JP5279868B2 - Endothelial function test device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a vascular endothelium function testing instrument which can prevent the expansion of a cuff wound around a part of a living body from hindering the measurement of the diameter of a blood vessel. <P>SOLUTION: The vascular endothelium function testing instrument 30 includes an elbow supporting member 86 receiving and supporting the vicinity of the elbow of the living body 14 and a dorsum manus supporting member 88 receiving and supporting the dorsum manus of the living body 14, and floats the cuff 74 wound around the forearm of the living body 14 into a space during examination and measurement. Consequently, since the expansion of the cuff 74 appropriately restrains the forearm from moving, a relative movement is prevented from occurring between an ultrasonic probe 12 supported by a sensor holding device 10 due to the movement of the forearm associated with the expansion of the cuff 74, and the brachial artery 20 to which the probe is applied and a stable image of a blood vessel can be obtained and the occurrence of hindrance to the measurement of the diameter of the blood vessel can be suitably solved. <P>COPYRIGHT: (C)2011,JPO&amp;INPIT

Description

  The present invention relates to a vascular endothelial function testing device that examines the endothelial function of a blood vessel of a living body by radiating ultrasonic waves from a radiation surface of an ultrasound probe arranged on a part of the skin of the living body.

  Endothelial function, such as the rate of increase in blood vessel diameter during reactive hyperemia, is closely related to the degree of progression of arteriosclerosis. Various inspection methods have been proposed. For example, it is described in Patent Document 1.

  According to this, the ultrasonic probe supported by the tip of the robot arm is pressed against the upper arm of the subject, and the blood vessel image at rest and the blood vessel image after the forearm is blocked are collected. At the same time, the rate of increase of the blood vessel diameter dmax during expansion relative to the blood vessel diameter d at rest or the FMD value (= 100 × (dmax−d) / d) is calculated and used to evaluate arteriosclerosis.

JP 2003-245280 A

  By the way, in the vascular endothelial function testing apparatus as described above, for example, ultrasonic waves disposed on a part of the skin of a living body after release of ischemia by a cuff or the like, after blood flow change by a drug, and after blood flow change by heat. By emitting the radiation surface of the probe, the cross-sectional shape of the blood vessel of the living body is measured. However, when the blood is blocked by a body movement, a part of the body, for example, a cuff wound around the forearm, the skin may be pulled by the cuff compression, or the forearm may move due to the expansion of the cuff. A relative movement occurs between an ultrasonic probe supported by a sensor holding device such as a robot arm and an artery adjacent to a part of the living body to which the ultrasonic probe is applied, for example, the brachial artery, and the blood vessel image fluctuates. However, there is a problem that the measurement of the blood vessel diameter is hindered.

  The present invention has been made against the background of the above circumstances, and its object is to provide a vascular endothelial function that does not hinder measurement of blood vessel diameter due to the expansion of a cuff wound around a part of a living body. It is to provide an inspection device.

The gist of the invention according to claim 1 for achieving the above object is that a cuff wound around a part of a living body for ischemia and a skin near the cuff of the part of the living body. A vascular endothelial function testing device for testing the endothelial function of an artery under the skin by radiating ultrasound from the radiation surface of the ultrasound probe , comprising: A cross-sectional image generating means for generating a cross-sectional image of the artery based on the reflected wave of the ultrasonic wave detected by the acoustic probe, and (b) a reference in the artery before ischemia in the cross-sectional image after ischemia is released. A blood vessel position search means for searching for the artery within a preset search range including a point; and (c) an artery of the artery indicated by the cross-sectional image of the artery after release of ischemia searched by the blood vessel position search means Blood vessel inner diameter calculation algorithm with membrane diameter stored in advance A blood vessel diameter calculating means for calculating according to beam, characterized in that it contains.

According to the vascular endothelial function testing device of the invention according to claim 1, (a) a cross-sectional image generating means for generating a cross-sectional image of the artery based on the reflected wave of the ultrasonic wave detected by the ultrasonic probe; b) In the cross-sectional image after ischemia release, blood vessel position search means for searching the artery within a preset search range including a reference point in the artery before ischemia, and (c) blood vessel position search means And blood vessel diameter calculating means for calculating the intima diameter of the artery indicated by the cross-sectional image of the artery after release of the ischemia searched according to a previously stored blood vessel inner diameter calculation algorithm. even artery image is changed by moving the forearm or be pulled, arterial location within the search range by the vessel position searching means is searched, since the inner diameter of the artery is calculated by the blood vessel diameter calculating means It is preferably eliminated which trouble occurs in the measurement of the inner diameter of the artery.

