JP2013046662A - Autonomic nerve function diagnostic apparatus and program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To respectively independently determine whether or not a function of a sympathetic nerve and a function of a parasympathetic nerve are normal.SOLUTION: An electrocardiogram monitor 14 measures electrocardiographic data of a person to be diagnosed. A sympathetic nerve activity calculation part 24 calculates a sympathetic nerve activity index (LH/HF) on the basis of the measured electrocardiographic data, a CVRR calculation part 25 calculates CVRR on the basis of the electrocardiographic data, and a CCV(HF) calculation part 27 calculates CCV(HF) on the basis of the electrocardiographic data. A controller 18 calculates a CVRR change amount which is a difference of values of the CVRR before and after a stand-up instruction, a sympathetic nerve activity index change amount which is a difference of values of the LF/HF before and after a stand-up test, and a CCV(HF) change amount which is a difference of values of the CCV(HF) before and after a sitting instruction, and determines whether or not the function of the sympathetic nerve and the function of the parasympathetic nerve of the person to be diagnosed are normal.

Description

  The present invention relates to an autonomic nerve function diagnostic apparatus and program for diagnosing an autonomic nerve function.

  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 and autonomic dysfunction 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 motion 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

  When the person to be diagnosed stands up, an autonomic response of baroreceptor reflex against gravity occurs. That is, the change of the autonomic nerve by the standing motion means the change of the autonomic nerve in which the sympathetic nerve is dominant. Prior art as described above calculates whether sympathetic and parasympathetic switching is normal by calculating changes in sympathetic nerve due to standing motion and determining whether the sympathetic nerve is in a dominant state or not. Is evaluated. Therefore, in the prior art as described above, the function of the entire autonomic nerve including the change of the parasympathetic nerve has not been evaluated.

  The objective of this invention is providing the autonomic-nerve diagnostic apparatus and program which can determine independently whether the function of a sympathetic nerve and the function of a parasympathetic nerve are normal, respectively.

[Autonomic nerve diagnostic device]
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,
Based on the electrocardiogram data measured by the electrocardiograph measurement means, a sympathetic nerve activity degree calculating means for calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity,
CVRR calculating means for calculating CVRR that is a coefficient of variation of the RR interval based on the electrocardiographic data measured by the electrocardiographic measuring means;
A high frequency fluctuation coefficient calculating means for calculating a high frequency fluctuation coefficient from a high frequency component and an average value of RR intervals based on a power spectrum obtained as a result of frequency analysis of the electrocardiographic data measured by the electrocardiogram measuring means;
Instructing means for instructing to be seated after elapse of a predetermined time after instructing to stand up and instructing to stand up,
CVRR change amount calculating means for calculating a CVRR change amount which is a difference between a value of CVRR calculated after instructing to stand by the instruction means and a value of CVRR calculated before instructing to stand;
Sympathetic activity index change, which is the difference between the value of the sympathetic nerve activity index calculated after instructing to stand by the instruction means and the value of the sympathetic nerve activity index calculated before instructing to stand Sympathetic activity index change amount calculating means for calculating the amount;
A high-frequency variation coefficient change amount calculation that calculates a high-frequency variation coefficient change amount that is a difference between a high-frequency variation coefficient calculated after the instruction means instructs seating and a high-frequency variation coefficient calculated before seating is instructed. Means,
Based on the CVRR change amount and the sympathetic nerve activity index change amount, whether or not the sympathetic nerve function of the subject is operating normally, and based on the high frequency variation coefficient change amount, the subject Determining means for respectively determining whether or not the parasympathetic nerve function of
Display means for displaying the result determined by the determination means;
It is an autonomic nerve function diagnostic apparatus provided with.

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.
Sympathetic 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 CVRR that is a coefficient of variation of the RR interval based on the electrocardiogram data received by the receiving means;
A high frequency fluctuation coefficient calculating means for calculating a high frequency fluctuation coefficient from a high frequency component and an average value of RR intervals based on a power spectrum obtained as a result of frequency analysis of the electrocardiographic data received by the receiving means;
Instructing means for instructing to be seated after elapse of a predetermined time after instructing to stand up and instructing to stand up,
CVRR change amount calculating means for calculating a CVRR change amount which is a difference between a value of CVRR calculated after instructing to stand by the instruction means and a value of CVRR calculated before instructing to stand;
Sympathetic activity index change, which is the difference between the value of the sympathetic nerve activity index calculated after instructing to stand by the instruction means and the value of the sympathetic nerve activity index calculated before instructing to stand Sympathetic activity index change amount calculating means for calculating the amount;
A high-frequency variation coefficient change amount calculation that calculates a high-frequency variation coefficient change amount that is a difference between a high-frequency variation coefficient calculated after the instruction means instructs seating and a high-frequency variation coefficient calculated before seating is instructed. Means,
Based on the CVRR change amount and the sympathetic nerve activity index change amount, whether or not the sympathetic nerve function of the subject is operating normally, and based on the high frequency variation coefficient change amount, the subject Determining means for respectively determining whether or not the parasympathetic nerve function of
Display means for displaying the result determined by the determination means;
It is an autonomic nerve function diagnostic apparatus provided with.

