JP5095463B2 - Biological information measuring device - Google Patents

Description

  The present invention relates to a biological information measuring device, and more particularly to a biological information measuring device capable of oscillometric blood pressure measurement.

  The oscillometric blood pressure measurement is one of the general blood pressure measurement techniques, and is used not only for the blood pressure examination of the subject but also for the examination of the degree of arteriosclerosis of the subject. In this blood pressure measurement method, a blood vessel is compressed by a cuff wound around the arm or leg of the subject, and the blood pressure of the subject is determined based on the pulse wave amplitude and the cuff pressure (atmospheric pressure inside the cuff) detected at that time. Determine.

In a sphygmomanometer that performs blood pressure determination based on the pulse wave amplitude and cuff pressure during cuff decompression (ie, during exhaust from the cuff) (see, for example, Patent Document 1), the maximum blood pressure is determined in the process of increasing the amplitude of the pulse wave. The diastolic blood pressure is determined in the process of decreasing the amplitude of the pulse wave. Further, in a sphygmomanometer (for example, see Patent Document 2) that performs blood pressure determination based on the pulse wave amplitude and the cuff pressure during cuff pressurization (that is, during air supply to the cuff), the lowest is the process in which the pulse wave amplitude increases. The blood pressure is determined, and the systolic blood pressure is determined in the process in which the pulse wave amplitude decreases.
JP 2006-75437 A JP 2001-204698 A

  By the way, depending on the subject, the blood vessel at the measurement site may be hardened due to, for example, calcification. In this case, elastic deformation of the blood vessel is difficult to occur. Therefore, in the oscillometric blood pressure measurement, the cuff pressure required to cause stenosis or occlusion of the blood vessel increases, and therefore the measured blood pressure value tends to be higher than the actual blood pressure value.

  However, in the above-described conventional sphygmomanometer that performs oscillometric blood pressure measurement, it is not possible to determine the presence or absence of vascular calcification. There is a problem that it is not possible and therefore not suitable for use against those who develop vascular calcification.

  This invention is made | formed in view of this point, and it aims at providing the biometric information measuring apparatus suitable for the use with respect to the onset person of vascular calcification.

  The biological information measuring apparatus according to the present invention is configured to determine a difference between a measurement unit that measures blood pressure during pressurization and decompression of the cuff pressure, and a value of the blood pressure measured during pressurization and decompression of the cuff pressure. And a display unit that displays information indicating the possibility of blood vessel calcification when there is the difference as a result of the determination.

  ADVANTAGE OF THE INVENTION According to this invention, the biometric information measurement result suitable for the use with respect to the onset person of vascular calcification can be provided.

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

  FIG. 1 is a diagram showing a configuration of a blood pressure pulse wave inspection apparatus according to an embodiment of the present invention.

  The blood pressure pulse wave test apparatus in FIG. 1 includes an arithmetic control unit 10, a blood pressure pulse wave measurement unit 20, a heart sound measurement unit 30, an electrocardiogram measurement unit 40, a pulse wave measurement unit 50, a display unit 70, a recording unit 75, In addition to the storage unit 80, the sound generation unit 85, and the operation unit 90, the hose 22a, the cuff 21a for the left arm, the cuff 21b for the right arm, the cuff 21c for the left leg, and the cuff 21d for the right leg are respectively attached to the apparatus body. 22b, 22c, 22d, connected to the heart sound microphone 31, connected to the electrocardiogram electrode part 41a for the extremities and the electrocardiogram electrode part 41b for the chest, and connected to the pulse wave sensors 51a, 51b. Is.

  The arithmetic control unit 10 includes an arithmetic processing device and a storage device, and will be described below by executing a control program stored in the storage device in advance according to an input signal from the operation unit 90. The operation of the entire apparatus is controlled to realize each function of the blood pressure pulse wave inspection apparatus.