BRIEF DESCRIPTION OF THE DRAWINGS It is a figure which illustrates roughly the structure of the vascular endothelial function test | inspection apparatus of one Example of this invention. It is a figure which expands and demonstrates the structure of the universal joint and stopper apparatus which hold | maintain an ultrasonic array in the front-end | tip part of the sensor holding apparatus of FIG. It is a figure which shows the state which test | inspects endothelial function using the ultrasonic array provided with the flange part of FIG. 1, Comprising: The resting state before the ischemia by a cuff is shown. It is a figure which shows the state which test | inspects an endothelial function using the ultrasonic array provided with the flange part of FIG. 1, Comprising: The state in the ischemia by a cuff is shown. It is a figure which shows the state which test | inspects endothelial function using the ultrasonic array provided with the flange part of FIG. 1, Comprising: The state after the ischemia release by a cuff is shown. It is a figure which shows the state which test | inspects endothelial function using the ultrasonic array which is not equipped with the flange part, Comprising: The resting state before the ischemia by a cuff is shown. It is a figure which shows the state which test | inspects an endothelial function using the ultrasonic array which is not equipped with the flange part, Comprising: The state in the ischemia by a cuff is shown. It is a figure which shows the state which test | inspects endothelial function using the ultrasonic array which is not equipped with the flange part, Comprising: The state after the ischemia release by a cuff is shown. It is a figure which shows the position of the supporting member for supporting the to-be-measured person's arm on a bed, and a back support member, when test | inspecting endothelial function using the vascular endothelial function test | inspection apparatus of FIG. It is a figure explaining the structure of the back support member which has the height adjustment function shown in FIG. 1 and FIG. It is a figure explaining the vascular endothelial function test | inspection apparatus of the other Example of this invention. It is a figure explaining the vascular endothelial function test | inspection apparatus of the other Example of this invention. It is a figure explaining the front-end | tip part of the ultrasonic probe of the other Example of this invention, Comprising: It is a figure equivalent to FIG. It is a figure explaining the front-end | tip part of the ultrasonic probe of the other Example of this invention, Comprising: It is a figure equivalent to FIG. It is a flowchart explaining the principal part of the control action of the electronic control apparatus of the Example of FIG. It is a figure which shows the cross-sectional image, ie, a short-axis image, explaining the principal part of the control action of the electronic control apparatus of the Example of FIG.

  DESCRIPTION OF EXEMPLARY EMBODIMENTS Hereinafter, preferred embodiments of the invention will be described in detail with reference to the drawings. FIG. 1 shows an ultrasonic probe (ultrasonic probe) 12 held by a sensor holding device 10 according to an embodiment of the present invention, and the skin 18 of an upper arm 16 of a living body 14 which is a detection target is viewed from above. It is a front view explaining the vascular endothelial function test | inspection apparatus 30 provided with the blood vessel image measuring apparatus 22 which measures the cross-sectional image (short-axis image) or the longitudinal cross-sectional image (long-axis image) of the blood vessel 20 located just under the skin 18. FIG. .

  The ultrasonic probe 12 functions as a sensor for detecting biological information. For example, a single row is formed by arranging a plurality of ultrasonic transducers made of piezoelectric ceramics in a row. Alternatively, the distal end portion 24 including two rows of ultrasonic arrays parallel to each other is provided on the probe main body 28 via the triaxial drive mechanism 26.

