CN102247169B - 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 122
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- 210000004204 blood vessel Anatomy 0.000 claims abstract description 195
- 230000017531 blood circulation Effects 0.000 claims abstract description 116
- 238000009530 blood pressure measurement Methods 0.000 claims description 34
- 239000000523 sample Substances 0.000 claims description 13
- 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
- 230000005540 biological transmission Effects 0.000 claims description 7
- 230000010339 dilation Effects 0.000 claims description 4
- 210000002321 radial artery Anatomy 0.000 description 19
- 238000012937 correction Methods 0.000 description 11
- 210000000707 wrist Anatomy 0.000 description 8
- 238000003556 assay Methods 0.000 description 5
- 238000006073 displacement reaction Methods 0.000 description 4
- 238000006243 chemical reaction Methods 0.000 description 3
- 238000001514 detection method Methods 0.000 description 3
- 230000002792 vascular Effects 0.000 description 3
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- 238000005259 measurement Methods 0.000 description 2
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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, as the method measuring blood pressure, propose and used ultrasound wave to carry out method for measuring.Such as, at the part of tremulous pulse, obtain maximum gauge and minimum diameter, and these parameters are given to nonlinear function, by this nonlinear function, the diameter in inputted each moment is converted, thus calculates the pressure (for example, referring to patent documentation 1) in each moment about part.
In addition, following method is proposed: by ultrasound examination blood flow rate, flow or capacity etc., and detect pulse wave velocily by light wave, these two amounts be associated and calculate blood pressure and variable quantity (for example, referring to patent documentation 2 and 3) thereof.
[patent documentation 1] Japanese Unexamined Patent Publication 2004-041382 publication
[patent documentation 2] Japanese Unexamined Patent Publication 4-250135 publication
[patent documentation 3] Japanese Unexamined Patent Publication 2004-154231 publication
But, when using ultrasound wave to calculate pressure value as patent documentation 1 ~ 3 in the past, needed to utilize cuff type sphygomanometer to correct.There is following inconvenience etc. in this, that is: when consider to carry out in 24 hours act on one's own blood pressure determination (24ABPM) or by each clap carry out continuous blood pressure mensuration, with it cuff will being worn over all the time, or need cuff is carried with and in time uses.And this may be difficult to obtain practical application in common life.
And, except needs utilize except cuff type sphygomanometer corrects, also may exist and need regularly (30 minutes ~ 1 hours) to carry out the problem of this correction.As everyone knows, generally speaking, when according to pulse wave velocity estimated blood pressure value, change is large along with correction interval is elongated for the probability of error.This is because: although can be considered as constant by blood vessel elasticity characteristic (E0: blood vessel elasticity modulus, γ without during pressure: the constant of particular blood vessel) at short notice, become large at the above time error of certain hour.In patent documentation 1, stiffness coefficient β is calculated according to the maximal blood pressure Ps obtained by cuff type sphygomanometer and minimal blood pressure Pd, but this and aforesaid blood vessel elasticity modulus exist dependency, if be therefore more than certain hour, its value obviously also can change.That is, in order to continuously and obtain pressure value accurately constantly, it is inadequate for only once correcting, and needs every interval to a certain degree, such as corrects every a hours.
Summary of the invention
The present invention, just in order to solve completing at least partially in above-mentioned problem, can be used as and realize with under type or application examples.
[application examples 1] a kind of blood pressure measurement apparatus, it is characterized in that, this blood pressure measurement apparatus has: blood flow rate sensor part, and its surface of live body from person to be measured sends relative to the blood of live body inside and receives fluctuation, detects the blood flow of this live body inside; Blood flow rate sensor probe, it drives described blood flow rate sensor part; Blood flow rate sensor signal operational part, it controls described blood flow rate sensor probe and described blood flow rate sensor part, obtains the blood flow rate of described live body inside; Blood vessel diameter sensor part, it sends relative to the blood vessel of described live body inside and receives ultrasound wave, and the reflection detecting the blood vessel wall of this live body inside arrives time difference; Blood vessel diameter sensor probe, it drives described blood vessel diameter sensor part; Blood vessel diameter sensor signal operational part, it controls described blood vessel diameter sensor probe and described blood vessel diameter sensor part, obtains the blood vessel diameter of described live body inside; And 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 worn can be provided: this blood pressure measurement apparatus only needs to obtain correction coefficient according to the initial pressure value using cuff type sphygomanometer to measure, just can measure blood pressure accurately when not using cuff type sphygomanometer afterwards, when person to be measured continues to carry out blood pressure determination in acting on one's own, can correct simply without the need to using cuff type sphygomanometer.
The feature of [application examples 2] above-mentioned blood pressure measurement apparatus is, described blood pressure signal operational part performs following computing: obtain described blood pressure by described blood vessel diameter is scaled head pressure.
