JP2023086338A - Blood pressure pulse wave measuring device and blood pressure pulse wave measuring method - Google Patents

Abstract

To provide a blood pressure pulse wave measuring device and a blood pressure pulse wave measuring method capable of suppressing deterioration in reliability of an arteriosclerosis examination due to tension or the like felt by a subject.SOLUTION: A blood pressure pulse wave measuring device includes: a blood pressure pulse wave measuring part for measuring the blood pressure pulse wave of a subject; a heartbeat analysis part for detecting a rest state of the subject by analyzing a heartbeat trend of the subject; an extraction part for extracting the blood pressure pulse wave when the rest state of the subject is detected by the heartbeat analysis part, of the blood pressure pulse wave measured by the blood pressure pulse wave measuring part; and a degree-of-arteriosclerosis calculation part for calculating an index of the arteriosclerosis of the subject using the blood pressure pulse wave extracted by the extraction part.SELECTED DRAWING: Figure 2

Description

(1) Affiliated company of Fukuda Denshi Co., Ltd. Sale date February 5, 2021 Fukuda Denshi Hokkaido Sales Co., Ltd. February 17, 2021 Fukuda Denshi North Tohoku Sales Co., Ltd. February 6, 2021 Fukuda Denshi Minamitohoku Sales Co., Ltd. (20 other companies) (2) Websites accessible by affiliates of Fukuda Denshi (not open to the public) Posting date January 2021 (3) Web study session for affiliated companies of Fukuda Denshi (closed) Date December 16, 2020 December 17, 2020

The present invention relates to a blood pressure pulse wave examination apparatus and a blood pressure pulse wave examination method for calculating an index of arteriosclerosis such as CAVI (Cardio Ankle Vascular Index) and PWV (Pulse Wave Velocity) from measured pulse waves.

Conventionally, CAVI and PWV are generally used as indices of arteriosclerosis. PWV is the speed at which waves generated when blood is pumped from the heart to the aorta propagate through the walls of the arteries. PWV is obtained by measuring the pulse wave at two points on the blood vessel and its propagation time (PWT) and dividing the distance between these two points by the propagation time.

A blood pressure pulse wave examination device capable of measuring PWV is described in Patent Document 1, for example. A blood pressure pulse wave examination apparatus capable of measuring CAVI in addition to PWV is described in Patent Document 2, for example.

JP 2017-164301 A JP 2006-110155 A

By the way, it is known that the hardness of blood vessels is affected by autonomic nerves and increases when vascular smooth muscles are contracted, such as when the body is tense. For this reason, when measuring the hardness of blood vessels, the measurement is performed in a state in which the subject is sufficiently rested and not tense.

However, the examiner does not know how tense each examinee is, and it is difficult for the examinee himself/herself to know. Therefore, if measurement of arteriosclerosis is performed while the subject is tense, there is a risk of obtaining an erroneous test result that the arteriosclerosis is more advanced than it actually is.

The present invention has been made in consideration of the above points, and provides a blood pressure and pulse wave examination apparatus and a blood pressure and pulse wave examination method capable of suppressing deterioration in the reliability of arteriosclerosis examination caused by subject's tension and the like. offer.

One aspect of the blood pressure pulse wave examination device of the present invention is
a blood pressure pulse wave measuring unit that measures the blood pressure pulse wave of the subject;
a heartbeat analysis unit that detects the resting state of the subject by analyzing the heartbeat trend of the subject;
an extraction unit for extracting, from among the blood pressure pulse waves measured by the blood pressure pulse wave measurement unit, the blood pressure pulse wave when the heartbeat analysis unit detects a resting state of the subject;
an arteriosclerosis calculating unit that calculates an index of arteriosclerosis of the subject using the blood pressure pulse wave extracted by the extracting unit;
Prepare.

One aspect of the blood pressure pulse wave examination method of the present invention is
a step of measuring the blood pressure pulse wave of the subject;
detecting a resting state of the subject by analyzing the heart rate trend of the subject;
a step of extracting a blood pressure pulse wave when a resting state of the subject is detected from the measured blood pressure pulse wave;
a step of calculating an index of arteriosclerosis of the subject using the extracted blood pressure pulse wave;
including.

According to the present invention, it is possible to calculate an index of arteriosclerosis using the blood pressure pulse wave at rest. A wave inspection device and a blood pressure pulse wave inspection method can be realized.

