JP2005279248A - Circulatory organ function measuring instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a circulatory organ function measuring instrument capable of highly precisely measuring the functions of the circulatory organ such as the arteriosclerosis. <P>SOLUTION: This circulatory organ function measuring instrument extracts a difference (width) W1 between compressive pressure p1 having an amplitude value r1 of a certain pulse wave and a boundary value pα in a region P1 of high pressure side compression in an envelope and a difference (width) W2 between compressive pressure p2 having an amplitude value f2 different from the amplitude value r1 and the boundary value pα in a region P2 of low pressure side compression as feature quantities based on the physical characteristics of a person to be measured. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a circulatory function measuring device that analyzes a state of a living body based on a pulse wave obtained from the living body.

  In the living body, fluctuation (pulse) occurs in the pressure in the artery as the heart rhythmically pumps out blood. 2. Description of the Related Art Conventionally, a technique for inspecting a state of a circulatory function such as arteriosclerosis using a change (feature amount) of vibration (pulse wave) generated by a pulse is known.

  As one of the techniques, when the external pressure applied to the detection location of the pulse wave is changed, for example, the feature value of the pulse wave related to the degree of arteriosclerosis is extracted by using the change of the amplitude value of the pulse wave. Thus, there is known a technique for inspecting the progress of arteriosclerosis (for example, see Patent Document 1 below).

The following technique is disclosed in Patent Document 1 below. That is, after increasing the compression pressure to a predetermined target compression pressure, the amplitude of the pulse wave is sequentially detected in the process of gradually reducing the compression pressure, and the relationship between the compression pressure and the amplitude of the pulse wave is derived. The relationship between the compression pressure and the amplitude of the pulse wave draws an envelope that maximizes the amplitude value of the pulse wave when the compression pressure substantially matches the average blood pressure value. Then, as shown in FIG. 42, one inclination angle θ of a straight line connecting a point corresponding to the maximum blood pressure value and a point having an amplitude value of 63.2% of the maximum amplitude value in this envelope is derived, The degree of arteriosclerosis of the measurement subject is determined according to the magnitude of the inclination angle θ, or the difference (width) W between the two compression pressures taking the amplitude value of 90% of the maximum amplitude value and the maximum as shown in FIG. A technique for determining the degree of arteriosclerosis of a measurement subject according to a ratio with the amplitude value H is disclosed.
Japanese Patent No. 2938238

  However, it is considered that each of the above-described conventional techniques has room for improving the accuracy of measurement of the circulatory function, particularly arteriosclerosis.

  That is, in general, the pulse wave includes various information related to the circulatory function, for example, information indicating the state of the blood vessel and the state of the heart. In the case of a blood vessel as an example, when focusing on the change in volume of the blood vessel in the process of changing the pressure acting on the blood vessel, as shown in FIG. 10, generally, the volume change rate of the blood vessel is not constant. Without changing depending on the pressure. In particular, the volume change rate of the blood vessel is greatly different between a state where the pressure acting on the blood vessel is small and a state where the pressure acting on the blood vessel is large. This is because the blood vessel has a three-layer structure with different elastic properties of the intima, media and adventitia, and in the state where the pressure is small, the extensibility of the blood vessel wall is in the properties of the intima and media. This is because, in a state where the pressure is large, the extensibility of the blood vessel wall depends on the characteristics of the outer membrane, and the tissue related to the extensibility differs depending on the pressure acting on the blood vessel.

  Therefore, as in the prior art (FIGS. 42 and 43), only one feature amount (the inclination θ) at a certain compression pressure or one feature amount (the width W) that summarizes the entire envelope. ) Is a method for measuring arteriosclerosis using only the above, for example, it is difficult to grasp whether an abnormality is present in the intima and media of the blood vessel or an abnormality in the outer membrane of the blood vessel. It is difficult to say that sufficient information on blood vessels showing various properties can be obtained according to the compression pressure.

  In addition, it is preferable if the cardiovascular function suitable for the physical characteristics of the measurement subject can be measured.

  The present invention has been made in view of such circumstances, and is suitable for the physical characteristics of a person to be measured and capable of measuring cardiovascular function including arteriosclerosis with higher accuracy. It aims at providing a function measuring device.

  In order to achieve the above-mentioned object, a circulatory function measuring device according to the first means of the present invention detects a pressure application means for compressing a predetermined part of the body of a person to be measured, and a compression pressure by the pressure application means. Pressure detecting means that performs pressure control means that changes the compression pressure by the pressure application means based on the detected compression pressure, and a pulse that occurs in the predetermined site in the process of changing the compression pressure based on the detected compression pressure Pulse wave detection means for detecting pulse wave information relating to the magnitude of the wave, pulse wave information storage means for storing the detected pulse wave information in association with the compression pressure information relating to the compression pressure at the time of detection, and The envelope formed based on the correspondence between the pulse wave information stored in the pulse wave information storage means and the compression pressure information is divided into a plurality of regions with a predetermined compression pressure as a boundary, and the entire envelope The A feature quantity that extracts a feature quantity that indicates a feature of the shape of the envelope within at least two areas of the entire area and each of the divided areas when viewed as one area. Extraction means, circulatory function determination means for determining circulatory function based on each extracted feature quantity, display means for displaying the determination result of the circulatory function determination means, and physical characteristics of the subject to be measured Input means for input, and second extraction method setting means for setting a feature value extraction method including the boundary value setting and the type of feature value to be extracted based on the input physical characteristics, The feature quantity extracting means extracts the feature quantity according to the feature quantity extraction method set by the second extraction method setting means.

  In such a circulatory function measuring device and a circulatory function measuring method, a feature value extraction method including setting of boundary values and types of feature values to be extracted is set based on physical characteristics, and pulse wave information and the above-mentioned The envelope formed based on the correspondence relationship with the compression pressure information is divided into a plurality of regions with a predetermined compression pressure as a boundary, and the entire region and the division when the entire envelope is viewed as one region Each of the divided areas is extracted from at least two of the divided areas, and the feature quantity indicating the feature of the shape of the envelope is extracted, and the cardiovascular function is determined based on the extracted feature quantities. Do. For this reason, the measurement of the cardiovascular function including arteriosclerosis suitable for the physical characteristics of the measurement subject can be performed with higher accuracy.

(First embodiment)
First, a circulatory function measuring method using the circulatory function measuring apparatus according to the present invention will be described. 1 to 5 are diagrams for explaining the cardiovascular function measurement method.

  In the cardiovascular function measurement method of the present embodiment, first, as shown in FIG. 1, for example, a rubber bag-like cuff 1 is attached while being wound around, for example, the upper arm of the person to be measured. Air is supplied and the upper arm (brachial artery) is compressed. When the atmospheric pressure in the cuff 1 (hereinafter referred to as compression pressure) reaches a predetermined pressure value that is higher than the maximum blood pressure expected by the person to be measured, the compression pressure is slightly reduced.

  FIG. 2 is a graph showing changes in the compression pressure for compressing the brachial artery, where the horizontal axis is the elapsed time from the start of pressurization by the cuff 1, and the vertical axis is the compression pressure. A waveform 201 in FIG. 2 shows a change in the compression pressure until the compression pressure reaches the predetermined pressure value, and a waveform 202 in FIG. 2 shows a change in the compression pressure at the time of slow depressurization.

  When the cuff 1 is depressurized at a low speed in this way, as shown in FIG. 2, a pulse wave 203 is generated in the process of depressurizing the compression pressure very slowly. The amplitude value of the pulse wave 203 is detected from the pressure signal corresponding to the waveform 202. FIG. 3 is a graph showing how the amplitude value of the pulse wave for each heartbeat sequentially detected in the slow depressurization process changes in time series according to the change in the compression pressure. As shown in FIG. As the pressure in the cuff 1 changes, the amplitude value of the detected pulse wave also changes. The amplitude value of the pulse wave shows a characteristic change and draws a mountain-shaped envelope.

  FIG. 4 is a graph showing an envelope obtained in time series (that is, when arranged in accordance with the compression pressure) the maximum amplitude value of the pulse wave for each heartbeat obtained in the slow depressurization process of the cuff 1 compressing the brachial artery. It is. For example, the amplitude value of the pulse wave is extracted from the pressure signal obtained when the pressure is reduced at a constant speed within a predetermined range of the compression pressure including the maximum blood pressure and the minimum blood pressure of the measurement subject, and time-series (to the pressure value of the compression pressure) When aligned, a mountain-shaped envelope 206 as shown in FIG. 4 is obtained, and the amplitude value of the pulse wave changes with the change of the compression pressure. The envelope 206 is known to have a characteristic shape depending on the individual, and furthermore, the shape is known to change depending on various diseases, and examples thereof are shown in FIGS.

  The change in the amplitude value of the pulse wave according to the change in the compression pressure (the shape of the envelope) reflects the change in the volume of the blood vessel accompanying the change in the compression pressure, and thus the actual mechanical characteristics of the blood vessel. Therefore, it is considered that the degree of arteriosclerosis (progress status) is particularly shown. Therefore, it is considered that the features of the envelope shape can be digitized and the cardiovascular function mainly including the degree of arteriosclerosis can be measured based on the digitized feature amount.

