CN109222936A - A kind of application is stood up the device and method of experiment measurement autonomic nerve cardiovascular system - Google Patents
A kind of application is stood up the device and method of experiment measurement autonomic nerve cardiovascular system Download PDFInfo
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B5/0205—Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
- A61B5/02416—Detecting, measuring or recording pulse rate or heart rate using photoplethysmograph signals, e.g. generated by infrared radiation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- 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
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
- A61B5/02438—Detecting, measuring or recording pulse rate or heart rate with portable devices, e.g. worn by the patient
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/103—Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
- A61B5/11—Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb
- A61B5/1118—Determining activity level
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- 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]
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- A—HUMAN NECESSITIES
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/40—Detecting, measuring or recording for evaluating the nervous system
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- A—HUMAN NECESSITIES
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- 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
- A61B5/6802—Sensor mounted on worn items
Abstract
It stands up the invention discloses a kind of application and tests the device and method of measurement autonomic nerve cardiovascular system, the equipment includes data acquisition unit (100) and data processing unit (200), acceleration signal, electrocardiosignal and pulse wave signal of the data acquisition unit (100) for synchronous acquisition measured in experiment of standing up, and it is sent to the data processing unit (200)；Data processing unit (200) is used to calculate the heart rate and mean blood pressure of measured, and calculates the personalizing parameters of autonomic nerve heart regulation-control model, finally calculates pressoreceptor sensitivity and sympathetic parasympathetic activity.The present invention uses pressoreceptor sensitivity and sympathetic parasympathetic nerve activity to carry out real-time display as the index for measuring autonomic nerve heart regulation state, achievees the purpose that clinical evaluation and test cardiovascular system dynamic function.
Description
Technical field
This application involves technical field of human body physiological parameter measurement, and in particular to a kind of application is stood up the autonomous mind of experiment measurement
Device and method through cardiovascular system.
Background technique
" Chinese cardiovascular disease report 2017 " summary shows, the disease incidence of China's resident's cardiovascular disease, be presented on become younger,
Rapid growth and individual aggregation tendency in low-income group.Cardiovascular disease has high illness rate, high disability rate and high mortality
Feature, it is more crucial for the treatment in the opposite later period of prevention ahead of time.The diagnosis of cardiovascular disease, especially early diagnoses, it should main
It will be dependent on the assessment to cardiovascular system dynamic function.
In entire cardiovascular closed loop regulator control system, pressoreceptor sensitivity (Baroreflex Sensitivity,
BRS) the most key, and physical significance is obvious, clinical application significance is great, is proved by anatomy.It is repeatedly extensive in the world
Studies have shown that the reduction of pressoreceptor sensitivity, the death rate of the cardiac events such as heart infarction, heart failure, sudden death increases to 3 times of left sides
It is right.BRS is an important and independent hazard index of cardiovascular system.Stably measured BRS is for disease of cardiovascular system
Diagnosis and quantitative management are of great significance.The parameters of autonomic nerve cardiovascular system measure it is difficult, clinically frequently with
Invasive method causes blood pressure to increase to patient injection phyenlephrinium (vasoconstrictor), heart rate reduces, but this passes through injection
Drug is not often accepted by patients come the method measured.With deepening continuously for scientific research, rising for blood pressure noninvasive can be caused
Vertical experiment and inclined experimental are increasingly widely adopted.
Autonomic imbalance is the first big cause of disease of cardiovascular disease, and autonomic nerve regulation is unbalance, shows feeling of stress
Receiver sensitivity decline, the active decline of sympathetic and parasympathetic nerve.These are all the cardiovascular pathogenetic origins of many mortality
And individual index.Quantitative measurment pressoreceptor sensitivity measures sympathetic and parasympathetic nerve activity, for having for cardiovascular disease
Diagnosis, the assessment of therapeutic effect, prevention, rehabilitation are imitated, is all of great significance.
Summary of the invention
The present invention measures autonomic nerve cardiovascular system by experiment of standing up, using pressoreceptor sensitivity and
Sympathetic parasympathetic nerve activity carries out real-time display as the index for measuring autonomic nerve heart regulation state, reaches clinic and comments
The purpose of thought-read vascular system dynamic function.
