rate prediction clinical episodes.
According to one embodiment of the invention, a kind of method also is provided, it comprises:
Do not contact or the habited situation of the object of observation or object institute under, respectively near first position of object and the first and second motion relevant parameters of vicinity, second position sensed object;
Obtain first and second from the first and second motion relevant parameters respectively and breathe coherent signal; With
Analyze first and second and breathe the measured value of coherent signal with the breast abdomen asynchronism (TAA) of definite object.
Use for some, analyze first and second and breathe the phase shifts that coherent signal comprises that calculating first and second is breathed between the coherent signals.
Use for some, first position comprises the lung of object, and second position comprises the hypogastric region of object, and sensing is included in lung and near the sensing first and second motion relevant parameters respectively of hypogastric region.
According to one embodiment of the invention, a kind of method also is provided, it comprises:
Do not contact or the habited situation of the object of observation or object institute under, respectively near first position of object and the first and second motion relevant parameters of vicinity, second position sensed object;
Obtain first and second from the first and second motion relevant parameters respectively and breathe coherent signal; With
Analyze first and second and breathe coherent signal to determine the active measured value of supernumerary muscle of object.
Use for some, analyze first and second and breathe the ratios that coherent signal comprises that coherent signals are breathed in calculating first and second.Use for some, first position comprises the lung of object, and second position comprises the hypogastric region of object, and sensing is included in lung and near the sensing first and second motion relevant parameters respectively of hypogastric region.
According to one embodiment of the invention, a kind of method that is used for monitoring target also is provided, it comprises:
Set the first and second different separately threshold values;
Do not contact or the object of observation or object at least one parameter of sensed object under the habited situation;
Analyze described parameter to produce score value;
If score value between first and second threshold values, then produces first output that indication prediction clinical episodes begins; With
If score value surpasses second threshold value, then produce second output of the present occurent clinical episodes of indication.
Use for some, at least one parameter of sensing be included in do not contact or the habited situation of the object of observation or object institute under a plurality of parameters of sensed object, and analyze this parameter and comprise and analyze a plurality of parameters with the generation score value to produce score value.
Use for some, parameter comprises the breathing relevant parameter of object, and analytical parameters comprises according to parameter to be determined at least one breathing pattern of object and compare breathing pattern and baseline breathing pattern.
Use for some, at least one parameter comprises at least one motion relevant parameter of object, and at least one parameter of sensing comprises at least one motion relevant parameter of sensing.
According to one embodiment of the invention, a kind of method that is used to detect paradoxical pulse also is provided, it comprises:
Do not contact or the object of observation or object at least one parameter of sensed object under the habited situation;
Analyze this parameter air-breathing to be created in/measured value of the cycle period object blood pressure of exhaling;
The measured value and the threshold value that compare blood pressure; With
Detect paradoxical pulse according to measured value greater than threshold value.
In one embodiment, at least one parameter comprises at least one motion relevant parameter of object, and at least one parameter of sensing comprises at least one motion relevant parameter of sensing.
According to one embodiment of the invention, a kind of method of predicting that asthma attack begins of being used to also is provided, it comprises:
Do not contact or the object of observation or object at least one parameter of sensed object under the habited situation; With
To the beginning of small part according to the parameter prediction asthma attack of sensing.
In one embodiment, at least one parameter comprises at least one motion relevant parameter of object, and at least one parameter of sensing comprises at least one motion relevant parameter of sensing.
Use for some, the nursing staff that the prediction outbreak begins to be included in object or object awares prediction outbreak beginning before the outbreak beginning.
Use for some, the prediction outbreak begins to comprise that the appearance by asthma attack before analyzing produces the object specific data that relates to parameter and predicts the outbreak beginning according to these data to small part.
Use for some, the prediction outbreak begins to comprise measured value that determination object is restless and predicts the outbreak beginning according to restless measured value to small part.As selecting or extraly, this method comprises the measured value of determination object cough, the prediction outbreak begins to comprise to small part predicts the outbreak beginning according to the parameter of sensing and the measured value of cough.
In one embodiment, at least one parameter of sensing is included at least one parameter of sensing under the situation of the compliance that does not need the people.For some application, at least one parameter of sensing is included at least one parameter of sensing between the object sleep period.In one embodiment, this method comprises that only the outbreak to object warning prediction begins in object awakening back.
In one embodiment, at least one parameter comprises at least one breathing relevant parameter of object, and at least one parameter of sensing comprises sensing, and at least one breathes relevant parameter.For some application, at least one parameter comprises at least one heart beating relevant parameter of object, at least one parameter of sensing comprises at least one heart beating relevant parameter of sensing, and the beginning of prediction asthma attack comprises to small part predicts the beginning of asthma attack according to breathing relevant and heart beating relevant parameter.
Use for some, the prediction outbreak begins to comprise at least one breathing pattern of determining object according to the breathing relevant parameter of sensing, relatively breathing pattern and baseline breathing pattern and predict relatively that according to this outbreak begins to small part.
In one embodiment, at least one parameter of sensing comprise in the dependence surface that measuring object lies, on or below pressure.Use for some, at least one parameter of sensing comprise utilize place lean in the surface, on or below just what a pick off come gaging pressure.
According to one embodiment of the invention, a kind of method that the prediction outbreak relevant with congestive heart failure (CHF) begins that is used for also is provided, it comprises:
Do not contact or the object of observation or object at least one parameter of sensed object under the habited situation; With
To the beginning of small part according to the parameter prediction outbreak of sensing.
In one embodiment, at least one parameter comprises at least one motion relevant parameter of object, and at least one parameter of sensing comprises at least one motion relevant parameter of sensing.
In one embodiment, at least one parameter of sensing comprise in the dependence surface that measuring object lies, on or below pressure.
For some application, at least one parameter of sensing is included at least one parameter of sensing between the object sleep period.
In one embodiment, at least one parameter of sensing comprises sensing, and at least one breathes the blood pressure of relevant parameter and object, and the prediction outbreak begins to comprise to small part predicts the outbreak beginning according to breathing relevant parameter and blood pressure.In one embodiment, at least one parameter of sensing is included at least one parameter of sensing under the situation of the compliance that does not need the people.
According to one embodiment of the invention, a kind of method of predicting that clinical episodes begins of being used to also is provided, it comprises:
At least one parameter of sensed object; With
When the breathing rate of object be lower than object the asymptomatic breathing rate of baseline 120% the time, predict the beginning of clinical episodes according to the parameter of sensing to small part.
In one embodiment, at least one parameter of sensing be included in do not contact or the habited situation of the object of observation or object institute under at least one parameter of sensing.
In one embodiment, clinical episodes comprises asthma attack, the prediction clinical episodes begin to comprise the beginning of predicting asthma attack.
Use for some, the prediction outbreak begin to comprise when breathing rate be lower than object the asymptomatic breathing rate of baseline 110%, for example be lower than object the asymptomatic breathing rate of baseline 105% the time prediction outbreak begin.
According to one embodiment of the invention, a kind of method of predicting that asthma attack begins of being used to also is provided, it comprises:
At least one parameter of sensed object; With
When the forced expiratory volume in 1 second (FEV1) of object greater than the asymptomatic FEV1 of the baseline of object 90% the time, predict the beginning of asthma attack according to the parameter of sensing to small part.
For some application, at least one parameter of sensing be included in do not contact or the habited situation of the object of observation or object institute under at least one parameter of sensing.
According to one embodiment of the invention, a kind of method of predicting that clinical episodes begins of being used to also is provided, it comprises:
Do not contact or the object of observation or object at least one parameter of sensed object under the habited situation; With
At least one hour before clinical episodes begins, predict beginning according to the parameter of sensing to small part.
Use for some, at least one parameter of sensing be included in do not contact or the habited situation of the object of observation or object institute under at least two parameters of sensed object, the prediction outbreak begins to comprise to small part predicts that according to the parameter of sensing outbreak begins.
For some application, prediction outbreak at least four hours began before the prediction outbreak began to be included in beginning.
Use for some, at least one parameter of sensing is included in basic at least one parameter of sensing continuously in the time period that continues at least one hour.
For some application, clinical episodes comprises asthma attack, the prediction clinical episodes begin to comprise the beginning of predicting asthma attack.
According to one embodiment of the invention, a kind of method of predicting that clinical episodes begins of being used to also is provided, it comprises:
Basic at least one parameter of sensing continuously in the time period that continues at least one hour; With
At least one hour before clinical episodes begins, predict outbreak beginning according to the parameter of sensing to small part.
In one embodiment, at least one parameter of sensing be included in do not contact or the habited situation of the object of observation or object institute under at least one parameter of sensing.
Use for some, at least one parameter of sensing is included in basic at least two parameters of sensed object continuously in this time period, and the prediction outbreak begins to comprise to small part predicts the outbreak beginning according to the parameter of sensing.
In one embodiment, clinical episodes comprises asthma attack, the prediction clinical episodes begin to comprise the beginning of predicting asthma attack.
For some application, prediction outbreak at least four hours began before the prediction outbreak began to be included in beginning.
Use for some, this time period has at least four hours persistent period, and at least one parameter of sensing is included in basic at least one parameter of sensing continuously in the time period that continues at least four hours.
According to one embodiment of the invention, a kind of method of predicting that clinical episodes begins of being used to also is provided, it comprises:
The object section length of one's sleep at night at least 80% during basic at least one parameter of sensing continuously; With
To the parameter of small part according to sensing, the beginning of at least one hour prediction clinical episodes before clinical episodes begins.
Use for some, at least one parameter of sensing be included in this time period at least 80% during basic at least one parameter of sensing continuously, prediction begins to comprise to small part predicts beginning according to the parameter of sensing.
In one embodiment, clinical episodes comprises asthma attack, the prediction clinical episodes begin to comprise the beginning of predicting asthma attack.
In one embodiment, at least one parameter of sensing be included in do not contact or the habited situation of the object of observation or object institute under at least one parameter of sensing.
According to one embodiment of the invention, a kind of method also is provided, it comprises:
At least one parameter of sensed object; With
To the parameter of small part, calculate the probability that clinical episodes will take place in the preset time section after calculating according to sensing.
Use for some, at least one parameter of sensing comprises at least two parameters of sensed object, and calculating probability comprises to small part and comes calculating probability according to the parameter of sensing.
For some application, this method comprises if probability surpasses threshold value then notify object.
In one embodiment, clinical episodes comprises asthma attack, the prediction clinical episodes begin to comprise the beginning of predicting asthma attack.
In one embodiment, at least one parameter of sensing be included in do not contact or the habited situation of the object of observation or object institute under at least one parameter of sensing.
In one embodiment, calculating probability comprise to small part according to comprising that the data of colony's meansigma methods of parameter come calculating probability.As selecting or extraly, calculating probability comprise analyze before the appearance of asthma attack produce the object specific data that relates to parameter and come calculating probability according to these data to small part.
According to one embodiment of the invention, also provide a kind of and be used to predict that clinical episodes begins ground method, it comprises:
At least one parameter of sensing under the situation of the compliance that does not need the people; With
Predict outbreak beginning according to the parameter of sensing to small part.
In one embodiment, at least one parameter of sensing be included in do not contact or the habited situation of the object of observation or object institute under at least one parameter of sensing.
In one embodiment, at least one parameter comprises at least one motion relevant parameter of object, and at least one parameter of sensing is included at least one motion relevant parameter of sensing under the situation of the compliance that does not need the people.
For some application, at least one parameter of sensing is included at least one parameter of sensing between the object sleep period and comprises that only the outbreak to object warning prediction begins in object awakening back.
Use for some, under the situation of the compliance that does not need the people at least one parameter of sensing comprise in the dependence surface that measuring object lies, on or below pressure.
In one embodiment, clinical episodes comprises asthma attack, the prediction clinical episodes begin to comprise the beginning of predicting asthma attack.Perhaps, clinical episodes comprises the relevant outbreak of congestive heart failure (CHF) with object, and the prediction outbreak begins to comprise the beginning of predicting the outbreak relevant with CHF.Also or, clinical episodes comprises the hypoglycemia that is caused by diabetes, prediction outbreak begins to comprise the beginning of predicting hypoglycemic episodes.Also or, clinical episodes is selected from: periodic limb movement (PLMS) outbreak in the movable unusual outbreak of the autonomic nervous system that is caused by nervous system disease, epilepsy, the sleep, apoplexy, essential tremor show effects, stress show effect, fibrillation outbreak, the outbreak relevant with chronic obstructive pulmonary disease (COPD), the outbreak relevant with cystic fibrosis (CF) and the outbreak of anaphylactic shock, and prediction shows effect and begins to comprise the beginning of predicting the clinical episodes of selecting.
In one embodiment, at least one parameter comprise object at least one breathe relevant parameter, at least one parameter of sensing is included under the situation of the compliance that does not need the people sensing, and at least one breathes relevant parameter.Use for some, the prediction outbreak begins to comprise at least one breathing pattern of determining object according to the breathing relevant parameter of sensing, relatively breathing pattern and baseline breathing pattern and predict relatively that according to this outbreak begins to small part.
According to one embodiment of the invention, a kind of equipment also is provided, it comprises:
Non-contact sensor, its be suitable for not contact object or object the motion relevant parameter of sensed object under the habited situation; With
Control unit, it is suitable for:
Obtain heart beating and breathe relevant signal from the motion relevant parameter; With
Utilize and breathe coherent signal rectification heart beating coherent signal.
According to one embodiment of the invention, a kind of equipment that is used for measuring conceived object fetal heartbeat also is provided, it comprises:
Non-contact sensor, it is the conceived motion of objects relevant parameter of sensing under the habited situation of not contact object or object institute; With
Control unit, it is suitable for obtaining fetal heartbeat from the motion relevant parameter.
According to one embodiment of the invention, a kind of equipment also is provided, it comprises:
Non-contact sensor, it is the conceived motion of objects relevant parameter of sensing under the habited situation of not contact object or object institute; With
Control unit, it is suitable for obtaining from the motion relevant parameter measured value of fetal movements.
According to one embodiment of the invention, a kind of equipment also is provided, it comprises:
Pick off is suitable at least one parameter of sensing when object is slept;
User interface; With
Control unit, it is suitable for:
Analytical parameters,
To small part according to the beginning of this analyses and prediction clinical episodes and
Only begin to the outbreak of object warning prediction in object awakening rear drive user interface.
According to one embodiment of the invention, a kind of equipment of predicting that clinical episodes begins of being used to also is provided, it comprises:
Pick off, it is suitable for obtaining the relevant time-domain signal of breathing of object; With
Control unit, it is suitable for:
Convert time-domain signal to frequency-region signal,
Determine the breathing rate of object by the peak in the relevant frequency range of the breathing of identification frequency-region signal;
Determine one or more harmonic waves of peak frequency;
Determine following relation between the two:
(a) first energy level is selected from: with relevant energy level in one or more harmonic waves and with the energy level of peak frequency dependence and
(b) second energy level is relevant with in one or more harmonic waves one;
Relatively should concern and be somebody's turn to do the baseline values of relation; With
Relatively predict the beginning of outbreak according to this to small part.
According to one embodiment of the invention, a kind of equipment that is used to monitor blood pressure also is provided, it comprises:
Non-contact sensor, it is suitable for the conceived motion of objects relevant parameter of sensing under the habited situation of not contact object or object institute; With
Control unit, it is suitable for analyzing this parameter to determine the blood pressure measurement of object.
According to one embodiment of the invention, a kind of equipment that is used for the treatment of object also is provided, it comprises:
Non-contact sensor, its be suitable for not contact object or object the motion relevant parameter of sensed object under the habited situation;
Doser, it is suitable for medicament administration in object; With
Control unit, it is suitable for:
Analytical parameters,
Analyze to determine the predose of medicine according to this to small part; With
Send predose to doser.
According to one embodiment of the invention, a kind of equipment of predicting that clinical episodes begins of being used to also is provided, it comprises:
Pick off, it is suitable at least one parameter of sensed object; With
Control unit, it is suitable for:
Analytical parameters,
Receive the data relevant with the medicine that is administered to object; With
Predict the beginning of clinical episodes according to the combination of this analysis and administration data to small part.
Use for some, this equipment comprises the doser that is fit to medicament administration is given object, and control unit is suitable for receiving the administration data from doser.
According to one embodiment of the invention, a kind of equipment that is used for the treatment of clinical episodes also is provided, it comprises:
Non-contact sensor, its be suitable for not contact object or object at least one parameter of sensed object under the habited situation;
Therapy equipment, it is suitable for implanting in the object; With
Control unit, it is suitable for:
Analytical parameters, to small part according to this analyze detect clinical episodes and
According to detecting clinical episodes, drive therapy equipment and treat clinical episodes.
According to one embodiment of the invention, a kind of equipment also is provided, it comprises:
Non-contact sensor, its be suitable for when object is slept not contact object or object at least one parameter of sensed object under the habited situation; With
Control unit, it is suitable for analyzing this parameter to determine the restless measured value of object.
According to one embodiment of the invention, a kind of equipment also is provided, it comprises:
Non-contact sensor, its be suitable for when object is slept not contact object or object at least one parameter of sensed object under the habited situation; With
Control unit, it is adapted to pass through this parameter of analysis and comes periodic limb movement (PLMS) in the sleep of detected object.
