JP3842390B2 - Blood pressure measurement device and cardiac function analysis device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a blood pressure measuring device and a cardiac function analysis apparatus analyzes the cardiac function by particularly given exercise in certain conditions from normal time in human body, measures the changes over time of various circulatory dynamics factor to normal return, The present invention relates to a blood pressure measurement device and a cardiac function analysis device for evaluation.
[0002]
BACKGROUND OF THE INVENTION
Conventionally, blood pressure values are effective as a guideline for grasping the state of the circulatory system, and there are both open and non- invasive methods for measuring blood pressure. Obtaining non- invasive methods (indirect measurement methods) are widespread.
[0003]
There are various methods for this non- invasive method, which can be broadly divided into cuff and continuous methods. In any case, a standard blood pressure value is generally obtained by obtaining a maximum blood pressure value and a minimum blood pressure value. The evaluation is made by comparing with the reference value.
[0004]
[Problems to be solved by the invention]
However, the conventional evaluation from the blood pressure value is general, and is insufficient for analyzing cardiac function, and there are individual differences, so the accuracy of the above evaluation is also stochastically low. It was something that would end up.
[0005]
OBJECT OF THE INVENTION
Accordingly, the present invention is conventional circumstances described above, which has been made in view of the problems, to eliminate the problems of, and shall be made with high accuracy rating than as individual basis, a novel blood pressure measurement device It aims to provide a cardiac function analysis device.
[0006]
[Means for Solving the Problems]
In order to achieve this object, a blood pressure measurement device according to the present invention has a pulse waveform detection means for acquiring a pulse waveform accompanying a decrease in cuff pressure attached to a subject, and a notch generation point in the pulse waveform. Is the maximum blood pressure, and the disappearance point of the notch in the pulse waveform is obtained as the minimum blood pressure.
In order to achieve this object, the cardiac function analysis apparatus according to the present invention obtains a pulse waveform acquisition means for acquiring a pulse waveform at regular intervals from the start of exercise to normal recovery after the end of exercise with a constant load condition. From the pulse waveform, maximal blood pressure, minimum blood pressure, heart rate, left ventricular ejection time are obtained as basic factors of circulatory kinetic factors, and circulatory kinetics are obtained as mean blood pressure, pulse pressure and double product as complex factors of circulatory kinetic factors. For each of the factor calculation means, the circulatory dynamic factor, the integral value calculation means for calculating the time-series integral value of the change surrounded by each station with the value at rest as 0, and the circulatory dynamic factor have a analysis means for analyzing cardiac function using a time series integrated value of change in hemodynamics factor calculating means, the time point of generation of a notch in the pulse wave and systolic blood pressure, the disappearance time of the notch in the pulse waveform It is characterized by determining as a small blood pressure.
[0007]
[Action]
With the above-described configuration, it is possible to take data from a normal time to a normal return through a certain exercise load, and it is possible to analyze the cardiac function from this data. And the evaluation obtained as a result also becomes a thing with high precision, and in addition, based on the reliability of this data, the drug effect at the time of administering a blood pressure agent can also be confirmed.
[0008]
DETAILED DESCRIPTION OF THE INVENTION
Next, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a block diagram of a blood pressure measurement device embodying the present invention, FIG. 2 is a pulse waveform diagram at rest, A is a real waveform, B is a waveform through a filter, and FIG. 3 is a pulse waveform diagram during exercise. A is a real waveform, B is a waveform through a filter, FIG. 4 is a diagram showing the integral value% of each factor, FIG. 5 is a diagram in which healthy groups and disease groups are distributed as coordinates, and FIG. It is the figure distributed by the quadrant divided by the coordinate.
[0009]
In these drawings, reference numeral 1 denotes a personal computer (personal computer). The personal computer 1 is electrically connected with a cuff band 2 wound around the upper arm of the subject. Connected to the cuff band 2 is an automatic opening valve 4 that also operates the sphygmomanometer 3 for calibration.
[0010]
In order to drive the automatic opening valve 4 from the personal computer 1 described above, a pressurization reference voltage is applied as pump control, and the pressurization reference voltage is input to the pressurization control circuit 6 as an alternating current by the D / A converter 5. The The pressure control circuit 6 sends a pressure status to the personal computer 1.
[0011]
Further, the pressurizing control circuit 6 operates the automatic opening valve 4 by driving the pressurizing pump 7. In the figure, 8 is a manual opening valve for calibration.
[0012]
Further, a pressure sensor 9 is attached to the automatic release valve 4, and a signal from the pressure sensor 9 is DC-converted by the A / D converter 11 through the voltage converter 10 and inputted to the personal computer 1.
