JP5900129B2 - Blood pressure estimation parameter calibration method, blood pressure measurement method, and blood pressure measurement device - Google Patents

Description

  The present invention relates to a method for calibrating parameters related to blood pressure estimation processing and the like.

  2. Description of the Related Art Conventionally, devices that measure blood flow, blood vessel diameter, and blood pressure using ultrasonic waves, and devices that measure the elasticity of blood vessels have been devised. These devices are characterized in that measurement can be performed without causing pain or discomfort to the subject.

  For example, Patent Document 1 discloses a method for estimating blood pressure from a stiffness parameter representing the hardness of a blood vessel and a blood vessel diameter or blood vessel cross-sectional area, taking a change in blood vessel diameter or blood vessel cross-sectional area as a non-linear relationship. It is disclosed.

JP 2004-41382 A

  The biological information such as the blood vessel diameter, the blood vessel cross-sectional area, and the blood pressure changes from time to time due to external factors such as changes in weather and temperature, and internal factors such as the physical condition of the subject and the degree of stress. For this reason, the above-mentioned correlation characteristic also changes every moment. Therefore, when the blood pressure is estimated based on the fixed and uniform correlation characteristics, the estimation result is not always reliable and may include a large error.

  The present invention has been made in view of the above-described problems, and an object thereof is to propose a new method for correctly estimating blood pressure.

  The first form for solving the above-described problem is that the blood vessel diameter or blood vessel cross-sectional area of the target artery (hereinafter collectively referred to as “blood vessel cross-section index value”) in the first part of the subject where the target artery is running. Blood vessel cross-sectional index value measurement for measuring) and blood pressure measurement for measuring the blood pressure of the subject at a second site different from the first site, the target artery running on the second site. The blood pressure is estimated from the blood vessel cross-sectional index value using the measurement result by the blood vessel cross-section index value measurement and the measurement result by the blood pressure measurement, depending on whether or not the region is a part of the blood vessel. And calibrating parameters relating to blood pressure estimation processing.

  As another form, a blood vessel cross-section index value measurement unit that measures a blood vessel cross-section index value of the target artery at the first site of the subject where the target artery is running, and a second that is different from the first site. A control unit for controlling blood pressure measurement guidance notification for urging execution of blood pressure measurement for measuring the blood pressure of the subject in an external blood pressure measurement device at a site, and measurement execution by the blood vessel cross-section index value measurement unit, Control is performed so that the measurement by the blood pressure measurement device and the measurement by the blood vessel cross-section index value measurement unit are performed simultaneously or in time division depending on whether or not the second part is a part where the target artery is running. A calibration unit that calibrates a parameter related to blood pressure estimation processing for estimating blood pressure from a blood vessel cross-section index value, using a control unit that performs measurement by the blood vessel cross-section index value measurement unit and a measurement result by the blood pressure measurement device; The It is also possible to configure the example was a blood pressure measuring device.

  According to the first aspect and the like, the blood vessel cross-sectional index value measurement for measuring the blood vessel cross-sectional index value of the target artery at the first site of the subject where the target artery is running differs from the first site. The blood pressure measurement for measuring the blood pressure of the subject at two sites is performed simultaneously or in time division depending on whether or not the second site is a site where the target artery is running. For example, in blood pressure measurement using a pressurized sphygmomanometer, it is difficult to correctly measure the blood vessel cross-sectional index value of the target artery in the first part because the second part is pressurized and driven during blood pressure measurement. is there. Therefore, for example, when the second part is a part where the target artery is running, it is preferable to perform blood vessel cross-sectional index value measurement and blood pressure measurement in a time-sharing manner.

  In the first embodiment and the like, a parameter related to blood pressure estimation processing for estimating blood pressure from a blood vessel cross-section index value is calibrated using a measurement result by blood vessel cross-section index value measurement and a measurement result by blood pressure measurement. Since the parameters related to the blood pressure estimation process are calibrated using the blood vessel cross-sectional index value and the measurement result obtained by actually measuring the blood pressure, the blood pressure of the subject can be correctly estimated in the subsequent blood pressure estimation process.

