JP5230161B2 - Heart machine diagram inspection device - Google Patents

Description

  The present invention relates to a cardiac device inspection apparatus for measuring a cardiac device (Mechanocardiography).

As described in, for example, Patent Document 1, the cardiac device inspection apparatus measures a plurality of types of biological information related to cardiac phenomena, such as heart sounds and electrocardiograms, and represents a waveform diagram representing the measurement results. That is, it is a medical device that displays a heartbeat diagram in real time. In recent years, there has been an electrocardiogram inspection apparatus that measures a combination of electrocardiogram, heart sound, and pulse wave as an electrocardiogram.
Japanese Patent Publication No. 5-46216

  However, in the above-described conventional cardiac device inspection apparatus, although a waveform diagram based on a plurality of types of measured biological information can be displayed, the heart sound can be output as a sound for auscultation (hereinafter referred to as “auscultation sound”). could not. Therefore, when comprehensively diagnosing a subject's heart disease based on measurement results regarding a plurality of types of biological information, available judgment materials may be limited to visual ones.

  Here, other medical devices capable of measuring and displaying a plurality of types of biological information include a polygraph and a biological information monitor. Although these devices can output an R-wave synchronization sound, they cannot output an auscultation sound, as in the conventional cardiac device inspection apparatus.

  Auscultation of heart sounds is one of the heart disease diagnosis methods that have been performed for a long time. Moreover, it is not only a simple stethoscope that can be used easily, but also a disease that can be detected earlier, so it is a very important diagnostic technique. On the other hand, in recent years, the measurement technique of heart phenomenon has been advanced, and various diagnoses have been performed by various types of devices. As a result, in clinical practice, the importance of visual information such as waveform diagrams and echo images is increasing compared to auditory information such as auscultation sounds. This tendency is the same in, for example, education and training for medical students and the like. In other words, waveform information and other visual information can be provided as educational materials and training materials to deepen understanding of the heart phenomenon, while high-quality auscultatory information such as auscultatory sounds is provided as educational materials and training materials. It was not easy to do.

  This invention is made | formed in view of this point, and it aims at providing the heart-cardiogram inspection apparatus which can improve the usefulness also in clinical and educational training.

The heartbeat diagram inspection apparatus of the present invention includes an acquisition unit that acquires measurement data of heart sounds and measurement data of biological information different from the heart sounds, and outputs auscultation sounds based on the acquired measurement data of the heart sounds to a voice output unit An auscultation sound processing unit to be displayed, a waveform diagram processing unit for displaying a waveform diagram based on the acquired measurement data of the biological information on a display unit, an output of the auscultation sound based on the measurement data of the heart sound, and the measurement data of the biological information A synchronization unit that synchronizes the display of the waveform diagram based on , and an auscultation sound data buffer that temporarily accumulates the measurement data of the heart sound before the auscultation sound based on the measurement data of the heart sound is output. Yes, and wherein the synchronization unit, the display of the waveform based on the measurement data of the biological information, to delay according temporary storage of the measured data of the heart sounds by the auscultatory sound data buffer, the biometric information Having a waveform diagram data buffer for outputting the measurement data from the temporarily storing block diagram showing a configuration.

  ADVANTAGE OF THE INVENTION According to this invention, the usefulness of a heart-cardiogram inspection apparatus can be improved in clinical and educational training.

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

  FIG. 1 is an external view of a heartbeat diagram inspection apparatus according to an embodiment of the present invention. The heartbeat diagram inspection apparatus 1 in FIG. 1 includes amorphous pulse wave sensors (hereinafter simply referred to as “pulse wave sensors”) 2a and 2b as pulse wave measurement means, and heart sound microphones 3a and 3b as heart sound measurement means. And electrocardiogram electrodes 4a, 4b, and 4c as electrocardiogram measuring means, an input box 5, a terminal device 6, and a speaker device 7 as an audio output unit.

  The input box 5 accommodates various measurement units that measure biological information by the various measurement means in a box-shaped housing. The terminal device 6 is a PC (Personal Computer) terminal device, and includes a terminal device main body 6a, a display device 6b (for example, an LCD (Liquid Crystal Display)) as a display unit, and an operation unit 6c (for example, a keyboard or a mouse). Have

  FIG. 2 is a block diagram showing a configuration of the heartbeat diagram inspection apparatus 1 shown in FIG.

  First, the configuration of the input box 5 will be described.