  The vascular endothelial function testing device 30 includes an electronic control device 32 composed of a so-called microcomputer, a monitor screen display device 34, a keyboard 36 and a mouse 37 which are input operation devices, and an ultrasonic drive control circuit 38. The electronic control device 32 supplies a drive signal from the ultrasonic drive control device 36 to emit ultrasonic waves from the ultrasonic array at the distal end portion 24 of the ultrasonic probe 12, and is detected by the ultrasonic array at the distal end portion 24. By receiving the ultrasonic reflected signal and processing the ultrasonic reflected signal, an ultrasonic image under the skin 18 is generated and displayed on the monitor screen display device 34. The lower end surface of the distal end portion 24 corresponds to the radiation surface S that emits ultrasonic waves. Further, when generating a cross-sectional image (short axis image) of the blood vessel 20, the electronic control device 32 drives the three-axis positioning mechanism 26 so that the ultrasonic array is at a position orthogonal to the blood vessel 20. Therefore, when generating a longitudinal section image (long axis image) of the blood vessel 20, the ultrasonic array is positioned by the triaxial positioning mechanism 26 so as to be parallel to the blood vessel 20.

  The ultrasonic drive control circuit 38 receives a predetermined number of ultrasonic vibrations from the end of a large number of ultrasonic transducers arranged in a line constituting the ultrasonic array in accordance with a command from the electronic control unit 32. A beam forming drive that simultaneously drives at a frequency of about 10 MHz while giving a predetermined phase difference for each child group to sequentially emit a convergent ultrasonic beam toward the blood vessel 20 in the arrangement direction of the ultrasonic transducers, The reflected wave for each radiation is received and input to the electronic control unit 32. An acoustic lens for converging the ultrasonic beam in a direction orthogonal to the arrangement direction of the ultrasonic transducers is provided on the radiation surface of the ultrasonic array.

  The electronic control unit 32 synthesizes an ultrasonic cross-sectional image based on the reflected wave detected by the ultrasonic array, generates a cross-sectional image (short axis image) of the blood vessel 20 under the skin 18, or A longitudinal section image (long axis image) is generated and displayed on the monitor screen display device 34. Further, the diameter of the blood vessel 20 or the endothelial diameter (intimal diameter) is calculated from the image. In order to evaluate the vascular endothelial function, the change rate (%) of the endothelial diameter (intimal diameter) of the blood vessel representing FMD (blood flow-dependent vasodilatation reaction) after ischemic reactive hyperemia [= 100 × ( dmax−d) / d] (where d is the resting vascular endothelium diameter and dmax is the maximum vascular endothelium diameter after release of ischemia). When the vascular endothelial diameter is detected, an accurate flow cross-sectional area of the blood vessel 20 is calculated, and an accurate blood flow rate is calculated using, for example, a blood flow velocity detected by an ultrasonic Doppler device.

  The ultrasonic probe 12 does not deform the blood vessel 20 located just below the skin 18 from the skin 18 of the upper arm 16 of the living body 14 which is a detection target at a desired position in the three-dimensional space, that is, a predetermined position. The sensor holding device 10 is held in a desired posture in a state where it is lightly contacted. The ultrasonic probe 12 is generally well-known between the end face of the distal end portion 24 and the skin 18 for suppressing the attenuation of ultrasonic waves, reflection and scattering at the boundary surface, and clarifying the ultrasonic image. A coupling agent such as jelly is interposed. This jelly is a gel-like water-absorbing polymer containing water at a high rate, for example, agar, etc., and has a sufficiently higher specific impedance (= sound speed × density) than air to suppress attenuation of ultrasonic transmission / reception signals. Is. Further, instead of the jelly, a water bag in which water is confined in a resin bag, olive oil, glycerin, or the like can be used.

  The sensor holding device 10 is provided in a fixed position on a desk, a pedestal or the like, and has a base 42 having a fitting hole 40 formed in the direction of the vertical rotation axis C, and a relative position in the fitting hole 40. A rotation member 46 that includes a fitting shaft 44 that is rotatably fitted, is provided so as to be rotatable about a rotation axis C perpendicular to the base 42, and is fixed to the rotation member 46. The first link mechanism 48 includes four links 48a to 48d including the first fixed link 48a, and the four links 50a to 50d include the first fixed link 50a fixed to the distal end portion of the first link mechanism 48. The second link mechanism 50, the universal joint 52 which is fixed at the distal end of the second link mechanism 50 and rotatably connects the ultrasonic probe 12 and supports the second probe mechanism 50, and the operation lever 54 is not operated. Always turn the joint 52 Fixed, and a stopper device 56 for releasing acceptable i.e. the fixed state the times songs that were fixed at all times in accordance with operation of the operating lever 54.

