JP4879038B2 - Blood pressure measurement device capable of pulse wave detection - Google Patents

Description

  The present invention also detects a pulse wave during blood pressure measurement performed by a compression band being wound around a compression site such as an ankle of a living body, the compression band expanding and the compression site being compressed. The present invention relates to a blood pressure measurement device to be performed.

Conventionally, there has been proposed a blood pressure pulse wave measuring device capable of detecting a pulse wave when performing the blood pressure measurement and calculating the pulse wave propagation velocity PWV based on the pulse wave. For example, this is the blood pressure pulse wave measuring device of Patent Document 1. In such a blood pressure pulse wave measuring device, as shown in FIG. 1 of Patent Document 1, when performing blood pressure measurement by an oscillometric method, the pressure of the air is provided in an air supply path for inflating a compression band. The pulse wave signal is obtained by acquiring the pressure signal output from the pressure sensor for detecting the signal via a pulse wave discriminating circuit including a band pass filter.
JP 2004-321438 A

  According to the conventional blood pressure pulse wave measuring device shown in FIG. 1 of Patent Document 1 above, since a pulse wave is obtained based on the air pressure of the compression band wound around the pressed part, When three arteries, the posterior tibial artery, radial artery, and anterior tibial artery, pass through and a plurality of arteries pass through the compression site, the pulse is required unless at least one of the arteries is occluded. In some cases, the waves were detected, and it could not be determined whether or not a specific artery was occluded.

  An object of the present invention is to provide a test artery, which is one of the plurality of arteries, when a compression band is wound around the ankle, which is a compression site through which the plurality of arteries pass, and blood pressure measurement is performed. An object of the present invention is to provide a blood pressure pulse wave measuring device capable of determining whether or not the blood vessel is occluded.

In order to achieve this object, the invention according to claim 1 includes (a) a compression band wound around an ankle of a living body through which a plurality of arteries pass, and by expanding the compression band and compressing the ankle A blood pressure measuring device for measuring an ankle blood pressure by an oscillometric method based on a change in pressure vibration generated in the compression band, and (b) an artery to be examined which is one of the plurality of arteries A detector for detecting a heartbeat synchronizing wave generated from the blood pressure during the blood pressure measurement is provided in the compression band, and (c) a Korotkoff sound and the subject to be inspected from the heartbeat synchronizing wave detected by the detector. An arterial that can detect both arterial pulse waves, and discriminates the Korotkoff sound pulse wave discriminating circuit, and an artery that determines that blood flow exists in the inspected artery when both the Korotkoff sound and the pulse wave are detected Blockage judgment Characterized in that it comprises a stage.

The invention according to claim 2 is characterized in that the arterial occlusion determination means uses the Korotkoff sound and the pulse wave when the pressure vibration generated in the compression band is a maximum value section.

Moreover, in the invention which concerns on Claim 3 , (a) the said compression belt is arrange | positioned in the outer peripheral side of the expansion | swelling bag in order to suppress the expansion | swelling to the outer peripheral side of the inflatable bag and its expansion bag, A relatively high-rigidity flexible restraint plate provided with notches cut in the axial direction at a plurality of locations on the end side edge, and disposed on the outer peripheral side of the restraint plate, than the restraint plate A flexible curved plate formed into a cylindrical shape having high rigidity, an inflatable bag, the restraining plate, and an outer bag for housing the curved plate, and when the inflated bag is inflated, The other end side edge of the restraining plate is pressed against the outer bag, and the other end side edge of the restraining plate can be deformed to the inner peripheral side, and (b) the arterial artery to be examined is more than the other arteries. The detector is provided on the other end side of the inner periphery of the compression band so that the detector is positioned in proximity. .

The invention according to claim 4 is characterized in that one side edge portion of the suppression plate is connected to the expansion bag.

The invention according to claim 5 is characterized in that the curved plate is integrally provided inside the outer bag.

Further, in the invention according to claim 6 , the side edge is curved when the compression band is developed in a plane, and the circumferential length on one end side is longer than the circumferential length on the other end side when wound in a cylindrical shape. It has a shape that forms a head cone shape.

In the invention according to claim 7 , the curved plate is composed of two plates, and one of the plates is formed in a cylindrical shape and disposed on the one end side, and the other plate has a cross section. It is formed in an elliptical cylindrical shape and is arranged on the other end side.

  According to the blood pressure measurement device capable of detecting a pulse wave according to the first aspect of the present invention, the blood pressure measurement device repeatedly generates from the inspected artery of the ankle during a pressing period for blood pressure measurement of the compression band wound around the ankle. Since a detector for detecting a heartbeat synchronization wave during the blood pressure measurement is provided in the compression band, the heartbeat synchronization wave can be detected during the pressing period for the blood pressure measurement, and the heartbeat synchronization is performed. Based on the wave, it can be determined whether or not the artery to be examined is occluded.

  In addition, according to the blood pressure measurement device capable of detecting a pulse wave of the invention according to claim 1, since the heartbeat synchronous wave is detected during the blood pressure measurement, the compression band can be easily attached only once. Blood pressure measurement and detection of the heartbeat synchronization wave can be performed.

Further, according to the blood pressure measuring apparatus capable of pulse wave detection of the invention according to claim 1, wherein the heartbeat-synchronous wave detected by the detector, the object to be detected pulse wave and the Korotkoff sound which is pulse wave of the test artery And a Korotkoff sound pulse wave discrimination circuit that discriminates each of them, and when both the detected pulse wave and Korotkoff sound are detected, it is determined that blood flow exists in the inspected artery. . Therefore, when it is determined whether or not the artery to be examined is occluded, the measurement is performed in comparison with the case where the artery occlusion is determined based only on either the detected pulse wave or the Korotkoff sound. It is possible to prevent an erroneous determination of the arterial occlusion due to disturbance caused by the movement of the subject being measured, and to perform an accurate determination of the arterial occlusion.

According to the blood pressure measurement device capable of detecting a pulse wave of the invention according to claim 2 , the arterial occlusion determination means is configured to detect the detected pulse wave and Korotkoff when the pressure vibration generated in the compression band is a maximum value section. Since the sound is used, the detected pulse wave and Korotkoff sound having a sufficiently large amplitude can be obtained, and the arterial occlusion determination can be performed accurately.

The ankle has a tapered outer peripheral surface in which the circumference at one end that is the calf side is longer than the circumference at the other end that is the ankle side. In a state where the compression band included in the blood pressure measurement device capable of detecting a pulse wave of the invention according to claim 3 is wound around the tapered ankle, the expansion bag is inflated, and the compression band compresses the ankle Then, the reaction force perpendicular to the outer peripheral surface which is the tapered shape of the ankle with respect to the compression has an axial component toward the other end side, so that the compression band tends to shift to the other end side. In that case, since the inner peripheral surface of the outer bag is pressed against the ankle, the friction force generated between the ankle and the inner peripheral surface of the outer bag can slide them. However, the other end side of the compression band causes a winding deformation that tends to be deformed so that the outer peripheral side of the outer bag is wound on the inner peripheral side. Moreover, the outer peripheral side of the outer bag moves integrally with the suppression plate by the frictional force generated between them. However, in the compression band, the notch cut in the axial direction is provided at a plurality of locations on the other end side edge of the suppression plate, and when the expansion bag is inflated, The other end side edge is pressed against the outer bag, and the other end side edge of the restraining plate can be deformed to the inner peripheral side. Therefore, when the expansion bag is inflated, the other end side edge of the suppression plate is already deformed to the inner peripheral side by being pressed by the outer bag. It becomes difficult to be wound further to the inner peripheral side, and the restraining plate prevents the winding deformation of the outer bag from proceeding. As a result, the mounting position of the compression band is prevented from shifting.

