CN102247169A - Blood pressure measuring device and blood pressure measuring method - Google Patents
Blood pressure measuring device and blood pressure measuring method Download PDFInfo
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- 230000036772 blood pressure Effects 0.000 title claims abstract description 130
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- 238000009530 blood pressure measurement Methods 0.000 claims description 33
- 230000002792 vascular Effects 0.000 claims description 20
- 230000035488 systolic blood pressure Effects 0.000 claims description 13
- 239000008280 blood Substances 0.000 claims description 10
- 210000004369 blood Anatomy 0.000 claims description 10
- 238000002604 ultrasonography Methods 0.000 claims description 10
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- 210000002321 radial artery Anatomy 0.000 description 19
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- 238000003556 assay Methods 0.000 description 5
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Abstract
The invention provides a blood pressure measuring device and a blood pressure measuring method. The blood pressure measuring device is provided with: a blood flow speed sensor part which detects the blood flow inside a living body; a blood flow speed sensor driving part which drives the blood flow speed sensor part; a blood flow speed sensor signal operational part which controls the blood flow speed sensor driving part and the blood flow speed sensor part and calculates the blood flow speed inside the living body; a blood vessel diameter sensor part which detects the reflection arrival time difference of a vessel wall inside the living body; a blood vessel diameter sensor driving part which drives the blood vessel diameter sensor part; a blood vessel diameter sensor signal operational part which controls the blood vessel diameter sensor driving part and the blood vessel diameter sensor part and calculates the blood vessel diameter inside the living body; and a blood pressure signal operational part which calculates the blood pressure of the measured people by using the operational result of the blood flow speed sensor signal operational part and the blood vessel diameter sensor signal operational part.
Description
Technical field
The present invention relates to blood pressure measurement apparatus and blood pressure measuring method.
Background technology
Now, the method as measuring blood pressure has proposed the use ultrasound wave and has carried out method for measuring.For example, part at tremulous pulse, obtain maximum gauge and minimum diameter, and these parameters are given to nonlinear function, by this nonlinear function, each diameter constantly of being imported is converted, thereby calculate each pressure (for example, with reference to patent documentation 1) constantly about part.
In addition, following method has been proposed:, and, these two amounts are associated calculating blood pressure and variable quantity (for example, with reference to patent documentation 2 and 3) thereof by light wave detection pulse wave velocily by ultrasound examination blood flow rate, flow or capacity etc.
[patent documentation 1] TOHKEMY 2004-041382 communique
[patent documentation 2] Japanese kokai publication hei 4-250135 communique
[patent documentation 3] TOHKEMY 2004-154231 communique
But, when as patent documentation 1～3, using ultrasound wave to calculate pressure value, need utilize cuff type sphygomanometer to proofread and correct in the past.There is following inconvenience etc. in this, that is: considering in 24 hours act on one's own, to carry out blood pressure determination (24ABPM) or undertaken by each bat under the situation of continuous blood pressure mensuration, on one's body cuff will being worn over all the time, perhaps need cuff to be carried and in time used.And this may be difficult to obtain practical application in common life.
And, except needs utilize cuff type sphygomanometer proofreaies and correct, also may exist needs regularly (about 30 minutes～1 hour) carry out this calibration problem.As everyone knows, generally speaking, when according to pulse wave velocity estimated blood pressure value, the probability of error becomes big along with proofreading and correct elongated at interval.This be because: though at short notice can be with blood vessel elasticity characteristic (E0: the blood vessel elasticity modulus during no pressure, γ: the constant of particular blood vessel) be considered as constantly, become greatly at the above time error of certain hour.In patent documentation 1, calculate stiffness coefficient β according to maximal blood pressure Ps that obtains by cuff type sphygomanometer and minimal blood pressure Pd, but there are dependency in this and aforesaid blood vessel elasticity modulus, if be more than the certain hour therefore, its value obviously also can change.That is, in order to obtain pressure value accurately continuously and constantly, it is not enough only once proofreading and correct, need be every to a certain degree interval, for example proofread and correct every about one hour.
Summary of the invention
The present invention finishes at least a portion that solves in the above-mentioned problem just, can be used as following mode or application examples and realizes.
[application examples 1] a kind of blood pressure measurement apparatus is characterized in that this blood pressure measurement apparatus has: the blood flow rate sensor part, and fluctuating with respect to the blood transmission and the reception of live body inside in its live body surface from person to be measured, detects the blood flow of this live body inside; Blood flow rate pick off drive division, it drives described blood flow rate sensor part; Blood flow rate sensor signal operational part, it is controlled described blood flow rate pick off drive division and described blood flow rate sensor part, obtains the blood flow rate of described live body inside; The blood vessel diameter sensor part, its blood vessel with respect to described live body inside sends and receives ultrasound wave, and the reflection that detects the blood vessel wall of this live body inside arrives time difference; Blood vessel diameter pick off drive division, it drives described blood vessel diameter sensor part; Blood vessel diameter sensor signal operational part, it is controlled described blood vessel diameter pick off drive division and described blood vessel diameter sensor part, obtains the blood vessel diameter of described live body inside; And the blood pressure signal operational part, it utilizes the operation result of described blood flow rate sensor signal operational part and described blood vessel diameter sensor signal operational part to obtain the blood pressure of described person to be measured.
