JP2012125383A - Autonomic nervous function diagnostic apparatus and program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enable even a person having no specialized knowledge to easily determine the autonomic nervous condition of a subject.SOLUTION: An electrocardiogram monitor 14 measures the electrocardiographic data of the person to be diagnosed. Based on the electrocardiographic data measured, an autonomic nerve activity index calculating part 24 calculates the sympathetic nerve activity index (LH/HF), and a CVRR calculating part 25 calculates the CVRR based on the electrocardiographic data. A controlling apparatus 18 calculates the CVRR changing quantity being a difference of CVRR values before and after a standing-up test, the sympathetic nerve activity index changing quantity being a difference of the values of LF/HF before and after the standing-up test as an index showing the condition of the sympathetic nerve function, and based on the combination of the values of these indexes, it is determined that to which type the condition of the sympathetic nervous function of the person to be diagnosed belongs among predetermined types of the sympathetic nervous function.

Description

  The present invention relates to an autonomic nerve function diagnostic apparatus and program for determining the state of an autonomic nerve.

  In modern society, various stresses based on the social environment are increasing. Therefore, in recent years, an increase in patients with mental illnesses such as depression, autonomic dystonia, orthostatic dysregulation, and chronic fatigue syndrome has become a major social problem. And when it falls into such a mental illness, the functional disorder which an autonomic nerve does not function normally generate | occur | produces.

  Autonomic nerves include sympathetic nerves that function mainly in an active state and parasympathetic nerves that function mainly in a resting state. When the living body is in a resting state, the state of the autonomic nerve becomes parasympathetic dominant, and the blood pressure value and the pulse rate decrease. When the living body is in a tension / active state, the state of the autonomic nerve becomes a sympathetic dominant state, and the blood pressure value and the pulse rate increase.

  When the autonomic nerve function is normal, switching between the sympathetic nerve dominant state and the parasympathetic nerve dominant state is performed while maintaining a balance between the sympathetic nerve and the parasympathetic nerve. However, it is known that when the autonomic nerve function becomes abnormal, this balance is lost, and the autonomic nerve function does not react properly even when a load is applied to the patient.

  Therefore, various methods for diagnosing the autonomic nerve function by performing a load test such as a standing test on the subject and observing the reaction of the autonomic nerve function have been proposed (for example, Patent Document 1). To 4).

  In the conventional diagnostic methods described in Patent Documents 1 to 4, evaluation of autonomic nerve function is performed using heart rate dispersion, or R wave interval data obtained from electrocardiographic data is obtained by spectrum analysis. Using the LF component and the HF component in the obtained power spectrum, the activity of the sympathetic nerve and the activity of the parasympathetic nerve are measured, or the electrocardiogram RR interval variation coefficient (CVRR: Coefficient of Coefficient of R wave interval). A diagnosis of whether or not the autonomic nervous function is normal was performed by seeking Variance of RR intervals.

JP 2010-35896 A Japanese Patent No. 4327243 Japanese Patent No. 4487015 Japanese Patent No. 4516623

  However, there are various states of the autonomic nerve, and it is difficult to grasp the state of the autonomic nerve from the measurement result unless the person has specialized knowledge. In particular, when a load test such as a standing test is performed, if the state of the autonomic nerve is changed, the state of the subject's autonomic nerve is normal, and if it is changed, there is a problem. There is a problem that it is not easy to determine whether there is any.

  An object of the present invention is to provide an autonomic nervous function diagnostic apparatus and program that can easily determine the state of the autonomic nerve of a person to be diagnosed even if the person does not have specialized knowledge. .

[Autonomic nerve function diagnostic equipment]
In order to achieve the above object, an autonomic nervous function diagnostic apparatus according to the present invention includes an electrocardiogram measuring means for measuring an electrocardiogram of a subject,
Autonomic nerve activity calculating means for calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the electrocardiographic data measured by the electrocardiogram measuring means;
CVRR calculation means for calculating an electrocardiogram RR interval variation coefficient based on the electrocardiogram data measured by the electrocardiogram measurement means;
Instructing means for instructing a load test for the diagnosed person,
The CVRR change amount, which is the difference between the CVRR value calculated after the load test is instructed by the instruction means and the CVRR value calculated before the load test is instructed, is used as an index of the reactive power of the autonomic nervous function. And the difference between the value of the sympathetic nerve activity index calculated after the load test is instructed by the instruction means and the value of the sympathetic nerve activity index calculated before the load test is instructed An index calculating means for calculating a sympathetic nerve activity index change amount as an index of the switching power of the autonomic nerve function;
A determination means for determining which type of autonomic nerve type a predetermined state of the subject's autonomic function belongs to based on the CVRR change amount and the sympathetic activity index change amount;
Display means for displaying the autonomic nerve type determined by the determination means.