  The input box 5 includes a measurement data buffer 10, a measurement data processing unit 11, a pulse wave measurement unit 12, a heart sound measurement unit 13, and an electrocardiogram measurement unit 14. The input box 5 includes a connector 15a for the pulse wave sensors 2a and 2b, a connector 15b for the cardiac sound microphones 3a and 3b, a connector 15c for the ECG electrodes 4a to 4c, and a connector 15d for a network cable ( For example, USB (Universal Serial Bus) cables) are connected to each other.

  The pulse wave measurement unit 12 includes a carotid wave signal indicating a pulse wave measurement result input from the pulse wave sensor 2a attached to the subject's carotid artery, and a pulse wave sensor attached to the subject's hip artery. A signal processing circuit that performs predetermined signal processing such as amplification, filtering, and analog / digital (A / D) conversion on the hip artery signal indicating the pulse wave measurement result input from 2b. The pulse wave measurement unit 12 outputs the carotid artery wave data obtained from the carotid artery wave signal by signal processing and the hip artery wave data obtained from the hip artery signal by signal processing to the measurement data processing unit 11.

  In addition, the attachment site | part of the pulse wave sensors 2a and 2b is not limited to a carotid artery part and a hip artery part, The attachment to another site | part is also possible. Further, the number of pulse wave sensors is not limited to two, and may be one or three or more.

  The heart sound measurement unit 13 includes a heart apex heart sound signal indicating a heart sound measurement result input from the heart sound microphone 3a attached to the subject's apex, and a heart sound microphone 3b attached to the subject's left sternum. It has a signal processing circuit that performs predetermined signal processing such as amplification, filtering, and A / D conversion on the sternum left edge heart sound signal indicating the input heart sound measurement result. The heart sound measuring unit 13 uses the apex heart sound data obtained from the apex heart sound signal by signal processing and the left sternal heart sound data obtained from the left sternal heart sound signal by signal processing, as the measurement data processing unit 11. Output to.

  In addition, the attachment site | part of the heart sound microphone 3a, 3b is not limited to the apex part and the left sternum edge part, The attachment to another site | part is also possible. Further, the number of heart sound microphones is not limited to two, and may be one or three or more.

  The electrocardiogram measurement unit 14 amplifies, filters, and performs A / D conversion on the electrocardiogram signals indicating the electrocardiogram measurement results input from the electrocardiogram electrodes 4a to 4c attached to the limbs of the subject. A signal processing circuit for performing the signal processing. The electrocardiogram measurement unit 14 outputs the electrocardiogram data obtained from the electrocardiogram signal by signal processing to the measurement data processing unit 11.

  In addition, the attachment site | part of the electrocardiogram electrodes 4a-4c is not limited to a limb part, The mounting | wearing to another site | part is also possible. Further, the number of electrocardiographic electrodes is not limited to three. For example, when a limb electrode including four electrocardiographic electrodes and a chest electrode including six electrocardiographic electrodes are used, the heart sound measuring unit 13 can obtain standard 12-lead electrocardiographic data.

  The measurement data processing unit 11 has an arithmetic processing unit that processes digital signals. The measurement data processing unit 11 integrates the input carotid artery wave data, hip artery wave data, apex heart sound data, sternal left edge heart sound data, and electrocardiogram data to the terminal device body 6a via the network cable. Transmittable measurement data is generated, and this measurement data is sent to the terminal device body 6a via the measurement data buffer 10.

  Since the measurement data processing unit 11 can generate and output the measurement data without causing a significant delay from the timing at which the biological information on which the measurement data is based is measured, the measurement data output from the measurement data processing unit 11 However, the processing speed of the arithmetic processing unit (not shown) of the terminal device main body 6a varies depending on the operating environment or operation setting, and therefore the rate of measurement data captured by the terminal device main body 6a is variable. It becomes. By disposing the measurement data buffer 10 at the subsequent stage of the measurement data processing unit 11 in the input box 5, it is possible to avoid an undesirable operation due to such a difference in data rate.

  Next, the configuration of the terminal device body 6a will be described.

  The terminal device body 6a includes a measurement data storage unit 17, a measurement data output control unit 18, a waveform diagram data buffer 19, an auscultation sound data buffer 20, a variable delay unit 21, a waveform diagram processing unit 22, and an auscultation sound processing unit 23. The waveform diagram processing unit 22 includes an editing unit 24, a variable gain unit 25, and a variable filter unit 26, and the auscultatory sound processing unit 23 includes a volume control unit 27 and a sound quality control unit 28.

