CN111202505B - Vascular endothelial function detection equipment and application method thereof - Google Patents
Vascular endothelial function detection equipment and application method thereof Download PDFInfo
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Abstract
The invention provides a vascular endothelial function detection device, which comprises a ophthalmoscope and an information processing terminal, wherein the information processing terminal receives ophthalmoscope information, the information processing terminal comprises a main storage module, a main processing module, a main input module and a main display module, the main storage module stores information measured by the ophthalmoscope, the main display module displays the information measured by the ophthalmoscope, the main processing module controls the main storage module and the main display module, and the main input module controls the main processing module; the fundus image is acquired by adopting the ophthalmoscope, the difference between the human body blood vessel injection or before and after taking the medicine in the fundus image is compared through the information processing terminal, then the vascular endothelial function is evaluated, other clinical manifestations are not required to be tested indirectly to evaluate the vascular endothelial function, the damage of angiography to the human body is avoided, the change of blood vessels can be directly observed, the influence factors are few, and the analysis result is accurate.
Description
Technical Field
The invention relates to the technical field, in particular to equipment for detecting vascular endothelial function and a using method thereof.
Background
Vascular endothelial cells are smooth and continuous monolayers of cells that cover the lumen of a blood vessel and play a vital role in regulating vascular function and maintaining vascular structure. Once endothelial cells function is compromised, the blood vessels are more prone to shrinkage and can lead to atherosclerotic changes such as proliferation of vascular smooth muscle, expression of inflammatory factors, oxidation of lipoproteins, platelet aggregation and thrombosis, ultimately leading to various cardiovascular events. Early endothelial dysfunction is reversible, and by using an effective diagnostic method, endothelial dysfunction is discovered early and therapeutic intervention is timely, which can reverse endothelial dysfunction and reduce the incidence rate and mortality rate of cardiovascular diseases.
In the prior art, coronary angiography is a gold standard for measuring vascular endothelial function, acetylcholine is injected into the coronary arteries, and the response of the inside diameter of the coronary arteries to acetylcholine is measured. The healthy population's response to acetylcholine is mild vasodilation, and the endothelial dysfunction patient's response to acetylcholine is reduced or even vasoconstrictor. The method has the advantages of complex operation, high cost, certain side effect of angiography on human body, inapplicability to early diagnosis and follow-up observation of diseases and low social popularization.
The main current method in the market is to test the vascular endothelial function by observing blood flow mediated vasodilation (Flow Mediated Dilation, FMD), the principle of FMD is to block the blood flow in an artery (preferably brachial artery) by using a pressurizing means, release pressure after 5 minutes to enable blood to flow again, and the shearing force of the blood flow on the vascular wall triggers the mechanism of releasing vasodilator factors (NO and the like) by vascular endothelial cells, so that the vascular endothelial function of a subject is analyzed by observing the degree of vasodilation. The method can realize noninvasive detection of vascular endothelial functions, and two devices existing in the market are presented below:
One device is an ultrasonic FMD. The implementation steps of the device are as follows: the blood flow is blocked by pressurizing the forearm portion to 60mmHg higher than the systolic pressure by using the cuff, the blocking is released after 5 minutes, and the vascular endothelial function is evaluated by measuring the diameter ratio of the brachial artery before blocking and after blocking by using precise color Doppler ultrasound. The method has the advantages that the blood vessel is directly observed, but has the defects that a professional operator is required, the observed quantity of ultrasonic equipment is easily affected by various factors, such as a cuff tangent plane, probe pressing force, external environment and the like, the vascular endothelial function cannot be stably and accurately analyzed, and larger errors exist.
Another apparatus measures the rate of change of amplitude of the fingertip tension pulse wave (PERIPHERAL ARTERY Tonometry, PAT) before and after the brachial artery occlusion by using a fingertip plethysmograph device, and analyzes the vascular endothelial function according to the magnitude of the rate of change. Compared with ultrasonic FMD, the device is simple and convenient to operate, but because the principle is that the reactive congestion of the blood vessel is indirectly measured, the result is easily influenced by the environment and other factors of the subject.
Therefore, the prior art cannot simply and accurately detect the vascular endothelial function, and has the defect that the result is easily affected.
Disclosure of Invention
Technical problem to be solved
The invention aims to solve the problem that the existing equipment for detecting the vascular endothelial function cannot simply and accurately detect the vascular endothelial function.