1 is a block diagram showing the overall configuration of a blood pressure pulse wave examination apparatus according to an embodiment; FIG. FIG. 1 is a block diagram showing a main configuration for realizing a blood pressure pulse wave examination apparatus and method according to an embodiment; FIG. 3A is a diagram showing a display example of a blood pressure pulse wave according to the embodiment, and FIG. 3B is a diagram showing an enlarged heart rate trend (HR trend). A diagram showing the flow of blood pressure pulse wave measurement in a blood pressure pulse wave examination device

BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

<1> Overall Configuration of Blood Pressure and Pulse Wave Examination Apparatus FIG. 1 is a block diagram showing the overall configuration of a blood pressure and pulse wave examination apparatus according to an embodiment of the present invention.

In FIG. 1, the main body 1a of the blood pressure and pulse wave test device 1 includes an arithmetic processing unit 10, an input unit 70, a display unit 80, a display control unit 81, a printing unit 91, a storage unit 92, an audio output unit 93, a blood pressure pulse wave A measurement unit 30, a heart sound measurement unit 40, an electrocardiogram measurement unit 50, and a pulse wave measurement unit 60 are provided.

The blood pressure pulse wave measurement unit 30 has an upper arm measurement control unit 31 and a lower limb measurement control unit 32 . A right upper arm cuff 21R and a left upper arm cuff 21L are connected to the upper arm measurement control unit 31 via hoses 21h, respectively. are connected via hoses 22h.

The blood pressure pulse wave measurement unit 30 has an oscillometric blood pressure measurement function and an air bladder type pulse wave measurement function.

The upper-limb measurement control unit 31 includes a pressure sensor 33, a signal processing circuit that performs predetermined signal processing such as amplification on a signal detected by the pressure sensor 33, a pump and an exhaust valve that supply and exhaust the cuff 21R and the cuff 21L. and a computer having a CPU (Central Processing Unit), a ROM (Read Only Memory), a RAM (Random Access Memory), and various interfaces for controlling the air supply/exhaust operation. The upper limb measurement control unit 31 pressurizes the internal pressure of the cuffs 21R and 21L (hereinafter, the internal pressure of the cuffs is referred to as "cuff pressure") by introducing air into the rubber sacs of the cuffs 21R and 21L through the hose 21h. At the same time, air is discharged from the rubber bag to reduce the cuff pressure of the cuffs 21R and 21L. The cuff 21R is worn on the right upper arm of the subject, and the cuff 21L is worn on the left left arm of the subject. The target value of the cuff pressure after pressurization differs between the case of pulse wave measurement and the case of blood pressure measurement, and can be set individually.

In the case of pulse wave measurement, the measurement control unit 31 for upper limbs detects changes in the cuff pressure of the cuffs 21R and 21L after pressurization as a pulse wave signal by the pressure sensor 33, and the detected pulse wave signal is sent to the arithmetic processing unit 10. output to Pulse wave measurement is performed in response to a request from the arithmetic processing unit 10 . For pulse wave measurement, only one of the two cuffs 21R and 21L may be used, or both of them may be used.

In the case of blood pressure measurement, the upper-limb measurement control unit 31 detects the vibration of the cuff pressures of the cuffs 21R and 21L during decompression with the pressure sensor 33, and detects the cuff pressure with the most pronounced increase in amplitude as the systolic blood pressure. At the same time, the cuff pressure at which the decrease in vibration is most pronounced is detected as the diastolic blood pressure. The upper limb measurement control unit 31 then outputs blood pressure signals indicating the detected systolic blood pressure and diastolic blood pressure to the arithmetic processing unit 10 . Blood pressure measurement is performed in response to a request from the arithmetic processing unit 10 . When there is a request from the arithmetic processing unit 10, normally, right blood pressure measurement using only the cuff 21R and left blood pressure measurement using only the cuff 21L are sequentially performed, but these blood pressure measurements are performed in parallel. may be done.

The lower limb measurement control unit 32 includes a pressure sensor 34, a signal processing circuit that performs predetermined signal processing such as amplification on a signal detected by the pressure sensor 34, a pump and an exhaust valve that supply and exhaust the cuff 22R and the cuff 22L. and a computer having a CPU, ROM, RAM, and various interfaces for controlling the air supply/exhaust operation. The lower limb measurement control unit 32 pressurizes the cuff pressure of the cuffs 22R and 22L by introducing air into the rubber sacs of the cuffs 22R and 22L through the hose 22h, and discharges the air from the rubber sacs to increase the cuff pressure. Decrease the cuff pressure of 22R and 22L. The cuff 22R is attached to the subject's right ankle, and the cuff 22L is attached to the subject's left ankle. The target value of the cuff pressure after pressurization differs between the case of pulse wave measurement and the case of blood pressure measurement, and can be set individually. Since the operation of the lower limb measurement control unit 32 during pulse wave measurement and blood pressure measurement is the same as that of the upper limb measurement control unit 31, detailed description thereof will be omitted here.

