CN102488525B - Hepatic functional reserve detector capable of removing blood oxygen fluctuation interference - Google Patents

Abstract

The invention relates to a hepatic functional reserve detector capable of removing blood oxygen fluctuation interference. The hepatic functional reserve detector consists of a photoelectric finger clip sensor, a data memory, a liquid crystal display module, a light source driving circuit, a microprocessor, a signal separating circuit, a signal amplifying circuit, an A/D (analog/digital) conversion circuit, a wireless communication module and a computer, the photoelectric finger clip sensor is respectively connected with the data memory and the liquid crystal display module via the light source driving circuit and the microprocessor, the photoelectric finger clip sensor is connected with the microprocessor via the signal separating circuit, the signal amplifying circuit and the A/D conversion circuit, the microprocessor is connected with the wireless communication module, and the computer is connected with the wireless communication module via Bluetooth. A concentration spectrum of indocyanine green (ICG) pigment used as indicator is separated from a blood oxygen absorbing spectrum, inference of low blood oxygen and blood oxygen fluctuation to pigment concentration measurement is suppressed, a diluted concentration curve of the ICG pigment injected via a vein is accurately measured, the purpose of non-invasively and continuously measuring cardiovascular and hepatic haemodynamics parameters such as pigment blood plasma disappearance rate K, 15-minute detaining rate R15 and the like is achieved, surgery risks can be accurately predicted by means of detecting hepatic functional reserve, a proper therapy mode is selected, and operative mortality and postoperative complications can be effectively reduced.

Description

The hepatic functional reserve checkout gear that a kind of oxygen fluctuation of dehematizing is disturbed

Technical field:

The present invention relates to a kind of pigment detecting for hepatic functional reserve dilution and excretion test method and checkout gear based on pulse spectrophotometric principle.By blood oxygen absorption spectrum and pigment concentration spectrum are carried out to separating treatment, suppress low blood oxygen and the interference of blood oxygen fluctuation to pigment measurement of concetration, the Measurement accuracy of the diluted concentration curve of indocyanine green pigment is injected in realization to vein, reach noinvasive and continuous measurement pigment blood plasma disappearance rate K and 15 minutes retention rate R ₁₅object Deng cardiovascular and liver blood flow kinetic parameter.

Background technology:

Hepatopathy is the mankind's important diseases that is global distribution, the existing hepatopath 3.5 hundred million in the whole world, and the number of dying from every year hepatopathy surpasses 1,000,000.Liver reserve function refers to the summation of hepatocyte maximum function, directly reflects the size of liver function potentiality.On clinical medicine, by checking liver reserve function level, the risk of Accurate Prediction operation, selects suitable therapeutic modality, can effectively reduce the generation of operation case fatality rate and post-operative complication.

Current, to adopt indocyanine green ICG (Indocyanine Green) indicator to carry out concentration dilution and excretion test pigment concentration measuring method is the liver reserve function detection technique means that domestic and international clinical medicine generally adopts.ICG can be combined with plasma protein rapidly after vein injects blood, with tremulous pulse blood system cloth whole body, only by hepatocyte, absorbed and drain to bile, its concentration in blood is exponential law and declines, the slope of downward trend is blood plasma disappearance rate K (/min), it represents the speed of the ICG concentration minimizing per minute in blood, 15 minutes retention rate R ₁₅represent that ICG administration is after 15 minutes, the residual ratio of ICG in blood, both are contrary relation, all reflect the foreign body discharge capacity of liver.The spectral absorption peak of ICG indicator is at 805nm wavelength.Owing to not absorbed by the outer organ of other livers such as kidney, by measuring the pigment concentration of ICG in arterial blood, change, just can carry out ICG blood plasma disappearance rate K and 15 minutes retention rate R ₁₅etc. the detection of liver function parameter, and then assessment liver reserve function.

CN87107376 discloses a kind of " liver function testing apparatus ", by vein, pigment is injected to human body, by liver, it is absorbed and is drained, utilize the light source irradiating biological tissue of two kinds of specific wavelengths, wherein the utilizing emitted light of light source is by a pigment absorption, and another kind is not absorbed.Transillumination pulse is received by photelectric receiver, and is converted to digital signal and carries out sampling processing.According to the absorbance variable quantity in sampled data, obtain the measurement parameter corresponding with pigment concentration in blood, finally try to achieve pigment blood plasma disappearance rate and retention rate.Although this device has been realized the continuous measurement of pigment concentration, do not consider that in blood, hemoglobin composition changes, that is the impact of blood oxygen fluctuation on pigment measurement of concetration, so accuracy and reliability that liver function detects are limited.