In order to achieve the above objectives, one aspect of the present invention proposes a kind of equipment for measuring autonomic nerve cardiovascular system, including
Data acquisition unit and data processing unit: the data acquisition unit adding in experiment of standing up for synchronous acquisition measured
Speed signal, electrocardiosignal and pulse wave signal, and it is sent to the data processing unit；The data processing unit is for calculating
The heart rate and mean blood pressure of measured, and the personalizing parameters of autonomic nerve heart regulation-control model are calculated, finally calculate pressure
Receptor sensitivity and sympathetic parasympathetic activity.
According to the preferred embodiment of the present invention, the data acquisition unit includes: pulse wave acquisition module, is used to adopt
Pulse wave signal of the collection measured in experiment of standing up；Electrocardiogram acquisition module is used to acquire measured in experiment of standing up
Electrocardiosignal；Acceleration acquisition module is used to acquire movement and position chanP of the measured in experiment of standing up；Data are synchronous
Module is used for the acquisition of acceleration signal, electrocardiosignal described in synchronously control and pulse wave signal；Data acquisition control mould
Block is used for collected signal real-time transmission to the data processing unit.
According to the preferred embodiment of the present invention, the data processing unit includes: mean blood pressure computing module, based on
Calculate the mean blood pressure of measured；Rate calculation module, for calculating the heart rate of measured；Motion detection of standing up module, for examining
Survey the generation for movement of standing up；Autonomic nerve parameter calculating module, in experiment of standing up, according to autonomic nerve cardiovascular regulation
Model calculates personalized model parameter, and calculates pressoreceptor sensitivity and sympathetic parasympathetic nerve activity in turn.
According to the preferred embodiment of the present invention, the pulse wave acquisition module uses pressure sensor or infrared sensing
Device.
Another aspect of the present invention also proposes a kind of method for measuring autonomic nerve cardiovascular system, comprising: synchronous acquisition quilt
Acceleration signal, electrocardiosignal and pulse wave signal of the survey person in experiment of standing up；The heart rate and mean blood pressure of measured are calculated,
And the personalizing parameters of autonomic nerve heart regulation-control model are calculated, finally calculate pressoreceptor sensitivity and sympathetic parasympathetic
The activity of nerve.
Detailed description of the invention
Fig. 1 is the device structure using the experiment measurement autonomic nerve cardiovascular system that stands up of one embodiment of the present of invention
Block diagram；
Fig. 2 is the structural block diagram of wearable data acquisition unit of the invention；
Fig. 3 is the structural block diagram of the data processing unit of one embodiment of the present of invention；
Fig. 4 is the present invention the setting using the experiment measurement autonomic nerve cardiovascular system that stands up of one embodiment of the present of invention
Standby wearing schematic；
Fig. 5 is one embodiment of the present of invention in the action schematic diagram of experiment that stand up.
Specific embodiment
This bright exemplary embodiment is more fully described below with reference to accompanying drawings.Although being shown in attached drawing of the invention
Exemplary embodiment, it being understood, however, that the present invention may be realized in various forms, and embodiment is not intended to limit the invention
Range.On the contrary, purpose of providing these embodiments is in order to make those skilled in the art thoroughly understand the present invention.
Term "and/or" herein is only a kind of incidence relation for describing affiliated partner, indicates may exist three kinds
Relationship, for example, " A and/or B " can be indicated: individualism A exists simultaneously A and B, these three situations of individualism B.In addition,
Character "/" herein, typicallys represent the relationship that forward-backward correlation object is a kind of "or".
Stand up experiment principle it is as follows: when normal human becomes upright from horizontal position, about 300-800ml blood is from chest
Chamber is transferred to lower limb, and normal physiological reaction is that heart rate is slightly fast, and systolic pressure slightly reduces, and diastolic pressure increases, and mean arterial pressure is constant.
This experiment can cause orthostatic position low blood pressure, convenient for carrying out controllable measurement to autonomic nerve cardiovascular system.