Technical proposal
The invention provides a vascular endothelial function detection device, which comprises a ophthalmoscope and an information processing terminal, wherein the information processing terminal receives ophthalmoscope information, the information processing terminal comprises a main storage module, a main processing module, a main input module and a main display module, the main storage module stores information measured by the ophthalmoscope, the main display module displays the information measured by the ophthalmoscope, the main processing module controls the main storage module and the main display module, and the main input module controls the main processing module.
Further, the ophthalmoscope is connected with the main storage module, and the main processing module controls the ophthalmoscope.
Further, the ophthalmoscope is provided with an auxiliary control module, an auxiliary input module, an auxiliary storage module and an auxiliary display module, the ophthalmoscope displays measured information on the auxiliary display module in a picture mode, the auxiliary storage module stores the measured information, the auxiliary control module controls the auxiliary display module, the auxiliary storage module and the ophthalmoscope, the auxiliary input module controls the auxiliary control module, and the main storage module receives the ophthalmoscope information in the auxiliary storage module.
Further, the auxiliary storage module is connected with a wireless transmission module, the wireless transmission module is controlled by the auxiliary control module to transmit the information of the auxiliary storage module to the information processing terminal, a wireless receiving module is arranged in the information processing terminal, the wireless receiving module receives the information of the wireless transmission module, and the information received by the wireless receiving module is stored in the main storage module.
Further, the auxiliary storage module is a mobile hard disk, and the auxiliary storage module is connected to the main storage module after being disassembled, and/or the auxiliary storage module and the main storage module transmit data through a data line.
Further, the main input module and the main display module are integrated into a main touch screen module, and the auxiliary input module and the auxiliary display module are integrated into an auxiliary touch module.
The invention also provides a using method of the device for detecting the vascular endothelial function, which comprises the following steps:
a. acquiring fundus images: acquiring human fundus images by using a ophthalmoscope, and selecting one or more fundus images;
b. Measuring fundus blood vessel parameters: measuring the vascular caliber parameter of the fundus image obtained by the ophthalmoscope in the step a through an information processing terminal;
c. administering or injecting a vasodilating drug: the acetylcholine, nitroglycerin or sodium nitroprusside medicine is injected into human body through taking or injection needle;
d. Fundus images after injection or drug administration of human body were measured: re-acquiring human fundus images by using a ophthalmoscope, and selecting one or more fundus images;
e. measuring fundus blood vessel parameters: measuring the vascular caliber parameter of the fundus image obtained by the ophthalmoscope in the step d through an information processing terminal;
f. The comparison results in: and (3) comparing the change of the vascular caliber parameters of the fundus images obtained in the step (b) and the step (e) to obtain a result.
Further, the parameters of the fundus blood vessel in the step b, the step e and the step f include, but are not limited to, the change of the vessel diameter, the fundus blood vessel includes vein or artery or the sum of the vein and the artery, and the fundus blood vessel measured and compared includes, but is not limited to, a single blood vessel; the comparison method in the step f comprises, but is not limited to, AI intelligent comparison of the diameters of blood vessel measuring points, the fundus blood vessel measuring points in the comparison in the step f comprise, but are not limited to, one measuring point,
Further, the vasodilating agents include, but are not limited to, acetylcholine, nitroglycerin, sodium nitroprusside, or similar acting agents.
Further, the fundus images in the step a and the step d are left eye or right eye, and the fundus images include but are not limited to photo forms.
Advantageous effects
1. The invention adopts the ophthalmoscope to collect the fundus image, compares the difference before and after the human blood vessel is injected or the medicine is taken in the fundus image through the information processing terminal, then evaluates the vascular endothelial function, does not need to indirectly test other clinical manifestations to evaluate the vascular endothelial function, avoids the damage of angiography to the human body, can directly observe the change of blood vessels, has less influencing factors and accurate analysis result.
2. The invention evaluates the vascular endothelial function by directly observing the change of the fundus blood vessel, can diagnose and analyze the vascular endothelial function earlier, has simple operation, and is suitable for the field of diagnosing and screening large-scale vascular endothelial dysfunction in hospitals, communities and physical examination institutions.