  According to the present invention, the function of the sympathetic nerve is evaluated by a change in the CVRR and the sympathetic nerve activity index before and after the standing motion, and the function of the parasympathetic nerve is evaluated by a change in the high frequency variation coefficient before and after the seating motion. It is possible to independently determine whether or not a person's sympathetic nerve function and parasympathetic nerve function are normal.

Furthermore, in another autonomic nerve diagnostic apparatus of the present invention, the autonomic nerve activity calculation means performs frequency analysis on the electrocardiographic data within a predetermined period each time an R wave is detected in the electrocardiographic data. Calculate a sympathetic nerve activity index indicating the degree of sympathetic nerve activity,
The CVRR calculating means calculates CVRR based on the electrocardiographic data within the predetermined period each time an R wave is detected in the electrocardiographic data,
The high-frequency fluctuation coefficient calculating means calculates a high-frequency fluctuation coefficient by performing frequency analysis on the electrocardiographic data within a predetermined period each time an R wave is detected in the electrocardiographic data. It is a diagnostic device.

  According to the present invention, each time an R wave is detected, the sympathetic nerve activity index, CVRR, and high-frequency variation coefficient are calculated. Therefore, the sympathetic nerve activity index, CVRR, and high-frequency variation coefficient can be accurately monitored. It becomes possible.

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,
Based on the pulse wave data measured by the pulse wave measuring means, a sympathetic 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 measured by the pulse wave measuring means, a pulse wave interval fluctuation coefficient calculating means for calculating a pulse wave interval fluctuation coefficient;
A high frequency fluctuation coefficient that is a fluctuation coefficient of a high frequency component from a high frequency component and an average value of pulse wave intervals based on a power spectrum obtained as a result of frequency analysis of pulse wave data measured by the pulse wave measuring means A coefficient of variation calculation means;
Instructing means for instructing to be seated after elapse of a certain time after the instructed standing and instructing to stand for the diagnosis subject,
Pulse wave interval variation coefficient change amount, which is the difference between the value of the pulse wave interval variation coefficient calculated after instructing standing by the instruction means and the value of the pulse wave interval variation coefficient calculated before instructing standing A pulse wave interval variation coefficient change amount calculating means for calculating
Sympathetic activity index change, which is the difference between the value of the sympathetic nerve activity index calculated after instructing to stand by the instruction means and the value of the sympathetic nerve activity index calculated before instructing to stand Sympathetic activity index change amount calculating means for calculating the amount;
A high-frequency variation coefficient change amount calculation that calculates a high-frequency variation coefficient change amount that is a difference between a high-frequency variation coefficient calculated after the instruction means instructs seating and a high-frequency variation coefficient calculated before seating is instructed. Means,
Based on the pulse wave interval variation coefficient change amount and the sympathetic activity index change amount, whether the sympathetic nerve function of the subject is normal, and based on the high frequency variation coefficient change amount, Determining means for determining whether or not the parasympathetic nerve function of the subject is normal, and
Display means for displaying the result determined by the determination means;
It is an autonomic nerve function diagnostic apparatus provided with.

  According to the present invention, the pulse wave data is measured instead of the electrocardiographic data of the diagnosed person, and the sympathetic nerve activity index, the pulse wave interval variation coefficient, and the high frequency variation coefficient of the diagnosed person are respectively calculated. It is possible to independently determine whether the sympathetic nerve function and the parasympathetic nerve function are normal.