  Further, as a second form, in the blood pressure estimation parameter calibration method of the first form, the target artery is a radial artery, the first part is a wrist part, and the second part is an upper arm part, A blood pressure estimation parameter calibration method, wherein the blood vessel cross-section index value measurement and the blood pressure measurement are performed simultaneously or in a time-sharing manner depending on whether the first part and the second part are the same arm or not. It may be configured.

  According to the second embodiment, the blood vessel cross-sectional index value of the radial artery is measured at the wrist of the subject where the radial artery is running. In addition, the blood pressure of the subject is measured at the upper arm. Then, blood vessel cross-section index value measurement and blood pressure measurement are performed simultaneously or in a time-sharing manner depending on whether or not the wrist and upper arm are the same arm. When the wrist and upper arm are the same arm (for example, the right arm for the right arm), blood pressure is measured at the upper arm when blood pressure is measured at the upper arm, so blood vessel cross-sectional index value measurement at the wrist and the upper arm It is preferable to perform blood pressure measurement at the time division in a time division manner.

  Further, as a third form, in the blood pressure estimation parameter calibration method of the first or second form, in the blood vessel cross-section index value measurement, a blood vessel cross-section index value of the target artery is measured for a predetermined time, and the blood pressure In the measurement, the systolic blood pressure and the diastolic blood pressure are measured, and the parameters are calibrated from the measurement result of the blood vessel cross-sectional index value measurement during the predetermined time from the systolic blood vessel cross-sectional index value and the diastolic blood vessel cross-section. Obtaining an index value, and calibrating the parameter based on the systolic blood pressure and the diastolic blood pressure, the systolic blood vessel cross-sectional index value and the diastolic blood vessel cross-sectional index value, and a blood pressure estimation parameter A calibration method may be configured.

  According to the third aspect, in the blood vessel cross-section index value measurement, the blood vessel cross-section index value of the target artery is measured for a predetermined time. In blood pressure measurement, systolic blood pressure and diastolic blood pressure are measured. A systolic blood vessel cross-sectional index value and a diastolic blood vessel cross-sectional index value are obtained from the measurement result of the blood vessel cross-sectional index value measurement during a predetermined time. Based on the systolic blood pressure and the diastolic blood pressure, the systolic blood vessel cross-sectional index value, and the diastolic blood vessel cross-sectional index value, the parameters relating to the blood pressure estimation process are calibrated. This makes it possible to appropriately calibrate parameters related to blood pressure estimation processing.

  In addition, as a fourth embodiment, after performing the blood pressure estimation parameter calibration method according to any one of the first to third embodiments, normal measurement is performed in which the blood vessel cross-sectional index value of the target artery is measured at the first site. And using the parameters calibrated by the blood pressure estimation parameter calibration method to estimate the blood pressure by performing the blood pressure estimation process from the measurement result of the normal measurement, the blood pressure measurement method may be configured. .

  According to the fourth aspect, after performing the blood pressure estimation parameter calibration method according to any one of the above forms, normal measurement is performed in which the blood vessel cross-sectional index value of the target artery is measured at the first site. Then, by using the parameter calibrated by the blood pressure estimation parameter calibration method, blood pressure estimation processing is performed from the measurement result of the normal measurement to estimate the blood pressure, thereby correctly estimating the blood pressure of the subject.

(1) Schematic configuration diagram of an ultrasonic sphygmomanometer. (2) A state diagram in which an ultrasonic sphygmomanometer is attached. (1) A state diagram in which an upper arm-mounted pressure sphygmomanometer is mounted. (2) A state diagram in which a wrist-worn pressure sphygmomanometer is worn. The block diagram which shows an example of a function structure of an ultrasonic sphygmomanometer. The flowchart which shows the flow of a main process. The flowchart which shows the flow of the data acquisition process for calibration. Explanatory drawing of the combination of an ultrasonic sphygmomanometer and a pressurized sphygmomanometer.