According to the blood pressure measuring device capable of detecting a pulse wave of the invention according to claim 3 , since the detector is provided on the other end side of the inner periphery of the compression band, the other end side of the compression band is provided. The detector is pressed against the ankle by the wrapping deformation of the outer bag, and the detected pulse wave can be obtained as a sufficiently large detection signal. Further, in the compression band, the detector is positioned closer to the artery to be examined than other arteries, so that the detected pulse is hardly affected by the pulse wave propagating through the other artery. Can detect waves.

Further, the compression band included in the blood pressure measurement device capable of detecting a pulse wave according to the third aspect of the invention is housed in the outer bag so as to be positioned on the outer peripheral side of the suppression plate, and has a higher rigidity than the suppression plate. Since the flexible curved plate formed into a cylindrical shape is provided, the compression band before mounting is deformed into a cylindrical shape according to the shape of the curved plate. Therefore, when the compression band is wound around the ankle, the work can be easily performed.

  In order to deform the compression band into a cylindrical shape in order to facilitate the operation, the curved plate needs to have a certain degree of rigidity. According to the compression band, since the curved plate is responsible for the function of performing the deformation before the compression band is mounted, the function does not need to be performed by the suppression plate, and the rigidity of the suppression plate is reduced to some extent. When the expansion bag is inflated, the other end side edge of the restraining plate is pressed against the outer bag, and the other end side edge of the restraining plate is easily deformed to the inner peripheral side. it can. As a result, compared with the case where there is no curved plate, the detector is provided on the other end side of the inner periphery of the compression band. The detector can be pressed more strongly against the ankle.

According to the blood pressure measurement device capable of detecting a pulse wave of the invention according to claim 4 , the suppression plate has one side edge connected to the expansion bag, and the suppression plate is compared with the expansion bag. Since the rigidity is relatively high, the expansion bag is accommodated in the outer bag along the suppression plate, and the expansion bag can be prevented from being bent in the outer bag.

According to the blood pressure measurement device capable of detecting a pulse wave of the invention according to claim 5 , since the curved plate is integrally provided inside the outer bag, the position of the curved plate within the compression band. Can be held.

According to the blood pressure measurement device capable of detecting a pulse wave of the invention according to claim 6 , the compression band has a curved side edge in a state where it is unfolded in a plane, and in a state where it is wound in a cylindrical shape, the circumference of one end side thereof Since it has a truncated cone shape whose length is longer than the peripheral length on the other end side, the compression band can be wound around the ankle following the tapered ankle, and the inflatable bag is inflated Then, the detector provided at the other end on the inner periphery of the compression band is pressed against the ankle, and the detected pulse wave can be obtained as a sufficiently large detection signal.

According to the blood pressure measuring device capable of detecting a pulse wave of the invention according to claim 7 , the curved plate is constituted by two plates, and one of the plates is formed in a cylindrical shape and the one end. The other plate is formed in a cylindrical shape having an elliptical cross section, and is arranged on the other end side. Therefore, according to the shape of the curved plate, the compression band is cylindrical on the one end side. The other end is deformed into a cylindrical shape having an elliptical cross section. Therefore, by winding the compression band around the ankle so that the one end side is located on the calf side of the ankle and the other end side is located on the heel side, the compression band is imitated according to the outer shape of the ankle. When the inflatable bag can be wound up, the detector provided on the other end on the inner periphery of the compression band is pressed against the ankle, and the detected pulse wave is detected with a sufficiently large detection signal. Can be obtained as

  Hereinafter, an embodiment of the present invention will be described in detail with reference to the drawings.

  FIG. 1 is a block diagram illustrating the configuration of a lower limb upper limb blood pressure pulse wave measuring apparatus 10 to which the present invention is applied. In FIG. 1, the upper arm compression band 12 is a general upper arm blood pressure measurement compression band, and is wound around, for example, the upper arm portion 14 which is a part of the upper limb of a patient. A pressure sensor 16 and a pressure control valve 18 are connected to the upper arm compression band 12 by a pipe 20. Further, the pressure control valve 18 is further connected to an air pump 24 by a pipe 22. The upper arm compression band 12 has a structure in which an expansion bag made of a soft resin such as soft polyvinyl chloride is accommodated in a cloth-shaped outer bag. The lower limb upper limb blood pressure pulse wave measuring device 10 corresponds to the blood pressure measuring device capable of detecting a pulse wave of the present invention.

  The pressure control valve 18 gradually discharges the pressure in the pressure supply state that allows the supply of pressure into the upper arm compression band 12, the pressure maintenance state that maintains the pressure in the upper arm compression band 12, and the upper arm compression band 12. It is configured so that it can be switched to a four-state state of a gradual-speed exhaust pressure state and a rapid exhaust pressure state in which the inside of the upper arm compression band 12 is rapidly exhausted.

The pressure sensor 16 detects the pressure in the upper arm compression band 12 and supplies a pressure signal SP _B representing the pressure to the static pressure discrimination circuit 26 and the pulse wave discrimination circuit 28, respectively. The static pressure discriminating circuit 26 is provided with a low-pass filter, and the upper arm compression pressure signal SC _B representing the upper arm compression pressure PC _B which is the steady pressure included in the pressure signal SP _B , that is, the compression pressure of the upper arm compression band 12 is valved. Separately, the upper arm compression pressure signal SC _B is supplied to the electronic control unit 30 via an A / D converter (not shown). Pulse-wave filter circuit 28 includes a band-pass filter, through the A / D converter (not shown) the upper arm-pulse-wave signal SM _B to discriminate the brachial pulse wave signal SM _B is a vibration component of the pressure signal SP _B Supply to the electronic control unit 30. Brachial pulse wave signal SM _B to be discriminated by the pulse-wave filter circuit 28, indicative of the pressure vibration i.e. brachial pulse wave in synchronization with the pulsation of the artery through the upper arm generated upper-arm cuff 12.

The ankle compression band 110 is an ankle blood pressure measurement compression band having a structure to be described later, and is a part of the lower limb of the patient, through which three arteries, the posterior tibial artery, radial artery, and anterior tibial artery pass. Attached to the left and right ankles 32, respectively. Here, the ankle compression band 110 corresponds to the compression band of the present invention. A pressure sensor 36 and a pressure control valve 38 are connected to the ankle compression band 110 via a pipe 34. The pressure control valve 38 is further connected to an air pump 42 by a pipe 40. The pressure control valve 38 adjusts the pressure of the high-pressure air supplied from the air pump 42 and supplies it to the ankle compression band 110, or exhausts the air in the ankle compression band 110 for the ankle. The pressure in the compression band 110 is adjusted. The pressure sensor 36 detects the pressure in the ankle compression band 110 and supplies a pressure signal SP _A representing the pressure to the static pressure discrimination circuit 44 and the pulse wave discrimination circuit 46, respectively.

The static pressure discrimination circuit 44 and the pulse wave discrimination circuit 46 have the same configurations as the static pressure discrimination circuit 26 and the pulse wave discrimination circuit 28, respectively. The static pressure discriminating circuit 44 discriminates an ankle compression pressure signal SC _A representing an ankle compression pressure PC _A which is a steady pressure included in the pressure signal SP _A , that is, a compression pressure of the ankle compression band 110, and the ankle compression pressure is discriminated. The signal SC _A is supplied to the electronic control unit 30 via an A / D converter (not shown). Pulse-wave filter circuit 46, the electronic control device 30 via an A / D converter ankle pulse wave signal SM _A is a vibration component by discriminating in frequency (not shown) the ankle pulse wave signal SM _A pressure signal SP _A To supply. The ankle pulse wave signal is discriminated by the pulse-wave filter circuit 46 SM _A represents a pressure vibration That ankle pulse wave in synchronization with the pulsation of the artery through the ankle occur ankle cuff 110.