  For example, FIG. 5A shows an example of a healthy person, and the shape pattern of FIG. 5C has less change in the volume of the blood vessel when the compression pressure changes than the shape pattern of FIG. 5A. Therefore, it is considered that arteriosclerosis is progressing or the subject is elderly. FIG. 5B shows a case where blood pressure is low (when the maximum blood pressure is low (for example, a state of 100 or less)) or when the blood vessel is soft (the blood vessel wall is flexible and the blood vessel follows the external pressure due to the internal pressure). FIG. 5 (d) shows an example of an envelope when it is considered that the heart has some disease, and FIG. 5 (e) Shows an example of an envelope when the blood pressure is high blood pressure and arteriosclerosis is considered to be progressing or when the patient is elderly.

  The present inventor divides such an envelope into a plurality of regions with one or a plurality of compression pressures as boundaries, and extracts feature amounts in the compression pressure bands (compression pressure ranges) in each region, respectively. It was found that a highly accurate measurement can be performed by measuring the cardiovascular function mainly including arteriosclerosis using the feature amount. Hereinafter, this point will be described. 6-8 is a figure for demonstrating regarding the feature-value employ | adopted in the circulatory-function measurement method of this embodiment.

  In the present embodiment, the compression pressure at which the amplitude value of the pulse wave is maximized is defined as a boundary value, and the region corresponding to the compression pressure zone on the high pressure side from the boundary value (hereinafter referred to as the high pressure compression pressure zone P1) and the low pressure side. Are divided into regions corresponding to the compression pressure zone (hereinafter referred to as the low-pressure compression zone P2), and feature quantities for measuring the circulatory function in the respective compression pressure zones P1 and P2 are obtained.

  That is, FIG. 6 shows the difference (width) W1 between the compression pressure p1 that takes an amplitude value r1 of a certain pulse wave and the boundary value pα in the region of the high pressure compression pressure zone P1 in the envelope, and the low pressure compression pressure zone. In P2, it is a figure which shows extracting the compression pressure p2 which takes the amplitude value r2 different from the said amplitude value r1, and the difference (width) W2 of the said boundary value p (alpha) as a feature-value.

  FIG. 7 shows the slope θ1 at the point where the amplitude value of the pulse wave is r3 and the compression pressure is p3 in the region of the high pressure side compression pressure zone P1 in the envelope, and the pulse in the region of the low pressure side compression pressure zone P2. It is a figure which shows extracting the amplitude value r4 (≠ r3) of a wave, and inclination (theta) 2 in the point where compression pressure becomes p4 as a feature-value.

  FIG. 8 shows the pressure difference t1 between the compression pressures p5 and p6 that take amplitude values r5 and r6 of a certain pulse wave and the region of the low pressure compression pressure zone P2 in the region of the high pressure compression pressure zone P1 in the envelope. FIG. 5 shows that the pressure difference t2 between the compression pressures p7 and p8 having amplitude values r7 and r8 different from the amplitude values r5 and r6 is extracted as a feature amount.

  6 to 8, the amplitude values r1 to r8 of the pulse waves corresponding to the feature amounts W1, W2, θ1, θ2, t1, and t2 are values obtained by multiplying the maximum amplitude value rmax by a certain ratio, respectively. This ratio is derived beforehand by statistics.

  Here, in order to obtain a feature value for measuring the circulatory function, the boundary value when dividing the envelope into a plurality of regions is set to the compression pressure at which the amplitude value of the pulse wave is maximized. explain.

  When a blood vessel is compressed, pressure (internal pressure) and external pressure (compression pressure) from blood are applied to the blood vessel wall. Here, when the compression pressure substantially coincides with the average blood pressure, the pressure difference between the average internal and external pressures applied to the blood vessel wall (average blood pressure-compression pressure) is substantially 0, and the state becomes no load. At this time, the compliance of the blood vessel (followability of the blood vessel wall with respect to the pulsation) is maximized, and the amount of change in the volume of the blood vessel with respect to a certain pulse pressure is maximized, so that the amplitude value of the pulse wave is maximized.

  Therefore, as shown in FIG. 9, the compression pressure at which the amplitude value of the pulse wave becomes the maximum substantially matches the average blood pressure. In the envelope shown in FIG. 9, the region on the left side of the average blood pressure is a region where the compression pressure is greater than the average blood pressure, and the region on the right side of the average blood pressure is a region where the compression pressure is less than the average blood pressure.

  FIG. 10 is a graph showing a change in volume at the compression site of the blood vessel according to the pressure difference (mean blood pressure−compression pressure), where the horizontal axis represents the intravascular / external pressure difference and the vertical axis represents the blood vessel volume.

  As shown in FIG. 10, at the point where the pressure difference becomes 0, that is, at the point where the direction of the resultant force acting on the blood vessel wall (the resultant force of the pressure from the blood (internal pressure) and the external pressure (compression pressure)) changes, The volume change characteristics of blood vessels are greatly different.

  Therefore, by dividing the envelope into a plurality of regions with the compression pressure that maximizes the amplitude value of the pulse wave, that is, the average blood pressure as a boundary, and extracting the feature amount from each region, the state of the blood vessel wall can be determined. Can be detected according to the direction of the force (combined force) acting on the. Therefore, it is possible to grasp the progress of arteriosclerosis more accurately than when only one feature amount is obtained for the entire envelope as in the prior art.

Derived by substituting the characteristic quantities obtained as described above, that is, the width (W1, W2), the inclination (θ1, θ2) or the time (t1, t2) into (X, Y) in the following equation (1). The circulatory function mainly including arteriosclerosis is measured based on the determination value Q.
Q = a * X + b * Y + c (1)
In addition, a, b, and c are constants and are values set based on statistics.

  Next, the configuration of the circulatory function measuring apparatus 100 according to the first embodiment for executing the above circulatory function measuring method will be described with reference to FIG.

  As shown in FIG. 1, the circulatory function measuring apparatus 100 according to the present embodiment includes a cuff 1, a pressure control unit 2, a pressure detection unit 3, a pulse wave detection unit 4, a control unit 5, and a circulatory function display unit 6. Prepare. As described above, the cuff 1 is attached in a state of being wound around the upper arm portion of the measurement subject, for example. The pressure control unit 2 includes a pressurizing pump for pressurizing the cuff 1 and an exhaust valve for depressurizing the cuff 1, performs pressure increase / decrease of the cuff 1 according to a control signal from the control unit 5, and measures the subject. This adjusts the pressure applied to the upper arm. The pressure detector 3 includes, for example, an unillustrated pressure sensor and an A / D converter, and outputs a pressure signal indicating the pressure of the cuff 1 as a digital signal to the pulse wave detector 4 and the controller 5. The pulse wave detection unit 4 includes, for example, a predetermined filter circuit, and generates a pulse wave signal by removing a predetermined frequency component such as a direct current component from the pressure signal output from the pressure detection unit 3, for example. The amplitude of the pulse wave is extracted from the pulse wave signal.

The control unit 5 controls the overall operation of the circulatory function measuring apparatus 100. For example, a control program for controlling the operation of the circulatory function measuring apparatus 100, a determination program for determining the state of the circulatory function, etc. ROM (Read Only Memory) to be stored, RAM (Random Access Memory) that temporarily stores data generated during or after execution of the program, CPU (Central Processing Unit) that reads and executes control programs from the ROM, etc. Composed.

  In addition, in order to measure the circulatory function mainly of arteriosclerosis as described above, the control unit 5 functionally includes a pulse wave detection pressure calculation unit 51, a pulse wave data storage unit 52, and a feature amount. The extraction pressure zone deriving unit 53, the feature amount extracting unit 54, and the circulatory function determining unit 55 are included.

  The pulse wave detection pressure calculation unit 51 associates the compression pressure output from the pressure detection unit 3 and the pulse wave detection unit 4 with a predetermined period with the amplitude value of the pulse wave, in other words, the horizontal axis represents the compression pressure. A peak-shaped envelope 206 as shown in FIG. 4 in which the maximum amplitude value of the pulse wave for each heartbeat is plotted in a two-dimensional coordinate system with the vertical axis as the amplitude value of the pulse wave is generated.

  The pulse wave data storage unit 52 stores the compression pressure associated with the pulse wave detection pressure calculation unit 51 and the amplitude value of the pulse wave in a table format (the envelope).

The feature amount extraction pressure zone deriving unit 53 sets a plurality of compression pressure zones for extracting feature amounts in accordance with a preset program. In the present embodiment, the feature amount extraction pressure band deriving unit 53 uses the compression pressure that takes the maximum amplitude value rmax of the pulse wave as a boundary value, and a compression pressure band P1 on the higher pressure side than the boundary value and a compression pressure band P2 on the lower pressure side. (See FIGS. 6 to 8).

  The feature quantity extraction unit 54 extracts the feature quantity (W1, W2) or (θ1, θ2) or (t1, t2) in each compression pressure zone P1, P2 set by the feature quantity extraction pressure zone derivation unit 53. Is.