The computers of the upper-limb measurement control unit 101 and the lower-limb measurement control unit 32 perform arithmetic processing for blood pressure pulse wave measurement, etc., which will be described below, by executing a control program stored in the ROM.

In the present embodiment, the blood pressure pulse wave measurement unit 30 is provided with the upper limb measurement control unit 31 and the lower limb measurement control unit 32 independently. It may be integrated with the measurement control unit 32 .

A heart sound microphone 23 is connected to the heart sound measurement unit 40 . The electrocardiogram measurement unit 50 is connected to the limb electrocardiogram electrode unit 24a and the chest electrocardiogram electrode unit 24b. Amorphous pulse wave sensors 25 a and 25 b are connected to the pulse wave measurement unit 60 .

The arithmetic processing unit 10 is a computer having a CPU, ROM, RAM, various interfaces, and the like. The arithmetic control unit 10 executes the control program stored in the ROM by the CPU.

The arithmetic processing unit 10 controls a blood pressure pulse wave measuring unit 30, a heart sound measuring unit 40, an electrocardiogram measuring unit 50, and a pulse wave measuring unit 60 (hereinafter referred to as "each biological information measuring unit").

Further, the arithmetic processing unit 10 receives biological information supplied from each biological information measuring unit. Then, the received biometric information is edited or converted into data for display when it is necessary to be displayed on the screen and then edited or converted into data for display on the display unit 80, and when it is necessary to be printed on paper for a report, it is edited or converted into data for printing. Then, it is output to the printing section 91 . Further, the arithmetic processing unit 10 appropriately stores the received biometric information in the storage unit 92 and reads the stored biometric information.

Further, the arithmetic processing unit 10 performs waveform analysis and the like of the biological information received from each biological information measuring unit. In the waveform analysis, characteristic portions (division points) in the waveform are detected. Characteristic portions include, for example, the beginning of the second heart beat, the rising portion of the pulse wave on the upper arm, the rising portion of the pulse wave on the ankle, the notch of the pulse wave, the notch portion of the pulse wave on the upper arm, and the like. be done.

The arithmetic processing unit 10 calculates the degree of arteriosclerosis based on the analysis result and the numerical value (for example, blood pressure) indicated by the received biological information.

A specific description will be given. The arithmetic processing unit 10 obtains the brachial-ankle pulse wave velocity baPWV (brachial-ankle Pulse Wave Velocity) and the heart-ankle arterial pulse wave velocity haPWV (heart-ankle Pulse Wave Velocity) as the pulse wave velocity. At the same time, an ankle brachial pressure index (ABI) is obtained as a lower limb upper limb blood pressure ratio. That is, the arithmetic processing unit 10 uses the pulse wave detected by the blood pressure pulse wave measuring unit 30 to calculate the ankle-brachial blood pressure ratio (ABI) and the pulse wave velocity (PWV). The calculation control unit 10 also calculates the blood pressure value of the subject using the pulse wave detected by the blood pressure pulse wave measurement unit 30 . Further, the arithmetic control unit 10 also calculates indices such as CAVI (Cardio Ankle Vascular Index) calculated based on the heart-ankle arterial pulse wave velocity haPWV. Here, the arithmetic control unit 10 calculates CAVI by correcting the heart-ankle arterial pulse wave propagation velocity haPWV with a logarithmic pulse wave. As is known, the brachial-ankle pulse wave velocity baPWV and the heart-ankle arterial pulse wave velocity haPWV are indicators of arterial stiffness, and the ankle-brachial blood pressure ratio ABI is an indicator of arterial stiffness. It is an indicator of clogging.

Further, the arithmetic processing unit 10 receives from the input unit 70 the content of the input and instruction by the user's operation, and according to the received content, the biological information measuring unit, the display unit 80, the printing unit 91, the storage unit 92 and the voice output unit 93 functions, and controls the start and stop of each operation.

The display unit 80 is a display device having a display screen such as an LCD (Liquid Crystal Display), and displays biological information, analysis results, arteriosclerosis degree, etc. input as display data from the arithmetic processing unit 10 on the screen. .

The printing unit 91 has a paper feeding mechanism, a printing head, etc. as main components, and prints biometric information, analysis results, and arteriosclerosis degree input from the arithmetic processing unit 10 as printing data on paper.

The storage unit 92 is configured by a hard disk drive, a writable optical disk drive, a non-volatile memory, or the like, and can store information from the arithmetic processing unit 10 . In addition, the storage unit 92 records biological information measured by each biological information measuring unit, that is, an electrocardiogram, a pulse wave, and a heart sound.