Further, another autonomic nervous function diagnostic apparatus of the present invention is a receiving means for receiving the electrocardiographic data of the diagnosed person measured by the electrocardiograph.
Autonomic nerve activity degree calculating means for calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the electrocardiographic data received by the receiving means;
CVRR calculating means for calculating an electrocardiogram RR interval variation coefficient based on the electrocardiogram data received by the receiving means;
Instructing means for instructing a load test for the diagnosed person,
The CVRR change amount, which is the difference between the CVRR value calculated after the load test is instructed by the instruction means and the CVRR value calculated before the load test is instructed, is used as an index of the reactive power of the autonomic nervous function. And the difference between the value of the sympathetic nerve activity index calculated after the load test is instructed by the instruction means and the value of the sympathetic nerve activity index calculated before the load test is instructed An index calculating means for calculating a sympathetic nerve activity index change amount as an index of the switching power of the autonomic nerve function;
A determination means for determining which type of autonomic nerve type a predetermined state of the subject's autonomic function belongs to based on the CVRR change amount and the sympathetic activity index change amount;
Display means for displaying the autonomic nerve type determined by the determination means.

  According to the present invention, the state of the autonomic nerve of the diagnosis subject is selected and determined based on the CVRR change amount and the sympathetic activity index change amount from a plurality of predetermined autonomic nerve types. Therefore, even a person who does not have specialized knowledge can easily determine the state of the autonomic nerve of the person to be diagnosed.

という式に基づいて低周波成分変動係数および高周波成分変動係数を算出し、前記低周波成分変動係数および前記高周波成分変動係数の和に対する前記高周波成分変動係数の割合を、負荷試験が指示されてから一定期間が経過する前後で算出し、その差を自律神経機能の回復力の指標として算出し、
前記判定手段は、前記ＣＶＲＲ変化量が所定値以上の場合には、前記回復力の指標の値に基づいて、自律神経タイプの判定を行うようにしてもよい。 Further, the index calculating means includes low frequency components LF and 0.15 which are integral values in the region of 0.04 to 0.15 Hz in the frequency components of the power spectrum obtained as a result of frequency analysis of the ECG RR interval data. From the high frequency component HF, which is an integral value in the region of ˜0.45 Hz, and the average value AVRR of the RR interval,

The low-frequency component variation coefficient and the high-frequency component variation coefficient are calculated based on the expression, and the ratio of the high-frequency component variation coefficient to the sum of the low-frequency component variation coefficient and the high-frequency component variation coefficient is calculated after the load test is instructed. Calculated before and after a certain period of time, and the difference is calculated as an index of the resilience of autonomic nervous function.
When the CVRR change amount is equal to or greater than a predetermined value, the determination unit may determine the autonomic nerve type based on the value of the resilience index.

  According to the present invention, in addition to the amount of change in CVRR and the amount of change in sympathetic nerve activity index, the ratio of the high frequency component variation coefficient to the sum of the low frequency component variation coefficient and the high frequency component variation coefficient before and after the load test Since the autonomic nerve type is determined based on the amount, the state of the autonomic nerve of the person to be diagnosed can be determined in more detail.

Further, another autonomic nerve function diagnostic apparatus of the present invention is a pulse wave measuring means for measuring a pulse wave of a subject,
Autonomic nerve activity calculation means for calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the pulse wave data measured by the pulse wave measurement means;
Based on the pulse wave data measured by the pulse wave measuring means, a pulse wave interval fluctuation coefficient calculating means for calculating a pulse wave interval fluctuation coefficient;
Instructing means for instructing a load test for the diagnosed person,
Pulse wave interval fluctuation, which is the difference between the pulse wave interval fluctuation coefficient value calculated after the load test is instructed by the instruction means and the pulse wave interval fluctuation coefficient value calculated before the load test is instructed The coefficient change amount is calculated as an index of the reactive power of the autonomic nerve function, and the value of the sympathetic nerve activity index calculated after the load test is instructed by the indicating means and the load test is calculated before the load test is instructed. An index calculating means for calculating a sympathetic activity index change amount, which is a difference from the value of the sympathetic activity index, as an index of the switching power of the autonomic nerve function;
Based on the change amount of the pulse wave interval variation coefficient and the change amount of the sympathetic nerve activity index, it is determined which type of the autonomic nerve type of the subject's autonomic nerve function belongs to A determination means;
Display means for displaying the autonomic nerve type determined by the determination means.