  The circulatory function determination unit 55 is obtained by statistically investigating in advance a relationship between a state related to circulatory functions such as arteriosclerosis, endothelial cell dysfunction, hypertension, peripheral vasoconstriction, and the feature amount. Based on the statistical data, it stores determination table data that correlates the state of the circulatory function estimated to be statistically corresponding to the extracted feature amount and the degree of the state. Based on the extracted feature quantity (W1, W2) or (θ1, θ2) or (t1, t2), the cardiovascular function of the measurement subject is determined. For example, for arteriosclerosis, the circulatory organ function determination unit 55 uses the determination table data indicating the relationship between the arteriosclerosis degree and the determination value Q, which is obtained based on statistical data, to calculate the expression from the feature amount. The degree of arteriosclerosis corresponding to the determination value Q calculated by (1) is derived. The degree of arteriosclerosis is expressed by a numerical value from 1 to 100, for example, and the larger the numerical value, the more arteriosclerosis is progressing.

  The circulatory function display unit 6 is a display device including a liquid crystal display, for example, and displays the determination result data output from the circulatory function determination unit 55. The circulatory function measuring apparatus 100 of the present embodiment is configured such that, for example, a numerical value from 1 to 100 indicating the degree of arteriosclerosis derived by the circulatory function determining unit 55 is displayed on the circulatory function display unit 6. Yes. FIG. 11 shows that the arteriosclerosis degree of a certain subject was measured as “65”.

  Next, the operation of the circulatory function measuring device 100 configured as described above will be described. FIG. 12 is a flowchart showing an example of the operation of the circulatory function measuring apparatus 100.

  As shown in FIG. 12, first, when the control unit 5 detects that the power is turned on and a start switch (not shown) is pressed, the pressure control unit 2 controls the control unit 5 in step ST1. In response to the signal, air is supplied into the cuff 1 to perform a compression operation on the upper arm.

  Next, in step ST2, when the pressure detection unit 3 detects that the pressure of the cuff 1 has reached the predetermined pressure, for example, a predetermined pressure higher than the expected maximum blood pressure of the measurement subject, the control unit 5 In response to the control signal, the pressure controller 2 starts the slow depressurization of the cuff 1.

  Next, in step ST3, the pressure detector 3 outputs a pressure signal corresponding to the waveform 202 (see FIG. 2) to the pulse wave detector 4, and the pulse wave detector 4 A pulse wave is detected from the pressure signal, and an amplitude value of the pulse wave is detected from the obtained pulse wave.

Next, in step ST4, the pulse wave detection-time pressure calculation unit 51 associates the compression pressure output from the pressure detection unit 3 and the pulse wave detection unit 4 with a predetermined period with the amplitude value of the pulse wave, and the pulse wave The data storage unit 52 stores the compression pressure associated with the pulse wave detection pressure calculation unit 51 and the amplitude value of the pulse wave in a table format. In other words, the maximum amplitude value of the pulse wave for each heartbeat is plotted in a two-dimensional coordinate system in which the horizontal axis is the compression pressure of the cuff 1 and the vertical axis is the amplitude value of the pulse wave, and a mountain-shaped envelope as shown in FIG. A line 206 is generated.
Next, in step ST5, the feature quantity extraction pressure band deriving unit 53 sets a compression pressure that takes the maximum amplitude value rmax of the pulse wave as a boundary value according to a preset program, and a compression pressure higher than the boundary value. A band P1 and a compression pressure band P2 on the low pressure side are set.

  Next, in step ST6, the feature quantity extraction unit 54 uses the feature quantities (W1, W2) or (θ1, θ2) or (t1, θ2) in the compression pressure zones P1, P2 set by the feature quantity extraction pressure zone derivation unit 53. Each t2) is extracted.

  Next, in step ST7, the circulatory function determining unit 53 calculates the determination value Q from the above-described equation (1), and associates it with the value of Q based on the determination table data stored in the ROM. The stored state of the circulatory function is read as a determination result.

  Next, in step ST8, the pressure control unit 2 rapidly exhausts the air in the cuff 1 in accordance with a control signal from the control unit 5, the compression pressure is reduced, and the compression on the upper arm of the measurement subject is released. The In step ST9, the circulatory function determination unit 55 outputs the read determination result data about the state of the circulatory function to the circulatory function display unit 6, and the circulatory function display unit 6 displays the state of the circulatory function. The determination result (for example, the above-described numerical degree of arteriosclerosis) is displayed.

  As described above, the compression pressure at which the amplitude value of the pulse wave is the maximum is used as a boundary value, and the envelope is divided into the high-pressure compression pressure zone P1 and the low-pressure compression pressure zone P2 from the boundary value. Since the characteristic amounts are obtained in P1 and P2, respectively, the measurement of the circulatory function mainly including arteriosclerosis can be performed with high accuracy. In the present invention, the compression pressure set as the boundary value is not limited to the compression pressure that maximizes the amplitude value of the pulse wave.

  In addition, the determination of the circulatory function can be performed with high accuracy even in the form in which the determination value Q is derived from the feature quantities extracted as described above and the measurement of the circulatory function is performed based on the determination value Q. Diagnosis concerning the circulatory function can also be performed by comparing the feature amounts extracted from the compression pressure bands P1 and P2, respectively.

  That is, comparing the feature quantities extracted from the compression pressure zones P1 and P2, respectively, for example, there is no particular problem with the outer membrane, but the hardening and aging of the inner membrane and the middle membrane are progressing, Information such as the progress of sclerosis of the blood vessel can be obtained to diagnose the progress of the disease state and which tissue of the blood vessel is abnormal.

  Further, the degree of arteriosclerosis of the measurement subject is determined in accordance with the ratio between the difference between the two compression pressures that take 90% of the maximum amplitude value and the maximum amplitude value. In the case of the above-described conventional technique in which the degree of arteriosclerosis is measured from the ratio (width) of the compression pressure, the maximum amplitude value depends on various factors such as the thickness of the measurement subject's muscle not related to the hardness of the blood vessel. However, in the extraction form shown in FIG. 6 of the present embodiment, only the widths W1 and W2 are features for measuring the circulatory function. Since it is used as a quantity, it is possible to measure the circulatory function more accurately than the prior art.

  As another extraction form for extracting the feature amount, for example, as shown in FIG. 13, in the region of the high-pressure compression pressure zone P1 in the envelope, a compression pressure p9 and a boundary value taking an amplitude value r9 of a certain pulse wave A difference (width) W3 from pα and a difference (width) W4 between two compression pressures p10 and p11 having an amplitude r10 different from the amplitude value r9 in the entire envelope region are extracted as features. May be. In this case, the region of the high-pressure compression pressure zone P1 and the entire region of the envelope correspond to “at least two regions” in claim 1 of the claims.

(Second Embodiment)
In addition to the configuration of the first embodiment (configuration shown in FIG. 1), the circulatory function measuring apparatus 100 of the present embodiment includes a blood pressure calculation unit 56 that estimates blood pressure based on the detected amplitude value of the pulse wave, The blood pressure value display unit 7 for displaying each blood pressure value calculated by the blood pressure calculation unit 56 is further mounted. Since the other parts are substantially the same as those in the first embodiment, only the differences will be described. FIG. 14 is a block diagram for explaining the configuration of the circulatory function measuring apparatus 100 according to the second embodiment. In addition, the same code | symbol is attached | subjected about the structure same as 1st Embodiment.

  Specifically, the blood pressure calculation unit 56 is provided in the control unit 5 and is based on the envelope indicating the relationship between the compression pressure and the amplitude value of the pulse wave stored in the pulse wave data storage unit 52. And the average blood pressure is calculated. The blood pressure calculation unit 56 sets the compression pressure at the time when the amplitude value of the pulse wave suddenly increases (inflection point A in FIG. 6) as the maximum blood pressure in the process of depressurizing the compression pressure very quickly, and the top of the envelope In the process of reducing the compression pressure very quickly, for example, the compression pressure at the time when the amplitude value of the pulse wave suddenly decreases (inflection point B in FIG. 6) is set as the minimum blood pressure. .

  The blood pressure value display unit 7 displays each blood pressure value (maximum blood pressure, minimum blood pressure, and average blood pressure) calculated by the blood pressure calculation unit 56. The blood pressure value display unit 7 may be configured by the same display device as the circulatory function display unit 6.

  Next, the operation of the circulatory function measuring device 100 configured as described above will be described. FIG. 15 is a flowchart showing an example of the operation of the circulatory function measuring apparatus 100. The measurement of the blood pressure value is performed in parallel with the determination process of the circulatory function described in the first embodiment, but in order to avoid duplicating the same description as much as possible, in this flowchart, the measurement of the blood pressure value is performed. Only processing is shown.

  As shown in FIG. 15, steps ST11 to ST14 are substantially the same as steps ST1 to ST4 of the first embodiment, and a description thereof will be omitted.

  In step ST15, the blood pressure calculation unit 56, based on the envelope indicating the relationship between the compression pressure stored in the pulse wave data storage unit 52 and the amplitude value of the pulse wave, the maximum blood pressure, the minimum blood pressure, and Average blood pressure is calculated.

  Next, in step ST16, the cuff 1 is quickly exhausted by the pressure control unit 2 in response to a control signal from the control unit 5, the cuff 1 is decompressed, and the compression of the upper arm portion of the measurement subject is released. In step ST <b> 17, data indicating the blood pressure value calculated by the blood pressure calculation unit 56 is output to the blood pressure value display unit 7, and each blood pressure value is displayed on the blood pressure value display unit 7.

  With the above configuration, it is possible to realize a circulatory function measuring apparatus that can measure not only the circulatory function but also the blood pressure.