The voice output unit 93 has a speaker or the like as a main component, and outputs a guidance voice, a notification sound, or the like according to the guidance data or the notification sound output instruction signal input from the arithmetic processing unit 10 .

The input unit 70 includes a keyboard, a mouse, buttons, a touch panel, etc., receives inputs and instructions from user operations, and sends them to the arithmetic processing unit 10 .

The pulse wave measurement unit 60 supplies the arithmetic processing unit 10 with the subject's pulse wave signals detected by the amorphous pulse wave sensors 25a and 25b appropriately attached to the subject. Thereby, pulse wave measurement and analysis are performed. One of the amorphous pulse wave sensors 25a and 25b is attached to the subject's carotid artery, for example, and the other is attached to the subject's femoral artery or knee, for example.

The electrocardiogram measurement unit 50 supplies the arithmetic processing unit 10 with electrocardiogram signals detected by the limb electrocardiogram electrode unit 24a and the chest electrocardiogram electrode unit 24b attached to the subject. As a result, electrocardiogram measurement and analysis are performed. The limb electrocardiographic electrode section 24a typically consists of four electrocardiographic electrodes attached to the right wrist, left wrist, right ankle, and left ankle, respectively. As for electrocardiographic electrodes for both ankles, it is preferable that they are formed so that they are not prevented from being worn on both ankles by the right ankle cuff 22R and the left ankle cuff 22L. The chest electrocardiographic electrode section 25b typically consists of six electrocardiographic electrodes attached to six locations on the chest.

The heart sound measurement unit 40 supplies the heart sound signal detected by the heart sound microphone 23 attached to the subject to the arithmetic processing unit 10 . As a result, heart sounds are measured and analyzed.

<2> Configuration of Principal Part of Present Embodiment FIG. 2 is a block diagram showing the configuration of a main part of the blood pressure and pulse wave examination apparatus according to the present embodiment. In the case of this embodiment, the configuration of FIG. 2 is provided in the arithmetic processing unit 10 . As described above, the arithmetic processing unit 10 is a computer having a CPU, ROM, RAM, various interfaces, and the like. The arithmetic control unit 10 implements each function shown in FIG. 2 by executing a control program stored in the ROM with the CPU.

The heartbeat analysis unit 101 detects the resting state of the subject by analyzing the heartbeat trend of the subject. Specifically, the heartbeat analysis unit 101 inputs the electrocardiogram obtained by the electrocardiogram measurement unit 50 to obtain information on the heart rate, the heart rate is equal to or less than a predetermined heart rate, and the change in the heart rate exceeds a predetermined threshold value. It is judged that the subject is in a resting state when the following conditions are met. The heartbeat analysis unit 101 outputs information indicating that the subject is in a resting state to the extraction unit 102 .

The extraction unit 102 receives the blood pressure pulse wave measured by the blood pressure pulse wave measurement unit 30, and extracts the blood pressure pulse wave when the heart rate analysis unit 102 detects a resting state from the measured blood pressure pulse waves. and output to the arteriosclerosis calculation unit 103 .

The arteriosclerosis calculation unit 103 uses the blood pressure pulse wave input from the extraction unit 102 to calculate an index of arteriosclerosis such as CAVI and PWV. Since the method of calculating CAVI and PWV is a known technology described in Patent Documents 1 and 2, etc., description thereof will be omitted here.

As a result, the blood pressure and pulse wave examination apparatus 1 of the present embodiment detects the resting state of the subject based on the heartbeat trend of the subject, and detects the arteriosclerosis using the blood pressure pulse wave under the resting state. By calculating the index, it is possible to calculate the index of arteriosclerosis in a normal state, not in a special state in which the vascular smooth muscle contracts due to tension or the like. As a result, deterioration in the reliability of arteriosclerosis examination can be suppressed.

Further, in the case of the present embodiment, the heartbeat trend obtained by heartbeat analysis section 101 is displayed on display section 80 via display control section 81 .

FIG. 3A is a diagram showing a display example of blood pressure pulse waves according to the present embodiment. A heartbeat trend (HR trend) is displayed on the same screen as the real-time blood pressure pulse waveform. Note that FIG. 3B is an enlarged view of the heart rate trend (HR trend). A medical worker such as a doctor can grasp whether the currently measured blood pressure pulse wave is at rest or not at rest by looking at the heartbeat trend.