According to one embodiment of the invention, a kind of equipment also is provided, it comprises:
What a pick off just, it is fit to place in the dependence surface that object lies or the below, makes the not clothes worn of contact object or object of pick off, with at least one parameter of sensed object; With
Control unit, it is adapted to pass through the cough that analytical parameters comes detected object.
According to one embodiment of the invention, a kind of equipment of predicting that asthma attack begins of being used to also is provided, it comprises:
Pick off, it is suitable for the breathing of sensed object and the heart beating of object; With
Control unit, it is suitable for:
Determine at least one breathing pattern of object and determine at least one heart beating pattern of object according to the breathing of sensing according to the heart beating of sensing,
Relatively breathing pattern and baseline breathing pattern, and relatively heart beating pattern and baseline heart beating pattern and
Relatively predict the beginning of asthma attack according to this to small part.
Use for some, pick off comprises the first sensor of suitable sensing respiration and second pick off of suitable sensing heart beating.
According to one embodiment of the invention, a kind of equipment of predicting that asthma attack begins of being used to also is provided, it comprises:
Pick off, the breathing of its suitable sensed object; With
Control unit, it is suitable for:
Determine at least one breathing pattern of object according to the breathing of sensing;
Compare breathing pattern and baseline breathing pattern;
Determine the measured value of object cough; With
Predict the beginning of asthma attack according to the measured value of this comparison and cough to small part.
According to one embodiment of the invention, a kind of equipment that the prediction outbreak relevant with congestive heart failure (CHF) begins that is used for also is provided, it comprises:
Pick off, it is suitable for the breathing of sensed object and the blood pressure of object; With
Control unit, it is suitable for:
Determine at least one breathing pattern of object according to the breathing of sensing;
Compare breathing pattern and baseline breathing pattern; With
Predict the beginning of outbreak according to this comparison and blood pressure to small part.
Use for some, pick off comprises the first sensor of suitable sensing respiration and second pick off of suitable sense blood pressure.
According to one embodiment of the invention, a kind of equipment that is used for the determination object heart rate also is provided, it comprises:
First non-contact sensor, it is suitable for first pulse signal of the primary importance proximity sensing object of the object in the abdominal part of chest that is selected from object and object:;
Second non-contact sensor, it is suitable for second pulse signal of the second position proximity sensing object below the anatomy waist of object; With
Control unit, it is suitable for determining heart rate according to first and second pulse signals.
According to one embodiment of the invention, a kind of equipment also is provided, it comprises:
First and second pick offs, its be suitable for not contact object or object under the habited situation respectively near first position at object and the first and second motion relevant parameters of vicinity, second position sensed object; With
Control unit, it is suitable for:
Obtain the first and second motion coherent signals from the first and second motion relevant parameters respectively; With
Analyze first and second and breathe the measured value of coherent signal with the breast abdomen asynchronism (TAA) of definite object.
According to one embodiment of the invention, a kind of equipment also is provided, it comprises:
First and second pick offs, its be suitable for not contact object or object under the habited situation respectively near first position at object and the first and second motion relevant parameters of vicinity, second position sensed object; With
Control unit, it is suitable for:
Obtain first and second from the first and second motion relevant parameters respectively and breathe coherent signal; With
Analyze first and second and breathe coherent signal to determine the active measured value of supernumerary muscle of object.
According to one embodiment of the invention, a kind of equipment that is used for monitoring target also is provided, it comprises:
Non-contact sensor, its be suitable for do not contact or the object of observation or object at least one parameter of sensed object under the habited situation;
User interface; With
Control unit, it is suitable for:
Set the first and second different separately threshold values,
Analytical parameters to be producing score value,
If score value between first and second threshold values, then drive first output that user interface begins with the clinical episodes that produces the indication prediction and
If score value surpasses second threshold value, then drive user interface to produce second output of the present occurent clinical episodes of indication.
According to one embodiment of the invention, a kind of equipment that is used for the paradoxical pulse of detected object also is provided, it comprises:
Non-contact sensor, its be suitable for not contact object or object at least one parameter of sensed object under the habited situation; With
Control unit, it is suitable for:
Analytical parameters is air-breathing to be created in/measured value of the cycle period object blood pressure of exhaling;
The measured value and the threshold value that compare blood pressure; With
Detect paradoxical pulse according to measured value greater than threshold value.
According to one embodiment of the invention, a kind of equipment of predicting that asthma attack begins of being used to also is provided, it comprises:
Non-contact sensor, its be suitable for not contact object or object at least one parameter of sensed object under the habited situation; With
Control unit, it is suitable for predicting according to the parameter of sensing to small part the beginning of asthma attack.
For some application, this equipment comprises user interface, and control unit is fit to only warn the outbreak of prediction to begin in object awakening back to object.
Use for some, pick off comprise be configured in the dependence surface that measuring object lies, on or below the piezometer of pressure.For some application, piezometer comprises just what a piezometer.
According to one embodiment of the invention, a kind of equipment that the prediction outbreak relevant with congestive heart failure (CHF) begins that is used for also is provided, it comprises:
Non-contact sensor, its be suitable for not contact object or object at least one parameter of sensed object under the habited situation; With
Control unit, it is suitable for predicting according to the parameter of sensing to small part the beginning of outbreak.
Use for some, pick off comprise be configured in the dependence surface that measuring object lies, on or below the piezometer of pressure.
According to one embodiment of the invention, a kind of equipment of predicting that clinical episodes begins of being used to also is provided, it comprises:
Pick off, it is suitable at least one parameter of sensed object; With
Control unit, its be suitable for breathing rate when object be lower than object the asymptomatic breathing rate of baseline 120% the time, predict the beginning of clinical episodes according to the parameter of sensing to small part.
According to one embodiment of the invention, a kind of equipment of predicting that asthma attack begins of being used to still also is provided, it comprises:
Pick off, it is suitable at least one parameter of sensed object; With
Control unit, its be suitable for when object forced expiratory volume in 1 second (FEV1) greater than the asymptomatic FEV1 of the baseline of object 90% the time, predict the beginning of asthma attack according to the parameter of sensing to small part.
According to one embodiment of the invention, a kind of equipment that clinical episodes begins that is used for also is provided, it comprises:
Non-contact sensor, its be suitable for not contact object or object at least one parameter of sensed object under the habited situation; With
Control unit, it is suitable for to the beginning of small part according to parameter at least one hour prediction clinical episodes before clinical episodes begins of sensing.
According to one embodiment of the invention, a kind of equipment of predicting that clinical episodes begins of being used to also is provided, it comprises:
Pick off, it is suitable for basic at least one parameter of sensing continuously in the time period that continues at least one hour; With
Control unit, it is suitable for before clinical episodes begins at least one hour to small part and predicts beginning according to the parameter of sensing.
According to one embodiment of the invention, a kind of equipment of predicting that clinical episodes begins of being used to also is provided, it comprises:
Pick off, its be suitable for the object section length of one's sleep at night at least 80% during basic at least one parameter of sensing continuously; With
Control unit, it is suitable for to the beginning of small part according to parameter at least one hour prediction clinical episodes before clinical episodes begins of sensing.
According to one embodiment of the invention, a kind of equipment also is provided, it comprises:
Pick off, it is suitable at least one parameter of sensed object; With
Control unit, it is suitable for calculating the probability that clinical episodes will take place in the preset time according to the parameter of sensing to small part after calculating.
According to one embodiment of the invention, a kind of equipment of predicting that clinical episodes begins of being used to also is provided, it comprises:
Pick off, it is suitable at least one parameter of sensing under the situation of the compliance that does not need the people; With
Control unit, it is suitable for predicting the outbreak beginning to small part according to the parameter of sensing.
In one embodiment, pick off comprises non-contact sensor, and it is suitable at least one parameter of sensing under the habited situation of not contact object or object institute.
For some application, pick off is suitable at least one parameter of sensing when object is slept, and equipment comprises user interface, and control unit is suitable for driving user interface so that only the outbreak to object warning prediction begins in object awakening back.
Use for some, pick off comprise be configured in the dependence surface that measuring object lies, on or below the piezometer of pressure.
In some embodiments of the present invention, under suitable situation, equipment mentioned above is suitable for carrying out one or more methods mentioned above.For example, the control unit of equipment can be fit to one or more steps (for example analytical procedure) of implementation method, and/or the pick off of equipment can be fit to one or more sensing steps of implementation method.
In conjunction with the accompanying drawings, can understand the present invention more fully from the detailed description of following embodiment, in the accompanying drawing:
Description of drawings
Fig. 1 is the sketch map according to the system of the chronic internal medicine disease that is used for monitoring target of one embodiment of the invention;
Fig. 2 is the schematic block diagram of the parts of control unit in Fig. 1 system that illustrates according to an embodiment of the invention;
Fig. 3 is the schematic block diagram of the breathing pattern analysis module of control unit in Fig. 2 system that illustrates according to an embodiment of the invention;
Fig. 4 A～C is the figure that the motor message analysis of measuring according to an embodiment of the invention is shown;
Fig. 5 is the figure that is illustrated in the chronic asthma patient's that experimental session carrying out according to an embodiment of the invention measures breathing rate pattern;
Fig. 6 and 7 is exemplary baseline and the breathing rate of measurement and the figure of heart rate Night that measure respectively according to an embodiment of the invention;
Fig. 8 A～B is the figure that shows the different frequency component of motor message according to an embodiment of the invention;
Fig. 9 comprises the demonstration time domain according to an embodiment of the invention and the figure of the several signals in the corresponding frequency domain;
Figure 10 A～C is the figure that shows the frequency spectrum of measuring according to an embodiment of the invention;
Figure 11 comprises combination and the mother of decomposition and the figure of fetal heartbeat signal that demonstration is measured according to an embodiment of the invention;
Figure 12 is the figure that shows body kinematics according to an embodiment of the invention;
Figure 13 be show according to an embodiment of the invention during the ortho sleep and the figure of the restless incident during the asthma clinical episodes;
Figure 14 A～B is the figure that shows the power spectral density of the signal of measuring according to an embodiment of the invention;
Figure 15 is the sketch map of the system configuration of Fig. 1 that comprises two motion sensors according to an embodiment of the invention;
Figure 16 A～B is the figure that shows according to an embodiment of the invention the cross correlation between the signal of simultaneously-measured pulse signal and Figure 16 A below the lower limb of object and the abdominal part of measurements and calculations respectively;
Figure 17 is the sketch map of system of Fig. 1 of fetus that is suitable for monitoring conceived object and she according to an embodiment of the invention;
Figure 18 is the flow chart that the method that is used for the predict physiologic disease according to an embodiment of the invention is shown;
Figure 19 be illustrate according to an embodiment of the invention be used to implement figure with reference to the exemplary power of the described method of Figure 18 spectrum;
Figure 20 shows the figure of the ratio of two harmonic waves of the breath signal of the asthma object of measurement according to an embodiment of the invention;
Figure 21 A～B be show respectively according to an embodiment of the invention expression Cheyne-Stokes respiration (CSR) and the figure of the signal analysis of Figure 21 A;
Figure 22 shows the representative figure of the breath signal of the expression Cheyne-Stokes respiration (CSR) of measurement according to an embodiment of the invention;
Figure 23 is respectively the figure of the breathing rate Night of the exemplary baseline measured respectively according to an embodiment of the invention and measurement; With
Figure 24 is the graphics that the breathing rate of measuring during several nights according to an embodiment of the invention is shown.
The specific embodiment
Fig. 1 is the sketch map according to the system 10 of the chronic internal medicine disease that is used for monitoring target 12 of one embodiment of the invention.System 10 generally includes motion sensor 30, control unit 14 and user interface 24.For some application, user interface 24 is integrated in the control unit 14, and as shown in the figure, and for other application, user interface and control unit are separate units.For some application, motion sensor 30 is integrated in the control unit 14, and in this case, user interface 24 also is integrated in the control unit 14 or leaves control unit 14.
Fig. 2 is the schematic block diagram that the parts of control unit 14 according to an embodiment of the invention are shown.Control unit 14 generally includes exercise data acquisition module 20 and pattern analysis module 16.Pattern analysis module 16 generally includes one or more with lower module: breathing pattern analysis module 22, heart beating pattern analysis module 23, cough analysis module 26, restless analysis module 28, analysis of blood pressure module 29 and awakening analysis module 31.Use two or more being encapsulated in the single shell in the analysis module 20,22,23,26,28,29 and 31 for some.For some application, module is by encapsulation (for example, so that one or more pattern analysis module can be carried out remote analysis to the breath signal that data acquisition module 20 obtains in the part) separately.For some application, user interface 24 comprises a dedicated display unit, for example LCD or CRT monitor.As selecting or extraly, user interface 24 comprises being used for original and/or data processed be sent to and far is used for further analyzing and/or the communication line of decipher.
In one embodiment of the invention, data acquisition module 20 is fit to the breathing and the heart beating pattern of non-intruding monitor object 12.Breathing pattern analysis module 22 and heart beating pattern analysis module 23 are fit to analyze pattern separately, so that (a) the imminent clinical episodes that accumulates such as asthma attack or the lung liquid relevant of prediction, and/or (b) when taking place, clinical episodes monitors its order of severity and development with heart disease.User interface 24 is fit to notify object 12 and/or health care provider is prediction or occurent outbreak.Predict that upcoming clinical episodes helps early stage prophylactic treatment, this generally reduces required dosage, and/or reduces mortality rate and sickness rate.When treatment asthma, it is to reverse the relevant side effect of the required usually high dose of inflammatory disease to minimize that the dosage of this minimizing generally makes with showing effect when beginning.
In one embodiment of the invention, the supplemental characteristic that 16 combinations of pattern analysis module are produced by two or more analysis modules 20,22,23,26,28,29, and the data of analysis combination are with prediction and/or monitoring clinical events.For some application, pattern analysis module 16 draws the score value of each parameter based on the deviation of parameter and baseline value (be used for given patient or based on colony's meansigma methods).Pattern analysis module 16 for example by average, other function of maximum, standard deviation or score value makes up score value.The score value of comparison combination and one or more threshold value (it can be scheduled to) with determine outbreak whether predicted to, taking place at present or both do not predicted also generation, and/or monitor the order of severity and the development of occurent outbreak.Use for some, 16 study of pattern analysis module are used for given patient or patient's group standard and/or the function based on the single parameter score value combination of case history.For example, pattern analysis module 16 can be carried out this study by analyzing the parameter of measuring before the former clinical events.
Breathe and the heart beating pattern although system 10 can monitor at any time, for some application, it generally the most effectively monitors these patterns at night between sleep period.When object is awakened, breathe and the heart beating pattern with the movable often influence of body ﹠ mind that the monitoring disease is irrelevant.The movable general lower influence that during most of nighttime sleeps, has that these are irrelevant.Use for some, system's 10 monitorings are also write down the pattern at whole or most of night.Resulting data acquisition system generally comprises typical long-term the breathing and the heart beating pattern, and helps analysis-by-synthesis.In addition, this large data set can be given up the part of passive movement or other anthropic factor pollution when keeping the data that enough are used for the statistical significance analysis.
Refer again to Fig. 2.Data acquisition module 20 generally includes the circuit that is used to handle the original motion data that is produced by motion sensor 30, for example at least one preamplifier 32, at least one wave filter 34 and modulus (A/D) transducer 36.Wave filter 34 generally includes band filter or low pass filter, is lower than half frequency overlapped-resistable filter of sample rate as cut-off frequency.Low-pass data is usually with the sample rate digitized of 10Hz at least, and is stored in the memorizer.For example, the choice point of frequency overlapped-resistable filter can be configured to 5Hz, sample rate is set to 40Hz.
Referring again to Fig. 1.In one embodiment of the invention, motion sensor 30 comprises piezometer (for example piezoelectric transducer) or strain gauge (for example silicon or other semiconductor strain gauge, or metal strain meter), it is generally suitable for being installed in the dependence surface 37 that object for example lies to be slept, on or below, with the breathing of the sensed object motion relevant with heart beating.All piezometers of mentioning in the sentence before used " piezometer " includes but not limited in claims.Usually, lean on the surface and comprise mattress, mattress overcover, sheet, bedding pad and/or bedding cover.For some application, motion sensor 30 is integrated into and leans in the surface 37, for example be integrated in the mattress, so motion sensor and dependence surface provides as integrated unit together.Use for some, motion sensor 30 is adapted to be mounted within the abdominal part 38 of object 12 or near the dependence surface 37 the chest 39, on or below.As selecting or extraly, motion sensor 30 be installed near the object part that is positioned at object waist below on the anatomy near the lower limb 40 of object for example dependence surface 37, on or below.Use for some, this location is than providing more clearly pulse near abdominal part 38 that pick off is positioned at object or the chest 39.For some application, motion sensor 30 comprises Fibre Optical Sensor, and for example Butter and Hocker are put down in writing in AppliedOptics 17:2867-2869 (Sept.15,1978).
For some application, piezometer or strain gauge are encapsulated in the rigidity compartment, this compartment has 10cm at least usually
2Surface area and be less than the thickness of 5mm.The output of this meter is directed at electronic amplifier, and for example the charge amplifier that uses with piezoelectric accelerometer and capacitance type sensor usually is adjusted to the low-impedance voltage that is fit to through long cable transmission with the high output impedance with pick off.Strain gauge and electronic amplifier convert mechanical vibration to the signal of telecommunication.Perhaps, utilize Wheatstone bridge and such as the analog module numbering 3B16 that is used for minimum bandwidth or be used for the 3B18 of wider bandwidth (Texas USA) amplifies the output of strain gauge for National Instruments Corporation, Austin.