  In this embodiment, all blood pressures of the maximum blood pressure, the minimum blood pressure, and the average blood pressure are calculated (estimated). However, the present invention is not limited to this, and the blood pressure calculation unit 56 calculates the maximum blood pressure, the minimum blood pressure, and the average blood pressure. At least one of them may be calculated (estimated).

(Third embodiment)
As shown in FIG. 16, the circulatory function measuring apparatus 100 of the present embodiment shows the blood pressure value calculated by the blood pressure calculation unit 56 in addition to the configuration of the second embodiment (configuration shown in FIG. 14). The difference is that the data is output to the feature amount extraction pressure band deriving unit 53, and the other points are substantially the same as in the second embodiment.

  In the present embodiment, each blood pressure value (maximum blood pressure, minimum blood pressure, and average blood pressure) calculated by the blood pressure calculation unit 56 is used as a boundary value that divides the envelope. 17 to 19 show an example in which each blood pressure value (maximum blood pressure, minimum blood pressure, and average blood pressure) calculated by the blood pressure calculation unit 56 is used as a boundary value for dividing the envelope to obtain a feature amount. FIG.

  FIG. 17 shows the envelope of the compression pressure band P3 higher than the maximum blood pressure, the compression pressure band P4 between the average blood pressure and the maximum blood pressure, and the compression pressure band P5 between the average blood pressure and the minimum blood pressure. Are divided into four compression pressure zones, ie, a compression pressure zone P6 lower than the minimum blood pressure, and in each of the compression pressure zones P3 to P6, compression pressures and boundary values that take different amplitude values of pulse waves. The difference (width) W5 to W8 is extracted.

  That is, the difference (width) W5 between the compression pressure p12 (average blood pressure <p12 <maximum blood pressure) and the average blood pressure at which the amplitude value of the pulse wave takes r11, and the compression pressure p13 (minimum blood pressure) at which the amplitude value of the pulse wave takes r12 The difference (width) W6 between <p13 <average blood pressure) and the average blood pressure, the difference (width) W7 between the compression pressure p14 (p14> maximal blood pressure) at which the amplitude value of the pulse wave takes r13, and the maximum blood pressure, and the pulse wave The circulatory function is determined using the compression pressure p15 (p15 <minimum blood pressure) and the difference (width) W8 between the minimum blood pressure and the amplitude value of r14 as the feature amount.

  FIG. 18 shows three envelopes: an area of the compression pressure band P7 higher than the maximum blood pressure, an area of the compression pressure band P8 between the average blood pressure and the maximum blood pressure, and an area of the compression pressure band P9 below the average blood pressure. FIG. 4 shows an example in which the difference (width) W9 to W11 between the compression pressure and the boundary value, which are divided into two compression pressure zones, and have different pulse wave amplitude values in each of the compression pressure zones P7 to P9, is shown. .

  That is, the difference (width) W9 between the compression pressure p16 (average blood pressure <p16 <maximum blood pressure) and the average blood pressure at which the amplitude value of the pulse wave takes r15, and the compression pressure p17 (p17 <p < The difference between the mean blood pressure) and the mean blood pressure (width) W10, and the difference (width) W11 between the compression pressure p18 (p18> highest blood pressure) and the maximum blood pressure at which the amplitude value of the pulse wave takes r17, are used as circulatory organs. Determine function.

  FIG. 19 shows three envelopes: an area of the compression pressure band P10 higher than the maximum blood pressure, an area of the compression pressure band P11 between the maximum blood pressure and the minimum blood pressure, and an area of the compression pressure band lower than the minimum blood pressure. The pressure pressure zone P12 is divided into three compression pressure zones, and in each pressure pressure zone P10 to P12, the difference W12 between two compression pressures having the same pulse wave amplitude value or different pulse wave amplitude values. The difference (widths) W13 and W14 between the compression pressure and the boundary value is extracted.

  That is, the difference (width) W12 between the two compression pressures p18 and p19 (pulse pressure <p19 <p18 <maximum blood pressure) at which the amplitude value of the pulse wave takes r18, and the compression pressure p20 at which the amplitude value of the pulse wave takes r19. The difference (width) W13 between (p20> systolic blood pressure) and the systolic blood pressure, and the difference (width) W14 between the compression pressure p21 (p21 <minimum blood pressure) at which the amplitude value of the pulse wave takes r20 and the minimum blood pressure are characterized. To determine cardiovascular function.

  In the case of FIG. 19, when the compression pressure substantially coincides with the average blood pressure, the average pressure difference between the internal and external pressures (average blood pressure−compression pressure) applied to the blood vessel wall is substantially 0, and the pressure with respect to a certain pulse pressure is reduced. As described above, the amount of change in the volume of the blood vessel, and thus the amplitude value of the pulse wave, is maximized. Examining blood vessel compliance when this pressure difference is 0 is also a means for grasping the progress of arteriosclerosis. Conceivable. The blood vessel compliance when the pressure difference is 0 can be examined by using the inclination θ (the volume change rate of the blood vessel) at the point C where the pressure difference is 0 in the curve shown in FIG. 10 as one parameter, and this inclination θ is reflected. In order to obtain the feature amount, as shown in FIG. 19, two compression pressures (p18, p19) before and after taking the same pulse wave amplitude value and relatively close to the average blood pressure are obtained. .

  As described above, by increasing the number of envelope divisions more than in the first embodiment, it is possible to measure the circulatory function with higher accuracy than in the first embodiment. In particular, stress for buckling the blood vessel wall is necessary to occlude the blood vessel, and this buckling stress depends on the properties of the blood vessel, such as the hardness of the blood vessel. By obtaining the feature amount in the region of higher pressure pressure zones P3, P7 and P10, it is possible to detect the nature of the blood vessel. In FIG. 10, it is also effective to extract the feature amount in a region where the pressure difference between the blood pressure and the compression pressure is positive, that is, a region of the compression pressure where the compression pressure is smaller than the blood pressure.

  In this embodiment, since each blood pressure value (maximum blood pressure, minimum blood pressure, and average blood pressure) calculated by the blood pressure calculation unit 56 is used as a boundary value that divides the envelope, the boundary value can be obtained relatively easily. Can do.

  Note that the feature quantity to be extracted is not limited to the widths W5 to W14 as described above, but two compression pressures that take two amplitude values with different slopes and pulse wave amplitude values in each region on the envelope. The pressure difference may be. The blood pressure set as the boundary value may be at least one of the maximum blood pressure, the minimum blood pressure, and the average blood pressure calculated using the following calculation formula.

(Fourth embodiment)
In the third embodiment, the maximum blood pressure, the average blood pressure, and the minimum blood pressure set as the boundary values are detected from the envelope. In the present embodiment, the maximum blood pressure and the minimum blood pressure are detected in the third embodiment. The mean blood pressure is derived by calculation without using the envelope.

The circulatory function measuring apparatus 100 according to the present embodiment has a configuration (configuration shown in FIG. 16) that is substantially the same as that of the third embodiment, but the blood pressure calculation unit 56 uses, for example, the following formula (2) for the average blood pressure: Calculate using.
Average blood pressure = (Maximum blood pressure-Minimum blood pressure) / 3 + Minimum blood pressure (2)
The arithmetic expression (2) is a well-known arithmetic expression derived from statistics.

  The reason for deriving the mean blood pressure by calculation in this way is as follows. In particular, in the case of an elderly person or a person who has advanced arteriosclerosis, as shown in FIGS. 20 and 21, even if the amplitude value of the pulse wave is similarly measured for the same person, the pulse wave Since the maximum amplitude value of the pulse wave and the amplitude value of the pulse wave in the vicinity thereof become unstable, the compression pressure at which the amplitude value of the pulse wave becomes maximum is not constant. As a result, as shown in FIGS. 20 and 21, the differences (widths) W15 and W16 between the compression pressure and the boundary values taking certain amplitude values r21 and r22 are not constant as the boundary values change, and the circulation There is a risk that variations will occur in the determination results of the function.

  Therefore, as shown in FIG. 22, by setting the average blood pressure derived from the arithmetic expression as described above (estimated average blood pressure in FIG. 22) as the boundary value, a substantially constant boundary value can be obtained for the same person. As a result, the differences (widths) W15 and W16 between the compression pressure having a certain amplitude value and the boundary value (average blood pressure) are also substantially constant. Therefore, even if the compression pressure that takes the maximum amplitude value of the pulse wave is not stable, it is possible to obtain a substantially stable feature amount, and determination of circulatory function suitable for the elderly or those who are progressing atherosclerosis It can be performed.

(Fifth embodiment)
In the first embodiment, one feature quantity is extracted from each of the divided compression pressure bands P1 and P2. However, in this embodiment, a plurality of feature quantities are extracted from each compression pressure band. It is a thing.

  In FIG. 23, the widths W17 and W18 are extracted as feature amounts in the region of the compression pressure zone P1 on the high pressure side from the boundary value, and the widths W19 and W20 are extracted as feature amounts in the region of the compression pressure zone P2 on the low pressure side from the boundary value. It shows what we did.

  24, the width W21 is extracted as a feature amount in the region of the compression pressure zone P1 on the high pressure side from the boundary value, and the widths W22 to W24 are extracted as feature amounts in the region of the compression pressure zone P2 on the low pressure side from the boundary value. It shows what was made.