According to this application examples, regarding blood vessel diameter as and blood pressure roughly linearly changes, therefore, by measuring the time variations of blood vessel diameter, the value relevant to the time variations of blood pressure can be obtained.
The feature of [application examples 3] above-mentioned blood pressure measurement apparatus is, this blood pressure measurement apparatus also comprises height and position sensor part, under the 1st state that the predetermined position of described person to be measured is located in predetermined altitude, this height and position sensor part obtains the difference of height of the described predetermined position between the 2nd state that the 1st state and described predetermined position be located in the heart height of described person to be measured, utilize the described difference of height measured by described height and position sensor part, obtain described head pressure.
According to this application examples, the difference of height as key element when obtaining head pressure easily can be measured.
The feature of [application examples 4] above-mentioned blood pressure measurement apparatus is, described blood flow rate sensor part is formed with element and reception element by sending, and described transmission element and described reception element is multipair to existing, the direct of travel of fluctuation sending and receive and the flow direction angulation of blood for each to different.
According to this application examples, even if when blood vessel is with fluctuation angulation the unknown, also can blood flow rate be obtained.
The feature of [application examples 5] above-mentioned blood pressure measurement apparatus is, described blood flow rate sensor part utilizes piezoelectric element to form.
According to this application examples, because the structure of piezoelectric element is simple, therefore, it is possible to make blood flow rate sensor miniaturization.
[application examples 6] a kind of blood pressure measuring method, this blood pressure measuring method measures the blood pressure of person to be measured, wherein, under the 1st state that the predetermined position of described person to be measured is positioned predetermined altitude, the blood pressure of described person to be measured is proportional divided by square value obtained of the blood vessel diameter of this predetermined position with the blood flow rate of predetermined proportionality constant and described predetermined position, the feature of this blood pressure measuring method is, comprises the following steps: the aligning step obtaining described proportionality constant; Under described 1st state, measure the described blood vessel diameter of described predetermined position and described blood flow rate respectively; Described blood vessel diameter, described blood flow rate and described proportionality constant is utilized to obtain described blood pressure; Described blood pressure is shown; And judge whether to need to correct described proportionality constant.
According to this application examples, the blood pressure measuring method in the following sustainable blood pressure measurement apparatus worn can be provided: only need obtain correction coefficient according to the initial pressure value using cuff type sphygomanometer to measure, just can measure blood pressure accurately when not using cuff type sphygomanometer afterwards, when person to be measured continues to carry out blood pressure determination in acting on one's own, can correct simply without the need to using cuff type sphygomanometer.
The feature of [application examples 7] above-mentioned blood pressure measuring method is, described aligning step comprises the following steps: under the 2nd state of heart height described predetermined position being positioned described person to be measured, measure the blood vessel diameter of the blood vessel diameter of described predetermined position and the systole of this predetermined position and expansionary phase respectively, obtain the 1st average blood vessel diameter, average shrinkage phase blood vessel diameter and mean dilation phase blood vessel diameter; Under described 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 2nd state; Described difference of height is utilized to obtain head pressure between described 1st state and described 2nd state; Under described 1st state, measure blood flow rate and the blood vessel diameter of the blood vessel diameter of described predetermined position and the systole of this predetermined position and expansionary phase respectively, obtain the 2nd average blood vessel diameter, systolic blood Flow Velocity, systole blood vessel diameter, expansionary phase blood flow rate and expansionary phase blood vessel diameter; Described 1st average blood vessel diameter and described 2nd average blood vessel diameter is utilized to obtain average blood vessel diameter change; Utilize that described head pressure, described average blood vessel diameter change, described average shrinkage phase blood vessel diameter and described mean dilation phase blood vessel diameter, obtain the blood pressure difference between systolic blood pressure and expansionary phase blood pressure; And utilize described blood pressure difference, described systolic blood Flow Velocity, 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, easily proportionality constant can be corrected.
The feature of [application examples 8] above-mentioned blood pressure measuring method is, in described difference of height determination step, is measured by the height and position sensor part of the described difference of height of the described predetermined position measured between described 1st state and described 2nd state.
According to this application examples, the difference of height as key element when obtaining head pressure easily can be measured.
Accompanying drawing explanation
Fig. 1 is the outside drawing of the state that the blood pressure measurement apparatus adorning oneself with present embodiment is shown.
Fig. 2 illustrates the blood flow rate sensor of present embodiment and the figure of blood vessel diameter sensor.
Fig. 3 is the figure of the circuit module that present embodiment is shown.
Fig. 4 is the figure located of the blood pressure measurement apparatus that present embodiment is shown.
Fig. 5 is the figure of the blood vessel diameter after the applying head pressure that present embodiment is shown.
Fig. 6 is the figure of the relation illustrated between the blood vessel wall pressure of present embodiment and blood vessel diameter (volume).
Fig. 7 is the figure of the cuff pressurization measured value that present embodiment is shown.
Fig. 8 is the figure of the blood flow rate sensor that present embodiment is shown.