  The first link mechanism 48 includes a pair of first fixed links 48a and first movable links 48b parallel to each other, and the pair of first fixed links 48a and first movable links so as to form a parallelogram. A pair of first rotation links 48c and 48d parallel to each other are rotatably connected to both ends of 48b, and the first movable link 48b moves in a plane including the rotation axis C. Thus, the first fixed link 48a is fixed to the rotating member 46. The first link mechanism 48 is provided with a first coil spring 49 that functions as a first urging device that generates a thrust having a directional component against the load applied to the first movable link 48b. . The first coil spring 49 is stretched between a connection point between the first rotation link 48c and the first fixed link 48a and a connection point between the first rotation link 48d and the first movable link 48b. The first movable link 48b generated by the moment that pulls up the first movable link 48b generated by the first coil spring 49 and the load applied to the first movable link 48b. The moment in the downward pulling direction is substantially canceled out.

  The second link mechanism 50 has a pair of second rotation links 50c and 50d that are parallel to each other, and rotates at both ends of the pair of second rotation links 50c and 50d so as to form a parallelogram. A pair of second fixed links 50a and a second movable link 50b that are movably connected to each other, and the second fixed link 50b is moved so as to move within a plane including the rotation axis C. The link 50a is fixed in a posture substantially orthogonal to the first movable link 48b. The second link mechanism 50 is provided with a second coil spring 51 that functions as a second urging device that generates a thrust having a directional component against a load applied to the second movable link 50b. The second coil spring 51 is stretched between a connection point between the second rotation link 50c and the second fixed link 50a and a connection point between the second rotation link 50d and the first movable link 50b. The second movable link 50b generated by the second coil spring 51 and the moment in the direction of pulling up the second movable link 50b upward and the load applied to the second movable link 50b. The moment in the downward pulling direction is substantially canceled out. Due to the canceling action of the first coil spring 49 and the second coil spring 51 as described above, the ultrasonic probe 12 is held at a desired position in the three-dimensional space or is slowly lowered, and the blood vessel 20 is deformed. The tip portion 24 of the ultrasonic probe 12 can be lightly adhered in a surface contact state via a coupling agent such as jelly to such an extent that it does not occur.

  As shown in an enlarged view in FIG. 2, the universal joint 52 includes a first connecting member 52a having a distal end portion 58 having a base end portion fixed to the second movable link 50b and formed in a spherical shape, and a first connection member 52a. A second connecting member 52b provided with a fitting hole 60 into which the spherical tip 58 of the connecting member 52a is slidably fitted, and connected so as to be capable of relative turning around the spherical center B of the spherical tip 58. The ultrasonic probe 12 is held in a desired posture.

  The stopper device 56 includes an operation lever 54 guided by a pair of guide holes 62 and 64 provided in the second connecting member 52b so as to be able to approach and separate from the spherical tip 58, and the operation lever 54 in a spherical shape. And a pressing spring 66 that presses against the distal end portion 58. Normally, when the operating lever 54 is not operated, the operating lever 54 is pressed against the spherical distal end portion 58 by the pressing spring 66. The joint 52 is prevented from turning and is always fixed, but when the operation lever 54 is operated against the urging force of the pressing spring 66, the operation lever 54 is separated from the spherical tip 58. The fixing of the universal joint 52 is released and its turning is allowed. A one-dot chain line in FIG. 1 indicates a state in which the ultrasonic probe 12 is raised.

  As shown in FIG. 3, a coupling agent 76 such as a jelly is provided between the radiation surface S and the skin 18 at the distal end 24 which is the lower end of the ultrasonic probe 12 regardless of the movement of the skin 18 under examination. In order to make it interpose, the flange part 70 protrudes in the direction away from a radiation surface in the outer peripheral part of the said radiation surface S, and is provided. The flange portion 70 holds a sufficient amount of coupling agent between the holding surface 72 of the flange portion 70 facing the skin 18 and the skin 18. In order to evaluate the vascular endothelial function, when a change rate (%) of the vascular diameter representing FMD (blood flow-dependent vasodilatation reaction) after ischemic reactive hyperemia is obtained, the cuff 74 wound around the forearm is obtained. The change in blood vessel diameter when the ischemia is terminated by releasing the cuff 74 after being ischemic for a certain period of time by the compression of the cuff 74 is obtained from a short-axis image obtained using the ultrasonic probe 12. A sufficient amount of the ring agent 76 means that when the skin 18 is pulled by the compression of the cuff 74 as shown in FIG. 4 and then the tension of the skin 18 is returned by the release of the cuff 74 as shown in FIG. This means that the coupling agent 76 is present between the radiation surface S of the ultrasonic probe 12 and the skin 18 and there is an amount capable of transmitting ultrasonic waves almost without attenuation.