[0013]
On the other hand, reference numeral 12 in the figure denotes a pulse waveform transducer, and the waveform converted by the pulse waveform transducer 12 is amplified by an amplifier 13. The amplifier 13 performs gain (GAIN) adjustment 13a.
[0014]
The signal wave amplified by the amplifier 13 is sent to the A / D converter 11 through the level voltage adjusting circuit 15 while being displayed on the LED 14. The signal wave from the amplifier 13 passes through a filter 16 arranged in parallel with the level voltage adjustment circuit 15, is subjected to waveform adjustment and is sent to the A / D converter 11, and data is sent from the A / D converter 11 to the personal computer 1. Input as a signal. In the figure, reference numeral 17 denotes a start / stop circuit of the personal computer 1.
[0015]
The data input from the A / D converter 11 is subjected to waveform processing, file processing, and sent to an output file 18 for screen display, printout, etc. as necessary.
[0016]
The blood pressure measurement of the subject using the above-described apparatus is performed as follows. That is, the subject checks the pulse waveform at regular time intervals while walking with an upright treadmill while wearing the cuff belt 2 on the upper arm.
[0017]
This exercise load condition takes into account the Japanese body type, especially the length, physique and physical strength of the lower limbs, and the heart rate and the maximum blood pressure value increase by about 50% even in healthy people, and there is no accident even in the sick, elderly people, exercise It is calculated because it is possible to carry out even if there is a shortage of people, some knee joints, the speed is 3Km / h, the slope is 14%, the time is 4 minutes, from the start of exercise to normal recovery before the load The measurement is made every 20 seconds.
[0018]
Further, the principle of the blood pressure measurement method according to the present invention is that the arterial minute aperture displacement waveform of the upper arm around which the cuff band 2 is wound appears with a sharp notch in the ascending leg portion as the cuff pressure decreases, and when the pressure is further reduced, the notch disappears. As a result of measuring with an ultrasonic displacement meter, the occurrence of a notch begins to open from the brachial artery occlusion, that is, the maximum blood pressure, and the disappearance of the notch coincides with the complete opening of the artery, that is, the minimum blood pressure. It depends on the direct pressure and Korotkoff sound.
[0019]
Furthermore, in the present invention, by taking the pulse waveform, each of the hemodynamic factors, that is, the heart rate (HR), the maximum blood pressure ( _max BP), the minimum blood pressure ( _min BP), and the left ventricular ejection time (ET) are obtained. Calculation is based on four. In other words, the maximum blood pressure and minimum blood pressure are measured by notch observation, the heart rate is calculated based on the interval between the recorded arterial pressure waveforms, and the left ventricular ejection time is the time difference between the ascending leg starting point and the descending leg notch immediately after the minimum blood pressure. Calculate with feed rate taken into account.
[0020]
The notch N is expressed in the waveform even if it passes through the filter 16 as shown in the waveform charts at rest and exercise shown in FIG. 2 and FIG. By passing the signal, the target element can be understood more clearly and the processing can be facilitated.
[0021]
In addition to the above four basics, each circulatory dynamic factor is an integrated value of time series changes of seven items of complex factors including _mean blood pressure ( _mean BP), pulse pressure (pulse pressure), and double product ( _max BP × HR) ( Integral Value%). As described above, each basic factor is measured at the time of standing up and measured every 20 seconds from the start of exercise to the return to normal.
[0022]
Integrated value of four and composite factor three basic factors measured or calculated at measurement points per 20 seconds, including at rest, when the resting values of variation enclosed by the measuring points as 0-series integration The value is automatically calculated by the personal computer 1.
[0023]
Although the absolute value of the basic factor varies depending on the subject, it can be compared with the individual transition and other cases regardless of the value at rest when calculated by the change from exercise load to normal recovery after load Therefore, the display of each factor is integral value% as shown in FIG.
[0024]
According to the principal component analysis, the contribution rate of the first principal component is 59.44%, and the maximum blood pressure and the average blood pressure in order from the double product. It has been found that pulse pressure, minimum blood pressure, heart rate, and left ventricular ejection time have large information for factor interpretation, and the first principal component can be interpreted as a factor for determining a disease. In addition, the contribution ratio of the second main component is 19.09%, and the cumulative contribution ratio is a high value exceeding 78.5%, which sufficiently suggests the characteristics of the disease group with respect to the healthy group.