  The arithmetic control unit 10 executes measurement of a blood pressure pulse wave measurement unit 20, a heart sound measurement unit 30, an electrocardiogram measurement unit 40, and a pulse wave measurement unit 50 (hereinafter collectively referred to as “biological information measurement unit”) that measure various biological information. The timing is controlled, and digital data (biological data) indicating the measurement result of the biological information is received from each biological information measuring unit. The arithmetic control unit 10 stores the received biological data as readable data in the storage unit 80.

  The arithmetic control unit 10 converts the received biometric data into display data or print data for display or printing on the display unit 70 or the recording unit 75 as visual information such as characters and waveforms. The data for printing or the data for printing is output to the display unit 70 or the recording unit 75. The biometric data to be converted may be read from the storage unit 80.

  Further, when the blood vessel calcification determination data, which will be described later, is received from the blood pressure pulse wave measurement unit 20 together with the blood pressure data, the arithmetic control unit 10 uses the received blood vessel calcification determination data as visual information such as characters. The data is converted into display data or print data to be displayed or printed on the display unit 70 or the recording unit 75, and the display data or print data is output to the display unit 70 or the recording unit 75.

  In addition, the arithmetic control unit 10 performs waveform analysis such as feature point detection on the received or read biological data, or evaluates arteriosclerosis based on the result of the waveform analysis. (For example, ABI (Ankle Brachial Index), PWV (Pulse Wave Velocity), CAVI (Cardio-Ankle Vascular Index), etc.). The arithmetic control unit 10 converts the waveform analysis result and the arteriosclerosis evaluation index into display data or print data in the same manner as the biological data, and outputs the display data or print data to the display unit 70 or the recording unit 75. .

  Further, the arithmetic control unit 10 outputs guidance data to the voice generation unit 85 when voice guidance for assisting the user's operation is necessary.

  The display unit 70 is a display device such as an LCD (Liquid Crystal Display), for example, and in accordance with display data input from the arithmetic control unit 10, measurement results of biological information, vascular calcification determination results, waveform analysis results, and arteriosclerosis The evaluation index is displayed on the screen as visual information such as characters and waveforms.

  The recording unit 75 is a printer, and in accordance with the printing data input from the arithmetic control unit 10, the measurement result of biological information, the vascular calcification determination result, the waveform analysis result, and the arteriosclerosis evaluation index are visually displayed as characters or waveforms Print on paper as useful information.

  The storage unit 80 is a storage device and can hold biometric data input from the arithmetic control unit 10.

  The sound generation unit 85 is a speaker, and outputs a guidance sound according to the guidance data input from the arithmetic control unit 10.

  The operation unit 90 is an input device such as a keyboard, a mouse, a button, or a touch panel. The operation unit 90 generates an input signal so that a measurement operation or a display / printing operation is executed according to a user (inspector) operation, and the arithmetic control unit 10. Output to.

  The pulse wave measurement unit 50 includes an amplifier, a filter, and an A / D (analog / digital) converter (none of which are shown), and is attached to, for example, a carotid artery portion and a hip artery portion of a subject. The detection signals from the amorphous pulse wave sensors 51a and 51b are subjected to signal processing such as amplification, high-frequency noise removal, and A / D conversion, and the digital data after the signal processing is supplied to the arithmetic control unit 10 as pulse wave data. . The pulse wave measurement by the pulse wave measurement unit 50 is preferably used when the calculation control unit 10 obtains the aorta PWV.

  The electrocardiogram measurement unit 40 includes an amplifier, a filter, and an A / D (analog / digital) converter (none of which are shown), and an electrocardiogram electrode unit 41a attached to the limb and chest of the subject, The detection signal by 41b is subjected to signal processing such as amplification, high-frequency noise removal, and A / D conversion, and the digital data after the signal processing is supplied to the arithmetic control unit 10 as electrocardiogram data.

  The heart sound measuring unit 30 includes an amplifier, a filter, and an A / D (analog / digital) converter (none of which is shown), and detects a detection signal from a heart sound microphone 31 attached to, for example, the apex of the subject. On the other hand, signal processing such as amplification, high-frequency noise removal, and A / D conversion is performed, and the digital data after the signal processing is supplied to the arithmetic control unit 10 as heart sound data.

