CN106618537A - Continuous dynamic blood pressure monitoring device and method based on pulse wave transit - Google Patents
Continuous dynamic blood pressure monitoring device and method based on pulse wave transit Download PDFInfo
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
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- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
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Abstract
The invention provides an independently researched and developed continuous dynamic blood pressure monitoring device and method based on pulse wave transit time (PWTT) and pulse wave transit velocity (PWV). According to the device, an electrocardiosignal collecting module (104) is arranged on a main case (101) in a wristwatch form, a pulse wave signal collecting module (103) is arranged at the position, corresponding to the wrist radial artery, of a wristband (102), and the electrocardiosignal collecting module (104) and the pulse wave signal collecting module (103) are in signal connection with a control module (105). The device and algorithm can obtain pulse waves in real time, the problem that in-vitro heart pulse waves are inconvenient to obtain is solved, the method for rapidly and accurately obtaining the cardiac ejection time point is provided, and the method is an important part of continuous dynamic blood pressure monitoring.
Description
Technical field
The invention belongs to noninvasive ambulatory blood pressure continuous monitoring technical field, more particularly to it is a kind of by obtaining pulse transit
Time and the device and method of velocity interpolation ambulatory blood pressure continuous monitoring.
Background technology
Cardiovascular and cerebrovascular disease is the murderous main reason of global range.Chinese cardiovascular disease illness rate is in lasting
Ascent stage.The year end of cut-off 2014, the whole nation about cardiovascular patient 2.9 hundred million (《Chinese cardiovascular disease report 2014》).It is high
Blood pressure is modal angiocardiopathy, and with SAP the clinical syndrome as main performance is increased.Angiosthenia includes
Systolic pressure (SBP) and diastolic pressure (DBP), the mean value of arterial pressure is referred to as mean arterial pressure during a cardiac cycle
(MAP).The pathogenic factors of hypertension has a lot, such as hereditary (constituting about 40%), disease or extraneous factor, such as nervous, long
Phase sodium intake is excessive, smoking, obesity, excessive drinking, lack motion etc..Long-term hypertension can change the structure and then shadow of arterial vessel
The physiological function of the target organs such as heart, brain, kidney is rung, the exhaustion of these organ dysfunctions is ultimately resulted in.Therefore hyperpietic have must
Want the blood pressure and active treatment of actively monitoring itself.The diagnosis and treatment of hypertension is required for carrying out regularly blood to patient
Pressure measurement, its measurement will meet 3 conditions：First, 3 blood pressures are surveyed respectively；Second, 3 times measurement blood pressure can not be on the same day；The
Three, systolic pressure >=140mmHg, diastolic pressure >=90mmHg.For the patient for being diagnosed as hypertension then needs to measure blood daily
Pressure.The method of blood pressure measurement is divided into invasive method (invasive) and Noninvasive (non-invasive) method.Intrusion method is most
Need to insert the catheter into blood vessel for continuous monitoring arterial pressure, the method can accurate measurement angiosthenia, but danger coefficient
With and nursing cost is all very high, the method is not common method.Most of non-invasive blood pressure measurement product in the market is adopted
It is stethoscopy (Korotkoff ' s Sound) and oscillographic method (Oscillography).Both approaches are required for wearing fills
Gas formula cuff, and apply pressure acquisition blood pressure values to arteries.Oscillographic method is widely used in electronic sphygmomanometer, is added by inflation
After pressure, the change of the built-in chip of machine and pressure sensitive components to Sasser is judged, and obtains systolic pressure and diastolic pressure.
But due to electronic sphygmomanometer all the time with human ear hearing difference, therefore repeatedly have inaccurate during result after measurement, it sometimes appear that
Larger error.So far, the pressure value for being measured using stethoscopy and mercury sphygmomanometer is still medical institutions' office hypertension sufferer
Gold normative reference.However, stethoscopy there are certain requirements to the method for operating of user.First, the position that cuff is worn needs
Meet the requirement of operating instruction, and stethoscopic placement location also there are certain requirements, if misoperation, as a result also occur compared with
Big error.For different operators, because individual difference causes hearing different, measurement result also can be variant.No matter make
Use which kind of method, the discomfort that cannot all avoid inflating pressure from causing.Generally, a blood pressure measurement needs 1 minute used time left side
It is right.Additionally, the size length of measuring cuff is also required to be changed according to individual difference, otherwise also measurement result can be made
Into impact.Therefore, existing non-intrusive sphygmomanometry is unsuitable for frequently repeatedly continuous monitoring blood pressure long-term with needs
Hyperpietic.For the user for needing continuous blood pressure to monitor, applying pressure to wearing position for a long time can cause office
Portion's dermohemia, and wearer can affect sleep quality because of cuff inflation when using at night.
In recent years, repeatedly proposed using the method for pulse velocity of wave indirect measurement of blood pressure, having for haemodynamics field is big
Amount literature research points out that pulse wave conduction speed (pulse wave velocity, pwv) has phase with blood pressure and blood vessel property
There is certain relation between Guan Xing, with blood pressure.PWV refer to pulse wave both pinpointed at two of arterial system between propagation speed
Degree.The computing formula of the PWV in universal significance is as follows：PWV=L/PWTT.Wherein, L be two arterial pulse wave test points away from
From PWTT is pulse wave translation time.