In addition, another autonomic nervous function diagnostic apparatus of the present invention includes an accepting unit that receives the pulse wave data of the diagnosed person measured by the pulse wave measuring device
Autonomic nerve activity degree calculating means for calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the pulse wave data received by the receiving means;
A pulse wave interval variation coefficient calculating means for calculating a pulse wave interval variation coefficient based on the pulse wave data received by the receiving means;
Instructing means for instructing a load test for the diagnosed person,
Pulse wave interval fluctuation, which is the difference between the pulse wave interval fluctuation coefficient value calculated after the load test is instructed by the instruction means and the pulse wave interval fluctuation coefficient value calculated before the load test is instructed The coefficient change amount is calculated as an index of the reactive power of the autonomic nerve function, and the value of the sympathetic nerve activity index calculated after the load test is instructed by the indicating means and the load test is calculated before the load test is instructed. An index calculating means for calculating a sympathetic activity index change amount, which is a difference from the value of the sympathetic activity index, as an index of the switching power of the autonomic nerve function;
Based on the change amount of the pulse wave interval variation coefficient and the change amount of the sympathetic nerve activity index, it is determined which type of the autonomic nerve type of the subject's autonomic nerve function belongs to A determination means;
Display means for displaying the autonomic nerve type determined by the determination means.

  According to the present invention, the pulse wave data is measured instead of the electrocardiographic data of the diagnosed person, and the autonomic nerve type to which the state of the autonomic nervous function of the diagnosed person belongs is determined. Can be determined.

[program]
The program of the present invention includes a step of measuring the electrocardiogram of the subject,
Calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the measured electrocardiographic data;
Calculating an electrocardiogram RR interval variation coefficient based on the measured electrocardiogram data;
Instructing a load test for the person to be diagnosed;
Calculating the amount of CVRR change, which is the difference between the value of CVRR calculated after the load test is instructed and the value of CVRR calculated before the load test is instructed, as an index of the reactive power of the autonomic nervous function; The amount of change in the sympathetic nerve activity index that is the difference between the value of the sympathetic nerve activity index calculated after the load test is instructed and the value of the sympathetic nerve activity index calculated before the load test is instructed. Calculating as an index of the switching power of the autonomic nervous function;
Determining which type of the autonomic nerve type a predetermined state of the subject's autonomic function belongs to based on the CVRR change amount and the sympathetic activity index change amount;
Causing the computer to execute a step of displaying the determined autonomic type.

Further, another program of the present invention includes a step of accepting an electrocardiogram of a subject to be diagnosed,
Calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the received electrocardiogram data;
Calculating an electrocardiogram RR interval variation coefficient based on the received electrocardiogram data;
Instructing a load test for the person to be diagnosed;
Calculating the amount of CVRR change, which is the difference between the value of CVRR calculated after the load test is instructed and the value of CVRR calculated before the load test is instructed, as an index of the reactive power of the autonomic nervous function; The amount of change in the sympathetic nerve activity index that is the difference between the value of the sympathetic nerve activity index calculated after the load test is instructed and the value of the sympathetic nerve activity index calculated before the load test is instructed. Calculating as an index of the switching power of the autonomic nervous function;
Determining which type of the autonomic nerve type a predetermined state of the subject's autonomic function belongs to based on the CVRR change amount and the sympathetic activity index change amount;
Causing the computer to execute a step of displaying the determined autonomic type.

  As described above, according to the present invention, it is possible to obtain an effect that even a person who does not have specialized knowledge can easily determine the state of the autonomic nerve of the diagnosed person. Can do.

It is a block diagram which shows the structure of the autonomic nerve function diagnostic apparatus of one Embodiment of this invention. It is a figure for demonstrating the change of a to-be-diagnosed person state when an autonomic-nerve function diagnosis is performed by the autonomic-nervous function diagnostic apparatus of one Embodiment of this invention. It is a flowchart which shows operation | movement of the autonomic-nervous function diagnostic apparatus of one Embodiment of this invention. It is a flowchart for demonstrating LF / HF calculation method. It is a figure which shows the heart rate fluctuation | variation measuring method in the case of LF / HF calculation. It is a figure which shows an example which spectrum-analyzed in the case of LF / HF calculation. It is a figure for demonstrating the list | wrist of the parameter | index which shows the magnitude | size of autonomic nerve activity, a balance, a reaction power, switching power, and recovery power. It is a figure which shows an example at the time of displaying each parameter | index which shows the state of an autonomic nerve activity on the display apparatus. It is a figure which shows an example of the table | surface used in order to determine an autonomic nerve type based on the parameter | index which shows the state of an autonomic nerve activity. It is a figure which shows the example of a display of the display apparatus 22 in the autonomic-nervous function diagnostic apparatus of one Embodiment of this invention.

  Next, embodiments of the present invention will be described in detail with reference to the drawings. FIG. 1 is a block diagram showing a configuration of an autonomic nervous function diagnostic apparatus according to an embodiment of the present invention.

  As shown in FIG. 1, the autonomic nervous function diagnostic apparatus according to the present embodiment displays an electrocardiogram monitor 14 for acquiring electrocardiographic data of a diagnosis subject, a control device 18, a storage device 20, and biological information. Display device 22, autonomic nerve activity calculation unit 24, and CVRR (Coefficient of Variation of RR intervals) calculation unit 25.