  As an embodiment to which the present invention is applied, an embodiment will be described in which the subject's wrist is the target site and the subject artery is the radial artery, and the blood pressure of the subject is measured. In the present embodiment, the blood vessel diameter is described as the blood vessel cross-sectional index value, but the blood vessel cross-sectional area may be used instead of the blood vessel diameter (in this case, “blood vessel diameter” in the following text is changed to “blood vessel cross-sectional area”). Just replace it and read it.) Of course, the form to which the present invention can be applied is not limited to the embodiment described below.

1. Schematic Configuration FIG. 1 (1) is a diagram showing a schematic configuration of an ultrasonic sphygmomanometer 1 in the present embodiment. The ultrasonic sphygmomanometer 1 is configured so that the main body can be attached to a subject site (especially a wrist) of a subject using a belt-like portion 15. The belt-shaped portion 15 is a mounting tool for mounting the apparatus main body on the subject site of the subject, and includes a band having a hook-and-loop fastener, a clip for sandwiching the measurement site, and the like. The ultrasonic sphygmomanometer 1 can be attached to either the right wrist or the left wrist of the subject. In the present embodiment, the case where the ultrasonic sphygmomanometer 1 is attached to the left wrist of the subject will be described as an example.

  The main body of the ultrasonic sphygmomanometer 1 is configured by connecting a first part 1A and a second part 1B via a hinge part 11.

  In the first part 1A, an operation button 12, a liquid crystal display 13, and a speaker 14 are provided.

  The operation button 12 is used by the subject to input a blood pressure measurement start instruction and various amounts related to blood pressure measurement.

  The liquid crystal display 13 displays the blood pressure measurement result by the ultrasonic sphygmomanometer 1. As a display method, the blood pressure measurement value may be displayed as a numerical value, or may be displayed as a graph or the like.

  From the speaker 14, various kinds of voice guidance related to blood pressure measurement are output as sound. In the present embodiment, when the ultrasonic sphygmomanometer 1 is calibrated, it is necessary to measure the blood pressure with the pressurized sphygmomanometer 2. Therefore, for example, sound guidance for instructing attachment / detachment of the pressurized sphygmomanometer 2 may be output from the speaker 14.

  An ultrasonic sensor unit 20 is provided in the second part 1B. The ultrasonic sensor unit 20 is an ultrasonic transmission / reception unit in which ultrasonic transducers are arranged in an array. The ultrasonic sensor unit 20 transmits an ultrasonic pulse signal or burst signal of several MHz to several tens of MHz from the transmission unit toward the target artery. Then, the reception unit receives the reflected waves from the front wall and the rear wall of the target artery, and measures the blood vessel diameter of the target artery from the reception time difference between the reflected waves of the front wall and the rear wall.

  Although not shown, the main body of the ultrasonic sphygmomanometer 1 incorporates a control board for controlling the devices in an integrated manner. On the control board, a microprocessor, a memory, a circuit for transmitting and receiving ultrasonic waves, an internal battery, and the like are mounted.

  FIG. 1 (2) is a diagram showing a state in which the ultrasonic sphygmomanometer 1 is worn on the left wrist of the subject. As shown in FIG. 1 (2), the ultrasonic sphygmomanometer 1 is mounted on the wrist of a subject in such a posture that a measurement surface for transmitting / receiving ultrasonic waves faces the inside of the wrist. At this time, the second portion 1B provided with the ultrasonic sensor unit 20 is mounted so as to come to the thumb side of the wrist of the subject. This is because the target artery is the radial artery that flows on the thumb side of the wrist, and the ultrasonic sensor unit 20 is positioned immediately above.

  In the present embodiment, the ultrasonic sphygmomanometer 1 is calibrated using an external blood pressure measurement device different from the ultrasonic sphygmomanometer 1. Various blood pressure monitors can be applied as the blood pressure measurement device, but in this embodiment, an additivity configured to measure systolic blood pressure (maximum blood pressure) and diastolic blood pressure (minimum blood pressure) using the oscillometric method. A pressure sphygmomanometer 2 (cuff type sphygmomanometer) is used.