One complete pulse wave is mainly made up of two pressure waves, is respectively the pressure wave that blood generation is penetrated in ventricular contraction
Receive to penetrate the pressure wave that blood expands rapidly generation with aorta ascendens, therefore, pulse wave has the property of mechanical wave and to be exceedingly fast
Speed is conducted from heart along arterial tree.It is dynamic when the energy conversion that pulse wave occurs in conduction is mainly pulse transit
Energy conversion between energy and lumen of artery elastic potential energy.The PWV proposed according to Moens-Korteweg in haemodynamics and blood
The formula of pipe property relation：PWV2(E is Young's modulus to=E h/2r ρ, and h is artery wall thickness, and r is blood vessel inside radius, and ρ is
Density of blood) as can be seen that Young's modulus represents blood vessel elasticity and PWV is directly proportional and arterial elasticity is poorer in the case of, pulse
The conduction of velocity of ripple is faster.Further to regard to formula E=Δ PDd/ (Δ Dh) (its of Young's modulus in haemodynamics
In, h is artery wall thickness, and Δ P is blood pressure, and Dd is diastole end of term blood vessel diameter, and Δ D is vessel diameter change) carry out point
Analysis is visible, and blood vessel elasticity has direct relation with blood pressure especially systolic pressure change, therefore haemodynamics aspect confirms pwv and blood
There is relation in pipe internal pressure：PWV2=Δ PDd/ Δ D2r ρ；On the other hand, from Moens-Korteweg and Young's modulus
Parameter in formula can be seen that the contraction and diastole of Diameter, thickness, density of blood, the viscous elasticity of artery and heart
Deng the conduction of velocity for all affecting pulse wave to a certain extent, artery internal pressure is also indirectly have impact on.
PWV has many kinds, such as neck-stock pulse velocity of wave, arm-ankle pulse velocity of wave, but these methods are more suitable for sustainer
Pressure is calculated.For most of crowds, arteria brachialis is then blood pressure measurement site more often.Therefore, for using heart extremely
The pulse velocity of wave of arteria brachialis calculates the demand that blood pressure is more suitable for most people.However, the position of arteria brachialis is not appropriate for for a long time
Measuring instrument is worn, therefore is more adapted to using heart-radial artery.By the identification to ECG signal R ripple, can be to extracting heart
Ejection time point.For the method that radial artery pulse wave is obtained, can be by obtaining to radial pulse point of maximum intensity direct measurement
Radial artery pulse wave, and be jointly processed by with ECG signal, obtain pulse wave conduction speed.The change of Pwv is right with what systolic pressure changed
Should be related to more substantially, but the feedback to diastolic pressure can not rely solely on pwv, in addition it is also necessary to consider viscous elasticity, the blood vessel of blood vessel
The impact of the isoparametric Pressure Changes On The Blood of diameter, density of blood, compliance, dilatancy.
Windkessel blood vessel elasticities chamber model provides suitable theory for the change of blood vessel parameter in haemodynamics
Background.Windkessel models regard cardiovascular system as an equivalent circuit.Power supply generation periodic potentials are poor, represent the heart
Dirty function, q represents blood flow；L is inductance, represents the inertia that the blood trickled in artery is subject to, and its numerical value is bigger, Hemodynamic environment
Degree is slower and relevant with density of blood ρ；R is resistance, also represent the maximum microcirculation system of peripheral resistance in cardiovascular circulation
System；C1, C2 are electric capacity, represent arteries at different levels, and the C1 near current source represents sustainer, and C2 represents arterial branch,
The size of capacitance reflects the dilatancy of blood vessel, and its value is bigger, and the dilatancy for representing blood vessel is better,；On the other hand, blood flow
Mechanics proposes the concept of vascular dilation (Distensibility), and its compliance with arteries in the diastole end of term has
Close.Vascular dilation defines the relation of the change in pressure that arteries diameter is subject to vascular wall.Its formula is：
(wherein, Δ D represents blood vessel diameter in heart contraction and the difference of diastole to Distensibility=Δ D/ Δ PDd；Dd
For diastole end of term blood vessel diameter).Because electric capacity is identical with dilatancy property in Windkessel models, therefore C=Δ D/ Δ P
Dd.On the other hand, Bramwell-Hill proposes the relational expression of PWV and blood pressure in hemodynamic research：
PWV2(wherein, h is artery wall thickness to=Δ PV/ (Δ V ρ), and Δ P is pressure change, and Δ V is volume change, and V is baseline
Volume).Proving by the same methods, with the relation between PWV and Windkessel correlation formulas, can calculate other relevant blood vessel parameters
And regression equation is obtained by sampling(wherein R is the vascular resistence of blood flow, and resistance causes more greatly
Pressure drop it is more notable；C is vascular compliance, is the tolerance for reacting arteries to accumulation of blood energy；tdFor diastole
Time.) and then obtain more accurately blood pressure values.
The computing formula of the PWV in universal significance is as follows：PWV=L/PWTT.Wherein, L is two arterial pulse wave detections
The distance of point, PWTT is pulse wave translation time.Prior art such as Chinese patent CN100413464C and Deutsche Bundespatent
DE10061189A1, is obtained by the time difference between the index point for 2 pulse waves being reflected to cardiac ejection synchronization
PWTT, and directly using PWTT replacement PWV calculating blood pressures.However, the method have ignored the distance between 2 points of periphery measurement point L
The impact that blood pressure is calculated.Due to the impact of crowd's individual difference, the size of L can be variant.Therefore, PWTT fittings are only suitable for
Pressure value can cause larger error.
Although some patents in prior art (such as CN201110218935, CN201410537675, CN1524490A)
Have and calculate blood pressure using pulse wave signal, but all obtain pulse wave using the mode of inflation, pressurization, be not truly
Continuous ambulatory blood pressure monitoring, rarely patent can realize real continuous ambulatory blood pressure monitoring.
Also have in prior art some other patents (as CN201110218935, CN201610078117,
CN1524490A the absolute pressure value to pulse wave, amplitude of its method to pulse wave using pressure sensor acquisition are mentioned in)
Have high demands, but signal amplitude can be applied stressed not equal factor and be affected the accuracy of its result by subcutaneous fat and outside.