Fig. 9 is the figure of the assay method that present embodiment is shown.
Figure 10 is the figure of the correction routine that present embodiment is shown.
Label declaration
2: blood pressure measurement apparatus; 4: person to be measured; 10: blood flow rate sensor; 12: blood vessel diameter sensor; 14: Radial artery (blood vessel); 16: wrist portion; 18: blood flow rate sensor part; 20: drive division (blood flow rate sensor probe); 22: signal operation portion (blood flow rate sensor signal operational part); 24: emission part (transmission element); 26: acceptance division (reception element); 27: blood vessel diameter sensor part; 28: drive division (blood vessel diameter sensor probe); 29: emission part; 30: signal operation portion (blood vessel diameter sensor signal operational part); 31: acceptance division; 32: 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.
Detailed description of the invention
Below, according to accompanying drawing, present embodiment is described.In addition, show used accompanying drawing in the mode suitably zoomed in or out, thus become the state that can identify the part that will illustrate.
Fig. 1 is the outside drawing of the state that the blood pressure measurement apparatus adorning oneself with present embodiment is shown.Fig. 2 illustrates the blood flow rate sensor of present embodiment and the figure of blood vessel diameter sensor.Fig. 3 is the figure of the circuit module that present embodiment is shown.The blood pressure measurement apparatus 2 of present embodiment has blood flow rate sensor 10 and blood vessel diameter sensor 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 blood flow rate v and the blood vessel diameter d of Radial artery (blood vessel) 14, thus obtains blood pressure P.
Blood flow rate sensor 10 is installed in and can irradiates hyperacoustic position to the Radial artery 14 inside wrist portion 16.The basic fluctuation f sent from blood flow rate sensor 10 mixes with the reception f ' that fluctuates by blood flow rate sensor 10.Mixed fluctuation carries out detection by blood flow rate sensor signal operational part (signal operation portion) 22, thus only extracts the frequency component of Doppler displacement.In signal operation portion 22, according to this doppler-frequency component Δ f (=f-f '), fluctuation f, f ' calculate blood flow rate v with Radial artery 14 angulation θ.
Blood flow rate sensor 10 has blood flow rate sensor part 18, blood flow rate sensor probe (drive division) 20 and signal operation portion 22.Blood flow rate sensor part 18 sends relative to the blood of live body inside from the live body of person to be measured 4 surface and receives fluctuation, the blood flow of detection live body inside.Blood flow rate sensor part 18 is made up of emission part (transmission element) 24 and acceptance division (reception element) 26.Emission part 24 is multipair to existing with acceptance division 26, the direct of travel of the fluctuation sending and receive and Radial artery 14 angulation for each to different.Drive division 20 drives blood flow rate sensor part 18.22 pairs, signal operation portion drive division 20 and blood flow rate sensor part 18 control, and obtain the blood flow rate v of live body inside.Blood flow rate sensor part 18 utilizes piezoelectric element to form.Thus, because the structure of piezoelectric element is simple, therefore, it is possible to make blood flow rate sensor miniaturization.
Blood vessel diameter sensor 12 is installed in and can irradiates hyperacoustic position to the Radial artery 14 inside wrist portion 16.Blood vessel diameter sensor 12 sends pulse signal or burst (burst) signal of a few M ~ tens MHz, measures the time of advent from the echo of the wall of Radial artery 14 by transmission ripple and reception ripple.Blood vessel diameter sensor part 27 sends relative to the Radial artery 14 of live body inside and receives ultrasound wave, and the reflection detecting the wall of the Radial artery 14 of live body inside arrives time difference.
Blood vessel diameter sensor 12 has blood vessel diameter sensor part 27, blood vessel diameter sensor probe (drive division) 28 and blood vessel diameter sensor signal operational part (signal operation portion) 30.Blood vessel diameter sensor part 27 is made up of emission part 29 and acceptance division 31.Blood vessel diameter sensor part 27 sends relative to the Radial artery 14 of live body inside and receives ultrasound wave, and the reflection detecting the wall of the Radial artery 14 of live body inside arrives time difference.Drive division 28 drives blood vessel diameter sensor part 27.30 pairs, signal operation portion drive division 28 and blood vessel diameter sensor part 27 control, 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 in 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 display part 34 pairs of person to be measureds 4 shows.In addition, visual display can also be carried out with curve chart etc. to blood pressure P.In addition, also can show equally for pulse.Further, the content representing that needs correct also is shown.The height and position of baroceptor 36 pairs of blood pressure measurement apparatus 2 measures.The power supply that switch 37 switches from power supply unit 40 for each function part of blood pressure measurement apparatus 2 supplies/cuts off.Power supply unit 40 provides power supply to each function part of blood pressure measurement apparatus 2.In the present embodiment, for example, assuming that be chargeable secondary cell.