  The terminal device body 6a is connected to the network cable via a connector 28a, so that the input box 5 and the terminal device body 6a can communicate with each other. When a printer (not shown) is substituted or used as a display unit, the printer can be connected to the terminal device body 6a by connecting a printer cable to the connector 28b.

  Further, the cable of the speaker device 7 is connected to the terminal device main body 6a by a connector 28c. Note that the terminal device body 6a may include the speaker device 7. When headphones (not shown) are substituted or used together as an audio output unit, the headphones can be connected to the terminal device body 6a by connecting a headphone cable to the connector 28d.

  The measurement data storage unit 17 as a storage unit has a storage device. The measurement data storage unit 17 stores the measurement data received from the input box 5 in association with the data indicating the measurement time.

  The measurement data output control unit 18 as an acquisition unit is realized by executing a software program stored in a storage device (not shown) with an arithmetic processing unit (not shown).

  The measurement data output control unit 18 outputs a heartbeat diagram in real time, more specifically, while measuring biological information, the user outputs a heartbeat diagram based on the measurement data of the biological information. When the operation unit 6 c is operated, measurement data is received from the input box 5. In addition, the measurement data output control unit 18 allows the user to operate the operation unit 6c so as to reproduce a cardiac diagram, more specifically, to output a cardiac diagram based on measurement data of biological information in a specified past period. When operated, the measurement data in that period is read from the measurement data storage unit 17. The measurement data output control unit 18 uses the carotid artery wave data, the hip artery wave data, the apex heart sound data, the sternal left edge heart sound data, and the electrocardiogram data in the received or read measurement data as waveform diagram data. The apex heart sound data and the left sternal heart sound data in the received or read measurement data are stored in the auscultation sound data buffer 20 as auscultation sound data.

  The waveform diagram data buffer 19 serving as a synchronization unit temporarily accumulates the waveform diagram data stored by the measurement data output control unit 18 and then outputs the waveform diagram data to the waveform diagram processing unit 22. Delay the input of the waveform diagram data. In this way, the waveform diagram display is synchronized with the auscultatory sound output. This delay processing eliminates the time difference between the auscultatory sound output and the waveform diagram display caused by the auscultatory sound output delay accompanying the temporary accumulation of the auscultatory sound data by the auscultatory sound data buffer 20, and the time phase of the output auscultatory sound. Is matched with the time phase of the waveform diagram.

  Thereby, it is possible to eliminate a shift in timing between the heartbeat diagram display and the auscultation sound output caused by the temporary accumulation of the auscultation sound data by the auscultation sound data buffer 20 which is performed in order to prevent sound loss of the auscultation sound. Therefore, when the waveform of the heartbeat diagram at a certain timing is displayed, it is possible to provide effective audiovisual information that can accurately grasp the auscultatory sound corresponding to the waveform. Such audiovisual information is very useful in both clinical and educational training.

  The waveform diagram processing unit 22 and the editing unit 24, the variable gain unit 25, and the variable filter unit 26 in the inside thereof, like the measurement data output control unit 18, operate a software program stored in a storage device (not shown) as an arithmetic processing unit. This is implemented by executing (not shown).

  The waveform diagram processing unit 22 is specifically described below for the left sternal heart sound data, apex heart sound data, electrocardiogram data, carotid wave data, and hip artery wave data integrated in the input waveform diagram data. The processing described is performed individually.

  First, regarding the heart sound, the waveform diagram processing unit 22 processes at least one of the left sternum heart sound data and the apex heart sound data, which is designated in advance as a default or by a user operation. The processing of the designated data includes a command for displaying a phonocardiogram defined by data after application of filter processing by the variable filter unit 26, sensitivity adjustment by the variable gain unit 25, filter processing and sensitivity adjustment, and the like. The generation of heart sound waveform data is mainly included.