In sum, the subject matter of prior art is：
1) inflating the device of cuff pressurization can not realize the continuous Circadian blood pressure profile of real meaning；
2) do not carry apart from some difficulty of the measuring method of L, prior art between two measurement points that pulse wave is gathered
And definite solution；
3) to the impact without specified cardiovascular relevant parameter when blood pressure is calculated using PWV, it is adopted prior art
Sample result obtains corresponding blood pressure values diversity factor greatly, and the matched curve for being obtained is larger with actual conditions deviation；
4) photoelectric cell because detect that position skin color difference, scar, cuticula be blocked up and skin attachement is not tight etc. because
The impact of element causes result error；
5) pressure sensor obtains the absolute pressure value to pulse wave, and its method has high demands to the amplitude of pulse wave, but believes
Number amplitude can be applied stressed not equal factor and be affected the accuracy of its result by subcutaneous fat and outside；
6) prior art clearly do not illustrated for the relation that PWV calculates systolic pressure and diastolic pressure, especially for diastole
The comparison for calculation methods of pressure is obscured.
The content of the invention
The problem to be solved in the present invention is a kind of continuous ambulatory blood pressure monitoring device and side based on pulse transit of design
Method, based on pulse wave translation time (PWTT) and pulse wave conduction speed (PWV) continuous ambulatory blood pressure monitoring, noninvasive, nothing are realized
It is inflatable cuff, portable and with very strong adaptivity, accuracy and extensibility.
The present invention key technology be：Pulse wave be cardiac ejection and diastole beating (vibration) along sustainer to periphery
The waveform that arteries is propagated and formed, heart-radial pulse velocity of wave refers to same cardiac cycle, the pulse of myocardial movement
Ripple is conducted to the speed of wrist radial artery, the signal intensity that Artery Vein stress occurs is received with sensor, by calculating
The relation and pulse wave conduction speed of pulse wave translation time and heart to artery measurement point distance, menses pressure meter internal computer core
Measure systolic pressure, the diastolic pressure of human body after piece process, the method can be also used for detecting the different artery measurement points of human body two it
Between artery sclerosis situation.
Based on above-mentioned key technology, the technical scheme that the present invention takes is：
A kind of continuous ambulatory blood pressure monitoring device based on pulse transit, the monitoring device be watch form, main frame
It is furnished with ecg signal acquiring module (104) on shell (101), is furnished with pulse wave signal at wrist strap (102) correspondence wrist radial artery and adopts
Collection module (103), the ecg signal acquiring module (104) and pulse wave signal acquisition module (103) signal connection control mould
Block (105).
Further, the control module includes amplification module (106), filtration module (107), the AD conversion being sequentially connected
Device (108), blood pressure computing module (109), the amplification module (106) and the ecg signal acquiring module (104) and pulse
Ripple signal acquisition module (103) signal connects.
Further, ecg signal acquiring module (104) include be located at main case on cover electrocardio Top electrode piece (201) with
And be used to be close to electrocardio bottom electrode piece (202) and electrocardio ground pole piece (203) of skin positioned at main case bottom surface, electricity on the electrocardio
Pole piece (201), electrocardio bottom electrode piece (202), electrocardio ground pole piece (203) are connected with control module (105).
Further, the ecg signal acquiring module (104) includes the upper patch electrode for being close to below left clavicle
(401) the lower patch electrode (402) and above left nipple, and the biography being connected with control module (105) on main case (101)
Defeated line interface (206), upper patch electrode (401) and lower patch electrode (402) are by described in ECG Data Transmission Based line (403) connection
Transmission line interface (206).
Further, the ecg signal acquiring module (104) is including manual ecg signal acquiring module and automatic electrocardio
Signal acquisition module；
The manual ecg signal acquiring module includes electrocardio Top electrode piece (201) covered on main case and is located at
Main case bottom surface is used to be close to electrocardio bottom electrode piece (202) and electrocardio ground pole piece (203) of skin, the electrocardio Top electrode piece
(201), electrocardio bottom electrode piece (202), electrocardio ground pole piece (203) are connected with control module (105)；
The automatic ecg signal acquiring module includes upper patch electrode (401) and the left nipple for being close to below left clavicle
The lower patch electrode (402) of top, and the transmission line interface being connected with control module (105) on main case (101)
(206), upper patch electrode (401) and lower patch electrode (402) connect the transmission line and connect by ECG Data Transmission Based line (403)
Mouthful (206), it should be noted that the human body for heart on the right, upper patch electrode (401) is close to right subclavian side, lower patch electricity
It is close to right nipple top in pole (402).
Further, the pulse wave signal acquisition module (103) includes the pulse wave sensing being fastened on wrist strap (102)
The sensor connecting line (205) of device (204) and connection pulse wave sensor (204) and control module (105), the pulse
Wave sensor (204) includes the PVDF piezoelectric membranes (302) and silica gel contact (301) for being arranged at sensor outer housing (303).
Another aspect of the present invention, it is also proposed that the simple monitoring method of continuous ambulatory blood pressure based on pulse transit, including：
(1) the pulse wave signal S1 of a cycle of radial artery pulse point is continuously obtained by pulse wave sensor and is sent
To control module；
(2) decomposition is carried out to signal S1 and obtains left ventricle pulse wave and aortic pulse wave, while obtaining diastole duration；
(3) the time difference PWTT between left ventricle pulse wave and aortic pulse wave crest is calculated；
(4) systolic pressure PWTT is calculated according to PWTTSBP；
(5) according to systolic pressure PWTTSBPWith diastole duration calculation diastolic pressure PWTTDBP。
Further, in step (1) collection pulse wave signal at intervals of 2ms.
Further, the concrete grammar of step (2) is：
(201) summit in each cycle in signal S1 is recognized；
(202) signal S2 is obtained to signal S1 regularizations；
(203) it is cumulative to signal S2 to obtain displacement signal S3；
(204) decomposition is carried out to signal S3 with beta function and obtains left ventricle pulse wave and aortic pulse wave；
(205) diastole duration Td [Td0, Td1 ... Tdn] is calculated by signal s3.
Further, step (4) systolic pressure PWTTSBPThe fitting formula of calculating is：
PWTTSBP=exp (pt1*PWTT)+pt2；
Wherein, pt1, pt2 are the fitting parameter with reference to user's relevant parameter.
