CN112754521A - Method and system for evaluating brain blood flow automatic regulation capability - Google Patents

Method and system for evaluating brain blood flow automatic regulation capability Download PDF

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CN112754521A
CN112754521A CN202110034925.8A CN202110034925A CN112754521A CN 112754521 A CN112754521 A CN 112754521A CN 202110034925 A CN202110034925 A CN 202110034925A CN 112754521 A CN112754521 A CN 112754521A
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blood flow
blood pressure
external counterpulsation
individual
cerebral blood
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CN112754521B (en
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杨明
严宇钊
叶四维
吴瑞良
余波
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Shanghai Jiaotong University
Shanghai First Peoples Hospital
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Shanghai First Peoples Hospital
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Abstract

The invention discloses a method and a system for evaluating the automatic regulating capacity of cerebral blood flow, which relate to the field of medical treatment and comprise the following steps: using an ultrasonic external counterpulsation device to carry out two external counterpulsation operations on an individual, wherein the force degrees applied by the two external counterpulsation operations are different, and carrying out continuous blood pressure monitoring and cerebral blood flow velocity monitoring on the individual during the implementation of the external counterpulsation operations; obtaining a cerebral blood flow velocity change value and a blood pressure data change value by using a blood pressure influence separation method; analyzing and obtaining the relation between the cerebral blood flow velocity change value and the blood pressure data change value by using a transfer function method; and evaluating the cerebral blood flow automatic regulation capability of the individual according to the relation between the cerebral blood flow velocity change value and the blood pressure data change value. By implementing the method, the interference of other factors influencing the change of the cerebral blood flow speed except the blood pressure can be eliminated, and the accuracy of the evaluation of the cerebral blood flow automatic regulation capability is improved.

Description

Method and system for evaluating brain blood flow automatic regulation capability
Technical Field
The invention relates to the field of medical treatment, in particular to a method and a system for evaluating the automatic regulating capacity of cerebral blood flow.
Background
The concept of Cerebral blood flow autoregulation (CA) was first proposed by Lassen in 1959, and refers to the ability of the brain blood flow to remain stable in the Cerebral vessels when the blood pressure of the human body fluctuates within a certain range. The automatic regulation of cerebral blood flow is an important cerebral protection mechanism, and avoids the excessive or insufficient blood supply of the brain when the blood pressure of a human body changes. The evaluation method of the cerebral blood flow autoregulation ability can be divided into two types: static and dynamic automatic cerebral blood flow regulation (tca) assessments. The static automatic cerebral blood flow regulation and evaluation method causes the blood pressure to change slowly through the intervention of medicines, while the dynamic automatic cerebral blood flow regulation and evaluation method usually causes the blood pressure to change rapidly through certain external excitation, and the dynamic automatic regulation method has greater advantages compared with the static automatic regulation method and is the main method for evaluating the automatic cerebral blood flow regulation capability at present.
External excitation methods adopted by the dynamic cerebral blood flow automatic regulation and evaluation method include a lower limb cuff release method, a common carotid artery compression method and the like, but the external excitation methods can cause patients to feel uncomfortable, so the external excitation methods are not suitable for patients with serious diseases, old people or patients with cognitive impairment, and the evaluation of the cerebral blood flow automatic regulation capacity by using external counterpulsation can compensate the problems.
However, the existing traditional external counterpulsation device mostly adopts an air bag type structure, and has the following disadvantages:
1) the time for the air bag type external counterpulsation device to reach the target equilibrium pressure is longer;
2) the stability of pressurization in diastole can not reach the expectation, and the counterpulsation pressure is difficult to control accurately;
3) the air pump and the electromagnetic valve have high noise when working, and can affect the nervous system.
In addition, many factors influence the automatic regulation of cerebral blood flow, and are influenced by factors such as vascular reactivity and neurovascular coupling mechanism, in addition to blood pressure change. Although the external counterpulsation can avoid the discomfort of a patient, the effect of vascular reactivity and a neurovascular coupling mechanism is not eliminated by the single pneumatic external counterpulsation pressurization, and the problem of poor consistency of the evaluation result of the cerebral blood flow automatic regulation capability is not solved.