  In this embodiment, as the pressurization sphygmomanometer 2, there are two types of an upper arm attachment type pressurization sphygmomanometer 2 </ b> A that is attached to the upper arm part and a wrist attachment type pressurization sphygmomanometer 2 </ b> B that is attached to the wrist part. A pressurized sphygmomanometer 2 is assumed. Which of these two types of pressurization sphygmomanometer 2 is used depends on which pressurization sphygmomanometer 2 the subject owns. That is, the subject calibrates the ultrasonic sphygmomanometer 1 using the pressurized sphygmomanometer 2 that he / she owns.

  FIG. 2 (1) is a block diagram of the upper arm-mounted pressure sphygmomanometer 2A. In the upper arm-mounted pressure sphygmomanometer 2A, for example, a cuff that senses blood pressure and the apparatus main body are configured separately, and the cuff is wrapped around the upper arm of the subject to measure the blood pressure of the brachial artery. The upper arm-mounted pressure sphygmomanometer 2A can be mounted on either the upper right arm or the left upper arm of the subject.

  FIG. 2 (2) is a configuration diagram of the wrist-worn pressurization sphygmomanometer 2B. The wrist-worn pressure sphygmomanometer 2B includes a cuff that senses blood pressure and an apparatus main body, and wraps the cuff around the wrist of the subject to measure the blood pressure in the wrist artery. In this embodiment, since the ultrasonic sphygmomanometer 1 is attached to the left wrist, when using the wrist-mounted pressure sphygmomanometer 2B, it is attached to the subject's right wrist.

  With the pressure sphygmomanometer 2 attached, the blood vessel diameter measurement for measuring the blood vessel diameter of the target artery at the first site of the subject and the blood pressure of the subject at the second site different from the first site are measured. The blood pressure measurement is performed simultaneously or in time division depending on whether or not the second part is a part where the target artery is running. Then, using the measurement result by the blood vessel diameter measurement and the measurement result by the blood pressure measurement, the value of the parameter related to the blood pressure estimation process for estimating the blood pressure from the blood vessel diameter is calibrated.

  In this embodiment, blood vessel diameter measurement is performed with the left wrist of the subject as the first site and the radial artery of the left arm as the target artery. In this case, the part where the target artery is running is the left upper arm part, and the part where the target artery is not running is the upper right arm part and the right wrist part. When the left upper arm is the second part and calibration is performed using the upper arm-mounted pressure sphygmomanometer 2A, blood pressure is induced in the left upper arm by cuff pressurization. Cannot be measured correctly. Therefore, in this case, blood vessel diameter measurement and blood pressure measurement are performed in a time division manner.

  On the other hand, in the case where calibration is performed using the upper arm wearing type pressurization sphygmomanometer 2A with the upper right arm as the second part, and in the case where calibration is performed using the wrist wearing type pressurization sphygmomanometer 2B with the right wrist as the second part. Then, the above problems do not occur. That is, even if the upper right arm or the right wrist is driven by cuff pressurization, the radial artery and the blood pressure can be measured simultaneously because the radial artery running on the left wrist is not affected.

  In the present embodiment, a parameter related to blood pressure estimation processing for estimating blood pressure from a blood vessel diameter is calibrated. In order to estimate the blood pressure from the blood vessel diameter, a correlation characteristic that links the blood vessel diameter and the blood pressure can be used. For example, the blood vessel diameter and the blood pressure can be linked with a certain nonlinear correlation characteristic.

Specifically, using the pressure applied to the blood vessel and the blood vessel diameter at each blood pressure, for example, the correlation characteristic can be expressed by a correlation equation such as the following equation (1).
P = Pd · exp [β (D / Dd−1)] (1)
Where β = ln (Ps / Pd) / (Ds / Dd−1)

  Here, “Ps” is systolic blood pressure, and “Pd” is diastolic blood pressure. “Ds” is a systolic blood vessel diameter that is a blood vessel diameter at the time of systolic blood pressure, and “Dd” is a diastolic blood vessel diameter that is a blood vessel diameter at the time of diastolic blood pressure. “Β” is a vascular elasticity index value called a stiffness parameter.

