JP2006340896A - Blood pressure correction method and hemodynamometer - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To correct a measured blood pressure when a blood pressure change of a living body is occurring during blood pressure measurement. <P>SOLUTION: During blood pressure measurement time with a correction, pressure change (pulse) which occurs in an artery of an upper arm of the living body sensed by a manometric section 18 is stored as pulse data, and blood pressure such as systolic blood pressure and diastolic blood pressure is identified (measured) with the oscillometric method. A fluctuation analysis section of a blood pressure correction program analyzes fluctuations of each of pulse data at before and after blood pressure measurement and calculates sextuple average pulse rates before and after blood pressure measurement. In the blood pressure correction program, a blood pressure elevation calculation section calculates a blood pressure elevation value using the sextuple average pulse rates before and after blood pressure measurement, and the blood pressure correction section corrects the blood pressure data using the blood elevation value. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a blood pressure correction method and a sphygmomanometer that corrects blood pressure of a living body.

  It is generally said that the blood pressure of outpatients in medical facilities starts to increase when the outpatient enters the examination room and tends to return to the original value in about 5 minutes after blood pressure measurement. Therefore, when evaluating blood pressure, it is necessary to consider a transient increase in blood pressure due to tension or the like. Therefore, as a method for determining whether or not there is a transient increase in blood pressure, it is known to detect a pulse wave after blood pressure detection and determine whether the patient has white coat hypertension based on the detected pulse wave. (See Patent Document 1).

JP 2003-265420 A

  However, the conventional example has a problem that the detected blood pressure cannot be corrected even if the patient has white coat hypertension.

  Therefore, the present invention provides a blood pressure correction method and a blood pressure monitor that can correct the measured blood pressure when a blood pressure change of a living body due to, for example, tension occurs at the time of blood pressure measurement. It is intended to provide.

  The present inventor has found that when measuring the blood pressure of a living body, it can be determined whether it is a tension state or a relaxation state based on a change in pulse before and after the blood pressure measurement, and the blood pressure change can be corrected.

  That is, the first feature of the present invention is that a pre-measurement pulse rate that is a pulse rate before blood pressure measurement is detected, a post-measurement pulse rate that is a pulse rate after blood pressure measurement is detected, and the blood pressure measurement is performed. In the blood pressure correction method, the measured blood pressure is corrected based on the pre-measurement pulse rate and the post-measurement pulse rate.

  Preferably, the blood pressure increase value at the time of blood pressure measurement is calculated based on the ratio of the blood pressure increase value to the pulse rate increase value due to a predetermined tension, the pre-measurement pulse rate and the post-measurement pulse rate, and the calculated blood pressure increase The blood pressure measured by the blood pressure measurement is corrected using the value.

  The second feature of the present invention is that a blood pressure measuring means for measuring blood pressure, a pre-measurement pulse rate that is a pulse rate before the blood pressure measuring means measures blood pressure, and the blood pressure measuring means measures blood pressure. A pulse rate detecting means for detecting a post-measurement pulse rate that is a pulse rate after measurement, and the blood pressure measured by the blood pressure measurement means based on the pre-measurement pulse rate and the post-measurement pulse rate detected by the pulse rate detection means. A sphygmomanometer having blood pressure correction means for correction.

  Preferably, the blood pressure correction unit is configured to measure the blood pressure based on a pre-measurement pulse rate and a post-measurement pulse rate detected by the pulse rate detection unit, and a ratio of a blood pressure increase value to a pulse rate increase value due to a predetermined tension. The blood pressure measured by the means is corrected.

  ADVANTAGE OF THE INVENTION According to this invention, when the blood pressure change of the biological body has arisen at the time of blood pressure measurement, the measured blood pressure can be corrected.

  Hereinafter, embodiments according to the present invention will be described with reference to the drawings.

  In FIG. 1, an outline of a sphygmomanometer 10 is shown. The sphygmomanometer 10 can be examined while a living body is seated on the chair 12. A cuff 14 is attached to the upper arm portion of the living body sitting on the chair 12. The cuff 14 is connected to a cuff pressure control device 16 via a pressure detector 18 described later. As is well known, the cuff pressure control device 16 is composed of a pump, a pressure adjusting valve, and the like, and controls the cuff pressure of the cuff 14. The cuff 14 applies a predetermined pressure (cuff pressure) to the upper arm portion of the living body under the control of the cuff pressure control device 16. The cuff 14 is configured to output a change in pressure received from the artery of the upper arm portion of the living body to the pressure detecting unit 18. The pressure detection unit 18 detects pressure fluctuation (pulse) that occurs in the artery of the upper arm input from the cuff 14.