In one embodiment of the invention, motion sensor 30 comprises the grid (grid) of a plurality of piezometers or strain-gage pickup, be adapted to be mounted within lean in the surface 37, on or below.Use this grid rather than single instrument can improve the reception of breathing and heartbeat signal.
Breathing pattern analysis module 22 is fit to see below the described breathing pattern that extracts of Fig. 3 from exercise data, heart beating pattern analysis module 23 is fit to extract the heart beating pattern from exercise data.As selecting or extraly, system 10 comprises the pick off of another kind of type, for example attached to or the acoustics or the pneumatic sensor of face, neck, breast and/or the back of the body of point at objects.
Fig. 3 is the schematic block diagram that breathing pattern analysis module 22 according to an embodiment of the invention is shown.Breathing pattern analysis module 22 generally includes digital signal processor (DSP) 41, two-port RAM (DPR) 42, EEPROM 44 and I/O port 46.Breathing pattern analysis module 22 is fit to extract breathing pattern from the initial data that is produced by data acquisition module 20, and breathing pattern is handled and classified.Breathing pattern analysis module 22 is analyzed usually the variation in the breathing pattern between sleep period.According to analysis, module 22 (a) is predicted imminent clinical episodes, and/or (b) order of severity and the development of monitoring outbreak.
Referring again to Fig. 1.User interface 24 generally includes special-purpose display unit, for example LCD or CRT monitor.As selecting or extraly, output module comprises wireless or the wire communication port, be used for the initial data that will obtain and/or data processed and be sent to and far be used for further analysis, decipher, expert and check and/or clinical trail.For example, data can transmit through telephone wire, and/or carry out wireless or wired transmission through the Internet or another kind of broadband network.
With reference to Fig. 4 A～C, it illustrates the figure of the analysis of the motor message of measuring according to an embodiment of the invention.As mentioned above, in one embodiment, motion sensor 30 comprises pressure or the strain gauge that is adapted to be mounted within the motion that leans on surperficial 37 belows and sensed object 12.The motion of object between sleep period comprises the relevant motion of respiratory movement, heart beating and other irrelevant body kinematics of rule, as hereinafter discussing.Fig. 4 A shows as passes through the original mechanical signal 50 of the piezoelectric strain gage sensor measurement of mattress below, and it comprises the composition of the signal relevant with breathing and heart beating.Utilize technology hereinafter described that signal 50 is decomposed into breathing correlated components 52 that shows as Fig. 4 B and the heart beating correlated components 54 that shows as Fig. 4 C.All experimental datas that occur among the application all utilize one or more piezoelectric transducers to record (yet scope of the present invention comprises that use measures such as other manometric other motion sensor 30, and is described with reference to Fig. 1 as mentioned).
Referring again to Fig. 2, for some application, wave filter 34 comprises band filter, its have about 0.03Hz between about 0.2Hz, for example about 0.05Hz low cut-off frequency and arrive between about 10Hz at about 1Hz, the higher cutoff frequency of about 5Hz for example.As selecting or extraly, the output of motion sensor 30 is transmitted by several Signal Regulation passages, each passage has self gaining and the filtering setting of regulating according to the signal of expectation.For example, for breath signal, can use lower gain and the frequency passband of the highest about 5Hz, and, can use the altofrequency slightly of medium gain and about 10Hz to end for heartbeat signal.For some application, motion sensor 30 also is used for the recording voice signal, and for the latter, about 100Hz is useful to the frequency passband of about 8Hz.
In one embodiment of the invention, exercise data acquisition module 20 extracts the breathing coherent signal by carrying out spectral filter at about 0.05Hz in the scope of about 0.8Hz, and extracts the heart beating coherent signal by carrying out spectral filter at about 0.8Hz in the scope of about 5.0Hz.Use for some, exercise data acquisition module 20 changes spectral filter based on the age of object 12.Therefore usually for example, the child has higher breathing rate and heart rate usually, spectral filter is set at more high-end near frequency range, for example for breathing at about 0.1Hz between about 0.8Hz, arrives between about 5Hz at 1.2Hz for heart beating.For the adult, usually spectral filter is set at more low side near frequency range, for example, arrive between about 2.5Hz at 0.5Hz for heart beating for breathing at about 0.05Hz between about 0.5Hz.
For some application, 20 utilizations zero of exercise data acquisition module are intersected or power spectrumanalysis extracts breathing rate and heart rate from filtering signal.
As mentioned above, the motion of object between sleep period comprises the relevant relevant motion with heart beating of breathing and other irrelevant body kinematics of rule.Generally speaking, breathing relevant motion is the major part of body kinematics between sleep period.Pattern analysis module 16 is fit to the basic motor message part of removing the motion that the representative that receives from exercise data acquisition module 20 and breathing and heart beating have nothing to do.For example, pattern analysis module can be removed by the signal segment that pollutes with the irrelevant motion of breathing and heart beating.Though breathe the signal relevant with heart beating is periodically, other move generally be at random with uncertain.Use for some, the pattern analysis module utilizes frequency domain spectra analysis or time domain regression analysis to remove and breathing and the irrelevant motion of heart beating.For the those skilled in the art that read the application, the technology of using these analytical technologies will be conspicuous.Use for some, pattern analysis module 16 use such as the statistical method of linear prediction or outlier analysis come from signal, to remove and breathe irrelevant and with the irrelevant motion of heart beating.Exercise data acquisition module 20 comes the digitized exercise data with the sample rate of 10Hz at least usually, although lower frequency is suitable for some application.
Breathing pattern analysis module 22 is generally suitable for extracting breathing pattern from the sequence of transient state breathing pulse, and each pulse comprises an air-breathing-exhalation cycle.Breathing pattern between sleep period generally belongs in the several types, comprising:
Fast-changing relatively breathing pattern at random, it mainly occurs between the REM sleep period;
Circulatory and respiratory rate changing pattern, its typical case's persistent period scope arrived somewhat for example Cheyne-Stokes respiration (CSR) or periodic breathing at several seconds;
(usually, during the ortho sleep of health objects, this slow trend comprises the breathing rate that continues the sectional basic monotone decreasing of several hrs usually to slow trend in the breathing rate; For the object of suffering from for a long time such as some disease of asthma, dull decline can be more not obvious or disappearance, for example hereinafter discusses with reference to Fig. 5);
Interruption in the breathing pattern, for example cough and other sleep disorder; With
The breathing pattern that is caused by awakening in short-term interrupts.
These breathing patterns are relevant with various physiological parameters, for example Sleep stages, anxiety and body temperature.For example, the REM sleep is attended by the breathing pattern of change at random usually, and the deep sleep stage is attended by more regular and stable pattern usually.Unusual high body temperature can be accelerated breathing rate, but keeps normal circulatory and respiratory rate changing pattern usually.Psychological factor such as anxiety also is the adjusting factor of breathing pattern between sleep period, and their influence carrying out and normally reduce with sleep.Interrupt to be normal, relevant or to be correlated with such as cough or the breathing pattern that causes by temporary transient awakening, and in context, assess with other irrelevant pathology with asthma.
In one embodiment of the invention, pattern analysis module 16 is configured to predict the beginning of asthma attack, and/or monitors its seriousness and development.The beginning of asthma attack is predicted in variation in pattern analysis module 22 and 23 common combinative analysis breathing rate patterns, breathing rate changing pattern, heart and/or the changes in heart rate pattern.For some application, Fourier transform by the calculation of filtered signal and from correspondence breathe and the allowed band of heart rate in find the frequency of corresponding the highest spectrum peak to come from signal, to extract breathing and/or heart beating pattern, perhaps by using the method for zero crossing, the perhaps heart beating of finding per minute interpulse period in the peak peace homogeneous by finding time-domain signal minute.For some application, after removing outlier, carry out this average.
Although breathing rate slightly increases usually before beginning to show effect, has only the specificity marker that begins of outbreak always of this increase.Therefore, for the beginning of prediction outbreak more accurately and the order of severity and the development of monitoring outbreak, in one embodiment of the invention, breathing pattern analysis module 22 is also analyzed the variation in the breathing rate changing pattern.Use for some, module 22 more one or more following patterns and baseline modes separately, and will resolve to the beginning of indication (a) outbreak and/or the order of severity of (b) showing effect and carrying out with the deviation of baseline:
Slow trend breathing pattern.Module 22 will resolve to indication with respect to the increase of baseline and be about to take place or ongoing outbreak, for example, object for general health, usually at least 1 hour for example dull decline of the typical segmenting of at least 2,3 or 4 hours internal respiration rates weaken, or this breathing rate pattern of successively decreasing and being transformed into increase, this depends on the order of severity of outbreak;
The breathing rate pattern.Module 22 will be in for example increase during initial 2,3 or 4 hours in sleep or do not reduce to resolve to and be about to take place or ongoing outbreak during the first few hour of sleep;
The breathing rate changing pattern.The minimizing that module 22 changes breathing rate resolves to expression and is about to take place or ongoing outbreak.This minimizing generally appears at the beginning near outbreak, and Tachypneicly carries out and aggravate with interparoxysmal;
The respiratory work cyclic pattern.Module 22 resolves to indication soon generation or ongoing outbreak with the essence increase in respiratory work cycle.The respiratory work cyclic pattern includes but not limited to inspiratory duration/total time breathing cycle, expiratory duration/total time breathing cycle and (air-breathing+expiratory duration)/total time breathing cycle;
The breathing rate pattern is towards the variation of nighttime sleep latter stage (usually between about 3:00A.M. and about 6:00A.M.); With
For example the breathing pattern that is caused by cough, sleep disorder or awakening interrupts.Module 22 quantizes these incidents, and determines they and the dependency of predicting potential asthma attack.
Breathing pattern analysis module 22 and 23 usually determines respectively baseline mode by analytic target in the breathing and/or the heart at non-symptom night.As selecting or extraly, using baseline mode to come to module 22 and 23 programmings based on colony's meansigma methods.Use for some, this kind of groups meansigma methods is carried out segmentation by characteristic trait such as age, height, body weight and sex.
In one embodiment of the invention, pattern analysis module 16 is determined the beginning of outbreak and/or the order of severity that outbreak is carried out by the breathing rate pattern that compares and measures and baseline breathing rate pattern and/or the heart that compares and measures and baseline heart rate pattern.
In one embodiment of the invention, breathing pattern analysis module 22 makes at the breathing rate pattern of the object calculating length of one's sleep and passes low pass filter (for example finite impulse response filter) to reduce the short-term effect such as the REM sleep.For some application, 23 pairs of heart rate datas of heart beating pattern analysis module carry out similar filtering.
With reference to Fig. 5, it is the figure that is illustrated in the chronic asthma patient's that experimental session carrying out according to an embodiment of the invention measures breathing rate pattern.Monitor the breathing of asthma object at several nights.For per hour sleep, patient's breathing rate averaged, and (do not comprise rapid eye movement (REM) sleep, it is removed by low pass filter, to reduce the short-term effect of REM sleep; Perhaps, discern and remove the REM sleep for consideration).During 2 months, patient does not experience any asthma attack at monitoring patient's original treaty.Therefore line 200 representatives represent this patient's the slow trend breathing rate of baseline pattern at the slow trend breathing pattern of this non-interparoxysmal typical case.Should be noted that, with usually in non-asthma patient observed breathing rate dull descend different, chronic asthma patient's the baseline breathing rate pattern of experiment reflects that breathing rate initially reduces between the sleep period of first few hour, and the rate of internal respiration At All Other Times at most of nights increases gradually then.
Utilize the technology of describing in the literary composition, the pattern of breathing pattern analysis module 22 alternative lines 202 and the baseline mode of line 200 may experience asthma attack with forecasting object.The pattern of module 22 alternative lines 204 and the baseline mode of line 200 are with the development of assessment asthma attack.
In one embodiment of the invention, be defined as the cumulative departure of measurement pattern and baseline mode with the deviation of baseline.The threshold setting of indication critical condition is the standard error (for example standard error) that equals given number.As selecting or extraly, using other deviation measured value between measurement pattern and the baseline mode, for example maximum difference between correlation coefficient, mean square error, the pattern and the area between the pattern.Be further used as and select or extraly, pattern analysis module 16 uses weighted analysises for example to emphasize specific region along pattern by the double weight that hour gives for initial two hours of sleep or 3:00～6:00a.m..
Fig. 6 and 7 is respectively the exemplary baseline of one embodiment of the invention measurement and the breathing rate and the heart rate Night of measurement.The normal baseline pattern of line 100 and 102 (respectively in Fig. 6 and 7) representative when not having asthma attack.The bar line is represented a standard error.Night before on behalf of asthma attack, line 104 and 106 (respectively in Fig. 6 and 7) begin.Monitor respectively line 100 and 102 and line 104 and 106 between the variation of pattern can predict imminent asthma attack early.
In one embodiment of the invention, pattern analysis module 16 is configured to predict the beginning of the clinical symptoms of heart failure, and/or monitors its order of severity and development.When module 16 detects the breathing rate increase of following the heart rate increase, and/or breathing and/or the heart beating pattern of working as monitoring have the specific characteristics relevant with heart failure, when for example indicating the feature of asphyxia, Cheyne-Stokes respiration and/or periodic breathing, module 16 determines that usually outbreak is coming.
In one embodiment of the invention, the breathing cycle is divided into continuous segment air-breathing and that exhale.Breathing pattern analysis module 22 will be slept during (normally nighttime sleep) and to be resolved to indication with longer trend of the persistent period of air-breathing proportional section of exhaling and be about to take place or ongoing outbreak.In another embodiment, the respiratory activity working cycle (expiration adds air-breathing period persistent period) is more resolved for being about to the sign of generation or ongoing outbreak with the motion that breathes no more.
Referring again to Fig. 2, in one embodiment of the invention, system 10 also comprises and is used to measure such as by panting or the acoustic sensor 110 of the breathing related sound that causes of coughing.(for some application, wherein respiration pickup 30 comprises piezometer, and acoustic sensor 110 combines with piezometer.For example, can use single-sensor to carry out acoustics sensing and measurement body kinematics simultaneously.Perhaps, acoustic sensor 110 can be independent parts.) pattern analysis module 16 for example by the spectrum averaging method with the pant signal to noise ratio of sound of raising, come this Breathiness of independent process or to exhaling and/or the air-breathing time synchronized (time-locked) of carrying out.Use for some, the level of panting and it are provided for predicting upcoming asthma attack and/or the order of severity of monitoring outbreak and the extraneous information of development with respect to air-breathing and the periodic timing of exhaling.
Panting to be considered as the special part of breathing cycle (mainly being air-breathing and expiration), and the useful judgement about coming or ongoing respiratory distress pattern is provided thus.In addition, can filter according to the periodicity of breathing cycle and pant, strengthen identification thus, and improve the ability of giving up the environmental noise that has nothing to do with respiratory activity the breathing related sound of stopping up air flue.The periodicity relevant with the breathing cycle is panted can provide extra judgement about coming or ongoing respiratory distress pattern.
In one embodiment of the invention, pattern analysis module 16 comprises cough analysis module 26, and it is suitable for monitoring and/or assessment and the relevant coughing fit of coming or ongoing clinical episodes.In asthma, tussiculaing often is sign before the clinical asthma attack of the indication important early onset thereof that is about to begin (for example referring to above-mentioned Chang AB paper).In congestive heart failure (CHF), cough can provide the early warning by fluid retention in the lung that heart failure worsens or the myovascular insufficiency development causes.
Use for some, utilize usually between about 50Hz and the about 8kHz, for example sonic-frequency band filtering between about 100Hz and about 1kHz, from be installed in dependence surperficial interior, on or below motion sensor 30 extraction cough sound.Perhaps, filtering signals is become two or more frequency bands, exercise data acquisition module 20 uses at least one frequency band at the common extremely low frequency of the highest 5Hz scope to be used for the recording body motion, and uses the frequency band of the upper frequency of another one at least between all 50Hz according to appointment and about 8kHz to be used for recording voice.Use for some, this module is used narrower sonic-frequency band, for example between about 200Hz and about 1kHz.
With reference to Fig. 8 A～B, it is the figure that shows the different frequency component of motor message according to an embodiment of the invention.Coughing fit comprises the unvoiced sound outburst after synchronous body kinematics and the voice.Cough analysis module 26 will be by joining the cough incident of extracting from the cough signal of acoustic signal with from the body kinematics signal correction of motor message.Usually, module 26 relies on machinery and acoustic component the two directly detects coughing fit.Fig. 8 A shows low frequency (the being less than 5Hz) component 114 of measuring-signal, and Fig. 8 B shows high frequency (200Hz to the 1kHz) component 116 of measuring-signal.Cough analysis module 26 is identified as cough simultaneous unique incident in low and high fdrequency component 114 and 116 usually.For example, the high frequency incident A in the component 116 does not follow low frequency events corresponding in the component 114.Therefore, module 26 is not identified as cough with incident A.On the other hand, high frequency incident B, C, D and the E in the component 116 is attended by low frequency events corresponding in the component 114, therefore is identified as cough.Use for some, cough analysis module 26 uses the technology of describing in the above-mentioned paper of Korpas J etc., Piirila P etc. and SalmiT etc. one or more.