Method that CN1991367 discloses a kind of " liver function test ", coloured fluorescence bile acid derivative of doses is injected in patient body by vein, after being absorbed by liver, by certain hour interval, gather the blood sample that comprises this bile acid derivative, (spectrophotometry is while having two kinds of different extinction materials in blood to carry out spectrophotometry, by obtaining transillumination with two different wavelength illumination tissues, pulse, obtain two extinction material concentration ratios in blood), object is to measure color or the fluorescence intensity of bile acid derivative in blood plasma, obtain plasma clearance curve, thereby calculate blood plasma disappearance rate parameter.Although the method can realize the measurement of this liver function parameter of blood plasma disappearance rate, as a kind of non-continuous method that has wound, actual mechanical process is complicated, precision is wayward, is difficult to be used widely at clinical medicine.

CN1047571 discloses a kind of " liver function testing apparatus ", use the light-pulse generator of dual wavelength and special dye indicator, when patient is irradiated by the second light timesharing of the absorbable the first light of dyestuff and nonabsorable, transillumination pulse converts two paths of signals to through photoelectric apparatus, and detect flutter component wherein by pulsation detecting device, deliver to arithmetic element, calculate blood plasma dissipation rate and be detained speed.Although this instrument has been realized the liver functional test of non-blood sampling, but in the calculating of liver functional test, only considered the ripple component of transillumination, do not comprise the flip-flop that human body skin and muscular tissue absorb, also do not consider oxygenate and the impact of deoxidation reaction on absorbance that in arterial blood, hemoglobin occurs, so there is Systematic Errors in measurement result.

In prior art, still the concentration spectrum of the ICG pigment as indicator is not carried out to separating treatment with blood oxygen absorption spectrum, under the disturbed condition of low blood oxygen and the fluctuation of blood oxygen, the noinvasive of realizing liver reserve function injures the photoelectricity pulse pigment density method of continuous detecting.

Summary of the invention:

The object of the invention is the deficiency for existing liver function detection technique, provide a kind of under the disturbed condition of low blood oxygen and the fluctuation of blood oxygen, the concentration spectrum of the dilution of ICG pigment and excretion test is carried out to separating treatment with blood oxygen absorption spectrum, complete the photoelectricity pulse pigment density method without wound continuous detecting of liver reserve function, and realize the hepatic functional reserve checkout gear that the useful clinically oxygen fluctuation of dehematizing is disturbed.

The object of the invention is to be achieved through the following technical solutions:

Photoelectricity refers to press from both sides sensor and under the driving of light source driving circuit, exports measurement incident illumination, by receptor, receive optical signal transmissive, through demultiplexing circuit, signal amplification circuit, A/D conversion, send into microprocessor processes and store, by wireless telecommunications, pulse wave data being sent to host computer; Host computer carries out the pulse wave signal receiving final analyzing and processing and calculates relevant hepatic functional reserve parameter.

The hepatic functional reserve checkout gear that a kind of oxygen fluctuation of dehematizing is disturbed, by photoelectricity, to refer to press from both sides sensor be connected with LCD MODULE with data storage respectively with microprocessor through light source driving circuit, photoelectricity refers to press from both sides sensor and is connected with microprocessor through demultiplexing circuit, signal amplification circuit and A/D change-over circuit, microprocessor is connected with wireless communication module, and computer connects and composes by bluetooth and wireless communication module.

Signal amplification circuit is through split circuit, to connect respectively three filter circuit I by pre-amplification circuit, and three filter circuit I connect respectively three main amplifying circuits, and three main amplifying circuits connect respectively three filter circuit II and form.

Demultiplexing circuit is to be connected and composed through second order active high-pass filter, gain adjustable amplifier, four-order active low pass filter and lifting circuit and negative circuit by input signal.

The hepatic functional reserve checkout gear that the oxygen of dehematizing fluctuation is disturbed, the analysis of host computer comprises following order and step:

A, beginning → display interface;

B, driving bluetooth connect, and connect unsuccessful returning, and reconnect;

C, the storage of successful connection → reception data → receive → data;

D, be written into data;

E, calculating liver deposit parameter and waveform show;

F, whether exit or be again written into new data;

G, exit.