The sphygmomanometer body 20 is composed of, for example, a personal computer, and includes a keyboard for inputting data, a computing device for processing data, a display device for displaying data, and the like. The sphygmomanometer main body 20 outputs a control signal to the cuff pressure control device 16 and receives a pressure fluctuation (pulse) detected by the pressure detecting unit 18.
In other words, the sphygmomanometer 10 is configured to be able to measure the blood pressure of the living body, detect the pulse rate, and the like by the blood pressure monitor main body 20 processing the pulse of the living body detected by the pressure detecting unit 18.

  As shown in FIG. 2, the sphygmomanometer 10 is provided with a cylindrical body 22 into which a biological arm can be freely inserted, and a pressure sensor 24 in which the inner side of the upper arm of the biological body hits the cylindrical body 22, and a cuff. 26 may be arranged. Here, the cuff 26 applies a predetermined pressure to the upper arm portion of the living body under the control of the cuff pressure control device 16, and the pressure sensor 24 detects pressure fluctuation (pulse) occurring in the artery of the upper arm portion of the living body to detect the blood pressure monitor body. By outputting to 20, the sphygmomanometer 10 can measure the blood pressure of the living body and detect the pulse rate.

Next, blood pressure measurement with correction by the sphygmomanometer 10 will be described.
FIG. 3 is a program configuration diagram showing a configuration of a blood pressure correction program 30 executed by the sphygmomanometer body 20 in blood pressure measurement with correction by the sphygmomanometer 10.
FIG. 4 is a graph showing the pulse (intraarterial pressure) of the living body and the cuff pressure of the cuff 14 during the blood pressure measurement time with correction.
The blood pressure correction program 30 includes a pulse acquisition unit 300, a storage unit 302, a blood pressure identification unit 304, a fluctuation analysis unit 306, a blood pressure increase calculation unit 308, and a blood pressure correction unit 310, and corresponds to the change in the cuff pressure of the cuff 14. Correct blood pressure.

The pulse acquisition unit 300 (FIG. 3) acquires the pulse of the living body (FIG. 4) in the blood pressure measurement time with correction from the pressure detection unit 18 and outputs it to the storage unit 302 as pulse data. The pulse data output from the pulse acquisition unit 300 includes the ms from the rising point of the waveform for each beat to the rising point of the next waveform in the pulse detection time (pulse for 100 beats) before and after blood pressure measurement. The unit time and the time in ms from the peak point of the waveform for each beat to the peak point of the next waveform are included as data indicating the interval time of each pulse of 100 beats. Note that the cuff pressure is maintained at, for example, about 50 mmHg during the pulse detection time before and after blood pressure measurement.
The storage unit 302 stores the pulse data input from the pulse acquisition unit 300, and outputs the pulse data according to the access of the blood pressure specifying unit 304 and the fluctuation analysis unit 306.

  The blood pressure specifying unit 304 obtains pulse data of the blood pressure measurement time (FIG. 4) by accessing the storage unit 302, and specifies (measures) blood pressure such as systolic blood pressure and diastolic blood pressure by, for example, the oscillometric method. And output to the blood pressure correction unit 310 as blood pressure data.

  The fluctuation analysis unit 306 obtains pulse data by accessing the storage unit 302, analyzes fluctuations of the pulse data before and after blood pressure measurement, removes noise, and calculates 6-beat average pulse before blood pressure measurement, which will be described later. The 6-beat average pulse rate is output to the blood pressure increase calculation unit 308 after the number and blood pressure measurement.