  More specifically, the waveform diagram processing unit 22 applies first filter processing (hereinafter referred to as “L filter processing”) to the designated data by the variable filter unit 26, whereby first waveform data ( Hereinafter, it is referred to as “L heart sound waveform data”). The L filter process is a high-pass filter (hereinafter simply referred to as “HPF”) having a preset cutoff frequency of, for example, 50 Hz and a preset attenuation slope of, for example, −6 dB / oct, and is a low-frequency component of heart sound. Is mainly extracted. Therefore, the L heart sound waveform data generated by this processing is waveform data mainly showing the fluctuation of the low frequency component of the heart sound. The waveform diagram processing unit 22 can change the frequency characteristics of the L filter processing according to a user operation during real-time display of the heartbeat diagram, before playback, or during playback. In particular, since the change before reproduction or during reproduction is made possible, a high-quality waveform diagram can be obtained without re-measurement of biological information, and the measurement time can be shortened.

  Further, the waveform diagram processing unit 22 applies second filter processing (hereinafter referred to as “M1 filter processing”) to the designated data by the variable filter unit 26 to thereby generate second heart sound waveform data (hereinafter referred to as “M1 heart sound”). Waveform data "). The M1 filter process is an HPF having a preset cutoff frequency of, for example, 50 Hz and a preset attenuation slope of, for example, -18 dB / oct, and mainly extracts the mid-frequency component of the heart sound. Therefore, the M1 heart sound waveform data generated by this processing is waveform data mainly showing fluctuations in the middle frequency component of the heart sound. The waveform diagram processing unit 22 can change the frequency characteristics of the M1 filter processing according to a user operation during real-time display of the heartbeat diagram, before playback, or during playback. In particular, since the change before reproduction or during reproduction is made possible, a high-quality waveform diagram can be obtained without re-measurement of biological information, and the measurement time can be shortened.

  Further, the waveform diagram processing unit 22 applies third filter processing (hereinafter referred to as “M2 filter processing”) to the designated data by the variable filter unit 26 to thereby generate third cardiac sound waveform data (hereinafter referred to as “M2 heart sound”). Waveform data "). The M2 filter process is an HPF having a preset cutoff frequency of, for example, 160 Hz or 200 Hz and a preset attenuation slope of, for example, −24 dB / oct, and mainly extracts the mid-frequency component of the heart sound. Therefore, the M2 heart sound waveform data generated by this processing is another waveform data mainly showing the fluctuation of the mid-range component of the heart sound. The waveform diagram processing unit 22 can change the frequency characteristic of the M2 filter processing according to a user operation during real-time display of the heartbeat diagram, before playback, or during playback. In particular, since the change before reproduction or during reproduction is made possible, a high-quality waveform diagram can be obtained without re-measurement of biological information, and the measurement time can be shortened.

  In addition, the waveform diagram processing unit 22 performs fourth filter processing (hereinafter referred to as “H filter processing”) on the designated data by the variable filter unit 26 to thereby generate fourth heart sound waveform data (hereinafter referred to as “H heart sound”). Waveform data "). The H filter process is an HPF having a preset cutoff frequency of, for example, 315 Hz and a preset attenuation slope of, for example, −24 dB / oct, and extracts a high frequency component of the heart sound. Therefore, the H heart sound waveform data generated by this processing is waveform data indicating the fluctuation of the high frequency component of the heart sound. The waveform diagram processing unit 22 can change the frequency characteristics of the H filter processing according to a user operation during real-time display of the heartbeat diagram, before playback, or during playback. In particular, since the change before reproduction or during reproduction is made possible, a high-quality waveform diagram can be obtained without re-measurement of biological information, and the measurement time can be shortened.

  Further, the waveform diagram processing unit 22 uses the variable gain unit 25 to set the gain of the L heart sound waveform data to, for example, −32 dB or −30 dB, and the gain of the M1 heart sound waveform data to, for example, −32 dB or −20 dB. For example, the gain is set to -16 dB or -10 dB, the gain of the H heart sound waveform data is set to 0 dB, for example, and a sensitivity difference is provided in each band. The waveform diagram processing unit 22 can change each gain of the variable gain unit 25 in accordance with a user operation during real-time display of the cardiac diagram, before reproduction, or during reproduction. In particular, since the change before reproduction or during reproduction is made possible, a high-quality waveform diagram can be obtained without re-measurement of biological information, and the measurement time can be shortened.

  Thus, regarding the heart sound, L heart sound waveform data, M1 heart sound waveform data, M2 heart sound waveform data, and H heart sound waveform data are generated as heart sound waveform data.

  Regarding the electrocardiogram, the waveform diagram processing unit 22 processes the electrocardiogram data. The processing of the electrocardiographic data mainly includes filtering processing by the variable filter unit 26 and generation of electrocardiographic waveform data including a command for displaying an electrocardiogram defined by the electrocardiographic data after application of the filtering processing or the like. .