Further, step (5) the diastolic pressure PWTTDBPThe fitting formula of calculating is：
PWTTDBP=Td*exp { PWTTSBP/ (pt3PWTT) 2 }-hr1* hearts rate；
Wherein, Td is diastole duration；Pt1, pt2 are the fitting parameter with reference to user's relevant parameter.
Another aspect of the present invention, it is also proposed that simply monitored based on the continuous ambulatory blood pressure calibration value of pulse transit
Method, including：
(1) electrocardiosignal and pulse wave are gathered by pulse wave sensor and manual ecg signal acquiring module continuous synchronization
Signal s1 is simultaneously sent to control module；
(2) heart-oar pulse wave translation time hrPWTT is obtained；
(3) systolic pressure PWTT is calculated according to hrPWTTSBP；
(4) according to systolic pressure PWTTSBPWith diastole duration calculation diastolic pressure PWTTDBP。
Further, in step (1) synchronous acquisition electrocardiosignal and pulse wave signal at intervals of 2ms.
Further, the concrete grammar of step (2) is：
(201) summit in each cycle in signal S1 is recognized；
(202) signal S2 is obtained to signal S1 regularizations；
(203) it is cumulative to signal S2 to obtain displacement signal S3；
(204) valley value [V0, V1 ... Vn] in signal S3 is extracted；
(205) the R ripples of electrocardiosignal are recognized and [R0, R1 ... Rn] is labeled as；
(206) time difference with the P [V0, V1 ... Vn] and R ripples [R0, R1 ... Rn] of heart cycle is processed, is obtained
The heart-oar pulse wave translation time hrPWTT.
Further, step (3) systolic pressure PWTTSBPThe fitting formula of calculating is：
PWTTSBP=exp (pt1*hrPWTT)+pt2；
Wherein, pt1, pt2 are the fitting parameter with reference to user's relevant parameter.
Further, step (4) the diastolic pressure PWTTDBPThe fitting formula of calculating is：
PWTTDBP=Td*exp { PWTTSBP/ (pt3hrPWTT) 2 }-hr1* hearts rate；
Wherein, Td is diastole duration；Pt1, pt2 are the fitting parameter with reference to user's relevant parameter.
Another aspect of the present invention, additionally provides based on the accurate monitoring method of continuous ambulatory blood pressure of pulse transit, including：
(1) measured's individual's parameter is obtained；
(2) core signal ECG, pulse wave letter are gathered by pulse wave sensor and ecg signal acquiring module continuous synchronization
Number s1 is simultaneously sent to control module；
(3) heart-oar pulse wave translation time hrPWTT and diastole duration TD is obtained；
(4) heart-oar pulse wave conduction speed hrPWV is calculated according to the heart-oar pulse wave translation time hrPWTT；
(5) systolic pressure PWV is calculated according to the heart-oar pulse wave conduction speed hrPWVSBP；
(6) according to systolic pressure PWVSBPAnd diastole duration TD calculates diastolic pressure PWVDBP。
Further, step (1) the personal parameter includes height height of measured, and body weight BMI, age Age inhales
Cigarette situation and medication situation.
Further, in step (2) synchronous acquisition electrocardiosignal and pulse wave signal at intervals of 2ms.
Further, the detailed process of step (3) is：
(201) summit in each cycle in signal S1 is recognized；
(202) signal S2 is obtained to signal S1 regularizations；
(203) it is cumulative to signal S2 to obtain displacement signal S3；
(204) diastole duration Td [Td0, Td1 ... Tdn] is calculated by signal s3；
(205) valley value [V0, V1 ... Vn] in signal S3 is extracted；
(206) the R ripples of electrocardiosignal are recognized and [R0, R1 ... Rn] is labeled as；
(207) time difference with the P [V0, V1 ... Vn] and R ripples [R0, R1 ... Rn] of heart cycle is processed, is obtained
The heart-oar pulse wave translation time hrPWTT.
Further, the formula of step (4) calculating hrPWV is as follows：
HrPWV=(h1* heights -5.085)/hrPWTT；
Wherein, h1 is fitting parameter.
Further, step (5) calculates systolic pressure PWVSBPFormula it is as follows：
PWVSBP=gen1 × sex+pw1 × hrPWV+bm1 × BMI+age1 × age+Sm1* smoker+drug1* clothes
Medicine person；
Wherein, gen1, pw1, bm1, age1, Sm1, drug1 are the fitting parameter with reference to user's relevant parameter.
Further, the computing formula of step (6) is：
Wherein,By displacement signal s3Obtain, RC2Value is obtained by fitting parameter.
For prior art, beneficial effects of the present invention are：The invention provides a kind of noninvasive continuous blood pressure monitoring device
And method, realize a kind of miniaturization, it is portable, without the need for cuff inflation pressurization and continuous blood pressure measurer and method.The equipment
Cuff need not only be inflated can just realize the function of sphygmomanometer, while can realize that Long-term continuous blood pressure changes, and only
Need to be worn on wrist such as wrist-watch, flexibly apply to various living scenes.The present invention is based on blood in the method for continuous blood pressure monitoring
The influence factor of hydromechanics and blood vessel elasticity chamber model medium vessels parameter, the result for making long-term continuous BP measurement more may be used
Lean on.