The vibration sensor 48 corresponding to the detector of the present invention is a general sensor that converts vibration into an electric signal. When the ankle compression band 110 is attached to the ankle 32 that is a pressed portion, the vibration sensor 48 is described later. As shown, the ankle compression band 110 is held on the inner peripheral side so as to be pressed onto the posterior tibial artery of the ankle 32. The vibration sensor 48 is supplied to the Korotkoff sounds pulse-wave filter circuit 50 the heartbeat-synchronous wave signal SV _AR representing the heartbeat-synchronous waves including pulse wave and the Korotkoff sound from the rear tibial artery. The posterior tibial artery corresponds to the artery to be examined according to the present invention.

The Korotkoff sound pulse wave discriminating circuit 50 is a pulse wave band-pass filter for discriminating a pulse wave having a frequency within a range of 0.1 Hz to 15 Hz, and a vibration having a frequency within a range of 30 Hz to 100 Hz. A Korotkoff sound band-pass filter for discriminating Korotkoff sounds. The Korotkoff sound pulse wave discrimination circuit 50 uses an arterial pulse wave signal SM _AR representing a pulse wave propagating through the posterior tibial artery from the heartbeat synchronous wave signal SV _AR supplied from the vibration sensor 48 using the pulse wave bandpass filter. the by discrimination is supplied to the electronic control device 30 via an a / D converter (not shown) the arterial pulse wave signal SM _AR. Further, Korotkoff sounds pulse-wave filter circuit 50, Korotkoff sound signal from the heartbeat synchronization wave signal SV _AR supplied from the vibration sensor 48 by using a band pass filter for the Korotkoff sound representing a Korotkoff sound from the rear tibial artery SK _AR the by discrimination is supplied to the electronic control device 30 via an a / D converter (not shown) the Korotkoff sound signal SK _AR.

The lower limb upper limb blood pressure pulse wave measurement device 10 further includes an input device 52 and an output device 54. The input device 52 includes a plurality of numeric input keys (not shown) for inputting the patient's height T and the like, and supplies a height signal ST representing the input patient's height T to the electronic control device 30. The output device 54 outputs information sent from the electronic control device 30 such as the blood pressure values BP _B and BP _A of the upper arm and an ankle and the pulse wave velocity PWV by printing or screen display.

The electronic control unit 30 is constituted by a so-called microcomputer including a CPU 56, a ROM 58, a RAM 60, an I / O port (not shown), and the like. The CPU 56 executes signal processing using the temporary storage function of the RAM 60 according to a program stored in the ROM 58 in advance, and outputs a drive signal from the I / O port, whereby the pressure control valves 18 and 38, the air pump 24, 42 is controlled. In addition, the CPU 56 executes arithmetic processing based on a signal supplied to the electronic control unit 30 to determine whether or not the posterior tibial artery is occluded, blood pressure values BP _B and BP _A , and lower limb upper limbs The blood pressure index ABI (ABI = BP _A / BP _B ) and the pulse wave velocity PWV are determined, and the determined determination results, the blood pressure values BP _B and BP _A , the lower limb upper limb blood pressure index ABI and the pulse wave velocity PWV are output. Display on the device 54.

  FIG. 2 is a view showing the appearance of the ankle compression band 110. FIG. 3 is a view showing a state in which the outer peripheral side of the ankle compression band 110 is developed. In order to show the internal structure of the ankle compression band 110, the central portion of the figure is a partial cross-sectional view. As shown in FIG. 3, the ankle compression band 110 has a fan-shaped and curved band-like shape in the unfolded state, and is wound around the ankle 32 which is a taper-shaped pressed portion. The ankle compression band 110 is an inner winding portion 114 having a width of about 140 mm that is directly wound around the ankle 32, with the surface fastener 112 provided on the outer peripheral surface, with the central portion in the longitudinal direction as a boundary. On the other hand, a cloth that can be attached to the surface fastener 112 is used on the inner peripheral surface thereof, and the width dimension decreases as the distance from the inner winding portion 114 increases, and the width of the tip is about 90 mm. It is an outer winding part 116 for winding. Then, the inner side of the taper-shaped ankle 32 is positioned so that one side edge that becomes the large-diameter side when positioned in the cylindrical shape of the ankle compression band 110 is positioned on the large-diameter side (calf side). The winding part 114 is wound around the ankle 32, the outer winding part 116 is wound around the outer periphery, and the inner peripheral surface of the outer winding part 116 is attached to the hook-and-loop fastener 112. 110 is fixed. At this time, the ankle compression band 110 follows the shape of the ankle 32 and forms a frustoconical shape in which the circumferential length on one end side is longer than the circumferential length on the other end side.

  As shown in FIG. 3, the exterior of the ankle compression band 110 is constituted by an outer bag 118, and the outer bag 118 has an inner winding part 114 and an outer winding part 116. Then, the outer bag 118 is sewn together with the outer edge cloth 120 that goes around the outer edge of the cloth that forms the inner peripheral surface and the cloth that forms the outer peripheral surface of the outer bag 118, with the respective outer edges substantially aligned. It is formed in a bag shape. As shown in FIG. 3 and FIG. 4, in the inner winding portion 114 of the outer bag 118, these are the outer bag so that the curved plates 122 and 124, the suppression plate 126, and the inflatable bag 128 are arranged in order from the outer peripheral side. 118.

  The restraining plate 126 is made of a flexible resin such as polypropylene having a thickness of about 1 mm, and has a size that can be accommodated in the outer bag 118 over almost the entire inner winding portion 114, as shown in FIGS. It is a fan-shaped and strip-shaped plate. As shown in FIGS. 3 and 5, a plurality of connection holes 130 for connecting the suppression plate 126 and the expansion bag 128 are provided along the side edge of the suppression plate 126 on the one end side of the ankle compression band 110. Is provided. In addition, a plurality of notches 132 cut in the axial direction in which the width dimension becomes larger as approaching the tip of the side edge are provided on the side edge of the restraining plate 126 on the other end side of the ankle compression band 110. .

  As shown in FIGS. 3 and 4, the side edge of the restraint plate 126 provided with the notch 132 is folded back at the tip of the side edge so as to cover the notch 132 from both sides of the restraint plate 126 over the entire length thereof. The elongated cloth 134 is affixed.

  The expansion bag 128 is a fan-shaped belt-like bag having substantially the same outer shape as the suppression plate 126, and is made of a soft resin such as soft polyvinyl chloride having a thickness of about 0.3 mm. In addition, the restraining plate 126 is relatively rigid with respect to the expansion bag 128.

  As shown in FIGS. 3 and 4, the side edge of the inflatable bag 128 on the one end side of the ankle compression band 110 has a longitudinal shape that is sufficiently smaller in width than the restraining plate 126 over its entire length. The side edges of two connecting sheets 136 are fused. A plurality of suppression plates 126 are inserted between the connection sheets 136 so that the expansion bags 128 and the outer periphery thereof are substantially aligned with each other, and pass through the connection holes 130 provided in the suppression plate 126. Thus, the connecting sheets 136 are fused to each other. Thereby, the suppression board 126 and the expansion bag 128 are connected mutually.

  Each of the curved plates 122 and 124 is relatively rigid with respect to the restraining plate 126 and is made of a flexible resin such as polypropylene having a thickness of about 1.5 mm. One of the curved plates 122 has a width dimension of about 50 mm and is arranged on the one end side of the ankle compression band 110, and the other curved plate 124 has a width dimension of 30 mm. However, it is disposed near the other end of the ankle compression band 110 at a position that does not cover the notch 132. A holding sheet 140 made of a soft resin such as soft polyvinyl chloride disposed between the curved plates 122 and 124 and the restraining plate 126 and the outer edge of the outer bag 118 substantially coincides with the outer edge thereof, The outer cloth 142 constituting the outer peripheral surface of the inner winding portion 114 of the bag 118 is melted so as to form an elongate fusion margin 144 at a position outside the both side edges parallel to the longitudinal direction of the curved plates 122 and 124. By wearing, the curved plates 122 and 124 inserted into the outer cloth 142 and the holding sheet 140 are integrally held by the outer bag 118.