Drawings
FIG. 1 is a schematic diagram of a functional apparatus for detecting vascular endothelium according to example 1;
FIG. 2 is a schematic diagram of a functional apparatus for detecting vascular endothelium according to example 2;
FIG. 3 is a schematic diagram of a functional apparatus for detecting vascular endothelium according to example 3;
FIG. 4 is a schematic diagram of a functional apparatus for detecting vascular endothelium according to example 4;
FIG. 5 is a schematic diagram of a second embodiment of the apparatus for detecting vascular endothelial function according to the second embodiment of FIG. 5;
FIG. 6 is a schematic diagram showing the apparatus for detecting vascular endothelial function according to the first and third cases of embodiment 5;
FIG. 7 is a schematic diagram showing a device for detecting vascular endothelial function according to the fourth embodiment of the present invention;
FIG. 8 is a binary image schematic;
fig. 9 is a schematic diagram of a method of identifying the same vessel.
Detailed Description
The following describes the embodiments of the present invention in further detail with reference to examples. The following examples are illustrative of the invention and are not intended to limit the scope of the invention;
Example 1
As shown in fig. 1, the vascular endothelial function detecting device comprises a ophthalmoscope and an information processing terminal, wherein the information processing terminal receives ophthalmoscope information, the specific information processing terminal comprises a main storage module, a main processing module, a main input module and a main display module, wherein the main storage module stores the information measured by the ophthalmoscope, the main display module displays the information measured by the ophthalmoscope, the main processing module controls the main storage module and the main display module, the main input module controls the main processing module, namely, commands are input in a key and other modes, the further main input module and the main display module can be an integral main touch screen module, the commands are directly input through a touch screen, the ophthalmoscope and the information processing terminal are integral, the ophthalmoscope is directly connected with the main storage module, and the main processing module controls the ophthalmoscope.
Example 2
As shown in fig. 2, this embodiment is different from embodiment 1 in that both the ophthalmoscope and the information processing terminal are separate machines.
The specific information processing terminal comprises a main storage module, a main processing module, a main input module and a main display module, wherein the main storage module stores information measured by the ophthalmoscope, the main display module displays the information measured by the ophthalmoscope, the main processing module controls the main storage module and the main display module, the main input module controls the main processing module, namely, commands are input in a key and other modes, and the further main input module and the main display module can be integrated with the main touch screen module and directly input the commands through a touch screen.
The ophthalmoscope comprises a main storage module, an auxiliary display module, an auxiliary control module, an auxiliary input module, an auxiliary storage module and an auxiliary display module, wherein the ophthalmoscope displays measured information on the auxiliary display module in a picture mode, the auxiliary storage module stores the measured information, the auxiliary control module controls the auxiliary display module, the auxiliary storage module and the ophthalmoscope, the auxiliary input module controls the auxiliary control module, the further auxiliary input module and the auxiliary display module can be integrated with the auxiliary touch screen module, a command is directly input through a touch screen, the main storage module receives the ophthalmoscope information in the auxiliary storage module, the auxiliary storage module is a mobile hard disk, the mobile hard disk is taken out, and the mobile hard disk is directly connected to an information processing terminal through a card reader and is controlled by the main processing module to guide data into the main storage module.
Example 3
As shown in fig. 3, the difference between the present embodiment and embodiment 2 is that the main storage module receives the ophthalmoscope information in the auxiliary storage module in a wireless transmission manner, wherein the wireless transmission may be a 4G connection, a 5G connection, an NB-IOT connection, a WIFI connection, the specific auxiliary storage module is connected with a wireless transmission module, the wireless transmission module is controlled by the auxiliary control module to transmit the information of the auxiliary storage module to the information processing terminal, the information processing terminal is provided with a wireless receiving module, the wireless receiving module receives the information of the wireless transmission module, and the information received by the wireless receiving module is stored in the main storage module.
Example 4
As shown in fig. 4, the difference between the present embodiment and embodiment 2 or 3 is that the main storage module receives the ophthalmoscope information in the auxiliary storage module, and the auxiliary storage module and the main storage module transmit data through the data line, i.e. the auxiliary storage module and the main storage module are both provided with USB interfaces, and then are connected through the data line.
Example 5
As shown in fig. 5-7, the difference between this embodiment and embodiment 2,3 or 4 is that the main storage module receives the ophthalmoscope information in the auxiliary storage module, and any two or three of the methods in which the main storage module in embodiment 2-4 receives the ophthalmoscope information in the auxiliary storage module are used simultaneously.