According to this application examples, the following sustainable blood pressure measurement apparatus of wearing can be provided: this blood pressure measurement apparatus only needs to obtain correction coefficient according to the initial pressure value that uses cuff type sphygomanometer to measure, just can under the situation of not using cuff type sphygomanometer, measure blood pressure accurately afterwards, in person to be measured is acting on one's own, continue to carry out under the situation of blood pressure determination, need not to use cuff type sphygomanometer and can proofread and correct simply.
[application examples 2] above-mentioned blood pressure measurement apparatus is characterised in that described blood pressure signal operational part is carried out following computing: obtain described blood pressure by described blood vessel diameter is scaled head pressure.
According to this application examples, regard blood vessel diameter and blood pressure as and roughly be linear change, therefore,, can access the relevant value of time variation with blood pressure by measuring the time variation of blood vessel diameter.
[application examples 3] above-mentioned blood pressure measurement apparatus is characterised in that, this blood pressure measurement apparatus also comprises the height and position sensor part, predetermined position in described person to be measured is located under the 1st state of predetermined altitude, this height and position sensor part is obtained the difference of height of the described predetermined position between the 2nd state of heart height that the 1st state and described predetermined position be located in described person to be measured, the described difference of height that utilization is measured by described height and position sensor part is obtained described head pressure.
According to this application examples, can easily measure the difference of height of a key element when obtaining head pressure.
[application examples 4] above-mentioned blood pressure measurement apparatus is characterised in that, described blood flow rate sensor part constitutes with element by sending with element and receiving, and described transmission is with how right to existing with element of element and described reception, the direct of travel of the fluctuation that sends and receive and the flow direction angulation of blood for each to having nothing in common with each other.
According to this application examples, even under blood vessel and fluctuation angulation condition of unknown, also can obtain blood flow rate.
[application examples 5] above-mentioned blood pressure measurement apparatus is characterised in that described blood flow rate sensor part utilizes piezoelectric element to constitute.
According to this application examples,, therefore can make blood flow rate pick off miniaturization because piezoelectric element is simple in structure.
[application examples 6] a kind of blood pressure measuring method, this blood pressure measuring method is measured the blood pressure of person to be measured, wherein, be positioned at predetermined position under the 1st state of predetermined altitude described person to be measured, the blood pressure of described person to be measured is proportional divided by square value that obtains of the blood vessel diameter of this predetermined position with the blood flow rate of predetermined proportionality constant and described predetermined position, this blood pressure measuring method is characterised in that, may further comprise the steps: the aligning step of obtaining described proportionality constant; Under described the 1st state, measure the described blood vessel diameter and the described blood flow rate of described predetermined position respectively; Utilize described blood vessel diameter, described blood flow rate and described proportionality constant to obtain described blood pressure; Described blood pressure is shown; And judge whether to proofread and correct described proportionality constant.
According to this application examples, can provide the blood pressure measuring method in the following sustainable blood pressure measurement apparatus of wearing: only need obtain correction coefficient according to the initial pressure value that uses cuff type sphygomanometer to measure, just can under the situation of not using cuff type sphygomanometer, measure blood pressure accurately afterwards, in person to be measured is acting on one's own, continue to carry out under the situation of blood pressure determination, need not to use cuff type sphygomanometer and can proofread and correct simply.
[application examples 7] above-mentioned blood pressure measuring method is characterised in that, described aligning step may further comprise the steps: under the 2nd state of the heart height that described predetermined position is positioned described person to be measured, measure blood vessel diameter and the systole of this predetermined position and the blood vessel diameter of expansionary phase of described predetermined position respectively, obtain the 1st mean vascular diameter, average shrinkage phase blood vessel diameter and average expansionary phase blood vessel diameter; Under described the 1st state, measure the difference of height determination step of the difference of height of the described predetermined position between the 1st state and described the 2nd state; Utilize described difference of height to obtain head pressure between described the 1st state and described the 2nd state; Under described the 1st state, measure the blood vessel diameter of described predetermined position and systole and the blood flow rate of expansionary phase and the blood vessel diameter of this predetermined position respectively, obtain the 2nd mean vascular diameter, systole blood flow rate, systole blood vessel diameter, expansionary phase blood flow rate and expansionary phase blood vessel diameter; Utilize described the 1st mean vascular diameter and described the 2nd mean vascular diameter to obtain the mean vascular vary in diameter; Utilize described head pressure, described mean vascular vary in diameter, described average shrinkage phase blood vessel diameter and described average expansionary phase blood vessel diameter, obtain the blood pressure difference between systolic blood pressure and the expansionary phase blood pressure; And utilize described blood pressure difference, described systole blood flow rate, described systole blood vessel diameter, described expansionary phase blood flow rate and described expansionary phase blood vessel diameter, obtain described proportionality constant.
According to this application examples, can easily proofread and correct proportionality constant.
[application examples 8] above-mentioned blood pressure measuring method is characterised in that, in described difference of height determination step, is measured by the height and position sensor part of the described difference of height of measuring the described predetermined position between described the 1st state and described the 2nd state.
According to this application examples, can easily measure the difference of height of a key element when obtaining head pressure.
Description of drawings
Fig. 1 is the outside drawing that the state of the blood pressure measurement apparatus that adorns oneself with present embodiment is shown.
Fig. 2 illustrates the blood flow rate pick off of present embodiment and the figure of blood vessel diameter pick off.