  The electrocardiogram monitor 14 wears a minus electrode, for example, at the throat of the subject, a plus electrode on the left flank, and a body ground on the right flank, obtains heart movement as an electrical signal and records it as electrocardiographic data.

  The autonomic nerve activity calculation unit 24 calculates a sympathetic nerve activity index (LH / HF) indicating the degree of sympathetic nerve activity based on the electrocardiogram data measured by the electrocardiogram monitor 14. A specific method for calculating the sympathetic nerve activity index (LH / HF) will be described later.

  The CVRR calculation unit 25 calculates CVRR (electrocardiogram RR interval variation coefficient) based on the electrocardiogram data measured by the electrocardiogram monitor 14. A specific method for calculating the CVRR will also be described later.

  The control device 18 includes, for example, a computer, processes the biological information obtained by the autonomic nerve activity calculation unit 24 and the CVRR calculation unit 25, stores the processed information in the storage device 20, or displays it on the display device 22. To do. Further, the control device 18 functions as an instruction means for instructing the person to be diagnosed to stand up via the display device 22, an audio device or the like (not shown).

  Specifically, the control device 18 determines the value of CVRR calculated by the CVRR calculation unit 25 after the standing test is instructed (CVRR at the time of standing) and the value of CVRR calculated before the standing test is instructed (resting). The CVRR change amount ΔCVRR, which is a difference from the time CVRR), is calculated as an index of the reactive power of the autonomic nerve function, and the value of the sympathetic nerve activity index LF / HF calculated after instructing the standing test (LF / HF at the time of standing) ) And the sympathetic activity index change amount ΔLF / HF, which is the difference between the sympathetic activity index LF / HF calculated before the standing test is instructed (LF / HF at rest), the autonomic function It is calculated as an index of the switching force.

という式に基づいて低周波成分変動係数ＣＣＶ（ＬＦ）および高周波成分変動係数ＣＣＶ（ＨＦ）を算出する。 Further, the autonomic nerve activity calculation unit 24 includes a low frequency component LF that is an integral value of a region of 0.04 to 0.15 Hz in the frequency component of the power spectrum obtained as a result of frequency analysis of the data of the ECG RR interval, and From the high frequency component HF that is an integral value in the region of 0.15 to 0.45 Hz and the average value AVRR of the RR interval,

The low frequency component variation coefficient CCV (LF) and the high frequency component variation coefficient CCV (HF) are calculated based on the above formula.

  Further, the control device 18 is instructed to perform the upright test on the ratio normCCV (HF) of the high frequency component variation coefficient CCV (HF) to the sum of the low frequency component variation coefficient CCV (LF) and the high frequency component variation coefficient CCV (HF). The control device 18 calculates the difference as an index of the resilience of the autonomic nerve function.

Specifically, the control device 18 calculates normCCV (HF) based on the following formula, and autonomously calculates the difference ΔnormCCV (HF) between the normCCV (HF) when standing up and the normCCV (HF) when standing. Calculated as an index of recovery of nerve function.

  And the control apparatus 18 is based on the combination of the value of CVRR variation | change_quantity (DELTA) CVRR and sympathetic nerve activity index variation | change_quantity (DELTA) LF / HF. Determine which type it belongs to. Furthermore, when the CVRR change amount ΔCVRR is equal to or greater than a predetermined value, the control device 18 determines the autonomic nerve type based on the value of ΔnormCCV (HF) that is an index of resilience.

  Then, the autonomic nerve type determined by the control device 18 is displayed on the display device 22.

  Next, the operation of the autonomic nervous function diagnosis apparatus of this embodiment will be described in detail with reference to the drawings.

  First, a change in the state of the person being diagnosed when the autonomic nerve function diagnosis is performed by the autonomic nerve function diagnosis apparatus of the present embodiment will be described with reference to FIG. In the autonomic nervous function diagnostic apparatus of this embodiment, the measurement is started in a resting (sitting) state in which the subject is sitting. Then, the autonomic nervous function diagnosis apparatus gives a standing instruction to the person to be diagnosed when a certain time, for example, 3 minutes elapses. Since the state of the person to be diagnosed until the standing instruction is given is a resting (sitting) state, the measurement data until the standing instruction is given is stored as the measurement data at rest.

  Since the person to be diagnosed performs an erection operation based on this erection instruction, the state of the diagnosing person is standing up until a predetermined period, for example, one minute elapses after the erection instruction is performed. Treated as a thing. That is, measurement data measured from when the standing instruction is given until a predetermined period elapses is stored as measurement data at the time of standing.

  When a predetermined time elapses after the standing instruction is given, the state of the diagnosis subject is treated as standing (or standing and resting), and the measurement data measured during this period is the standing position. Is stored as measurement data.

  Next, the operation of the autonomic nervous function diagnostic apparatus of this embodiment will be described with reference to the flowchart of FIG.