  FIG. 5 is a graph showing an example of pulse data that the fluctuation analysis unit 306 analyzes fluctuations, in which (A) shows pulse data of a pulse detection time before blood pressure measurement, and (B) shows pulse detection after blood pressure measurement. The pulse data of time is shown, (C) is a graph which shows the example of pulse data used as the object of addition averaging. The fluctuation analysis unit 306 extracts the first six beats as the addition average target pulse from the 100 beats in the pulse detection time before blood pressure measurement shown in FIG. In addition, as shown in FIG. 5C, the fluctuation analysis unit 306 generates the next waveform from the rising point a of the waveform for each beat with respect to the first six beats that are the target pulses of the addition average before blood pressure measurement. The pulse rate corresponding to each interval time (a1 to a6) until the rising point is calculated. Further, the fluctuation analysis unit 306 performs the interval time (b1 to b6) from the peak point b of the waveform for each beat to the peak point of the next waveform with respect to the first six beats of the target pulse of the addition average before blood pressure measurement. The pulse rate corresponding to each is calculated. Then, the fluctuation analysis unit 306 calculates the addition average of each pulse rate calculated with respect to the target pulse of the addition average before blood pressure measurement, and sets it as the 6-beat average pulse rate before blood pressure measurement.

  Next, the fluctuation analysis unit 306 extracts the last six beats as the addition average target pulse from the 100 beats in the pulse detection time after blood pressure measurement shown in FIG. Similarly, the fluctuation analysis unit 306 calculates the pulse rate corresponding to each waveform for each of the last 6 beats which are the target pulses of the addition average after blood pressure measurement. Then, the fluctuation analysis unit 306 calculates the addition average of each pulse rate calculated with respect to the target pulse of the addition average after blood pressure measurement, and sets it as the 6-beat average pulse rate after blood pressure measurement.

  The blood pressure increase calculation unit 308 (FIG. 3) is said to have an average blood pressure increase value of, for example, 22.6 mgHg and an average pulse increase value of, for example, 17.7 per minute, for example in outpatient white coat hypertension. From the 6-beat average pulse rate before blood pressure measurement and the 6-beat average pulse rate after blood pressure measurement received from the fluctuation analysis unit 306, a blood pressure increase value due to tension is calculated by the following equation 1, and the blood pressure correction unit 310 and the sphygmomanometer Output to the display device of the main body 20.

22.6 ÷ 17.7 × (6 beats average pulse rate before blood pressure measurement−6 beats average pulse rate after blood pressure measurement)
= Blood pressure increase value (1)

However, if the calculated blood pressure increase value is a negative value, the blood pressure increase calculation unit 308 considers that the blood pressure increase value due to tension is 0, for example, and does not evaluate the blood pressure increase value.
Moreover, the average blood pressure increase value and the average pulse increase value in white coat hypertension used in Formula 1 may be unique to an individual.

The blood pressure correction unit 310 corrects the blood pressure data received from the blood pressure specifying unit 304 using the blood pressure increase value received from the blood pressure increase calculation unit 308, and outputs the corrected blood pressure to the display device of the sphygmomanometer body 20. To do.
The display device of the sphygmomanometer main body 20 can also display the blood pressure before correction.

In FIG. 6, the process (S10) in the blood pressure measurement with correction of the sphygmomanometer 10 is shown.
As shown in FIG. 6, in step 100 (S100), the pressure detector 18 detects pressure fluctuations (pulses) that occur in the artery of the upper arm portion of the living body.

  In step 102 (S102), the pulse acquisition unit 300 acquires the pulse of the living body in the blood pressure measurement time with correction from the pressure detection unit 18.

  In step 104 (S104), the storage unit 302 stores the pulse data input from the pulse acquisition unit 300.

  In step 106 (S106), the blood pressure identification unit 304 obtains pulse data of blood pressure measurement time by accessing the storage unit 302, and identifies blood pressure such as systolic blood pressure and diastolic blood pressure by, for example, an oscillometric method. (taking measurement.

  In step 108 (S108), the fluctuation analysis unit 306 obtains pulse data by accessing the storage unit 302, analyzes fluctuations of the pulse data before and after blood pressure measurement, and averages six beats before blood pressure measurement. The pulse rate and the 6-beat average pulse rate after blood pressure measurement are output to the blood pressure increase calculation unit 308.

  In step 110 (S110), the blood pressure increase calculation unit 308 calculates the blood pressure increase value using the 6-beat average pulse rate before blood pressure measurement and the 6-beat average pulse rate after blood pressure measurement.

  In step 112 (S112), the blood pressure correction unit 310 corrects the blood pressure data received from the blood pressure specifying unit 304 using the blood pressure increase value received from the blood pressure increase calculation unit 308.

  In step 114 (S114), the display device of the sphygmomanometer body 20 displays the blood pressure increase value calculated by the blood pressure increase calculation unit 308 and the corrected blood pressure corrected by the blood pressure correction unit 310.