Therefore, in order to overcome the above-mentioned drawbacks, those skilled in the art have made an effort to develop a method and a system for evaluating an automatic cerebral blood flow regulation capability, which can exclude interference of factors affecting a change in cerebral blood flow velocity other than blood pressure, and have high evaluation accuracy.
Disclosure of Invention
In view of the above-mentioned drawbacks of the prior art, the technical problem to be solved by the present invention is that the existing assessment techniques do not eliminate the influence of vascular reactivity and neurovascular coupling mechanism, etc., and the consistency of the assessment results is poor.
In order to achieve the above object, the present invention provides a method for evaluating an ability of automatically regulating cerebral blood flow, comprising the steps of:
under a stable and controllable environment, an ultrasonic external counterpulsation device is used for implementing two external counterpulsation operations on an individual, the force degrees applied by the two external counterpulsation operations are different, and continuous blood pressure monitoring and cerebral blood flow velocity monitoring are carried out on the individual during the implementation of the two external counterpulsation operations;
obtaining preprocessing data by using a blood pressure influence separation method, wherein the preprocessing data comprises a cerebral blood flow velocity change value and a blood pressure data change value;
analyzing the preprocessed data by using a transfer function method to obtain the relation between the brain blood flow velocity change value and the blood pressure data change value;
and evaluating the cerebral blood flow automatic regulation capability of the individual according to the relation between the cerebral blood flow velocity change value and the blood pressure data change value.
In the technical scheme, the stable and controllable environment means that the environment for carrying out the ultrasonic external counterpulsation device and the detection process on an individual is stable and controllable; the ultrasonic external counterpulsation device has the characteristic of high control precision of applied force.
The method is characterized in that proper force change is added on the basis of the force applied by the first external counterpulsation operation to obtain the force applied by the second external counterpulsation operation, and the influence of blood pressure change on the change of the cerebral blood flow speed is separated by utilizing the characteristic that the vascular reactivity and the neural coupling mechanism are not changed during the implementation of the two external counterpulsation operations and the difference between the applied blood pressure difference and the corresponding monitoring difference of the cerebral blood flow change speed through the two external counterpulsation operations.
In one technical scheme of the invention, the force difference value applied by two times of external counterpulsation operation is configured to be the minimum value on the premise of meeting the requirement of blood pressure change; the force difference value is configured to be generated by calculation of the evaluation device.
In one technical solution of the present invention, the method for calculating and generating the force difference by the evaluation device is as follows: in the calculation process, the force needs to be adjusted according to the measurement requirement of the cerebral blood flow automatic adjustment force, for example, the motor thrust needs to be increased when the force is too small to accurately measure until the blood pressure change meets the measurement requirement, and meanwhile, the pressure generated by the thrust on a human body needs to be ensured to be less than 59 kPa.
In the technical scheme, the requirements for meeting the blood pressure change comprise the requirement for measuring the blood pressure change and the requirement for the individual to bear the highest blood pressure.
In one technical scheme of the invention, the use environment and the use flow of the two external counterpulsation operations are consistent; and the second external counterpulsation operation is continuously carried out after the first external counterpulsation operation is finished.
Further, the blood pressure influence separation method comprises the following steps:
correspondingly subtracting the cerebral blood flow velocity value detected during the second external counterpulsation operation from the cerebral blood flow velocity value detected during the first external counterpulsation operation to obtain a cerebral blood flow velocity change value;
and correspondingly subtracting the blood pressure data detected during the second external counterpulsation operation from the blood pressure data detected during the first external counterpulsation operation to obtain the blood pressure data change value.
In the technical scheme, the two external counterpulsation operations are continuously performed, the two external counterpulsation operations have small force variation, the using environment, the using time interval and the using process are highly consistent, and other factors influencing the change of the cerebral blood flow speed except blood pressure in the two using processes before and after can be considered to be unchanged, wherein the unchanged factors comprise the psychological change and the respiratory change of the individual. The change of the cerebral blood flow velocity in the preprocessed data obtained by adopting the blood pressure influence separation method is only caused by the change of the blood pressure data, and the blood pressure influence separation method can exclude the interference of other factors influencing the change of the cerebral blood flow velocity besides the blood pressure, thereby improving the evaluation accuracy.