  First, as an initial setting, before the examination is started, patient information such as the name, age, ID number, sex, and past history (diabetes, vascular disorder, etc.) of the diagnosis subject is input to the control device 18. When the examination is started, the electrocardiogram data of the living body is measured by the electrocardiogram monitor 14 (step S202). Then, the autonomic nerve activity calculation unit 24 calculates a sympathetic nerve activity index LF / HF (resting LF / HF) (step S101). Then, the CVRR calculation unit 25 calculates CVRR (resting CVRR) that is an index indicating the degree of variation in the RR interval (step S102). The calculation result calculated by the autonomic nerve activity calculation unit 24 and the calculation result calculated by the CVRR calculation unit 25 are stored in the storage device 20 by the control device 18 and displayed on the display device 22.

  Then, when the measurement in the resting state is performed for a predetermined period, the control device 18 gives a standing instruction to the person to be diagnosed via the display device 22 (step S103). Then, the autonomic nerve activity calculation unit 24 calculates the sympathetic nerve activity index LF / HF (the LF / HF at the time of standing) until a predetermined time elapses after the standing instruction is given (step S104). The CVRR calculation unit 25 calculates CVRR (CVRR when standing) (step S105). Further, during this period, the autonomic nerve activity calculation unit 24 calculates CCV (LF) and CCV (HF), and the control device 18 calculates normCCV (HF) (step S106).

  When a certain time has elapsed (Yes in step S107), the control device 18 calculates normCCV (HF) and stores it in the storage device 20 as standing-time normCCV (HF) (step S108).

  When the measurement process is completed, the control device 18 calculates indices indicating the magnitude, balance, response force, switching force, and recovery force of the autonomic nerve activity based on the measurement data stored in the storage device 20. Then, based on these indices, the type (type) of the state of the autonomic nerve of the diagnosis subject is determined (step S110). Finally, the measurement data, each calculated index, and the determined autonomic nerve type are displayed on the display device 22 by the control device 18 (step S111). Note that how the autonomic nerve type is determined based on the index indicating the state of the autonomic nerve activity will be described later.

  Next, details of the LF / HF calculation method shown in steps S101 and S104 of FIG. 3 are shown in FIGS.

  First, in step S <b> 301, the autonomic nerve activity calculation unit 24 calculates heartbeat variability from electrocardiographic data input from the electrocardiogram monitor 14. As shown in FIGS. 5A and 5B, the heart rate variability is calculated by measuring the RR interval by taking the interval between the R wave and the next R wave, and then FIG. ) And FIG. 5D, the measured R—R interval data is plotted at the time position of the backward R wave, and after interpolating it, at equal intervals (dotted line in FIG. 5C) This is done by creating resampled data. In the next step S302, spectrum analysis (frequency conversion) is performed on the data obtained in step S301. An example of the spectrum analysis in step S302 is shown in FIG. In the next step S303, a low frequency component LF is obtained. Here, the low frequency component LF is an integral value of the power spectrum component of 0.04 to 0.15 Hz. In the next step S304, a high frequency component HF is obtained. Here, the high frequency component HF is an integral value of the power spectrum component of 0.15 to 0.40 Hz. In step S305, the ratio between the LF obtained in step S303 and the HF obtained in step S304 is calculated as LF / HF.

  In this manner, the autonomic nerve activity calculation unit 24 calculates the sympathetic nerve activity index (LH / HF) from the electrocardiogram data measured by the electrocardiogram monitor 14.

Next, details of the CVRR calculation method shown in steps S102 and S105 of FIG. 3 will be described.
CVRR is an index indicating the degree of variation in heart rate variability, and is a coefficient indicating the degree of variation in the RR interval (interval of the apex of the R wave in the electrocardiogram waveform) shown in FIG. is there. Specifically, this CVRR is calculated by the following equation.
CVRR = R−R interval standard deviation / R−R interval average × 100 (%)

  Here, the RR interval standard deviation (SDRR) is a standard deviation of the RR interval in a predetermined period of one minute or a predetermined number of heartbeats such as 100 beats. The RR interval average (AVRR) is, for example, an average of RR intervals in a predetermined period or a predetermined number of heartbeats.

  The CVRR calculation unit 25 calculates CVRR from the electrocardiogram data measured by the electrocardiogram monitor 14 based on the above formula.

  Next, FIG. 7 shows a list of indices indicating the magnitude, balance, reaction force, switching force, and recovery force of the autonomic nerve activity calculated in the autonomic nerve function diagnosis apparatus of the present embodiment.

  As shown in FIG. 7, CVRR (resting CVRR) measured at rest is used as an index indicating the magnitude of autonomic nerve activity, and LF / HF (resting LF / HF) measured at rest is autonomous. It is used as an index indicating the balance of neural activity.