  More specifically, the waveform diagram processing unit 22 removes 50 Hz or 60 Hz hum noise from the electrocardiographic data, and removes electromyogram noise of 25 Hz or less or 35 Hz or less, for example, by the variable filter unit 26. EMG noise removal processing to be performed, and baseline drift removal processing to remove, for example, a low frequency component of 0.25 Hz or less or 0.5 Hz or less appearing as baseline drift in the electrocardiogram. Therefore, the electrocardiographic waveform data generated by this processing is waveform data that accurately shows the variation of the electromotive force. Note that the waveform diagram processing unit 22 can variably set whether or not to apply the baseline drift removal processing and, if applied, the attenuation frequency according to a user operation. The delay unit 21 is notified.

  Regarding the pulse wave, the waveform diagram processing unit 22 processes at least one of the carotid artery wave data and the hip artery wave data as a default or specified in advance by a user operation. The processing of the pulse wave data mainly includes generation of pulse wave waveform data including a command for displaying a pulse wave diagram defined by the pulse wave data.

  The waveform diagram processing unit 22 generates image frame data for displaying a heartbeat diagram at the measurement timing from the electrocardiographic data, electrocardiogram waveform data and pulse wave waveform data at the same measurement timing obtained by the above processing. The generated image frame data is sent to the display device 6b, and a heartbeat diagram is displayed according to the image frame data.

  When the image frame data to be sent is based on the measurement data received from the input box 5 in the measurement data output control unit 18, the image frame data is sent from the waveform diagram processing unit 22 to the display device 6b. The waveform diagram based on the received measurement data is displayed in real time. On the other hand, when the transmitted image frame data is based on the measurement data read from the measurement data storage unit 17 in the measurement data output control unit 18, the image frame data is sent from the waveform diagram processing unit 22 to the display device 6b. Is transmitted, the waveform diagram based on the received measurement data is reproduced and displayed.

  Further, the waveform diagram processing unit 22 performs the operation of stopping the waveform drawing during the reproduction of the heartbeat diagram based on the measurement data of the biological information in the specified past period, or the reproduction of the heartbeat diagram is ended. In some cases, a freeze image of a heartbeat diagram can be displayed on the display device 6a. The waveform diagram processing unit 22 can edit the freeze image by the editing unit 24 in accordance with a user operation. For example, it is possible to adjust the baseline position of various waveform diagrams and delete unnecessary waveform portions in the freeze image. Thereby, when it is necessary to present a cardiac diagram to a subject or a third party, the cardiac diagram can be easily viewed. Furthermore, it is possible to insert text (for example, a comment) in the freeze image. This makes it possible to increase the added value and usefulness of the materials and teaching materials when it is necessary to print the mind map as training materials and teaching materials. Furthermore, a two-screen display with a freeze image of a heartbeat diagram based on measurement data of biological information in another period is also possible. Therefore, a more objective or more accurate diagnosis of heart disease is possible.

  In addition, when the heartbeat diagram freeze screen is displayed, the waveform diagram processing unit 22 displays the corresponding auscultation sound in the screen in synchronization with the auscultation sound to be reproduced when the user requests the reproduction of the auscultation sound. A command for displaying the moving auxiliary line superimposed on the heartbeat diagram in the freeze screen is sent to the display device 6b to display the auxiliary line. As a result, the cardiac diagram display and the auscultatory sound output can be synchronized. That is, in this case, the waveform diagram processing unit 22 functions as a synchronization unit together with the waveform diagram data buffer 19 and the variable delay unit 21 described later.

  The auscultation sound data buffer 20 as an accumulation unit buffers the auscultation sound data stored by the measurement data output control unit 18 and outputs it to the variable delay unit 21. As a result of buffering, the auscultatory sound data is temporarily accumulated, and the timing at which the auscultatory sound is output from the speaker device 7 is, for example, 1.5 seconds from the measurement timing of the heart sound that is the basis of the auscultatory sound. Although it is delayed as much as possible, it is possible to obtain an effect of preventing sound loss of the auscultation sound.

