CN110772243A - Atrial fibrillation blood pressure optimization calculation method based on oscillography principle - Google Patents
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Abstract
The invention discloses an oscillometric principle-based atrial fibrillation blood pressure optimization calculation method, which adopts the working principle of oscillometric blood pressure measurement, collects pulse wave signals of both hands in the process of acting on pressure cuffs by means of three cuffs, and processes the pulse wave signals by a blood pressure optimization calculation method. According to the optimization method, in the measurement process of patients with atrial fibrillation and arrhythmia, the optimization result of the blood pressure can be obtained by comparing the static pressure measured by the pressure cuff and the pulse wave characteristics sensed by the cuff in a comparison manner, so that the problem of inaccuracy of the blood pressure measurement result caused by the irregularity of the pulse wave in the conventional oscillometric sphygmomanometer is solved, and the accuracy of the blood pressure measurement of the patients with arrhythmia is improved. Therefore, the method has important significance for measuring the blood pressure of the arrhythmia patients.
Description
Technical Field
The invention belongs to the technical field of biomedical engineering, and particularly relates to an atrial fibrillation blood pressure optimization calculation method based on an oscillometric principle.
Background
The wave method blood pressure measurement is a clinically accepted Blood Pressure (BP) measurement mode which is the most common. Hitherto, both the auscultatory sphygmomanometer and the electronic sphygmomanometer have large measurement errors. The accuracy of the auscultatory method depends on the experience of the user, and the most direct reason is that both methods can obtain more accurate Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Pulse Rate (PR) results only for Sinus Rhythm (SR). However, patients with arrhythmia are ubiquitous, and particularly, patients with Atrial Fibrillation (AF) are increasing year by year, and unlike sinus rhythm, the ventricular beats in AF are irregular, and the corresponding pulse wave patterns are relatively disordered. If the measurement method and calculation formula corresponding to the sinus rhythm measurement are used, it is impossible to calculate accurate SBP, DB and PR. Such inaccurate measurements may mislead the physician and patient, ultimately affecting treatment.
The design of the existing oscillometric sphygmomanometer is based on SR as a premise, a pulse wave peak point is extracted, and then SBP and DBP are calculated from the peak point. Practice proves that the method has good applicability to SR measurement, and has a plurality of difficulties such as peak extraction and pulse envelope morphology extraction when measuring for AF patients. It is easy to verify that: when the conventional sphygmomanometer based on the oscillometric measurement principle is used for measuring the blood pressure of AF sinus patients, particularly patients with fast Heart Rate (HR), the obtained blood pressure values SBP and DBP have obvious defects, and the obvious defects are that the measurement result is always abnormal fluctuation, and the real blood pressure value cannot be determined. Therefore, there is a need to optimize the existing oscillometric sphygmomanometer to meet the blood pressure measurement requirements of sinus rhythm users and to obtain more accurate and effective blood pressure results for patients with atrial fibrillation.
Disclosure of Invention
Aiming at the defects and difficult problems in the prior art, the invention aims to provide an optimal calculation method of atrial fibrillation blood pressure based on the oscillometric principle, which is used for optimizing an oscillometric sphygmomanometer, so that the method can be used for measuring the blood pressure of patients with sinus rhythm and can also be used for measuring the blood pressure of patients with atrial fibrillation.
The invention is realized by the following technical scheme:
an oscillography principle-based atrial fibrillation blood pressure optimization calculation method comprises the following steps:
(1) the method comprises the following steps that three groups of cuffs including a group of pressure cuffs and two groups of pulse wave sensing cuffs are tied to two arms of a patient, wherein the group of pressure cuffs and the group of pulse wave sensing cuffs act on the same arm, the other group of pulse wave sensing cuffs act on the other arm, the blood flow of the arm is adjusted and a static pressure value is fed back by inflating and deflating the pressure cuffs, the two groups of pulse wave sensing cuffs are used for sensing pulse wave signals of the corresponding arms, a gas pressure sensor is used for collecting signals, and pulse wave signals of the two arms of the patient and pressure cuff signal data are synchronously collected;
(2) in the data acquisition process, the pressure cuff is inflated until the blood flow of the current arm is blocked or the pressure cuff is deflated until the blood flow is not blocked, and pulse wave signals of the pulse wave sensing cuffs of the two arms and signals returned by the pressure cuff are synchronously acquired;
(3) filtering the acquired pulse wave signals of the testee and the pressure cuff signals to obtain three groups of synchronous pulse wave data of the double-pulse-wave sensing cuff and static pressure data of the pressure cuff;
(4) and performing optimized systolic pressure and optimized diastolic pressure calculation on the three groups of data, establishing a relation model of pulse wave forms and static pressure values, and combining the pulse wave data of the two arms and the static pressure value of the pressure cuff to use the blood pressure value of a model optimization calculation method.