Host computer is the relation curve in 940nm wavelength points according to the specific absorbance of Hb H b and blood oxygen saturation

(S) revise the measurement result of pigment concentration, realize the separated of blood oxygen absorption spectrum and ICG pigment concentration spectrum, remove the interference of blood oxygen fluctuation to pigment measurement of concetration.

Host computer is by the ICG pigment concentration C recording _ifrom Oximetry, reject, eliminate pigment and inject and the residual impact on Oximetry of pigment.

The present invention is different from the ICG excretion test method that spectrophotometric colorimetric measurement is carried out in blood sampling, it is the pigment concentration method based on pulse spectrophotometric principle, traditional pulse pigment concentration etection theory is to suppose that the condition of blood oxygen saturation SpO2=100% is basic, but clinical, low blood oxygen and the fluctuation of blood oxygen have changed the specific absorbance of Hb H b, cause chromogenesis measurement of concetration error, and blood oxygen levels is lower, this error is larger; The pulse spectrophotometric principle the present invention is based on, by ICG concentration spectrum is carried out to separated method with pulse blood oxygen absorption spectrum, disclose the specific absorbance of Hb H b and the dependency rule of blood oxygen saturation, solve the fluctuation of blood oxygen to mutual interference problem between the measurement of ICG pigment concentration, and realize on this basis blood plasma disappearance rate K and 15 minutes retention rate R ₁₅deng liver blood flow kinetic parameter without wound continuous measurement.

Photoelectricity refers to press from both sides sensor for measuring the pulse wave signal of human body; Light source driving circuit presss from both sides the measurement incident illumination of three wavelength of sensor emitter for driving photoelectricity to refer to, produce measurement light source; Microprocessor is used for controlling other modules, and pulse wave signal is sampled, and data are stored and output to liquid crystal display, and by wireless telecommunications, pulse wave data is sent to host computer; Demultiplexing circuit, the transillumination AC and DC mixed signal that is mainly used in receptor to receive is carried out separation, and AC signal AC is separated separately, to facilitate, calculates absorbance ratio φ; Signal amplification circuit is for separated by three wavelength transilluminations that receive, and faint pulse wave signal is carried out to filtering and amplification, to offer A/D converter, carry out analog digital conversion, digital quantity after conversion is carried out next step analyzing and processing and storage by microprocessor, and by wireless telecommunications, pulse wave data is sent to host computer; Upper computer software is for the calculating to hepatic functional reserve parameter after the pulse wave signal receiving is carried out to final analyzing and processing.

Beneficial effect: the present invention carries out separating treatment by blood oxygen absorption spectrum and pigment concentration spectrum, suppress low blood oxygen and the interference of blood oxygen fluctuation to pigment measurement of concetration, the Measurement accuracy of the diluted concentration curve of ICG pigment is injected in realization to vein, reach noinvasive and continuous measurement pigment blood plasma disappearance rate K and 15 minutes retention rate R ₁₅deng the object of cardiovascular and liver blood flow kinetic parameter, in clinical medicine application, by checking liver reserve function level, the risk of Accurate Prediction operation, selects suitable therapeutic modality, can effectively reduce the generation of operation case fatality rate and post-operative complication.

Accompanying drawing explanation:

The hepatic functional reserve structure of the detecting device block diagram that a kind of oxygen fluctuation of dehematizing of Fig. 1 is disturbed;

Signal amplification circuit structured flowchart in Fig. 2 accompanying drawing 1;

Demultiplexing circuit structured flowchart in Fig. 3 accompanying drawing 1;

Fig. 4 is upper computer software flow chart;

Fig. 5 carries out ICG concentration spectrum and blood oxygen absorption spectrum the flow chart of separating treatment;

Fig. 6 HbO2 Oxyhemoglobin O ₂the curve of spectrum of Hb, reduced hemoglobin RHb and ICG pigment;

Fig. 7 is dilution and the excretion cyclic curve of ICG pigment;

Fig. 8 is the 940nm wavelength of AC and DC separation front and back and the AC and DC signal waveform of 805nm wavelength;

Fig. 9 is O ₂hb, RHb and ICG are measuring the specific absorbance of wavelength;

The specific embodiment:

Below in conjunction with drawings and Examples, be described in further detail.