In one embodiment of the invention, pattern analysis module 16 is utilized and is extracted breathing rate such as the frequency demodulation system of standard FM rectification technology from successive heart rate signal.This is possible, because the general demonstration of the heart rate signal arrhythmia pattern relevant with eupnea.
In one embodiment of the invention, pattern analysis module 16 is utilized and is extracted breathing rate such as the amplitude demodulation system of standard A M rectification technology from successive heart rate signal.This is possible, because the chest wall movement relevant with breathing comprises the machinery modulation of heartbeat signal.
In one embodiment of the invention, pattern analysis module 16 uses the heart rate signal of amplitude and/or frequency demodulation system by relatively heart rate signal and extraction are confirmed fully to obtain to breathe and heart rate signal from the rectification arrhythmia pattern of heart rate signal.Use for some,, thus ongoing breathing pattern is provided not have partially and estimate by obtaining a series of time difference frequency demodulation system arrhythmia patterns between the successive heartbeat.As selecting or extraly, utilizing high-pass filtering, all wave rectification and low-pass filtering to come amplitude demodulation system heart rate.
With reference to Fig. 9, it comprises the demonstration time domain according to an embodiment of the invention and the figure of the several signals in the corresponding frequency domain.Figure 120 and 122 is presented at the breath signal in time domain and the frequency domain respectively.Figure 124 and 126 shows the breathing pattern of amplitude demodulation system and frequency demodulation system respectively, and the both derives from the heartbeat signal that shows among Figure 128.Figure 130 and 132 shows the breath signal that derives from Figure 124 and 126 in the frequency domain respectively.
These figure show that (a) is as the breathing rate patterns that directly derive from breath signal of Figure 120 and 122 demonstrations with (b) as the similarity between Figure 124,126, the 130 and 132 breathing rate patterns that derive from heartbeat signal indirectly that show.This similarity is particularly remarkable in frequency domain, as shown in Figure 122,130 and 132.
In one embodiment of the invention, pattern analysis module 16 obtains heartbeat signal from breathe coherent signal.For example, if it is clearer than the heartbeat signal of directly monitoring to breathe coherent signal, then this approach is useful.This situation occurs sometimes, because breathe coherent signal by producing than the more significant mechanical body motion of heart beating coherent signal.
In one embodiment of the invention, the breathing coherent signal of measuring is used for rectification heart beating coherent signal, and the detection that can improve the heart beating coherent signal thus.For some application, 22 utilizations of breathing pattern analysis module are filtered in the spectrum in about 0.05Hz and about 0.8Hz scope and are extracted the breathing coherent signal, and heart beating pattern analysis module 23 utilizes the filtering in about 0.8Hz and about 5Hz scope to extract the heart beating coherent signal.Heart beating pattern analysis module 23 utilizes the breathing coherent signal to come rectification heart beating coherent signal, for example comes rectification by multiply by the heart beating coherent signal with the breathing coherent signal.This rectification produces the more clearly rectification signal of heart beating coherent signal, can improve its detection thus.In some cases, the power spectrum of rectification signal can show the clearly peak corresponding to the rectification heart rate.
Figure 10 A～C is the figure that shows the frequency spectrum of measuring according to an embodiment of the invention.Figure 10 A shows the spectrum signal 140 of the relevant primary signal (not showing primary signal) of heart beating, and Figure 10 B shows simultaneously-measured breathing relevant frequency spectrum signal 142.Figure 10 C shows the spectrum signal 144 of rectification, and it is for breathing the product of the relevant relevant spectrum signal 140 with heart beating of spectrum signal 142 (Figure 10 B) (Figure 10 A).Can see clearly peak 150 in the spectrum signal 144 of rectification, it represents the palmic rate of rectification.
Use for some, filter breathing coherent signal used in the rectification with the higher cutoff frequency (for example 0.5Hz, rather than 0.8Hz mentioned above) that reduces.This reduction generally guarantees only to use the breathing coherent signal of fundamental sine wave shape in rectification calculates.
In one embodiment of the invention, breathing pattern analysis module 22 is configured to detect usually the abnormal breathing pattern relevant with CHF, for example rapid breathing, Cheyne-Stokes respiration (CSR) or periodic breathing during nighttime sleep.
In one embodiment of the invention, system 10 is suitable for measuring fetal heart frequency.Usually, mother's heart rate is lower than 100BPM loosening under the situation, and healthy fetal heart frequency is usually above 110BPM.The heart beating pattern analysis module 23 of system 10 is utilized lower passband filtering to be used for mother's heartbeat signal usually and is used upper passband filtering to obtain the heartbeat signal that the fetal heartbeat signal distinguishes from mother's heartbeat signal fetus.
Figure 11 comprises combination and the mother of decomposition and the figure of fetal heartbeat signal that demonstration is measured according to an embodiment of the invention.Figure 22 0 and 222 shows mother and the breathing of fetus and the combination of heartbeat signal in time domain and the frequency domain respectively.The signal that shows among Figure 22 0 is broken down into its two compositions: (1) mother's heartbeat signal, be presented in time domain in Figure 22 4 and 226 and the frequency domain respectively and the heartbeat signal of (2) fetus, and be presented at respectively in the time domain and frequency domain in Figure 22 8 and 230.
In one embodiment of the invention, the breath of mother signal is used for distinguishing or confirming by the arrhythmia pattern match that makes breath of mother pattern and mother's heart mother's heart beating pattern.This is possible, because mother's as indicated above pulse is to come frequency and amplitude-modulated by the breath of mother rate.Confirm correctly to have discerned the heart beating pattern that mother's heart beating can be discerned fetus.
In one embodiment of the invention, breath of mother coherent signal (it is stronger than the heart beating coherent signal of fetus usually) is used for the heart beating coherent signal of rectification fetus.This is possible, because the heart rate signal of fetus is to come amplitude-modulated by the breath of mother signal in some cases.In these cases, the relatively easy breath of mother signal that detects is used for from the heart rate signal of background noise extract phase to the fetus that is difficult to detect.For example, can measure the heart rate signal of fetus by following steps: (1) utilizes technical measurement breath of mother rate mentioned above; (2) make the band filter (for example at about 1.2Hz arrive about 3Hz between) of motor message by being applicable to fetal heart frequency; (3) multiply by filtering signal with breath signal; (4) signal that obtains is carried out fast fourier transform; (5) peak value corresponding in the signal after the identification conversion with fetal heart frequency.
In one embodiment of the invention, system 10 is suitable for measuring the motor pattern of fetus, and the motor pattern of fetus has amplitude or the frequecy characteristic different with mother's motion.A little less than the signal that the signal that fetal movements produces produces than mother's motion, but has the higher frequency of the signal that produces (when the frequency-domain analysis) of moving than mother.In addition, the motion of fetus generally main (or at least the most consumingly) is by the abdominal part sensor record, and mother's motion is general simultaneously by abdominal part pick off and other pick off (for example lower limb pick off) record.For some application, system 10 comprises a plurality of motion sensors 30, and near the high frequency motion system's 10 monitoring mother abdominal paries, so that identification and calculating fetal movements.
In one embodiment of the invention, system 10 is suitable for measuring fetal movements and fetal heart frequency simultaneously, sees below that Fig. 2 describes.The fetal heart frequency relevant with fetal movements changes the indication that can be used as foetus health.The general experience of healthy fetus is attended by the related movement slot that increases of fetal heart frequency.Unsound fetus generally has the motion of minimizing or not motion, and/or constant relatively heart rate.
Referring again to Fig. 2.In one embodiment of the invention, system 10 is suitable for for example measuring fetal heart frequency by the technology of describing in the literary composition.For some application, user interface 24 comprises speaker 240, and user interface is suitable for driving the acoustical signal of speaker with the fetal heart frequency data of output representative measurement.Use for some, the fetal heartbeat sound that user interface 24 is produced by the fetal monitor of standard by simulation is exported the heart rate as heart beating, for example simulates by the sound of synthetic video or played pre-recorded.Perhaps, user interface 24 is used and is exported heart rate such as other sound of single-tone.
In one embodiment of the invention, fetus parameter of pattern analysis module 16 more one or more monitorings (heart rate, breathing rate and motion) and baseline mode separately, and the deviation of identification and baseline.Use for some, the parameter combinations technology that pattern analysis module 16 is described above with reference to Fig. 2 by utilization makes up one or more fetuses and mother's parameter, and comparison combination parameter and combination baseline parameter separately.Analysis module will be identified as indication with the deviation of baseline or predict disease.For example, change mother and fetus parameter the time and may indicate the preeclampsia outbreak.
In one embodiment of the invention, system 10 is suitable for detecting fetal heartbeat, and analyzes heart beating to determine the variation of fetal heart frequency.Changes in heart rate is as the index of fetal movements and vigor.For example, the fetal heart frequency of healthy fetus is expected in period of 10 minutes 15 to jump/minute to continue and changed twice or more times in 15 to 30 seconds, or changes 5 times or more times in 20 minutes period.System 10 uses with the obvious deviation of these values and indicates possible pathology.
In one embodiment of the invention, wherein motion sensor 30 comprises the grid of a plurality of pressure or strain-gage pickup, system 10 uses this grid: (a) with the assessment body posture, for example discern the position of abdominal part and/or lung, (b) with the optimum reception of the air-breathing and breath signal guaranteeing to breathe, and/or (c) with monitoring two-phase breast-abdominal respiration pattern or the phase angle that be called breast abdomen asynchronism (TAA) relevant with asthma.In TAA, between the respiratory movement of thoracic cavity and abdominal part, there is phase shift.Use a plurality of pick offs make system 10 can measure by with the pick off that is positioned at separately near the strain of measuring of the relevant different sensors of different body parts or the phase contrast of pressure.
In one embodiment of the invention, wherein motion sensor 30 comprises the grid of a plurality of pressure or strain-gage pickup, and system 10 uses the weight change of grid with the assessment lung.During the pulmonary congestion, the fluid retention causes significant lung weight change in lung tissue in CHF.This fluid retention generally need be carried out pharmaceutical intervention immediately.Use for some, system 10 is configured to monitor day by day and/or pursues the lung weight change at night.
In one embodiment of the invention, system 10 is configured to provide second signals to object and/or bio-modification system, breathes and/or heart rate with control and adjusting.Use for some, the bio-modification system uses the technology of describing in one or more above-mentioned patents and/or people's such as Gavish or Gavish patent application, and necessary modifications in addition.In this embodiment, motion sensor 30 be installed in usually lean in 37 (Fig. 1) of surface, on or below.Use some parts of a using system 10, rather than complete system, for example exercise data acquisition module 20, motion sensor 30, breathing pattern analysis module 22 and/or heart beating pattern analysis module 23 (Fig. 2) for some.
In one embodiment of the invention, system 10 is configured to come the monitoring sleep cycle by monitoring heart and breath data, and the user that identification is being slept is in the best Sleep stages that is fit to wake up, for example hypophypnosis or REM sleep.In the wakeup time scope that the user selects, after monitoring this Sleep stages, system's 10 driving user interfaces, 24 generation visions and/or audible signal are to wake the user up.Use for some, the technology of the in addition necessary change of describing in people's such as Shinar Z above-mentioned paper is used for from breathing and heart rate data acquisition sleep stage information.In this embodiment, motion sensor 30 be installed in usually lean in 37 (Fig. 1) of surface, on or below.Use some parts of a using system 10, rather than complete system, for example exercise data acquisition module 20, motion sensor 30, breathing pattern analysis module 22 and/or heart beating pattern analysis module 23 (Fig. 2) for some.
In one embodiment of the invention, system 10 is carrying out continuous monitoring and record by on the basis at night to multiple sign data, and this multiple sign comprises vital sign and auxiliary sign, for example breathing pattern, heart beating pattern, motion event and cough.The multiple sign data of record are used to make up personalized patient files, and it is as the reference of tracking with the Pathophysiology deviation of normal mode.
In one embodiment of the invention, utilize following formula to make up the parameter of a plurality of measurements:
F=A1* Δ P1+A2* Δ P2+...+An* Δ Pn (equation 1)
Wherein Ai is a relative weighting of giving Pi, and Δ Pi is used for difference between the baseline value of Pi for the Pi value at given night and definition.F usually by the hour or calculate night, and with or the reference value determined predetermined based on case history relatively.If the F value surpasses reference value, then system gives a warning to object and/or health care provider.Under the situation suitable to any parameter Pi, can estimate the absolute value of Δ Pi, rather than the signed value of Δ Pi.Under the situation suitable, can estimate square, square root, index, logarithm or any other similar function any parameter Pi.As selecting or extraly,, using the value that produces by with Δ Pi input lookup table, rather than use Δ Pi for arbitrary parameter Pi.Be further used as and select or extraly, with resulting function F input lookup table (pre-defined or study) with analysis result.
In one embodiment of the invention, make up a plurality of parameters by score value that calculates each parameter and the function of using such as equation 1 in conjunction with score value.Use for some, if the probability that each score value representative clinical episodes can not come interim parameter value to occur in for example be right after in the regular hour section 1 hour, 4 hours, 24 hours or 48 hours.If clinical episodes can not arrive in this time period, then function is estimated the combined probability that the combination parameter value occurs.For example, have threshold value t (i) separately and can not come n monitoring parameter of the Probability p (i) of interim crossing threshold t (i) when clinical episodes for each, the calculating binomial distribution is at random to indicate observed threshold combined crosswise.If it is low to observe the probability of combination, then produces warning signal or take other action.For example, can comparative observation the threshold value of the predetermined or study of the probability of combination and system 10.If probability is less than threshold value, then system 10 produces warning, and indication exists than the coming high probability more very of outbreak.Use for some, the score value of each parameter is weighted, described as reference equation 1.
In one embodiment of the invention, system 10 is suitable for learning above-mentioned threshold value, weight and/or probability.For some application, system 10 uses following method to carry out this study:
After showing effect at every turn, indication process user interface 24 input systems 10 that object or health care provider will be shown effect and be taken place.As selecting or extraly, the parameter of system self by detecting the clearly indication outbreak breathing rate of 30 breaths/min (for example above) discerned outbreak.Be further used as selection, system 10 is based on determining that from the input of doser 266 (for example system will be identified as the generation of indication outbreak above the usage level of the inhaler of certain threshold value) takes place in outbreak.
Sometimes (for example whenever biweekly), the relatively actual outbreak of system 10 and this system provide the outbreak of warning to it;
For outbreak, false negative and the false positive of each correct prediction, system detects its forecasting accuracy that provides according to current threshold value, weight and probability distribution; With
According to inspection, the one or more threshold values of system's up regulation, weight or probability distribution.
For example, the cough before its outbreak of some asthma patients, and other patient does not have.Per two weeks, the symptom of whether coughing before the each outbreak of systems inspection.System raises or the downward modulation threshold value with certain percentage (for example 5%) each false positive or false negative in view of the above.For example, use for some, to the outbreak of each correct prediction, system regulates the weight (for example, if having substantive cough before nearest five outbreaks, then system increases the weight of cough parameter) of cough parameter.As selecting or extraly, system can be at the weight of false positive or false negative adjustment cough parameter.
In one embodiment of the invention, system 10 detects and analyzes the incident that night is restless and/or awaken, and it is the symptom such as several chronic diseases of asthma and CHF.Usually, system 10 quantizes these incidents so that the objective measurement value that night is restless and/or awaken to be provided.As mentioned before, system 10 analyzes the cycle movement signal of object in the frequency domains, and the peak (with optional corresponding harmonic wave) of corresponding breathing rate and heart rate in the identification frequency-region signal.The body kinematics of object produces unexpected, general stronger aperiodic component in motor message.If this motion is temporary transient (for example having the persistent period between about 2 seconds to about 10 seconds) and restore cycle property breathing/heart rate signal subsequently, then system 10 resolves to restless incident with this aperiodicity motion.If this motion even lasting above certain hour does not have cyclical signal (both's denoted object is no longer at bed) if perhaps surpass certain hour, then system 10 resolves to awakening with the appearance of this aperiodicity motion.
With reference to Figure 12, it is the figure that shows body kinematics according to an embodiment of the invention.In this embodiment, system 10 monitoring shows as between sleep period the restless of excessive body kinematics.System 10 quantizes restless to provide night restless objective measurement value.As shown in Figure 12, restless incident 250 is characterised in that the substance of comparing body kinematics with the ortho sleep phase 252 increases.In this embodiment, motion sensor 30 be installed in usually lean in the surface 37, on or below (Fig. 1).Use for some, when the standard deviation of the motor message of measuring during the time period was a certain multiple at least of mean standard deviation of the motor message during partial sleep time period at least, it is restless that system 10 is categorized as representative with this time period.For example, this multiple can for example be about 3 between about 2 and about 5.Perhaps, system 10 uses the deviation index of other mathematics and/or statistics, for example above-described frequency-domain analysis technology.Perhaps, system 10 uses the integral function J (i) by following equation definition:
J (i)=(1-alpha) * J (i-1)+alpha*abs (X (i)) (equation 2)
Wherein X (i) is from the primary signal of motion sensor 30 samplings.If for example X (i) is 10 samples/sec, then the desired value of alpha will for example be 0.05 between 0.01 and 0.1.Usually the signal J to All Through The Night averages and basis of calculation deviation.If for the period that continues at least 2 seconds, J (i) exceeds the twice of standard deviation than meansigma methods, then defines restless incident in the arbitrfary point.