  The blood pressure pulse wave measurement unit 20 as a measurement unit and a determination unit includes an amplifier, a filter, and an A / D (analog / digital) converter (none of which are shown), and the left arm, right arm, and left of the subject. Cuff pressure data is obtained by performing signal processing such as amplification, high-frequency noise removal, and A / D conversion on detection signals from the cuffs 21a to 21d attached to the leg and the right leg, respectively. The blood pressure pulse wave measurement unit 20 includes a pump 24a to 24d, exhaust valves 25a to 25d, pressure sensors 26a to 26d, conduits 27a to 27d, control programs for the pumps 24a to 24d and exhaust valves 25a to 25d, and blood pressure. An arithmetic processing device (not shown) for executing a program for determination processing and a storage device (not shown) for storing these programs are further included. When obtaining cuff pressure data, the pumps 24a to 24 24d and the exhaust valves 25a to 25d are controlled. Here, the detection signals by the cuffs 21a to 21d are signals indicating the air pressure inside the air bags 211a to 211d of the cuffs 21a to 21d, and are detected by the pressure sensors 26a to 26d. In the case of pulse wave measurement, the blood pressure pulse wave measurement unit 20 supplies, for example, left arm or right arm cuff pressure data to the arithmetic control unit 10 as pulse wave data, and in the case of blood pressure measurement, cuff pressure data of each limb. The blood pressure is determined for the blood pressure, and the result is supplied to the arithmetic control unit 10 as blood pressure data. The blood pressure pulse wave measurement unit 20 also performs vascular calcification determination when performing blood pressure determination. When the onset of vascular calcification is recognized by this determination, the blood pressure pulse wave measurement unit 20 calculates a calcification index representing the degree of vascular calcification, and controls the vascular calcification determination data indicating this together with the blood pressure data. Supplied to the unit 10. The vascular calcification determination will be described more specifically later.

  The pump 24a supplies air to the inside of the air bag 211a of the cuff 21a via the conduit 27a and the hose 22a that are in fluid communication, according to the control of the blood pressure pulse wave measurement unit 20, and thereby the cuff pressure (that is, the air bag). The air pressure inside 211a is increased. The configuration of the pumps 24b to 24d is the same as that of the pump 24a.

  The exhaust valve 25a is, for example, an electromagnetic valve, and is provided in the conduit 27a. The opening degree of the exhaust valve 25a is adjusted according to the control of the blood pressure pulse wave measurement unit 20, and the exhaust valve 25a prevents the air in the air bag 211a from being exhausted when the valve is closed, and exhausts the air in the air bag 211a when the valve is opened. To do. The configuration of the exhaust valves 25b to 25d is the same as that of the exhaust valve 25a.

  Hereinafter, the blood vessel calcification determination operation will be described with reference to FIG. Here, a case where the cuff 21c is wound around and fixed to the left leg of the subject and blood pressure determination and vascular calcification determination are performed on the left leg will be described as an example.

First, in step S10, the blood pressure pulse wave measurement unit 20 performs primary blood pressure measurement. The primary blood pressure measurement is performed when the air supply to the air bladder 211c is performed by completely closing the exhaust valve 25c and operating the pump 24c, that is, at the time of cuff pressurization. In the primary blood pressure measurement, the cuff pressure of the cuff 21c when the amplitude of the pulse wave becomes maximum during cuff pressurization is acquired as the measurement value MBP ₁ of the average blood pressure of the left leg, and the amplitude of the pulse wave increases to the maximum amplitude. The cuff pressure of the cuff 21c when rapidly increasing in the process is acquired as a measured value SBP ₁ of the minimum blood pressure of the left leg, and the cuff pressure of the cuff 21c when rapidly decreasing in the process of decreasing the amplitude of the pulse wave from the maximum amplitude is left Acquired as a measured value DBP ₁ of the systolic blood pressure of the leg. The cuff pressurization is stopped when the cuff pressure rises to a preset value. The cuff pressurization may be stopped by using the measurement value of the maximum blood pressure as a trigger.