  6, 7, and 8 illustrate the case of the ultrasonic probe 12 that does not include the flange portion 70. 6 shows a state before compression by the cuff 74, FIG. 7 shows a state in which the skin 18 is pulled by the compression by the cuff 74, and FIG. 8 shows a state in which the tension of the skin 18 is returned by releasing the cuff 74. ing. When the tension of the skin 18 is returned, the coupling agent 76 between the radiation surface S of the ultrasonic probe 12 and the skin 18 is plastically deformed and air is contained in the ultrasonic wave propagation path, so that the ultrasonic wave is attenuated. It occurs remarkably.

  As shown in FIG. 9, the living body 14 as the measurement subject lies on the bed 80 in a supine state with his arms protruding sideways. In order to ensure the measurement accuracy of FMD after ischemic reactive hyperemia, it is important to place the arm in a natural state, that is, in a relaxed state. For this reason, in this embodiment, a support base 84 having a horizontal support surface (top surface or top surface) 82 is provided, and the elbow between the forearm portion and the upper arm portion of the living body 14 is received and supported. A support member 86 and a back support member 88 that receives and supports the back of the living body 14 are placed on the support surface 82 of the support base 84 so that the position thereof can be changed in the horizontal direction. The elbow support member 86 and the back support member 88 pass through a magnetic attracting force by a permanent magnet or an electromagnet, an attracting force by a negative pressure generated or supplied to the contact surface, and a long hole penetrating the support surface 82. It is fixed on the support surface 82 of the support base 84 by the fastening force by the fixing tool.

  The elbow support member 86 is a block-like member having a substantially horizontal elbow receiving surface 90. As shown in FIG. 10, the back support member 88 includes a substrate 92 and a receiving plate 94 that are parallel to each other, and a height adjustment handle 96 for adjusting the height in accordance with a rotation operation. A height adjusting device 100 having a pantograph-like link mechanism 98 provided on the receiving plate 94 is provided. The receiving plate 94 is provided with an inclined receiving surface 102 for receiving the back of the hand. The height of the elbow support member 86 and the back support member 88 is set so that a sufficient space is formed between the cuff 74 wound around the forearm and the support surface 82 of the support base 84. Furthermore, the height of the back support member 88 is adjusted so that the hand of the living body 14 can be relaxed naturally.

  According to the vascular endothelial function testing device 30 of the present embodiment, the elbow support member 86 that receives and supports the elbow between the forearm portion and the upper arm portion of the living body 14, and receives and supports the back of the living body 14. The cuff 74 wound around the forearm portion of the living body 14 is floated in the space during the test measurement, so that the movement of the forearm portion due to the expansion of the cuff 74 is suitable. Therefore, the relative relationship between the ultrasonic probe 12 supported by the sensor holding device 10 and the brachial artery 20 to which it is applied is caused by the movement of the forearm related to the expansion of the cuff 74. Occurrence of movement is prevented, and stable blood vessel images are obtained, and troubles in measuring blood vessel diameters are preferably eliminated.

  Further, according to the vascular endothelial function testing device 30 of the present embodiment, the elbow support member 86 and the back support member 88 are disposed on the support surface 82 of the support base 84 having the horizontal support surface 82, and the horizontal direction Therefore, it is possible to position the elbow support member 86 and the back support member 88 at the optimum positions so that the arm has a natural posture in accordance with the body shape of the measurer lying on the bed 80. Can test vascular endothelial function in a relaxed state.