Fig. 1 is the device structure using the experiment measurement autonomic nerve cardiovascular system that stands up of one embodiment of the present of invention
Block diagram.The present invention can measure and assess autonomic nerve heart adjusting function, especially measure and calculating pressoreceptor is sensitive
Degree and sympathetic parasympathetic nerve activity etc..As shown in Figure 1, whole equipment is by data acquisition unit 100, data processing unit 200
Composition.Data acquisition unit is preferably wearable.Wearable data acquisition unit 100 includes data acquisition and control module 150,
Under the control of data acquisition and control module 150,100 synchronous acquisition acceleration information of data acquisition unit, electrocardiogram (ECG) data and arteries and veins
Wave number of fighting evidence, and it is sent to data processing unit 200.During measured stands up test, data processing unit 200 calculates heart rate
And mean blood pressure, and the personalizing parameters of autonomic nerve heart regulation-control model are calculated, finally calculate pressoreceptor sensitivity
With sympathetic parasympathetic activity.
The data acquisition unit 100 includes pulse wave acquisition module 110, is used to acquire the pulse wave letter of measured
Number；Electrocardiogram acquisition module 120 is used to acquire the electrocardiosignal of measured；Acceleration acquisition module 130 is for acquiring measured's
Movement and position chanP；Data simultaneous module 140 is for acceleration signal, electrocardiosignal and pulse wave signal described in synchronously control
Acquisition；Data acquisition and control module 150 is used for collected signal real-time transmission to the data processing unit (200).
The embodiment of the present invention is described in detail below:
The structural block diagram and wearing schematic shown in Fig. 4 of wearable data acquisition unit 100 as shown in Figure 2, this hair
Bright three kinds of signals of equipment synchronous acquisition, it may be assumed that pulse wave, electrocardiosignal and acceleration signal.Pulse wave acquisition module 110 uses
Pressure sensor or infrared sensor.The position shown in Fig. 4, acquisition radial artery pulse wave in other embodiments can also
To use the sensor acquisition photoplethysmogra PPG for being worn on finger to replace pulse wave.Electrocardiogram acquisition module 120 uses two
A electrocardioelectrode enables the line of two electrodes by heart, acquires electrocardiosignal；Three axis in acceleration acquisition module 130 add
Velocity sensor measurement movement and position chanP；3-axis acceleration sensor output is 3-axis acceleration digital metric；It is above-mentioned
The pulse wave data and electrocardiogram (ECG) data of acquisition are analog signal, need to include difference amplifier and filtering in acquisition module
Device amplifies analog signal and filters.140 synchronous acquisition acceleration of data simultaneous module, electrocardio and pulse wave signal, and
Collected analog signal is made into analog-to-digital conversion.Data acquisition and control module 150 is by the digital signal received according to agreement
Communication protocol is packaged, by wired (such as USB) or wireless (such as bluetooth) mode by data real-time transmission to data processing unit
200。
As shown in 200 structural block diagram of Fig. 3 data processing unit, there are four modules for lower point of data processing unit 200.At data
Reason unit 200 receives data, after unpacking according to communication protocol, respectively by pulse wave signal, electrocardiosignal and acceleration signal
It send to mean blood pressure computing module 210, rate calculation module 220 and motion detection module 230 of standing up.Autonomic nerve parameter calculates
Module 240 is stood up from mean blood pressure computing module 210, rate calculation module 220 and motion detection module 230 of standing up respectively
Movement starts heart rate in latter 90 seconds and average pressure value sequence and stands up to act the time started, according to autonomic nerve angiocarpy tune
Model is controlled, personalized model parameter is calculated, and calculates pressoreceptor sensitivity and sympathetic parasympathetic nerve activity in turn.
Autonomic nerve cardiovascular regulation model inference principle is as follows:
The severe degree of pressoreceptor afferent impulse is not only related with blood pressure size, also has with the speed of blood pressure
It closes, is modeled using following formula:
Wherein i=S, I, L respectively indicate short-term (≈ 1s), mid-term (≈ 5s) and long-term (being approximately equal to 250s), kiIt is i class
The gain of nerve, n are pressoreceptor firing rate, meet n=ns+ni+nl+ N, M are maximum excitation rate.T is time, τiFor with ni
Relevant time constant.N is basic firing rate, be may be expressed as: with the relationship of maximum excitation rate M
Response such as following formula of the parasympathetic mind to pressoreceptor firing rate:
TparIt is responded for parasympathetic nerve, and M is maximum excitation rate.For parasympathetic transient response, hand over
Feeling neural response has certain delay.In addition, parasympathetic nerve response also plays the role of inhibition to sympathetic nerve.It tests simultaneously
Data also indicate that it is preceding lasting low to also contribute to the reflection triggering of answering pressure receptor for the sympathetic reflection of vestibular during postural change
The situation of blood pressure.Various effects above are described with following formula:
β indicates parasympathetic nerve inhibiting factor, τ in formuladFor time delay, u (t) is the impulse response letter of vestibular reflexes
Number, as follows:
Wherein tstartWith tstopParameter is respectively beginning and the finish time of impulse, u0It is then response amplitude.