[program]
Further, in another program of the present invention, the step of measuring the electrocardiogram of the diagnosed person,
Calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the measured electrocardiographic data;
Calculating CVRR, which is a coefficient of variation of the RR interval, based on the measured electrocardiogram data;
Calculating a high frequency variation coefficient from a high frequency component and an average value of RR intervals based on a power spectrum obtained as a result of frequency analysis of measured electrocardiographic data;
Instructing to be seated after a predetermined time has passed since instructing to stand and instructing to stand;
Calculating a CVRR change amount which is a difference between a value of CVRR calculated after instructing standing and a value of CVRR calculated before instructing standing;
The amount of change in the sympathetic nerve activity index, which is the difference between the value of the sympathetic nerve activity index calculated after instructing to stand and the value of the sympathetic nerve activity index calculated before instructing to stand up is calculated. Steps,
Calculating a high-frequency variation coefficient change amount that is a difference between the high-frequency variation coefficient calculated after the seating is instructed and the high-frequency variation coefficient calculated before the seating is instructed;
Based on the CVRR change amount and the sympathetic nerve activity index change amount, whether or not the sympathetic nerve function of the subject is operating normally, and based on the high frequency variation coefficient change amount, the subject Each determining whether or not the parasympathetic function of
Displaying the determined result; and
Is a program for causing a computer to execute.

Further, another program of the present invention includes a step of receiving electrocardiographic data of a diagnosis subject measured by an electrocardiograph,
Calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the received electrocardiogram data;
Calculating CVRR which is a coefficient of variation of the RR interval based on the received electrocardiogram data;
Calculating a high frequency variation coefficient from a high frequency component and an average value of the RR interval based on a power spectrum obtained as a result of frequency analysis of the received electrocardiogram data;
Instructing to be seated after a predetermined time has passed since instructing to stand and instructing to stand;
Calculating a CVRR change amount which is a difference between a value of CVRR calculated after instructing standing and a value of CVRR calculated before instructing standing;
The amount of change in the sympathetic nerve activity index, which is the difference between the value of the sympathetic nerve activity index calculated after instructing to stand and the value of the sympathetic nerve activity index calculated before instructing to stand up is calculated. Steps,
Calculating a high-frequency variation coefficient change amount that is a difference between the high-frequency variation coefficient calculated after the seating is instructed and the high-frequency variation coefficient calculated before the seating is instructed;
Based on the CVRR change amount and the sympathetic nerve activity index change amount, whether or not the sympathetic nerve function of the subject is operating normally, and based on the high frequency variation coefficient change amount, the subject Each determining whether or not the parasympathetic function of
Displaying the determined result; and
Is a program for causing a computer to execute.

  As described above, according to the present invention, it is possible to independently determine whether or not the sympathetic nerve function and the parasympathetic nerve function are normal.

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 which shows the heart rate fluctuation | variation measuring method at the time of calculating LF and HF in one Embodiment of this invention. It is a figure which shows an example which spectrum-analyzed at the time of calculating LF and HF in one Embodiment of this invention. It is a figure which shows an example of the state change of a diagnostic subject in one Embodiment of this invention. It is a flowchart which shows the flow of operation | movement of the autonomic nerve function diagnostic apparatus in one Embodiment of this invention. It is a flowchart which shows the flow which determines whether the function of the sympathetic nerve in one Embodiment of this invention is normal. It is a flowchart which shows the flow which determines whether the function of the parasympathetic nerve in one Embodiment of this invention is normal. It is a figure which shows an example of the relationship between (DELTA) CVRR, (DELTA) LF / HF, (DELTA) CCV (HF), and a determination result in 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 evaluation apparatus according to the present embodiment stores an electrocardiogram monitor 14 for measuring electrocardiographic data of a diagnosis subject, a control device 18, measurement data, determination results, and the like. Storage device 20, display device 22 for displaying biological information, frequency analysis unit 24, CVRR (Coefficient of Variation of RR intervals) calculation unit 25, and sympathetic nerve activity calculation Unit 26 and a CCV (HF) calculation unit 27.

  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 frequency analysis unit 24 obtains a high frequency component HF and a low frequency component LF by performing frequency analysis of heart rate variability based on the electrocardiogram data measured by the electrocardiogram monitor 14.

  Specifically, first, the frequency analysis unit 24 calculates heart rate variability from electrocardiographic data input from the electrocardiogram monitor 14. As shown in FIGS. 2A and B, the heart rate variability was calculated by measuring the RR interval by taking the interval between the R wave and the next R wave, and then measuring it as shown in FIGS. 2C and D. The RR interval data is plotted at the time position of the backward R wave, and after interpolation, data is resampled at equal intervals (dotted line in FIG. 2C). Then, the frequency analysis unit 24 performs spectrum analysis (frequency conversion) on the created data. Here, an example of spectrum analysis is shown in FIG. Next, the frequency analysis unit 24 obtains a low frequency component LF and a high frequency component HF. Here, the low frequency component LF is an integral value of the power spectrum component of 0.04 to 0.15 Hz. The high frequency component HF is an integral value of the power spectrum component of 0.15 to 0.40 Hz.

