CN105769122A - Method for measuring sleep apnea hyponea index - Google Patents

Method for measuring sleep apnea hyponea index Download PDF

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CN105769122A
CN105769122A CN201610150793.4A CN201610150793A CN105769122A CN 105769122 A CN105769122 A CN 105769122A CN 201610150793 A CN201610150793 A CN 201610150793A CN 105769122 A CN105769122 A CN 105769122A
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breath signal
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value
amplitude
breathing
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CN105769122B (en
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方震
盛婷钰
赵湛
陈贤祥
杜利东
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Institute of Electronics of CAS
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/48—Other medical applications
    • A61B5/4806—Sleep evaluation
    • A61B5/4818—Sleep apnoea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/683—Means for maintaining contact with the body
    • A61B5/6832—Means for maintaining contact with the body using adhesives
    • A61B5/6833—Adhesive patches
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7271—Specific aspects of physiological measurement analysis

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Abstract

The invention discloses a method for measuring a sleep apnea hyponea index.A patch provided with two electrocardio-electrodes and a three-axis accelerometer is used for tests, and the problem that a testee feels uncomfortable is avoided.By analyzing data acquired by a sensor and using sleep postures, three paths of respiratory signals are obtained, the three paths of signals are fused, a fusion signal is obtained, and accordingly a testing result is more accurate.Distribution and allocation of sympathetic nerves and pneumogastric nerves on the heart are not symmetric, and accordingly the measurement value of the first respiratory signal is not accurate.In order to avoid the problem, the first respiratory signal is corrected through the method to improve accuracy.

Description

A kind of measuring method of apnea hypopnea indexes
Technical field
The present invention relates to domestic medical device field, be specifically related to the measuring method of a kind of apnea hypopnea indexes.
Background technology
Sleep Apnea-hypopnea Syndrome (SleepApneaHypopneaSyndrome, SAHS) refer to that a variety of causes causes repeatedly occurring asphyxia, low ventilation, hypercapnia and/or interruptions of sleep under sleep state, so that the clinical syndrome of a series of pathophysiological changes occurs human body.The preliminary Epidemiological study result of this disease is shown that prevalence is about 4% by China, calculates with China 1,300,000,000 population, and China has at least 52,000,000 patients with sleep apneas at present.Therefore, the monitoring of sleep-respiratory is one of important step of prevention and diagnosis and treatment sleep disordered breathing.
The order of severity of sleep disordered breathing can represent with apnea hypopnea indexes (AHI).The value of current AHI is tested mainly through the polysomnogram (PSG) of hospital's Sleeping Center and is obtained, and according to formula: apnea hypopnea indexes=[(asphyxia number of times+low ventilation number of times)/length of one's sleep (minute)] × 60.Wherein, AHI < 5: healthy without SAHS/；5 < AHI < 15: slight SAHS；15 < AHI < 30: moderate SAHS；The serious SAHS of AHI > 30.
What polysomnogram (PSG) was well recognized as quantifies the golden standard of the AHI evaluation sleep apnea syndrome order of severity.But, the testing expense of polysomnogram very high, and acquisition must be tested in special sleep laboratory, it is necessary to professional is operated, it is thus achieved that the result of polysomnogram typically requires fortnight.Compare in the home environment of patient, laboratory test environment may the normal sleep pattern of appreciable impact, and may result in more apnea low event, it is necessary to a kind of portable respiratory disorder equipment substitutes.At present, the method for portable set measurement respiratory disorder has:
(1) adopting chest strap directly to measure the displacement of body surface, the method for this contact needs to apply certain precompression to thorax, and this can make experimenter produce sense of discomfort, will necessarily original breathing be impacted simultaneously.
(2) using temperature, pressure, humidity and pneumatic sensor as nostril sensor, survey breathing according to the change of temperature, humidity or air-flow, this sensor is worn inconvenient and unbecoming, also easily affects the eupnea of experimenter.