As shown in fig. 6, the mobile hard disk of embodiment 2 and the wireless transmission of embodiment 3 are adopted, and the two modes are simultaneously applied; or as shown in fig. 5, the mobile hard disk of the embodiment 2 and the data line of the embodiment 4 are adopted for transmission, and the two modes are simultaneously applied; or as shown in fig. 6, the wireless transmission of the embodiment 3 and the data line transmission of the embodiment 4 are adopted, and the two modes are simultaneously applied, or as shown in fig. 7, the mobile hard disk of the embodiment 2, the wireless transmission mode of the embodiment 3 and the data line transmission of the embodiment 4 are simultaneously applied.
The invention also provides a use method of the vascular endothelial function detection device of the embodiments 1-5, comprising:
a. Acquiring fundus images:
The subject is left to stand for 5 minutes or more in a dark environment or mydriatic eye drops (tolterodine 0.5% or 1% concentration) are used, so that the pupil of the subject is ensured to be large enough, the collection of fundus images of the subject and the quality of collected images are facilitated, then, the fundus images of a human body are acquired by using a ophthalmoscope, the fundus images can be left eyes or right eyes, and then one or more fundus images are selected, wherein the fundus images comprise but are not limited to photo forms.
The fundus images obtained by the apparatus of example 1 are transferred to the main storage module for storage, while the fundus images obtained by the apparatus of examples 2 to 5 are stored in the auxiliary storage module, and then transferred to the main storage module, or the fundus images of a plurality of inspection persons can be collected and transferred to the main storage module at one time.
B. measuring fundus blood vessel parameters:
The fundus image in the step a transmitted to the information processing terminal is processed by adopting a main processing module, and the specific processing mode is as follows: the method comprises the steps of selecting a medical semantic image segmentation network UNET to segment blood vessels of fundus images, using Tversky Loss and running an Adam optimization algorithm training network, performing forward propagation through the network after training to obtain a blood vessel segmentation effect graph, performing binarization processing on the segmented images with a threshold value of 0.5 to obtain a binary image shown in fig. 8, wherein a black area is 0 and is represented as a background area, a white area is 1 and is represented as a blood vessel area, and measuring parameters such as the diameter of clear blood vessels on the binary image, wherein the parameters of fundus blood vessels comprise but are not limited to changes of the diameter of blood vessels, fundus blood vessels comprise veins or arteries or the sum of the veins and arteries, and the measured fundus blood vessels comprise but are not limited to single blood vessels.
C. Administering or injecting a vasodilating drug:
The acetylcholine, nitroglycerin or sodium nitroprusside is specifically taken or injected into human body by injection needle, then the normal reaction of human body blood vessel is slight vasodilation under the action of the medicine, and the patient with endothelial dysfunction, the medicine such as acetylcholine causes vasoconstriction, wherein the vasodilation medicine includes but is not limited to acetylcholine, nitroglycerin, sodium nitroprusside or the medicine with similar action.
D. fundus images after injection or drug administration of human body were measured:
And b, acquiring human fundus images again by using a ophthalmoscope, and selecting one or more fundus images in the same way as in the step a.
E. measuring fundus blood vessel parameters:
And b, specifically, processing the fundus image transmitted to the information processing terminal in the step d by adopting a main processing module, wherein the specific processing mode is the same as that of the step b.
F. the comparison results in:
And c, specifically comparing the change of the vascular diameter parameters of the fundus images obtained in the step b and the step e through an information processing terminal, and analyzing the endothelial function of the blood vessel to obtain a result.
The invention also discloses a method for determining the compared same blood vessel parameter test points:
As shown in fig. 9, first, the optic disc on the fundus image is segmented by an automatic thresholding method, and the segmented image is subjected to morphological processing to optimize the segmented region. Then, the minimum circumscribing circle of the segmented area is calculated, the circular boundary is calculated through a Canny edge detection algorithm, the circle center is calculated through Hough transformation, a proper numerical value R2 (2-4 times of the radius R1 of the optic disc) is used as a radius to form an arc intersecting with the fundus blood vessel, and the intersecting point with the blood vessel is the test blood vessel point.
Wherein the radius is selected to avoid crossing points at the vessel crossing points, reducing errors in measuring vessel parameters.