  In addition, the curved plate 122 is formed in a cylindrical shape in advance, and the curved plate 124 is formed in a cylindrical shape having an elliptical cross section. Therefore, as shown in FIG. 2, the inner winding portion 114 of the ankle compression band 110 is formed. The one end side has a circular cross section, and the other end side has an oval cross section so as to maintain a substantially cylindrical shape.

  As shown in FIGS. 2 and 3, air is supplied to the cylindrical expansion bag 128 inclined to the other end side of the ankle compression band 110 at an elevation angle of about 20 degrees on the outer peripheral side of the central portion of the expansion bag 128. A connecting pipe 146 for connecting to the pipe 34 to be connected is provided. Then, the connecting pipe 146 passes through the insertion hole 148 provided in the suppression plate 126 shown in FIG. 5, between the two curved plates 122 and 124, and the hole 150 provided in the outer bag 118, and passes through the ankle. It protrudes from the outer peripheral surface of the compression band 110.

  6 is a view showing a state in which the inner peripheral side of the ankle compression band 110 is expanded, and FIG. 7 is a view showing a state in which the ankle compression band 110 is attached to the ankle 32. As shown in FIG. 7, in order to position the vibration sensor 48 with respect to the ankle 32, a mounting mark 152 is provided on a part of the other end side edge of the inner winding portion 114. Further, as shown in FIG. 6, a sensor holding portion 154 for holding the vibration sensor 48 on the ankle compression band 110 is provided on the other inner peripheral end side of the inner winding portion 114 of the outer bag 118. As shown in FIG. 7, the relative positional relationship between the mounting mark 152 and the sensor holding portion 154 is such that the mounting mark 152 is aligned with the upper part of the ankle 156 inside the ankle 32 and the ankle compression band 110 is positioned at the ankle. It is determined that the vibration sensor 48 held by the sensor holding part 154 is positioned closer to the posterior tibial artery than the other two arteries when the sensor is attached to the sensor 32.

  The sensor holding part 154 is a bag-like holding part having the opening on the other end side, and the vibration sensor 48 is inserted into the sensor holding part 154 from the opening so that the vibration sensor 48 is It is held on the other inner peripheral side of the compression band 110 and can be pressed onto the posterior tibial artery.

FIG. 8 is a functional block diagram showing the main part of the control function of the electronic control unit 30. The compression pressure control means 170 determines the upper arm compression pressure PC _B and the ankle compression pressure PC _A based on the upper arm compression pressure signal SC _B and the ankle compression pressure signal SC _A supplied from the static pressure discrimination circuits 26 and 44. Meanwhile, the air pumps 24 and 42 and the pressure control valves 18 and 38 are controlled, and the upper arm compression pressure PC _B and the ankle compression pressure PC _A are respectively set to pressures set in advance higher than the general maximum blood pressure value BP _SYS. The pressure is rapidly increased to the pressure target values PC _BM and PC _AM (for example, 180 mmHg), and then the upper arm compression pressure PC _B and the ankle compression pressure PC _A are respectively gradually decreased at a speed of about 3 to 5 mmHg / sec. Then, after the blood pressure values BP _B and BP _A are determined by the upper arm blood pressure value determining means 172 and the ankle blood pressure value determining means 174 in the deceleration pressure reduction period, the upper arm pressure pressure PC _B and the ankle pressure pressure PC _A are respectively set. Exhaust pressure to atmospheric pressure.

Brachial blood pressure determining means 172, the amplitude of the brachial pulse wave based on the brachial pulse wave signal SM _B sequentially supplied in the process of pressing pressure of the upper-arm cuff 12 by the pressure changing means 170 is brought into the step-down the slow The blood pressure value BP _B in the upper arm portion 14 is determined using a well-known oscillometric method based on the sequential change and the change in the amplitude of the brachial pulse wave sequentially determined in the slow pressure reduction process. This blood pressure value BP _B includes a maximum blood pressure value BP _BSYS , an average blood pressure value BP _BMEAN , and a minimum blood pressure value BP _BDIA of the upper arm portion 14. Then, the blood pressure value BP _B is output to the ABI calculating means 176 described later.

Ankle-blood-pressure determining means 174, the amplitude of the ankle pulse wave based on the ankle pulse wave signal SM _A sequentially supplied in the process of compression pressure of ankle cuff 110 by the pressure changing means 170 is brought into the step-down the slow with successively determined, based on the change in the amplitude of the ankle pulse wave that are successively determined by the slow decreasing process, well known by using the oscillometric method to determine blood pressure values BP _a in the ankle 32. Systolic blood pressure BP _ASYS ankle 32 for this blood pressure value BP _A, mean blood pressure BP _AMEAN, include diastolic blood pressure BP _ADIA. The ankle blood pressure value determining unit 174 outputs the blood pressure value BP _A to the ABI calculating unit 176 described later.

The ABI calculating unit 176 obtains the blood pressure value BP _B and the blood pressure value BP _A from the upper arm blood pressure value determining unit 172 and the ankle blood pressure value determining unit 174, respectively, and divides the blood pressure value BP _A by the blood pressure value BP _B. Lower limb upper limb blood pressure index ABI (= BP _A / BP _B ) is calculated. Then, the blood pressure values BP _B and BP _A and the lower limb upper limb blood pressure index ABI are output to a measured value output means 182 described later.

The ankle pulse wave during blood pressure measurement performed using the oscillometric method is sequentially determined based on the ankle pulse wave signal SM _A when stepped down to a pressure that ankle pressing pressure PC _A by the ankle blood-pressure determining means 174 The amplitude of the ankle pulse wave becomes maximum when the amplitude of the ankle pulse wave increases, and at the same time, when there is blood flow in the posterior tibial artery, the arterial pulse wave signal SM _AR and the Korotkoff sound signal SK The amplitude of _AR is also maximized. Pulse wave velocity calculation means 178, and sequentially acquires the amplitude of the ankle pulse wave from the ankle-blood-pressure determining means 174 calculates the amplitude difference D _AM obtained by subtracting the magnitude of the amplitude of the immediately preceding from the newest amplitude, When the amplitude difference D _AM changes from a positive value to a negative value and the amplitude of the ankle pulse wave changes from increasing to decreasing, that is, when the amplitude of the ankle pulse wave becomes maximum, the brachial pulse wave ( that artery are distinguished by the upper arm-pulse-wave signal SM _B), and the ankle pulse wave (i.e. Korotkoff sound pulse-wave filter circuit 50 from the heartbeat synchronization wave signal SV _AR detected by the vibration sensor 48 is discriminated by the pulse-wave filter circuit 28 Based on the pulse wave signal SM _AR ), the pulse wave propagation velocity PWV is calculated. That is, the time when a predetermined portion such as a rising point or a peak is detected in the brachial pulse wave obtained when the amplitude difference _DAM changes from a positive value to a negative value, and the brachial pulse wave in the ankle pulse wave. The time difference from the time when the part corresponding to the predetermined part is detected is calculated as the pulse wave propagation time DT (sec). The pulse wave propagation time DT calculated here is the time during which the pulse wave propagates from the heart through the aorta to the site where the vibration sensor 48 is worn, and the brachial compression band 12 is worn from the heart through the aorta. This is the time difference from the time that the pulse wave propagates to the site. Then, the patient's height T supplied from the input device 52 is vibrated from the heart through the aorta by substituting it into the following equation (1) which is a prestored relationship between the height T and the distance difference L. A distance difference L between the distance at which the pulse wave propagates to the site where the sensor 48 is worn and the distance at which the pulse wave propagates from the heart to the site where the brachial compression band 12 is worn is obtained. The pulse wave velocity calculating means 178 calculates the pulse wave velocity PWV (cm / sec) by substituting the obtained distance difference L and the pulse wave propagation time DT into the following equation (2). Then, the calculated pulse wave propagation velocity PWV is output to a measured value output means 182 described later.
L = aT + b (1)
(A and b are constants determined based on experiments)
PWV = L / DT (2)