  In this way, the frequency analysis unit 24 obtains the low frequency component LF and the high frequency component HF of the heart rate variability from the electrocardiographic data measured by the electrocardiogram monitor 14.

  The CVRR calculation unit 25 calculates CVRR (electrocardiogram RR interval variation coefficient) based on the electrocardiogram data measured by the electrocardiogram monitor 14.

Specifically, CVRR is an index indicating the degree of variation in heart rate variability, and indicates the degree of variation in the RR interval (interval of the apex of the R wave in the electrocardiogram waveform) shown in FIG. 2A. It is a coefficient. 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 is, for example, the standard deviation of the RR interval in a predetermined period of 1 minute or a predetermined number of heartbeats such as 100 beats. The RR interval average 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.

  The sympathetic nerve activity calculating unit 26 calculates a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the values of the high frequency component HF and the low frequency component LF obtained by the frequency analyzing unit 24.

Specifically, the sympathetic nerve activity calculating unit 26 calculates a sympathetic nerve activity index by the following formula using the low frequency component LF and the high frequency component HF obtained by the frequency analyzing unit 25.
Sympathetic nerve activity index = LF / HF

The CCV (HF) calculation unit 27 calculates the high frequency variation coefficient CCV (HF) by the following formula based on the high frequency component HF obtained by the frequency analysis unit 24 and the average value AVRR of the RR interval in the electrocardiogram data. calculate.

  The control device 18 includes, for example, a computer, and functions as a determination unit that determines whether or not the function of the sympathetic nerve and the function of the parasympathetic nerve of the diagnosis subject are normal. Further, the control device 18 stores the determination result in the storage device 20 or displays it on the display device 22. Furthermore, the control device 18 functions as an instruction means for instructing the person to be diagnosed to stand up and to give a seating instruction after a certain period of time has elapsed after instructing to stand up via the display device 22 or a sound device (not shown). To do.

  Specifically, the control device 18 determines the CVRR change amount (ΔCVRR), which is the difference between the CVRR value calculated after the standing is instructed and the CVRR value calculated before the standing is instructed, as the autonomic nerve. It is calculated as an index of the reaction power of. Further, the control device 18 changes the sympathetic nerve activity index change amount (the difference between the LF / HF value calculated after the standing is instructed and the LF / HF value calculated before the standing is instructed ( ΔLF / HF) is calculated as an index of the switching power of the autonomic nerve. Further, the control device 18 determines the amount of change in the high-frequency coefficient of variation (ΔCCV (HF)) that is the difference between the CCV (HF) calculated after the seating instruction is given and the CCV (HF) calculated before the seating instruction is given. ) As an index of autonomic recovery. Then, the control device 18 determines whether or not the sympathetic nerve function of the subject is working normally based on ΔCVRR and ΔLF / HF. Further, the control device 18 determines whether or not the parasympathetic nerve function of the diagnosed person is working normally based on ΔCCV (HF).

  Further, the control device 18 displays on the display device 22 the determination result as to whether or not the sympathetic nerve function and the parasympathetic nerve function obtained as described above are working normally.

  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 according to the present embodiment, the measurement is started in a resting 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 subject to be diagnosed until the standing instruction is given is in a resting 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 autonomic nervous function diagnosis apparatus issues a seating instruction to the diagnosed person when a certain time, for example, 3 minutes elapses after the state of the diagnosed person is in the standing position. From the time when the seating instruction is given until the elapse of a predetermined period, for example, 1 minute, the state of the person being diagnosed is treated as being in the sitting position. That is, the measurement data measured from when the seating instruction is given until the predetermined period elapses is stored as the measurement data at the time of sitting.

  Next, the operation of the autonomic nervous function diagnosis apparatus of this embodiment will be described in detail with reference to FIG. FIG. 5 is a flowchart showing the operation of the autonomic nervous function diagnosis apparatus of this embodiment.

  First, as an initial setting, before the examination is started, patient information such as the name, age, ID number, sex, medical history (diabetes, vascular disorder, etc.) of the diagnosis is input to the control device 18 (step S101). ).