  Further, according to the vascular endothelial function testing device 30 of the present embodiment, the back support member 88 is provided with the height adjusting device 100 that adjusts the height of the receiving surface 102, so that it is placed on the bed 80. The height of the back support member 88 can be positioned at an optimal position so that the arm has a natural posture in accordance with the body shape of the lying measurement person, and the vascular endothelial function can be examined in a relaxed state.

  Further, according to the vascular endothelial function testing device 30 of the present embodiment, the coupling agent between the radiation surface S of the ultrasonic probe 12 and the skin 18 regardless of the movement of the skin 18 due to the expansion of the cuff 74 under examination. In order to interpose 76, since the holding surface 72 is provided around the radiation surface S of the ultrasonic probe 12 and faces the skin 18, even if the skin 18 is pulled by the expansion of the cuff 74, the ultrasonic wave Since the coupling agent 76 such as jelly is reliably interposed between the radiation surface S of the probe 12 and the skin 18, it is preferable to solve the problem that a stable blood vessel image is obtained and the measurement of the blood vessel diameter is hindered. Is done.

  Further, according to the vascular endothelial function testing device 30 of the present embodiment, the distal end portion 24 of the ultrasonic probe 12 is made of a metal plate material or a resin plate material protruding in a direction away from the radiation surface S and away from the cuff 74. Since the flange portion 70 is provided and the holding surface 72 is provided on the side of the flange portion 70 facing the skin 18, the ultrasonic probe 12 can be used even when the skin 18 is pulled by the expansion of the cuff 74. Since the coupling agent 76 such as jelly is reliably interposed between the radiation surface S and the skin 18, it is possible to suitably solve the problem that a stable blood vessel image is obtained and the measurement of the blood vessel diameter is hindered. .

  Next, another embodiment of the present invention will be described. In the following description, functions or components common to the embodiments are denoted by the same reference numerals and description thereof is omitted.

  In the vascular endothelial function testing device 108 shown in the embodiment of FIG. 11, the elbow support member 86 is not a block-shaped member, but includes a height adjustment device 110 similar to the height adjustment device 100 of the dorsal support member 88. 1 is different in that the hand support member 88 is provided with a belt 112 to be gripped by the hand of the living body 14 when receiving the back of the living body 14, and the other structure is the vascular endothelial function testing device 30 shown in FIG. It is the same.

  As shown in FIG. 11, the elbow support member 86 includes a substrate 114 and a receiving plate 116 that are parallel to each other, and a height adjusting handle 118 for adjusting the height according to a rotation operation. A height adjusting device 110 having a pantograph-like link mechanism 118 provided on the plate 116 is provided. Further, an annular belt 112 is fixed to the receiving plate 94 of the back support member 88 so as to be gripped by a living hand when the back of the hand is received by the inclined receiving surface 102.

  According to the vascular endothelial function testing device 108 of the present embodiment, the elbow support member 86 is also provided with a height adjustment device 110 similar to the height adjustment device 100 of the back support member 88. To test the vascular endothelial function in a relaxed state, the height of the back support member 88 can be more easily positioned in an optimal position so that the arm is in a natural posture according to the body shape of the lying measurer Can do.

  Further, according to the vascular endothelial function testing device 108 of the present embodiment, an annular belt 112 is attached to the back support member 88 so as to be gripped by the hand of the living body when the back of the living body 14 is received. Therefore, the hand and arm of the living body 14 being measured are stabilized, a more stable blood vessel image is obtained, and the measurement accuracy of the blood vessel diameter is increased.

  In the vascular endothelial function testing device 120 shown in the embodiment of FIG. 12, a support base 84 having a horizontal support surface 82 on which an elbow support member 86 and a back support member 88 are placed is configured to be height-adjustable. In this respect, the hand support member 88 is different from the vascular endothelial function testing apparatus 30 shown in FIG.

  As shown in FIG. 12, the support base 84 is fixed to the substrate 122, the top plate 124 having an upper surface functioning as a horizontal support surface 82, the tubular member 126 erected on the substrate 122, and the lower surface of the top plate 124. Strut adjustable strut 132 having a shaft member 128 inserted into the tubular member 126 and a set screw 130 screwed into the tubular member 126 to secure the shaft member 128 to the tubular member 126; It is composed of By changing the position at which the shaft member 128 is fixed to the tubular member 126 by the set screw 130, the height of the top plate 124 is adjusted.