The liver reserve function checkout gear that anti-blood oxygen fluctuation is disturbed refers to press from both sides sensor, light source driving circuit, microprocessor, demultiplexing circuit, signal amplification circuit, A/D change-over circuit, upper computer software and wireless telecommunications, data storage and LCD MODULE by photoelectricity and forms, as shown in Figure 1.Photoelectricity refers to press from both sides sensor for measuring the pulse wave signal of human body; Light source driving circuit presss from both sides the incident illumination of three wavelength of sensor emitter for driving photoelectricity to refer to, produce measurement light source; Microprocessor is used for controlling other modules, and signal is sampled and processed, and data are stored and output to liquid crystal display, and by wireless telecommunications, pulse wave data is sent to host computer; Demultiplexing circuit, the AC and DC mixed signal in the transillumination that is mainly used in receptor to receive is carried out separation, and AC signal AC is separated separately, to facilitate, calculates absorbance ratio φ; Signal amplification circuit is for separated by three wavelength transilluminations that receive, and faint pulse wave signal is carried out to filtering and amplification, to offer A/D converter, carry out analog digital conversion, digital quantity after conversion is carried out next step analyzing and processing and storage by microprocessor, and by wireless telecommunications, pulse wave data is sent to host computer; Upper computer software is for the calculating to hepatic functional reserve parameter after the pulse wave signal receiving is carried out to final analyzing and processing.

Photoelectricity refers to press from both sides sensor design and becomes integral structure form transmission-type, that consist of emitter and receptor.Wherein, emitter comprises that centre wavelength is respectively three LEDs of 660nm, 805nm and 940nm, and they share a photocell receptor.Pulse wave sensor is under the control of microprocessor, by light source driving circuit timesharing, exported the measurement incident illumination of above-mentioned three wavelength, at the finger other end, by photocell, in each pulse cycle, receive optical signal transmissive, the optical signal transmissive that photocell receives is herein to hand over, the signal that direct current mixes, calculate for convenience absorbance ratio φ, this device carried out the separation of alternating current-direct current signal to it before optical signal transmissive carries out analog digital conversion, AC signal AC is separated separately, small-signal after alternating current-direct current separation more after filtering and amplify, A/D converter carries out analog digital conversion to it, digital quantity after conversion is carried out next step analyzing and processing and storage by microprocessor, and by wireless telecommunications, pulse wave data are sent to host computer.

Microprocessor is the core of whole device, controls light source driving circuit, demultiplexing circuit, signal amplification circuit, A/D change-over circuit and wireless blue tooth, data storage and LCD MODULE.Wherein demultiplexing circuit as shown in Figure 6, for the transillumination AC and DC mixed signal that receptor is received, carry out separation, signal is after second order active high-pass filter, gain adjustable amplifier, four-order active low pass filter, lifting circuit and negater circuit, AC signal AC is separated separately, and separating effect as shown in Figure 7.Signal amplification circuit shown in Fig. 5 comprises the optical signal transmissive difference processing and amplifying of three signalling channel: 660nm, 805nm and tri-wavelength of 940nm.Photoelectricity refers to press from both sides signal that the receptor of sensor receives through pre-amplification circuit and split circuit, and the optical signal transmissive of three wavelength is circuit I, main amplifying circuit and filter circuit II after filtering respectively, completes the filtering of faint pulse wave signal and amplification.Data memory module adopts large capacity SD memorizer, and capacity can reach 8G, signal that can a plurality of patients of Coutinuous store; Wireless communication module adopts the wireless blue tooth technology of low-power consumption, two-forty, pulse wave signal is transferred to the calculating that host computer carries out analyzing and processing and hepatic functional reserve parameter under the control of microprocessor.

The analysis software of host computer is by MATLAB platform development, and software is by bluetooth, to connect microprocessor by user command, and software flow pattern as shown in Figure 4.