The arterial occlusion determination means 180 determines the arterial pulse wave signal SM of one or more beats discriminated by the Korotkoff sound pulse wave discrimination circuit 50 when the ankle pulse wave amplitude difference D _AM changes from a positive value to a negative value. based on the _AR and Korotkoff sound signal SK _AR (a) that the pulse wave from the tibial artery after the ankle 32 is detected, the two arterial occlusion condition that the Korotkoff sound is detected from the (b) thereafter tibial artery If both are satisfied, it is determined that blood flow exists in the posterior tibial artery, that is, it is subsequently determined that the tibial artery is not occluded. If any of the arterial occlusion conditions is not satisfied, it is determined that there is no blood flow in the posterior tibial artery, that is, thereafter, it is determined that the tibial artery is occluded. Then, the arterial occlusion determination unit 180 outputs the determination result to a measurement value output unit 182 described later. For example, the predetermined determination value artery occlusion determining section 180 corresponds to the arterial pulse wave signal SM _AR prestores a, when the amplitude difference D _AM of the ankle pulse wave changes from a positive value to a negative value when the amplitude of the resultant arterial pulse wave signal SM _AR is the predetermined determination value or more, as the pulse wave is detected, the arterial occlusion determining unit 180 asserts the arterial occlusion condition (a). Similarly to this true for the arterial occlusion condition (b), arterial occlusion determination unit 180 previously stores a predetermined judgment value corresponding to the Korotkoff sound signal SK _AR, amplitude difference D _AM of the ankle pulse wave as but when the amplitude of the Korotkoff sound signal SK _AR obtained when it is from a positive value to a negative value is the predetermined determination value or more, the Korotkoff sound is detected, the arterial occlusion determining section 180 Affirms the arterial occlusion condition (b).

After the measurement of the blood pressure values BP _B and BP _A and the pulse wave velocity PWV is completed, the measurement value output means 182 displays the blood pressure values BP _B and BP _A acquired from the ABI calculation means 176, the lower limb upper limb blood pressure index ABI, and the pulse wave propagation. The pulse wave propagation velocity PWV acquired from the velocity calculation unit 178 and the determination result regarding the occluding of the posterior tibial artery acquired from the artery occlusion determination unit 180 are displayed on the output device 54.

  FIG. 9 is a diagram for explaining the main part of the control operation of the electronic control unit 30 as a flowchart. This flowchart is started by a start button (not shown) on condition that the height signal ST is supplied from the input device 52 in advance.

First, in step (hereinafter abbreviated as “step”) SA1, the pressure control valves 18 and 38 are switched to the pressure supply state, whereby rapid increase in the upper arm compression pressure PC _B and the ankle compression pressure PC _A is started. Based on the upper arm compression pressure signal SC _B and the ankle compression pressure signal SC _A , each of the upper arm compression pressure PC _B and the ankle compression pressure PC _A has reached preset compression pressure target values PC _BM and PC _AM . Determine whether or not. If the determination of whether or not the air pressure has reached is affirmed, the air pumps 24 and 42 corresponding to the upper arm compression pressure PC _B or the ankle compression pressure PC _A are stopped. In the subsequent SA2, the pressure control valves 18 and 38 are switched to the decelerating and exhausting state, so that the upper arm compression pressure PC _B and the ankle compression pressure PC _A are gradually reduced at a rate of about 3 to 5 mmHg / sec. Are started almost simultaneously.

In SA3, systolic blood pressure values of the upper arm pressing pressure PC slow decreasing brachial pulse wave is sequentially determined in the process signal SM upper arm 14 on the basis of a change in the amplitude of the brachial pulse wave _B represents a _B BP _Bsys, mean blood pressure BP _A well-known oscillometric blood pressure measurement algorithm is executed to determine _BMEAN , the minimum blood pressure value BP _BDIA . Similarly, in parallel with the ankle 32 side with this, the systolic blood pressure of the ankle 32 based on a change in the amplitude of the ankle pulse wave represented by the ankle-pulse-wave signal SM _A which is sequentially determined during the slow decreasing of the ankle compression pressure PC _A value BP _ASYS, mean blood pressure BP _AMEAN, for determining a diastolic blood pressure BP _ADIA, blood pressure measurement algorithm of the oscillometric method is executed.

In SA4, the amplitude of the ankle pulse wave whether turned to decrease from increase, that is, whether the amplitude difference D _AM of the ankle pulse wave is a negative value is determined. If the determination is negative, the process proceeds to SA8, and if the determination is affirmative, the process proceeds to SA5. In SA5, the brachial pulse wave signal SM _B supplied from the pulse wave discrimination circuit 28, the arterial pulse wave signal SM _AR and the Korotkoff sound signal SK _AR supplied from the Korotkoff sound pulse wave discrimination circuit 50 are read one by one. It is. Then move to SA6, in SA6, pulse-wave propagation velocity PWV is calculated on the basis of the upper-arm pulse-wave signal SM _B and arterial pulse wave signal SM _AR of the one heartbeat. That is, in SA6, the brachial pulse wave and the ankle pulse wave loaded brachial pulse wave signal SM _B and arterial pulse wave signal SM _AR represents respectively SA5, predetermined predetermined portion (e.g., rising point) are determined respectively Then, the detection time difference between the predetermined part of the brachial pulse wave and the predetermined part of the ankle pulse wave is calculated as the pulse wave propagation time DT, and then the height T of the patient represented by the height signal ST supplied in advance is expressed by the above equation (1). The distance difference L is calculated by substituting into, and the pulse wave propagation speed PWV is calculated by substituting the pulse wave propagation time DT and the distance difference L into the equation (2).

In SA7, (a) a pulse wave is detected from the posterior tibial artery of the ankle 32 based on the arterial pulse wave signal SM _AR and the Korotkoff sound signal SK _AR for one beat, and (b) the Korotkoff sound from the tibial artery thereafter. Is detected, the posterior tibial artery is determined not to be occluded, and if either of the artery occlusion conditions is not satisfied, the posterior tibia The artery is determined to be occluded and the process moves to SA8. For example, when a predetermined determination value corresponding to the arterial pulse wave signal SM _AR is stored in advance in the electronic control unit 30, and the amplitude of the arterial pulse wave signal SM _AR for one beat is equal to or greater than the predetermined determination value If the pulse wave is detected, the arterial occlusion condition (a) is affirmed. Similarly to this true for the arterial occlusion condition (b), when the amplitude of the Korotkoff sound signal SK _AR of the one heartbeat is the predetermined determination value or more corresponding to the Korotkoff sound signal SK _AR is the arterial The blocking condition (b) is affirmed. In this flowchart, SA4 to SA7 correspond to the pulse wave velocity calculation means 178 and the arterial occlusion determination means 180.

In SA8, it is determined whether or not the determination of the blood pressure values BP _B and BP _A is completed in SA3. When this determination is negative, the slow pressure reduction is continued, and when the determination is affirmative, the process proceeds to SA9. In this flowchart, SA3 and SA8 correspond to the upper arm blood pressure value determining means 172 and the ankle blood pressure value determining means 174 as a whole.