(3) using mike to measure the sound of snoring, this method is subject to outside noise interference, and some apnea patients can't be snored night.
(4) blood oxygen probe is used, it is impossible to direct detection respiratory movement, only longer in the asphyxia time, when causing blood oxygen saturation to be decreased significantly, apnea just can be detected.
In addition, above-mentioned portable measurement apparatus can only judge to there occurs apnea, do not possess the function quantifying and calibrating AHI, particularly with the method indirectly surveying respiratory air flow, do not account for the sleeping position impact on it when gathering signal, cause that measured result often has larger difference with standard polysomnogram test result.
Summary of the invention
In view of this, the invention provides the measuring method of a kind of apnea hypopnea indexes, it is possible to convenient obtain apnea hypopnea indexes accurately, and for patient, this measuring method is comfortable.
The measuring method of a kind of apnea hypopnea indexes, adopts SMD measurement device to measure, including a paster can being attached on human body skin and one for carrying out the electronic module of data acquisition and processing (DAP)；Wherein, paster include gather singly lead bipolar Electrocardiographic two electrocardioelectrodes；Concrete measuring method is:
Step one, the bipolar electrocardiogram of singly leading two electrocardioelectrodes collected are analyzed, and electronic module is respectively adopted following two method, it is thus achieved that two-way breath signal:
1), according to heart rate variability theory, gather R peak to the peak-to-peak phase time series of R, process and obtain the first breath signal BR1；
2), search and singly lead the adjacent maximum in time window threshold value of all R peaks in bipolar electrocardiogram and minima, and ask poor, obtain a series of ECG-QRS Wave amplitude, afterwards, the all ECG-QRS Wave amplitudes obtained are carried out resampling, obtain the time dependent continuous wave of amplitude, described waveform is carried out low-pass filtering, it is thus achieved that the second breath signal BR2；
Step 2, using SMD measurement device position as initial point, using the width of human body, height direction and thorax fore-and-aft direction respectively correspondingly as x-axis, y-axis and z-axis direction, set up human body three-dimensional coordinate system；No matter current person to be measured for supine position or lies on one's side state:
First exhale and suppress, finding two coordinate axess perpendicular with gravity direction in human body three-dimensional coordinate system, be defined as N1 and N2；
Afterwards, then air-breathing suppressing, under this state:
The N1 coordinate axes deflection angle relative to air-breathing and when suppressing state is α,
The N2 coordinate axes deflection angle relative to air-breathing and when suppressing state is β；By deflection angle α and deflection angle β approximately equal, definition deflection angle is θ；Calculate gravity exhaling and suppressing the component of coordinate axes N1 under state and in air-breathing and suppress the component of coordinate axes N1 under state, it is thus achieved that the knots modification of gravity；Calculate and exhaling and suppressing the component of coordinate axes N2 under state and in air-breathing and suppress the component of coordinate axes N2 under state, it is thus achieved that the knots modification of gravity；Two knots modification obtained are merged, it is thus achieved that the 3rd breath signal BR3；
Step 3, according to BR1, BR2 and BR3 three road signal give weights, and after carrying out weighted average, it is thus achieved that merge revised breath signal；
Wherein, BR1, BR2 and BR3 three road signal give weights method particularly includes:
1st step: access time window, obtain the value of the current all wave crest points of breath signal and trough point in described time window, adjacent crest value deducts valley value as amplitude of wave form, it is thus achieved that the meansigma methods of amplitude of wave form is also subtracted each other with the expection standard value P set and takes absolute value, and obtains f1；
2nd step: the current breath signal amplitude of wave form meansigma methods obtained according to the 1st step, it is thus achieved that the standard deviation of corresponding breath signal amplitude of wave form, and as coefficient f2；
3rd step: with the time window of the 1st step, choose all minimum point in current breath signal, and calculate standard deviation, and as coefficient f3；
According to E=f1+f2+f3, it is thus achieved that combination coefficient E；And according toObtain the weights of corresponding breath signal；Wherein, τ is a constant more than zero；
Step 4, the breathing to obtaining in step 3 of the employing linear SVM merge signal classifies, it is judged that currently whether there is asphyxia situation；And according toThe event number EPH of asphyxia situation is there is in obtaining one hour；WL is time window length of window selected in step 3；Physical meaning be one hour interior number of windows；P is the number of minutes having event in accumulating a hour, and N is the number of minutes that event does not occur；
Step 5, employing lead the EPH result and apnea hypopnea indexes AHI result that retain in dormant data storehouse more, use the relation y=β between quadratic regression model matching EPH and AHI value by the method for least-squares estimation2x2+β1x+β0；Wherein, x is the value of EPH, and y is the AHI value of non-negative, β2It is the parameter of quadratic effect, β1It is linear effect parameter, intercept β0It is set to zero；Obtain parameter beta2、β1And β0；Set up model；When actually used, according to event number x in obtaining a hour, substitute into y=β2x2+β1x+β0In, apnea hypopnea indexes can be obtained.