Further, the parameters obtained by the transfer function analysis include: gain and phase difference;
the value of the gain is set to be inversely proportional to the cerebral blood flow autoregulation ability;
the disappearance of the phase difference is set to a decrease in the cerebral blood flow autoregulation ability.
In one technical solution of the present invention, the transfer function method may be replaced by an auto-tuning exponential method or a pearson correlation coefficient method.
In one technical scheme of the invention, the external counterpulsation operation comprises the following steps:
at the initial diastole stage of the individual, the ultrasonic external counterpulsation device pushes upwards to the limb of the individual through a linear ultrasonic motor to pressurize the limb of the individual; when the applied pressure reaches a first pressure value, the linear ultrasonic motor is powered off to maintain the pressure, and the pressurization is released before the systolic period comes, wherein the first pressure value ranges from 40kPa to 59kPa, and the pressurization mode is set to continuously pressurize in turn according to the sequence of the lower leg, the thigh and the hip.
The first pressure value needs to reach a certain pressure value so as to meet the requirement of meeting the blood pressure change.
In one technical scheme of the invention, the limb is a lower limb.
Furthermore, the ultrasonic external counterpulsation device acts in the diastole of the human body after delaying the first period of time after detecting the R wave of the electrocardiosignal; after the second period of time, the pressurization is released before the systolic period of the human heart comes; the first period of time and the second period of time are determined according to the relation between the diastole, the systole and the heartbeat cycle of the human body.
Further, the mode of pressurizing the individual by the external counterpulsation operation is that the individual is continuously and sequentially pressurized according to the sequence of the lower leg, the thigh and the hip.
Further, the detection device for blood pressure monitoring is configured as a non-invasive blood pressure continuous monitor, the detection device for cerebral blood flow velocity monitoring is configured as a transcranial doppler ultrasound apparatus, and the detection device for electrocardiosignal R wave is configured as an electrocardiosignal monitoring module.
In one embodiment of the present invention, the individual is a brain disease patient.
The invention also provides a cerebral blood flow automatic regulation ability evaluation system, which comprises:
an ultrasound external counterpulsation device configured to enable an external counterpulsation procedure to be performed on the individual to cause a change in the individual's cerebral blood flow and blood pressure;
a monitoring device configured to be capable of monitoring cerebral blood flow and blood pressure of the individual;
an evaluation device configured to be capable of analyzing the cerebral blood flow value and the blood pressure value of the individual obtained by monitoring by the monitoring device, and evaluating the cerebral blood flow autoregulation ability of the individual; the evaluation device is configured to be able to set a thrust value applied by the ultrasound external counterpulsation device to the individual.
Furthermore, the ultrasonic external counterpulsation device comprises an ultrasonic external counterpulsation device main body part and an electrocardiosignal monitoring module; the electrocardiosignal monitoring module is configured to be capable of detecting electrocardiosignals of the individual and providing a triggering signal to the main body part of the ultrasonic external counterpulsation device; the main body part of the ultrasonic external counterpulsation device comprises a device driving part and a fixing part;
the device driving part comprises a linear ultrasonic motor and a linear ultrasonic motor driver, and the linear ultrasonic motor driver is configured to control the linear ultrasonic motor to advance or retreat so as to complete the external counterpulsation operation to the individual.
In the technical scheme, the linear ultrasonic motor driver controls the linear ultrasonic motor to act according to the requirements on the thrust and the speed of the linear ultrasonic motor.
Further, the monitoring device comprises a transcranial doppler ultrasound apparatus configured to be able to monitor the cerebral blood flow velocity, a non-invasive blood pressure continuous monitor configured to be able to monitor the blood pressure.
Further, the evaluation device comprises a PC and a control algorithm; the PC is configured to analyze the brain blood flow value and the blood pressure value of the individual obtained by monitoring of the monitoring device through a pre-programmed program, evaluate the brain blood flow automatic regulation capacity of the individual and send the set thrust value to the main body part of the ultrasonic external counterpulsation device; the PC is configured to analyze the cerebral blood flow value and the blood pressure value of the individual obtained by monitoring of the monitoring device by using a transfer function method, and obtain the relation between the cerebral blood flow velocity change value and the blood pressure data change value.
Further, the transfer function method may be replaced with an auto-tuning exponential method or a pearson correlation coefficient method.