This software comprises following processing sequence and step:

A, beginning → display interface;

B, driving bluetooth connect, and connect unsuccessful returning, and reconnect;

C, the storage of successful connection → reception data → receive → data;

D, be written into data;

E, calculating liver deposit parameter and waveform show;

F, whether exit or be again written into new data;

G, exit;

Pulse spectrophotometric principles:

Photoelectricity pulse pigment concentration spectrum (comprises HbO2 Oxyhemoglobin O with the Hb H b in arterial blood ₂hb and reduced hemoglobin RHb) and ICG pigment be measuring object, Fig. 2 is the spectral pattern of these several materials.In 3 characteristic absorption wavelength shown in drop wire, 805nm is the absworption peak wavelength of ICG in the drawings, is also O simultaneously ₂the isoabsorptive point of Hb and RHb; And on 940nm wavelength, the specific absorbance of ICG is zero.From operation principle, analyze, existing pulse pigment concentration measuring method, is to select 805nm and two wavelength points of 940nm, and 805nm is considered as to O ₂the isoabsorptive point of Hb and RHb, to suppose blood oxygen saturation S _po ₂=100% is that realize on basis.In fact, when blood oxygen is on the low side or fluctuation occurs, existing pulse pigment concentration measuring method will produce principle measurement error, and blood oxygen saturation is lower, and the measurement of concetration error of ICG is just larger.In addition, pigment injection and pigment are residual, also have influence on the accuracy of reading of blood oxygen saturation.

The theoretical basis of photoelectricity pulse pigment concentration method is the spectrophotometry principle based on Lambert-Beer's law (Lamber-Bill ' s Law).When a branch of directional light is during from finger or the incident of the easy printing opacity of the human body position such as the wing of nose, it is simultaneously by pulsation blood, and the tissue such as fat, muscle absorbs, but the light intensity form of the two transillumination is different: the light intensity that pulsation arterial blood absorbs, variation with arterial pulse changes, and is called alternating component AC; And the light intensity that tissue absorbs does not change with pulse, keep stable, be called flip-flop DC.While only having two kinds of extinction materials to exist, utilize two different wave length λ in blood ₁and λ ₂light source irradiate, obtain the ratio psi of the pulsating quantity of transillumination, as formula (1) definition, just can calculate the concentration ratio of these two kinds of extinction materials in the blood of pulsing.Like this, a kind of concentration of material is under known condition therein, just can calculate the concentration of another material.

${\mathrm{\φ}}_{{\mathrm{\λ}}_1,{\mathrm{\λ}}_2}\≡\frac{{\mathrm{AC}}_{{\mathrm{\λ}}_1}/{\mathrm{DC}}_{{\mathrm{\λ}}_1}}{{\mathrm{AC}}_{{\mathrm{\λ}}_2}/{\mathrm{DC}}_{{\mathrm{\λ}}_2}}---\left(1\right)$

According to Lambert-Beer's law, when intensity is I ₀, the wavelength directional light that is λ is by after uniform dielectric, transmitted intensity is I, has

$A^{\mathrm{\λ}}\≡\log \frac{I_0}{I}{=\mathrm{\ϵ}}_{\mathrm{\λ}}\mathrm{CD}---\left(2\right)$

In formula, A ^λbe defined as absorbance, ε _λfor specific absorbance, the thickness that D is uniform dielectric, C is its concentration.

When arterial blood is beaten with pulse, when thickness increases Δ D, transmitted light intensity is reduced to I-Δ I, and the variable quantity of absorbance is

$\mathrm{\Δ}{A}^{\mathrm{\λ}}\≡\log \frac{I}{I-\mathrm{\ΔI}}={\mathrm{\ϵ}}_{\mathrm{\λ}}\mathrm{C\ΔD}---\left(3\right)$

In the conductive process of light, if there is scattering, will cause energy loss.By absorbance variation delta A in above formula ^λintroducing, can make the dissipation of incident intensity and transmitted light intensity occur simultaneously, that is by the calculating to the composition of beating of extinction material, significantly improve certainty of measurement.

In formula (3), the percentage ratio that accounts for flip-flop due to alternating component in transillumination is much smaller than 1, and this formula can be rewritten as

$\mathrm{\Δ}{A}^{\mathrm{\λ}}\≈\frac{\mathrm{\ΔI}}{I}={\mathrm{\ϵ}}_{\mathrm{\λ}}\mathrm{C\ΔD}---\left(4\right)$

After injecting ICG pigment, pigment concentration spectral measurement system utilizes near infrared band centre wavelength for the LED light source of 805nm and 940nm by finger-clipped photoelectric sensor, to the ICG pigment in arterial blood and these two kinds of extinction materials of Hb H b, carry out continuous absorbance measuring.