For some application, in case quantize the restless incident of this class, then the event number in each period (for example, can have 30 minutes persistent period) is calculated in each period by system 10.For detecting clinical episodes (for example above-described any disease), system 10 comes comparison Night and reference model according to certain standard.For example, if detect restless incident in the period that surpasses certain percentage (for example above 10%, 20% or 30%), then system 10 produces the clinical episodes warning.Perhaps, if restless total number of events every night surpasses threshold value, then system 10 produces the clinical episodes warning.For some application, determine reference model or threshold value based on colony's meansigma methods, and use for other, determine reference model or threshold value by the data of average object during several non-symptom night.
With reference to Figure 13, its be show according to an embodiment of the invention during the ortho sleep and the figure of the restless incident during the clinical episodes in asthma.Restless event number (the bar line is represented standard error) during the line 260 demonstration ortho sleep during per 30 minutes.Line 262 indicating characteristics are the restless event number during per 30 minutes of the night of asthma clinical episodes.
In one embodiment of the invention, system 10 monitors awakening incident restless owing to generality or that cough causes, so that for providing extra evidence such as some pathology that is about to generation or ongoing asthma attack.
In one embodiment of the invention, the parameter of system's 10 record monitorings, for example breathing between the sleep period at night, heart rate and/or cough.This system continuously or after sleep finishes for example in the morning the parameter of analytic record to predict upcoming clinical episodes.In the morning or daytime later on, system 10 drives user interfaces 24 warning objects about upcoming clinical episodes.This upcoming clinical episodes generally after system 10 predicts their arriving at least several hrs just can take place for example at least 12 hours or 24 hours.Therefore, notice is deferred to morning or daytime generally later on begins prophylactic treatment before still providing time enough to begin, and need not the sleep of interrupt object with clinical symptoms in outbreak to object.Use for some, the order of severity and/or the urgency of system's 10 analytical parameters to assess upcoming clinical episodes, and determine whether to wake up object according to the order of severity and/or urgency.
Detect some application that the deterioration of the clinical episodes that has carried out or outbreak will (for example in 4 hours) beginnings in the short time period for system wherein 10, system 10 provides warning immediately so that can fast processing worsen incident.In addition, system 10 is usually in sleep period interocclusal record and continuous analysis and monitoring parameter.
In one embodiment of the invention, system 10 is configured to for example detect the irregular incident of pulse during ventricular fibrillation or cardiac arrest, and instant warning is provided after detecting this scrambling.As selecting or extraly, detect this irregular after, system 10 applies suitable electric or magnetic automatically and impacts.For example, user interface 24 can comprise implantable or outside cardioverter/defibrillator as known in the art.
In one embodiment of the invention, motion sensor 30 and all or part of exercise data acquisition module 20 are encapsulated in the biocompatibility shell (or a plurality of shell) that is suitable for implanting in the object 12.Implantable parts comprise transmitting set, and it is suitable for utilizing such as RF and (for example, uses
Or ZigBee agreement, or proprietary protocol) or ultrasonic the signal that obtains is sent to outside receptor.Perhaps, one or more analysis modules 22,23,26,28,29 or 31 and/or user interface 24 also be suitable in the shell that implantable parts are identical as other or in independent shell, implanting object.Be further used as selection, motion sensor 30 is suitable for implanting in the object 12, and exercise data acquisition module 20 is adapted at the object outside, and is communicated with motion sensor 30 with wireless or the wired mode of process.
Therein in system's 10 all or part of implantable embodiments, motion sensor 30 comprises multisensor, it comprises the two or more pick offs that are used to measure one or more following parameters: (a) mechanical vibration, (b) acoustic vibration, (c) electrocardiogram, (d) electromyogram, (e) lung impedance and (f) acceleration.For some application, system 10 uses multi-sensor data to carry out one or more following analyses: (a) breast rail, for example breathing rate, working cycle, exhalation/inhalation ratio and/or respiratory depth; (b) cough is measured; (c) pulse analysis, for example heart rate, changes in heart rate and/or interpulse period; (d) the restless analysis of sleeping.Use for some, multi-sensor data is used for predicting and/or monitor the clinical episodes such as the chronic disease of asthma, CHF, diabetes and epilepsy.
Use for some, the implantable parts of system 10 be installed in lean on the surface interior, on or below or the external device (ED) that is installed on the subject's body outer surface be communicated with.According to such as the critical pulse scrambling of ventricular fibrillation or cardiac arrest or the detection of pathology, external device (ED) is suitable for applying suitable electric or magnetic to be impacted.For example, external device (ED) can comprise implantable or external heart electric converter/defibrillator as known in the art.Perhaps, the implantable parts of system 10 are communicated with as known in the art external heart electric converter/defibrillator in wireless or wired mode.Perhaps, the partial parameters (for example leg exercise) that the external device (ED) monitoring is directly externally monitored, and the implantable parts of system 10 are monitored the parameter of direct internal monitoring.That implant or ppu integrate information is to provide above-mentioned complete multi-parameter monitoring functional.
In one embodiment of the invention, user interface 24 is configured to receive the information input relevant with the medical treatment of object acceptance at present, for example medicine and dosage information.Preventative or clinical drug therapy may influence such as breathing, heart rate, cough and restless physiological parameter.For example, the consumption of bronchodilator may influence the breathing pattern of asthma patient.Therefore, when estimating the deviation of measurement parameter and baseline parameter, pattern analysis module 16 is considered the information of input.For example, increase about 10% and after this lasting up to 8 hours if occur breathing rate in about one hour after using the bronchodilator administration than baseline breathing rate, then breathing pattern analysis module 22 can be ignored this increase.
Referring again to Fig. 2.For some application, medication information is directly sent to system 10 from doser 266, rather than in the manual input user interface 24.This drug information is handled can comprise which kind of medicine (and/or active constituents of medicine) of for example using, the dosage and/or the administration time of used medicine.Use for some, when determining that system offers the dosage of doser 266 and/or administration timing information, system 10 considers medication informations.Can adopt wireless or wired mode to send data to system 10.For example, doser 266 can comprise the commercially available doser with communication capacity, for example Nebulizer Chronolog (Medtrac Technologies, Inc., Lakewood, CO, USA) or Doser (MEDITRACK Products, Hudson, MA).
In one embodiment of the invention, the parametric model that system's 10 automatic detections are relevant with particular medication with extraction changes, and considers the patterns of change of extraction when the deviation of evaluation and baseline mode.For example, the breathing rate of asthma patient increases about 10% and recovered normal after about 6 to 8 hours, can is relevant with the use of bronchodilator by system identification.
Referring again to Fig. 2.In one embodiment of the invention, system 10 is used in the auto-closing loop of being furnished with doser 266.Doser is delivered to object 12 with medicine.System 10 monitors the clinical effectiveness of medicines, and provides feedback to keep or the renewal drug dose to doser.For some application, doser 266 comprise following one or more: aerosol apparatus, inhaler, vaporizer (for example in the room at object place), continuous positive airway pressure device, spraying system or intravenously administrable system.As selecting or extraly, system 10 is configured to determine the optimal humidity level in the room at object place, so that optimize one or more physiological parameters of object, and driving vaporizer or other humidifying device are with appropriate controlled humidity.Be further used as and select or extraly, system 10 is configured to determine best room temperature,, and drive air-conditioning and/or heater with appropriate control temperature so that optimize one or more physiological parameters of object.
For some application, medication information is directly sent to system 10 from doser 266, rather than in the manual input user interface 24.This drug information is handled can comprise which kind of medicine (and/or active constituents of medicine) of for example using, the dosage and/or the administration time of used medicine.Use for some, when determining that system offers the dosage of doser 266 and/or administration timing information, system 10 considers medication informations.
Use for some, doser 266 is regulated the dosage of several drugs.For example, doser can be regulated the drug dose that belongs to following one or more classifications: bronchodilator, antibiotic medicine, antibiotic and placebo.Be used for the treatment of the application of asthma patient for some, doser 266 comprises metered-dose inhaler (MDI), and it comprises three chambers that hold such as the several types medicine of bronchodilator, antiinflammatory and placebo.When object 12 was waken up in the morning, system 10 determined the current symptom of object, and determined the suitable dosage combination of three kinds of medicines in view of the above.System 10 passes to MDI with this dosage information, is prepared the correlation combiner that is inhaled into by it.Object starts MDI and uses appropriate drug dose combination automatically.These technology make object not need to know or control the drug regimen that MDI sends.The technology of this section description also is applicable to the doser except that MDI.
With reference to Figure 14 A～B, it is the figure that shows the power spectral density of the signal of measuring according to an embodiment of the invention.Line 270 and 272 among Figure 14 A and the 14B shows the power spectral density of the signal of measuring respectively respectively below abdominal part and shank.Peak 274 and 276 is the breathing rate and the heart rate of corresponding objects respectively.As seen in FIG., use for some, can clearer detection heart rate in the signal that below shank, detects.
With reference to Figure 15, it is the sketch map of the configuration of the system 10 that comprises two motion sensor 30A and 30B according to an embodiment of the invention.Motion sensor 30A and 30B be installed in and lean in the surface 37, on or below, pick off 30A is installed near the abdominal part 38 or chest 39 of object 12, and pick off 30B is installed near object 12 parts that are positioned on the anatomy below the object waist, for example near the lower limb 40 of object.System 10 is generally simultaneously from pick off 30A and 30B sampling and analysing signal.The heart of heart of beating impacts (cardioballistic) effect and advances to shank from heart with the speed of about 5 meter per seconds.Use for some, system 10 uses from the delay pulse of the pick off 30B detection of shank 40 belows and confirms from the pulse of the pick off 30A detection of abdominal part 38 or chest 39 belows.Use for some, system 10 comprises the motion sensor 30 more than two.
With reference to Figure 16 A～B, it is to be presented at the lower limb 40 of object and the simultaneously-measured pulse signal in abdominal part 38 belows and the figure of the cross correlation between the signal of Figure 16 A of measurements and calculations respectively according to an embodiment of the invention.For some application, system 10 calculate be positioned on (a) anatomy the object waist following such as object 12 parts of lower limb 40 and (b) cross correlation between the signal of abdominal part 39 or the measurement of chest 39 belows.For example, the signal 290 among Figure 16 A and 292 shows simultaneously-measured pulse signal below the lower limb of abdominal part 38 and object respectively.The cross correlation of two pulse signals among the line 294 displayed map 16A among Figure 16 B.The first peak 296 of line 294 is corresponding to the delay of heart impact signal, and it is about 0.12 second in this example.The peak 296 of identification cross-correlated signal.Second peak 298 of identification cross-correlation.Distance between the corresponding heart beating of peak-to-peak distance, and make it possible to calculate heart rate.Use for some, system 10 uses the heart rate of this indirect calculation to come may cause in the correction signal the directly inaccurate background noise of heart rate of measurement.
Referring again to Figure 15.In one embodiment of the invention, abdominal part and lower limb pick off 30A and 30B are arranged in known mutual distance D (for example, D can measuring between the center separately at pick off) and lean on surperficial 37 belows.System 10 is by calculating the speed that the heart impact signal is advanced with distance D divided by the time difference at the peak 296 (Figure 16 B) of corresponding cross-correlated signal 294 in subject's body.For some application, system 10 calculates this speed continuously.The variation of speed is as the index of object change of illness state.For example, use for some, system 10 uses the time difference between two pulse signals and/or changes blood pressure and/or the blood pressure of estimating object.The technology of describing in the literary composition can be used in combination with the above-mentioned United States Patent (USP) 6,599,251 of having done the people such as Chen of necessary correction.Use for some, system 10 uses the blood pressure information that obtains to monitor and predict the beginning and the development of clinical episodes.Use the absolute blood pressure of system's 10 calculating objects for some.For some application, utilize standard blood measuring apparatus to come corrective system usually such as the amount of shaking cuff (oscillometric cuff).
With reference to Figure 17, it is the sketch map of system 10 that is suitable for monitoring conceived object 300 and her fetus 302 according to an embodiment of the invention.In this embodiment, system 10 comprises two or more motion sensors 30, and system discerns and distinguish mother's pulse and the pulse of fetus with motion sensor 30.Use for some, be the pulse signal of detected object clearly, first sensor 30C is positioned at and is positioned at the following below, object position such as shank 40 of conceived object 300 waists on the anatomy.The second pick off 30D is positioned at abdominal part 38 belows of object 300, and measures the composite signal of mother and fetus pulse.Can use extra pick off 30 further enhancing signal quality.Pattern analysis module 16 is removed mother's pulse signal to determine the pulse of fetus from the assembled pulse signal.
For some application, system 10 is configured to use two or more pick offs, on the one hand to discern and to distinguish mother's body kinematics and pulse, on the other hand to discern and to distinguish motion and the pulse of fetus.Usually, this system uses first sensor 30C to be used for the signal of the pulse of detected object clearly and mother's body kinematics, and uses the second pick off 30D to measure mother and the pulse of fetus and the composite signal of body kinematics.Pattern analysis module 16 is removed mother's pulse and motor message to determine pulse and the motion of fetus from the pulse of combination and motor message.
For some application, pattern analysis module 16 is according to the pulse recognition and the pulse of distinguishing mother of the pick off of (for example shank) below the waist on abdominal part and the anatomy from fetus.For example, pattern analysis module 16 can be used the cross-correlation technique of doing necessary correction mentioned above.For example, can use above-described cross-correlation technique to discern mother's pulse.From composite signal, deduct this signal.Perhaps, after the pulse of finding mother, utilize the notch filter of the pulse frequency of removing mother to filter composite signal.Utilize for example band filter between about 1Hz and about 4Hz that is suitable for the fetus pulse to filter resulting signal then, and utilize above-described technology to discern the pulse of fetus.
With reference to Figure 18, it is the flow chart that schematically shows the method that is used for the predict physiologic disease according to an embodiment of the invention.In this embodiment, system 10 is configured in the power spectrum of the motor message that produces according to motion sensor 30 to small part the ratio between the different harmonic waves and changes and come the predict physiologic disease.In measuring process 310, motion sensor 30 is measured motor message.In power spectrum calculation procedure 312, breathing pattern analysis module 22 calculates the power spectrum of the motor message of measuring.In breathing rate determination step 314, module 22 with breathing rate be identified as the correlated frequency scope of breathing (for example about 0.1 and about 1.0Hz between) in the peak.As selection, for measuring breathing rate, breathing pattern analysis module 22 uses zero crossing or the peak in the time domain to detect, and counts the peak then.Be further used as selection, peak-to-peak interval is measured at this module identification peak, arranges this interval by mode from high to low, deletes the top (for example 10%) of certain percentage and bottom (for example 10%), and the meansigma methods of getting all the other intervals.Then, in harmonic wave identification step 316, the one or more harmonic waves of module 22 identification, the i.e. integral multiple at this peak in the power spectrum (or little molecule/denominator mark, for example 1/2, if the frequency that obtains is in the frequency range that allows).In ratio and phase difference calculating step 318, module 22 is calculated the energy level ratio of harmonic wave and the phase contrast between the harmonic wave.In the beginning of disease prediction steps 310, module 22 is analyzed these parameter comparison baseline measureses, and will resolve to the upcoming physiological disorder of indication with the deviation of baseline.For example, this deviation can be indicated level or its phase angle of breast abdomen asynchronism (TAA).
With reference to Figure 19, its be illustrate according to an embodiment of the invention be used to implement figure with reference to the exemplary power of the described method of Figure 18 spectrum.This power spectrum gets the data of measuring in the asthma patient of comfortable reality.Line 321 representatives are as the power spectrum of measurement and filtering breath signal in the step 310 and 312 of the method for Figure 18.In step 314, peak 322 is identified as the maximum peak that arrives in about 0.5Hz scope about 0.1.The basic breathing rate of this peak representative.In step 316, peak 324 is identified as the second harmonic of breath signal.In step 318, calculate the aspect ratio at peak 322 and peak 324, and the several hrs during the length of one's sleep is drawn.Use for some, calculate the baseline reference ratio at peak based on the measurement result during the ortho sleep.In step 320, relatively the baseline reference at peakedness ratio between sleep period and peak indicates clinical episodes to be about to begin than whether departing from baseline with the estimation peakedness ratio thus.In step 318, Fourier analysis provides phase place for each frequency.Usually, it is poor mutually that basic harmonic wave and second harmonic are carried out phase place, and analyze difference in the mode that is similar to above-mentioned analysis.
Figure 20 is the figure that shows according to an embodiment of the invention the ratio of the first harmonic of breath signal of the asthma patient of measuring and base frequency.As can be seen, between the outbreak sleep period, the harmonic wave energy level ratio of line 330 representatives is higher than the ratio of sleeping before the normal non-outbreak of line 332 representatives substantially.(the bar line on the line is represented standard deviation).Use the basic deviation of error bar size prediction itself or indication clinical episodes for some.
The quantity of the sleep apnea incident that occurs during the section between in one embodiment of the invention, system 10 is suitable for discerning and count at a time.System 10 is event number and the baseline that derives from non-symptom day relatively, and deviation is resolved to the indication outbreak.