Further, the model optimization calculation method comprises the following processes:
firstly, establishing a blood pressure optimization model jointly formed by the static pressure of a pressure cuff and pulse wave characteristics, wherein the model is expressed as follows: bp is c (Bp2+ Bp1), wherein Bp is the result of blood pressure value, Bp2 is the static pressure of the pressure cuff when the pulse wave characteristics appear in the inflation (deflation) process, Bp1 is the static pressure of the pressure cuff when the pulse wave disappears in the inflation (deflation) process, and c is the coefficient corresponding to the pulse wave characteristics;
secondly, analyzing the characteristics of the current pulse wave data, and calculating the pulse wave amplitude, the pulse wave integrity and the pulse wave frequency characteristic coefficient between the two arms by contrasting the two-hand pulse wave data under the action of the pressure cuff and the non-pressure cuff;
and finally, substituting the current pulse wave part and the static pressure of the pressure cuff into the blood pressure optimization model, and calculating to obtain the current blood pressure value.
In order to facilitate the observation of the data, in the step (2), the pressure cuff is inflated or deflated step by gradually increasing or gradually decreasing the air pressure, so that the pressure of the pressure cuff is stepped
Compared with the prior art, the optimization method provided by the embodiment of the invention can sense the characteristics of cuff feedback through the static pressure fed back by the pressure cuff and the pulse wave in the measurement process of patients with atrial fibrillation and abnormal heart rhythm, differentially compares the two groups of data, and calculates to obtain the optimized result of the blood pressure, thereby avoiding the problem of fluctuation of the measurement result of the existing oscillometric sphygmomanometer, and having important significance for the blood pressure measurement of patients with arrhythmia.
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FIG. 1 is a schematic view of a three cuff use in the present invention;
fig. 2 is a schematic diagram of the two-hand pulse wave data and the pressure cuff static pressure data synchronously acquired during inflation according to the embodiment of the present invention;
fig. 3 is a schematic diagram of the two-hand pulse wave data and the pressure cuff static pressure data synchronously acquired during deflation according to the embodiment of the invention.
Detailed Description
The invention will be further described with reference to the accompanying drawings.
Fig. 1 is a schematic view of an installation structure of three groups of cuffs in the invention, wherein 1.1 and 1.2 are pulse wave sensing cuffs which can be used for blood pressure measurement and are commonly realized by hard-wall cuffs, and the cuffs are connected with a gas pressure sensor and a data acquisition device; 1.3 is a pressure cuff which is inflated and deflated to realize the adjustment of the blood flow of the arm; 1.4 the arm of the patient to be tested, and the left hand and the right hand can be selected arbitrarily.
The invention provides an oscillography principle-based atrial fibrillation blood pressure optimization calculation method, which comprises the following steps of:
the three groups of cuffs are tied on the two arms of a patient, as shown in figure 1, a pressure cuff 1.3 and a pulse wave sensing cuff 1.2 are applied to the same arm, the other pulse wave sensing cuff 1.1 is applied to the other arm, and the left hand and the right hand can be selected according to requirements.
(II) inflating the pulse wave sensing cuffs 1.1 and 1.2 on the two arms to increase the pressure (such as 10mmHg), and then setting the air pressure on the pressure cuff 1.3 in a stepwise increasing or decreasing mode to regulate the blood flow of the arm to make the cuff pressure in a step shape,
the pressure decreasing operation mode is that the pressure cuff 1.3 is inflated first until the pulse wave of the arm pressed by the pressure cuff 1.3 does not beat; then, the pressure cuff 1.3 is subjected to step deflation, the pressure cuff is reduced by 2-5 mmHg for 3.3 times in the figure, the pressure cuff stays for 1-5 s, and the steps are repeated until the pulse waveforms of the pulse wave sensing cuffs 1.1 and 1.2 respectively positioned on the two arms are basically consistent with each other and are 3.5 in the figure;
or
The pressure increasing mode is that the pressure cuff 1.3 is inflated in a step mode, as shown in the figure, 3.3 increases 2-5 mmHg each time, stays for 1-5 s, and circulates until the pulse wave of the pressure cuff 1.3 pressing the arm on the side has no pulsation, and the measurement is stopped as shown in the figure 3.3.