  The variable delay unit 21 constitutes a synchronization unit together with the waveform diagram data buffer 19 and the waveform diagram processing unit 22. The variable delay unit 21 outputs the auscultation sound data input from the auscultation sound data buffer 20 to the auscultation sound processing unit 23. The variable delay unit 21 delays the output of the auscultatory sound data according to the characteristics of the variable filter unit 26 notified from the waveform diagram processing unit 22. Specifically, when the baseline drift removal processing is set to be applied to the electrocardiographic data by the variable filter unit 26, the processing of the electrocardiographic data by the waveform diagram processing unit 22 is delayed by, for example, 1 to 2 seconds. Therefore, the output of the auscultatory sound data is delayed by the variable delay unit 21. On the other hand, when such setting is not made, the output of the auscultatory sound data is not delayed by the variable delay unit 21. When the delay is performed, the delay time is set to be relatively long because the processing delay of the waveform diagram processing unit 22 is relatively large when the attenuation frequency of the baseline drift removal processing is relatively low (for example, 0.25 Hz). On the other hand, when the attenuation frequency of the baseline drift removal processing is relatively high (for example, 0.5 Hz), the processing delay of the waveform diagram processing unit 22 is relatively small, so that it is set relatively short. Such variable setting of the delay time can be realized by allocating an additional buffer area for auscultatory sound data in accordance with the setting of the filter characteristics.

  Thereby, the shift of the timing of the heart-cardiogram display and auscultation sound output resulting from the characteristic of the variable filter part 26, especially the filter characteristic about the electrocardiogram waveform diagram which is the biometric information different from the heart sound can be eliminated. Therefore, when the waveform of the heartbeat diagram at a certain timing is displayed, it is possible to provide effective audiovisual information that can accurately grasp the auscultatory sound corresponding to the waveform. Such audiovisual information is very useful in both clinical and educational training.

  The auscultation sound processing unit 23 and the sound volume control unit 27 and the sound quality control unit 28 inside it, like the measurement data output control unit 18 and the waveform diagram processing unit 22, operate a software program stored in a storage device (not shown). This is realized by being executed by a processing device (not shown).

  The auscultation sound processing unit 23 processes at least one of the left sternum heart sound data and the apex heart sound data integrated in the input auscultation sound data as a default or specified in advance by a user operation. The processing of the designated data mainly includes volume control by the volume control unit 27 and sound quality control by the sound quality control unit 28. Volume control and sound quality control are performed according to settings made by user operations or the like. The sound quality control includes, for example, removal of environmental noise. The auscultation sound processing unit 23 sends the auscultation sound data after the volume control and the sound quality control are performed to the speaker device 7 and outputs the auscultation sound according to the auscultation sound data.

  When the auscultation sound data to be sent is based on the measurement data received from the input box 5 in the measurement data output control unit 18, the auscultation sound processing unit 23 sends the auscultation sound data to the speaker device 7. The auscultation sound based on the received measurement data is output in real time. On the other hand, when the transmitted auscultation sound data is based on the measurement data read from the measurement data storage unit 17 in the measurement data output control unit 18, the auscultation sound data is sent from the auscultation sound processing unit 23 to the speaker device 7. Is transmitted, the auscultatory sound is reproduced and output based on the received measurement data.

  Note that when the auscultatory sound is output in real time, for example, in the same room as the place where the heart sound is measured, in order to prevent howling, the auscultatory sound data is transmitted to the headphones (not shown) instead of the speaker device 7. Preferably it is set.

  The configuration of the cardiac device inspection apparatus 1 has been described above.

  Next, the display screen of the heartbeat diagram displayed on the display device 6b when the heartbeat diagram inspection apparatus 1 operates will be described with two examples.

  First, the real-time display of the heartbeat diagram will be described using the example of the screen shown in FIG. 3. Based on various biological information currently being measured, the screen 30 displays the heart sounds of the third intercostal sternum left edge and apex. 31, the electrocardiogram 32, and the pulse wave diagram 33 are swept so that the past waveform is overwritten in the direction from the left to the right of the screen 30. In this example, the waveform based on the latest measurement data is swept to the update region 34. Since the auscultatory sound output at this time is based on a heart sound measured about 1.5 seconds ago, for example, the waveform swept in the update region 34 is a living body measured about 1.5 seconds ago. It is based on information.