It is preferred that the first breath signal BR1 obtained in step one is modified:
First, person to be measured is supine position, adopts the method extracting the first breath signal BR1 in step one, and before extracting, the amplitude of n time, seeks its meansigma methods, be defined as A；Usually, n=5；
Person to be measured is left lateral position state, adopts the method extracting the first breath signal BR1 in step one, and before extracting, the amplitude of n time, seeks its meansigma methods, be defined as A'；According toObtain the scale factor t of left lateral position；
Person to be measured is right arm reclining state, adopts the method extracting the first breath signal BR1 in step one, and before extracting, the amplitude of n time, seeks its meansigma methods, be defined as A "；According toObtain the scale factor t' of right arm reclining；
When reality is tested, according to measured's current state, select corresponding scale factor, the first breath signal is modified, it is thus achieved that revised signal BR1Revise。
It is preferred that the concrete value of described expection standard value P is:
First breath signal is set to 50ms, and the second breath signal is set to 100 μ V, and the 3rd breath signal is set to 0.01g.
It is preferred that said two electrocardioelectrode is separately fixed at paster two, each electrode is covered by hydrogel disk, and singly leads bipolar electrocardiogram with what 125Hz sample frequency recorded person to be measured；Described electronic module comprises flush bonding processor, three axis accelerometer and wireless transceiver.
It is preferred that the docile position of described SMD measurement device is any one position in three below position:
(1) above the second intercostal of left side midclavicular line；
(2) left border of sternum vertically it is attached to；
(3) level is in the 6th Intercostal Space in left side midclavicular line.
Beneficial effect:
1, the present invention can provide the solution easy to use, with low cost of a continuous sleep apnea monitoring at many nights, it is possible to obtains AHI value and screening SAHS.
2, the present invention uses the paster shape testing equipment containing two electrocardioelectrodes and a three axis accelerometer, it is to avoid the problem that person to be measured produces discomfort.And, the data that the present invention is gathered by analyte sensors, obtain three road breath signals in conjunction with sleeping posture, Bing Jiang tri-road signal has merged, it is thus achieved that one merges signal, and the result making test is more accurate.
3, due to its distribution of the sympathetic nerve on heart and vagus nerve and domination asymmetric.In order to avoid causing the inaccurate problem of measured value of the first breath signal that changes in heart rate causes because of above-mentioned situation, the first breath signal is also corrected by the present invention, to improve accuracy.
Accompanying drawing explanation
When Fig. 1 is human exhaled breath and air-breathing under erectility, gravity produces the schematic diagram of projection in z-axis and y-axis.
When Fig. 2 is human exhaled breath and air-breathing under erectility, gravity produces the schematic diagram of projection in x-axis and y-axis.
Fig. 3 is the mechanical analysis schematic diagram under supine position.
Fig. 4 is the mechanical analysis schematic diagram lain on one's side under state.
Fig. 5 is for measuring AHI algorithm flow chart.
Fig. 6 is the wearing position schematic diagram of SMD sensor.