Influence of the autonomic nerves system to heart rate is mainly completed by controlling the release of related mediator.In the model will
The mediator controlled by parasympathetic nerve is acetylcholine, is norepinephrine by the mediator controlled by sympathetic nerve.Respectively
To following two formula
Wherein CnorFor norepinephrine concentration, CachFor acetylcholine concentration.τachWith τnorFor time constant.
Finally the influence to mediator to heart rate models.Heart rate potential energy φ can pass through following integrated fire model table
Show.
Here H0(usually 100beats/min) indicates benchmark heart rate.It is left two parameter Ms, MpIt indicates to change two kinds
Learn the intensity of element variation reaction.In order to make heart rate within normal physical extent, we limit Ms, MpBetween [0,1],
In order to reach this effect, we introduce other two variable ξs、ξp, they and Ms, MpRelationship it is as follows.
When time correlation function φ becomes 1, illustrate to produce a heartbeat.It is reset to 0 at this time.If the heart twice
It fights in continuous moment tiWith ti+1Upper generation, then heart rate is 1/ (ti+1-ti), that is, the inverse of heart beat time interval twice.
HR=1/ (tφ=1-tφ=0)
To sum up, autonomic nerve cardiovascular regulation model can arrange are as follows:
X=(n, Tsym,Tpar,Cnor,Cach,φ)
θ=(KS,KI,KL,τS,τI,τL,τnor,τach,η,
ξS,ξp,μ0,tstart,tper,τd,β)
Wherein, x is the state variable in model, and p (t) indicates the input (being blood pressure) of model, and θ indicates the ginseng of model
Number.By above-mentioned model, it is apparent that in the case where input (blood pressure) of known models, it can go out correspond to by this model solution
Heart rate.
In order to accurately measure pressoreceptor sensitivity, one is obtained by way of noninvasive, devoid of risk, without special operation
Kind blood pressure and heart rate have the measurement scene of large change, avoid being covered by other factors.For this purpose, selecting " standing up " dynamic
As measurement scene.Due to the effect of gravity, when adult stands up there are about 500 milliliters of blood be not by venous return, and
It is to flow to lower limb.This transition state causes blood pressure to reduce.The compensation condition reaction that blood pressure reduces was occurred in the 10-15 second
Afterwards.This " low blood pressure of the initially standing up " process that is referred to as was after 30-60 seconds.Due to vascular compliance and sympathetic activity
Difference, the degree and recovery of " low blood pressure of initially standing up " of different people and time are also different.
It is that a human body stands up the schematic diagram of experiment shown in Fig. 5, in the application present invention, experimentation need to be divided into two
Point: one is blood pressure calibration process, and one is the process of standing up.Blood pressure calibration process utilizes a series of different movements, measurement
The corresponding pulse wave velocity of different pressure values, and it is fitted correlativity.Calibration process is specific as follows:
1) acquisition subject lay flat, be sagging, it is upper lift three kinds of action states under ppg, ecg signal
2) simultaneously with the pressure value of Full automatic digital blood pressure acquisition equipment acquisition standard
3) every time after the completion of signal acquisition every 30 seconds, signal stabilizations is waited to acquire next group of signal again later
It stands up experiment, i.e., experimenter carries out from sitting to this process that stands, and detailed process is as follows:
1) subject is sitting on chair, and the chair back is leaned at back, and upper body is straight and upright.
2) equipment is opened, the stabilization signal of 1min is acquired
3) it allows subject to stand, while acquiring corresponding ppg, ecg signal
4) above procedure is repeated three times
It should be appreciated that in order to simplify the present invention and help it will be understood by those skilled in the art that various aspects of the invention,
Above in the description of exemplary embodiment of the present invention, each feature of the invention is retouched in a single embodiment sometimes
It states, or is described referring to single figure.But should not be by the feature that the present invention is construed to include in exemplary embodiment
The essential features of patent claims.