Further, the parameters obtained by the transfer function analysis include: gain and phase difference;
the value of the gain is set to be inversely proportional to the cerebral blood flow autoregulation ability;
the disappearance of the phase difference is set to a decrease in the cerebral blood flow autoregulation ability.
In one technical solution of the present invention, the transfer function method may be replaced by an auto-tuning exponential method or a pearson correlation coefficient method.
Compared with the prior art, the implementation of the invention has at least the following beneficial technical effects:
according to the technical scheme disclosed by the invention, under a stable and controllable environment, the individual is subjected to two times of external counterpulsation operations, the two times of applied forces are different, the blood pressure influence separation method is used for evaluating the automatic regulating capacity of cerebral blood flow, the interference of other factors influencing the change of the cerebral blood flow speed except the blood pressure is eliminated, and the evaluation accuracy is improved.
The conception, the specific structure and the technical effects of the present invention will be further described with reference to the accompanying drawings to fully understand the objects, the features and the effects of the present invention.
Drawings
FIG. 1 is a schematic diagram of an evaluation system for cerebral blood flow autoregulation capability according to a preferred embodiment of the present invention;
FIG. 2 is a structural diagram of a main body part of the ultrasonic external counterpulsation device of the embodiment shown in FIG. 1;
FIG. 3 is a schematic diagram of the measurement of cerebral blood flow velocity, blood pressure and cardiac electrical signals as set forth in the embodiment of FIG. 1;
FIG. 4 is a schematic view of the proposed ultrasound extracorporeal counterpulsation compression site of the embodiment shown in FIG. 1;
FIG. 5 is a flow chart of the blood pressure effect isolation method of the embodiment shown in FIG. 1.
The device comprises a binding belt 1, a limb bracket 2, a linear ultrasonic motor 3, a mounting base 4, a buffer belt 5, a limb 6, a pressure sensor 7, a transcranial Doppler ultrasonic instrument measuring point 8, a noninvasive blood pressure continuous monitor measuring point 9, an electrocardiosignal monitoring device electrode patch position point 10 and an external counterpulsation pressurization part 11.
Detailed Description
The technical contents of the preferred embodiments of the present invention will be more clearly and easily understood by referring to the drawings attached to the specification. The present invention may be embodied in many different forms of embodiments and the scope of the invention is not limited to the embodiments set forth herein.
In the drawings, structurally identical elements are represented by like reference numerals, and structurally or functionally similar elements are represented by like reference numerals throughout the several views. The size and thickness of each component shown in the drawings are arbitrarily illustrated, and the present invention is not limited to the size and thickness of each component. The thickness of the components may be exaggerated where appropriate in the figures to improve clarity.
In the description of the embodiments of the present application, it should be clear that the terms "center", "upper", "lower", "left", "right", "inner", "outer", "top", "bottom", "side", "vertical", "horizontal", etc. indicate orientations or positional relationships based on those shown in the drawings, and are only for convenience of describing the embodiments of the present application and simplifying the description, but do not indicate or imply that the described devices or elements must have specific orientations or positional relationships, i.e., cannot be construed as limiting the embodiments of the present application; furthermore, the terms "first," "second," "third," "fourth," and the like are used merely to facilitate description or to simplify description, and do not indicate or imply importance.
As shown in fig. 1, the present embodiment provides an automatic cerebral blood flow regulation capability assessment system, which includes an ultrasonic external counterpulsation device configured to perform an external counterpulsation operation on an individual to cause a change in cerebral blood flow and blood pressure of the individual;
a monitoring device configured to be capable of monitoring cerebral blood flow and blood pressure of an individual;
the evaluation device is configured to analyze the cerebral blood flow value and the blood pressure value of the individual obtained by monitoring of the monitoring device and evaluate the cerebral blood flow automatic regulation capability of the individual; the evaluation device is configured to be able to set the thrust value applied by the ultrasound external counterpulsation device to the individual.
The ultrasonic external counterpulsation device comprises an ultrasonic external counterpulsation device main body part and an electrocardiosignal monitoring module; the electrocardiosignal monitoring module is configured to detect electrocardiosignals of an individual and provide triggering signals to the main body part of the ultrasonic external counterpulsation device; the main body part of the ultrasonic external counterpulsation device comprises a device driving part and a fixing part; the device driving part comprises a linear ultrasonic motor 3 and a linear ultrasonic motor driver, wherein the linear ultrasonic motor driver is configured to control the linear ultrasonic motor 3 to advance or retreat so as to complete the external counterpulsation operation to the individual.