At wavelength X point, the specific absorbance of Hb H b can be expressed as

${\mathrm{\ϵ}}_{\mathrm{Hb}}^{\mathrm{\λ}}={\mathrm{S\ϵ}}_O^{\mathrm{\λ}}+(1-S){\mathrm{\ϵ}}_R^{\mathrm{\λ}}---\left(5\right)$

In formula,

with

represent respectively Hb H b, HbO2 Oxyhemoglobin O ₂hb and reduced hemoglobin RHb are at the specific absorbance of λ wavelength points, and S is blood oxygen saturation SpO ₂abbreviation.

From Fig. 2, see, 805nm wavelength is HbO2 Oxyhemoglobin O ₂the isoabsorptive point of Hb and reduced hemoglobin RHb,

${\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="805"\; label="O"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">O</figure-callout>}}^{805}={\mathrm{\&epsiv;}}_R^{805}---\left(6\right)$

The specific absorbance of Hb H b can be expressed as

${\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="805"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{805}={\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="805"\; label="O"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">O</figure-callout>}}^{805}={\mathrm{\&epsiv;}}_R^{805}---\left(7\right)$

Its value is not subject to blood oxygen variable effect.

But at 940nm wavelength,

${\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="940"\; label="O"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">O</figure-callout>}}^{940}\&NotEqual;{\mathrm{\&epsiv;}}_R^{940}---\left(8\right)$

with

having definite numerical value, is constant,

can be expressed as

${\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="940"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{940}=S{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="940"\; label="O"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">O</figure-callout>}}^{940}+(1-S){\mathrm{\&epsiv;}}_R^{940}---\left(9\right)$

Its value changes with the variation of blood oxygen levels.

ICG pigment concentration C _icomputing formula as follows

${\mathrm{\&phi;}}_{\mathrm{805,940}}\&equiv;\frac{\mathrm{\&Delta;}{A}^{805}}{\mathrm{\&Delta;}{A}^{940}}=\frac{{\mathrm{\&epsiv;}}_I^{805}\&CenterDot;C_I+{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="805"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{805}\&CenterDot;C_{\mathrm{Hb}}}{{\mathrm{\&epsiv;}}_I^{940}\&CenterDot;C_I+{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="940"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{940}\&CenterDot;C_{\mathrm{Hb}}}$

(10)

$=\frac{{\mathrm{\&epsiv;}}_I^{805}\&CenterDot;C_I+{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="805"\; label="O"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">O</figure-callout>}}^{805}\&CenterDot;C_{\mathrm{Hb}}}{{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="940"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{940}\&CenterDot;C_{\mathrm{Hb}}}$

In formula,

be ICG at the specific absorbance of 805nm wavelength, at 940nm wavelength,

According to formula above, before ICG injects, by peripheral blood, record the concentration C of Hb H b _hb, just can measurements and calculations obtain the concentration C of ICG _i, then calculate hepatic functional reserve parameter by measuring dilution and the excretion cyclic curve of ICG pigment.The dilution of ICG pigment and excretion cyclic curve are as shown in Figure 3.The foundation of the dependency mathematical model of Hb H b specific absorbance and blood oxygen saturation

By HbO2 Oxyhemoglobin O in Fig. 2 ₂the absorption spectrum of Hb, reduced hemoglobin RHb and ICG pigment, the specific absorbance value at characteristic wavelength point mark provides in table 1.

By gathering arterial blood label taking originally, through 1000RPM, after centrifugal 10 minutes, get blood plasma, with spectrophotometer, in 940nm wavelength points, measure the absorbance of this specimen.By ways of oxygen inhalation, change blood oxygen levels, with standard oximeter monitoring blood oxygen reading, set up as formula (9) expression simultaneously

relation curve with blood oxygen saturation S.The isolation technics of ICG pigment concentration spectrum and blood oxygen absorption spectrum

Set up the specific absorbance of Hb H b and blood oxygen saturation at the relation curve of 940nm wavelength points

when there is low blood oxygen or the fluctuation of blood oxygen, it affects direct reaction and exists

in, revise accordingly the measurement result of pigment concentration, realize the separated of ICG pigment concentration spectrum and blood oxygen absorption spectrum, separating treatment flow process is as shown in Figure 8.