Fig. 4 is the figure located of the blood pressure measurement apparatus 2 that present embodiment is shown.Fig. 5 is the figure of the blood vessel diameter d after the applying head pressure that present embodiment is shown.Here, being described for following method: in the blood pressure determination of non-invasion and attack, measuring blood flow rate v and blood vessel diameter d when not using cuff (compression band) to calculate blood pressure P.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 the blood vessel diameter d shown in formula (2) and blood flow rate v to obtain.
Q＝(π·d
2·v)/8...2)
In addition, vascular resistance R is determined with the ratio of blood vessel diameter d by the blood viscosity η of flowing in Radial artery 14, and following relation is set up: blood vessel diameter d more trunk resistance R is less.When C is regarded as constant,
R＝η·C/d
4...(3)。
When deriving blood pressure P when considering these relational expressions, the Strength Changes being called as the plethysmographic pulsate wave of pulse wave is actually the change that blood is occurred blood vessel diameter d when pulsing and captures as volume change, by measuring plethysmographic pulsate wave, the value relevant to blood vessel diameter d can be determined, the value relevant to vascular resistance R can be determined.Further, by measuring endovascular blood flow rate v, the value relevant to blood flow Q can also be obtained, thereby, it is possible to determine blood pressure P.
Then, for systolic blood pressure Psys and expansionary phase blood pressure Pdia calculating be described.Systolic blood pressure Psys and expansionary phase blood pressure Pdia can use formula (1) ~ (3) and obtain such as formula (4) and (5) Suo Shi.
Psys＝π/8·η·C·vsys/dsys
2...(4)
Pdia＝π/8·η·C·vdia/ddia
2...(5)
Thus, can such as formula the blood pressure difference (Psys-Pdia) obtained (6) Suo Shi between systolic blood pressure Psys and expansionary phase blood pressure Pdia.
Psys-Pdia＝π/8·η·C·(vsys/dsys
2-vdia/ddia
2)...(6)
Here, vsys is systolic blood Flow Velocity, dsys is systole blood vessel diameter, vdia be expansionary phase blood flow rate, ddia is blood vessel diameter expansionary phase.
Fig. 6 is the figure of the relation illustrated between the blood vessel wall pressure of present embodiment and blood vessel diameter (volume).Fig. 6 shows the pipe rule of blood vessel.In the existing blood pressure determination based on cuff pressurization, in order to obtain oscilloscopic waveform (oscillometric waveform), employ the nonlinear area of pipe rule.On the other hand, in the present embodiment, the substantial linear approximate region shown in Fig. 6 is used.In the portion, blood vessel diameter d can being regarded as and blood pressure wall pressure power (blood pressure P) roughly linearly changes, therefore, by measuring the time variations of blood vessel diameter d, the value relevant to the time variations of blood pressure P can be obtained.
Then, for use above formula calculate systolic blood pressure Psys and expansionary phase blood pressure Pdia mode be described.First, at the height H place identical with the position of heart 38, namely under the state not needing head pressure to correct, obtain systolic blood Flow Velocity vsys, systole blood vessel diameter d sys, expansionary phase blood flow rate vdia and expansionary phase blood vessel diameter ddia.Send relative to the blood vessel of live body inside and receive fluctuation, according to the Doppler displacement gauge of blood flow scattered wave calculate systolic blood Flow Velocity vsys and expansionary phase blood flow rate vdia, according to the reflection of blood vessel two wall arrive time difference calculate systole blood vessel diameter d sys and expansionary phase blood vessel diameter ddia.Meanwhile, the time variations of blood vessel diameter d is measured.Pipe according to blood vessel is restrained, do not pressurize or micro-pressurization time blood vessel diameter d and blood vessel wall pressure (blood pressure P) be roughly similar to linearly.Now, the time variations of blood vessel diameter d similar to the time variations of blood pressure P (with reference to Fig. 6).
Then, the position L of the state after reducing height h from the position of heart 38 measures blood vessel diameter d equally.Now, when being set to person to be measured 4 and being in steady statue, in the blood vessel, compared with the position of heart 38, only the pressure corresponding to head pressure is applied with redundantly.That is, when redeterminating the time variations of blood vessel diameter d in this condition, the time variations (with reference to Fig. 5) of the blood pressure P after applying head pressure can be obtained.Thereby, it is possible to learn the variation delta d of the blood vessel diameter d corresponding with head pressure (ρ gh) (ρ: density of blood, g: acceleration of gravity).By measuring the variable quantity of blood vessel diameter d when can obtain systole and expansionary phase, the blood pressure difference Δ P (=Psys-Pdia) between systolic blood pressure Psys and expansionary phase blood pressure Pdia can also be calculated.If this value to be applied to formula (6), then can obtain proportionality constant (π/8 η C), therefore, it is possible to 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
2left and right, therefore on the impact of pressure value be ± zero point a few mmHg, so can be considered constant.It can thus be appreciated that: for head pressure (ρ gh), as long as elevation measurement can be carried out exactly, just can be worth accurately.According to the present embodiment, do not need to utilize other sphygomanometers such as cuff type sphygomanometer to correct, but by using head pressure, can correct very easily.And not needing the measurement carrying out plethysmographic pulsate wave, by means of only measuring the blood flow rate and blood vessel diameter that cause by fluctuating, just can realize the test constantly of blood pressure.