Fig. 3 is the figure that the circuit module of present embodiment is shown.
Fig. 4 is the figure that locates that the blood pressure measurement apparatus of present embodiment is shown.
Fig. 5 is the figure that applies the blood vessel diameter behind the head pressure that present embodiment is shown.
Fig. 6 illustrates the blood vessel wall pressure of present embodiment and the figure of the relation between the blood vessel diameter (volume).
Fig. 7 is the figure that the cuff pressurization measured value of present embodiment is shown.
Fig. 8 is the figure that the blood flow rate pick off of present embodiment is shown.
Fig. 9 is the figure that the assay method of present embodiment is shown.
Figure 10 is the figure that the correction routine of present embodiment is shown.
Label declaration
2: blood pressure measurement apparatus; 4: person to be measured; 10: the blood flow rate pick off; 12: the blood vessel diameter pick off; 14: Radial artery (blood vessel); 16: wrist portion; 18: the blood flow rate sensor part; 20: drive division (blood flow rate pick off drive division); 22: signal operation portion (blood flow rate sensor signal operational part); 24: emission part (send and use element); 26: acceptance division (receive and use element); 27: the blood vessel diameter sensor part; 28: drive division (blood vessel diameter pick off drive division); 29: emission part; 30: signal operation portion (blood vessel diameter sensor signal operational part); 31: acceptance division; 32: the blood pressure signal operational part; 34: display part; 36: baroceptor (height and position sensor part); 37: switch; 38: heart; 40: power supply unit; 42: cuff adding pressure type sphygomanometer.
The specific embodiment
Below, according to accompanying drawing present embodiment is described.In addition, show employed accompanying drawing with the suitable amplification or the mode of dwindling, thereby become the state that to discern the part that will illustrate.
Fig. 1 is the outside drawing that the state of the blood pressure measurement apparatus that adorns oneself with present embodiment is shown.Fig. 2 illustrates the blood flow rate pick off of present embodiment and the figure of blood vessel diameter pick off.Fig. 3 is the figure that the circuit module of present embodiment is shown.The blood pressure measurement apparatus 2 of present embodiment has blood flow rate pick off 10 and blood vessel diameter pick off 12.Blood pressure measurement apparatus 2 is worn on the wrist portion 16 of person to be measured 4 (with reference to Fig. 4), measures the blood flow rate v and the blood vessel diameter d of Radial artery (blood vessel) 14, thereby obtains blood pressure P.
Blood flow rate pick off 10 is installed in can be to the hyperacoustic position of Radial artery 14 irradiations of wrist portion 16 inboards.Blood flow rate pick off 10 will mix with reception fluctuation f ' from the basic fluctuation f that blood flow rate pick off 10 sends.Mixed fluctuation is carried out detection by blood flow rate sensor signal operational part (signal operation portion) 22, thereby only extracts the frequency component of Doppler displacement.In signal operation portion 22, calculate blood flow rate v with Radial artery 14 angulation θ according to this Doppler frequency component Δ f (=f-f '), fluctuation f, f '.
Blood flow rate pick off 10 has blood flow rate sensor part 18, blood flow rate pick off drive division (drive division) 20 and signal operation portion 22.Blood flow rate sensor part 18 fluctuates with respect to the blood transmission and the reception of live body inside from the live body surface of person to be measured 4, detects the blood flow of live body inside.Blood flow rate sensor part 18 is made of emission part (send and use element) 24 and acceptance division (receive and use element) 26.How right emission part 24 is to existing with acceptance division 26, the direct of travel of the fluctuation that sends and receive and Radial artery 14 angulations for each to having nothing in common with each other.Drive division 20 drives blood flow rate sensor part 18.22 pairs of drive divisions 20 of signal operation portion and blood flow rate sensor part 18 are controlled, and obtain the blood flow rate v of live body inside.Blood flow rate sensor part 18 utilizes piezoelectric element to constitute.Thus, because piezoelectric element is simple in structure, therefore can make blood flow rate pick off miniaturization.
Blood vessel diameter pick off 12 is installed in can be to the hyperacoustic position of Radial artery 14 irradiations of wrist portion 16 inboards.Blood vessel diameter pick off 12 sends pulse signal or burst (burst) signal of several M～tens MHz, measures time of advent from the echo of the wall of Radial artery 14 by sending ripple and receiving ripple.Blood vessel diameter sensor part 27 sends and receives ultrasound wave with respect to the Radial artery 14 of live body inside, and the reflection of the wall of the Radial artery 14 of detection live body inside arrives time difference.
Blood vessel diameter pick off 12 has blood vessel diameter sensor part 27, blood vessel diameter pick off drive division (drive division) 28 and blood vessel diameter sensor signal operational part (signal operation portion) 30.Blood vessel diameter sensor part 27 is made of emission part 29 and acceptance division 31.Blood vessel diameter sensor part 27 sends and receives ultrasound wave with respect to the Radial artery 14 of live body inside, and the reflection of the wall of the Radial artery 14 of detection live body inside arrives time difference.Drive division 28 drives blood vessel diameter sensor part 27.30 pairs of drive divisions 28 of signal operation portion and blood vessel diameter sensor part 27 are controlled, and obtain the blood vessel diameter d of live body inside.