And (III) synchronously detecting and acquiring data of the three groups of cuffs in the air inflation (deflation) adjustment process in the step (II), wherein the data are pulse wave signals and pressure cuff signals on the two arms respectively, and filtering the signals of the three groups of cuffs to obtain two-hand pulse wave data such as 2.1, 2.2, 3.1 and 3.2 in the figure and pressure cuff static pressure data such as 2.3 and 3.3 in the figure.
The above data detection results are shown in fig. 2 and 3, in which,
2.1 is pulse wave data obtained by filtering after the pulse wave sensing cuff 1.1 at the non-pressure cuff side is collected, wherein the horizontal axis is time, and the vertical axis is pulse wave amplitude;
2.2 is pulse wave data obtained by filtering the collected pulse wave sensing cuff 1.2 at the pressure cuff side;
2.3 is the static pressure obtained after the gas pressure applied by the pressure cuff 1.3 is filtered, the pressure value changes from small to large, and the characteristic of step-shaped change is set for the convenience of data observation;
3.1 is pulse wave data obtained by filtering after the pulse wave sensing cuff 1.1 at the non-pressure cuff side is collected, wherein the horizontal axis is time, and the vertical axis is pulse wave amplitude;
3.2 pulse wave data is obtained by filtering after the pulse wave sensing cuff 1.2 at the pressure cuff side is collected;
3.3 is the static pressure obtained by filtering the gas pressure applied by the pressure cuff 1.3, the pressure value changes from large to small, and the characteristic of step-like change is set for the convenience of data observation.
(IV) analyzing and calculating the data of the three groups of cuffs in the inflation and deflation stages in the step (III), comparing 2.1 with 2.2 and 3.1 with 3.2, and respectively extracting nodes 2.4 with 2.5 and 3.4 with 3.5, wherein 2.4 with 2.5 respectively represent the time nodes corresponding to the pressure cuff 1.3 when the pulse wave characteristics appear and disappear in the inflation stage in the model (respectively illustrate that the blood flow appears and is completely blocked, the process can be used for optimizing the calculation of systolic pressure; 3.4 with 3.5 respectively represent the time nodes corresponding to the pressure cuff 1.3 when the pulse wave characteristics appear and disappear in the deflation stage in the model (respectively illustrate that the blood flow is completely blocked and the blood flow is not blocked), the process can be used for optimizing the calculation of diastolic pressure; reading the static pressure values corresponding to Bp2 and Bp1 from the cuffs 2.3 and 3.3, BP2 is the static pressure value corresponding to the pressure characteristic when the pulse wave characteristics appear and the difference in the inflation (deflation) process as 2.4 in the cuff, and the inflation (deflation) stage in the step (3) as the graph as 2.3, the static pressure value in the inflation stage (1) of the inflation stage as the graph as, and c is a coefficient corresponding to the characteristic of the pulse wave in the formula Bp (Bp2+ Bp1) c; according to the intervals of 2.4-2.5 and 3.4-3.5, comparing the ratio of the amplitude, the frequency, the area and the like of the two groups of pulse waves of 2.1 and 2.2 with the ratio of the amplitude, the frequency, the area and the like of the two groups of pulse waves of 3.1 and 3.2, calculating to obtain a coefficient c corresponding to the pulse wave characteristics, and finally calculating to obtain an optimized blood pressure value.
TABLE 1 measured data and calculated values of the present example
| Pressure increase | Pressure decrease | |
| Bp2 | 120 | 150 |
| Bp1 | 145 | 130 |
| c | 0.515 | 0.485 |
| Bp | 136 | 133 |
Under the influence of the irregularity and the incompleteness of the pulse wave form, if the method is not adopted, the sphygmomanometer with the conventional oscillometric principle generally shows that the measurement result fluctuates greatly and the blood pressure value is inaccurate for patients with arrhythmia (atrial fibrillation and abnormal heart rhythm).
Table 1 shows that two sets of BP1 and BP2 data (respectively, the inflation/deflation pressure is adjusted incrementally and decrementally) obtained by measurement of the same patient through the above operation process (wherein) can calculate the accurate value of BP (the measured and calculated values are not completely the same because the blood pressure of a person fluctuates in a small range), so that the measurement method can obtain more accurate and reliable blood pressure values.