(head pressure (ρ gh) being scaled the method for blood vessel diameter d)
As shown in Figure 4, under the state that the blood pressure measurement apparatus of present embodiment is worn on wrist portion 16, measure the time variations of blood vessel diameter d in the position of the height H identical with the height of heart 38, and utilize cuff adding pressure type sphygomanometer 42 measure systole actual blood pressure Prsys and expansionary phase actual blood pressure Prdia.Then, by wrists uncock to the position of height L, the time variations of blood vessel diameter d is measured.Thereby, it is possible to the force value calculating head pressure corresponds to the change (with reference to Fig. 5) of the blood vessel diameter d of which kind of degree.
Fig. 7 is the figure of the cuff pressurization measured value that present embodiment is shown, shows the cuff pressurization measured value of height H position.Force value about head pressure corresponds to the calculating of the change of the blood vessel diameter d of which kind of degree, there is the method for following (a) ~ (c).
A () measures the change of the blood vessel diameter d of about 10 seconds, respectively the average blood vessel diameter (dm1 and dm2) of the height H of calculation chart 4, the position of L.Then, through type (7) obtains the variation delta dm of average blood vessel diameter (dm1, dm2).
Δdm＝dm2-dm1...(7)
Through type (8) obtains the vessel diameter change Δ d corresponding with head pressure.
Δd＝Δdm...(8)
Thus, as average shrinkage phase blood vessel diameter dmsys1 and average blood vessel diameter dmdial expansionary phase of the height H position of use Fig. 4, if consider the relation between pressure and blood vessel diameter, then formula (9) is set up.
(Prsys-Prdia)∶ρ·g·h＝(dmsys1-dmdia1)∶Δdm...(9)
Thus, through type (10) obtains head pressure (ρ gh) (with reference to Fig. 7 (A)).
ρ·g·h＝(Prsys-Prdia)·Δdm/(dmsys1-dmdia1)...(10)
B () measures the change of the blood vessel diameter d of about 10 seconds, 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 based on above-mentioned value, obtain the vessel diameter change Δ d of head pressure according to formula (13).
Δd＝(Δdmsys+Δdmdia)/2...(13)
Thus, when considering the relation between pressure and blood vessel diameter, formula (14) is set up.
(Prsys-Prdia)∶ρ·g·h＝(dmsys1-dmdia1)∶(Δdmsys+Δdmdia)/2...(14)
Thus, through type (15) obtains head pressure (ρ gh) (with reference to Fig. 7 (B)).
ρ·g·h＝(Prsys-Prdia)·(Δdmsys+Δdmdia)/2·(dmsys1-dmdia1)...(15)
C (), in method of above-mentioned (a) and (b), calculates when using this design of substantial linear approximate region of Fig. 6, and provide here and carry out method for measuring more accurately.First, according to the time variations of the blood vessel diameter d of the height H position of Fig. 4, calculate the time variations of blood vessel volume V.Generally speaking, blood vessel volume V and the relation between intravascular pressure and the pressure differential Pt of cuff pressure are represented by formula (16), therefore when using b=0.03mmHg-1, according to the relation of the blood vessel volume (Vrsys, Vrdia) at systole actual blood pressure Prsys and actual blood pressure Prdia expansionary phase place, obtain V0 and Vmax.Thereby, it is possible to according to the time variations of blood vessel volume V, calculate the time variations of the intravascular pressure of the position of height H and the pressure differential Pt of cuff pressure.
V＝Vmax+(V0-Vmax)·eb·Pt...(16)
Then, according to the time variations of the blood vessel diameter d of height L position, calculate the time variations of blood vessel volume (Vrsys, Vrdia), use formula (16) to obtain the time variations of the pressure differential Pt between intravascular pressure and cuff pressure.According to the time variations of the pressure differential Pt between the intravascular pressure of height H and L position and cuff pressure, obtain the difference of the meansigma methods of the pressure differential Pt between the intravascular pressure of each position and cuff pressure, its value is set to head pressure (ρ gh).Or, obtain each average shrinkage phase blood pressure and average blood pressure expansionary phase difference each other respectively, and the meansigma methods of this difference be set to head pressure.If the conversion of head pressure (ρ gh) and blood vessel diameter d (blood vessel volume) can be carried out, then such as formula obtain shown in (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 systolic blood pipe volume, Vdia is blood vessel volume expansionary phase.