Description of the drawings
Fig. 1 is the apparatus structure schematic diagram in the embodiment of the present invention；
Fig. 2 is the watch front elevation in the embodiment of the present invention；
Fig. 3 is the watch back view (being close to wrist skin) in the embodiment of the present invention；
Fig. 4 is the sectional view that the device in the embodiment of the present invention is worn on wrist；
Fig. 5 is manual ecg signal acquiring schematic diagram (the calibration operation side of ordinary surveying method in the embodiment of the present invention
Formula)；
Fig. 6 is that the accurate measurement method in the embodiment of the present invention wears figure (continuous)；
Fig. 7 is the left ventricle-sustainer PWTT schematic diagrames in the embodiment of the present invention；
Fig. 8 is the pulse wave signal in the embodiment of the present invention and electrocardiosignal schematic diagram；
Fig. 9 is the reduction displacement signal S3 schematic diagrames in the embodiment of the present invention；
Figure 10 is the diastole duration td definition figure in the embodiment of the present invention；
Figure 11 is the pulse wave translation time schematic diagram of the heart to radial artery in the embodiment of the present invention；
Figure 12 is the ordinary surveying method in the embodiment of the present invention and quickly calibrated ordinary surveying method schematic flow sheet；
Figure 13 is the schematic flow sheet of the accurate measurement method in the embodiment of the present invention；
Figure 14 is the signal vertex recognition schematic flow sheet in the embodiment of the present invention；
Figure 15 is the diastole duration Td calculation process schematic diagram in the embodiment of the present invention.
Wherein：
101st, main case；102nd, wrist strap；103rd, pulse wave signal acquisition module；104th, ecg signal acquiring module；
105th, control module；106th, amplification module；107th, filtration module；108th, a/d converter；
109th, blood pressure computing module；110th, key control circuit；111st, power circuit；112nd, signal input output；
113rd, display module；201st, electrocardio Top electrode piece；202nd, electrocardio bottom electrode piece；203rd, electrocardio ground pole piece；
204th, pulse transducer；205th, sensor connecting line；206th, the mounted ECG Data Transmission Based line interface of chest；
207th, radius；208th, radial artery；209th, wrist cross section；301st, silica gel contact；
302nd, PVDF piezoelectric membranes；303rd, sensor outer housing；401st, upper patch electrode；402nd, lower patch electrode；
403rd, ECG Data Transmission Based line；404th, heart.
Specific embodiment
With reference to specific embodiment, the present invention will be further described.
The present invention establishes PWTT, PWV and blood of complete set by many experiments design and lot of experimental data fitting
The Mathematical Modeling of pressure relation, demonstrates the relation of PWTT, PWV and blood pressure, it is possible to realize continuous ambulatory blood pressure monitoring.The present invention
Used independent research " is based on the continuous blood pressure monitoring of pulse wave translation time (PWTT) and pulse wave conduction speed (PWV)
Device and method ".Pulse wave is that the beating (vibration) of cardiac ejection and diastole is propagated and shape along sustainer to periphery arteries
Into waveform.Heart-radial pulse velocity of wave refers to same cardiac cycle, and the pulse transit of myocardial movement is dynamic to wrist oar
The speed of arteries and veins.Receive the signal intensity that Artery Vein stress occurs with sensor, by calculate pulse wave translation time and
The relation and pulse wave conduction speed of heart to artery measurement point distance, menses pressure meter internal computer chip measures human body after processing
Systolic pressure, diastolic pressure, the method can be also used for detecting the artery sclerosis situation between the different artery measurement points of human body two.
Equipment therefor of the present invention provides the method for two kinds of continuous ambulatory blood pressure monitorings and a kind of bearing calibration：
I. simple monitoring method：Pulse wave (the pulse that i.e. one time heartbeat is produced of single arterial site can only be continuously acquired
Ripple) PWTT that decomposites continuous heart to sustainer is just obtained continuous pressure value (fitting brachial arterial pressure value).
Ii. accurate monitoring method：The pulse wave that synchronization obtains two different arterial pulse moving points is continuously acquired, is obtained continuous
Two arteries between PWV, accurate continuous ambulatory blood pressure values (fitting brachial arterial pressure value) can be monitored.
Iii. the present invention is directed to ordinary surveying method there is provided one kind method for quickly correcting, i.e., using two different artery arteries and veins
PWTT corrections between ripple of fighting, only by decomposing the PWTT that single artery is obtained, correct the systolic pressure SBP value of ordinary surveying method, it is ensured that
The accuracy of ordinary surveying result.
Therefore, in sum：
First, the present invention provides a kind of wrist wearable device (as shown in Figure 1) of noninvasive continuous Circadian blood pressure profile：
The present invention structure as shown in figure 1, and the Main Morphology of the present invention be watch, see Fig. 2, Fig. 3：Including being furnished with display
Module 113, is furnished with ecg signal acquiring module 104 on its main case 101, wrist strap 102 is furnished with pulse wave signal acquisition module
103, the simple two-way signal that ecg signal acquiring module 104 and pulse wave signal acquisition module 103 are collected is through control module 105
In modules (including amplification module 106, filtration module 107, a/d converter 108, blood pressure computing module 109) process after
To pressure value.
It is defeated that the present invention is additionally provided with the key control circuit 110 that is connected with control module 105, power circuit 111, signal input
Go out 112.
The application example of the present invention has used the pulse wave translation time (hrPWTT) and its corresponding heart of heart-radial artery
Dirty-radial artery pulse wave conduction of velocity hrPWV, is fitted brachial arterial pressure, realizes continuous ambulatory blood pressure monitoring.
Collection arterial pulse wave signal 601 is the premise for calculating PWTT and PWV.
Pulse wave signal acquisition module 103 includes in this application example：It is fastened on the pulse wave sensor 204 of watchband 102
It includes the sensor of silica gel contact 301, PVDF piezoelectric membranes 302 and sensor outer housing 303, connection 204 and control module 105
Connecting line 205.
Pulse wave sensor 204 in pulse wave signal acquisition module 103 is placed on radial artery pulse by this application example
Point 208 obtains the pulse wave 601 (see Fig. 4) of pulse wave signal, i.e. radial artery using the method for measurement Diameter pace of change.
2nd, in two kinds of continuous blood pressure monitoring methods that the present invention is provided, distinct methods are required for the acquisition of pulse wave：
I. simple monitoring method：Only need to a pulse wave sensor (204) and continuously obtain same arterial pulse moving point
Pulse wave.Pulse wave sensor (204) in this application example is positioned over radial artery pulse point from piezoelectric type capacitance sensor
(208) for continuously acquiring radial artery pulse wave (601).