  Next, the control device 18 determines whether or not the function of the subject's sympathetic nerve before and after the standing up is instructed is normal (step S102). A specific method for determining whether or not the function of the sympathetic nerve is normal will be described later.

  Next, the control device 18 determines whether or not the function of the parasympathetic nerve of the diagnosed person is normal before and after the seating is instructed (step S103). A specific method for determining whether or not the function of the parasympathetic nerve is normal will be described later.

  Finally, the control device 18 causes the display device 22 to display a determination result as to whether or not the sympathetic nerve function and the parasympathetic nerve function obtained in steps S102 and S103 are normal.

  Next, a specific method for determining whether or not the function of the sympathetic nerve in step S102 is normal will be described in detail with reference to FIG.

  First, the electrocardiogram monitor 14 measures the electrocardiographic data of the subject at rest. Then, the frequency analysis unit 24 calculates the low frequency component LF and the high frequency component HF based on the measured electrocardiographic data at rest (step S201).

  Next, the sympathetic nerve activity calculation unit 26 calculates the LF / HF at rest from the LF and HF calculated by the frequency analysis unit 24 (step S202).

  The CVRR calculation unit 25 calculates a resting CVRR from resting electrocardiographic data measured by the electrocardiogram monitor 14 based on the above formula (step S203).

  The calculation results calculated by the sympathetic nerve activity calculation unit 26 and the CVRR calculation unit 25 are stored in the storage device 20 by the control device 18 (step S204).

  Then, when the measurement at rest is performed for a predetermined period, the control device 18 gives a standing instruction to the diagnosis subject via the display device 22 (step S205).

  The electrocardiogram monitor 14 measures the electrocardiogram data of the diagnosis subject at the time of standing until a predetermined time elapses after the standing instruction is given. Then, the frequency analysis unit 24 calculates LF and HF based on the measured electrocardiographic data at the time of standing (step S206). Then, the sympathetic nerve activity calculation unit 26 performs an operation for obtaining LF / HF at the time of standing up from the LF and HF calculated by the frequency analysis unit 24 (step S207).

  Further, the CVRR calculation unit 25 calculates the CVRR at the time of standing from the electrocardiographic data at the time of standing measured by the electrocardiogram monitor 14 based on the above formula (step S208).

  Then, the control device 18 determines the value of ΔLF / HF, which is the difference between the LF / HF value at the time of standing and the LF / HF value at rest stored in the storage device 20, and the value of CVRR at the time of standing. And the value of ΔCVRR, which is the difference between the resting value of CVRR stored in the storage device 20, is calculated. The control device 18 determines that the function of the sympathetic nerve is abnormal when the value of ΔLF / HF is less than 0.5 or 5.0 or more, or the value of ΔCVRR is less than 0.1. The control device 18 determines that the function of the sympathetic nerve is normal when the value of ΔLF / HF is 0.5 or more and less than 5.0 and the value of ΔCVRR is 0.1 or more. Then, the determination result is stored in the storage device 20 by the control device 18 (step S209).

  In this way, the autonomic nerve diagnosis apparatus determines whether or not the function of the sympathetic nerve is normal.

  Next, a specific method for determining whether or not the function of the parasympathetic nerve in step S103 is normal will be described in detail with reference to FIG.

  First, the electrocardiogram monitor 14 measures the electrocardiographic data of the diagnosis subject at the time of standing after a predetermined time has elapsed from the standing instruction given by the control device 18 in step S205. Then, the frequency analysis unit 24 calculates HF based on the measured electrocardiographic data at the time of standing (step S301).

  Next, the CCV (HF) calculation unit 27 calculates the CCV (HF) when standing based on the HF calculated by the frequency analysis unit 24 and the average value AVRR of the RR interval in the electrocardiogram data. (Step S302).

  Then, the calculation result calculated by the CCV (HF) calculation unit 27 is stored in the storage device 20 by the control device 18 (step S303).

  Then, when the measurement at the time of standing is performed for a predetermined period, the control device 18 gives a seating instruction to the diagnosis subject via the display device 22 (step S304).

  The electrocardiogram monitor 14 measures the electrocardiogram data of the person being diagnosed at the time of sitting until a predetermined time elapses after the seating instruction is given. Then, the frequency analysis unit 24 calculates HF based on the measured electrocardiogram data at the time of sitting (step S305). Then, the CCV (HF) calculation unit 27 calculates the CCV (HF) when sitting from the HF and AVRR calculated by the frequency analysis unit 24 (step S306).