In this embodiment, the linear ultrasonic motor driver controls the linear ultrasonic motor 3 to operate according to the requirements on the thrust and speed of the linear ultrasonic motor 3.
The ultrasonic external counterpulsation device in the embodiment is an external counterpulsation device driven by a linear ultrasonic motor 3, and has the following advantages compared with an air bag type external counterpulsation device:
1) the position and speed control precision is high, the nano-scale positioning and high-precision speed control can be realized, and the operation is facilitated;
2) the moving part has quick response and better pressurizing effect, and the time is in millisecond level;
3) the operation is quiet, and the psychology of an implementation individual is prevented from being influenced by strong noise;
4) the magnetic field is not generated, the magnetic field is not interfered by an external magnetic field, and the magnetic field generator has the characteristic of nuclear magnetic compatibility and is convenient to be used together with equipment such as MRI and the like.
Quietness may be configured with noise below 45 dB.
The invention also discloses an ultrasonic external counterpulsation device main body part, which comprises a fixing part for fixing and a driving part for acting, wherein the fixing part comprises a binding belt 1, a limb bracket 2, a mounting base 4 and a buffer belt 5, the driving part comprises a linear ultrasonic motor 3 and a linear ultrasonic motor driver, a limb 6 is wrapped by the buffer belt 5, the binding belt 1, the limb bracket 2 and the buffer belt 5 can be automatically adjusted as required to adapt to limbs 6 of different individuals, and a pressure sensor 7 is used for recording the pressure between the buffer belt 5 and the limb 6, as shown in figure 2.
The linear ultrasonic motor driver can control the linear ultrasonic motor 3 to move forward and backward according to actual requirements so as to complete the motion process required by external counterpulsation, and the actual control requirements comprise the thrust requirement and the speed requirement of the motor.
The monitoring device comprises a transcranial Doppler ultrasound instrument and a non-invasive blood pressure continuous monitoring instrument, wherein the transcranial Doppler ultrasound instrument is configured to be capable of monitoring the speed of cerebral blood flow, and the non-invasive blood pressure continuous monitoring instrument is configured to be capable of monitoring blood pressure.
The evaluation device comprises a PC and a control algorithm; the evaluation device is matched with the monitoring device, and the PC is configured to analyze the obtained cerebral blood flow value and blood pressure value of the individual through a pre-programmed program, evaluate the cerebral blood flow automatic regulation capability of the individual and send the set thrust value to the main body part of the ultrasonic external counterpulsation device.
The PC is configured to analyze the brain blood flow value and the blood pressure value of the individual obtained by monitoring by the monitoring device by utilizing a transfer function method, and obtain the relation between the brain blood flow speed change value and the blood pressure data change value;
in another embodiment of the present invention, the transfer function method may be replaced with an auto-tuning exponential method or a pearson correlation coefficient method.
The embodiment also discloses a cerebral blood flow automatic regulation capability assessment method, which comprises the following steps:
step 1: under a stable and controllable environment, an ultrasonic external counterpulsation device is used for implementing two external counterpulsation operations on an individual, the force degrees applied by the two external counterpulsation operations are different, the second external counterpulsation operation is added with proper force change on the basis of the force applied by the first operation, the external counterpulsation operation needs to be triggered according to an electrocardiosignal of the individual, and continuous blood pressure monitoring and cerebral blood flow velocity monitoring are carried out on the individual during the implementation of the two external counterpulsation operations;
step 2: obtaining preprocessing data by using a blood pressure influence separation method, wherein the preprocessing data comprises a cerebral blood flow velocity change value and a blood pressure data change value;
and step 3: analyzing the preprocessed data by using a transfer function method to obtain the relation between the change value of the cerebral blood flow velocity and the change value of the blood pressure data; and evaluating the cerebral blood flow automatic regulation capability of the individual according to the relation between the cerebral blood flow speed change value and the blood pressure data change value.
The individual in this embodiment includes a brain disease patient.