  Subsequently, the reproduction of the cardiac diagram will be described using the example of the screen shown in FIG. 4. Based on various biological information measured in the past, the screen 40 displays the left edge of the third intercostal sternum and the apex of the heart. An electrocardiogram 41, an electrocardiogram 42, and a pulse wave diagram 43 are displayed as freeze images. Here, when a period corresponding to the region 44 is designated by the user operation, an auscultatory sound based on the heart sound measured during the period is reproduced and in a direction from the left to the right of the screen 40 in synchronization with the auscultatory sound. The moving auxiliary line 45 is displayed so as to overlap the cardiac diagram in the freeze screen.

  When a heartbeat diagram based on a certain measurement data is displayed in real time as shown in FIG. 3 and then played back as shown in FIG. 4, the heartbeat diagram based on the same measurement data is reproduced before or during the reproduction. Filter characteristics and gain can be varied. As a result, a high-quality heartbeat diagram can be obtained, and there is a case where re-measurement of biological information is not necessary, so that the measurement time can be greatly shortened. It is also possible to perform volume control by operating the volume controller 46 displayed on the screen 40 before or during the reproduction. Furthermore, the base line position can be adjusted by operating the heartbeat diagram in the freeze screen on the screen 40. Thereby, a heartbeat diagram can be displayed in an easy-to-see manner such that a plurality of waveforms do not overlap, and the heartbeat diagram can be printed. Further, when the terminal device 6 is provided with a function for measuring the pulse wave velocity (PWV), the systolic cardiac time phase (STIs), etc., the heartbeat diagram in the freeze screen is operated on the screen 40. Therefore, these measurements can be easily performed.

  As described above, according to the present embodiment, the display of the cardiac diagram and the output of the auscultatory sound are not only performed by an integrated apparatus but also synchronized with each other. Effective audiovisual information can also be provided in training.

  In the cardiac diagram, since the phonocardiogram, electrocardiogram and carotid pulse waveform can be recorded simultaneously, the systolic cardiac time phase (the simplest noninvasive evaluation of the left ventricular myocardial contraction force) STIs) can be measured. In addition, the simultaneous recording of the electrocardiogram, electrocardiogram, and carotid pulse waveform shows the aortic valve stenosis while measuring the position of the heart noise that appears in the heart sound and the electrocardiogram, focusing on the rise time of the pulse wave. Diagnosis of severity in symptom (AS) can also be made. In addition, if a cardiac phonogram, an electrocardiogram, a carotid pulse waveform, and a hip pulse waveform are recorded simultaneously in a heartbeat diagram, an artery that is attracting attention as a cause of ischemic heart disease or cerebrovascular disorder It is possible to measure the pulse wave velocity (PWV), which is an index of curing. In the cardiac device inspection apparatus according to the present embodiment, not only can these be measured, but also heart sounds can be auscultated in synchronization with the displayed cardiac image, so that various heart diseases can be diagnosed and severity It is very useful for grasping.

  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 and operation 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, in the present embodiment, the input device 5 and the terminal device 6 which are separate bodies are connected to each other via the network to constitute the heartbeat inspection device 1, but the input box 5 and the terminal device 6 are integrated. It may be a thing.

  Further, regarding the synchronization unit, in the present embodiment, a configuration in which the waveform diagram data buffer 19 is arranged between the measurement data output control unit 18 and the waveform diagram processing unit 22, or an auscultation sound data buffer 20 and an auscultation sound processing unit. 23, the buffer as the variable delay unit 21 is arranged. However, the means for delaying the data and the arrangement position thereof as the synchronization unit can be appropriately changed and implemented. .

  Furthermore, in the present embodiment, an example in which the biological information to be measured is a heart sound, an electrocardiogram, and a pulse wave has been described as an example, but an apparatus that only measures the heart sound and the electrocardiogram, only the heart sound and the pulse wave are A device to be measured, or a device that includes respiration in addition to heart sounds, electrocardiograms, and pulse waves, can also be implemented by appropriately changing the configuration of the above-mentioned cardiac device inspection apparatus 1. Since breathing and heart sound are closely related to each other, when recording them simultaneously as a heartbeat diagram, waveform diagrams and auscultation sounds indicate the division state of heart II sound during expiration and the division state of heart II sound during inspiration. By confirming with, it is possible to diagnose heart disease.