  Then, the control device 18 calculates a value of ΔCCV (HF), which is a difference between the value of CCV (HF) at the time of sitting and the value of CCV (HF) at the time of standing stored in the storage device 20. Then, the control device 18 determines that there is an abnormality in the function of the parasympathetic nerve when the value of ΔCCV (HF) is 0 or less. Further, when the value of ΔCCV (HF) is larger than 0, the control device 18 determines that the function of the parasympathetic nerve is normal. Then, the determination result is stored in the storage device 20 by the control device 18 (step S307).

  In this way, the autonomic nerve diagnosis apparatus determines whether or not the function of the parasympathetic nerve is normal.

  Then, the control device 18 displays the determination result obtained as described above on the display device 22.

  Next, FIG. 8 shows an example of the relationship between ΔCVRR, ΔLF / HF, ΔCCV (HF) and the determination result. For example, when ΔCVRR is 0.1 or more, ΔLF / HF is 0.5 or more and less than 5.0, and ΔCCV (HF) is greater than 0, the control device 18 functions as a sympathetic nerve and a parasympathetic nerve. Both are determined to be normal. When ΔCVRR is 0.1 or more, ΔLF / HF is 0.5 or more and less than 5.0, and ΔCCV (HF) is 0 or less, the control device 18 has a normal sympathetic nerve function, It is determined that the parasympathetic nerve function is abnormal. In addition, when ΔCVRR is less than 0.1, or ΔLF / HF is less than 0.5 or 5.0 and ΔCCV (HF) is greater than 0, the sympathetic nerve function is abnormal, and the parasympathetic nerve function is Determined to be normal. Furthermore, when ΔCVRR is less than 0.1, or ΔLF / HF is less than 0.5 or 5.0 or more, and ΔCCV (HF) is 0 or less, the sympathetic nerve function and the parasympathetic nerve function are abnormal. Is determined.

  The control device 18 displays the determination result obtained as described above via the display device 22. In this case, the display device 22 may display only the determination result, or may display the determination result and the value of each index obtained in the course of diagnosis.

  Here, as described above, sympathetic nerve changes occur due to baroreceptor reflex action when standing. On the other hand, since there is no resistance to gravity when seated, baroreceptor reflex does not work and parasympathetic nerve changes occur due to pure heart rate variability. In the autonomic nerve function diagnostic apparatus according to the present embodiment, as described above, whether or not the function of the subject's sympathetic nerve and the function of the parasympathetic nerve is normal is determined as follows: The determination is based on the sympathetic nerve activity index change amount ΔLF / HF and the value of the high-frequency fluctuation coefficient ΔCCV (HF) before and after the seating instruction. That is, the autonomic nerve diagnosis apparatus of this embodiment evaluates the function of the sympathetic nerve before and after the standing motion and the function of the parasympathetic nerve before and after the seating motion, so that the function of the sympathetic nerve and the function of the parasympathetic nerve of the subject are normal. It is possible to determine independently whether or not. Therefore, the function of the autonomic nerve of the person to be diagnosed can be grasped.

[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.

  Further, every time an R wave is detected in the electrocardiographic data, the frequency analyzing unit 24 performs frequency analysis on the electrocardiographic data within a predetermined period, and performs CVRR calculating unit 25, sympathetic nerve activity calculating unit 26, CCV (HF The calculation unit 27 may calculate CVRR, LF / HF, and CCV (HF) based on the electrocardiographic data within a predetermined period each time an R wave is detected in the electrocardiographic data.

  In the present embodiment, the electrocardiographic data of the subject is measured, and whether or not the sympathetic nerve function and the parasympathetic nerve function are normal based on the electrocardiogram RR interval obtained from the electrocardiographic data is determined. However, the present invention is not limited to this. 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 whether or not the function of the sympathetic nerve and the function of the parasympathetic nerve are normal by performing frequency analysis 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 (CVPR) is calculated based on pulse wave data. Further, the frequency analysis unit 24 calculates LF and HF based on the pulse wave data.

  Further, in the present embodiment, it has been described that the stand-up instruction and the seating instruction by the control device 18 are displayed on the display device 22. However, an acceleration sensor or the like is used to determine whether or not the person to be diagnosed has stood and seated. You may make it determine using.

  Further, blood pressure may be measured in a series of processes in the present embodiment. By measuring blood pressure, it becomes possible to evaluate blood circulation in addition to determination of autonomic nervous function.