The force difference value applied by the two external counterpulsation operations is configured to be the minimum value on the premise of meeting the requirement of blood pressure change; the force difference value is configured to be generated by calculation of the evaluation device; the force in the calculation process needs to be adjusted according to the measurement requirement of the cerebral blood flow automatic adjustment capability, for example, the motor thrust needs to be increased when the force is too small to accurately measure until the blood pressure change meets the measurement requirement, and meanwhile, the pressure generated by the thrust on a human body needs to be ensured to be less than 59 kPa; the requirements of blood pressure change including the measurement requirement of blood pressure change and the requirement of individuals on suffering from hypertension are met; the using environment and the using flow of the two external counterpulsation operations are consistent; the second external counterpulsation operation is continuously carried out after the first external counterpulsation operation is finished.
The blood pressure influence separation method comprises the following steps:
correspondingly subtracting the cerebral blood flow velocity value detected during the second external counterpulsation operation from the cerebral blood flow velocity value detected during the first external counterpulsation operation to obtain a cerebral blood flow velocity change value;
and correspondingly subtracting the blood pressure data detected during the second external counterpulsation operation from the blood pressure data detected during the first external counterpulsation operation to obtain a blood pressure data change value.
The two external counterpulsation operations are continuously carried out, the two external counterpulsation operations have small force change, the use environment, the use time interval and the use flow are highly consistent, and other factors influencing the change of the cerebral blood flow speed except the blood pressure in the two use processes before and after can be considered to be kept unchanged, wherein the factors which are kept unchanged comprise individual psychological change and respiration change. The blood pressure influence separation method can eliminate the interference of other factors influencing the change of the cerebral blood flow velocity besides the blood pressure, and improve the evaluation accuracy. The specific process is as follows:
an electrode patch position point 10 of the electrocardiosignal monitoring device is shown in figure 3, when an electrocardiosignal monitoring module detects that an electrocardiosignal R wave is delayed for a certain time, the delayed time is determined according to the relation between the diastole and the R wave, namely, an ultrasonic external counterpulsation device is started at the initial diastole stage of an individual, a linear ultrasonic motor driver drives a linear ultrasonic motor 3 to push upwards to push a buffer belt 5 and pressurize a limb 6 of the individual, wherein the limb 6 is a lower limb, a pressure sensor 7 is adopted to record the pressure between the buffer belt 5 and the limb 6 in the execution process, when the applied pressure reaches a specified pressure value, the linear ultrasonic motor 3 is powered off and kept still to enable the ultrasonic external counterpulsation device to maintain the pressure, the range of the specified pressure value to the pressure generated by the individual is 40kPa-59kPa, and before the systole comes, the linear ultrasonic motor 3 returns to the initial position to release, this is an external counterpulsation operation, the pressurization mode is to continuously and sequentially pressurize according to the sequence of the calf, the thigh and the hip, and the external counterpulsation pressurization part 11 is shown in fig. 3 and 4. The buffer belt 5 can ensure that the individual is stressed uniformly and has a certain protection effect.
During the implementation of external counterpulsation, a noninvasive blood pressure continuous monitor is adopted to carry out continuous blood pressure monitoring on an individual and a transcranial Doppler ultrasound instrument is adopted to carry out cerebral blood flow velocity monitoring on the individual, and the measuring point 9 of the noninvasive blood pressure continuous monitor is shown in figure 3; the electrocardiosignal R wave detection mentioned above adopts an electrocardiosignal monitoring module, the electrocardiosignal monitoring module consists of an electrocardiosignal sensor and a characteristic value detection module, and the positions of electrode patches of the electrocardiosignal monitoring device are the middle position of a right hand forearm, the middle position of a left hand forearm and the lower left corner of the abdomen.