  In this embodiment, the measurement result by blood vessel diameter measurement at the first part (for example, the left wrist part) of the subject and the measurement result by blood pressure measurement at the second part (for example, the left upper arm part) of the subject are used. Then, the stiffness parameter “β” is calibrated. This stiffness parameter “β” is a type of parameter related to blood pressure estimation processing for estimating blood pressure from a blood vessel cross-sectional index value.

  If the stiffness parameter “β” can be calibrated, by using this stiffness parameter “β”, the diastolic blood pressure “Pd” and the diastolic blood vessel diameter “Dd” obtained at the time of calibration, the blood vessel diameter “D” and The correlation formula of Formula (1) that links the blood pressure “P” can be determined. In the subsequent blood pressure estimation process, the blood pressure “P” can be estimated by substituting the blood vessel diameter “D” measured using ultrasonic waves into the correlation equation.

2. Functional Configuration FIG. 3 is a block diagram illustrating an example of a functional configuration of the ultrasonic sphygmomanometer 1. The ultrasonic sphygmomanometer 1 is a blood pressure measurement device that calibrates parameters related to blood pressure estimation processing using the above-described blood pressure estimation parameter calibration method and performs blood pressure estimation processing using the calibrated parameters to estimate blood pressure.

  The ultrasonic sphygmomanometer 1 includes an ultrasonic sensor unit 20, a first input unit 40, a second input unit 60, a processing unit 100, an operation unit 200, a display unit 300, a sound output unit 400, and communication. Unit 500, clock unit 600, and storage unit 800.

  The ultrasonic sensor unit 20 is an ultrasonic transmission / reception unit and includes an ultrasonic transmission / reception circuit. For example, according to the transmission / reception control signal output from the transmission / reception control unit 120, the transmission / reception circuit transmits and receives ultrasonic waves by switching between the ultrasonic transmission mode and the reception mode in a time division manner.

  The transmission / reception circuit includes an ultrasonic oscillation circuit that generates a pulse signal of a predetermined frequency, a transmission delay circuit that delays the generated pulse signal, and the like as a configuration for transmission. The reception configuration includes a reception delay circuit that delays the reception signal, a filter that extracts a predetermined frequency component from the reception signal, an amplifier that amplifies the reception signal, and the like.

  The first input unit 40 is an input unit that is connected to the upper arm wearable pressure sphygmomanometer 2A and inputs a blood pressure measurement value measured by the upper arm wearable pressure sphygmomanometer 2A.

  The second input unit 60 is an input unit that is connected to the wrist-worn pressurization sphygmomanometer 2B and inputs a blood pressure measurement value measured by the wrist-worn pressurization sphygmomanometer 2B.

  The processing unit 100 is a control device and an arithmetic device that comprehensively control each unit of the ultrasonic sphygmomanometer 1, and is a microprocessor such as a CPU (Central Processing Unit) or a DSP (Digital Signal Processor), or an ASIC (Application Specific Integrated). Circuit) and the like.

  The processing unit 100 includes a transmission / reception control unit 120, a blood vessel diameter calculation unit 130, a control unit 140, a calibration unit 150, and a blood pressure estimation unit 160 as main functional units. However, these functional units are only described as one embodiment, and all the functional units are not necessarily required as essential components. It goes without saying that functional units other than these may be essential components.

  The transmission / reception control unit 120 controls transmission / reception of ultrasonic waves by the ultrasonic sensor unit 20. Specifically, a transmission / reception control signal is output to the ultrasonic sensor unit 20, and control for switching between the transmission mode and the reception mode is performed.