The feature quantities (W17, W18, W19, W20) or (W21, W22, W23, W24) obtained as described above are used, for example, in the following formula (3) (W ₁ , W ₂ , W ₃ , W ₄ ). The cardiovascular function, mainly arteriosclerosis, is measured by the value Q derived by substituting for.
Q = a × W ₁ + b × W ₂ + c × W ₃ + d × W ₄ + e (3)
Note that a, b, c, d, and e are constants and are values set based on statistics.

  As described above, by extracting a plurality of feature amounts from at least one compression pressure zone of the plurality of compression pressure zones P1 and P2, it is possible to circulate more accurately than in the first embodiment. Instrument function can be measured. Here, a plurality of widths W17 to W24 are extracted as feature quantities from the areas of the compression pressure zones P1 and P2, but as other types of feature quantities, as shown in FIG. The inclination of a certain point in each region or a pressure difference between two compression pressures having two different amplitude values as shown in FIG. 8 may be used, and a plurality of these feature values are extracted from each region. You may do it.

(Sixth embodiment)
In the first to fifth embodiments, the same type (same dimension) feature amount (width, inclination, and pressure difference between the compression pressures) is extracted from each of the divided compression pressure zones. Then, different types of feature quantities are extracted from different compression pressure zones.

  FIG. 25 shows an example in which different feature amounts are extracted from regions of different compression pressure zones. As shown in FIG. 25, a width W25 is extracted from the region of the high-pressure compression pressure zone P1. The area S1 of the region surrounded by the boundary line and the envelope on the low pressure side is extracted from the region of the low pressure compression pressure zone P2.

  This also makes it possible to accurately measure the circulatory function. Although not shown, the combination of types of feature quantities to be extracted is not limited to the combination of width and area as described above, the combination of the slope and width of the envelope, and the slope and area. When the combination or the envelope is divided into three or more regions, a combination of width, area, and inclination may be used. In short, it is preferable to extract a feature amount considered to be optimal in each compression pressure zone.

(Seventh embodiment)
In addition to the configuration of the first embodiment (configuration shown in FIG. 1), the circulatory function measuring apparatus 100 of the present embodiment inputs physical characteristics such as the age, sex, height, and weight of the person being measured. It further includes a function and a function for setting a feature amount extraction method in accordance with the input physical characteristics. Since the other parts are substantially the same as those in the first embodiment, only the differences will be described. FIG. 26 is a block diagram for explaining the configuration of the circulatory function measuring apparatus 100 according to the seventh embodiment.

  As shown in FIG. 26, in addition to the circulatory function measuring apparatus 100 of the first embodiment, the circulatory function measuring apparatus 100 of the seventh embodiment includes a personal information input unit 8 and a feature quantity extraction method setting unit. 57.

  The personal information input unit 8 is for inputting physical characteristics such as the age, sex, height, and weight of the person to be measured, and the input physical characteristic information is output to the feature quantity extraction method setting unit 57. Is done.

  The feature amount extraction method setting unit 57 is provided in the control unit 5 and sets an appropriate feature amount extraction method according to the physical characteristics input by the personal information input unit 8. The feature value extraction method includes a boundary value setting method and a feature value type setting method to be extracted, and can be set based on statistical data. For example, since elderly people often show a distorted envelope as shown in FIGS. 20 and 21, for example, the feature amount extraction method described in the fourth embodiment is employed. The feature amount extraction pressure band deriving unit 53 sets a plurality of compression pressure bands for extracting feature amounts according to the feature amount extraction method set by the feature amount extraction method setting unit 57.

  Next, the operation of the circulatory function measuring device 100 configured as described above will be described. FIG. 27 is a flowchart showing an example of the operation of the circulatory function measuring apparatus 100.

  As shown in FIG. 27, when a physical characteristic is input by the personal information input unit 8 in step ST21, the feature amount extraction method setting unit 57 in step ST22 appropriately selects the physical characteristic according to the input physical characteristic. Select a feature extraction method. And step ST23-ST26 performs the process substantially the same as said step ST1-ST4.

  Next, in step ST27, the feature quantity extraction pressure zone deriving unit 53 sets a plurality of compression pressure zones for calculating the feature quantity according to a preset program.

  Next, in step ST <b> 28, the feature quantity extraction unit 54 performs the feature according to the feature quantity extraction method selected by the feature quantity extraction method setting unit 57 from the compression pressure zone set by the feature quantity extraction pressure zone derivation unit 53. Detect the amount. In steps ST29 to ST31, substantially the same processing as in steps ST7 to ST9 is performed.

  As described above, the cardiovascular function measuring apparatus 100 is equipped with the function of inputting the physical characteristics of the measurement subject and the function of selecting the feature extraction method according to the input physical characteristics. Since the feature quantity is extracted according to the feature quantity extraction method, it is possible to measure the circulatory function suitable for the physical feature of the measurement subject.

  Especially in elderly people, when there is an abnormality in the blood vessel from the upper arm to the wrist, the envelope shape is relatively different when the pulse wave is measured at the wrist and when the pulse wave is measured at the upper arm. In view of this, not only the physical characteristics described above, but also an appropriate feature amount extraction method according to the pulse wave measurement site is set in advance, and the actual pulse wave measurement site is set. A suitable feature amount extraction method may be selected.

  As for the input form of the physical characteristics, in addition to the form of inputting the physical characteristics for each measurement, the physical characteristics of the measurement subject are stored in the circulatory function measuring apparatus 100 in association with the ID (Identification). In addition, when measuring the circulatory function, an ID may be input instead of a physical characteristic.

(Eighth embodiment)
For example, in elderly people, only systolic blood pressure is high and diastolic blood pressure is often normal, while younger persons are either in cases where only the diastolic blood pressure is high or both the systolic blood pressure and the diastolic blood pressure are high. Often, the envelope is unique to these symptoms. Therefore, if there is an appropriate method for setting the boundary value for dividing the envelope and the type of feature value (such as the aforementioned width, inclination, or area) extracted from each compression pressure zone, according to the symptom. Conceivable.

  Therefore, the circulatory function measuring apparatus 100 according to the present embodiment estimates, for example, which symptom applies to the person to be measured from the blood pressure value in order to make the determination of the circulatory function more accurate, and is suitable for each symptom. The extraction method of the feature amount is set.

  In this embodiment, in order to realize this, in addition to the configuration of the first embodiment (configuration shown in FIG. 1), a feature amount extraction method is selected based on the state of each blood pressure of the measurement subject. And a function for selecting an appropriate feature quantity extraction method according to the calculated blood pressure value based on the selected feature quantity extraction method. Since the other parts are substantially the same as those in the first embodiment, only the differences will be described. FIG. 28 is a block diagram for explaining the configuration of the circulatory function measuring apparatus 100 according to the eighth embodiment.

  As shown in FIG. 28, in addition to the circulatory function measuring device 100 of the first embodiment, the circulatory function measuring device 100 of the eighth embodiment is similar to the blood pressure calculator 56 and the blood pressure value display shown in FIG. Unit 7 and a feature amount extraction method setting unit 57 ′.

  The blood pressure calculation unit 56 estimates each blood pressure value of the measurement subject based on the envelope, and the blood pressure value display unit 7 displays each blood pressure value estimated by the blood pressure calculation unit 56.

  The feature amount extraction method setting unit 57 ′ sets an appropriate feature amount extraction method according to the blood pressure value calculated by the blood pressure calculation unit 56. That is, the feature amount extraction method setting unit 57 ′ determines whether the measured person has only the highest blood pressure and the lowest blood pressure is normal, only the lowest blood pressure is high, or both the highest blood pressure and the lowest blood pressure are high. Is estimated from each blood pressure estimated by the blood pressure calculation unit 56, and a feature amount extraction method suitable for the estimated blood pressure state is set. Note that the feature quantity extraction method can be set based on statistical data, as in the seventh embodiment. The feature quantity extraction pressure zone deriving unit 53 sets a plurality of compression pressure zones for calculating the feature quantity according to the feature quantity extraction method set by the feature quantity extraction method setting unit 57 ′.

  Next, the operation of the circulatory function measuring device 100 configured as described above will be described. FIG. 29 is a flowchart showing an example of the operation of the circulatory function measuring apparatus 100.

  As shown in FIG. 29, steps ST41 to ST44 are substantially the same as steps ST1 to ST4 of the first embodiment, and a description thereof will be omitted.

  In step ST45, the blood pressure calculation unit 56 estimates the blood pressure value of the measurement subject based on the envelope, and in step ST46, the feature amount extraction method setting unit 57 ′ determines the blood pressure value estimated by the blood pressure calculation unit 56. An appropriate feature amount extraction method is set according to the above. In step ST47, the feature amount extraction pressure band deriving unit 53 sets a plurality of compression pressure bands for calculating the feature amount in accordance with the feature amount extraction method set by the feature amount extraction method setting unit 57 ′. To do.

  Steps ST48 to ST50 perform substantially the same processing as Steps ST6 to ST8. In Step ST51, the circulatory function display unit 6 displays the determination result of the circulatory function state by the circulatory function determination unit 55. At the same time, the blood pressure value display unit 7 displays the blood pressure value estimated by the blood pressure calculation unit 56.

  As described above, since the feature quantity extraction method corresponding to each blood pressure state of the measurement subject is selected, and the feature quantity is extracted according to the selected feature quantity extraction method, the circulatory function is more detailed. Can be measured.