With reference to Figure 21 A～B, it is respectively the figure that shows the signal analysis of the breath signal of indication Cheyne-Stokes respiration (CSR) according to an embodiment of the invention and Figure 21 A.In this embodiment, system 10 is suitable for CSR is identified as index such as the chronic disease of CHF.Signal 350 among Figure 21 A is represented the breath signal of measurement as mentioned above and filtering sleep object.This signal has the feature of CSR.The peak-to-peak time gap of consecutive of system's 10 measuring-signals 350, and calculate the peak-to-peak instantaneous breathing rate of representing as the line among Figure 21 B 352 of every pair of consecutive.The periodicity that line 352 shows among the CSR that expects, and be used to discern this pattern.Use for some, the also number in record this cycle is every night measured by system 10, and with this information as such as the beginning of the clinical episodes of CHF and the indication of the order of severity.
Figure 22 is the figure that shows the breath signal of the indication Cheyne-Stokes respiration (CSR) of measuring according to an embodiment of the invention.
Figure 23 is respectively the figure of the breathing rate Night of the exemplary baseline measured according to an embodiment of the invention and measurement.Line 400 representative does not have the normal baseline pattern during the CSR, and line 402 is represented the pattern during night during the CSR.The bar line is represented a standard error.
In one embodiment of the invention, system 10 is suitable for periodic limb movement (PLMS) in the identification sleep.The incidence rate of this symptom and level are as the index such as CHF, diabetes, anemia and nephropathy.For some application, system 10 comprises single-sensor 30, and for other application, system 10 comprises two or more pick offs 30.
Referring again to Fig. 2.In one embodiment of the invention, system 10 comprises the temperature sensor 380 that is used for take temperature.Use for some, temperature sensor 380 comprises the integrated infrared sensor that is used for take temperature.Body temperature is the vital sign of indication systemic infection and inflammation general state.The overall rising of body temperature is used as first screening implement in the medical diagnosis.
Referring again to Fig. 1 and 2.In one embodiment of the invention, system 10 comprises first and second motion sensors 30.Motion sensor 30 is installed in and leans in the surface 37, on or below, make first sensor be positioned near the pulmonary of object 12, the abdominal part that second pick off is positioned at object 12 is for example near the hypogastric region of object 12.Coherent signal is generally breathed from two sensor samples and analysis simultaneously by system 10.Use for some, breathing pattern analysis module 16 for example two by cross-correlation as indicated above is breathed phase shift between the breathing coherent signal that coherent signals come calculating sensor.Breathing pattern analysis module 16 is analyzed this phase shift to determine the measured value of breast abdomen asynchronism (TAA), and the latter is a remarkable Clinical symptoms of suffering from the patient of airway obstruction.As selecting or extraly, module 16 is analyzed the beginning of these phase shifts with the clinical disease of identification and monitoring such as asthma attack.Use for other, module 16 is calculated the amplitude ratio of breathing coherent signal, and analyzes the measured value of this ratio to determine that supernumerary muscle uses in the breathing.The higher proportion of the breathing coherent signal of abdominal part sensor measurement and the breathing coherent signal of lung sensor measurement is generally indicated supernumerary muscle higher usage level in breathing.The use of supernumerary muscle is a remarkable Clinical symptoms of suffering from the patient of airway obstruction.
Referring again to Fig. 1 and 2.In one embodiment of the invention, system 10 comprises first and second motion sensors 30.Motion sensor 30 is installed in and leans in the surface 37, on or below, make first sensor be positioned near the pulmonary of object 12, second pick off is positioned near the abdominal part of object 12.Coherent signal is generally breathed from two sensor samples and analysis simultaneously by system 10.Use for some, 16 analyses of breathing pattern analysis module derive from the composite signal of pick off to distinguish air-breathing and to exhale.For example, in some cases, intake period,, near the air-breathing motion the pulmonary is prior near the motion the abdominal part, and during exhaling, after the motion in lung district in the motion of abdominal part.Use for some, basic calculating continuously exhaled to the air-breathing persistent period.The expiration persistent period is compared the prolongation indication airway obstruction of inspiratory duration.
In one embodiment of the invention, system 10 is configured to discern the early signal of the hypoglycemia outbreak beginning of diabetes object.This system is identified as this beginning of indication with the tremble increase of level of physiology, and/or the increase of the level of will trembling is identified as indication cardiopalmus (analyzing the peak-to-peak timing of heartbeat signal by utilizing the technology of describing in the literary composition) with the variation such as heart rate, breathing rate and/or awakening and/or heart beating pattern mentioned above.Usually, this system by monitoring between about 4Hz and the about 18Hz for example the body kinematics between about 8Hz and about 12Hz detect physiology and tremble.Perhaps, this system is identified as the tremble increase of level of physiology the outbreak that indication is selected from following disease and begins or develop: parkinson disease, Alzheimer, apoplexy, essential tremor, epilepsy, stress, fibrillation and anaphylactic shock.Use for some, system 10 is fit to drive the user interface 24 one or more character to show that detected physiology trembles, the amplitude that for example trembles and spectrogram picture.For example, system 10 can be used as bedside hospital vital sign diagnostic system.For some application, discern hypoglycemia by analysis of cardiac signal identification cardiopalmus.
In one embodiment of the invention, the above-described physiological parameter subclass of system 10 monitoring, as the breathing rate of a plurality of time points at night, heart rate, cough counting, blood pressure, exhalation/inhalation than, breathe harmonic ratio and tremble.Pattern analysis module 16 is given score value for each parameter, and the combination score value is to obtain compound score value.Be the example formula that is used for this combination below:
Combination score value=constant 1 * (average night heart rate-baseline heart rate)+constant 2 * (average night breathing rate-baseline breathing rate)+constant 3 * (nocturnal cough's number)+constant 4 * (average respiration-hours 2 average respiration) (equation 3) hours 3
For some application, the regional disease control methodology that these technology and asthma object extensively adopt is united use, and in regional disease control methodology, " green " region representation does not have symptoms of asthma, " yellow " region representation hangs down the outbreak level, and the high outbreak level of " redness " region representation.If the combination score value is lower than first threshold, then system 10 drives user interface 24 and produces the green area indication, if the combination score value between first and second threshold values, then produces the yellow area indication, if and the combination score value then produces the red area indication greater than second threshold value.
For some application, if system 10 is configured to the combination score value greater than second threshold value then utilize instant warning that object is waken up from nighttime sleep, and if the combination score value between first and second threshold values, then wait until notify object just in morning.Instant warning can comprise warning and/or light.User interface can be behind the calculation combination score value any time with the mode of not waking object up export predict that symptom begins morning notify object information.
Use for some, system 10 is fit to one or two threshold value of study, one or more parameter and/or one or more constant that is used to produce the combination score value.Can use the above-described technology that is used for this study.
With reference to Figure 24, it is the graphics that the breathing rate of measuring during several nights according to an embodiment of the invention is shown.This figure is effective for the beginning of the process of demonstration clinical episodes directly perceived and/or identification outbreak.The x axle of the figure of Figure 24 represent night hour, the y axle is represented the index of night (i.e. 24 hours periods), the z axle is represented breathing rate.As selecting or extraly, on the z axle, showing heart rate.As selection, these data show by topography or as gray-scale map or color coding figure.Analyzing this graphics by people or machine is being useful aspect the pattern of identification indication outbreak beginning.
In one embodiment of the invention, system 10 comprises a plurality of motion sensors 30, and for example near first sensor abdominal part 38 or chest 39 and near second pick off shank 40 are described with reference to Figure 15 as mentioned.Pattern analysis module 16 is determined pulse signal and the time delay between the pulse signal of measuring below the shank measured in the pick off below abdominal part or chest.For example, this module can be by utilizing for example carrying out cross-correlation at the time window of about 1 and 3 heart beat cycle between heartbeat signal and come Measuring Time to postpone less than time breathing cycle.As selection, this module can be discerned the peak in the heartbeat signal, and calculates the peak-to-peak time difference in each signal.Module 16 is used continuous calculating blood pressure variable signal of the time difference, describes in the people's such as Chen that the do necessary correction for example as indicated above United States Patent (USP) 6,599,251.Module 16 is calculated the amplitude of blood pressure during air-breathing entirely/exhalation cycle, and relatively this amplitude with such as the threshold value of 10mmHg measure before be used for object or based on the baseline value of colony's meansigma methods.Module 16 will resolve to the indication paradoxical pulse greater than the amplitude of threshold value.As selecting or extraly, this system shows that amplitude and/or record amplitude are used to discern the baseline that disease changes thereafter with what be formed for special object.
Some embodiments of describing in the literary composition relate to one group of monitored vital sign and physiology behavior in order to prediction and/or monitoring clinical episodes.In some cases, some monitoring and/or predictive abilities for raising system 10 of making up in these abilities are useful, and the outbreak that for example is used for detecting diabetes object hypoglycemia begins, and is as indicated above.
In one embodiment of the invention, system 10 is fit to calculate the number of times of awakening at night.For some application, this counting worsens the indication that (drinking-water of for example waking up), the disease relevant with small intestinal and/or colon or prostate problems (urine of for example waking up) begin as asthma attack, diabetes.In one embodiment, utilize the technology in people's such as mentioned above and/or Shinar Z the above-mentioned paper (1998) to discern awakening.
In one embodiment of the invention, system 10 be fit to usually do not contact or the habited situation of the object of observation or object institute under the old object of monitoring.For example, system 10 can be configured to monitoring breathing rate, heart rate, cough, sack time, awakening outbreak and sleeps one or more in restless.Use for some, system 10 analyzes one or more to determine not have the moment that the object trial is got up under the situation about helping and notifying health care provider in these parameters.Patient is not having to attempt to get up under the situation about helping often to cause killed or wounded.
Although some embodiments of describing in the literary composition are particularly related to asthma attack or CHF, but principle of the present invention can be applied to predict and monitor other breathing that influences the eupnea pattern and non-breathing disease after the correction of necessity, for example chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), diabetes, neurological disorder (for example epilepsy) and some heart disease except that CHF.For some application, system 10 is configured to migrainous beginning of predetermined period and/or monitoring periods migraine, for example by the variation of monitoring as the breathing rate and/or the heart rate of upcoming migrainous early stage indication.Use for some, system 10 is configured to monitor the motion of small intestinal and/or the motion of colon, and analyzes this motion with the indication as gastrointestinal disorder.For example, system 10 can discern the characteristic frequency of gastrointestinal movement, for example discerns by the pick off of differentiation abdominal part below and the signal that pick off produced of pulmonary below.
One skilled in the art will appreciate that and the invention is not restricted to the above concrete content that shows and describe.On the contrary, scope of the present invention comprises above-described various combination of features and time combination, and their variation and modification that do not have in the prior art, that those skilled in the art can expect after reading above-mentioned description.
Claims (174)
1. method comprises:
Do not contact or the habited situation of the object of observation or object institute under, the described motion of objects relevant parameter of sensing;
Obtain the heart beating coherent signal and breathe coherent signal from described motion relevant parameter; With
Utilize described breathing coherent signal to come the described heart beating coherent signal of rectification.
2. multiply by described heart beating coherent signal according to the process of claim 1 wherein that the described heart beating coherent signal of rectification comprises with described breathing coherent signal.
3. according to the method for claim 1 or 2, wherein obtain described heart beating and comprise respectively at the described heart beating frequency range inner filtration described motion coherent signal relevant with breathing with the breathing coherent signal.
4. according to the method for claim 3, the relevant frequency range of wherein said heart beating 0.8 and 5Hz between.
5. according to the method for claim 3, the relevant frequency range of wherein said breathing 0.05 and 0.8Hz between.
6. method that is used for measuring conceived object fetal heartbeat comprises:
Do not contacting or observing under the habited situation of described object or described object institute, the described conceived motion of objects relevant parameter of sensing; With
Obtain described fetal heartbeat from described motion relevant parameter.
7. according to the method for claim 6, wherein the described motion relevant parameter of sensing comprise measure in the dependence surface that described object lies, on or below pressure.
8. according to the method for claim 6, comprise that the sound that is produced by foetal monitor by simulation produces the acoustic signal of the fetal heartbeat of gained.
9. according to the method for claim 6, comprise the measured value of determining fetal heart frequency by the fetal heartbeat of analyzing gained.
10. according to the method for claim 6, wherein obtaining described fetal heartbeat comprises from the described motion relevant parameter of indicating described fetal heartbeat and mother's heart beating simultaneously and obtains first signal and obtain the described fetal heartbeat of indication from described first signal but do not indicate the secondary signal of described mother's heart beating.
11., wherein obtain described fetal heartbeat and comprise according to each method in the claim 6～10:
Obtain from described motion relevant parameter: (a) breath of mother coherent signal and (b) the heart beating coherent signal of fetus; With
Utilize described breath of mother coherent signal to come the heart beating coherent signal of the described fetus of rectification.
12. a method that is used for monitoring conceived object fetal movements comprises:
Do not contacting or observing under the habited situation of described object or described object institute, the described conceived motion of objects relevant parameter of sensing; With
Obtain the measured value of described fetal movements from described motion relevant parameter.
13. according to the method for claim 12, wherein the described motion relevant parameter of sensing comprise measure in the dependence surface that described object lies, on or below pressure.
14. a method comprises:
At least one parameter of the described object of sensing between the object sleep period;
Analyze described parameter;
Predict the beginning of clinical episodes according to described analysis to small part; With
Only the outbreak of being predicted to described object warning in described object awakening back begins.
15. one kind is used to the method for predicting that clinical episodes begins, comprises:
Obtain the relevant time-domain signal of breathing of object;
Convert described time-domain signal to frequency-region signal;
Determine the breathing rate of described object by the peak in the breathing correlated frequency scope of discerning described frequency-region signal;
Determine one or more harmonic waves of described peak frequency;
Determine following relation between the two:
(a) first energy level is selected from: with relevant energy level in one or more harmonic waves and with the energy level of described peak frequency dependence and
(b) second energy level, its with one or more harmonic waves in one relevant;
The baseline values of more described relation and described relation; With
To small part according to the described beginning of relatively predicting described outbreak.
16. a method that is used to monitor blood pressure comprises:
Do not contact or the habited situation of the object of observation or object institute under, the described motion of objects relevant parameter of sensing; With
Analyze the measured value of described parameter with the blood pressure of definite described object.
17. according to the method for claim 16, wherein the described motion relevant parameter of sensing be included in do not contact or observe described object or described object under the habited situation respectively near first position of described object and the first and second motion relevant parameters of the second position proximity sensing object.
18. a method that is used for the treatment of object comprises:
Do not contact or the habited situation of the object of observation or object institute under, the described motion of objects relevant parameter of sensing;
Analyze described parameter;
Determine to be administered to the predose of the medicine of described object according to described analysis to small part; With
Send described predose to described object used doser.
19., wherein analyze described parameter and comprise according to the method for claim 18:
Analyze the clinical effectiveness of the described medicine that described doser uses under the predose of described transmission;
Determine the renewal drug dose different according to described analysis with described predose; With
Send described more new dosage to described doser.
20. one kind is used to the method for predicting that clinical episodes begins, comprises:
At least one parameter of sensed object;
Analyze described parameter;
Receive the data relevant with the medicine that is administered to described object; With
Predict the beginning of clinical episodes according to the combination of described analysis and described administration data to small part.
21., wherein receive described administration data and comprise from dispenser and receive described administration data for the doser of described object according to the method for claim 20.
22. according to the method for claim 20, wherein said administration data comprise the dosage of described medicine.
23. according to each method in the claim 20～22, described at least one parameter of sensing when wherein described at least one parameter of sensing is included in described object sleep.
24. a method that is used for the treatment of clinical episodes comprises:
Do not contact or the habited situation of the object of observation or object institute under, at least one parameter of the described object of sensing;
Analyze described parameter;
Detect described clinical episodes according to described analysis to small part; With
According to detecting described clinical episodes, utilize the device of implanting described object to treat described clinical episodes.
25. a method comprises:
Do not contact or the habited situation of the object of observation or object institute under, at least one parameter of the described object of sensing when described object sleep; With
Analyze described parameter to determine the restless measured value of described object.
26. according to the method for claim 25, wherein said at least one parameter comprises at least one motion relevant parameter of described object, and wherein described at least one parameter of sensing comprises described at least one the motion relevant parameter of sensing.
27. a method comprises:
Do not contact or the habited situation of the object of observation or object institute under, at least one parameter of the described object of sensing when described object sleep; With
By analyzing periodic limb movement (PLMS) in the sleep that described parameter detects described object.
28. according to the method for claim 27, wherein said at least one parameter comprises at least one motion relevant parameter of described object, described at least one parameter of sensing comprises described at least one the motion relevant parameter of sensing.
29. a method comprises:
Utilization place in the dependence surface that object lies or the below just what a do not contact described object or described object habited pick off at least one parameter of coming the described object of sensing; With
By analyzing the cough that described parameter detects described object.
30. according to the method for claim 29, wherein said at least one parameter comprises at least one motion relevant parameter of described object, and wherein described at least one parameter of sensing comprises described at least one the motion relevant parameter of sensing.