In the present embodiment, the configuration shown in FIG. 2 automatically extracts the blood pressure pulse wave at rest and calculates the degree of arteriosclerosis at rest. Timing for calculating the degree of arteriosclerosis may be manually selected based on such a heartbeat trend. For example, the blood pressure and pulse wave examination apparatus 1 is provided with an arteriosclerosis calculation start button, and when the medical staff determines that the subject is in a resting state based on the heart rate trend, the calculation start button is manually pressed. You may do so.

FIG. 4 is a diagram showing the flow of operations related to blood pressure pulse wave (hereinafter also simply referred to as pulse wave) measurement in blood pressure pulse wave examination apparatus 1. As shown in FIG.

First, in step F11, electrocardiographic electrodes are attached to the patient. From this point on, an electrocardiogram, or heartbeat, can be obtained. When the user presses the start button in step F12, pressurization of the cuffs 21R, 21L, 22R, and 22L is started at the same time (step F13). In step F14, the cuff pressurization is finished and the pressure is maintained.

In step F15, pulse wave measurement is started after waiting for the pulse wave to stabilize. The stabilization of the pulse wave here means, for example, that fluctuations in the baseline of the pulse wave become equal to or less than a predetermined value.

In steps F16-1 to F16-3, an appropriate pulse wave search is performed based on the heartbeat trend described above. Eventually, when an appropriate pulse wave measurement range is reached in step F17 (that is, when the heartbeat analysis unit 102 determines that the heartbeat is at rest), the pulse wave in that measurement range is extracted and stored in step F18, and the cuff is applied. Start exhaust. When the cuff is exhausted in step F19, blood pressure pulse wave measurement is completed.

<3> Conclusion As described above, according to the present embodiment, by analyzing the blood pressure pulse wave measurement unit 30 that measures the blood pressure pulse wave of the subject and the heartbeat trend of the subject, A heartbeat analysis unit 101 for detecting the subject's resting state, and among the blood pressure pulse waves measured by the blood pressure pulse wave measurement unit 30, the blood pressure pulse wave when the heartbeat analysis unit 101 detects the subject's resting state. By providing the extraction unit 102 for extraction and the arteriosclerosis degree calculation unit 103 for calculating the index of arteriosclerosis of the subject using the blood pressure pulse wave extracted by the extraction unit 102, the It is possible to realize the blood pressure and pulse wave examination apparatus 1 that can suppress the decrease in reliability of the arteriosclerosis examination caused by tension or the like.

The above-described embodiments are merely examples of specific implementations of the present invention, and the technical scope of the present invention should not be construed to be limited by these. Thus, the invention may be embodied in various forms without departing from its spirit or essential characteristics.

In the above-described embodiment, the heart rate analysis unit 101 detects heart rate fluctuations based on an electrocardiogram. good too.

INDUSTRIAL APPLICABILITY The present invention is widely applicable to a blood pressure pulse wave examination apparatus and a blood pressure pulse wave examination method for calculating the arteriosclerosis degree based on the blood pressure pulse wave.

1 blood pressure pulse wave test device 10 arithmetic processing unit 21R, 21L, 22R, 22L cuff 30 blood pressure pulse wave measurement unit 50 electrocardiogram measurement unit 101 heart rate analysis unit 102 extraction unit 103 arteriosclerosis degree calculation unit

Claims (4)

a blood pressure pulse wave measuring unit that measures the blood pressure pulse wave of the subject;
a heartbeat analysis unit that detects the resting state of the subject by analyzing the heartbeat trend of the subject;
an extraction unit for extracting, from among the blood pressure pulse waves measured by the blood pressure pulse wave measurement unit, the blood pressure pulse wave when the heartbeat analysis unit detects a resting state of the subject;
an arteriosclerosis calculating unit that calculates an index of arteriosclerosis of the subject using the blood pressure pulse wave extracted by the extracting unit;
A blood pressure pulse wave examination device. The heartbeat analysis unit detects that the subject is in a resting state when the heart rate of the subject is less than or equal to a predetermined heart rate and the change in the heart rate is less than or equal to a predetermined threshold.
The blood pressure pulse wave examination device according to claim 1. A display unit for displaying the graph of the heartbeat trend on the same screen as the blood pressure pulse wave measured by the blood pressure pulse wave measurement unit,
The blood pressure pulse wave examination device according to claim 1 or 2. a step of measuring the blood pressure pulse wave of the subject;
detecting a resting state of the subject by analyzing the heart rate trend of the subject;
a step of extracting a blood pressure pulse wave when a resting state of the subject is detected from the measured blood pressure pulse wave;
a step of calculating an index of arteriosclerosis of the subject using the extracted blood pressure pulse wave;
A blood pressure plethysmography method comprising:

Images