  Furthermore, in the present embodiment, the high-frequency variation coefficient is indicated as CCV (HF), but depending on the literature, it may be indicated as C-CV (HF) or CCVHF. However, these differ only in the marking method and show the same value.

  In this embodiment, whether or not the function of the parasympathetic nerve is normal based on whether or not the difference between the value of CCV (HF) when sitting and the value of CCV (HF) when standing is greater than zero. However, the function of the parasympathetic nerve is determined based on whether the difference between the HF value at the time of sitting and the HF value at the time of standing calculated by the frequency analysis unit 24 is greater than zero. You may make it determine whether it is normal.

14 ECG monitor 18 Control device 20 Storage device 22 Display device 24 Frequency analysis unit 25 CVRR calculation unit 26 Sympathetic nerve activity calculation unit 27 CCV (HF) calculation unit S101 to S104 Steps S201 to S209 Steps S301 to S307 Steps

Claims (6)

An electrocardiogram measuring means for measuring the electrocardiogram of the subject;
Based on the electrocardiogram data measured by the electrocardiograph measurement means, a sympathetic nerve activity degree calculating means for calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity,
CVRR calculating means for calculating CVRR that is a coefficient of variation of the RR interval based on the electrocardiographic data measured by the electrocardiographic measuring means;
A high frequency fluctuation coefficient calculating means for calculating a high frequency fluctuation coefficient from a high frequency component and an average value of RR intervals based on a power spectrum obtained as a result of frequency analysis of the electrocardiographic data measured by the electrocardiogram measuring means;
Instructing means for instructing to be seated after elapse of a predetermined time after instructing to stand up and instructing to stand up,
CVRR change amount calculating means for calculating a CVRR change amount which is a difference between a value of CVRR calculated after instructing to stand by the instruction means and a value of CVRR calculated before instructing to stand;
Sympathetic activity index change, which is the difference between the value of the sympathetic nerve activity index calculated after instructing to stand by the instruction means and the value of the sympathetic nerve activity index calculated before instructing to stand Sympathetic activity index change amount calculating means for calculating the amount;
A high-frequency variation coefficient change amount calculation that calculates a high-frequency variation coefficient change amount that is a difference between a high-frequency variation coefficient calculated after the instruction means instructs seating and a high-frequency variation coefficient calculated before seating is instructed. Means,
Based on the CVRR change amount and the sympathetic nerve activity index change amount, whether or not the sympathetic nerve function of the subject is operating normally, and based on the high frequency variation coefficient change amount, the subject Determining means for respectively determining whether or not the parasympathetic nerve function of
Display means for displaying the result 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;
Sympathetic 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 CVRR that is a coefficient of variation of the RR interval based on the electrocardiogram data received by the receiving means;
A high frequency fluctuation coefficient calculating means for calculating a high frequency fluctuation coefficient from a high frequency component and an average value of RR intervals based on a power spectrum obtained as a result of frequency analysis of the electrocardiographic data received by the receiving means;
Instructing means for instructing to be seated after elapse of a predetermined time after instructing to stand up and instructing to stand up,
CVRR change amount calculating means for calculating a CVRR change amount which is a difference between a value of CVRR calculated after instructing to stand by the instruction means and a value of CVRR calculated before instructing to stand;
Sympathetic activity index change, which is the difference between the value of the sympathetic nerve activity index calculated after instructing to stand by the instruction means and the value of the sympathetic nerve activity index calculated before instructing to stand Sympathetic activity index change amount calculating means for calculating the amount;
A high-frequency variation coefficient change amount calculation that calculates a high-frequency variation coefficient change amount that is a difference between a high-frequency variation coefficient calculated after the instruction means instructs seating and a high-frequency variation coefficient calculated before seating is instructed. Means,
Based on the CVRR change amount and the sympathetic nerve activity index change amount, whether or not the sympathetic nerve function of the subject is operating normally, and based on the high frequency variation coefficient change amount, the subject Determining means for respectively determining whether or not the parasympathetic nerve function of
Display means for displaying the result determined by the determination means;
An autonomic nervous function diagnostic apparatus comprising: The autonomic nerve activity degree calculation means calculates a sympathetic nerve activity index indicating the degree of sympathetic nerve activity by performing frequency analysis on the electrocardiographic data within a predetermined period each time an R wave is detected in the electrocardiographic data. Calculate
The CVRR calculating means calculates CVRR based on the electrocardiographic data within the predetermined period each time an R wave is detected in the electrocardiographic data,