Ii. accurate monitoring method：At least one pulse wave sensor is needed, the different arteries of synchronization two are continuously acquired
Pulse wave.The pulse wave of this application case-based system is radial artery pulse wave (501) and heart pulse rate ripple, due to cardiac position spy
Very, measure being critical that for heart pulse rate ripple and replaced pulse wave signal (502) with electrocardiosignal.
This application example center telecommunications acquisition module (104) includes two groups of EGC sensors (201-203,401-402)
With ECG Data Transmission Based line 403, and there is provided the acquisition methods of two kinds of electrocardiosignals：
I. manual ecg signal acquiring：(Fig. 2 to Fig. 4) is covered using single lead EGC sensor including on main case
Electrocardio Top electrode piece (201) positioned at main case bottom surface electrocardio bottom electrode piece (202) and electrocardio ground pole piece (203).During operation
202 and 203 are close to wrist skin, any finger contact 201 of another hand, you can constitute electrocardio path, obtain the company at this moment
Continuous electrocardiosignal, finger unclamps, and path disconnects, and signal disconnects.(see Fig. 5)
Ii. automatic ecg signal acquiring：Using the mounted EGC sensor of chest, including upper patch electrode (401) and lower patch electrode
(402), it is close to left clavicle lower section and left nipple top respectively, on ECG Data Transmission Based line (403) connection main case (101)
Transmission line interface (206), the continuous electrocardiosignal for getting can be with the control module in real-time Transmission to main frame (105).(see figure
6)
3rd, the embodiment of the present invention realized in the method for continuous monitoring ambulatory blood pressure, ordinary surveying method include it is following some：
I. the key of ordinary surveying method is the pulse transit for calculating the pulse transit to sustainer that cardiac ejection is produced
Time PWTT (607), specific implementation method is that the pulse wave (601) to obtaining a cycle of radial artery decomposes, one
Pulse wave contains the pulse wave (602) that produces during left ventricular ejection and aortic compression expands the aortic pulse wave to be formed
(603) pulse wave of the pulse transit to sustainer for, calculating the time difference between two crests and producing for cardiac ejection is passed
Lead time PWTT (607) (see Fig. 7).
Ii. systolic pressure PWTT in ordinary surveying methodSBPThe exemplary fitting formula for calculating is formula 1：
PWTTSBP=exp (pt1*PWTT)+pt2 (formula 1)
Wherein, pt1, pt2 are, with reference to the fitting parameter of user's relevant parameter, to be changed according to the change of individual difference.
Iii. diastolic pressure PWTT is received in ordinary surveying methodDBPThe exemplary fitting formula for calculating is formula 2：
PWTTDBP=Td*exp { PWTTSBP/(pt3·PWTT)2- hr1* hearts rate (formula 2)
Wherein, Td is diastole duration；Pt1, pt2 are the fitting parameter with reference to user's relevant parameter, according to individual difference
Different difference its value accordingly changes.
4th, the present embodiment realized in the method for continuous monitoring ambulatory blood pressure, accurate measurement method include it is following some：
I. height height that measured must be obtained of accurate measurement method, body weight BMI, age Age, tobacco smoking status kimonos
Medicine situation.
Ii. the key of accurate measurement method is the pulse for calculating the pulse transit to radial artery collection point that cardiac ejection is produced
Ripple conduction time hrPWTT, specific implementation method is to gather to obtain electrocardiosignal (502) and radial artery pulse wave (501) simultaneously,
Time difference in the simple two-way signal of calculating between the trough of R ripples crest and radial artery pulse wave (501) adjacent thereafter, as
hrPWTT。
Iii. the pulse wave for calculating the pulse transit to radial artery collection point that cardiac ejection is produced of accurate measurement method is passed
It is by expression formula to lead speed hrPWV：
HrPWV=(h1* heights -5.085)/hrPWTT (formula 3)
Wherein, the fitting formula of the distance of heart to radial artery is L=h1* height -5.085, wherein, h1 is fitting ginseng
Number, according to the difference of individual difference, its value accordingly changes.
Systolic pressure PWV in accurate measurement methodSBPCalculate exemplary fitting formula be
I. it is with regard to the exemplary fitting formula of systolic pressure SBP of PWV：
PWVSBP=gen1 × sex+pw1 × hrPWV+bm1 × BMI+age1 × age+Sm1* smoker
+ drug1* pill takers (formula 4)
Wherein, gen1, pw1, bm1, age1, Sm1, drug1 are the fitting parameter with reference to user's relevant parameter, according to individuality
The difference of difference its value accordingly changes.
Ii. it is with regard to the exemplary fitting formula of the diastolic pressure DBP of PWV：
Wherein,We can pass through displacement signal s3Obtain, RC2Value is obtained by fitting parameter.
5th, the present invention provides a kind of quickly calibrated method for ordinary surveying method, i.e., using radial artery and heart pulse rate
HrPWTT between ripple (electrocardiosignal replacement), replaces in ordinary surveying method by decomposing the PWTT that radial artery pulse wave is obtained, school
Positive systolic pressure SBP value, it is ensured that the accuracy of ordinary surveying result.(operation diagram is as shown in figure 5, process is shown in the flow chart of Figure 12
Middle 900-711).
6th, technical scheme also includes the method that blood pressure computing module is processed pulse wave signal：The signal
By rate signal S1 reduction displacement signal S3 (i.e. 602) of pulse wave signal and to displacement signal in blood pressure computing module 109
The method that the peak value in each cycle is identified in S3.(Fig. 8, Fig. 9, Figure 13, Figure 14)
I. blood pressure computing module is identified to the summit of pulse wave signal S1, and its key step is shown in Figure 14；
Ii. radial artery pulse wave signal s1 Regularizations are obtained by pulse wave signal by signal analysis and processing module
s2；
Iii. to s2It is cumulativeReduction displacement signal S3, reflection vessel radius are by cardiac ejection and relaxing factor
Impact occur change.(as shown in Figure 9),
Iv. need to decompose signal s3 using beta function in ordinary surveying method, obtain left ventricle pulse wave and sustainer
Pulse wave is recognized, and recognizes the pulse wave crest value for extracting the crest value and middle artery of signal left ventricle pulse wave.