The characteristic of high control precision of ultrasonic external counterpulsation is utilized, a blood pressure influence separation method can be realized, the flow of the blood pressure influence separation method is shown in figure 5, the blood pressure influence separation method needs to carry out second external counterpulsation operation on an individual, the first external counterpulsation force is F1, the second external counterpulsation operation is added with a proper force change delta F on the basis of the first operation applied force F1, the force change is set by an evaluation device, and the delta F is required to be as small as possible on the premise that the delta F change can meet the requirement of blood pressure change. The ultrasonic external counterpulsation has the characteristics of high control precision and convenient control, and the Delta F can be changed aiming at different subjects to meet the requirements in use. For example, if the force is too small to accurately measure, Δ F should be increased until the blood pressure changes meet the measurement requirement, and it is necessary to ensure that the pushing force does not cause discomfort to the human body, and it is preferable that the pressure generated by the pushing force to the human body is less than 59kPa in this embodiment. Except for the change of the external counterpulsation intensity, other use environments, use time intervals and use procedures are kept consistent, and the second external counterpulsation operation is continuously carried out after the first external counterpulsation operation is finished. And recording blood pressure and cerebral blood flow data obtained by two times of external counterpulsation, and correspondingly subtracting the monitored cerebral blood flow velocity and blood pressure data of the second group from the cerebral blood flow velocity and blood pressure data of the first group to obtain cerebral blood flow velocity change and blood pressure change caused by delta F.
Because the external counterpulsation operations are continuously carried out for two times, the delta F change is small, the use environment, the use time interval and the use flow are consistent, other factors influencing the change of the cerebral blood flow velocity, such as individual psychological change, respiration change and the like, except the blood pressure change caused by the delta F in the use processes of the external counterpulsation operations for two times are considered to be kept unchanged. After blood pressure influence separation, cerebral blood flow change in the preprocessed data is only caused by blood pressure change, and the blood pressure influence separation has the significance of eliminating interference of other factors influencing cerebral blood flow speed change besides blood pressure, so that the evaluation accuracy is improved.
And analyzing the relation between the blood pressure and the blood flow velocity after the blood pressure influences the separation by using a transfer function method, and evaluating the brain blood flow automatic regulation capability of the individual based on the relation. In other embodiments of the invention, the transfer function method for evaluating the cerebral blood flow automatic regulation capability can be replaced by an automatic regulation index method or a Pearson correlation coefficient method;
the relationship between the blood pressure change value and the cerebral blood flow velocity change value after the blood pressure influence separation is analyzed by the transfer function method in the embodiment is specifically as follows:
the transfer function method is a method for evaluating cerebral blood flow automatic regulation capability in a frequency domain, and the expression is as follows:
Figure BDA0002893832010000081
wherein S isxy(f) Is a cross-power spectrum of blood pressure signals and cerebral blood flow signals, Sxx(f) Is the self-power spectrum of the blood pressure signal, and H (f) is the defined transfer function.
Through the defined transfer function, two parameters used for the evaluation are found: gain and phase difference.
The expression for the gain is as follows:
Figure BDA0002893832010000082
the expression for the phase difference is as follows:
φ(f)＝tan-1(HI(f)/HR(f))；
wherein HR(f) Is the real part of the transfer function, HI(f) Is the imaginary part of the transfer function.
According to the blood pressure and the cerebral blood flow speed monitored during the external counterpulsation of the individual, two parameters of gain and phase difference can be calculated by using a transfer function method, and the cerebral blood flow automatic regulation capability of the individual can be evaluated by analyzing the two parameters.
A low gain indicates the presence of autoregulation of cerebral blood flow, while a high gain indicates a decrease in autoregulation of cerebral blood flow.
Disappearance of the phase difference indicates a decrease in the ability of cerebral blood flow autoregulation.
The foregoing detailed description of the preferred embodiments of the invention has been presented. It should be understood that numerous modifications and variations could be devised by those skilled in the art in light of the present teachings without departing from the inventive concepts. Therefore, the technical solutions available to those skilled in the art through logic analysis, reasoning and limited experiments based on the prior art according to the concept of the present invention should be within the scope of protection defined by the claims.

Claims (10)

1. A cerebral blood flow automatic regulation capability assessment method is characterized by comprising the following steps:
under a stable and controllable environment, an ultrasonic external counterpulsation device is used for implementing two external counterpulsation operations on an individual, the force degrees applied by the two external counterpulsation operations are different, and continuous blood pressure monitoring and cerebral blood flow velocity monitoring are carried out on the individual during the implementation of the two external counterpulsation operations;
obtaining preprocessing data by using a blood pressure influence separation method, wherein the preprocessing data comprises a cerebral blood flow velocity change value and a blood pressure data change value;
analyzing the preprocessed data by using a transfer function method to obtain the relation between the brain blood flow velocity change value and the blood pressure data change value;
and evaluating the cerebral blood flow automatic regulation capability of the individual according to the relation between the cerebral blood flow velocity change value and the blood pressure data change value.