The blood pressure measurement apparatus 2 of present embodiment has blood pressure signal operational part 32, display part 34, baroceptor (height and position sensor part) 36, switch 37 and power supply unit 40.Blood pressure signal operational part 32 uses the operation result of signal operation portion 22 and signal operation portion 30 to obtain the blood pressure P of person to be measured 4.The blood pressure P of 34 pairs of person to be measureds 4 of display part shows.In addition, can also carry out visualization display to blood pressure P with curve chart etc.In addition, also can show equally for pulse.And, show that also expression needs gauged content.The height and position of 36 pairs of blood pressure measurement apparatus 2 of baroceptor is measured.Switch 37 switches power supply supply/cut-out from power supply unit 40 at each function portion of blood pressure measurement apparatus 2.Power supply unit 40 provides power supply to each function portion of blood pressure measurement apparatus 2.In the present embodiment, for example be assumed to chargeable secondary cell.
Fig. 4 is the figure that locates that the blood pressure measurement apparatus 2 of present embodiment is shown.Fig. 5 is the figure that applies the blood vessel diameter d behind the head pressure that present embodiment is shown.Here, describe at following method: in the blood pressure determination of non-invasion and attack, mensuration blood flow rate v and blood vessel diameter d come calculating blood pressure P under the situation of not using cuff (compression band).Blood pressure P utilizes the product of blood flow Q and vascular resistance R to obtain.
P＝Q·R...(1)
Wherein, blood flow Q utilizes the product of blood vessel diameter d shown in the formula (2) and blood flow rate v to obtain.
Q＝(π·d
2·v)/8...2)
In addition, vascular resistance R is by the ratio decision of mobile blood viscosity η in Radial artery 14 with blood vessel diameter d, and following relation is set up: blood vessel diameter d trunk resistance R more is more little.When regarding C as constant,
R＝η·C/d
4...(3)。
When deriving blood pressure P when considering these relational expressions, the variation of blood vessel diameter d when the Strength Changes that is called as the volume pulse wave of pulse wave is actually pulsation is taken place blood captures as volume-variation, by measuring the volume pulse wave, the value relevant can be determined, the value relevant can be determined with vascular resistance R with blood vessel diameter d.And, by measuring endovascular blood flow rate v, can also obtain the value relevant with blood flow Q, thus, can determine blood pressure P.
Then, at systolic blood pressure Psys and expansionary phase blood pressure Pdia calculating describe.Systolic blood pressure Psys and expansionary phase blood pressure Pdia can use formula (1)～(3) and shown in (4) and (5), obtain.
Psys＝π/8·η·C·vsys/dsys
2...(4)
Pdia＝π/8·η·C·vdia/ddia
2...(5)
Thus, can obtain blood pressure difference (Psys-Pdia) between systolic blood pressure Psys and the expansionary phase blood pressure Pdia as the formula (6).
Psys-Pdia＝π/8·η·C·(vsys/dsys
2-vdia/ddia
2)...(6)
Here, vsys be systole blood flow rate, dsys be systole blood vessel diameter, vdia be expansionary phase blood flow rate, ddia be blood vessel diameter expansionary phase.
Fig. 6 illustrates the blood vessel wall pressure of present embodiment and the figure of the relation between the blood vessel diameter (volume).Fig. 6 shows the pipe rule of blood vessel.In existing blood pressure determination,, used the nonlinear area of pipe rule in order to obtain oscillography waveform (oscillometric waveform) based on the cuff pressurization.Relative therewith, in the present embodiment, use substantial linear approximate region shown in Figure 6.In this part, can regard blood vessel diameter d as and blood pressure wall pressure power (blood pressure P) roughly is linear change, therefore, change by the time of measuring blood vessel diameter d, can access with the time of blood pressure P and change relevant value.
Then, at use following formula calculate systolic blood pressure Psys and expansionary phase blood pressure Pdia mode describe.At first,, promptly do not needing under the gauged state of head pressure at the height H place identical with the position of heart 38, obtain systole blood flow rate vsys, systole blood vessel diameter d sys, expansionary phase blood flow rate vdia and expansionary phase blood vessel diameter ddia.Blood vessel with respect to live body inside sends and receives fluctuation, according to the Doppler displacement amount of blood flow scattered wave calculate systole blood flow rate vsys and expansionary phase blood flow rate vdia, according to the reflection of blood vessel two walls arrive time difference calculate systole blood vessel diameter d sys and expansionary phase blood vessel diameter ddia.Meanwhile, measure the time variation of blood vessel diameter d.According to the pipe of blood vessel rule, blood vessel diameter d and blood vessel wall pressure (blood pressure P) roughly are similar to linearity when not pressurization or little pressurization.At this moment, the time of blood vessel diameter d changes to the time of blood pressure P and changes similar (with reference to Fig. 6).
Then, the same blood vessel diameter d that measures of the position L of the state after the position from heart 38 reduces height h.At this moment,, in blood vessel, compare, only applied redundantly and the corresponding pressure of head pressure with the position of heart 38 being made as person to be measured 4 when being in steady statue.That is, the time that redeterminates blood vessel diameter d under this state is when changing, and can access the time that applies the blood pressure P behind the head pressure to change (with reference to Fig. 5).Thus, can learn and head pressure (ρ gh) (ρ: density of blood, g: the variation delta d of corresponding blood vessel diameter d acceleration of gravity).The variable quantity of blood vessel diameter d when can obtain systole and expansionary phase by measuring, can also calculate blood pressure difference Δ P between systolic blood pressure Psys and the expansionary phase blood pressure Pdia (=Psys-Pdia).If this value is applied to formula (6), then can obtain proportionality constant (π/8 η C), therefore can according to formula (4) and formula (5) calculate systole actual blood pressure Prsys and expansionary phase actual blood pressure Prdia.