[0025]
In FIG. 5, the healthy group is marked with a circle, the disease group is marked with a mark, the individual score is obtained from the factor loading, and the individual is plotted in orthogonal coordinates with the first principal component on the horizontal axis and the second principal component on the vertical axis. The distribution is seen. The healthy group is distributed with the first main component on the left side, that is, between -3 and -7, and the disease group is distributed on the right side with -3 to +8. However, with regard to the second main component, the healthy group is distributed from −2 to +2, and the disease group is distributed from −3 to +3.
[0026]
As a result of this distribution, the discriminant predictive value for discriminating between the healthy group and the disease group is 96.6% as high as the first principal component.
[0027]
Furthermore, coordinate points in a three-dimensional (solid) region in which the individual score is the first principal component from the X-axis, the second principal component from the Y-axis, and the third principal component from the Z-axis from the factor loading (−2. 8,8,0) can be divided into eight quadrants (spaces), and the distribution of the healthy group and the disease group in these eight quadrants is as shown in FIG. Both groups could be completely separated.
[0028]
【The invention's effect】
The blood pressure measurement device and the cardiac function analysis device according to the present invention are configured as described above. According to this, the basic factor is measured about 15 times or more, and this basic factor and time are automatically processed by a computer. In the healthy group, each factor is low and myocardial oxygen consumption is low, but in the disease group, this myocardial oxygen consumption is large and the external efficiency is clearly low. In the present invention, there is almost no error from direct pressure or Korotkoff sound, and the accuracy of evaluation of cardiac function is extremely high by taking blood pressure values during exercise as data.
[Brief description of the drawings]
FIG. 1 is a block diagram of a blood pressure measurement device embodying the present invention.
FIG. 2 is a pulse waveform diagram at rest.
FIG. 3 is a pulse waveform diagram during exercise.
FIG. 4 is a diagram showing each factor as an integral value%.
FIG. 5 is a partial coordinate view of a healthy group and a disease group with a first principal component and a second principal component as axes.
FIG. 6 is a diagram in which a healthy group and a disease group are distributed in quadrants separated by a solid coordinate with the first principal component, the second principal component, and the third principal component as axes.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Personal computer 2 Cuff belt 3 Calibration sphygmomanometer 4 Automatic release valve 5 D / A converter 6 Pressurization control circuit 7 Pressurization pump 8 Manual release valve 9 Pressure sensor 10 Voltage converter 11 A / D converter 12 Pulse waveform transducer 13 Amplifier 14 LED display 15 Level voltage adjustment circuit 16 Filter 17 Start / stop circuit 18 Output file N Notch

Claims (9)

It has a pulse waveform detection means for acquiring a pulse waveform accompanying a decrease in cuff pressure attached to a subject, the notch occurrence time in the pulse waveform is the maximum blood pressure, and the disappearance time of the notch in the pulse waveform is the minimum blood pressure A blood pressure measurement device characterized by being obtained . The blood pressure measuring device according to claim 1, wherein the notch is generated at an ascending leg portion. The blood pressure measuring device according to claim 1 or 2, wherein the pulse waveform is an arterial minute aperture displacement waveform. The blood pressure measurement device according to any one of claims 1 to 3, further comprising obtaining a heart rate and a left ventricular ejection time. 5. The blood pressure measurement device according to claim 1, further comprising obtaining an average blood pressure, a pulse pressure, and a double product. A pulse waveform acquisition means for acquiring a pulse waveform for every fixed time from the start of exercise to normal return after the end of exercise with a constant load condition;
From the pulse waveform, maximal blood pressure, minimum blood pressure, heart rate, left ventricular ejection time are obtained as basic factors of circulatory kinetic factors, and circulatory kinetics obtains mean blood pressure, pulse pressure and double product as complex factors of the circulatory kinetic factors. Factor calculation means;
For each of the circulatory dynamic factors, an integral value calculating means for calculating a time series integral value of a change surrounded by each measurement point with a value at rest being 0,
Have a analysis means for analyzing cardiac function using a time series integrated value of the change amount determined for each of the hemodynamics factor,
The cardiac function analysis apparatus, wherein the circulatory dynamic factor calculation means obtains the notch occurrence time in the pulse waveform as the maximum blood pressure and the notch disappearance time in the pulse waveform as the minimum blood pressure . The cardiac function analysis apparatus according to claim 6, wherein the pulse waveform acquisition unit and the hemodynamic factor calculation unit are the blood pressure measurement apparatus according to claim 1. The cardiac function analysis apparatus according to claim 6 or 7 , wherein the predetermined time is 20 seconds . 9. The cardiac function according to claim 6, wherein the analysis unit analyzes a cardiac function by performing a principal component analysis on the time-series integral value of the change obtained for each of the hemodynamic factors. The cardiac function analysis apparatus according to item 1.

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