It should be appreciated that can be to progress such as module, unit, the components for including in the equipment of one embodiment of the present of invention certainly
It adaptively changes so that they are arranged in equipment unlike this embodiment.The difference that can include the equipment of embodiment
Module, unit or assembly are combined into module, a unit or assembly, also they can be divided into multiple submodule, subelement or
Sub-component.
Module, unit or assembly in the embodiment of the present invention can realize in hardware, can also with one or
The software mode run on multiple processors is realized, or is implemented in a combination thereof.It will be understood by those of skill in the art that
Microprocessor or digital signal processor (DSP) can be used in practice to realize according to embodiments of the present invention.The present invention
It is also implemented as some or all computer program products or computer for executing method as described herein
On readable medium.
Claims (8)
1. a kind of equipment for measuring autonomic nerve cardiovascular system, including data acquisition unit (100) and data processing unit
(200), in which:
Acceleration signal, electrocardiosignal of the data acquisition unit (100) for synchronous acquisition measured in experiment of standing up
And pulse wave signal, and it is sent to the data processing unit (200)；
The data processing unit (200) is used to calculate the heart rate and mean blood pressure of measured, and calculates autonomic nerve heart tune
The personalizing parameters for controlling model, finally calculate pressoreceptor sensitivity and sympathetic parasympathetic activity.
2. the equipment of measurement autonomic nerve cardiovascular system according to claim 1, which is characterized in that the data acquisition
Unit (100) includes:
Pulse wave acquisition module (110) is used to acquire pulse wave signal of the measured in experiment of standing up；
Electrocardiogram acquisition module (120) is used to acquire electrocardiosignal of the measured in experiment of standing up；
Acceleration acquisition module (130) is used to acquire movement and position chanP of the measured in experiment of standing up；
Data simultaneous module (140) is used for adopting for acceleration signal, electrocardiosignal described in synchronously control and pulse wave signal
Collection；
Data acquisition and control module (150) is used for collected signal real-time transmission to the data processing unit
(200)。
3. the equipment of measurement autonomic nerve cardiovascular system according to claim 2, which is characterized in that the data processing
Unit includes:
Mean blood pressure computing module (210), for calculating the mean blood pressure of measured；
Rate calculation module (220), for calculating the heart rate of measured；
Motion detection of standing up module (230), for detecting the generation for movement of standing up；
Autonomic nerve parameter calculating module (240), for according to autonomic nerve cardiovascular regulation model, counting in experiment of standing up
Personalized model parameter is calculated, and calculates pressoreceptor sensitivity and sympathetic parasympathetic nerve activity in turn.
4. the equipment of measurement autonomic nerve cardiovascular system as claimed any one in claims 1 to 3, which is characterized in that institute
Pulse wave acquisition module (110) are stated using pressure sensor or infrared sensor.
5. a kind of method for measuring autonomic nerve cardiovascular system, comprising:
Acceleration signal, electrocardiosignal and pulse wave signal of the synchronous acquisition measured in experiment of standing up；
The heart rate and mean blood pressure of measured are calculated, and calculates the personalizing parameters of autonomic nerve heart regulation-control model, is finally counted
Calculate pressoreceptor sensitivity and sympathetic parasympathetic activity.
6. the method for measurement autonomic nerve cardiovascular system according to claim 5, which is characterized in that further include:
The acquisition of acceleration signal, electrocardiosignal described in synchronously control and pulse wave signal；
By collected signal real-time transmission to the data processing unit.
7. the method for measurement autonomic nerve cardiovascular system according to claim 6, which is characterized in that
According to autonomic nerve cardiovascular regulation model, personalized model parameter is calculated, and calculates pressoreceptor sensitivity in turn
With sympathetic parasympathetic nerve activity.
8. the method for the measurement autonomic nerve cardiovascular system as described in any one of claim 5 to 7, which is characterized in that.It adopts
With pressure sensor or the pulse wave signal of infrared sensor acquisition measured.
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| CN112057058A (en) * | 2020-08-07 | 2020-12-11 | 南京市中医院 | Method for evaluating autonomic nerve function and application |
| CN112842303A (en) * | 2020-11-23 | 2021-05-28 | 南京市中医院 | Autonomic nervous system screening method and system |
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