The individual differences of density of blood ρ is 1.055 ± 0.005g/cm
2About, therefore the influence to pressure value be ± zero point several mmHg, so can be considered constant.Hence one can see that: for head pressure (ρ gh), as long as can carry out elevation measurement exactly, just can access value accurately.According to present embodiment, do not need to utilize other sphygomanometers such as cuff type sphygomanometer to proofread and correct, but, can proofread and correct very easily by using head pressure.And do not need to carry out the measurement of volume pulse wave, only, just can realize the test constantly of blood pressure by measuring blood flow rate and the blood vessel diameter that causes by fluctuation.
(head pressure (ρ gh) being scaled the method for blood vessel diameter d)
As shown in Figure 4, be worn at blood pressure measurement apparatus under the state of wrist portion 16 present embodiment, the time of measuring blood vessel diameter d in the position of the height H identical with the height of heart 38 changes, and utilize cuff adding pressure type sphygomanometer 42 measure systole actual blood pressure Prsys and expansionary phase actual blood pressure Prdia.Then, with the position of wrists uncock to height L, the time of measuring blood vessel diameter d changes.Thus, can calculate of the variation (with reference to Fig. 5) of the force value of head pressure corresponding to the blood vessel diameter d of which kind of degree.
Fig. 7 is the figure that the cuff pressurization measured value of present embodiment is shown, and shows the cuff pressurization measured value of height H position.About the calculating of the force value of head pressure, there is the method for following (a)～(c) corresponding to the variation of the blood vessel diameter d of which kind of degree.
(a) variation of about 10 seconds blood vessel diameter d of measurement, the mean vascular diameter (dm1 and dm2) of the position of the height H of calculation chart 4, L respectively.Then, through type (7) is obtained the variation delta dm of mean vascular diameter (dm1, dm2).
Δdm＝dm2-dm1...(7)
Through type (8) is obtained the vessel diameter change Δ d corresponding with head pressure.
Δd＝Δdm...(8)
Thus, when the average shrinkage phase blood vessel diameter dmsys1 of the height H position of using Fig. 4 and average expansionary phase during blood vessel diameter dmdial, if consider relation between pressure and the blood vessel diameter, then formula (9) is set up.
(Prsys-Prdia)∶ρ·g·h＝(dmsys1-dmdia1)∶Δdm...(9)
Thus, through type (10) is obtained head pressure (ρ gh) (with reference to Fig. 7 (A)).
ρ·g·h＝(Prsys-Prdia)·Δdm/(dmsys1-dmdia1)...(10)
(b) variation of about 10 seconds blood vessel diameter d of measurement, the average shrinkage phase blood vessel diameter (dmsys1, dmsys2) of the height H of calculation chart 4 and the position of L and average blood vessel diameter expansionary phase (dmdia1, dmdia2).Then, through type (11) and formula (12) obtain average shrinkage phase blood vessel diameter variable quantity (Δ dmsys) and average expansionary phase blood vessel diameter variable quantity (Δ dmdia).
Δdmsys＝dmsys2-dmsys1...(11)
Δdmdia＝dmdia2-dmdia1...(12)
In addition, ask on average, obtain the vessel diameter change Δ d of head pressure according to formula (13) based on above-mentioned value.
Δd＝(Δdmsys+Δdmdia)/2...(13)
Thus, when considering concerning between pressure and the blood vessel diameter, formula (14) is set up.
(Prsys-Prdia)∶ρ·g·h＝(dmsys1-dmdia1)∶(Δdmsys+Δdmdia)/2...(14)
Thus, through type (15) is obtained head pressure (ρ gh) (with reference to Fig. 7 (B)).
ρ·g·h＝(Prsys-Prdia)·(Δdmsys+Δdmdia)/2·(dmsys1-dmdia1)...(15)
(c) in above-mentioned (a) and method (b), under the situation of this design of substantial linear approximate region of using Fig. 6, calculate, more accurately carry out method for measuring and provide here.At first, change according to time of the blood vessel diameter d of the height H position of Fig. 4, the time of calculating blood vessel volume V changes.Generally speaking, relation between the pressure differential Pt of blood vessel volume V and intravascular pressure and cuff pressure is represented by formula (16), therefore when using b=0.03mmHg-1, according to systole actual blood pressure Prsys and expansionary phase actual blood pressure Prdia place the relation of blood vessel volume (Vrsys, Vrdia), obtain V0 and Vmax.Thus, can change, calculate the time variation of intravascular pressure and the pressure differential Pt of cuff pressure of the position of height H according to time of blood vessel volume V.