  The difference ΔCVRR between the CVRR measured at the time of standing and the CVRR measured at the time of rest is used as an index indicating the reaction force of the autonomic nerve, and the LF / HF measured at the time of standing and the LF / HF measured at the time of resting. The difference ΔLF / HF is used as an index indicating the switching force of the autonomic nerve.

  Further, the difference ΔnormCCV (HF) between normCCV (HF) measured at the time of standing (at resting and standing) and normCCV (HF) measured at the time of standing is used as an index indicating the resilience of the autonomic nerve. Yes.

  And in the autonomic-nervous function diagnostic apparatus of this embodiment, each parameter | index which shows the state of the autonomic-nerve activity calculated in this way is displayed by a radar chart as shown in FIG. 8, for example.

  Next, how the autonomic nerve type is determined based on the index indicating the state of the autonomic nerve activity in the autonomic nerve function diagnosis apparatus of the present embodiment will be described in detail. FIG. 9 shows an example of a table used for determining the autonomic nerve type based on the index indicating the state of the autonomic nerve activity.

  In the example shown in FIG. 9, first, it is determined whether the value of ΔCVRR, which is an index of reaction force, is 0.1 (%) or more or less than 0.1 (%). When ΔCVRR is less than 0.1, it is further determined whether ΔLF / HF, which is an indicator of switching force, is 0 or more or less than 0. When ΔCVRR is less than 0.1 and ΔLF / HF is 0 or more, the autonomic nerve type is determined to be the “rising parasympathetic nerve reaction lowering type”. In addition, when ΔCVRR is less than 0.1 and ΔLF / HF is less than 0, the autonomic nerve type is determined to be “the sympathetic response lowering type when standing”.

  When ΔCVRR is 0.1 or more, ΔLF / HF, which is an indicator of switching force, is 5.0 or more, 0.5 or more to less than 5.0, or less than 0.5. It is determined whether there is any. When ΔCVRR is 0.1 or more and ΔLF / HF is 5.0 or more, it is determined that the autonomic nerve type is “excessive switching force at standing up / type”. Further, when ΔCVRR is 0.1 or more and ΔLF / HF is 0.5 or more and less than 5.0, the autonomic nerve type is determined to be “appropriate switching force at standing up / type”. . Further, when ΔCVRR is 0.1 or more and ΔLF / HF is less than 0.5, it is determined that the autonomic nerve type is “switching force drop at standing up / type”.

  Further, when ΔCVRR is 0.1 or more, it is determined whether the value of ΔnormCCV (HF), which is an index indicating resilience, is 20 or more, 0 to less than 20, or 0 or less. Then, when the value of ΔnormCCV (HF) is 20 or more, the autonomic nerve type is determined to be “recovery excessive type”, and when it is 0 to less than 20, it is “resilient appropriate type”. If it is less than 0, it is determined to be “reduced power reduction type”.

  When ΔCVRR is 0.1 or more, the determined two autonomic nerve types are combined, for example, “decreasing switching force at standing up / recovery power appropriate type”, “switching power at standing up / recovery force excess” It is displayed as one autonomic nerve type such as “type”.

  Finally, FIG. 10 shows a display example of the display device 22 in the autonomic nerve function diagnostic apparatus of the present embodiment. In FIG. 10, five indices indicating the state of the autonomic nerve are shown on a regular pentagonal radar chart, and a comment is displayed for each index. Moreover, the autonomic nerve type determined based on these indices is displayed on the upper right side of the screen.

  In the autonomic nerve function diagnostic apparatus of the present embodiment, as described above, the CVRR change amount ΔCVRR, the sympathetic nerve activity index change among a plurality of autonomic nerve types determined in advance as the state of the autonomic nerve of the diagnosis subject The selection is made on the basis of a combination of the values ΔLF / HF and ΔnormCCV (HF). That is, it is determined which type of the autonomic nerve of the person to be diagnosed is closest to a plurality of preset autonomic nerve types. Therefore, even those who do not have specialized knowledge can grasp the state of the autonomic nerve of the diagnosed person and easily grasp the transition of the autonomic nerve state even when measuring periodically. can do. In addition, since the determination of the autonomic nerve type is performed based on a combination of a plurality of indices, it is possible to perform a diagnosis that cannot be grasped only by looking at a single index. Thus, according to the autonomic nerve function diagnostic apparatus of the present embodiment, even the person who does not have specialized knowledge can easily determine the state of the autonomic nerve of the person to be diagnosed.

[Modification]
In the present embodiment, the case where the electrocardiogram monitor 14 for measuring electrocardiogram data is provided inside the autonomic nervous function diagnostic apparatus of the present invention has been described. However, the present invention is limited to such a form. It is not a thing. Without providing the electrocardiogram monitor 14, an accepting means for accepting external electrocardiogram data is provided inside the autonomic nervous function diagnostic apparatus, and the accepting means calculates CVRR from the electrocardiogram data accepted from the outside. You can also. By adopting such a configuration, the autonomic nervous function diagnosis device does not need to be provided with an electrocardiograph measuring device such as the electrocardiogram monitor 14.