  The blood vessel diameter calculation unit 130 calculates the blood vessel diameter of the target artery based on the signal processing result input from the ultrasonic sensor unit 20. Specifically, the blood vessel diameter of the target artery is calculated by detecting the reception time difference of the reflected wave of the ultrasonic waves from the front wall and the rear wall of the target artery. The blood vessel diameter calculating unit 130 includes a diastolic blood vessel diameter calculating unit 131 that calculates a diastolic blood vessel diameter and a systolic blood vessel diameter calculating unit 133 that calculates a systolic blood vessel diameter as functional units.

  The ultrasonic sensor unit 20, the transmission / reception control unit 120, and the blood vessel diameter calculation unit 130 constitute a blood vessel diameter measurement unit 110 that measures the blood vessel diameter of the target artery in the target region. The blood vessel diameter measuring unit 110 is a type of blood vessel cross-sectional index value measuring unit that measures the blood vessel cross-sectional index value of the target artery at the first part of the subject where the target artery is running. The blood vessel diameter measuring unit 110 is configured to continuously measure the blood vessel diameter. As a technique for continuously measuring the blood vessel diameter, for example, a phase difference tracking method can be applied. In addition, since the phase difference tracking method itself is conventionally well-known, description is abbreviate | omitted for the detail.

  The control unit 140 includes a blood pressure measurement guidance notification that prompts execution of blood pressure measurement for measuring the blood pressure of the subject with the pressurized sphygmomanometer 2 in a second part different from the first part, and measurement execution by the blood vessel diameter measuring part 110. It is a control part which controls. In addition, the control unit 140 performs the measurement by the pressurized sphygmomanometer 2 and the measurement by the blood vessel diameter measurement unit 110 simultaneously or in a time-sharing manner depending on whether or not the second part is a part where the target artery is running. Control to do.

  The calibration unit 150 calibrates the correlation equation parameter, which is a parameter related to blood pressure estimation processing for estimating blood pressure from the blood vessel diameter, using the measurement result obtained by the blood pressure measurement device and the measurement result obtained by the blood vessel diameter measurement unit 110.

  The blood pressure estimating unit 160 estimates the blood pressure of the subject using the blood vessel diameter measured by the blood vessel diameter measuring unit 110 and the correlation formula determined based on the correlation formula parameter configured by the calibration unit 150. Process. The blood pressure estimation unit 160 includes a diastolic blood pressure estimation unit 161 that estimates diastolic blood pressure and a systolic blood pressure estimation unit 163 that estimates systolic blood pressure as functional units.

  The operation unit 200 is an input device having a button switch or the like, and outputs a signal of a pressed button to the processing unit 100. By operating the operation unit 200, various instructions such as a blood vessel diameter measurement start instruction are input. The operation unit 200 corresponds to the operation button 12 in FIG.

  The display unit 300 includes an LCD (Liquid Crystal Display) or the like, and is a display device that performs various displays based on a display signal input from the processing unit 100. The display unit 300 displays a blood pressure estimation result by the blood pressure estimation unit 160 and the like. The display unit 300 corresponds to the liquid crystal display 13 of FIG.

  The sound output unit 400 is a sound output device that outputs various sounds based on the sound output signal input from the processing unit 100. The sound output unit 400 corresponds to the speaker 14 of FIG.

  The communication unit 500 is a communication device for transmitting and receiving information used inside the device to and from an external information processing device under the control of the processing unit 100. As a communication method of the communication unit 500, a form in which a wired connection is made through a cable compliant with a predetermined communication standard, a form in which a connection is made through an intermediate device that is also used as a charger called a cradle, or short-range wireless communication is used. Various systems such as a wireless connection type can be applied. When the connection with the upper arm pressure sphygmomanometer 2A or the wrist pressure sphygmomanometer 2B is a communication connection, the first input unit 40 and the second input unit 60 become the communication unit 500.

  The clock unit 600 includes a crystal oscillator including a crystal resonator and an oscillation circuit, and is a time measuring device that measures time. The time measured by the clock unit 600 is output to the processing unit 100 as needed.