The foregoing merely represents preferred embodiments of the invention, which are described in some detail and detail, and therefore should not be construed as limiting the scope of the invention. It should be noted that, for those skilled in the art, various changes, modifications and substitutions can be made without departing from the spirit of the present invention, and these are all within the scope of the present invention. Therefore, the protection scope of the present patent shall be subject to the appended claims.
Claims (3)
1. An atrial fibrillation blood pressure optimization calculation method based on an oscillography principle is characterized by comprising the following steps of:
(1) the method comprises the following steps that three groups of cuffs including a group of pressure cuffs and two groups of pulse wave sensing cuffs are tied to two arms of a patient, wherein the pressure cuffs and the pulse wave sensing cuffs are acted on the same arm, the other group of pulse wave sensing cuffs are acted on the other arm, the blood flow of the arm is adjusted and a static pressure value is fed back by inflating and deflating the pressure cuffs, the two groups of pulse wave sensing cuffs are used for sensing pulse wave signals of the corresponding arms, a gas pressure sensor is used for collecting signals, and pulse wave signals of the two arms of the patient and pressure cuff signal data are synchronously collected;
(2) in the data acquisition process, inflating the pulse wave sensing cuffs of the two arms, inflating the pressure cuffs until the blood flow of the current arm is blocked or deflating the pressure cuffs until no blocking effect exists, and synchronously acquiring pulse wave signals of the pulse wave sensing cuffs of the two arms and signals returned by the pressure cuffs;
(3) filtering the acquired pulse wave signals of the testee and the pressure cuff signals to obtain three groups of synchronous pulse wave data of the double-pulse-wave sensing cuff and static pressure data of the pressure cuff;
(4) and performing optimized systolic pressure and optimized diastolic pressure calculation on the three groups of data, establishing a relation model of pulse wave forms and static pressure values, and using the model to optimize the blood pressure value of the calculation method by combining the current pulse wave data of both hands and the static pressure value of the pressure cuff.
2. The atrial fibrillation blood pressure optimization calculation method based on the oscillography principle of claim 1, wherein the calculation method comprises the following steps of: the model optimization calculation method comprises the following processes:
firstly, establishing a blood pressure optimization model jointly formed by the static pressure of a pressure cuff and pulse wave characteristics, wherein the model is expressed as follows: bp is c (Bp2+ Bp1), wherein Bp is the result of blood pressure value, Bp2 is the static pressure of the pressure cuff when the pulse wave characteristics appear in the inflation (deflation) process, Bp1 is the static pressure of the pressure cuff when the pulse wave disappears in the inflation (deflation) process, and c is the coefficient corresponding to the pulse wave characteristics;
secondly, analyzing the characteristics of the current pulse wave data, and calculating the pulse wave amplitude, the pulse wave integrity and the pulse wave frequency characteristic coefficient between the two arms by referring to the two-hand pulse wave data under the action of the pressure cuff and the non-pressure cuff;
and finally, substituting the current pulse wave part and the static pressure of the pressure cuff into the blood pressure optimization model, and calculating to obtain the current blood pressure value.
3. The atrial fibrillation blood pressure optimization calculation method based on the oscillography principle of claim 1, wherein the calculation method comprises the following steps of: in the step (2), the pressure cuff is inflated or deflated in a stepwise manner by gradually increasing or gradually decreasing the air pressure, so that the pressure of the pressure cuff is in a step shape.
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113349751A (en) * | 2020-03-05 | 2021-09-07 | 深圳市理邦精密仪器股份有限公司 | Inflation and deflation control method and device and medical equipment |
| CN114052681A (en) * | 2021-11-23 | 2022-02-18 | 广州市康源图像智能研究院 | Blood pressure monitoring method and system based on electrocardiogram interpretation system |
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2019
- 2019-11-04 CN CN201911068404.3A patent/CN110772243A/en active Pending
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113349751A (en) * | 2020-03-05 | 2021-09-07 | 深圳市理邦精密仪器股份有限公司 | Inflation and deflation control method and device and medical equipment |
| CN114052681A (en) * | 2021-11-23 | 2022-02-18 | 广州市康源图像智能研究院 | Blood pressure monitoring method and system based on electrocardiogram interpretation system |
| CN114052681B (en) * | 2021-11-23 | 2024-03-22 | 广州市康源图像智能研究院 | Blood pressure monitoring method and system based on electrocardiograph interpretation system |
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