  Moreover, in this embodiment, although the control apparatus 18 is a structure which performs a standing-up test with respect to a to-be-diagnosed person, this invention is not limited to this. Examples of the load test performed by the control device 18 include physical or mental tests such as a load test that causes the patient to take a deep breath and a load test that causes the patient to stand up from a resting position. The present invention can be similarly applied even when a load test other than the standing-up test is performed, as long as it is a load test that gives a load to the person to be diagnosed.

  In the present embodiment, the electrocardiographic data of the diagnosis subject is measured, and the type of the autonomic nervous function is determined based on the electrocardiogram RR interval obtained from the electrocardiographic data. It is not limited to. In general, in order to measure electrocardiographic data, it is necessary to attach a plurality of electrodes to the subject. Therefore, although it is a simple method so that it can be measured more easily and simply, the pulse wave of the diagnosis subject is measured instead of the electrocardiographic data, and the pulse wave interval is obtained from the pulse wave data, It is possible to determine the type of autonomic function by performing frequency analysis in the same manner as in the case of the electric data.

  Specifically, for example, by using a pulse wave measuring device that measures a pulse wave of a diagnosis person using a pressure sensor applied to a radial artery of a living body instead of the electrocardiogram monitor 14, It becomes possible to configure the autonomic nervous function diagnostic apparatus of the present invention.

  In the case of such a configuration, instead of calculating CVRR, a pulse wave interval variation coefficient is calculated based on pulse wave data. Moreover, the autonomic nerve activity calculation part 24 will calculate a sympathetic nerve activity index (LH / HF) based on pulse wave data.

  Furthermore, in the present embodiment, the low frequency component variation coefficient and the high frequency variation coefficient are denoted as CCV (LF) and CCV (HF), respectively, but depending on the literature, C-CV (LF), C-CV ( HF). However, these differ only in the marking method and show the same value.

14 ECG Monitor 18 Control Device 20 Storage Device 22 Display Device 24 Autonomic Nerve Activity Calculation Unit 25 CVRR Calculation Unit

Claims (7)

An electrocardiogram measuring means for measuring the electrocardiogram of the subject;
Autonomic nerve activity calculating means for calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the electrocardiographic data measured by the electrocardiogram measuring means;
CVRR calculation means for calculating an electrocardiogram RR interval variation coefficient based on the electrocardiogram data measured by the electrocardiogram measurement means;
Instructing means for instructing a load test for the diagnosed person,
The CVRR change amount, which is the difference between the CVRR value calculated after the load test is instructed by the instruction means and the CVRR value calculated before the load test is instructed, is used as an index of the reactive power of the autonomic nervous function. And the difference between the value of the sympathetic nerve activity index calculated after the load test is instructed by the instruction means and the value of the sympathetic nerve activity index calculated before the load test is instructed An index calculating means for calculating a sympathetic nerve activity index change amount as an index of the switching power of the autonomic nerve function;
A determination means for determining which type of autonomic nerve type a predetermined state of the subject's autonomic function belongs to based on the CVRR change amount and the sympathetic activity index change amount;
Display means for displaying the autonomic nerve type determined by the determination means;
An autonomic nervous function diagnostic apparatus comprising: Receiving means for receiving the electrocardiogram data of the diagnosis subject measured by the electrocardiograph;
Autonomic nerve activity degree calculating means for calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the electrocardiographic data received by the receiving means;
CVRR calculating means for calculating an electrocardiogram RR interval variation coefficient based on the electrocardiogram data received by the receiving means;
Instructing means for instructing a load test for the diagnosed person,
The CVRR change amount, which is the difference between the CVRR value calculated after the load test is instructed by the instruction means and the CVRR value calculated before the load test is instructed, is used as an index of the reactive power of the autonomic nervous function. And the difference between the value of the sympathetic nerve activity index calculated after the load test is instructed by the instruction means and the value of the sympathetic nerve activity index calculated before the load test is instructed An index calculating means for calculating a sympathetic nerve activity index change amount as an index of the switching power of the autonomic nerve function;
A determination means for determining which type of autonomic nerve type a predetermined state of the subject's autonomic function belongs to based on the CVRR change amount and the sympathetic activity index change amount;
Display means for displaying the autonomic nerve type determined by the determination means;
An autonomic nervous function diagnostic apparatus comprising: The index calculation means includes low frequency components LF and 0.15 to 0 which are integral values in the region of 0.04 to 0.15 Hz in the frequency components of the power spectrum obtained as a result of frequency analysis of the ECG RR interval data. From the high frequency component HF that is an integral value in the region of .45 Hz and the average value AVRR of the RR interval,