V＝Vmax+(V0-Vmax)·eb·Pt...(16)
Then, change according to time of the blood vessel diameter d of height L position, the time of calculating blood vessel volume (Vrsys, Vrdia) changes, and the time that use formula (16) is obtained the pressure differential Pt between intravascular pressure and the cuff pressure changes.Time according to the intravascular pressure of height H and L position and the pressure differential Pt between the cuff pressure changes, and obtains meansigma methods poor of the intravascular pressure of each position and the pressure differential Pt between the cuff pressure, and its value is made as head pressure (ρ gh).Perhaps, obtain each average shrinkage phase blood pressure and each other poor of average expansionary phase of blood pressure respectively, and the meansigma methods that will differ from is made as head pressure.If can carry out the conversion of head pressure (ρ gh) and blood vessel diameter d (blood vessel volume), then obtain as the formula (17) systole actual blood pressure Prsys and expansionary phase actual blood pressure Prdia blood pressure difference (Prsys-Prdia).
Prsys-Prdia＝1/b·log{(Vsys-Vmax)/(Vdia-Vmax)}...(17)
Here, Vsys is that systolic blood pipe volume, Vdia are blood vessel volume expansionary phase.
If can calculate head pressure (ρ gh), then according to aforementioned relation, only measure blood vessel diameter d, just can learn the blood pressure difference (Prsys-Prdia) between systole actual blood pressure Prsys and the expansionary phase actual blood pressure Prdia.By carrying out the calculating of a head pressure (ρ gh) before the successive all the time mensuration of beginning, i.e. during the beginning at 1 day etc., can carry out more high-precision mensuration.In addition, the difference of height h of the height H that locates and L is the important parameter that influences precision, therefore, measure in identical position at every turn.For example height H is made as heart 38 the position, will height L be made as wrist is straight after putting down position etc., measure difference of height h.Perhaps, also can use high-precision baroceptor 36 grades to carry out high computational.Thus, can easily measure the difference of height of a key element when asking for head pressure.
(assay method of blood vessel diameter)
Under the situation of measuring blood vessel diameter d, the drive division 28 of blood vessel diameter pick off 12 shown in Figure 3 sends pulse signal or the burst of several M～tens MHz as illustrated in fig. 2, and the reception ripple of utilization transmission ripple and acceptance division 26 is measured the time of advent from the echo of blood vessel wall.If establish echo and be the time of advent velocity of sound of 1.73 μ s, live body inside when being 1500m/s, can calculate blood vessel diameter d is 2.6mm.For example, can in receiving, hyperacoustic transmission use piezoelectric element.In addition, as the assay method of blood vessel diameter d, known have a following echo tracing (echo tracking method): follow the trail of blood vessel wall etc. according to the echo signal that is obtained by ultrasonic beam.Utilize the echo tracing, can be with the displacement of measure of precision blood vessel wall about a few μ m below hyperacoustic wavelength etc.
(assay method of blood flow rate)
Fig. 8 is the figure that the blood flow rate pick off of present embodiment is shown.Under the situation of measuring blood flow rate v, the basic fluctuation f that will send from the drive division 20 of blood flow rate pick off 10 shown in Figure 3 mixes with the reception fluctuation f ' (with reference to Fig. 2) of acceptance division 26, and by carrying out detection, thereby only extract the frequency component of Doppler displacement with signal operation portion 22.In signal operation portion 22,, utilize formula (18) to calculate blood flow rate v according to this Doppler frequency component Δ f (=f-f ') and fluctuation and Radial artery 14 angulation θ.
v＝ε·Δf/(2·f·cosθ)...(18)
Here, ε is that the velocity of sound, the f of live body inside are that frequency, the v of the fluctuation imported is that blood flow rate, θ are Radial artery 14 and fluctuation angulation.In fact, be difficult to obtain fluctuation and Radial artery 14 angulation θ, therefore, for the fluctuation with Radial artery 14 angulation θ condition of unknown under, also can use a plurality of blood flow rate pick offs shown in Figure 8 to obtain blood flow rate v, use such pick off: this pick off utilizes the flow direction of two blood flow rate sensor determination blood flows, and can send and receive the angled θ of flow direction and these two ultrasound wave fluctuations of angle θ-α with the blood flow of this mensuration.When establishing two blood flow rate pick off angulations and be α, can obtain fluctuation and Radial artery 14 angulation θ.That is, sending and receive the blood flow rate pick off 10 that fluctuates with respect to inside from the live body surface is 1 pair.When establishing Doppler frequency component that the blood flow rate pick off receives respectively is Δ f0, Δ f1 and when establishing two blood flow rate pick off angulations and being α, use formula (19) is obtained θ.
θ＝Tan
-1(Δf1/Δf0-cosα)/sinα...(19)
Then, be updated to formula (18) and Doppler frequency component Δ f is made as Δ f=Δ f0 by the fluctuation that will obtain here and Radial artery 14 angulation θ and be updated to formula (18), obtain blood flow rate v thus.
For example,, send the pulse signal of 1MHz, calculate the Doppler frequency component Δ f that receives ripple in order to obtain blood flow rate v.At Doppler frequency component Δ f is 0.33kHz and Radial artery 14 and fluctuation angulation θ is 45 when spending, and can calculate blood flow rate v is about 50cm/s.According to above blood vessel diameter d that obtains and blood flow rate v, calculate the blood pressure P of each bat.That is, shown in (4) and (5), clap, utilize the fluctuation of ultrasound wave etc. to measure blood vessel diameter d and blood flow rate v, determine blood pressure P according to each.Proportionality constant in formula (4) and (5) (π/8 η C) is to obtain by the formula (20) after formula (6) is out of shape.