After completing the primary blood pressure measurement in step S10, in step S20, the blood pressure pulse wave measurement unit 20 performs secondary blood pressure measurement. The secondary blood pressure measurement is performed when exhaust from the air bag 211c is performed by performing control to open the exhaust valve 25c to a non-fully opened state, that is, when the cuff is decompressed. In the secondary blood pressure measurement, the cuff pressure of the cuff 21c at the time when the amplitude of the pulse wave becomes maximum during the cuff decompression is acquired as the measurement value MBP ₂ of the average blood pressure of the left leg, and the amplitude of the pulse wave increases to the maximum amplitude. The cuff pressure of the cuff 21c at the time of sudden increase in the process is acquired as the measurement value DBP ₂ of the maximum blood pressure of the left leg, and the cuff pressure of the cuff 21c at the time of sudden decrease in the process of decreasing the amplitude of the pulse wave from the maximum amplitude is Acquired as a measured value SBP ₂ of the minimum blood pressure of the leg. The cuff pressure reduction is stopped when the cuff pressure drops to a preset value. The stop of the cuff decompression may be executed with the acquisition of the measured value of the minimum blood pressure as a trigger.

  Here, examples of the results of primary blood pressure measurement (that is, blood pressure measurement during cuff pressurization) are shown in FIGS. 3B and 4B, and secondary blood pressure measurement (that is, blood pressure measurement during cuff decompression). ) Shows an example of the results of FIG. 3 (a) and FIG. 4 (a), respectively. As shown in these examples, the variation of the pulse wave amplitude is not the same between the cuff pressurization and the cuff decompression. Moreover, this non-identity becomes so remarkable that hardening by the calcification of the blood vessel progresses. The present inventor has arrived at the present invention as a result of paying attention to the non-identity of the fluctuation mode of the pulse wave amplitude between the cuff pressurization and the cuff decompression. The blood pressure calcification determination using the example shown in FIGS. 3 and 4 will be described in detail later.

After the completion of the secondary blood pressure measurement in step S20, in step S30, the blood pressure pulse wave measurement unit 20 calculates the difference d between the measured values SBP ₁ and SBP ₂ of the minimum blood pressure.

In step S40, the blood pressure pulse wave measurement unit 20 determines, for example, the possibility of the onset of vascular calcification by comparing the calculated difference d with a predetermined value. If the calculated difference d is greater than or equal to a predetermined value, that is, if there is a significant difference between the measured values SBP ₁ and SBP ₂ of the minimum blood pressure, there is a possibility that vascular calcification has developed in the left leg of the subject. Judge that there is. When the calculated difference d is less than a predetermined value, that is, when there is no significant difference between the measured values SBP ₁ and SBP ₂ of the minimum blood pressure, there is a possibility that vascular calcification has developed in the left leg of the subject. Judge that there is no.

When it is determined that there is a possibility of blood vessel calcification, the process proceeds to step S50, and the blood pressure pulse wave measurement unit 20 calculates the calcification index CS from the difference d between the measured values SBP ₁ and SBP ₂ .

In step S60, the blood pressure pulse wave measurement unit 20 substitutes, for example, the measured values SBP ₁ and SBP ₂ and the difference d thereof into a predetermined mathematical formula to obtain the determination value SBP of the minimum blood pressure as the measured value SBP ₁ , Calculated as the SBP ₂ correction value. The diastolic blood pressure determination value SBP obtained in this manner, in other words, the corrected diastolic blood pressure measurement value is indicated in the blood pressure data as a result of blood pressure determination, and is sent from the blood pressure pulse wave measurement unit 20 to the arithmetic control unit 10. Supplied. In addition to the blood pressure data, blood vessel calcification determination data indicating the calcification index CS is also supplied from the blood pressure pulse wave measurement unit 20 to the arithmetic control unit 10.

  In step S70, the arithmetic and control unit 10 converts the blood vessel calcification determination data into display data and outputs the display data to the display unit 70, whereby the display unit 70 has the calcification index CS and the blood vessel. A vascular calcification warning indicating the possibility of calcification is displayed.