Fig. 7 is that the second breath signal obtains schematic diagram.
Fig. 8 is SMD sensor construction schematic diagram.
Detailed description of the invention
Develop simultaneously embodiment below in conjunction with accompanying drawing, describe the present invention.
The invention provides the measuring method of a kind of apnea hypopnea indexes, the device concrete structure that the method adopts is as follows:
Device of the present invention is SMD measurement device；Being a paster can being attached on human body skin bottom this measurement device, top is an electronic module for carrying out data acquisition and processing (DAP)；Wherein paster comprises two electrocardioelectrodes and battery, and wherein, described electrocardioelectrode is separately fixed at paster two, and each electrode is covered by hydrogel disk, and singly leads bipolar electrocardiogram with what 125Hz sample frequency recorded person to be measured；Described electronic module comprises flush bonding processor, three axis accelerometer and wireless transceiver.
By above-mentioned measurement device docile near the position of heart, its docile position is referred to the electrode slice position of five lead electrocardiogram monitor instrument and places, so, it is thus achieved that electrocardiographic wave amplitude bigger；As in figure 2 it is shown, these positions exist: (1), above the second intercostal of left side midclavicular line, mainly reflects the potential change of left atrium；(2) left border of sternum vertically it is attached to, the main potential change reflecting right ventricle；(3) level is in the 6th Intercostal Space in left side midclavicular line, the main potential change reflecting left ventricle.
Step one, the bipolar electrocardiogram of singly leading that two electrocardioelectrodes on measurement device collect is analyzed, it is thus achieved that two-way breath signal；Its concrete acquisition pattern is:
Method one, theoretical it can be seen that the increase of sympathetic activity or the minimizing of vagal activity cause the acceleration of cardiomotility by heart rate variability.On the contrary, the increase of the minimizing of sympathetic activity or vagal activity causes slowing down of cardiomotility.In respiratory, internal vagus nerve and sympathetic nerve change, and will certainly cause changes in heart rate.Namely during air-breathing, heart rate increases (R peak is peak-to-peak every reducing to R), and during expiration, heart rate reduces (R peak is peak-to-peak every increasing to R).Wherein, R peak is the professional term in electrocardiogram；Therefore R peak can be processed to the peak-to-peak phase time series of R and obtain breath signal.Using the R peak that wavelet algorithm detection is singly led in bipolar electrocardiogram, two adjacent R peak-to-peak times are as the peak-to-peak phase time series in R peak to R.First, the R peak obtained is carried out 4Hz resampling to the peak-to-peak phase time series of R；Afterwards, counterweight sampled point carries out linear interpolation；The low pass filter adopting cut-off frequency to be 0.7Hz is filtered, and just can obtain the first breath signal BR1.
Method two, due in the breathing cycle, chest wall movement gives cardiac mechanical motion, and is not affected by autonomic nervous system, and this change shows as the Modulation and Amplitude Modulation of QRS complex, as shown in Figure 3.After R peakvalue's checking, maximizing and minima (V in 100ms (each 50ms in the both sides) window around R peakmaxAnd Vmin), measure Vmax-VminAs ECG-QRS Wave amplitude.QRS wave amplitude measurement is also that the low pass filter adopting cut-off frequency to be 0.7Hz afterwards is filtered, and just can obtain the second breath signal BR2 with 4Hz resampling.
Step 2, due to the sympathetic nerve on heart and vagal distribution and domination asymmetric.Sympathetic nerve is predominantly located at right side of heart, and vagus nerve is predominantly located at left side of heart.When left lateral position, it is possible to exciting sympathetic nerves, heart beating accelerates, and heart rate increases；And during right arm reclining, vagal excitation, heart beating is slack-off, and heart rate reduces.The first breath signal owing to obtaining in step one is that the variability theory according to heart rate obtains, so, the change of sleeping position, the first breath signal of acquisition will certainly be affected.Such as: lie on the back or when right side is sleeping when the sleeping position of measured is transferred to by lying on the left side, heart rate is by fast to slow, but this situation does not represent asphyxia or low ventilation.Therefore need to by this error concealment.Particularly as follows:
Using the first breath signal BR1 mean amplitude of tide A under supine position as standard value:
After extraction left lateral position, mean amplitude of tide A' of the first five time of the first breath signal, takesScale factor as left lateral position.When reality is tested, if the current sleeping position of measured is left lateral position, then the amplitude of the first breath signal BR1 extracted is multiplied by t and can obtain the first breath signal getting rid of sleeping position interference.