2. The method of claim 1, wherein the blood pressure effect separation method comprises the steps of:
correspondingly subtracting the cerebral blood flow velocity value detected during the second external counterpulsation operation from the cerebral blood flow velocity value detected during the first external counterpulsation operation to obtain a cerebral blood flow velocity change value;
and correspondingly subtracting the blood pressure data detected during the second external counterpulsation operation from the blood pressure data detected during the first external counterpulsation operation to obtain the blood pressure data change value.
3. The assessment method of claim 2, wherein said external counterpulsation procedure comprises the steps of:
at the initial diastole stage of the individual, the ultrasonic external counterpulsation device pushes upwards to the limb of the individual through a linear ultrasonic motor to pressurize the limb of the individual; when the applied pressure reaches a first pressure value, the linear ultrasonic motor is powered off to maintain the pressure, and the pressurization is released before the systolic period comes, wherein the first pressure value ranges from 40kPa to 59kPa, and the pressurization mode is set to continuously pressurize in turn according to the sequence of the lower leg, the thigh and the hip.
4. The assessment method as claimed in claim 3, wherein said ultrasound external counterpulsation device is operated in the diastolic phase of the human heart after a first time delay after the detection of the R wave of the cardiac signal; after the second period of time, the pressurization is released before the systolic period of the human heart comes; the first period of time and the second period of time are determined according to the relation between the diastole, the systole and the heartbeat cycle of the human body.
5. The assessment method according to claim 4, wherein the detection device for blood pressure monitoring is configured as a non-invasive blood pressure continuous monitor, the detection device for cerebral blood flow velocity monitoring is configured as a transcranial Doppler ultrasound apparatus, and the detection device for electrocardiosignal R wave is configured as an electrocardiosignal monitoring module.
6. An evaluation system using the evaluation method according to any one of claims 2 to 5, comprising:
an ultrasound external counterpulsation device configured to enable an external counterpulsation procedure to be performed on the individual to cause a change in the individual's cerebral blood flow and blood pressure;
a monitoring device configured to be capable of monitoring cerebral blood flow and blood pressure of the individual;
an evaluation device configured to be capable of analyzing the cerebral blood flow value and the blood pressure value of the individual obtained by monitoring by the monitoring device, and evaluating the cerebral blood flow autoregulation ability of the individual; the evaluation device is configured to be able to set a thrust value applied by the ultrasound external counterpulsation device to the individual.
7. The evaluation system of claim 6, wherein the ultrasound external counterpulsation device comprises an ultrasound external counterpulsation device main body part, an electrocardiosignal monitoring module; the electrocardiosignal monitoring module is configured to be capable of detecting electrocardiosignals of the individual and providing a triggering signal to the main body part of the ultrasonic external counterpulsation device; the main body part of the ultrasonic external counterpulsation device comprises a device driving part and a fixing part;
the device driving part comprises a linear ultrasonic motor and a linear ultrasonic motor driver, and the linear ultrasonic motor driver is configured to control the linear ultrasonic motor to advance or retreat so as to complete the external counterpulsation operation to the individual.
8. The evaluation system of claim 7, wherein the monitoring device comprises a transcranial doppler ultrasound meter configured to monitor cerebral blood flow velocity, a non-invasive blood pressure continuous monitor configured to monitor blood pressure.
9. The evaluation system of claim 8, wherein the evaluation device comprises a PC, a control algorithm; the PC is configured to analyze the brain blood flow value and the blood pressure value of the individual obtained by monitoring of the monitoring device through a pre-programmed program, evaluate the brain blood flow automatic regulation capacity of the individual and send the set thrust value to the main body part of the ultrasonic external counterpulsation device; the PC is configured to analyze the cerebral blood flow value and the blood pressure value of the individual obtained by monitoring of the monitoring device by using a transfer function method, and obtain the relation between the cerebral blood flow velocity change value and the blood pressure data change value.
10. The evaluation system of claim 9, wherein the parameters obtained by the transfer function method analysis comprise: gain and phase difference;
the value of the gain is set to be inversely proportional to the cerebral blood flow autoregulation ability;
the disappearance of the phase difference is set to a decrease in the cerebral blood flow autoregulation ability.
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