The low-frequency component variation coefficient and the high-frequency component variation coefficient are calculated based on the expression, and the ratio of the high-frequency component variation coefficient to the sum of the low-frequency component variation coefficient and the high-frequency component variation coefficient is calculated after the load test is instructed. Calculated before and after a certain period of time, and the difference is calculated as an index of the resilience of autonomic nervous function.
The autonomic nervous function diagnosis apparatus according to claim 1, wherein the determination unit determines an autonomic nerve type based on a value of the resilience index when the CVRR change amount is a predetermined value or more. A pulse wave measuring means for measuring the pulse wave of the subject;
Autonomic nerve activity calculation means for calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the pulse wave data measured by the pulse wave measurement means;
Based on the pulse wave data measured by the pulse wave measuring means, a pulse wave interval fluctuation coefficient calculating means for calculating a pulse wave interval fluctuation coefficient;
Instructing means for instructing a load test for the diagnosed person,
Pulse wave interval fluctuation, which is the difference between the pulse wave interval fluctuation coefficient value calculated after the load test is instructed by the instruction means and the pulse wave interval fluctuation coefficient value calculated before the load test is instructed The coefficient change amount is calculated as an index of the reactive power of the autonomic nerve function, and the value of the sympathetic nerve activity index calculated after the load test is instructed by the indicating means and the load test is calculated before the load test is instructed. An index calculating means for calculating a sympathetic activity index change amount, which is a difference from the value of the sympathetic activity index, as an index of the switching power of the autonomic nerve function;
Based on the change amount of the pulse wave interval variation coefficient and the change amount of the sympathetic nerve activity index, it is determined which type of the autonomic nerve type of the subject's autonomic nerve function belongs to A determination means;
Display means for displaying the autonomic nerve type determined by the determination means;
An autonomic nervous function diagnostic apparatus comprising: Receiving means for receiving the pulse wave data of the diagnosed person measured by the pulse wave measuring device;
Autonomic nerve activity degree calculating means for calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the pulse wave data received by the receiving means;
A pulse wave interval variation coefficient calculating means for calculating a pulse wave interval variation coefficient based on the pulse wave data received by the receiving means;
Instructing means for instructing a load test for the diagnosed person,
Pulse wave interval fluctuation, which is the difference between the pulse wave interval fluctuation coefficient value calculated after the load test is instructed by the instruction means and the pulse wave interval fluctuation coefficient value calculated before the load test is instructed The coefficient change amount is calculated as an index of the reactive power of the autonomic nerve function, and the value of the sympathetic nerve activity index calculated after the load test is instructed by the indicating means and the load test is calculated before the load test is instructed. An index calculating means for calculating a sympathetic activity index change amount, which is a difference from the value of the sympathetic activity index, as an index of the switching power of the autonomic nerve function;
Based on the change amount of the pulse wave interval variation coefficient and the change amount of the sympathetic nerve activity index, it is determined which type of the autonomic nerve type of the subject's autonomic nerve function belongs to A determination means;
Display means for displaying the autonomic nerve type determined by the determination means;
An autonomic nervous function diagnostic apparatus comprising: Measuring the electrocardiogram of the subject,
Calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the measured electrocardiographic data;
Calculating an electrocardiogram RR interval variation coefficient based on the measured electrocardiogram data;
Instructing a load test for the person to be diagnosed;
Calculating the amount of CVRR change, which is the difference between the value of CVRR calculated after the load test is instructed and the value of CVRR calculated before the load test is instructed, as an index of the reactive power of the autonomic nervous function; The amount of change in the sympathetic nerve activity index that is the difference between the value of the sympathetic nerve activity index calculated after the load test is instructed and the value of the sympathetic nerve activity index calculated before the load test is instructed. Calculating as an index of the switching power of the autonomic nervous function;
Determining which type of the autonomic nerve type a predetermined state of the subject's autonomic function belongs to based on the CVRR change amount and the sympathetic activity index change amount;
A program for causing a computer to execute the step of displaying the determined autonomic nerve type. Receiving the patient's electrocardiogram;
Calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the received electrocardiogram data;
Calculating an electrocardiogram RR interval variation coefficient based on the received electrocardiogram data;
Instructing a load test for the person to be diagnosed;
Calculating the amount of CVRR change, which is the difference between the value of CVRR calculated after the load test is instructed and the value of CVRR calculated before the load test is instructed, as an index of the reactive power of the autonomic nervous function; The amount of change in the sympathetic nerve activity index that is the difference between the value of the sympathetic nerve activity index calculated after the load test is instructed and the value of the sympathetic nerve activity index calculated before the load test is instructed. Calculating as an index of the switching power of the autonomic nervous function;
Determining which type of the autonomic nerve type a predetermined state of the subject's autonomic function belongs to based on the CVRR change amount and the sympathetic activity index change amount;
A program for causing a computer to execute the step of displaying the determined autonomic nerve type.

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