Trough V [the V of marking signal s3 are needed in accurate measurement method0,V1,…Vn]。
7th, technical scheme also includes：The blood pressure computing module (109) is in the displacement signal S3 after reduction
The method (Figure 10) of each periodicity extraction diastole duration Td [Td0, Td1...Tdn].Concrete grammar is shown in Figure 15；Use β letters
Number fitting displacement signal S3, calculating difference signal obtains diastole duration.
8th, technical scheme also includes：The corresponding time point of identification ecg-r wave marks R [R0,R1,…Rn],
And process with P labeled in the simple two-way signal (that is, pulse wave signal S3 and ECG) in heart cycle
[P0,P1,…Pn] and R [R0,R1,…Rn] between time difference, obtain the pulse wave translation time hrPWTT of heart-radial artery,
Such as Figure 11.
The invention provides a kind of noninvasive continuous blood pressure monitoring device and method, realize a kind of miniaturization, it is portable, need not
Cuff inflation is pressurizeed and continuous blood pressure measurer and method.The equipment need not only inflate cuff and can just realize sphygmomanometer
Function, while can realize that Long-term continuous blood pressure changes, and only need to be worn on wrist such as wrist-watch, flexibly apply to each
Plant living scene.The present invention is based on haemodynamics and blood vessel elasticity chamber model medium vessels parameter in the method for continuous blood pressure monitoring
Influence factor, make the result of long-term continuous BP measurement relatively reliable.
The foregoing is only the present invention specific embodiment, the protection domain being not intended to limit the present invention, it is all
Within the spirit and principles in the present invention, any modification, equivalent substitution and improvements done etc. should be included in the protection of the present invention
Within the scope of.
Claims (23)
1. a kind of continuous ambulatory blood pressure monitoring device based on pulse transit, it is characterised in that the monitoring device is watch
Form, is furnished with ecg signal acquiring module (104) on main case (101), be furnished with pulse at wrist strap (102) correspondence wrist radial artery
Ripple signal acquisition module (103), the ecg signal acquiring module (104) and pulse wave signal acquisition module (103) signal connect
Connect control module (105).
2. device according to claim 1, it is characterised in that the control module includes the amplification module being sequentially connected
(106), filtration module (107), a/d converter (108), blood pressure computing module (109), the amplification module (106) and the heart
Electrical signal collection module (104) and pulse wave signal acquisition module (103) signal connect.
3. device according to claim 1, it is characterised in that ecg signal acquiring module (104) includes being located at main case
Electrocardio Top electrode piece (201) of upper lid and it is used to be close to electrocardio bottom electrode piece (202) and the heart of skin positioned at main case bottom surface
Electric ground pole piece (203), the electrocardio Top electrode piece (201), electrocardio bottom electrode piece (202), electrocardio ground pole piece (203) and control mould
Block (105) connects.
4. device according to claim 1, it is characterised in that the ecg signal acquiring module (104) is included for tight
Upper patch electrode (401) and the lower patch electrode (402) above left nipple below patch left clavicle, and on main case (101)
The transmission line interface (206) being connected with control module (105), upper patch electrode (401) and lower patch electrode (402) are by electrocardio
Data line (403) the connection transmission line interface (206).
5. device according to claim 1, it is characterised in that the ecg signal acquiring module (104) is including the manual heart
Electrical signal collection module and automatic ecg signal acquiring module；
The manual ecg signal acquiring module includes electrocardio Top electrode piece (201) covered on main case and positioned at main frame
Shell bottom surface be used for be close to skin electrocardio bottom electrode piece (202) and electrocardio pole piece (203), the electrocardio Top electrode piece (201),
Electrocardio bottom electrode piece (202), electrocardio ground pole piece (203) are connected with control module (105)；
The automatic ecg signal acquiring module includes the upper patch electrode (401) for being close to below left clavicle and left nipple top
Lower patch electrode (402), and the transmission line interface (206) being connected with control module (105) on main case (101),
Upper patch electrode (401) and lower patch electrode (402) connect the transmission line interface by ECG Data Transmission Based line (403)
(206), it should be noted that the human body for heart on the right, upper patch electrode (401) is close to right subclavian side, lower patch electrode
(402) it is close to right nipple top.
6. device according to claim 1, it is characterised in that the pulse wave signal acquisition module (103) is including fastening
The biography of pulse wave sensor (204) and connection pulse wave sensor (204) and control module (105) on wrist strap (102)
Sensor connecting line (205), the pulse wave sensor (204) is including the PVDF piezoelectric membranes for being arranged at sensor outer housing (303)
And silica gel contact (301) (302).
7. the simple monitoring method of continuous ambulatory blood pressure of pulse transit is based on, it is characterised in that included：
(1) the pulse wave signal S1 of a cycle of radial artery pulse point is continuously obtained by pulse wave sensor and is sent to control
Molding block；
(2) decomposition is carried out to signal S1 and obtains left ventricle pulse wave and aortic pulse wave, while obtaining diastole duration；
(3) the time difference PWTT between left ventricle pulse wave and aortic pulse wave crest is calculated；
(4) systolic pressure PWTT is calculated according to PWTTSBP；
(5) according to systolic pressure PWTTSBPWith diastole duration calculation diastolic pressure PWTTDBP。
8. method according to claim 7, it is characterised in that collection pulse wave signal at intervals of 2ms in step (1).
9. method according to claim 7, it is characterised in that the concrete grammar of step (2) is：
(201) summit in each cycle in signal S1 is recognized；
(202) signal S2 is obtained to signal S1 regularizations；
(203) it is cumulative to signal S2 to obtain displacement signal S3；
(204) decomposition is carried out to signal S3 with beta function and obtains left ventricle pulse wave and aortic pulse wave；
(205) diastole duration Td [Td0, Td1 ... Tdn] is calculated by signal s3.