Revise forward and backward computing formula as follows:

Before correction:

${{\mathrm{\&Phi;}}_{805/940}}^{,}\&equiv;\frac{{\mathrm{\&Delta;A}}^{805}}{{\mathrm{\&Delta;A}}^{940}}=\frac{{\mathrm{\&epsiv;}}_I^{805}\&CenterDot;C_I+{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="805"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{805}\&CenterDot;C_{\mathrm{Hb}}}{{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="940"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{940}\&CenterDot;C_{\mathrm{Hb}}}$

(11)

$=\frac{{\mathrm{\&epsiv;}}_I^{805}\&CenterDot;C_I+{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="805"\; label="O"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">O</figure-callout>}}^{805}\&CenterDot;C_{\mathrm{Hb}}}{{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="940"\; label="O"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">O</figure-callout>}}^{940}\&CenterDot;C_{\mathrm{Hb}}}$

After correction:

${\mathrm{\&Phi;}}_{805/940}\&equiv;\frac{{\mathrm{\&Delta;A}}^{805}}{{\mathrm{\&Delta;A}}^{940}}=\frac{{\mathrm{\&epsiv;}}_I^{805}\&CenterDot;C_I+{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="805"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{805}\&CenterDot;C_{\mathrm{Hb}}}{{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="940"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{940}\&CenterDot;C_{\mathrm{Hb}}}$

(12)

$=\frac{{\mathrm{\&epsiv;}}_I^{805}\&CenterDot;C_I+{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="805"\; label="O"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">O</figure-callout>}}^{805}\&CenterDot;C_{\mathrm{Hb}}}{{\mathrm{\&epsiv;}}_{\mathrm{Hb}}^{940}\left(S\right)\&CenterDot;C_{\mathrm{Hb}}}$

ICG pigment injects and the residual correction technique that absorbance is disturbed of pigment

Before pigment injects, utilize infrared LED that red-light LED that wavelength is 660nm and wavelength are 940nm as measurement light source, have

$\mathrm{\&Delta;}{A}_{\mathrm{<figure-callout\; id="660"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{660}\&equiv;\log \frac{I_{\mathrm{Hb}}^{660}}{I_{\mathrm{Hb}}^{660}-{\mathrm{\&Delta;<figure-callout\; id="660"\; label="I\; Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">I</figure-callout>}}_{\mathrm{Hb}}^{}}={\mathrm{\&epsiv;}}_{\mathrm{Hb}}^{660}{C}_{\mathrm{Hb}}\mathrm{\&Delta;D}---\left(13\right)$

$\mathrm{\&Delta;}{A}_{\mathrm{<figure-callout\; id="940"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{940}\&equiv;\log \frac{I_{\mathrm{Hb}}^{940}}{I_{\mathrm{Hb}}^{940}-{\mathrm{\&Delta;<figure-callout\; id="940"\; label="I\; Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">I</figure-callout>}}_{\mathrm{Hb}}^{}}={\mathrm{\&epsiv;}}_{\mathrm{Hb}}^{940}{C}_{\mathrm{Hb}}\mathrm{\&Delta;D}---\left(14\right)$

In formula, C _hbthe concentration of hemoglobin,

with

that it is at the specific absorbance of 660nm and 940nm.Further have

$\mathrm{\&Delta;}{A}_{\mathrm{<figure-callout\; id="660"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{660}\&ap;\frac{{\mathrm{\&Delta;I}}_{\mathrm{Hb}}^{660}}{{\mathrm{<figure-callout\; id="660"\; label="I\; Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">I</figure-callout>}}_{\mathrm{Hb}}^{}}={\mathrm{\&epsiv;}}_{\mathrm{Hb}}^{660}{C}_{\mathrm{Hb}}\mathrm{\&Delta;D}---\left(15\right)$

$\mathrm{\&Delta;}{A}_{\mathrm{<figure-callout\; id="940"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{940}\&ap;\frac{{\mathrm{\&Delta;I}}_{\mathrm{Hb}}^{940}}{{\mathrm{<figure-callout\; id="940"\; label="I\; Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">I</figure-callout>}}_{\mathrm{Hb}}^{}}={\mathrm{\&epsiv;}}_{\mathrm{Hb}}^{940}{C}_{\mathrm{Hb}}\mathrm{\&Delta;D}---\left(16\right)$