  According to the vascular endothelial function testing device 120 of the present embodiment, the support base 84 having the horizontal support surface 82 on which the elbow support member 86 and the back support member 88 are placed is configured to be adjustable in height. In accordance with the body shape of the measurer lying on the bed 80, the height of the back support member 88 can be more easily positioned at an optimal position so that the arm has a natural posture, and the vascular endothelium can be relaxed. The function can be checked.

  13 and 14 show a modification for providing the holding surface 72 of the coupling agent 76 at the distal end portion 24 of the ultrasonic probe 12. Although the flange portion 70 of the embodiment shown in FIGS. 3 to 5 has a shape protruding in a direction away from the cuff 74, in the embodiment shown in FIGS. 13 and 14, the radiation located at the center of the lower surface of the tip portion 24. A circular holding surface 72 centering on the surface S is provided. In FIG. 13, the flange portion 134 formed of a circular metal plate or resin plate is provided at the distal end portion 24 of the ultrasonic probe 12 in a state of protruding in a direction away from the radiation surface S. A circular holding surface 72 centered on the radiation surface S is provided on the surface of the flange portion 134 facing the skin 18. In FIG. 14, a circular large-diameter portion 136 is provided at the lower end edge of the distal end portion 24 of the ultrasonic probe 12, and the circular surface around the radiation surface S is held on the surface of the large-diameter portion 136 facing the skin 18. According to the present embodiment in which the surface 72 is provided, a sufficient amount of the coupling agent 76 is reliably interposed between the skin 18 and the circular holding surface 72 centered on the radiation surface S. After the skin 18 is pulled by the expansion of the cuff 74 for ischemia, even if the skin 18 from which the cuff 74 is released returns to the position before ischemia, the radiation surface S and the skin 18 of the ultrasonic probe 12 are restored. Since the coupling agent 76 such as jelly is surely present between the two, a stable blood vessel image is obtained, and troubles in measuring the blood vessel diameter are preferably eliminated.

  FIG. 15 is a main part of the control operation of the electronic control device 32, and the blood vessel search in the blood vessel diameter cross-sectional image, ie, the short axis image, for measuring the endothelial diameter (intimal diameter) of the artery after release of ischemia. It is a flowchart explaining an action | operation. In FIG. 15, in step (hereinafter, step is omitted) S <b> 1, the short axis image is generated based on the ultrasonic reception signal from the ultrasonic probe 12 (the ultrasonic reflected wave from the blood vessel 20). In the present embodiment, S1 corresponds to a cross-sectional image generating unit. 16A is a short-axis image at rest before ischemia, and an image showing the blood vessel 20 is stored as the reference point X. FIG. FIG. 16B is a short-axis image during ischemia, and the image showing the blood vessel 20 is displayed at a position deviated from the reference point X when the skin 18 is pulled due to compression by the cuff 74. . (C), (d), and (e) of FIG. 16 show examples of the short-axis images generated in S1.

  In S2, the reference point X indicating the resting position of the artery, that is, the blood vessel 20, is displayed on the short axis image. FIG. 16 (c), (d), or (e) shows this state. Next, in S3, it is determined whether or not the reference point X is located in the blood vessel of the short axis image. If the determination in S3 is affirmative, the short axis image shown in FIG. 16 (c) is obtained, and in S8, the intima of the blood vessel 20 surrounding the reference point X is stored in accordance with the blood vessel inner diameter calculation algorithm stored in advance. The diameter is calculated. In this embodiment, S8 corresponds to the blood vessel diameter calculating means.

  However, if the determination in S3 is negative, since this is a short-axis image in which the reference point X is located near the outside of the blood vessel as shown in FIG. 16D, the reference point is determined in S4. The presence or absence of blood vessels is searched for within a predetermined search range based on X. This predetermined search range is indicated by a one-dot chain line in FIG. 16, and is a preset region in which it is expected that images such as veins and tendons do not exist, and the presence of arteries is exclusively predicted. In this embodiment, S4 corresponds to the blood vessel position searching means.