In SA9, the air pumps 24 and 42 are stopped, and the pressure control valves 18 and 38 are set in a rapid exhaust pressure state, so that the upper arm compression pressure PC _B and the ankle compression pressure PC _A are discharged to atmospheric pressure. Pressed. In this flowchart, SA1, SA2 and SA9 correspond to the compression pressure control means 170.

In SA10 corresponding to the ABI calculating means 176, the lower limb upper limb blood pressure index ABI (= BP _A / BP _B ) is calculated by dividing the blood pressure value BP _A determined in SA3 by the blood pressure value BP _B.

In SA11 corresponding to the measured value output means 182, the blood pressure values BP _B , BP _A determined in SA3, and the pulse wave velocity PWV calculated in SA6, the determination result about the occlusion of the posterior tibial artery at SA7 The lower limb upper limb blood pressure index ABI calculated in SA10 is displayed from the output device 54. Thereafter, the control operation of this flowchart ends.

The lower limb upper limb blood pressure pulse wave measuring apparatus 10 of the present embodiment has the following effects (1) to (13). (1) According to the present embodiment, the arterial pulse wave signal SM _AR and the Korotkoff sound signal SK _AR that are used to determine the occlusion of the posterior tibial artery during the deceleration reduction of the upper arm compression pressure PC _B and the ankle compression pressure PC _A Therefore, it is possible to determine the occlusion of the posterior tibial artery at the same time as measuring the blood pressure of the ankle by the oscillometric method.

(2) Three arteries such as the posterior tibial artery, radial artery and anterior tibial artery pass through the ankle 32 which is a part of the lower limb of the patient. According to the present embodiment, the vibration sensor 48 is held on the inner peripheral side of the ankle compression band 110 so that the vibration sensor 48 is positioned closer to the posterior tibial artery than the other two arteries. ing. Therefore, when the inflation bladder 128 ankle cuff 110 is mounted on the ankle 32 is inflated, the vibration sensor 48 by the expansion is pressed against the ankle 32, the heartbeat-synchronous wave signal SV _AR supplied from the vibration sensor 48 It is possible to detect an arterial pulse wave signal SM _AR representing a pulse wave propagating through the discriminated posterior tibial artery, and to determine whether the tibial artery is subsequently occluded based on the arterial pulse wave signal SM _AR Can do.

(3) Also, as shown in the flowchart of FIG. 9, after the deceleration reduction of the upper arm compression pressure PC _B and the ankle compression pressure PC _A for oscillometric blood pressure measurement is started in SA2, in SA8 Before the determination of the blood pressure values BP _B and BP _A is completed, the brachial pulse wave signal SM _B , the arterial pulse wave signal SM _AR and the Korotkoff sound signal SK _AR are read in SA5. In addition to the time required for reading the signals SM _B , SM _AR , and SK _AR , no extra measurement time is required, and the compression bands 10 and 110 need only be attached once, and the blood pressure measurement can be performed easily. And reading of the above three signals SM _B , SM _AR , and SK _AR .

  (4) FIG. 10 is a diagram schematically showing a cross section in the axial direction when the ankle compression band 110 is attached to the ankle 32 having a tapered shape. In FIG. 10, unnecessary members are not shown in order to explain the effects of the present embodiment. As shown in FIG. 10, when the inflatable bag 128 is inflated with the ankle compression band 110 wound around the ankle 32 and the ankle compression band 110 compresses the ankle 32, the taper of the ankle 32 with respect to the compression is increased. Since the reaction force 200 perpendicular to the outer peripheral surface having the shape has the axial component 202 directed to the other end side, the ankle compression band 110 tends to shift to the other end side. In that case, since the inner peripheral surface of the outer bag 118 is pressed against the ankle 32, the friction force generated between the ankle 32 and the inner peripheral surface of the outer bag 118 causes them to slide with each other. However, as shown by an arrow J, the outer circumferential side of the outer bag 118 is deformed so as to be wound around the inner circumferential side at the other end of the ankle compression band 110. Further, the outer peripheral side of the outer bag 118 moves integrally with the restraining plate 126 by the frictional force generated between them. However, in the ankle compression band 110, the notch 132 cut in the axial direction is provided at a plurality of locations on the other end side edge of the restraining plate 126, and the restraint is suppressed when the inflatable bag 128 is inflated. The other end side edge of the plate 126 is pressed against the outer bag 118, and the other end side edge of the restraining plate 126 can be deformed to the inner peripheral side. Accordingly, when the expansion bag 128 is inflated, the other end side edge of the suppression plate 126 is already deformed to the inner peripheral side by being pressed by the outer bag 118. It becomes difficult to be wound further into the inner peripheral side, and the suppression plate 126 prevents the above-described winding deformation of the outer bag 118 from proceeding. As a result, in the ankle compression band 110, the wearing position is prevented from shifting.

  The above effect will be described in more detail. A plurality of notches 132 are provided on the side edge of the restraining plate 126 on the other end side of the ankle compression band 110, and the thickness of the restraining plate 126 is as thin as about 1 mm. Has sufficient flexibility. The curved plate 124 inserted between the outer cloth 142 and the suppression plate 126 is disposed so as not to cover the notch 132. Accordingly, as shown in FIG. 10, when the ankle compression band 110 is wound around the tapered ankle 32 and the inflatable bag 128 is inflated, the side edge of the restraining plate 126 is covered by the outer cloth 142 on the other end side. Is pressed toward the expanded bag 128 and deformed toward the ankle 32 so as to be in close contact with the expanded bag 128. Then, the side edge of the restraining plate 126 that is deformed so as to be in close contact with the expansion bag 128 on the other end side is higher in rigidity than the expansion bag 128, so that the radius of curvature of the expansion bag 128 having a small curvature radius It cannot be deformed so as to be wound from the outer peripheral side to the inner peripheral side beyond the other end side, and the suppression plate 126 prevents the winding deformation of the outer bag 118 from proceeding. As a result, in the ankle compression band 110, the wearing position is prevented from shifting.

(5) In the ankle compression band 110, the vibration sensor 48 is held at the other end on the inner periphery of the outer bag 118, so that the vibration sensor 48 is pressed against the ankle 32 by the above-described winding deformation of the outer bag 118, A sufficiently large arterial pulse wave signal SM _AR and Korotkoff sound signal SK _AR can be obtained. In addition, since the vibration sensor 48 is positioned closer to the posterior tibial artery than the other two arteries, the vibration sensor 48 is hardly affected by pulse waves and Korotkoff sounds from the other two arteries. The arterial pulse wave signal SM _AR and the Korotkoff sound signal SK _AR can be obtained.

  (6) The flexible curved plates 122 and 124, which are housed in the outer bag 118 so as to be positioned on the outer peripheral side of the restraining plate 126 and have a higher rigidity than the restraining plate 126, are compressed by ankles. Since the belt 110 is provided, the ankle compression belt 110 before wearing is deformed into a cylindrical shape according to the shape of the curved plates 122 and 124. Therefore, when the ankle compression band 110 is wound around the ankle 32, the operation can be easily performed.

  (7) In order to deform the ankle compression band 110 into a cylindrical shape in order to facilitate the above work, the curved plates 122 and 124 need to have a certain degree of rigidity. In the ankle compression band 110, the curved plates 122 and 124 have the function of deforming the ankle compression band 110 before mounting. Therefore, the suppression plate 126 does not need to perform the function. When the expansion bag 128 is inflated to some extent, the other end side edge of the restraining plate 126 is pressed against the outer bag 118, and the other end side edge of the restraining plate 126 is the inner periphery. It can be easily deformed to the side. As a result, as compared with the case where the curved plates 122 and 124 are not provided, the vibration sensor 48 can be pressed more strongly against the ankle 32 by the wrapping deformation of the outer bag 118 on the other end side in the ankle compression band 110.