π/8·η·C＝(Psys-Pdia)/(vsys/dsys
2-vdia/ddia
2)...(20)
Thus, according to each sample rate or calculating blood pressure P at regular intervals, can under non-pressurized state, realize stable lasting blood pressure determination according to the relation of formula (4) and (5) thus.
(easy bearing calibration)
Proportionality constant (π/8 η C) has reflected a large amount of biological informations, therefore the correction that need be worth with interval to a certain degree.At this moment, as shown in Figure 4, utilize the fluctuation of ultrasound wave etc. to obtain the position of height H and position blood vessel diameter d and the blood flow rate v separately of height L as described above like that, obtain blood pressure difference (Psys-Pdia) between systolic blood pressure Psys and the expansionary phase blood pressure Pdia by the conversion of head pressure (ρ gh) and blood vessel diameter d, thus, can in time not proofread and correct even do not carry out the cuff pressurization yet.
(calculating of blood pressure measuring method and corrected value)
Fig. 9 is the figure that the blood pressure measuring method of present embodiment is shown.At first, after connecting switch 37, shown in step S10, be used to calculate the correction of proportionality constant (π/8 η C).The concrete condition of step S10 will be narrated in the back.
Then, shown in step S20, measure blood vessel diameter d and blood flow rate v.About assay method, use aforesaid mensuration ultrasonic reflections to measure the method for blood vessel diameter d the time of advent or measure the method for blood flow rate v by Doppler method.
Then, shown in step S30, use the proportionality constant of obtaining by the correction routine of step S10 to come calculating blood pressure P.Can also obtain the time variation of the blood vessel diameter d and the blood flow rate v in same place, the identical moment, the time of calculating blood pressure P changes.
Then, shown in step S40, display of blood pressure P on display part 34.In addition, can also on display part 34, carry out visualization display with curve chart etc. to blood pressure P.In addition, also can show equally for pulse.
Then, shown in step S50, judge whether and to proofread and correct once more.Then returning step 10 if desired proofreaies and correct.If do not need then enter step S60.Need gauged situation for example to be meant that blood pressure has changed ± the above situation of 15mmHg with comparing usually.At this moment, on display part 34, show gauged once more indication.
Then, shown in step S60, judging whether needs to continue to measure.Then return step 20 if desired and measure blood vessel diameter d and blood flow rate v.If do not need then end process.Thus, only need to obtain correction coefficient according to the initial pressure value that uses cuff type sphygomanometer to measure, just can under the situation of not using cuff type sphygomanometer, carry out high-precision blood pressure determination afterwards, in person to be measured is acting on one's own, carry out all the time under the situation of blood pressure determination, need not to use cuff type sphygomanometer and can proofread and correct simply.
Figure 10 is the figure that the correction routine of present embodiment is shown.
Figure 10 illustrates the flow process of the details of the correction routine of representing step S10.The process of head pressure conversion method (a) is as follows.At first, shown in step S110, in the blood vessel diameter d of the height H position of survey map 4, calculate mean vascular diameter d m1.Measure about 10 seconds vessel diameter change.
Then, shown in step S120, wrist is moved to the position of height L.Measure the difference of height h between the position of the height H of this moment and L.In addition, also can use high-precision baroceptor 36 (with reference to Fig. 3) as the height and position sensor part etc. to carry out high computational.Thus, can easily measure the difference of height of a key element when obtaining head pressure.
Then, shown in step S130, calculated water head pressure (ρ gh).
Then, shown in step S140, when measuring blood vessel diameter d and blood flow rate v, obtain mean vascular diameter d m2.
Then, shown in step S150, the mean vascular vary in diameter Δ dm of the position of computed altitude H and L (=dm1-dm2).
Then, shown in step S160, the blood pressure difference (Psys-Pdia) between calculating blood pressure Pdia expansionary phase and the systolic blood pressure Psys.When the average shrinkage phase blood vessel diameter dmsys1 of the height H position of using Fig. 4 and average expansionary phase during blood vessel diameter dmdia1, formula (9) is out of shape, according to formula (21), the blood pressure difference (Psys-Pdia) between calculating blood pressure Pdia expansionary phase and the systolic blood pressure Psys.
Psys-Pdia＝ρ·g·h·(dmsys1-dmdia1)/Δdm...(21)
In addition, at this moment, calculated expansionary phase actual blood pressure Prdia and systole actual blood pressure Prsys between blood pressure difference (Prsys-Prdia) equal expansionary phase blood pressure Pdia and systolic blood pressure Psys between blood pressure difference (Psys-Pdia).
Then, shown in step S170, calculate proportionality constant (π/8 η C) by following formula.Through type (20) calculates proportionality constant (π/8 η C).In addition, at this moment, calculated expansionary phase blood pressure Pdia and systolic blood pressure Psys between blood pressure difference (Psys-Pdia) equal expansionary phase actual blood pressure Prdia and systole actual blood pressure Prsys between blood pressure difference (Prsys-Prdia).In addition, the relation between head pressure and the vessel diameter change is constant, therefore, can calculate under the situation of no cuff pressure expansionary phase blood pressure Pdia and systolic blood pressure Psys between blood pressure difference (Psys-Pdia).Thus, can easily proofread and correct proportionality constant.