  In S5, it is determined whether or not a blood vessel exists within the search range. If the determination in S5 is affirmative, in S7, the reference point X is moved into the blood vessel determined to exist as shown in FIG. 16 (f). Next, in S8, the intima diameter of the blood vessel 20 surrounding the reference point X is calculated according to the blood vessel inner diameter calculation algorithm stored in advance. However, if the determination in S5 is negative, in S6, the reference point X is placed in the blood vessel in which the cross-sectional image is displayed in accordance with the operation of the mouse 37, which is a manual input device, as shown in FIG. After being moved, the above S7 and subsequent steps are executed.

  According to the present embodiment, (a) cross-sectional image generation means S1 that generates a cross-sectional image of the blood vessel 20 based on the reflected wave of the ultrasonic wave detected by the ultrasonic probe 12, and (b) the cross-section after the release of ischemia. In the image, blood vessel position search means S4 for searching for a blood vessel within a preset range based on the position of the blood vessel 20 before ischemia, and (c) the diameter of the blood vessel searched by the blood vessel position search means S4. Since the blood vessel diameter calculating means S8 is included, even if the skin is pulled or the forearm moves due to the expansion of the cuff 74 and the blood vessel image is changed, the blood vessel position searching means S4 searches for the blood vessel position. Since the inner diameter d of the blood vessel is calculated by the blood vessel diameter calculating means S8, troubles in measuring the blood vessel diameter are preferably eliminated.

  As mentioned above, although the Example of this invention was described in detail based on drawing, this invention can be applied also in another aspect.

  For example, in the embodiment shown in FIGS. 1 and 12, the elbow support member 86 having a fixed height and the back support member 88 having a variable height are used. In the embodiment shown in FIG. The elbow support member 86 and the back support member 88 are used. However, the elbow support member 86 and the back support member 88 having a fixed height are used. A fixed hand support member 88 may be used.

  1, 11 and 12, the elbow support member 86 and the back support member 88 are movably provided on the support surface 82 of the support base 84, but the elbow support member 86 and One of the back support members 88 may be provided so as to be movable, and the other may be provided in a fixed position.

  1, 11 and 12, the elbow support member 86 receives the elbow between the forearm portion and the upper arm portion of the living body 14, but the elbow side portion or the forearm portion of the upper arm portion. It can be received near the elbow, such as the elbow side.

  Further, in the embodiment of FIG. 1 described above, the sensor holding device 10 including the two link mechanisms 48 and 50 is used to hold the ultrasonic probe 12. However, the sensor holding device 10 includes a telescopic arm, a robot arm, and the like. Other configurations of the sensor holding device may be used.

  Further, although the height adjusting devices 100 and 119 of the above-described embodiments are configured by the pantograph type link mechanism, they may be configured by a telescopic rod so that the height can be adjusted.

  Further, in the above-described embodiments of FIGS. 1, 11, and 12, the living body 14 is measured in a supine state on the bed 80, but may be measured in a relaxed state sitting on a chair.

  The above description is only an embodiment, and the present invention can be implemented in variously modified and improved forms based on the knowledge of those skilled in the art.

12: Ultrasonic probe 14: Living body 18: Skin 30: Vascular endothelial function testing device 70: Flange 72: Holding surface 74: Cuff 76: Coupling agent 82: Support surface 84: Support base 86: Elbow support member 88: Dorsal Support member 100, 119: Height adjusting device 112: Belt S1: Cross-sectional image generating means S4: Blood vessel position searching means S8: Blood vessel diameter calculating means S: Radiation surface

Claims (1)

Comprising a cuff wound around the portion of a living body for ischemia, and an ultrasonic probe which is placed on the skin of the cuff near of the part of the living body, ultra from the radiating surface of the ultrasonic probe A vascular endothelial function test device for testing endothelial function of an artery under the skin by emitting sound waves,
A cross-sectional image generating means for generating a cross-sectional image of the artery based on the reflected wave of the ultrasonic wave detected by the ultrasonic probe;
In the cross-sectional image after ischemia release, blood vessel position search means for searching the artery within a preset search range including a reference point in the artery before ischemia;
Blood vessel diameter calculating means for calculating the intima diameter of the artery indicated by the cross-sectional image of the artery after release of ischemia searched by the blood vessel position searching means according to a blood vessel inner diameter calculation algorithm stored in advance. Vascular endothelial function testing device.

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