  In the above-described embodiment, the fluctuation analysis unit 306 uses the first six beats as an addition target pulse for 100 beats in the pulse detection time before blood pressure measurement, and 100 beats in the pulse detection time after blood pressure measurement. The case where the last 6 beats are added to the average pulse and the fluctuation of the pulse data before and after the blood pressure measurement is analyzed is described as an addition average target pulse, but the fluctuation analysis unit 306 is not limited to this, The average pulse rate before blood pressure measurement and the average pulse rate after blood pressure measurement may be calculated using all pulse data of the pulse detection time before and after blood pressure measurement.

Moreover, the interval time between the peaks point of the pulse fluctuation analysis unit 306 (pressure fluctuation occurring in the artery) is regarded as the RR interval of the electrocardiogram, the coefficient of variation before and after the blood pressure measurement CV RR _(Coefficient of variation of RR Intervals) is calculated, may be calculated blood pressure rise value pressor calculating unit 308 according to the difference of coefficient of variation CV _R-R before and after blood pressure measurement. It is also possible for the fluctuation analysis unit 306 to calculate the coefficient of variation CV _R-R before and after blood pressure measurement, so as to determine a functional disorder as an autonomic nerve function test.

  Further, the fluctuation analysis unit 306 may perform time-series frequency analysis on the pulses before and after blood pressure measurement based on the maximum entropy method, and the blood pressure increase calculation unit 308 may calculate a blood pressure increase value according to the analysis result. It is also possible to evaluate the balance between the sympathetic nerve and the parasympathetic nerve and to evaluate the degree of tension by the fluctuation analysis unit 306 performing frequency analysis of the pulses before and after blood pressure measurement in time series based on the maximum entropy method.

  The present invention can be used when a blood pressure change in a living body such as white coat hypertension occurs during blood pressure measurement.

It is a block diagram which shows the blood pressure meter which concerns on embodiment of this invention. It is a block diagram which shows the modification of the blood pressure meter shown in FIG. It is a program block diagram which shows the structure of the blood-pressure correction program which a blood pressure meter main body performs. It is a graph which shows the pulse (intraarterial pressure) of the living body in the blood pressure measurement time with correction | amendment, and the cuff pressure of a cuff. It is a graph which shows the pulse data example which a fluctuation analysis part analyzes fluctuation, Comprising: (A) shows the pulse data of the pulse detection time before blood pressure measurement, (B) shows the pulse data of the pulse detection time after blood pressure measurement. (C) is a graph which shows the example of pulse data used as the object of addition averaging. It is a flowchart which shows the process (S10) in the blood pressure measurement with correction | amendment of a sphygmomanometer.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Sphygmomanometer 12 Chair 14 Cuff 16 Cuff pressure control device 18 Pressure detection part 20 Sphygmomanometer main body 22 Cylindrical body 24 Pressure sensor 26 Cuff 30 Blood pressure correction program

Claims (4)

  A pre-measurement pulse rate that is a pulse rate before blood pressure measurement is detected, a post-measurement pulse rate that is a pulse rate after blood pressure measurement is detected, and the blood pressure measured by the blood pressure measurement is determined based on the pre-measurement pulse rate and the post-measurement pulse rate. A blood pressure correction method for correcting based on the pulse rate.   Based on the ratio of the blood pressure increase value to the pulse rate increase value due to a predetermined tension, the pre-measurement pulse rate and the post-measurement pulse rate, the blood pressure increase value at the time of blood pressure measurement is calculated, and the calculated blood pressure increase value is used. The blood pressure correction method according to claim 1, wherein the blood pressure measured by the blood pressure measurement is corrected.   A blood pressure measuring means for measuring blood pressure, a pre-measurement pulse rate before the blood pressure measuring means measures the blood pressure, and a post-measurement pulse rate that is the pulse rate after the blood pressure measuring means measures the blood pressure. A sphygmomanometer comprising: a pulse rate detecting unit for detecting; and a blood pressure correcting unit for correcting the blood pressure measured by the blood pressure measuring unit based on the pre-measurement pulse rate and the post-measurement pulse rate detected by the pulse rate detecting unit.   The blood pressure correction means is measured by the blood pressure measurement means based on a pre-measurement pulse rate and a post-measurement pulse rate detected by the pulse rate detection means, and a ratio of a blood pressure increase value to a pulse rate increase value due to a predetermined tension. The sphygmomanometer according to claim 3, which corrects blood pressure.

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