When it is determined that there is no possibility of blood vessel calcification, the process proceeds to step S80, and the blood pressure pulse wave measurement unit 20 calculates _one of the measurement values SBP ₁ and SBP ₂ or the average value of the measurement values SBP ₁ and SBP _2. The determination value SBP for the minimum blood pressure is used. The determination value SBP of the minimum blood pressure obtained in this way is indicated in the blood pressure data as a result of blood pressure determination, and is supplied from the blood pressure pulse wave measurement unit 20 to the arithmetic control unit 10. However, supply of blood vessel calcification determination data is not performed. Therefore, neither a calcification index nor a blood vessel calcification warning is displayed.

  The blood vessel calcification determination is performed as described above.

In the above example, the difference between the measured values SBP ₁ and SBP ₂ of the minimum blood pressure is calculated, but instead, the difference between the measured values MBP ₁ and MBP ₂ of the average blood pressure is calculated, and based on the calculation result Blood vessel calcification determination may be performed, or the difference between the measured values DBP ₁ and DBP ₂ of the systolic blood pressure may be calculated, and blood vessel calcification determination may be performed based on the calculation result. Alternatively, a plurality of the difference between the measured values SBP ₁ and SBP ₂ of the minimum blood pressure and the measured values MBP ₁ and MBP ₂ of the average blood pressure and the measured values DBP ₁ and DBP ₂ of the maximum blood pressure are calculated, Blood vessel calcification determination may be performed based on these calculation results. It is also possible to use measured values of blood pressure different from the minimum blood pressure, the average blood pressure and the maximum blood pressure.

  In the above example, the vascular calcification determination is performed for the left leg. However, the vascular calcification determination can be performed similarly for the right leg, the left arm, and the right arm. Therefore, the blood vessel calcification determination can be performed only for one place or for a plurality of places.

  In the above example, both the vascular calcification warning and the calcification index are displayed as information indicating the possibility of vascular calcification, but only one of the vascular calcification warning and the calcification index is displayed. You may let them.

  In the above example, the blood vessel calcification warning and the calcification index display / non-display are switched according to the determination result of the possibility of vascular calcification, while the blood pressure determination result is always hidden. The determination result may be always displayed.

  In the above example, if it is determined that there is no possibility of vascular calcification, no information is displayed on the determination result of vascular calcification, but information indicating that there is no possibility of vascular calcification is displayed. Also good.

  In the above example, the vascular calcification warning and the calcification index are displayed. However, the vascular calcification warning and the calcification index may be printed.

  Next, blood vessel calcification determination will be described by comparing the blood pressure measurement results shown in FIGS. 3 and 4.

FIG. 3 is a view showing a blood pressure measurement result for a subject, and FIG. 4 is a view showing a blood pressure measurement result for another subject. FIG. 3A and FIG. 4A show the measurement results during cuff decompression, and thus the measured values of blood pressure fluctuate in the directions of arrows P ₁ and P ₃ . FIG. 3B and FIG. 4B show the measurement results during cuff pressurization, and thus the blood pressure measurement values fluctuate in the directions of arrows P ₂ and P ₄ .

First, referring to FIG. 3, an A portion in FIG. 3 (a) shows a portion where the amplitude of the pulse wave becomes maximum during cuff decompression, and a B portion in FIG. 3 (b) shows a pulse during cuff pressurization. The part where the amplitude of the wave is maximum is shown. Difference between the blood pressure measurement value corresponding to the amplitude of the A portion (that is, the measurement value of the average blood pressure during decompression) and the blood pressure measurement value corresponding to the amplitude of the B portion (that is, the measurement value of the average blood pressure during pressurization) d _AB Is about 20 mmHg, which is relatively large and remarkable.

3A shows a portion where the amplitude of the pulse wave is about 50% of the maximum amplitude during cuff decompression, and D portion in FIG. 3B shows the pulse wave during cuff pressurization. Indicates a portion where the amplitude of is about 50% of the maximum amplitude. The difference d _CD between the blood pressure measurement value corresponding to the amplitude of the C portion (that is, the measurement value of the minimum blood pressure during decompression) and the blood pressure measurement value corresponding to the amplitude of the D portion (that is, the measurement value of the minimum blood pressure during pressurization) Is about 20 mmHg, which is relatively large and remarkable, similar to the difference d _AB described above.