Similarly, mean amplitude of tide A of the first five time of the first breath signal after extraction right arm reclining ", takeScale factor as right arm reclining.When reality is tested, if the current sleeping position of measured is left lateral position, then the amplitude of the first breath signal BR1 extracted is multiplied by t' and can obtain the first breath signal getting rid of sleeping position interference.
So, accordingly, it is thus achieved that the first breath signal at revised signal is:
BR1Revise=c × BR1 × T+ (1-c) × BR1 (1)
Wherein, T represents scale factor, when three axis accelerometer detects that measured for left lateral position is currently, and T=t；When three axis accelerometer detects that measured for right arm reclining is currently, T=t'；If sleeping position changes, to put coefficient c to non-supine position be 1.
Step 3, due to the first breath signal and the second breath signal all by electrocardiosignal be calculated obtain, in order to obtain the actual breath signal of measured more accurately, the present invention additionally uses three axis accelerometer, measurement that chest produced by the actual breathing of measured is periodically moved.
Owing to breathing can cause chest cycle movement, therefore the present invention is based on features described above, and SMD measurement device is placed on position, chest, such that it is able to breath signal is analyzed in the cyclically-varying according to the angle of inclination of the three axis accelerometer in electronic module.
First, three axis accelerometer is initialized；After measured brings SMD measurement device, uprightly, exhale and suppress.
As illustrated in fig. 1 and 2, using SMD measurement device position as initial point, using the width of human body, height direction and thorax fore-and-aft direction respectively correspondingly as x-axis, y-axis and z-axis direction, set up the first coordinate system of SMD measurement device.Owing to thoracic cavity can produce change when breathing, by the intensity of variation in thoracic cavity, its breathing state can be found out.Owing to human body respiration can to the movement of generation upper and lower, left and right, thoracic cavity, front and rear.That is, three directions of coordinate system all can be produced impact, but it is different for specifically producing effect, for simplified operation, the present invention, by passing through to contrast the respective sensitivity in three directions when human body respiration changes, chooses the most sensitive direction of the first two as the basis for selecting obtaining the 3rd breath signal.Particularly as follows:
When current human exhales and suppresses, the effect to power produced on three directions of the test gravity, after projecting: x-axis projection amount is 0；The projection amount of y-axis is g；Z-axis projection amount is 0；
Afterwards, measured's air-breathing and suppressing, make gassy in the thoracic cavity of measured,
Owing to when air-breathing, thoracic cavity can produce change, at this moment, each axle system can produce angle relative to exhaling and suppressing between axle system corresponding under state, and due to the angle approximately equal produced, therefore being defined as deflection angle is θ, it is generally the case that θ tends to 0；Calculating gravity direction is g relative to the projection amount of z-axisz=gsin θ, gravity direction is g relative to the projection amount of y-axisy=gsin θ, gravity direction is g relative to the projection amount of x-axisx=gsin θ；
Now, when upright, measured's knots modification of gravity when exhaling with air-breathing is: Δ gy=g (1-cos θ), Δ gz=gsin θ and Δ gx=gsin θ.When θ tends to 0, Δ gyIt is Δ gzHigher-order shear deformation, namely chest exercise causes acceleration of gravity to change big compared with y-axis in z-axis projection, is more convenient for measuring；In like manner, when θ tends to 0, Δ gyIt is Δ gxHigher-order shear deformation, namely chest exercise cause acceleration of gravity x-axis projection change big compared with y-axis.So can reason out: direction vertical with gravity direction during chest exercise is most sensitive, the direction parallel with gravity direction is least sensitive；So, when testing, it is only necessary to consider the projection of the both direction vertical with gravity direction；