31. a method of predicting that asthma attack begins comprises:
The breathing of sensed object;
The heart beating of the described object of sensing;
Determine at least one breathing pattern of described object and determine at least one heart beating pattern of described object according to the heart beating of institute's sensing according to the breathing of institute's sensing;
More described breathing pattern and baseline breathing pattern, and more described heart beating pattern and baseline heart beating pattern; With
To small part according to the described beginning of relatively predicting described asthma attack.
32. according to the method for claim 31,
Determine that wherein described at least one breathing pattern and described at least one heart beating pattern comprise at least one breathing rate pattern of determining described object respectively and at least one heart of described object,
Wherein more described breathing pattern and baseline breathing pattern comprise more described breathing rate pattern and baseline breathing rate pattern and
Wherein more described heart beating pattern and described baseline heart beating pattern comprise more described heart and baseline heart rate pattern.
33. according to the method for claim 31 or 32, wherein described breathing of sensing and described heart beating comprise at least one motion relevant parameter of the described object of sensing, and obtain described breathing and described heart beating from described motion relevant parameter.
34. according to the method for claim 33, comprise from described motion relevant parameter obtaining at least one extra physiological parameter, wherein predict described begin to comprise to small part predict described beginning according to described comparison and described extra physiological parameter.
35. according to the method for claim 34, wherein said extra physiological parameter is selected from: the measured value of described object cough, the measured value that described object is exhaled and air-breathing time ratio, the blood pressure of described object, described object are awakened between sleep period at measured value restless between sleep period and described object.
36. one kind is used to the method for predicting that asthma attack begins, comprises:
The breathing of sensed object;
Determine at least one breathing pattern of described object according to the breathing of described sensing;
More described breathing pattern and baseline breathing pattern;
Determine the measured value of described object cough; With
Predict the beginning of described asthma attack according to the measured value of described comparison and described cough to small part.
37. a method that is used for the beginning of the prediction outbreak relevant with congestive heart failure (CHF) comprises:
The breathing of sensed object;
The blood pressure of the described object of sensing;
Determine at least one breathing pattern of described object according to the breathing of described sensing;
More described breathing pattern and baseline breathing pattern; With
Predict the beginning of described outbreak according to described comparison and described blood pressure to small part.
38. a method that is used for the determination object heart rate, it comprises:
Under the habited situation of not contact object or object institute, near first pulse signal the primary importance of the described object of sensing in the position of the abdominal part of chest that is selected from described object and described object;
Do not contacting under the habited situation of described object or described object institute near second pulse signal of the second position that the described object anatomy of sensing waist is following; With
Determine described heart rate according to described first and second pulse signals.
39., determine that wherein described heart rate comprises the cross-correlated signal of calculating described first and second pulse signals, and determine that described heart rate is the frequency of described cross-correlated signal according to the method for claim 38.
40. according to the method for claim 39, the described second position of wherein said object comprises near the position of shank of described object.
41. according to the method for claim 39, wherein described first and second pulse signals of sensing are included in and do not contact or observe described first and second pulse signals of sensing under the habited situation of described object or described object institute.
42. according to the method for claim 39,
Wherein described first pulse signal of sensing comprise the described object of sensing near described primary importance the first motion relevant parameter and obtain described first pulse signal from the described first motion relevant parameter, and
Wherein described second pulse signal of sensing comprise the described object of sensing near the described second position the second motion relevant parameter and obtain described second pulse signal from the described second motion relevant parameter.
43., comprise the beginning of predicting described clinical episodes according to described heart rate according to the method for claim 39.
44. a method comprises:
Do not contact or the habited situation of the object of observation or object institute under, respectively near first position of described object and the first and second motion relevant parameters of the described object of second position vicinity sensing;
Obtain first and second from the described first and second motion relevant parameters respectively and breathe coherent signal; With
Analyze described first and second and breathe the measured value of coherent signal with the breast abdomen asynchronism (TAA) of definite described object.
45., wherein analyze described first and second and breathe the phase shifts that coherent signal comprises that calculating described first and second is breathed between the coherent signals according to the method for claim 44.
46. method according to claim 44 or 45, wherein said first position comprises the lung of described object, described second position comprises the hypogastric region of described object, and wherein sensing is included in described lung and near the described first and second motion relevant parameters of sensing respectively of hypogastric region.
47. a method comprises:
Do not contact or the habited situation of the object of observation or object institute under, respectively near first position of described object and the first and second motion relevant parameters of the described object of second position vicinity sensing;
Obtain first and second from the described first and second motion relevant parameters respectively and breathe coherent signal; With
Analyze described first and second and breathe coherent signal to determine the active measured value of described object supernumerary muscle.
48., wherein analyze described first and second and breathe the ratios that coherent signal comprises that coherent signals are breathed in calculating described first and second according to the method for claim 47.
49. method according to claim 47 or 48, wherein said first position comprises the lung of described object, wherein said second position comprises the hypogastric region of described object, and wherein sensing is included in described lung and near the described first and second motion relevant parameters of sensing respectively of hypogastric region.
50. a method that is used for monitoring target comprises:
Set the first and second different separately threshold values;
Do not contact or the habited situation of the object of observation or object institute under, at least one parameter of the described object of sensing;
Analyze described parameter to produce score value;
If described score value between described first and second threshold values, then produces first output that the clinical episodes of indication prediction begins; With
If described score value surpasses described second threshold value, then produce second output of the present occurent clinical episodes of indication.
51. method according to claim 50, wherein described at least one parameter of sensing be included in do not contact or the object of observation or object a plurality of parameters of the described object of sensing under the habited situation, and wherein analyze described parameter and comprise and analyze described a plurality of parameters to produce described score value to produce described score value.
52. method according to claim 50, wherein said parameter comprises the breathing relevant parameter of described object, and wherein analyze described parameter and comprise at least one breathing pattern and more described breathing pattern and the baseline breathing pattern of determining described object according to described parameter.
53. according to each method in the claim 50～52, wherein said at least one parameter comprises at least one motion relevant parameter of described object, and wherein described at least one parameter of sensing comprises described at least one the motion relevant parameter of sensing.
54. a method that is used for the paradoxical pulse of detected object comprises:
Do not contact or the habited situation of the object of observation or object institute under, at least one parameter of the described object of sensing;
Analyze described parameter air-breathing to be created in/measured value of the described object blood pressure of cycle period of exhaling;
The measured value of more described blood pressure and threshold value; With
Detect described paradoxical pulse according to measured value greater than threshold value.
55. according to the method for claim 54, wherein said at least one parameter comprises at least one motion relevant parameter of described object, and wherein described at least one parameter of sensing comprises described at least one the motion relevant parameter of sensing.
56. one kind is used to the method for predicting that asthma attack begins, comprises:
Do not contact or the habited situation of the object of observation or object institute under, at least one parameter of the described object of sensing; With
To the beginning of small part according to the described asthma attack of parameter prediction of institute's sensing.
57. according to the method for claim 56, wherein said at least one parameter comprises at least one motion relevant parameter of described object, and wherein described at least one parameter of sensing comprises described at least one the motion relevant parameter of sensing.
58., predict that wherein the described nursing staff who begins to be included in described object or described object predicts described beginning before awaring described beginning according to the method for claim 56.
59., wherein predict describedly to begin to comprise that the appearance by described asthma attack before analyzing produces the object specific data that relates to described parameter and predicts described beginning according to described data to small part according to the method for claim 56.
60. according to the method for claim 56, wherein predict described begin to comprise measure the restless measured value of described object and predict described beginning according to described restless measured value to small part.
61. according to the method for claim 56, comprise the measured value of measuring described object cough, wherein predict described begin to comprise to small part predict described beginning according to the parameter of institute's sensing and the measured value of described cough.
62. according to the method for claim 56, wherein described at least one parameter of sensing is included in described at least one parameter of sensing under the situation of the compliance that does not need the people.
63. according to each method in the claim 56～62, described at least one parameter of sensing when wherein described at least one parameter of sensing is included in described object sleep.
64. according to the method for claim 63, it comprises the beginning of only being predicted to described object warning in described object awakening back.
65. according to each method in the claim 56～62, wherein said at least one parameter comprise described object described at least one breathe relevant parameter, and wherein described at least one parameter of sensing comprise sensing described at least one breathe relevant parameter.
66. according to the method for claim 65,
Wherein said at least one parameter comprises at least one heart beating relevant parameter of described object,
Wherein described at least one parameter of sensing comprise described at least one the heart beating relevant parameter of sensing and
That wherein predicts described asthma attack begins to comprise the beginning of predicting described asthma attack to small part according to described breathing relevant parameter and described heart beating relevant parameter.
67., predict that wherein described the beginning comprises according to the method for claim 65:
Determine at least one breathing pattern of described object according to the breathing relevant parameter of institute's sensing;
More described breathing pattern and baseline breathing pattern; With
Relatively predict described beginning according to described to small part.
68. according to each method in the claim 56～62, wherein described at least one parameter of sensing comprise measure in the dependence surface that described object lies, on or below pressure.
69. according to the method for claim 68, wherein described at least one parameter of sensing comprise utilize place describedly lean in the surface, on or below just what a pick off measure described pressure.
70. one kind is used for the method that the prediction outbreak relevant with congestive heart failure (CHF) begins, comprises:
Do not contact or the habited situation of the object of observation or object institute under, at least one parameter of the described object of sensing; With
To the beginning of small part according to the described outbreak of parameter prediction of institute's sensing.
71. according to the method for claim 70, wherein said at least one parameter comprises at least one motion relevant parameter of described object, and wherein described at least one parameter of sensing comprises described at least one the motion relevant parameter of sensing.
72. according to the method for claim 70, wherein described at least one parameter of sensing comprise measure in the dependence surface that described object lies, on or below pressure.
73. according to the method for claim 70, wherein described at least one parameter of sensing is included in described at least one parameter of sensing between described object sleep period.
74. method according to claim 70, wherein described at least one parameter of sensing comprise the described object of sensing at least one breathe the blood pressure of relevant parameter and described object, and wherein predict described begin to comprise to small part predict described beginning according to described breathing relevant parameter and described blood pressure.
75. according to each method in the claim 70～74, wherein described at least one parameter of sensing is included in described at least one parameter of sensing under the situation of the compliance that does not need the people.
76. one kind is used to the method for predicting that clinical episodes begins, comprises:
At least one parameter of sensed object; With
When the breathing rate of described object be lower than described object the asymptomatic breathing rate of baseline 120% the time, predict the beginning of described clinical episodes according to the parameter of institute's sensing to small part.
77. according to the method for claim 76, wherein described at least one parameter of sensing is included in and does not contact or observe described at least one parameter of sensing under the habited situation of described object or described object institute.
78. according to the method for claim 76, wherein said clinical episodes comprises asthma attack, and wherein predict described clinical episodes begin to comprise the beginning of predicting described asthma attack.
79. according to each method in the claim 76～78, wherein predict described begin to comprise when described breathing rate be lower than described object the asymptomatic breathing rate of baseline 110% the time predict described beginning.
80. according to the method for claim 79, wherein predict described begin to comprise when described breathing rate be lower than described object the asymptomatic breathing rate of baseline 105% the time predict described beginning.
81. one kind is used to the method for predicting that asthma attack begins, comprises:
At least one parameter of sensed object; With
When the forced expiratory volume in 1 second (FEV1) of described object greater than the asymptomatic FEV1 of baseline of described object 90% the time, predict the beginning of described asthma attack according to the parameter of institute's sensing to small part.
82. 1 method according to Claim 8, wherein at least one parameter of sensing is included in and does not contact or observe described at least one parameter of sensing under the habited situation of described object or described object institute.
83. one kind is used to the method for predicting that clinical episodes begins, comprises:
Do not contact or the habited situation of the object of observation or object institute under, at least one parameter of the described object of sensing; With
At least one hour before described clinical episodes begins, predict described beginning according to the parameter of institute's sensing to small part.
84. 3 method according to Claim 8, wherein described at least one parameter of sensing be included in do not contact or observe described object or described object at least two parameters of the described object of sensing under the habited situation, and wherein predict described begin to comprise to small part predict described beginning according to the parameter of institute's sensing.
85. 3 method according to Claim 8 predicts that wherein described begin to be included in before the described beginning predicted described beginning at least in four hours.
86. 3 method according to Claim 8, wherein described at least one parameter of sensing is included in basic described at least one parameter of sensing continuously in the time period that continues at least one hour.
87. each method in 3～86 according to Claim 8, wherein said clinical episodes comprises asthma attack, and wherein predict described clinical episodes begin to comprise the beginning of predicting described asthma attack.
88. one kind is used to the method for predicting that clinical episodes begins, comprises:
Basic at least one parameter of sensed object continuously in the time period that continues at least one hour; With
At least one hour before described clinical episodes begins, predict described beginning according to the parameter of described sensing to small part.
89. 8 method according to Claim 8, wherein described at least one parameter of sensing is included in and does not contact or observe described at least one parameter of sensing under the habited situation of described object or described object institute.
90. 8 method according to Claim 8, wherein described at least one parameter of sensing is included in basic at least two parameters of the described object of sensing continuously in the described time period, and wherein predict described begin to comprise to small part predict described beginning according to the parameter of institute's sensing.
91. 8 method according to Claim 8, wherein said clinical episodes comprises asthma attack, and wherein predict described clinical episodes begin to comprise the beginning of predicting described asthma attack.
92. 8 method according to Claim 8 predicts that wherein described begin to be included in before the described beginning predicted described beginning at least in four hours.
93. each method in 8～92 according to Claim 8, the wherein said time period has at least four hours persistent period, and wherein at least one parameter of sensing is included in basic described at least one parameter of sensing continuously in the time period that continues at least four hours.
94. one kind is used to the method for predicting that clinical episodes begins, it comprises:
The object section length of one's sleep at night at least 80% during basic at least one parameter of the described object of sensing continuously; With
To the parameter of small part according to described sensing, at least one hour predicted the beginning of described clinical episodes before described clinical episodes begins.
95. method according to claim 94, wherein described at least one parameter of sensing be included in the described time period 80% during basic described at least two parameters of sensing continuously, and wherein predict described begin to comprise to small part predict described beginning according to the parameter of institute's sensing.
96. according to the method for claim 94, wherein said clinical episodes comprises asthma attack, and wherein predict described clinical episodes begin to comprise the beginning of predicting described asthma attack.
97. according to each method in the claim 94～96, wherein described at least one parameter of sensing is included in and does not contact or observe described at least one parameter of sensing under the habited situation of described object or described object institute.
98. a method comprises:
At least one parameter of sensed object; With
To the parameter of small part, calculate at the described probability that clinical episodes will take place in the preset time of back that calculates according to institute's sensing.
99. according to the method for claim 98, wherein described at least one parameter of sensing comprises at least two parameters of the described object of sensing, and wherein calculating probability comprises to small part and calculates described probability according to the parameter of institute's sensing.
100. according to the method for claim 98, it comprises if described probability surpasses threshold value then notifies described object.
According to the method for claim 98, wherein said clinical episodes comprises asthma attack, and wherein predict described clinical episodes begin to comprise the beginning of predicting described asthma attack.
According to the method for claim 98, wherein described at least one parameter of sensing is included in and does not contact or observe described at least one parameter of sensing under the habited situation of described object or described object institute.
According to the method for claim 98, wherein calculate described probability and comprise that at least part is according to comprising that the data of colony's meansigma methods of described parameter calculate described probability
According to each method in the claim 98～103, wherein calculate described probability comprise analyze before the appearance of described asthma attack produce the object specific data that relates to described parameter and calculate described probability according to described data to small part.
A kind of method of predicting that clinical episodes begins of being used to comprises:
At least one parameter of sensing under the situation of the compliance that does not need the people; With
Predict described beginning according to the parameter of institute's sensing to small part.
According to the method for claim 105, wherein described at least one parameter of sensing is included in and does not contact or observe described at least one parameter of sensing under the habited situation of described object or described object institute.
Method according to claim 105, wherein said at least one parameter comprises at least one motion relevant parameter of described object, and wherein described at least one parameter of sensing is included in described at least one motion relevant parameter of sensing under the situation of the compliance that does not need the people.
According to the method for claim 105, wherein described at least one parameter of sensing is included at least one parameter of sensing between the object sleep period, and comprises the beginning of only warning described prediction in described object awakening back to described object.
According to the method for claim 105, wherein under the situation of the compliance that does not need the people described at least one parameter of sensing comprise measure in the dependence surface that described object lies, on or below pressure.
110. according to the method for claim 105, wherein said clinical episodes comprises asthma attack, and wherein predict described clinical episodes begin to comprise the beginning of predicting described asthma attack.
111. according to the method for claim 105, wherein said clinical episodes comprises the relevant outbreak of congestive heart failure (CHF) with object, and wherein predicts the described beginning of predicting the outbreak relevant with described CHF that begins to comprise.
112. according to the method for claim 105, wherein said clinical episodes comprises the hypoglycemia outbreak that is caused by diabetes, and wherein predicts the described beginning that begins to comprise the described hypoglycemia outbreak of prediction.
113. method according to claim 105, wherein said clinical episodes is selected from: periodic limb movement (PLMS) outbreak in the movable unusual outbreak of the autonomic nervous system that is caused by nervous system disease, epilepsy, the sleep, apoplexy, essential tremor show effects, stress show effect, fibrillation outbreak, the outbreak relevant with chronic obstructive pulmonary disease (COPD), the outbreak relevant with cystic fibrosis (CF) and the outbreak of anaphylactic shock, and wherein predict the described beginning of predicting described selected clinical episodes that begins to comprise.