The two groups of images determine the same measuring point, the radius of the drawn circular arc is consistent, the specific fundus blood vessel measuring points for comparison comprise but are not limited to one measuring point, a plurality of groups of measuring points can be arranged on the same blood vessel, and then the difference of parameters such as the vessel diameter and the like of each group of measuring points of the same blood vessel is compared, so that the measuring error is reduced.
In summary, the above-described embodiments are not intended to be limiting embodiments of the present invention, and modifications and equivalent variations, which are within the spirit and scope of the present invention, will be within the technical scope of the present invention.
Claims (9)
1. The vascular endothelial function detection device is characterized by comprising a ophthalmoscope and an information processing terminal, wherein the information processing terminal receives ophthalmoscope information, the information processing terminal comprises a main storage module, a main processing module, a main input module and a main display module, the main storage module stores information measured by the ophthalmoscope, the main display module displays the information measured by the ophthalmoscope, the main processing module controls the main storage module and the main display module, and the main input module controls the main processing module;
the application method of the vascular endothelial function detection device comprises the following steps:
a. acquiring fundus images: acquiring human fundus images by using a ophthalmoscope, and selecting one or more fundus images;
b. Measuring fundus blood vessel parameters: measuring the vascular caliber parameter of the fundus image obtained by the ophthalmoscope in the step a through an information processing terminal;
c. administering or injecting a vasodilating drug: the acetylcholine, nitroglycerin or sodium nitroprusside medicine is injected into human body through taking or injection needle;
d. Fundus images after injection or drug administration of human body were measured: re-acquiring human fundus images by using a ophthalmoscope, and selecting one or more fundus images;
e. measuring fundus blood vessel parameters: measuring the vascular caliber parameter of the fundus image obtained by the ophthalmoscope in the step d through an information processing terminal;
f. The comparison results in: and (3) comparing the change of the vascular caliber parameters of the fundus images obtained in the step (b) and the step (e) to obtain a result.
2. The apparatus for detecting vascular endothelial function according to claim 1, wherein the ophthalmoscope is connected to a main storage module, and the main processing module controls the ophthalmoscope.
3. The device for detecting vascular endothelial function according to claim 2, wherein the ophthalmoscope is provided with an auxiliary control module, an auxiliary input module, an auxiliary storage module and an auxiliary display module, the ophthalmoscope displays the detected information on the auxiliary display module in a picture form, the auxiliary storage module stores the detected information, the auxiliary control module controls the auxiliary display module, the auxiliary storage module and the ophthalmoscope, the auxiliary input module controls the auxiliary control module, and the main storage module receives the ophthalmoscope information in the auxiliary storage module.
4. A device for detecting vascular endothelial function according to claim 3, wherein the auxiliary storage module is connected with a wireless transmission module, the wireless transmission module is controlled by the auxiliary control module to transmit information of the auxiliary storage module to the information processing terminal, a wireless receiving module is arranged in the information processing terminal, the wireless receiving module receives information of the wireless transmission module, and the information received by the wireless receiving module is stored in the main storage module.
5. The device for detecting vascular endothelial function according to claim 4, wherein the auxiliary storage module is a mobile hard disk, the auxiliary storage module is detachably connected to the main storage module, and/or the auxiliary storage module and the main storage module transmit data through a data line.
6. The device of any one of claims 3-5, wherein the primary input module is a primary touch screen module integral with the primary display module, and the secondary input module is a secondary touch module integral with the secondary display module.
7. A device for detecting vascular endothelial function according to claim 1, wherein the parameters of the fundus blood vessel in steps b, e and f include, but are not limited to, changes in vessel diameter, the fundus blood vessel including veins or arteries or the sum of both, and the measured and compared fundus blood vessel includes, but is not limited to, a single blood vessel; the comparison method in the step f comprises, but is not limited to, AI intelligent comparison of the diameters of blood vessel measurement points, and the fundus blood vessel measurement points subjected to comparison in the step f comprise, but are not limited to, one measurement point.
8. A device for detecting vascular endothelial function according to claim 1 wherein the vasodilator drug includes, but is not limited to, acetylcholine, nitroglycerin, sodium nitroprusside or similar acting drugs.
9. A device for detecting vascular endothelial function according to claim 1, wherein the fundus image in steps a and d is left or right eye, including but not limited to photographic forms.
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