For this, when carrying out actual test, still set up coordinate system according to method time upright and be analyzed, it is known that:
When lying on one's side, as it is shown on figure 3, acceleration of gravity overlaps with x-axis, now,
BR3=Δ gy+Δgz(2)
Wherein, BR3 is the 3rd breath signal measured by three axis accelerometer, Δ gyRepresent gravity knots modification on the y axis during with air-breathing of exhaling；ΔgzRepresent gravity knots modification in z-axis during with air-breathing of exhaling；
When lying on the back, as shown in Figure 4, acceleration of gravity overlaps with z-axis, now,
BR3=Δ gy+Δgx(3)
Wherein, Δ gxRepresent gravity knots modification in x-axis when breathing；
Step 4, undertaken merging and revising by three breath signals in step one, step 2 and step 3:
According to
Obtain three breath signals gathered from changes in heart rate, QRS wave amplitude and three axis accelerometer, be weighted the breathing after on average and merge signal.Wherein, Q is weights；Whether rationally and stable determine choosing by the quality according to this road signal of weights, the more good Q-value of quality is more big, and the more poor Q-value of quality is more little；The concrete basis of design of Q-value of each road signal is as follows: for each road breath signal:
1st step: using certain a period of time (one minute) as time window, obtain in described time window, the value of all wave crest points of current breath signal and trough point, adjacent crest value deducts valley value as amplitude of wave form, calculates the meansigma methods of amplitude of wave form and obtains f with expecting that standard value P subtracts each other and takes absolute value1, wherein, described expection standard value P is empirical value, and in the present embodiment, the first breath signal is set to 50ms, and the second breath signal is set to 100 μ V, and the 3rd breath signal is set to 0.01g；This coefficient represents Suo Ceci road breath signal mean amplitude of tide and expection standard deviation extent, and more big this signal of explanation of deviation does not more meet expection.
2nd step: the current breath signal amplitude of wave form meansigma methods obtained according to the 1st step, it is thus achieved that the standard deviation of corresponding breath signal amplitude of wave form, and as coefficient f2；This coefficient represents the degree of stability of the Suo Ceci road each amplitude of wave form of breath signal, and standard deviation is more big, illustrates that this signal is more unstable.
3rd step: with the time window of the 1st step, choose all minimum point in current breath signal, and calculate standard deviation, and as coefficient f3；This coefficient represents the degree of stability that Suo Ceci road breath signal waveform is worth most, and standard deviation is more big, illustrates that this signal is worth most more unstable, it is possible to somewhere is destroyed by outside noise.
According to formula
E=f1+f2+f3(5)
Obtain combination coefficient E；Due to coefficient f1、f2And f3Effectively having reacted the quality of the breath signal collected, coefficient value is more big, and the quality of the signal of collection is more poor.So, after being combined, it is possible to the quality showing signals collecting become apparent from.For this, employing exponential function formula represents above-mentioned concept, it may be assumed that
Selection of Function
Q = f ( E ) = e - E &tau; - - - ( 6 )
Wherein, τ is a constant (τ > 0).
Step 5, according in step 4 obtain breathing merge signal, adopt revise period map method carry out Power estimation, it is thus achieved that breathe merge signal signal characteristic, formed characteristic vector (Fv)；It is sent to linear SVM (SVM), as the input of linear SVM (SVM).Choosing of its signal characteristic is to set in the varying component of frequency domain according to heart rate variability, including: extremely low frequency (VLF), low frequency (LF) and high frequency (HF) passband power, LF/HF ratio, spectrum kurtosis, spectrum entropy and PAR peak to average ratio.