FIG. 1 is an external view of a heartbeat diagram inspection apparatus according to an embodiment of the present invention. The block diagram which shows the structure of the heartbeat diagram inspection apparatus which concerns on one embodiment of this invention The figure which shows the real-time display screen of the heart machine figure which concerns on one embodiment of this invention The figure which shows the reproduction | regeneration screen of the heartbeat figure which concerns on one embodiment of this invention

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Cardiac diagram inspection apparatus 5 Input box 6 Terminal apparatus 6a Terminal apparatus main body 6b Display apparatus 7 Speaker apparatus 12 Pulse wave measurement part 13 Heart sound measurement part 14 Electrocardiogram measurement part 18 Measurement data output control part 19 Waveform diagram data buffer 20 Auscultation sound data Buffer 21 Variable delay unit 22 Waveform diagram processing unit 23 Auscultation sound processing unit 24 Editing unit 25 Variable gain unit 26 Variable filter unit 27 Volume control unit 28 Sound quality control unit

Claims (9)

An acquisition unit that acquires measurement data of heart sounds and measurement data of biological information different from the heart sounds;
An auscultatory sound processing unit that causes the audio output unit to output an auscultatory sound based on the acquired measurement data of the heart sound;
A waveform diagram processing unit for displaying a waveform diagram based on the acquired measurement data of the biological information on a display unit;
A synchronization unit that synchronizes the output of the auscultatory sound based on the measurement data of the heart sound and the display of the waveform diagram based on the measurement data of the biological information;
An auscultation sound data buffer for temporarily storing the measurement data of the heart sound before the auscultation sound based on the measurement data of the heart sound is output;
I have a,
The synchronization unit temporarily transmits the measurement data of the biological information so as to delay the display of the waveform diagram based on the measurement data of the biological information according to the temporary accumulation of the measurement data of the heart sound by the auscultation sound data buffer. It has a waveform diagram data buffer that outputs after accumulating,
An apparatus for inspecting a heart mechanism diagram.   The cardiac image inspection apparatus according to claim 1, wherein the biological information includes at least one of electrocardiogram, pulse wave, and respiration. A storage unit for storing the acquired measurement data of the heart sound and the measurement data of the biological information;
The auscultatory sound processing unit reproduces the auscultatory sound based on the acquired measurement data of the heart sound by causing the audio output unit to output an auscultatory sound based on the stored measurement data of the heart sound,
The waveform diagram processing unit reproduces a waveform diagram based on the acquired measurement data of the biological information by causing the display unit to display a waveform diagram based on the stored measurement data of the biological information. The heartbeat diagram inspection apparatus according to claim 1. The waveform diagram processing unit displays a heart sound diagram based on the acquired measurement data of the heart sound on the display unit, and displays a heart sound diagram based on the stored measurement data of the heart sound on the display unit. , Play a heart sound diagram based on the acquired measurement data of the heart sound,
4. The heartbeat diagram inspection apparatus according to claim 3, further comprising an editing section for editing a heartbeat diagram including the reproduced waveform diagram and the heart sound diagram. It further has a variable part that varies the filter characteristic or gain for the waveform diagram,
4. The waveform diagram processing unit displays a waveform diagram based on the stored measurement data of the biological information on the display unit during or after the filter characteristic or the gain is varied. Heart machine diagram inspection device. Further comprising a variable section for varying the filter characteristics or gain of the heart sound diagram,
The auscultation sound processing unit displays a heart sound diagram based on the acquired measurement data of the heart sound on the display unit, and displays a heart sound diagram based on the stored measurement data of the heart sound with the filter characteristic or the gain. 4. The heartbeat diagram inspection apparatus according to claim 3, wherein a heart sound diagram based on the acquired measurement data of the heart sound is reproduced by being displayed on the display unit during or after the variable. A variable filter unit that varies a filter characteristic of the waveform diagram based on the measurement data of the biological information;
Wherein the synchronization unit is in accordance with the variable to said filter characteristics, heart machine view inspecting apparatus according to claim 1, wherein the delaying the output of the auscultatory sound based on the measurement data of the heart sounds. The waveform diagram based on the measurement data of the biological information includes at least an electrocardiogram,
The synchronization unit delays the output of the auscultatory sound based on the measurement data of the heart sound when the variable filter unit filters out a low-frequency component corresponding to the baseline drift of the electrocardiogram by the variable filter characteristic. The heartbeat diagram inspection apparatus according to claim 7, wherein:   The synchronization unit includes a waveform diagram displayed based on the stored measurement data of the biological information, and a mark that moves in synchronization with the auscultatory sound output based on the stored measurement data of the heart sound. The cardiac device inspection apparatus according to claim 2, wherein the display is performed on the display unit.

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