If head pressure (ρ gh) can be calculated, then according to forgoing relationship, only measure blood vessel diameter d, just can learn the blood pressure difference (Prsys-Prdia) between systole actual blood pressure Prsys and expansionary phase actual blood pressure Prdia.By before starting continuous print all the time and measuring, namely carry out the calculating of a head pressure (ρ gh) when the beginning of 1 day etc., can more high-precision mensuration be carried out.In addition, the difference of height h of the height H that locates and L is the important parameter affecting precision, therefore, will measure in identical position at every turn.Such as height H is set to the position of heart 38, height L is set to the position etc. after by straight for wrist putting down, measure difference of height h.Or, high-precision baroceptor 36 etc. also can be used to carry out high computational.Thereby, it is possible to easily measure the difference of height as key element when asking for head pressure.
(assay method of blood vessel diameter)
When measuring blood vessel diameter d, the drive division 28 of the blood vessel diameter sensor 12 shown in Fig. 3 sends pulse signal or the burst of a few M ~ tens MHz as illustrated in fig. 2, utilizes the time of advent of reception ripple mensuration from the echo of blood vessel wall of transmission ripple and acceptance division 26.If set echo time of advent as the velocity of sound of 1.73 μ s, live body inside be 1500m/s time, can calculate blood vessel diameter d is 2.6mm.Such as, piezoelectric element can be used in hyperacoustic transmission and reception.In addition, as the assay method of blood vessel diameter d, following E-tracking method (echo tracking method) is known to: the echo signal according to being obtained by ultrasonic beam follows the trail of blood vessel wall etc.Utilize E-tracking method, can with the displacement of the measure of precision blood vessel wall of about several μm below hyperacoustic wavelength etc.
(assay method of blood flow rate)
Fig. 8 is the figure of the blood flow rate sensor that present embodiment is shown.When measuring blood flow rate v, the basic fluctuation f and the reception of acceptance division 26 that are sent by drive division 20 from the blood flow rate sensor 10 shown in Fig. 3 f ' (with reference to Fig. 2) that fluctuates mixes, and carry out detection by with signal operation portion 22, thus only extract the frequency component of Doppler displacement.In signal operation portion 22, according to this doppler-frequency component Δ f (=f-f ') and fluctuation and Radial artery 14 angulation θ, utilize formula (18) to calculate blood flow rate v.
v＝ε·Δf/(2·f·cosθ)...(18)
Here, ε is the velocity of sound of live body inside, f is the frequency of inputted fluctuation, v is blood flow rate, θ is Radial artery 14 and fluctuation angulation.In fact, be difficult to obtain fluctuation and Radial artery 14 angulation θ, therefore, in order to when fluctuate with the θ the unknown of Radial artery 14 angulation, also the multiple blood flow rate sensors shown in Fig. 8 can be used to obtain blood flow rate v, use such sensor: this sensor utilizes two blood flow rate sensors to measure the flow direction of blood flows, and can send and to receive and the angled θ of flow direction of blood flow of this mensuration and these two ultrasound wave of angle θ-α fluctuate.When setting two blood flow rate sensor angulations as α, fluctuation and Radial artery 14 angulation θ can be obtained.That is, it is 1 right for sending relative to inside from live body surface and receive the blood flow rate sensor 10 fluctuated.When the doppler-frequency component setting blood flow rate sensor to receive respectively is as Δ f0, Δ f1 and when setting two blood flow rate sensor angulations as α, formula (19) is used to obtain θ.
θ＝Tan
-1(Δf1/Δf0-cosα)/sinα...(19)
Then, by the fluctuation obtained and Radial artery 14 angulation θ are updated to formula (18) and doppler-frequency component Δ f are set to Δ f=Δ f0 and are updated to formula (18), blood flow rate v is obtained thus here.
Such as, in order to obtain blood flow rate v, sending the pulse signal of 1MHz, calculating the doppler-frequency component Δ f receiving ripple.When doppler-frequency component Δ f is 0.33kHz and Radial artery 14 is 45 degree with fluctuation angulation θ, can calculate blood flow rate v is about 50cm/s.According to the blood vessel diameter d obtained above and blood flow rate v, calculate the blood pressure P that each is clapped.That is, such as formula shown in (4) and (5), clap according to each, utilize the fluctuation of ultrasound wave etc. to measure blood vessel diameter d and blood flow rate v, determine blood pressure P.Proportionality constant (π/8 η C) in formula (4) and (5) is obtained by the formula (20) after being out of shape formula (6).
π/8·η·C＝(Psys-Pdia)/(vsys/dsys
2-vdia/ddia
2)...(20)
Thus, according to the relation of formula (4) and (5) according to each sample rate or calculate blood pressure P at regular intervals, stable lasting blood pressure determination can be realized under non-pressurized state thus.