(Ninth embodiment)
In addition to the configuration of the first embodiment (configuration shown in FIG. 1), the circulatory function measuring apparatus 100 of the present embodiment has a function of estimating the blood pressure value of the person to be measured from the envelope, and the estimated blood pressure. And a function for correcting the value. Since the other parts are substantially the same as those in the first embodiment, only the differences will be described. FIG. 30 is a block diagram for explaining the configuration of the circulatory function measuring apparatus 100 according to the ninth embodiment.

  As shown in FIG. 30, the circulatory function measuring device 100 of the ninth embodiment is similar to the circulatory function measuring device 100 of the first embodiment, and also has a blood pressure calculation unit 56 and a blood pressure value display similar to those in FIG. 14. Unit 7 and an estimated blood pressure correction unit 58.

  The blood pressure calculation unit 56 estimates the maximum blood pressure, the minimum blood pressure, and the average blood pressure from the envelope, as in the second embodiment.

  The estimated blood pressure correction unit 58 corrects the blood pressure value estimated by the blood pressure calculation unit 56. The estimated blood pressure correction unit 58 has an envelope specific to each symptom, for example, an envelope specific to high blood pressure, an envelope specific to arteriosclerosis, among them, an envelope having an abnormality in the intima and media, and an abnormality in the entire blood vessel wall A predetermined correction formula or correction table is stored in correspondence with an envelope and a healthy person's envelope (examples are, for example, FIGS. 5A to 5E), and this correction formula or correction table is stored. Is used to correct the blood pressure value calculated by the blood pressure calculation unit 56. The number and type of correction formulas and correction tables used for the correction can be set as appropriate. For example, two types of envelopes, that is, an envelope of a healthy person and an envelope of a person with relatively advanced arteriosclerosis Only those corresponding to FIG. 5 may be set, or only those corresponding to FIG. 5A to FIG. 5C among FIGS. 5A to 5E may be set.

  The blood pressure value display unit 7 displays the blood pressure value corrected by the estimated blood pressure correction unit 58.

  Next, the operation of the circulatory function measuring device 100 configured as described above will be described. FIG. 31 is a flowchart showing an example of the operation of the circulatory function measuring apparatus 100.

  As shown in FIG. 31, steps ST61 to ST64 are substantially the same as steps ST1 to ST4 of the first embodiment, and a description thereof will be omitted.

  In step ST65, the feature quantity extraction pressure band deriving unit 53 sets a plurality of compression pressure bands for calculating the feature quantity in accordance with a preset program, and the blood pressure calculation unit 56 calculates from the envelope. Estimate blood pressure.

  Next, in step ST66, the feature quantity extraction unit 54 extracts the feature quantities in the compression pressure zone set by the feature quantity extraction pressure zone derivation unit 53, respectively.

  Next, in step ST67, the estimated blood pressure correction unit 58 corrects the blood pressure value estimated by the blood pressure calculation unit using the correction formula or the correction table described above.

  In step 68, the cuff 1 is quickly exhausted by the pressure control unit 2 in response to a control signal from the control unit 5, and the cuff 1 is decompressed to release the pressure on the upper arm portion of the measurement subject. In step ST69, the circulatory function determination unit 55 outputs the read determination result data about the state of the circulatory function to the display unit 6, and the circulatory function display unit 6 determines the determination result of the state of the circulatory function. The blood pressure value display unit 7 displays data indicating the blood pressure value estimated by the blood pressure calculation unit 56 as a blood pressure value.

  In this way, the blood pressure value of the measured person estimated from the envelope is corrected using the correction formulas or correction tables corresponding to various symptoms, so that the blood pressures of those having various symptoms are estimated the same. The blood pressure value can be estimated with higher accuracy than when the method is uniformly estimated.

  The present invention is not limited to the above-described embodiment, and the following modifications (1) to (11) can be employed.

  (1) In the first embodiment, after the pressure of the cuff 1 reaches a predetermined pressure where the predetermined pressure is higher than the expected maximum blood pressure of the measurement subject, the pulse wave signal is generated in the slow depressurization process of the cuff 1. Although the generated form is shown, the present invention is not limited to this. For example, in the process of increasing the pressure of the cuff 1 at a very low speed from the predetermined pressure where the predetermined pressure is lower than the expected minimum blood pressure of the measurement subject. The pulse wave signal may be detected. FIG. 32 shows an example of the temporal change in the pressure of the cuff 1 when the pulse wave is detected by pressurizing the pressure of the cuff 1 very quickly.

  (2) The place where the pulse wave is detected is not limited to the upper arm, but may be another part such as a wrist. Further, instead of the pressure signal of the cuff 1, for example, a similar feature amount may be detected using a pulse wave signal obtained by a photoelectric sensor installed in the cuff 1, and is limited by a pulse wave signal acquisition unit. It is not a thing.

  (3) In the first embodiment, the degree of arteriosclerosis of the measurement subject is expressed by a numerical value from 1 to 100 based on the magnitude of the value Q calculated by the expression (1), and the numerical value is expressed as a circulatory organ. Although displayed on the function display unit 6, the present invention is not limited to this, and in order to understand the progress of arteriosclerosis at a glance, 1 to 100 thereof, for example, 1 to 20, 21 to 40, 41 are used. 33, divided into five levels of 60, 61 to 80, 81 to 100. As shown in FIG. 33, the cardiovascular function display unit 6 has a bar graph divided into five in the vertical direction, and the degree of arteriosclerosis of the measurement subject. May be indicated at that level. FIG. 33 shows that the degree of arteriosclerosis of a certain subject was level 3 out of 5 levels.

  In addition to the bar graph as shown in FIG. 33, the cardiovascular function display unit 6 is provided with, for example, five lighting parts (for example, LEDs) arranged in the vertical direction as shown in FIG. Only the number of lighting portions corresponding to the level of the arteriosclerosis level may be turned on.

  Further, not limited to these, for example, as shown in FIG. 35, the arteriosclerosis degree of the measurement subject is represented by letters and symbols assigned to the level of the arteriosclerosis degree, for example, alphabets A to E, and the cardiovascular function display You may make it show to the part 6 the level of a to-be-measured person's arteriosclerosis level by the alphabet corresponding to this level.

  Further, as shown in FIG. 36, a lighting unit (for example, LED) that displays a different color according to the level of arteriosclerosis is provided, and the level of arteriosclerosis of the measurement subject is indicated by the display color. Good. In short, it is preferable to change the form of display indicating the state according to the state of the degree of arteriosclerosis.

  In FIG. 36, the level of arteriosclerosis is divided into four stages, and a plurality of light emitting units that emit light of different colors according to the stage where the arteriosclerosis progresses, for example, red, yellow, blue and Four types of green LEDs are associated with each other, indicating that the arteriosclerosis degree is advanced second in the four stages. In addition, when the form in which the LED does not emit light is used as a level indicating one degree of arteriosclerosis, the number of levels of arteriosclerosis is increased, or when the number of levels is determined, the number of LEDs is reduced to reduce the cost. You can plan.

  In this way, the stage data indicating which stage the arteriosclerosis degree of the measurement subject applies to among the plurality of stages set in advance with respect to the progress of the arteriosclerosis is output, and the circulatory function is performed according to the stage data. The display form on the display unit 6 may be changed.

  (4) As another example of displaying the state of the measured circulatory function, the circulatory function determination unit 55 is configured to determine a circulatory function determination reference value (average value) according to physical characteristics such as age and gender. 37, the cardiovascular function display unit 6 is provided with a display unit for displaying age and sex and a display unit for displaying the degree of arteriosclerosis, and the measured cardiovascular function determination result And the difference between the cardiovascular function determination reference value (average value) set according to age and sex may be displayed so as to be visually understood. FIG. 37 shows that the measurement value indicated by the horizontal line is more influenced by diseases other than aging as it is farther upward from the position indicating the reference value (average), and the average of the same age as it is farther downward from the position indicating the reference value. It shows what is healthier than.

  (5) The cardiovascular function determination unit 55 stores the relationship between the degree of arteriosclerosis of the healthy person derived based on the statistics and its age, and as shown in FIG. 38, the degree of arteriosclerosis of the actual person to be measured is stored. May be converted into the age (equivalent age) of a healthy person having the degree of arteriosclerosis, and the equivalent age and actual age may be displayed so that they can be compared. The equivalent age may be calculated as follows, for example.

That is, assuming that the equivalent age is Y and the determination value is X, the equivalent age Y is calculated by the following equation (4).
Y = aX + b (4)
In the formula (4), a and b are constants, and are preferably set by statistics obtained from a plurality of healthy persons who do not have a disease. The determination value X may be substituted with the above-described determination value Q, for example. FIG. 38 shows that although the actual age is 40 years old, the equivalent age is determined to be 55 years old, and arteriosclerosis is progressing more than the age.

  (6) Generally, the higher the number of lifestyle-related diseases such as hypertension, diabetes, hyperlipidemia, obesity, etc., the higher the possibility of progression of arteriosclerosis. Aging is also a major factor of arteriosclerosis. Furthermore, the presence or absence of smoking is one of the factors. As described above, the degree of arteriosclerosis correlates with the number of lifestyle-related disease factors, so the cardiovascular function determination unit 55 estimates the number of lifestyle-related disease factors from the degree of arteriosclerosis. The estimated number of possessions may be displayed on the circulatory function display unit 6. That is, when the age is 45 years or older and the factor holding number is considered as 1, for example, when the age of a subject to be smoked is 50 years old and has symptoms of hypertension, Since it has three factors of “with smoking”, “age 45 years and older” and “hypertension”, the factor holding number is “3”.