10. method according to claim 7, it is characterised in that step (4) systolic pressure PWTTSBPThe fitting of calculating is public
Formula is：
PWTTSBP=exp (pt1*PWTT)+pt2；
Wherein, pt1, pt2 are the fitting parameter with reference to user's relevant parameter.
11. methods according to claim 7, it is characterised in that step (5) the diastolic pressure PWTTDBPThe fitting of calculating is public
Formula is：
PWTTDBP=Td*exp { PWTTSBP/ (pt3PWTT) 2 }-hr1* hearts rate；
Wherein, Td is diastole duration；Pt1, pt2 are the fitting parameter with reference to user's relevant parameter.
The 12. simple monitoring methods of continuous ambulatory blood pressure calibration value based on pulse transit, it is characterised in that include：
(1) electrocardiosignal and pulse wave signal are gathered by pulse wave sensor and manual ecg signal acquiring module continuous synchronization
S1 is simultaneously sent to control module；
(2) heart-oar pulse wave translation time hrPWTT is obtained；
(3) systolic pressure PWTT is calculated according to hrPWTTSBP；
(4) according to systolic pressure PWTTSBPWith diastole duration calculation diastolic pressure PWTTDBP。
13. methods according to claim 12, it is characterised in that synchronous acquisition electrocardiosignal and pulse wave in step (1)
Signal at intervals of 2ms.
14. methods according to claim 12, it is characterised in that the concrete grammar of step (2) is：
(201) summit in each cycle in signal S1 is recognized；
(202) signal S2 is obtained to signal S1 regularizations；
(203) it is cumulative to signal S2 to obtain displacement signal S3；
(204) valley value [V0, V1 ... Vn] in signal S3 is extracted；
(205) the R ripples of electrocardiosignal are recognized and [R0, R1 ... Rn] is labeled as；
(206) time difference with the P [V0, V1 ... Vn] and R ripples [R0, R1 ... Rn] of heart cycle is processed, the heart-oar is obtained
Pulse wave translation time hrPWTT.
15. methods according to claim 12, it is characterised in that step (3) systolic pressure PWTTSBPThe fitting of calculating
Formula is：
PWTTSBP=exp (pt1*hrPWTT)+pt2；
Wherein, pt1, pt2 are the fitting parameter with reference to user's relevant parameter.
16. methods according to claim 12, it is characterised in that step (4) the diastolic pressure PWTTDBPThe fitting of calculating
Formula is：
PWTTDBP=Td*exp { PWTTSBP/ (pt3hrPWTT) 2 }-hr1* hearts rate；
Wherein, Td is diastole duration；Pt1, pt2 are the fitting parameter with reference to user's relevant parameter.
The 17. accurate monitoring methods of continuous ambulatory blood pressure based on pulse transit, it is characterised in that include：
(1) measured's individual's parameter is obtained；
(2) core signal ECG, pulse wave signal s1 are gathered by pulse wave sensor and ecg signal acquiring module continuous synchronization
And send to control module；
(3) heart-oar pulse wave translation time hrPWTT and diastole duration TD is obtained；
(4) heart-oar pulse wave conduction speed hrPWV is calculated according to the heart-oar pulse wave translation time hrPWTT；
(5) systolic pressure PWV is calculated according to the heart-oar pulse wave conduction speed hrPWVSBP；
(6) according to systolic pressure PWVSBPAnd diastole duration TD calculates diastolic pressure PWVDBP。
18. methods according to claim 17, it is characterised in that step (1) the personal parameter includes the body of measured
High height, body weight BMI, age Age, tobacco smoking status and medication situation.
19. methods according to claim 17, it is characterised in that synchronous acquisition electrocardiosignal and pulse wave in step (2)
Signal at intervals of 2ms.
20. methods according to claim 17, it is characterised in that the detailed process of step (3) is：
(201) summit in each cycle in signal S1 is recognized；
(202) signal S2 is obtained to signal S1 regularizations；
(203) it is cumulative to signal S2 to obtain displacement signal S3；
(204) diastole duration Td [Td0, Td1 ... Tdn] is calculated by signal s3；
(205) valley value [V0, V1 ... Vn] in signal S3 is extracted；
(206) the R ripples of electrocardiosignal are recognized and [R0, R1 ... Rn] is labeled as；
(207) time difference with the P [V0, V1 ... Vn] and R ripples [R0, R1 ... Rn] of heart cycle is processed, the heart-oar is obtained
Pulse wave translation time hrPWTT.
21. methods according to claim 17, it is characterised in that the formula that step (4) calculates hrPWV is as follows：
HrPWV=(h1* heights -5.085)/hrPWTT；
Wherein, h1 is fitting parameter.
22. methods according to claim 17, it is characterised in that step (5) calculates systolic pressure PWVSBPFormula it is as follows：
PWVSBP=gen1 × sex+pw1 × hrPWV+bm1 × BMI+age1 × age+Sm1* smoker+drug1* pill taker；
Wherein, gen1, pw1, bm1, age1, Sm1, drug1 are the fitting parameter with reference to user's relevant parameter.
23. methods according to claim 17, it is characterised in that the computing formula of step (6) is：
Wherein,By displacement signal s3Obtain, RC2Value is obtained by fitting parameter.
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| PCT/CN2017/110340 WO2018113442A1 (en) | 2016-12-21 | 2017-11-10 | Continuous ambulatory blood pressure monitoring device and method based on pulse wave transit |
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| CN107348952A (en) * | 2017-08-10 | 2017-11-17 | 上海理工大学 | Pulse Evolution Modes difference blood pressure monitor system |
| CN107550481A (en) * | 2017-08-24 | 2018-01-09 | 京东方科技集团股份有限公司 | A kind of portable equipment and blood pressure measuring method |
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| CN106618537B (en) | 2020-09-01 |
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