(easy bearing calibration)
Proportionality constant (π/8 η C) reflects a large amount of biological informations, therefore needs to carry out with interval to a certain degree the correction that is worth.Now, as shown in Figure 4, the fluctuation of ultrasound wave etc. is utilized to obtain the position of height H and the respective blood vessel diameter d in position of height L and blood flow rate v as described above, the blood pressure difference (Psys-Pdia) between systolic blood pressure Psys and expansionary phase blood pressure Pdia is obtained by the conversion of head pressure (ρ gh) and blood vessel diameter d, thus, also can in time correct even if do not carry out cuff pressurization.
(calculating of blood pressure measuring method and corrected value)
Fig. 9 is the figure of the blood pressure measuring method that present embodiment is shown.First, after turn on-switch 37, as shown in step S10, carry out the correction for calculating proportionality constant (π/8 η C).The concrete condition of step S10 will describe later.
Then, as shown in step S20, blood vessel diameter d and blood flow rate v is measured.About assay method, aforesaid mensuration ultrasonic reflections is used to measure the method for blood vessel diameter d the time of advent or measured the method for blood flow rate v by Doppler method.
Then, as shown in step S30, the proportionality constant obtained by the correction routine of step S10 is used to calculate blood pressure P.Same place, phase blood vessel diameter d in the same time and the time variations of blood flow rate v can also be obtained, calculate the time variations of blood pressure P.
Then, as shown in step S40, display of blood pressure P on display part 34.In addition, on display part 34, visual display can also be carried out to blood pressure P with curve chart etc.In addition, also can show equally for pulse.
Then, as shown in step S50, judge whether to need again to correct.If needed, return step 10 and correct.If do not needed, enter step S60.Situation about correcting is needed such as to refer to that blood pressure changes compared with usually ± situation of more than 15mmHg.Now, display part 34 shows the instruction again corrected.
Then, as shown in step S60, judge whether to need to continue to measure.If needed, return step 20 and measure blood vessel diameter d and blood flow rate v.If do not needed, end process.Thus, only need to obtain correction coefficient according to the initial pressure value using cuff type sphygomanometer to measure, just can carry out high-precision blood pressure determination when not using cuff type sphygomanometer afterwards, when person to be measured carries out blood pressure determination all the time in acting on one's own, can correct simply without the need to using cuff type sphygomanometer.
Figure 10 is the figure of the correction routine that present embodiment is shown.
Figure 10 illustrates the flow process of the details of the correction routine representing step S10.The process of head pressure conversion method (a) is as follows.First, as shown in step S110, while the blood vessel diameter d of the height H position of survey map 4, calculate average blood vessel diameter dm1.Measure the vessel diameter change of about 10 seconds.
Then, as shown in step S120, wrist is moved to the position of height L.Measure the difference of height h between height H now and the position of L.In addition, the high-precision baroceptor 36 (with reference to Fig. 3) etc. of height and position sensor part also can be used as to carry out high computational.Thereby, it is possible to easily measure the difference of height as key element when obtaining head pressure.
Then, as shown in step S130, calculated water head pressure (ρ gh).
Then, as shown in step s 140, while mensuration blood vessel diameter d and blood flow rate v, average blood vessel diameter dm2 is obtained.
Then, as shown in step S150, the average blood vessel diameter changes delta dm (=dm1-dm2) of the position of computed altitude H and L.
Then, as shown in step S160, the blood pressure difference (Psys-Pdia) between blood pressure Pdia and systolic blood pressure Psys expansionary phase is calculated.As average shrinkage phase blood vessel diameter dmsys1 and average blood vessel diameter dmdia1 expansionary phase of the height H position of use Fig. 4, formula (9) is out of shape, according to formula (21), calculate the blood pressure difference (Psys-Pdia) between blood pressure Pdia and systolic blood pressure Psys expansionary phase.
Psys-Pdia＝ρ·g·h·(dmsys1-dmdia1)/Δdm...(21)
In addition, now, the expansionary phase calculated, the blood pressure difference (Prsys-Prdia) between actual blood pressure Prdia and systole actual blood pressure Prsys equaled the blood pressure difference (Psys-Pdia) between blood pressure Pdia and systolic blood pressure Psys expansionary phase.
Then, as shown in step S170, proportionality constant (π/8 η C) is calculated by following formula.Through type (20), calculates proportionality constant (π/8 η C).In addition, now, the expansionary phase calculated, the blood pressure difference (Psys-Pdia) between blood pressure Pdia and systolic blood pressure Psys equaled the blood pressure difference (Prsys-Prdia) between actual blood pressure Prdia and systole actual blood pressure Prsys expansionary phase.In addition, the relation between head pressure and vessel diameter change is constant, therefore, it is possible to when without the blood pressure difference (Psys-Pdia) calculated when cuff pressure between blood pressure Pdia and systolic blood pressure Psys expansionary phase.Thereby, it is possible to easily correct proportionality constant.
Blood pressure measurement apparatus according to the present embodiment and blood pressure measuring method, when not using cuff simply and in time correct, can measure blood pressure P accurately.Further, can provide thus wearable can continue to carry out measuring blood pressure measurement apparatus and blood pressure measuring method.