The high-frequency variation coefficient calculating means calculates a high-frequency variation coefficient by performing frequency analysis on the electrocardiographic data within a predetermined period each time an R wave is detected in the electrocardiographic data. Or the autonomic nervous function diagnostic apparatus according to 2; A pulse wave measuring means for measuring the pulse wave of the subject;
Based on the pulse wave data measured by the pulse wave measuring means, a sympathetic 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 measured by the pulse wave measuring means, a pulse wave interval fluctuation coefficient calculating means for calculating a pulse wave interval fluctuation coefficient;
A high frequency fluctuation coefficient that is a fluctuation coefficient of a high frequency component from a high frequency component and an average value of pulse wave intervals based on a power spectrum obtained as a result of frequency analysis of pulse wave data measured by the pulse wave measuring means A coefficient of variation calculation means;
Instructing means for instructing to be seated after elapse of a certain time after the instructed standing and instructing to stand for the diagnosis subject,
Pulse wave interval variation coefficient change amount, which is the difference between the value of the pulse wave interval variation coefficient calculated after instructing standing by the instruction means and the value of the pulse wave interval variation coefficient calculated before instructing standing A pulse wave interval variation coefficient change amount calculating means for calculating
Sympathetic activity index change, which is the difference between the value of the sympathetic nerve activity index calculated after instructing to stand by the instruction means and the value of the sympathetic nerve activity index calculated before instructing to stand Sympathetic activity index change amount calculating means for calculating the amount;
A high-frequency variation coefficient change amount calculation that calculates a high-frequency variation coefficient change amount that is a difference between a high-frequency variation coefficient calculated after the instruction means instructs seating and a high-frequency variation coefficient calculated before seating is instructed. Means,
Based on the pulse wave interval variation coefficient change amount and the sympathetic activity index change amount, whether the sympathetic nerve function of the subject is normal, and based on the high frequency variation coefficient change amount, Determining means for determining whether or not the parasympathetic nerve function of the subject is normal, and
Display means for displaying the result 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 CVRR, which is a coefficient of variation of the RR interval, based on the measured electrocardiogram data;
Calculating a high frequency variation coefficient from a high frequency component and an average value of RR intervals based on a power spectrum obtained as a result of frequency analysis of measured electrocardiographic data;
Instructing to be seated after a predetermined time has passed since instructing to stand and instructing to stand;
Calculating a CVRR change amount which is a difference between a value of CVRR calculated after instructing standing and a value of CVRR calculated before instructing standing;
The amount of change in the sympathetic nerve activity index, which is the difference between the value of the sympathetic nerve activity index calculated after instructing to stand and the value of the sympathetic nerve activity index calculated before instructing to stand up is calculated. Steps,
Calculating a high-frequency variation coefficient change amount that is a difference between the high-frequency variation coefficient calculated after the seating is instructed and the high-frequency variation coefficient calculated before the seating is instructed;
Based on the CVRR change amount and the sympathetic nerve activity index change amount, whether or not the sympathetic nerve function of the subject is operating normally, and based on the high frequency variation coefficient change amount, the subject Each determining whether or not the parasympathetic function of
Displaying the determined result; and
A program that causes a computer to execute. Receiving the electrocardiogram data of the diagnosed person measured by the electrocardiograph;
Calculating a sympathetic nerve activity index indicating the degree of sympathetic nerve activity based on the received electrocardiogram data;
Calculating CVRR which is a coefficient of variation of the RR interval based on the received electrocardiogram data;
Calculating a high frequency variation coefficient from a high frequency component and an average value of the RR interval based on a power spectrum obtained as a result of frequency analysis of the received electrocardiogram data;
Instructing to be seated after a predetermined time has passed since instructing to stand and instructing to stand;
Calculating a CVRR change amount which is a difference between a value of CVRR calculated after instructing standing and a value of CVRR calculated before instructing standing;
The amount of change in the sympathetic nerve activity index, which is the difference between the value of the sympathetic nerve activity index calculated after instructing to stand and the value of the sympathetic nerve activity index calculated before instructing to stand up is calculated. Steps,
Calculating a high-frequency variation coefficient change amount that is a difference between the high-frequency variation coefficient calculated after the seating is instructed and the high-frequency variation coefficient calculated before the seating is instructed;
Based on the CVRR change amount and the sympathetic nerve activity index change amount, whether or not the sympathetic nerve function of the subject is operating normally, and based on the high frequency variation coefficient change amount, the subject Each determining whether or not the parasympathetic function of
Displaying the determined result; and
A program that causes a computer to execute.

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