On the other hand, referring to FIG. 4, an E portion in FIG. 4 (a) shows a portion where the amplitude of the pulse wave becomes maximum during cuff decompression, and an F portion in FIG. 4 (b) shows a pulse during cuff pressurization. The part where the amplitude of the wave is maximum is shown. The difference between the blood pressure measurement value corresponding to the amplitude of the E portion (that is, the measurement value of the average blood pressure during decompression) and the blood pressure measurement value corresponding to the amplitude of the F portion (that is, the measurement value of the average blood pressure during pressurization) d _EF Is about 5 mmHg, which is relatively small.

4A shows a portion where the amplitude of the pulse wave is about 50% of the maximum amplitude during cuff decompression, and the H portion in FIG. 4B shows the pulse wave during cuff pressurization. Indicates a portion where the amplitude of is about 50% of the maximum amplitude. The difference d _GH between the blood pressure measurement value corresponding to the amplitude of the G portion (ie, the measurement value of the minimum blood pressure during decompression) and the blood pressure measurement value corresponding to the amplitude of the H portion (ie, the measurement value of the minimum blood pressure during pressurization) Is about 10 mmHg, which is relatively small like the difference d _EF described above.

  Therefore, when blood vessel calcification determination is performed on the blood pressure measurement result shown in FIG. 3, it can be determined that there is a possibility of blood vessel calcification, while blood vessel calcification is performed on the blood pressure measurement result shown in FIG. It is possible to determine that there is no possibility of vascular calcification when the determination is made.

  Thus, according to the present embodiment, blood vessel calcification is also determined at the time of blood pressure determination, and when it is determined that there is a possibility of blood vessel calcification, the content corresponding to that is displayed. The blood pressure pulse wave inspection apparatus can be suitably used for those who develop vascular calcification.

  The embodiment of the present invention has been described above. The above description is an illustration of a preferred embodiment of the present invention, and the scope of the present invention is not limited to this. That is, the description of the configuration of the above apparatus is an example, and it is obvious that various modifications and additions to these examples are possible within the scope of the present invention. For example, the present invention can be applied to various biological information measuring devices such as an electronic blood pressure monitor as well as a blood pressure pulse wave inspection device.

The figure which shows the structure of the blood pressure pulse wave test | inspection apparatus which concerns on one embodiment of this invention. The flowchart for demonstrating the blood vessel calcification determination operation | movement which concerns on one embodiment of this invention. Figure showing an example of blood pressure measurement results The figure which shows the other example of the blood pressure measurement result

Explanation of symbols

10 Calculation control unit 20 Blood pressure pulse wave measurement unit 21a, 21b, 21c, 21d Cuff 24a, 24b, 24c, 24d Pump 25a, 25b, 25c, 25d Exhaust valve 26a, 26b, 26c, 26d Pressure sensor 70 Display unit 211a, 211b 211c, 211d Air bag

Claims (4)

A measurement unit for measuring blood pressure during cuff pressure pressurization and decompression;
A determination unit for determining a difference between values of the blood pressure measured during pressurization and decompression of the cuff pressure;
As a result of the determination, if there is the difference, a display unit that displays information that there is a possibility of vascular calcification;
A biological information measuring device comprising: The measurement unit measures average blood pressure, diastolic blood pressure or systolic blood pressure,
The determination unit determines a difference between the measured average blood pressure, the minimum blood pressure, or the maximum blood pressure;
The biological information measuring apparatus according to claim 1. The determination unit determines the degree of vascular calcification based on the determined difference,
The display unit displays information indicating the determined degree of vascular calcification,
The biological information measuring apparatus according to claim 1. The determination unit corrects the measured blood pressure value based on the determined difference,
The display unit displays the corrected blood pressure value.
The biological information measuring apparatus according to claim 1.

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