  (8) In the ankle compression band 110, the suppression plate 126 has one side edge connected to the expansion bag 128 via the connection sheet 136, and the suppression plate 126 is relatively rigid as compared to the expansion bag 128. Therefore, the expansion bag 128 is stored in the outer bag 118 along the suppression plate 126, and the expansion bag 128 can be prevented from being bent in the outer bag 118.

  (9) In the ankle compression band 110, since the curved plates 122 and 124 are integrally provided inside the outer bag 118, the positions of the curved plates 122 and 124 in the ankle compression band 110 are maintained. be able to. In addition, since the curved plate 124 is disposed so as not to cover the notch 132 of the suppression plate 126, the other side edge of the suppression plate 126 is expanded by the outer cloth 142 when the expansion bag 128 is expanded. The curved plate 124 does not prevent it from being pressed against the expansion bag 128.

(10) As shown in FIG. 3, the ankle compression band 110 has a fan-shaped and curved band-like shape in the unfolded state. Therefore, in the state of being wound in a cylindrical shape, the ankle compression band 110 is The circumference of the one end side forms a frustoconical shape longer than the circumference of the other end side, and the ankle compression band 110 can be wrapped around the ankle 32 following the tapered ankle 32. , the vibration sensor 48 and an expansion bladder 128 is inflated is pressed against the ankle 32, it is possible to obtain the arterial pulse wave signal SM _AR of sufficient size and the Korotkoff sound signal SK _AR.

(11) In the ankle compression band 110, the curved plate 122 is formed in a cylindrical shape in advance, and the curved plate 124 is formed in a cylindrical shape having an elliptical cross section. In the conical shape, the one end side has a circular cross section, and the other end side has an elliptical cross section. Accordingly, the ankle compression band 110 is wound so that the one end side is located on the calf side of the ankle 32 and the other end side is located on the heel side, so that the ankle compression band is imitated according to the outer shape of the ankle 32. can be wound 110, the vibration sensor 48 and an expansion bladder 128 is inflated is pressed against the ankle 32, it is possible to obtain the arterial pulse wave signal SM _AR of sufficient size and the Korotkoff sound signal SK _AR.

(12) In the lower limb upper limb blood pressure pulse wave measurement device 10, (a) a pulse wave is detected from the posterior tibial artery of the ankle 32 based on the arterial pulse wave signal SM _AR and the Korotkoff sound signal SK _AR ; When both of the two arterial occlusion conditions of detecting Korotkoff sounds from the tibial artery are satisfied, it is determined that the posterior tibial artery is not occluded, and any of the above arterial occlusion conditions is not satisfied Is determined to be occluded by the posterior tibial artery. Therefore, when it is subsequently determined whether or not the tibial artery is occluded, compared to the case where the arterial occlusion determination is made based on only one of the pulse wave or the Korotkoff sound, It is possible to prevent an erroneous determination of the arterial occlusion due to a disturbance caused by a measurement person's action and the like, and to make an accurate determination of the arterial occlusion.

(13) Generally, in blood pressure measurement using the oscillometric method, when the amplitude of the pulse wave from the compression site changes from increase to decrease during the deceleration reduction of the compression pressure of the compression band, The amplitude of the pulse wave and the amplitude of the Korotkoff sound are the largest. At this point, the brachial pulse wave signal SM _B , the arterial pulse wave signal SM _AR and the Korotkoff sound signal SK _AR for calculating the pulse wave velocity PWV and determining the occlusion of the posterior tibial artery are the amplitude difference D _AM Is read from the positive value, that is, when the amplitude of the pulse wave from the ankle 32, which is the pressed portion, changes from increasing to decreasing, the pulse wave velocity calculating means 178 and the artery The occlusion determination means 180 can acquire a sufficiently large brachial pulse wave signal SM _B , arterial pulse wave signal SM _AR and Korotkoff sound signal SK _AR , and accurately calculate the pulse wave propagation velocity PWV and the artery. Blockage can be determined.

  As mentioned above, although the Example of this invention was described in detail based on drawing, this is an embodiment to the last, and this invention is applied also in another aspect.

  For example, in the present embodiment, the upper arm compression band 12 and the ankle compression band 110 are attached to the upper arm and the ankle, respectively, and blood pressure measurement and the like are performed. It may be a part of the upper limb, and for example, a corresponding compression band may be attached to the finger of the hand.

  The vibration sensor 48 is a sensor for detecting a pulse wave and Korotkoff sound from the posterior tibial artery. When it is desired to determine whether another artery, for example, the radial artery is occluded, the vibration sensor 48 is used. 48 may be positioned on the radial artery closer to the other two arteries.

  In the ankle compression band 110, the sensor holding part 154 is a bag-like holding part. For example, the sensor holding part 154 is made of a cloth that can attach the inner peripheral surface of the outer bag 118 to a hook-and-loop fastener, and the vibration sensor 48. The vibration sensor 48 may be held by the ankle compression band 110 by providing a surface fastener and attaching the vibration sensor 48 to the inner peripheral surface.

  In FIG. 6, the vibration sensor 48 is held on the inner peripheral surface of the outer bag 118. For example, if the inner side is closer to the expansion bag 128, the vibration sensor 48 is stored in the outer bag 118, The vibration sensor 48 may be held.

  Further, the lower limb upper limb blood pressure pulse wave measuring device 10 of the present embodiment includes the upper arm compression band 12 and the ankle compression band 110, but does not calculate the lower limb upper limb blood pressure index ABI and the pulse wave velocity PWV. For example, the upper arm compression band 12 may be omitted.

Further, according to the flowchart of FIG. 9, in the slow decreasing of the upper arm pressing pressure PC _B and ankle pressing pressure PC _A for blood pressure measurement, the determination of blockage of the calculation and posterior tibial artery pulse wave velocity PWV Therefore, reading of the brachial pulse wave signal SM _B , the arterial pulse wave signal SM _AR and the Korotkoff sound signal SK _AR is executed, but the reading of the signals is performed at SA1 in the upper arm compression pressure PC _B and the ankle compression pressure PC _A. May be executed before the rapid pressure increase is performed, or after the blood pressure values BP _B and BP _A are determined.

In addition, during the slow reduction of the upper arm compression pressure PC _B and the ankle compression pressure PC _A for blood pressure measurement, the calculation of the pulse wave velocity PWV at SA6 and the determination of the occlusion of the posterior tibial artery at SA7 are executed. However, signal information of the brachial pulse wave signal SM _B , the arterial pulse wave signal SM _AR and the Korotkoff sound signal SK _AR is stored in the RAM 60 to calculate the pulse wave velocity PWV and to determine the occlusion of the posterior tibial artery. May be executed after the blood pressure values BP _B and BP _A are determined.

In SA6, the pulse wave velocity PWV is calculated based on the brachial pulse wave signal SM _B and the arterial pulse wave signal SM _AR , but is discriminated by the brachial pulse wave signal SM _B and the Korotkoff sound pulse wave discrimination circuit 50. pulse-wave propagation velocity PWV based on the Korotkoff sound signal SK _AR may be calculated.

  In SA7, the posterior tibial artery is based on two arterial occlusion conditions: (a) a pulse wave is detected from the posterior tibial artery of the ankle 32; and (b) a Korotkoff sound is subsequently detected from the tibia artery. However, the above determination may be made based on only one of the arterial occlusion conditions (a) and (b).