  In addition to the form of displaying the number of factors held in this way, as shown in FIG. 39, the possibility of occurrence of lifestyle-related diseases (risk, risk) is displayed, for example, at five levels. Also good. FIG. 39 shows that the possibility of the occurrence of lifestyle-related diseases is at level 3 out of 5 levels for a subject.

  As described above, aging is also a major factor of arteriosclerosis, but when only the risk of lifestyle-related diseases is considered, it is preferable to display the arteriosclerosis degree from which the influence of aging has been removed. The influence of aging may be derived from statistics. An input device for inputting the age of the person to be measured is provided, and the influence of aging corresponding to the age of the person to be measured input by the input device is provided. The risk of lifestyle-related diseases should be displayed after removal.

  (7) In the first embodiment, the feature amount is extracted in each compression pressure zone. However, as described above, in a state where the pressure acting on the blood vessel is small (a state where the compression pressure which is an external pressure is large). The extensibility of the blood vessel wall depends on the characteristics of the intima and the media, and the pressure acting on the blood vessel is large (the external pressure is small). The extensibility of the blood vessel wall depends on the characteristics of the adventitia Thus, the tissue related to extensibility varies depending on the pressure acting on the blood vessels, so that the arteriosclerosis degree is derived in each compression pressure zone based on each feature amount, and each arteriosclerosis degree is displayed. May be.

  FIG. 40 shows the degree of arteriosclerosis derived based on the feature amount extracted from the region of the high pressure side compression pressure zone (inside and outside pressure difference is the low pressure side) and the low pressure side compression pressure zone (inside and outside pressure difference is the high pressure side). ) Shows the degree of arteriosclerosis derived based on the feature amount extracted from the area of) at five levels (arteriosclerosis progresses as the number of levels increases). Then, for a certain subject, the degree of cure on the high pressure side (mainly the degree of cure of the inner film and the middle film) is level 4 in five stages, and the degree of cure on the low pressure side (mainly the degree of cure of the outer film) is 5. It shows that it is level 2 during the stage.

  Instead of displaying the degree of cure on the high-pressure side / low-pressure side in this way, for example, as shown in FIG. 41, the symptoms of the outer membrane / media and intima of the blood vessel are displayed by a level meter. May be. That is, the circulatory function determination unit 55 calculates the state of the tissue that constitutes the blood vessel of the subject based on the degree of arteriosclerosis of the subject, and the circulatory function display unit 6 calculates the state by the indexing unit. It is good to display the status of the designated organization. For example, FIG. 41 shows a form in which symptoms of the adventitia, media and intima are each displayed at three levels (the larger the number of levels, the worse the symptoms). In FIG. 41, the intima is level 3 in 3 stages, the intima is level 2 in 3 stages, and the adventitia is level 0 in 3 stages. Is shown.

  In this way, the degree of arteriosclerosis is derived and displayed in the compression pressure zone on the high pressure side and the compression pressure zone on the low pressure side, respectively, and the vascular symptoms are displayed separately in the adventitia, media and intima By doing this, it becomes clear which compression pressure zone has a problem or which vascular tissue has an abnormality, and it becomes easy to diagnose.

  (8) In each of the above embodiments, the compression pressure associated with the pulse wave detection pressure calculation unit 51 and the amplitude value of the pulse wave are stored in the pulse wave data storage unit 52 in a table format. In the case of a person to be measured with a small heart rate, since the number of obtained pulse waves is small, the pulse wave amplitude value for obtaining the feature amount is stored in a table format in the pulse wave data storage unit 52. In some cases, it does not coincide with the amplitude value of the pulse wave and becomes an intermediate value. In this case, the stored amplitude value of the pulse wave close to the amplitude value of the pulse wave for obtaining the feature amount and the compression pressure corresponding to the amplitude value are read out, and the read amplitude value and the compression pressure are read out. The compression pressure corresponding to the amplitude value of the pulse wave for obtaining the feature amount may be derived by interpolation calculation. In the interpolation calculation here, for example, an equation that approximates the shape (curve) of the portion around the amplitude value of the read pulse wave in the envelope is derived, and this equation and the pulse wave for obtaining the feature amount are derived. The pressure value corresponding to the amplitude value is derived from the amplitude value.

  (9) In each of the above embodiments, the pulse wave detection unit 4 generates a pulse wave signal indicating the amplitude value of the pulse wave based on the pressure signal output from the pressure detection unit 3. The pulse wave detection unit 4 generates a pulse wave signal indicating an area value of the pulse wave for each heartbeat based on the pressure signal, and the area value and the compression instead of the amplitude value of the pulse wave. You may make it extract a feature-value similarly to the above-mentioned using the envelope which shows the relationship with a pressure.

  (10) The magnitude of the pulse wave in the claims includes not only the amplitude value of the pulse wave but also the area value of the pulse wave. In addition, when the above-described width is used as the type of feature amount used for the determination of the circulatory function, the magnitude of the pulse wave, for example, as illustrated in FIGS. 6, 17 to 19, and 23 to 25, It is only necessary to include at least one difference between the compression pressure set as the boundary and the compression pressure corresponding to the predetermined pulse wave magnitude in the envelope (width W1, W2 in FIG. 6, width in FIG. 17). W5 to W8, W9 to W11 in FIG. 18, widths W13 and W14 in FIG. 19, widths W17 to W20 in FIG. 23, widths 21 to W24 in FIG. 24, and width W25 in FIG.

  (11) If necessary, a circulatory function measuring device that appropriately combines the functions of the first to tenth embodiments and the other modified embodiments (1) to (10) may be configured.

The main inventions described in the present specification are summarized as follows.
(Appendix 1)
Pressure applying means for compressing a predetermined part of the body of the subject,
Pressure detecting means for detecting the compression pressure by the pressure applying means;
Pressure control means for changing the compression pressure by the pressure application means based on the detected compression pressure;
Pulse wave detection means for detecting pulse wave information relating to the magnitude of the pulse wave generated in the predetermined part in the process of changing the compression pressure based on the detected compression pressure;
Pulse wave information storage means for storing the detected pulse wave information and the compression pressure information related to the compression pressure at the time of detection in association with each other;
An envelope formed based on a correspondence relationship between the pulse wave information stored in the pulse wave information storage unit and the compression pressure information is divided into a plurality of regions with a predetermined compression pressure as a boundary, and the envelope Extracting feature quantities indicating the features of the shape of the envelope within at least two areas out of the whole area and each of the divided divided areas when the whole is viewed as one area Feature quantity extraction means for
A circulatory function determination device comprising: a circulatory function determination unit that determines a circulatory function based on each extracted feature quantity.

(Appendix 2)
The extracted feature amount includes at least one difference between a compression pressure set as the boundary and a compression pressure corresponding to a predetermined pulse wave magnitude in the envelope. The circulatory function measuring device described.

(Appendix 3)
The circulatory function measuring device according to appendix 1 or 2, wherein the compression pressure set as the boundary is a compression pressure that maximizes the magnitude of the pulse wave.

(Appendix 4)
The cardiovascular function measuring device according to any one of appendices 1 to 3, further comprising blood pressure estimating means for estimating blood pressure using the envelope.

(Appendix 5)
The supplementary note 1 or 2, further comprising blood pressure estimating means for estimating blood pressure using the envelope, wherein the compression pressure set as the boundary is blood pressure estimated by the blood pressure estimating means Cardiovascular function measuring device.

(Appendix 6)
Blood pressure estimating means for estimating blood pressure using the envelope, and the compression pressure set as the boundary is a pressure at which the magnitude of the pulse wave is maximum, and a blood pressure estimated by the blood pressure estimating means The circulatory function measuring device according to supplementary note 3, characterized by comprising:

(Appendix 7)
The blood pressure estimated by the blood pressure estimating means is at least one of a maximum blood pressure, a minimum blood pressure, and an average blood pressure calculated from the maximum blood pressure and the minimum blood pressure using the following calculation formula: The cardiovascular function measuring device according to any one of appendices 4 to 6.
Average blood pressure = (Maximum blood pressure-Minimum blood pressure) / 3 + Minimum blood pressure

(Appendix 8)
Based on the blood pressure estimated by the blood pressure estimation unit, the feature value extraction unit includes a first extraction method setting unit that sets a feature value extraction method including the type of the feature value to be set and extracted. The cardiovascular function measuring device according to any one of appendices 4 to 7, wherein the feature quantity is extracted according to a feature quantity extraction method set by the first extraction method setting means.

(Appendix 9)
The circulatory function measuring apparatus according to any one of appendices 4 to 8, further comprising a correcting unit that corrects the blood pressure estimated by the blood pressure estimating unit using the extracted feature amount.

(Appendix 10)
10. The circulatory function measuring apparatus according to any one of appendices 1 to 9, wherein the feature amount extraction unit extracts a plurality of feature amounts from the same region.

(Appendix 11)
11. The circulatory function measuring apparatus according to any one of appendices 1 to 10, wherein the feature amount extraction unit extracts different types of feature amounts from each region.