${\mathrm{\&Phi;}}_{660/940}\&equiv;\frac{{\mathrm{\&Delta;A}}_{\mathrm{<figure-callout\; id="660"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{660}}{{\mathrm{\&Delta;A}}_{\mathrm{<figure-callout\; id="940"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{940}}=\frac{{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="660"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{660}}{{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="940"\; label="Hb"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">Hb</figure-callout>}}^{940}}$

(17)

$=\frac{S{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="660"\; label="O"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">O</figure-callout>}}^{660}+(1-S){\mathrm{\&epsiv;}}_R^{660}}{S{\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="940"\; label="O"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">O</figure-callout>}}^{940}+(1-S){\mathrm{\&epsiv;}}_{\mathrm{<figure-callout\; id="940"\; label="R"\; filenames="HDA0000119718010000061.png"\; state="\{\{state\}\}">R</figure-callout>}}^{940}}$

In formula,

with

hbO2 Oxyhemoglobin O ₂hb is at the specific absorbance of 660nm and 940nm,

with

that reduced hemoglobin RHb is at the specific absorbance of 660nm and 940nm.According to Φ _660/940, can calculate blood oxygen saturation.

Pigment injects and when residual, the reduction reaction that pulse blood oxygen is measured pigment absorption as hemoglobin is treated, and causes the reduction of blood oxygen reading.As shown in the formula

In formula

for HbO2 Oxyhemoglobin O ₂the concentration of Hb, C _rHbfor the concentration of reduced hemoglobin RHb, as long as by the pigment concentration C recording _ifrom above formula, deduct, can eliminate pigment and inject and the residual impact of pigment.

Claims (1)

1. the hepatic functional reserve checkout gear that the oxygen fluctuation of dehematizing is disturbed, it is characterized in that, described device comprises that photoelectricity refers to press from both sides sensor, light source driving circuit, microprocessor, data memory module, LCD MODULE, demultiplexing circuit, signal amplification circuit, A/D change-over circuit, wireless communication module and host computer; Described photoelectricity refers to press from both sides sensor and is connected with microprocessor through light source driving circuit, and data memory module is connected with microprocessor respectively with LCD MODULE; Described photoelectricity refers to press from both sides sensor and also through described demultiplexing circuit, described signal amplification circuit, described A/D change-over circuit, is connected with described microprocessor successively; Microprocessor is connected with wireless communication module, and host computer is connected with wireless communication module by bluetooth;

Described signal amplification circuit, is through split circuit, to connect respectively three filter circuit I by pre-amplification circuit, and three filter circuit I connect respectively three main amplifying circuits, and these three main amplifying circuits connect respectively three filter circuit II and form;

Described demultiplexing circuit is to be connected and composed successively by second order active high-pass filter, gain adjustable amplifier, four-order active low pass filter, lifting circuit and negative circuit, for transillumination AC and DC mixed signal is carried out to separation, AC signal AC is separated separately, to calculate absorbance ratio

numerical value;

Described host computer, according to hemoglobin

specific absorbance and blood oxygen saturation exist

the relation curve of wavelength points

, the measurement result of correction pigment concentration:

Formula before revising (11)

Formula after revising

(12)

In formula, with the ratio of 805nm wavelength points place absorbance variable quantity and 940nm wavelength points place absorbance variable quantity,

the concentration of pigment ICG,

the concentration of hemoglobin,

be ICG at the specific absorbance of 805nm wavelength,

with

be hemoglobin at the specific absorbance of 805nm and 940nm,

with be HbO2 Oxyhemoglobin at the specific absorbance of 805nm and 940nm,

the absorbance variable quantity at pulse 805nm wavelength points place while beating,

be the absorbance variable quantity at pulse 940nm wavelength points place while beating, S is blood oxygen saturation;

According to above-mentioned modification method, blood oxygen absorption spectrum and ICG pigment concentration spectrum is realized separated, thereby remove the interference of blood oxygen fluctuation to pigment measurement of concetration;

Described host computer also will record the concentration of pigment ICG

from following formula, deduct:

（18）

Thereby eliminating pigment injects and the residual impact on Oximetry of pigment; In this formula,

for HbO2 Oxyhemoglobin

concentration,

for reduced hemoglobin

concentration;

Described host computer is according to the concentration of the ICG finally obtaining

, by dilution and the excretion cyclic curve of ICG pigment, calculate hepatic functional reserve parameter.

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