The breathing fusion signal obtained in step 5 is classified by step 6, linear SVM (SVM), it is judged that currently whether there is asphyxia situation；Afterwards, according to formula:
E P H = P ( P + N ) &times; 3600 M L - - - ( 7 )
Event number in obtaining one hour.WL is time window length of window selected in step 3；Physical meaning be one hour interior number of windows.There is the number of minutes P of event in accumulating one hour and there is no the number of minutes N of event；
Step 7, due to AHI represent be the number of times that asphyxia and low ventilation occurred in a hour, and EPH represent be event number in a hour；The setting of event is then that asphyxia and low ventilation occur/do not occur, therefore the value of the value of EPH here and AHI exists certain relation.
The present invention utilizes the dormant data storehouse (MIT-BIHPolysomnographicDatabase) of leading of MIT BIH that patient therein is simulated diagnosis more, and the EPH result of diagnosis is contrasted with the AHI result of PSG diagnosis.The relation found between EPH value and AHI value is nonlinear；
Therefore, the relation between quadratic regression model matching EPH and AHI value is used by the method for least-squares estimation
Y=β2x2+β1x+β0(8)
Wherein, x is the value of EPH, and y is the AHI value of non-negative, β2It is the parameter of quadratic effect, β1It is linear effect parameter, intercept β0It is set to zero.
The EPH result leading dormant data storehouse of MIT BIH and AHI result are substituted into formula, it is thus achieved that parameter more, and then solve the mathematical relationship expression formula obtained between EPH and AHI；
When reality is tested, according to the EPH result obtained in step 4, it is thus achieved that the value of AHI, and then show the order of severity of the apnea low of measured.Final calculation result can be sent to intelligent terminal wirelessly, it is possible to real time inspection and storage data, thus reaching to measure in real time the purpose of apnea hypopnea indexes.
In sum, these are only presently preferred embodiments of the present invention, be not intended to limit protection scope of the present invention.All within the spirit and principles in the present invention, any amendment of making, equivalent replacement, improvement etc., should be included within protection scope of the present invention.

Claims (5)

1. the measuring method of an apnea hypopnea indexes, it is characterised in that adopt SMD measurement device to measure, including a paster can being attached on human body skin and one for carrying out the electronic module of data acquisition and processing (DAP)；Wherein, paster include gather singly lead bipolar Electrocardiographic two electrocardioelectrodes；Concrete measuring method is:
Step one, the bipolar electrocardiogram of singly leading two electrocardioelectrodes collected are analyzed, and electronic module is respectively adopted following two method, it is thus achieved that two-way breath signal:
1), according to heart rate variability theory, gather R peak to the peak-to-peak phase time series of R, process and obtain the first breath signal BR1；
2), search and singly lead the adjacent maximum in time window threshold value of all R peaks in bipolar electrocardiogram and minima, and ask poor, obtain a series of ECG-QRS Wave amplitude, afterwards, the all ECG-QRS Wave amplitudes obtained are carried out resampling, obtain the time dependent continuous wave of amplitude, described waveform is carried out low-pass filtering, it is thus achieved that the second breath signal BR2；
Step 2, using SMD measurement device position as initial point, using the width of human body, height direction and thorax fore-and-aft direction respectively correspondingly as x-axis, y-axis and z-axis direction, set up human body three-dimensional coordinate system；No matter current person to be measured for supine position or lies on one's side state:
First exhale and suppress, finding two coordinate axess perpendicular with gravity direction in human body three-dimensional coordinate system, be defined as N1 and N2；
Afterwards, then air-breathing suppressing, under this state:
The N1 coordinate axes deflection angle relative to air-breathing and when suppressing state is α,
The N2 coordinate axes deflection angle relative to air-breathing and when suppressing state is β；By deflection angle α and deflection angle β approximately equal, definition deflection angle is θ；Calculate gravity exhaling and suppressing the component of coordinate axes N1 under state and in air-breathing and suppress the component of coordinate axes N1 under state, it is thus achieved that the knots modification of gravity；Calculate and exhaling and suppressing the component of coordinate axes N2 under state and in air-breathing and suppress the component of coordinate axes N2 under state, it is thus achieved that the knots modification of gravity；Two knots modification obtained are merged, it is thus achieved that the 3rd breath signal BR3；