Claims (5)
1. a blood pressure measurement apparatus, this blood pressure measurement apparatus measures the blood pressure of the blood vessel of person to be measured, and it is characterized in that, this blood pressure measurement apparatus has:
Blood flow rate sensor part, it sends relative to the blood of the blood vessel of described person to be measured and receives fluctuation, detects the blood flow of the blood vessel of described person to be measured;
Blood flow rate sensor probe, it drives described blood flow rate sensor part;
Blood flow rate sensor signal operational part, it controls described blood flow rate sensor probe and described blood flow rate sensor part, under the 1st state that the predetermined position of described person to be measured is located in predetermined altitude, obtain the blood flow rate of described blood vessel;
Blood vessel diameter sensor part, it sends relative to described blood vessel and receives ultrasound wave, and the reflection detecting the blood vessel wall of described blood vessel arrives time difference;
Blood vessel diameter sensor probe, it drives described blood vessel diameter sensor part;
Blood vessel diameter sensor signal operational part, it controls described blood vessel diameter sensor probe and described blood vessel diameter sensor part, under described 1st state, obtains the blood vessel diameter of the described blood vessel of described predetermined position; And
Blood pressure signal operational part, the described blood vessel diameter that its described blood flow rate utilizing described blood flow rate sensor signal operational part to obtain under described 1st state, described blood vessel diameter sensor signal operational part are obtained under described 1st state and predetermined proportionality constant obtain the blood pressure of the blood vessel of described person to be measured, wherein, described predetermined proportionality constant is for the proportionality constant of the described blood flow rate obtained under described 1st state divided by square value obtained of the described blood vessel diameter obtained under described 1st state.
2. blood pressure measurement apparatus according to claim 1, is characterized in that,
Described blood pressure signal operational part performs following computing: obtain described blood pressure by the blood vessel diameter of described blood vessel is scaled head pressure,
This blood pressure measurement apparatus also comprises height and position sensor part, under the 1st state that described predetermined position is located in predetermined altitude, this height and position sensor part obtains the difference of height of the described predetermined position between the 2nd state that described 1st state and described predetermined position be located in the heart height of described person to be measured
Utilize the described difference of height measured by described height and position sensor part, obtain the described head pressure between described 1st state and described 2nd state,
Under described 2nd state, described blood vessel diameter sensor signal operational part measures the blood vessel diameter of described predetermined position and the systole of described predetermined position and the blood vessel diameter of expansionary phase respectively, obtain the 1st average blood vessel diameter, average shrinkage phase blood vessel diameter and mean dilation phase blood vessel diameter
Under described 1st state, described blood flow rate sensor signal operational part measures the blood vessel diameter of described predetermined position and the systole of described predetermined position and the blood flow rate of expansionary phase and blood vessel diameter respectively, obtain the 2nd average blood vessel diameter, systolic blood Flow Velocity, systole blood vessel diameter, expansionary phase blood flow rate and expansionary phase blood vessel diameter
Described 1st average blood vessel diameter and described 2nd average blood vessel diameter is utilized to obtain average blood vessel diameter change,
Utilize that described head pressure, described average blood vessel diameter change, described average shrinkage phase blood vessel diameter and described mean dilation phase blood vessel diameter, obtain the blood pressure difference between systolic blood pressure and expansionary phase blood pressure,
Utilize described blood pressure difference, described systolic blood Flow Velocity, described systole blood vessel diameter, described expansionary phase blood flow rate and described expansionary phase blood vessel diameter, obtain described proportionality constant.
3. blood pressure measurement apparatus according to claim 1 and 2, is characterized in that,
Described blood flow rate sensor part is formed with element and reception element by sending, and described transmission element and described reception element is multipair to existing, the direct of travel of fluctuation sending and receive and the flow direction angulation of the blood of described blood vessel for each to different.
4. blood pressure measurement apparatus according to claim 1 and 2, is characterized in that,
Described blood flow rate sensor part utilizes piezoelectric element to form.
5. blood pressure measurement apparatus according to claim 3, is characterized in that,
Described blood flow rate sensor part utilizes piezoelectric element to form.
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| JP5927889B2 (en) * | 2011-12-14 | 2016-06-01 | セイコーエプソン株式会社 | Blood pressure measurement device and blood pressure measurement method |
| JP6028897B2 (en) * | 2012-04-18 | 2016-11-24 | セイコーエプソン株式会社 | Blood pressure measurement device and blood pressure estimation parameter calibration method |
| JP6028898B2 (en) * | 2012-04-18 | 2016-11-24 | セイコーエプソン株式会社 | Blood pressure measurement device, blood pressure estimation parameter calibration method, and blood pressure measurement method |
| JP6019854B2 (en) * | 2012-07-13 | 2016-11-02 | セイコーエプソン株式会社 | Blood pressure measuring device and parameter correction method for central blood pressure estimation |
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