According to the blood pressure measurement apparatus and the blood pressure measuring method of present embodiment, can under the situation of not using cuff, simply and in time proofread and correct, can measure blood pressure P accurately.And, wearable blood pressure measurement apparatus that can continue to measure and blood pressure measuring method can be provided thus.
Claims (8)
1. a blood pressure measurement apparatus is characterized in that, this blood pressure measurement apparatus has:
The blood flow rate sensor part, fluctuating with respect to the blood transmission and the reception of live body inside in its live body surface from person to be measured, detects the blood flow of this live body inside;
Blood flow rate pick off drive division, it drives described blood flow rate sensor part;
Blood flow rate sensor signal operational part, it is controlled described blood flow rate pick off drive division and described blood flow rate sensor part, obtains the blood flow rate of described live body inside;
The blood vessel diameter sensor part, its blood vessel with respect to described live body inside sends and receives ultrasound wave, and the reflection that detects the blood vessel wall of this live body inside arrives time difference;
Blood vessel diameter pick off drive division, it drives described blood vessel diameter sensor part;
Blood vessel diameter sensor signal operational part, it is controlled described blood vessel diameter pick off drive division and described blood vessel diameter sensor part, obtains the blood vessel diameter of described live body inside; And
The blood pressure signal operational part, it utilizes the operation result of described blood flow rate sensor signal operational part and described blood vessel diameter sensor signal operational part to obtain the blood pressure of described person to be measured.
2. blood pressure measurement apparatus according to claim 1 is characterized in that,
Described blood pressure signal operational part is carried out following computing: obtain described blood pressure by described blood vessel diameter is scaled head pressure.
3. blood pressure measurement apparatus according to claim 1 and 2 is characterized in that,
This blood pressure measurement apparatus also comprises the height and position sensor part, predetermined position in described person to be measured is located under the 1st state of predetermined altitude, this height and position sensor part is obtained the difference of height of the described predetermined position between the 2nd state of heart height that the 1st state and described predetermined position be located in described person to be measured
The described difference of height that utilization is measured by described height and position sensor part is obtained described head pressure.
4. according to any described blood pressure measurement apparatus in the claim 1～3, it is characterized in that,
Described blood flow rate sensor part constitutes with element by sending with element and receiving, and described transmission is with how right to existing with element of element and described reception, the direct of travel of the fluctuation that sends and receive and the flow direction angulation of blood for each to having nothing in common with each other.
5. according to any described blood pressure measurement apparatus in the claim 1～3, it is characterized in that,
Described blood flow rate sensor part utilizes piezoelectric element to constitute.
6. blood pressure measuring method, this blood pressure measuring method is measured the blood pressure of person to be measured, wherein, be positioned at predetermined position under the 1st state of predetermined altitude described person to be measured, the blood pressure of described person to be measured is proportional divided by square value that obtains of the blood vessel diameter of this predetermined position with the blood flow rate of predetermined proportionality constant and described predetermined position, this blood pressure measuring method is characterised in that, may further comprise the steps:
Obtain the aligning step of described proportionality constant;
Under described the 1st state, measure the described blood vessel diameter and the described blood flow rate of described predetermined position respectively;
Utilize described blood vessel diameter, described blood flow rate and described proportionality constant to obtain described blood pressure;
Described blood pressure is shown; And
Judge whether to need to proofread and correct described proportionality constant.
7. blood pressure measuring method according to claim 6 is characterized in that,
Described aligning step may further comprise the steps:
Under the 2nd state of the heart height that described predetermined position is positioned described person to be measured, measure blood vessel diameter and the systole of this predetermined position and the blood vessel diameter of expansionary phase of described predetermined position respectively, obtain the 1st mean vascular diameter, average shrinkage phase blood vessel diameter and average expansionary phase blood vessel diameter;
Under described the 1st state, measure the difference of height determination step of the difference of height of the described predetermined position between the 1st state and described the 2nd state;
Utilize described difference of height to obtain head pressure between described the 1st state and described the 2nd state;
Under described the 1st state, measure the blood vessel diameter of described predetermined position and systole and the blood flow rate of expansionary phase and the blood vessel diameter of this predetermined position respectively, obtain the 2nd mean vascular diameter, systole blood flow rate, systole blood vessel diameter, expansionary phase blood flow rate and expansionary phase blood vessel diameter;
Utilize described the 1st mean vascular diameter and described the 2nd mean vascular diameter to obtain the mean vascular vary in diameter;
Utilize described head pressure, described mean vascular vary in diameter, described average shrinkage phase blood vessel diameter and described average expansionary phase blood vessel diameter, obtain the blood pressure difference between systolic blood pressure and the expansionary phase blood pressure; And
Utilize described blood pressure difference, described systole blood flow rate, described systole blood vessel diameter, described expansionary phase blood flow rate and described expansionary phase blood vessel diameter, obtain described proportionality constant.
8. blood pressure measuring method according to claim 7 is characterized in that,
In described difference of height determination step, measure by the height and position sensor part of the described difference of height of measuring the described predetermined position between described the 1st state and described the 2nd state.
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Also Published As
| Publication number | Publication date |
|---|---|
| CN102247169B (en) | 2015-03-11 |
| JP5884256B2 (en) | 2016-03-15 |
| CN104161547A (en) | 2014-11-26 |
| JP2011239972A (en) | 2011-12-01 |
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