Step 3, according to BR1, BR2 and BR3 three road signal give weights, and after carrying out weighted average, it is thus achieved that merge revised breath signal；
Wherein, BR1, BR2 and BR3 three road signal give weights method particularly includes:
1st step: access time window, obtain the value of the current all wave crest points of breath signal and trough point in described time window, adjacent crest value deducts valley value as amplitude of wave form, it is thus achieved that the meansigma methods of amplitude of wave form is also subtracted each other with the expection standard value P set and takes absolute value, and obtains f1；
2nd step: the current breath signal amplitude of wave form meansigma methods obtained according to the 1st step, it is thus achieved that the standard deviation of corresponding breath signal amplitude of wave form, and as coefficient f2；
3rd step: with the time window of the 1st step, choose all minimum point in current breath signal, and calculate standard deviation, and as coefficient f3；
According to E=f1+f2+f3, it is thus achieved that combination coefficient E；And according toObtain the weights of corresponding breath signal；Wherein, τ is a constant more than zero；
Step 4, the breathing to obtaining in step 3 of the employing linear SVM merge signal classifies, it is judged that currently whether there is asphyxia situation；And according toThe event number EPH of asphyxia situation is there is in obtaining one hour；WL is time window length of window selected in step 3；Physical meaning be one hour interior number of windows；P is the number of minutes having event in accumulating a hour, and N is the number of minutes that event does not occur；
Step 5, employing lead the EPH result and apnea hypopnea indexes AHI result that retain in dormant data storehouse more, use the relation y=β between quadratic regression model matching EPH and AHI value by the method for least-squares estimation2x2+β1x+β0；Wherein, x is the value of EPH, and y is the AHI value of non-negative, β2It is the parameter of quadratic effect, β1It is linear effect parameter, intercept β0It is set to zero；Obtain parameter beta2、β1And β0；Set up model；When actually used, according to event number x in obtaining a hour, substitute into y=β2x2+β1x+β0In, apnea hypopnea indexes can be obtained.
2. measuring method as claimed in claim 1, it is characterised in that
The the first breath signal BR1 obtained in step one is modified:
First, person to be measured is supine position, adopts the method extracting the first breath signal BR1 in step one, and before extracting, the amplitude of n time, seeks its meansigma methods, be defined as A；Usually, n=5；
Person to be measured is left lateral position state, adopts the method extracting the first breath signal BR1 in step one, and before extracting, the amplitude of n time, seeks its meansigma methods, be defined as A'；According toObtain the scale factor t of left lateral position；
Person to be measured is right arm reclining state, adopts the method extracting the first breath signal BR1 in step one, and before extracting, the amplitude of n time, seeks its meansigma methods, be defined as A "；According toObtain the scale factor t' of right arm reclining；
When reality is tested, according to measured's current state, select corresponding scale factor, the first breath signal is modified, it is thus achieved that revised signal BR1Revise。
3. measuring method as claimed in claim 1, it is characterised in that the concrete value of described expection standard value P is:
First breath signal is set to 50ms, and the second breath signal is set to 100 μ V, and the 3rd breath signal is set to 0.01g.
4. measuring method as claimed in claim 1, it is characterised in that said two electrocardioelectrode is separately fixed at paster two, and each electrode is covered by hydrogel disk, and singly lead bipolar electrocardiogram with what 125Hz sample frequency recorded person to be measured；Described electronic module comprises flush bonding processor, three axis accelerometer and wireless transceiver.
5. measuring method as claimed in claim 1, it is characterised in that the docile position of described SMD measurement device is any one position in three below position:
(1) above the second intercostal of left side midclavicular line；
(2) left border of sternum vertically it is attached to；
(3) level is in the 6th Intercostal Space in left side midclavicular line.
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