(Appendix 12)
Input means for inputting the physical characteristics of the person to be measured, and second extraction for setting a feature value extraction method including setting of the boundary values and types of feature values to be extracted based on the input physical characteristics Any one of Supplementary notes 1 to 11, wherein the feature amount extraction unit extracts the feature amount according to a feature amount extraction method set by the second extraction method setting unit. An apparatus for measuring cardiovascular function described in 1.

(Appendix 13)
The circulatory function measuring apparatus according to any one of appendices 1 to 12, further comprising display means for displaying a determination result of the circulatory function determining means.

(Appendix 14)
The circulatory function determining means outputs the progress of arteriosclerosis of the subject as a numerical value, and the display means displays the numerical value output by the circulatory function determining means. The circulatory function measuring device according to appendix 13.

(Appendix 15)
The cardiovascular function determination means outputs stage data indicating which stage of the arteriosclerosis degree of the measurement subject is applied to a stage among a plurality of stages set in advance with respect to the progress of arteriosclerosis. 15. The circulatory function measuring device according to appendix 13 or 14, wherein the means displays the stage data output by the circulatory function determining means.

(Appendix 16)
In the display means, a plurality of light emitting means for emitting light of different colors are associated with each other according to the stage, and the stage data output by the circulatory function determining means corresponds to the stage data. 16. The circulatory function measuring device according to appendix 15, wherein the illuminating means is configured to emit light for display.

(Appendix 17)
In addition to input means for inputting the physical characteristics of the measurement subject, the circulatory function determination means includes storage means for storing a reference value of the feature amount set in advance according to the physical characteristics, The display means determines based on the circulatory function determination result determined based on the feature amount extracted by the feature amount extraction means and the reference value corresponding to the physical characteristic of the measurement subject having the feature amount. The circulatory function measurement apparatus according to any one of appendices 13 to 16, wherein the circulatory function determination reference value is displayed.

(Appendix 18)
The cardiovascular function determination means includes a storage means for storing a relationship between the age of a healthy person derived from statistics and the age of a healthy person, and an artery derived from the feature quantity extracted by the feature quantity extraction means. Any one of appendices 13 to 17, characterized in that the display means displays the age converted by the conversion means, the conversion means converting the degree of hardening into the age of a healthy person corresponding to the degree of arteriosclerosis. The circulatory function measuring device according to any one of the above.

(Appendix 19)
The cardiovascular function determination means includes a conversion means for converting the degree of arteriosclerosis of the measurement subject into a factor holding number of lifestyle-related diseases, and the display means displays the factor holding number converted by the conversion means. The cardiovascular function measuring device according to any one of appendices 13 to 18, characterized in that:

(Appendix 20)
The circulatory function determining means determines the state of the tissue constituting the blood vessel of the subject based on the degree of arteriosclerosis of the subject, and the display means is the tissue determined by the circulatory function determining means The circulatory function measuring device according to any one of appendices 13 to 19, characterized in that the state is displayed.

It is a block diagram which shows the structure of 1st Embodiment of the cardiovascular function measuring apparatus which concerns on this invention. It is a graph which shows the pressure change in the cuff which presses the brachial artery. It is a graph which shows a mode that the pulse wave detected sequentially in a slow depressurization process changes in time series according to a pressure change. It is a graph which shows the outline of the envelope of the pulse wave obtained in the slow depressurization process of the cuff pressing the brachial artery. It is a graph which shows the example of the shape pattern of the envelope shown in FIG. It is a figure for demonstrating about the feature-value employ | adopted in the cardiovascular function measuring method of 1st Embodiment. It is a figure for demonstrating about the feature-value employ | adopted in the cardiovascular function measuring method of 1st Embodiment. It is a figure for demonstrating about the feature-value employ | adopted in the cardiovascular function measuring method of 1st Embodiment. It is a figure for demonstrating the relationship between the compression pressure in which the amplitude value of a pulse wave becomes the maximum, and average blood pressure. It is a graph which shows the volume change in the compression site | part of the blood vessel according to a pressure difference (average blood pressure-compression pressure). It is a figure which shows the form which displays the arteriosclerosis degree of a certain to-be-measured person numerically. It is a flowchart which shows an example of operation | movement of the circulatory organ function measuring apparatus of 1st Embodiment. It is a figure which shows the other extraction form which extracts a feature-value. It is a block diagram for demonstrating the structure of the cardiovascular function measuring apparatus of 2nd Embodiment. It is a flowchart which shows an example of operation | movement of the circulatory organ function measuring apparatus of 2nd Embodiment. It is a block diagram for demonstrating the structure of the cardiovascular function measuring apparatus of 3rd Embodiment. It is a figure which shows the example which obtained the feature-value using each blood-pressure value (maximum blood pressure, the minimum blood pressure, and average blood pressure) calculated by the blood-pressure calculation part as a boundary value which divides | segments an envelope. It is a figure which shows the example which obtained the feature-value using each blood-pressure value (maximum blood pressure, average blood pressure) calculated by the blood-pressure calculation part as a boundary value which divides | segments an envelope. It is a figure which shows the example which obtained the feature-value using each blood-pressure value (maximum blood pressure, minimum blood pressure) calculated by the blood-pressure calculation part as a boundary value which divides | segments an envelope. It is a graph which shows an example of the state where the maximum amplitude value of a pulse wave and the amplitude value of the pulse wave of the vicinity become unstable when measuring the amplitude of a pulse wave to the same person similarly. It is a graph which shows an example of the state where the maximum amplitude value of a pulse wave and the amplitude value of the pulse wave of the vicinity become unstable when measuring the amplitude of a pulse wave to the same person similarly. It is a figure for demonstrating the characteristic part of 4th Embodiment. An example in which a plurality of feature amounts are extracted from each compression pressure zone is shown. An example in which a plurality of feature amounts are extracted from each compression pressure zone is shown. An example is shown in which different feature amounts are extracted from regions of different compression pressure zones. It is a block diagram for demonstrating the structure of the cardiovascular function measuring apparatus of 7th Embodiment. It is a flowchart which shows an example of operation | movement of the circulatory organ function measuring apparatus of 7th Embodiment. It is a block diagram for demonstrating the structure of the cardiovascular function measuring apparatus of 8th Embodiment. It is a flowchart which shows an example of operation | movement of the circulatory organ function measuring apparatus of 8th Embodiment. It is a block diagram for demonstrating the structure of the cardiovascular function measuring apparatus of 9th Embodiment. It is a flowchart which shows an example of operation | movement of the circulatory organ function measuring apparatus of 9th Embodiment. It is a graph which shows the other example of the pressure change in the cuff which compresses the brachial artery. It is a figure which shows the display form of the determination result of a to-be-measured person's cardiovascular function. It is a figure which shows the display form of the determination result of a to-be-measured person's cardiovascular function. It is a figure which shows the display form of the determination result of a to-be-measured person's cardiovascular function. It is a figure which shows the display form of the determination result of a to-be-measured person's cardiovascular function. It is a figure which shows the display form of the determination result of a to-be-measured person's cardiovascular function. It is a figure which shows the display form of the determination result of a to-be-measured person's cardiovascular function. It is a figure which shows the display form of the determination result of a to-be-measured person's cardiovascular function. It is a figure which shows the display form of the determination result of a to-be-measured person's cardiovascular function. It is a figure which shows the display form of the determination result of a to-be-measured person's cardiovascular function. It is a figure for demonstrating a prior art. It is a figure for demonstrating a prior art.

Explanation of symbols

5 Control Unit 51 Pulse Wave Detection Pressure Calculation Unit 52 Pulse Wave Data Storage Unit 53 Feature Amount Extraction Pressure Band Derivation Unit 54 Feature Amount Extraction Unit 55 Circulatory Function Determination Unit 56 Blood Pressure Calculation Units 57 and 57 ′ Feature Amount Extraction Method Setting Unit 58 Estimated blood pressure correction unit 7 Blood pressure value display unit

Claims (1)

Pressure applying means for compressing a predetermined part of the body of the subject,
Pressure detecting means for detecting the compression pressure by the pressure applying means;
Pressure control means for changing the compression pressure by the pressure application means based on the detected compression pressure;
Pulse wave detection means for detecting pulse wave information relating to the magnitude of the pulse wave generated in the predetermined part in the process of changing the compression pressure based on the detected compression pressure;
Pulse wave information storage means for storing the detected pulse wave information and the compression pressure information related to the compression pressure at the time of detection in association with each other;
An envelope formed based on a correspondence relationship between the pulse wave information stored in the pulse wave information storage unit and the compression pressure information is divided into a plurality of regions with a predetermined compression pressure as a boundary, and the envelope Extracting feature quantities indicating the features of the shape of the envelope within at least two areas out of the whole area and each of the divided divided areas when the whole is viewed as one area Feature quantity extraction means for
Circulatory function determination means for determining circulatory function based on each extracted feature amount;
Display means for displaying the determination result of the cardiovascular function determination means;
An input means for inputting the physical characteristics of the measurement subject;
A second extraction method setting means for setting a feature value extraction method including the type of the feature value to be extracted and the setting of the boundary value based on the inputted physical characteristics;
The circulatory function measuring apparatus characterized in that the feature quantity extraction means extracts the feature quantity according to a feature quantity extraction method set by the second extraction method setting means.

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