Also, the brachial pulse wave signal SM _B , the arterial pulse wave signal SM _AR and the Korotkoff sound signal SK _AR used for the calculation of the pulse wave velocity PWV in SA 6 and the determination of the arterial occlusion condition in SA 7 are read. When the amplitude difference _DAM is changed from a positive value to a negative value, that is, when the amplitude of the ankle pulse wave is maximized, for example, the amplitude of the ankle pulse wave exceeds a predetermined reference value. At this time, the three signals SM _B , SM _AR , and SK _AR may be read.

In this embodiment, the amplitude used to determine when the three signals SM _B , SM _AR , and SK _AR used for calculating the pulse wave velocity PWV and determining the arterial occlusion condition are read. The difference D _AM is determined based on the ankle pulse wave signal SM _A discriminated by the pulse wave discriminating circuit 46. The arterial pulse wave signal SM _AR and the Korotkoff sound signal SK discriminated by the Korotkoff sound pulse wave discriminating circuit 50 are determined. it may be determined based on the _AR or pulse-wave filter circuit 28 brachial pulse wave signal SM _B which is discriminated by.

  In addition to the vibration sensor 48 corresponding to the posterior tibial artery, for example, a vibration sensor corresponding to the radial artery may be provided to determine whether or not the radial artery is occluded.

The vibration sensor 48, because the sensor for obtaining the Korotkoff sound signal SK _AR representative of the arterial pulse wave signal SM _AR and Korotkoff sounds representing a pulse wave from the rear tibial artery, as long as the resulting these signals For example, a pressure sensor may be used. Further, these signals SM _AR and SK _AR do not need to be obtained from one sensor, and sensors corresponding to the respective signals SM _AR and SK _AR may be provided.

Further, according to this embodiment, it provided separately Korotkoff sound pulse-wave filter circuit 50 includes an electronic control unit 30, the electronic control unit 30 to obtain the arterial pulse wave signal SM _AR and Korotkoff sound signal SK _AR, for example, with an electronic control unit 30 is a digital filter, heartbeat-synchronous wave signal SV _AR is supplied to the electronic control device 30 via an a / D converter, the heartbeat-synchronous wave signal SV _AR electronic controller 30 the digital A filter may be used to discriminate between the arterial pulse wave signal SM _AR and the Korotkoff sound signal SK _AR .

  In the ankle compression band 110, the curved plates 122 and 124 are inserted into the outer cloth 142 and the holding sheet 140 and fused together to be held integrally with the outer bag 118. Other methods such as bonding the curved plates 122 and 124 to the outer bag 118 may be used. Further, the curved plates 122 and 124 may be held with respect to the suppression plate 126 instead of the outer bag 118.

  Further, the ankle compression band 110 is a fan-shaped and curved band shape in the deployed state, but may be a linear band-shaped compression band.

  The ankle compression band 110 includes two curved plates 122 and 124. However, the curved plate may be one or both.

  In this embodiment, the ankle compression band 110 is attached to the ankle 32 with the attachment mark 152 aligned with the upper part of the heel 156 inside the ankle 32, so that the vibration sensor 48 is placed on the posterior tibial artery. For example, the ankle compression band 110 is attached to the ankle 32 with the end edge of the inner winding portion 114 aligned with one part of the living body, and the vibration sensor is adjusted accordingly. The position where 48 is held by the ankle compression band 110 may be determined, and the above-described positioning of the vibration sensor 48 may be performed.

In the present embodiment, the brachial blood pressure value determining means 172 and the ankle blood pressure value determining means 174 determine the blood pressure values BP _B and BP _A using the oscillometric method based on the change in the amplitude of the pulse wave. The blood pressure values BP _B and BP _A may be determined using an oscillometric method based on changes in the integral value, that is, changes in the area of the surface formed by the pulse wave graph on the time axis.

It is a block diagram explaining the structure of the lower-limbs upper-limb blood pressure pulse wave measurement device to which the present invention is applied. It is a figure which shows the external appearance of the compression band for an ankle with which the lower-limbs upper-limb blood pressure pulse wave measuring device of FIG. It is a figure which shows the state which expand | deployed the outer peripheral side of the compression band for ankles of FIG. Moreover, in order to show the internal structure of the compression band, the central part of the figure is a partial sectional view. FIG. 4 is a sectional view taken along line IV-IV in FIG. 3. It is a figure which shows the suppression board single item used for the ankle compression belt of FIG. It is a figure which shows the state which expand | deployed the inner peripheral side of the compression band for ankles of FIG. It is a figure which shows the state which mounted | wore the ankle with the ankle compression belt of FIG. As an example, the left ankle is shown as the ankle. It is a functional block diagram which shows the principal part of the control function of the electronic control apparatus of FIG. It is a figure for making the principal part of the control action of the electronic controller of Drawing 1 into a flowchart, and explaining. It is the figure which represented typically the axial direction cross section when the compression belt for ankles of FIG. 2 was mounted | worn with the taper-shaped ankle. Note that unnecessary members are not shown in order to explain the effects of the embodiment.

Explanation of symbols

10: Upper limb blood pressure pulse wave measurement device (blood pressure measurement device)
32: Ankle 48: Vibration sensor (detector)
50: Korotkoff sound pulse wave discrimination circuit 110: ankle compression band (compression band) 118: outer bag 122, 124: curved plate 126: suppression plate 128: inflation bag 132: notch 180: arterial occlusion determination means

Claims (7)

A compression band wound around an ankle of a living body through which a plurality of arteries pass, and by expanding the compression band and compressing the ankle, the ankle is oscillometrically based on a change in pressure vibration generated in the compression band A blood pressure measuring device for measuring blood pressure of
A detector for detecting, during the blood pressure measurement, a heartbeat synchronization wave generated from an artery to be examined, which is one of the plurality of arteries, is provided in the compression band ;
Both the Korotkoff sound and the pulse wave of the inspected artery can be detected from the heartbeat synchronous wave detected by the detector, and the Korotkoff sound pulse wave discriminating circuit for discriminating each is detected by both the Korotkoff sound and the pulse wave. A blood pressure measuring apparatus capable of detecting a pulse wave , comprising: an arterial occlusion determining unit that determines that blood flow exists in the artery to be examined . The blood pressure measurement capable of detecting a pulse wave according to claim 1 , wherein the arterial occlusion determination means uses the Korotkoff sound and the pulse wave when the pressure vibration generated in the compression band is a maximum value section. apparatus. The compression band is disposed on the outer circumferential side of the inflatable bag and the outer circumferential side of the inflatable bag to suppress expansion to the outer circumferential side of the inflatable bag, and is cut in the axial direction at a plurality of locations on the other end side edge. A relatively high-rigidity flexible restraining plate provided with a notch, and a flexible plastic plate disposed on the outer peripheral side of the restraining plate and having a higher rigidity than the restraining plate. The other end side edge of the restraining plate when the inflating bag is inflated. The other end side edge of the restraining plate can be deformed to the inner peripheral side,
Wherein as the detector closer than other arteries inspected artery is positioned, the detector is in claim 2, characterized in that provided on the inner peripheral end side of the cuff A blood pressure measuring device capable of detecting the described pulse wave. The blood pressure measuring device capable of detecting a pulse wave according to claim 3 , wherein one side edge portion of the suppression plate is connected to the expansion bag. The blood pressure measuring device capable of detecting a pulse wave according to claim 4 , wherein the curved plate is integrally provided inside the outer bag. The compression band has a shape in which a side edge is curved in a state where it is flattened and a frustoconical shape in which the circumference on one end side is longer than the circumference on the other end side when wound in a cylindrical shape. The blood pressure measurement device capable of detecting a pulse wave according to claim 5 . The curved plate is composed of two plates, one of which is formed in a cylindrical shape and disposed on the one end side, and the other plate is formed in a cylindrical shape having an elliptical cross section. The blood pressure measuring device capable of detecting a pulse wave according to claim 6 , wherein the blood pressure measuring device is disposed on the other end side.

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