114. according to each method in the claim 105～113, wherein said at least one parameter comprise described object at least one breathe relevant parameter, and wherein described at least one parameter of sensing be included under the situation of the compliance that does not need the people sensing described at least one breathe relevant parameter.
115., predict that wherein described the beginning comprises according to the method for claim 114:
Determine at least one breathing pattern of described object according to the breathing relevant parameter of institute's sensing;
More described breathing pattern and baseline breathing pattern; With
Relatively predict described beginning according to described to small part.
116. an equipment comprises:
Non-contact sensor, it is suitable for the described motion of objects relevant parameter of sensing under the habited situation of not contact object or object institute; With
Control unit, it is suitable for:
Obtain the heart beating coherent signal and breathe coherent signal from described motion relevant parameter; With
Utilize the described heart beating coherent signal of described breathing coherent signal rectification.
117. an equipment that is used for measuring conceived object fetal heartbeat comprises:
Non-contact sensor, it is suitable for the described conceived motion of objects relevant parameter of sensing under the habited situation of not contact object or object institute; With
Control unit, it is suitable for obtaining described fetal heartbeat from described motion relevant parameter.
118. an equipment that is used for monitoring conceived object fetal movements comprises:
Non-contact sensor, it is suitable for not contacting the described conceived motion of objects relevant parameter of sensing under the habited situation of described object or described object institute; With
Control unit, it is suitable for from the measured value of described motion relevant parameter acquisition to described fetal movements.
119. an equipment comprises:
Pick off, it is suitable at least one parameter of sensing when described object is slept;
User interface; With
Control unit, it is suitable for:
Analyze described parameter,
To small part according to described analysis predict described clinical episodes beginning and
Only warn the beginning of described prediction to described object in described object awakening rear drive user interface.
120. one kind is used to the equipment of predicting that clinical episodes begins, comprises:
Pick off, it is suitable for obtaining the relevant time-domain signal of breathing of object; With
Control unit, it is suitable for:
Convert described time-domain signal to frequency-region signal,
The breathing rate of described object is determined at peak in the relevant frequency range of breathing by discerning described frequency-region signal;
Determine one or more harmonic waves of described peak frequency;
Determine following relation between the two:
(a) first energy level is selected from: with relevant energy level in one or more harmonic waves and with the energy level of described peak frequency dependence and
(b) second energy level, its with one or more harmonic waves in one relevant;
The baseline values of more described relation and described relation; With
To small part according to the described beginning of relatively predicting described outbreak.
121. an equipment that is used to monitor blood pressure comprises:
Non-contact sensor, it is suitable for the described motion of objects relevant parameter of sensing under the habited situation of not contact object or object institute; With
Control unit, it is suitable for analyzing described parameter to determine the blood pressure measurement of described object.
122. an equipment that is used for the treatment of object comprises:
Non-contact sensor, it is suitable for the described motion of objects relevant parameter of sensing under the habited situation of not contact object or object institute;
Doser, it is suitable for medicament administration in described object; With
Control unit, it is suitable for:
Analyze described parameter,
Determine the predose of described medicine according to described analysis to small part; With
Send described predose to described doser.
123. one kind is used to the equipment of predicting that clinical episodes begins, comprises:
Pick off, it is suitable at least one parameter of sensed object; With
Control unit, it is suitable for:
Analyze described parameter,
Receive the data relevant with the medicine that is administered to described object; With
Predict the beginning of described clinical episodes according to the combination of described analysis and described administration data to small part.
124. according to the equipment of claim 123, it comprises the doser that is suitable for described medicament administration is given described object, wherein said control unit is suitable for receiving described administration data from described doser.
125. an equipment that is used for the treatment of clinical episodes comprises:
Non-contact sensor, its be suitable for not contact object or object at least one parameter of the described object of sensing under the habited situation;
Therapy equipment, it is suitable for implanting in the described object; With
Control unit, it is suitable for:
Analyze described parameter,
To small part according to described analysis detect described clinical episodes and
According to detecting clinical episodes, drive described blood processor and treat described clinical episodes.
126. an equipment comprises:
Non-contact sensor, its be suitable for when object is slept do not contact described object or described object at least one parameter of the described object of sensing under the habited situation; With
Control unit, it is suitable for analyzing described parameter to determine the restless measured value of described object.
127. an equipment comprises:
Non-contact sensor, its be suitable for when object is slept do not contact described object or described object at least one parameter of the described object of sensing under the habited situation; With
Control unit, it is adapted to pass through analyzes periodic limb movement (PLMS) in the sleep that described parameter detects described object.
128. an equipment comprises:
What a pick off just, it is suitable for placing in the described dependence surface of lying of object or the below, makes described pick off not contact the clothes that described object or described object are worn, and is suitable at least one parameter of sensed object; With
Control unit, it is adapted to pass through analyzes the cough that described parameter detects described object.
129. one kind is used to the equipment of predicting that asthma attack begins, comprises:
Pick off, it is suitable for the breathing of the described object of sensing and the heart beating of described object; With
Control unit, it is suitable for:
Determine at least one breathing pattern of described object and determine at least one heart beating pattern of described object according to the breathing of described sensing according to the heart beating of institute's sensing,
More described breathing pattern and baseline breathing pattern, and more described heart beating pattern and baseline heart beating pattern and
To small part according to the described beginning of relatively predicting described asthma attack.
130. according to the equipment of claim 129, wherein said pick off comprises the first sensor that is suitable for the described breathing of sensing and is suitable for second pick off of the described heart beating of sensing.
131. one kind is used to the equipment of predicting that asthma attack begins, comprises:
Pick off, it is suitable for the breathing of the described object of sensing; With
Control unit, it is suitable for:
Determine at least one breathing pattern of described object according to the breathing of described sensing;
More described breathing pattern and baseline breathing pattern;
Determine the measured value of described object cough; With
Predict the beginning of described asthma attack according to the measured value of described comparison and described cough to small part.
132. one kind is used for the equipment that the prediction outbreak relevant with congestive heart failure (CHF) begins, comprises:
Pick off, it is suitable for the breathing of the described object of sensing and the blood pressure of described object; With
Control unit, it is suitable for:
Determine at least one breathing pattern of described object according to the breathing of described sensing;
More described breathing pattern and baseline breathing pattern; With
Predict the beginning of described outbreak according to described comparison and described blood pressure to small part.
133. according to the equipment of claim 132, wherein said pick off comprises the first sensor that is suitable for the described breathing of sensing and is suitable for second pick off of the described blood pressure of sensing.
134. an equipment that is used for the determination object heart rate comprises:
First non-contact sensor, it is suitable for first pulse signal of the described object of primary importance proximity sensing of the described object in the abdominal part of chest that is selected from described object and described object;
Second non-contact sensor, it is suitable for second pulse signal of the described object of second position proximity sensing below the anatomy waist of described object; With
Control unit, it is suitable for determining described heart rate according to described first and second pulse signals.
135. an equipment comprises:
First and second pick offs, it is suitable under the habited situation of not contact object or object institute, respectively near first position of described object and the first and second motion relevant parameters of the described object of second position vicinity sensing; With
Control unit, it is suitable for:
Obtain first and second from the described first and second motion relevant parameters respectively and breathe coherent signal; With
Analyze described first and second and breathe the measured value of coherent signal with the breast abdomen asynchronism (TAA) of definite described object.
136. an equipment comprises:
First and second pick offs, it is suitable under the habited situation of not contact object or object institute, respectively near first position of described object and the first and second motion relevant parameters of the described object of second position vicinity sensing; With
Control unit, it is suitable for:
Obtain first and second from the described first and second motion relevant parameters respectively and breathe coherent signal; With
Analyze described first and second and breathe coherent signal to determine the active measured value of supernumerary muscle of described object.
137. an equipment that is used for monitoring target comprises:
Non-contact sensor, its be suitable for not contact object or object at least one parameter of the described object of sensing under the habited situation;
User interface; With
Control unit, it is suitable for:
Set the first and second different separately threshold values,
Analyze described parameter with the generation score value,
If described score value between described first and second threshold values, then drive first output that described user interface begins with the clinical episodes that produces the indication prediction and
If described score value surpasses described second threshold value, then drive described user interface to produce present second output that clinical episodes is taking place of indication.
138. an equipment that is used for the paradoxical pulse of detected object comprises:
Non-contact sensor, its be suitable for not contact object or object at least one parameter of the described object of sensing under the habited situation; With
Control unit, it is suitable for:
Analyze described parameter air-breathing to be created in/measured value of the described object blood pressure of cycle period of exhaling;
The measured value of more described blood pressure and threshold value; With
Detect described paradoxical pulse according to described measured value greater than described threshold value.
139. one kind is used to the equipment of predicting that asthma attack begins, comprises:
Non-contact sensor, its be suitable for not contact object or object at least one parameter of the described object of sensing under the habited situation; With
Control unit, it is suitable for predicting according to the parameter of institute's sensing to small part the beginning of described asthma attack.
140. according to the equipment of claim 139, wherein said at least one parameter comprises at least one motion relevant parameter of described object, and wherein said pick off is suitable for described at least one the motion relevant parameter of sensing.
141. according to the equipment of claim 139, wherein said control unit is suitable for the described beginning of prediction before the caregiver of described object or described object begins to aware described beginning.
142. according to the equipment of claim 139, the appearance of described asthma attack produced the object specific data that relates to described parameter and predicts described beginning according to described data to small part before wherein said control unit was adapted to pass through and analyzes.
143. according to the equipment of claim 139, wherein said control unit is suitable for measuring the restless measured value of described object and predicts described beginning according to described restless measured value to small part.
144. according to the equipment of claim 139, wherein said control unit is suitable for measuring the measured value of described object cough, and predicts described beginning according to the parameter of described sensing and the measured value of described cough to small part.
145. according to the equipment of claim 139, wherein said pick off is suitable for described at least one parameter of sensing under the situation of the compliance that does not need the people.
146. according to each equipment in the claim 139～145, wherein said pick off is suitable for described at least one parameter of sensing when described object sleep.
147. according to the equipment of claim 146, it comprises user interface, wherein said control unit is suitable for only warning to described object in described object awakening back the beginning of described prediction.
148. according to each equipment in the claim 139～145, wherein said at least one parameter comprise described object at least one breathe relevant parameter, and described pick off be suitable for sensing described at least one breathe relevant parameter.
149. according to the equipment of claim 148,
Wherein said at least one parameter comprises at least one heart beating relevant parameter of described object,
Wherein said pick off be suitable for described at least one the heart beating relevant parameter of sensing and
Wherein said control unit is suitable for predicting according to the relevant parameter relevant with described heart beating of described breathing to small part the beginning of described asthma attack.
150. according to the equipment of claim 148, wherein said control unit is suitable for:
Determine at least one breathing pattern of described object according to the breathing relevant parameter of institute's sensing;
More described breathing pattern and baseline breathing pattern; With
Relatively predict described beginning according to described to small part.
151. according to each equipment in the claim 139～145, wherein said pick off comprises piezometer, it is configured to measure in the dependence surface that described object lies, on or below pressure.
152. according to the equipment of claim 151, wherein said piezometer comprises just what a piezometer.153. one kind is used for the equipment that the prediction outbreak relevant with congestive heart failure (CHF) begins, comprises:
Non-contact sensor, its be suitable for not contact object or object at least one parameter of the described object of sensing under the habited situation; With
Control unit, it is suitable for predicting according to the parameter of institute's sensing to small part the beginning of described outbreak.
154. according to the equipment of claim 153, wherein said at least one parameter comprises at least one motion relevant parameter of described object, and wherein said pick off is suitable for described at least one the motion relevant parameter of sensing.
155. according to the equipment of claim 153, wherein said pick off comprise be configured to measure in the dependence surface that described object lies, on or below the piezometer of pressure.
156. according to the equipment of claim 153, wherein said pick off is suitable for described at least one parameter of sensing when described object is slept.
157. equipment according to claim 153, wherein said pick off is suitable for the breathing relevant parameter of the described object of sensing and the blood pressure of described object, and wherein said control unit is suitable for predicting described beginning to small part according to described breathing relevant parameter and described blood pressure.
158. according to each equipment in the claim 153～157, wherein said pick off is suitable for described at least one parameter of sensing under the situation of the compliance that does not need the people.
159. one kind is used to the equipment of predicting that clinical episodes begins, comprises:
Pick off, it is suitable at least one parameter of sensed object; With
Control unit, its be suitable for breathing rate when described object be lower than described object the asymptomatic breathing rate of baseline 120% the time, predict the beginning of described clinical episodes according to the parameter of institute's sensing to small part.
160. one kind is used to the equipment of predicting that asthma attack begins, it comprises:
Pick off, it is suitable at least one parameter of sensed object; With
Control unit, its be suitable for when described object forced expiratory volume in 1 second (FEV1) greater than the asymptomatic FEV1 of the baseline of described object 90% the time, predict the beginning of described asthma attack according to the parameter of institute's sensing to small part.
161. one kind is used to the equipment of predicting that clinical episodes begins, comprises:
Non-contact sensor, its be suitable for not contact object or object at least one parameter of the described object of sensing under the habited situation; With
Control unit, it is suitable for predicting according to parameter at least one hour before described clinical episodes begins of institute's sensing to small part the beginning of described clinical episodes.
162. one kind is used to the equipment of predicting that clinical episodes begins, comprises:
Pick off, it is suitable for basic at least one parameter of sensed object continuously in the time period that continues at least one hour; With
Control unit, it is suitable for before described clinical episodes begins at least one hour to small part and predicts described beginning according to the parameter of institute's sensing.
163. one kind is used to the equipment of predicting that clinical episodes begins, comprises:
Pick off, its be suitable for the object section length of one's sleep at night at least 80% during basic at least one parameter of sensing continuously; With
Control unit, it is suitable for predicting according to parameter at least one hour before described clinical episodes begins of institute's sensing to small part the beginning of described clinical episodes.
164. an equipment comprises:
Pick off, it is suitable at least one parameter of sensed object; With
Control unit, it is suitable for calculating at the described probability that clinical episodes will take place in the preset time of back that calculates according to the parameter of institute's sensing to small part.
165. one kind is used to the equipment of predicting that clinical episodes begins, comprises:
Pick off, it is suitable at least one parameter of sensed object under the situation of the compliance that does not need the people; With
Control unit, it is suitable for predicting described beginning to small part according to the parameter of institute's sensing.
166. according to the equipment of claim 165, wherein said pick off comprises non-contact sensor, it is suitable for described at least one parameter of sensing under the habited situation of not contact object or object institute.
167. equipment according to claim 165, wherein said at least one parameter comprises at least one motion relevant parameter of described object, and wherein said pick off is suitable for described at least one motion relevant parameter of sensing under the situation of the compliance that does not need the people.
168. equipment according to claim 165, wherein said pick off is suitable at least one parameter of sensing when object is slept, and comprise user interface, wherein said control unit is suitable for driving described user interface only to warn the beginning of described prediction to described object in described object awakening back.
169. according to the equipment of claim 165, wherein said pick off comprise be configured to measure in the dependence surface that described object lies, on or below the piezometer of pressure.
170. according to the equipment of claim 165, wherein said clinical episodes comprises asthma attack, and wherein said control unit is suitable for predicting the beginning of described asthma attack.
171. according to the equipment of claim 165, wherein said clinical episodes comprises the relevant outbreak of congestive heart failure (CHF) with object, and wherein said control unit is suitable for predicting the beginning of the outbreak relevant with described CHF.
172. according to the equipment of claim 165, wherein said clinical episodes comprises the hypoglycemia outbreak that is caused by diabetes, and wherein said control unit is suitable for predicting the beginning of described hypoglycemia outbreak.
173. equipment according to claim 165, wherein said clinical episodes is selected from: periodic limb movement (PLMS) outbreak in the movable unusual outbreak of the autonomic nervous system that is caused by nervous system disease, epilepsy, the sleep, apoplexy, essential tremor show effects, stress show effect, fibrillation shows effect, the outbreak relevant with chronic obstructive pulmonary disease (COPD), the outbreak relevant with cystic fibrosis (CF) and the outbreak of anaphylactic shock, and wherein said control unit is suitable for predicting the beginning of described selected clinical episodes.
174. according to each equipment in the claim 165～173, wherein said at least one parameter comprises at least one breathing relevant parameter of described object, and wherein said pick off is suitable for described at least one breathing relevant parameter of sensing under the situation of the compliance that does not need the people.
175. according to the equipment of claim 174, wherein said control unit is suitable for: at least one breathing pattern of determining described object according to the breathing relevant parameter of institute's sensing; More described breathing pattern and baseline breathing pattern; With relatively predict described beginning to small part according to described.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US69210505P | 2005-06-21 | 2005-06-21 | |
| US60/692,105 | 2005-06-21 | ||
| US11/197,786 | 2005-08-03 |
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| CN101365373A true CN101365373A (en) | 2009-02-11 |
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| CNA2006800303898A Pending CN101365373A (en) | 2005-06-21 | 2006-06-21 | Techniques for prediction and monitoring of clinical episodes |
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Application publication date: 20090211 |