  The storage unit 800 includes a storage device such as a ROM (Read Only Memory), a flash ROM, and a RAM (Random Access Memory). The storage unit 800 stores a system program for the ultrasonic sphygmomanometer 1, various programs for realizing various functions such as a transmission / reception control function, a blood vessel diameter measurement function, and a blood pressure estimation function, data, and the like. In addition, it has a work area for temporarily storing data being processed and results of various processes.

  The storage unit 800 stores a main program 810 that is read by the processing unit 100 and executed as a main process (see FIG. 4), for example. The main program 810 includes a calibration data acquisition program 811 executed as calibration data acquisition processing (see FIG. 5) as a subroutine. These processes will be described later in detail using a flowchart.

  In addition, the storage unit 800 stores attachment site setting data 820, calibration data 830, correlation parameter data 840, blood vessel diameter logging data 850, and blood pressure estimation result data 860 as data.

  The wearing part setting data 820 is setting data relating to a part where the subject wears the ultrasonic sphygmomanometer 1, the upper arm-worn pressure sphygmomanometer 2A, and the wrist-worn pressure sphygmomanometer 2B. The attachment site setting data 820 is operated and input by the subject via the operation unit 200, for example, as an initial setting.

  The calibration data 830 is data used to calibrate the correlation parameter, and includes blood pressure measurement data 831, blood vessel diameter measurement data 833, and characteristic value data 835.

  The blood pressure measurement data 831 is measurement result data obtained by measuring the blood pressure of the pressurized sphygmomanometer 2 in the calibration data acquisition process, and includes measurement results of diastolic blood pressure and systolic blood pressure.

  The blood vessel diameter measurement data 833 is data of the blood vessel diameter calculation result calculated by the blood vessel diameter calculation unit 130 based on the detection result of the ultrasonic sensor unit 20 in the calibration data acquisition process. This includes the vessel diameter.

  The characteristic value data 835 is data in which a characteristic value in which a blood pressure measurement result stored in the blood pressure measurement data 831 is associated with a blood vessel diameter measurement result stored in the blood vessel diameter measurement data 833 is stored. The characteristic value includes a diastolic characteristic value that associates the diastolic blood pressure with the diastolic blood vessel diameter, and a systolic characteristic value that associates the systolic blood pressure with the systolic blood vessel diameter. These characteristic values are used to calibrate the correlation parameters.

  The correlation equation parameter data 840 is data in which parameter values of the correlation equation representing the correlation characteristic between the blood vessel diameter and the blood pressure are stored. For example, this includes the stiffness parameter “β” in equation (1).

  The blood vessel diameter logging data 850 is blood vessel diameter logging data measured by the blood vessel diameter measuring unit 110. For example, the blood vessel diameter measured by the blood vessel diameter measuring unit 110 at a timing for each predetermined time interval is stored in time series in association with the measurement time.

  The blood pressure estimation result data 860 is data in which an estimation result of blood pressure estimated by the blood pressure estimation unit 160 performing blood pressure estimation processing is stored.

3. Processing Flow FIG. 4 is a flowchart showing a flow of main processing executed by the processing unit 100 according to the main program 810 stored in the storage unit 800.

  First, the processing unit 100 performs initial setting (step A1). Specifically, based on the wearing part input by the subject via the operation unit 200, the wearing arm of the ultrasonic sphygmomanometer 1, the type of the pressurized sphygmomanometer 2 to be used, and the pressurized sphygmomanometer 2 A wearing arm is set, and is stored in the storage unit 800 as wearing part setting data 820.

  Next, the processing unit 100 determines whether it is the acquisition timing of the calibration data (step A3). As the acquisition timing of the calibration data, for example, a predetermined time (for example, 8 am and 6 pm) can be set twice a day.

  When it is determined that it is the timing for acquiring the calibration data (step A3; Yes), the control unit 140 converts the blood pressure of the subject to an external blood pressure measurement device (pressurized blood pressure) at a second part different from the first part. The blood pressure measurement guidance notification that prompts the execution of the blood pressure measurement measured in step 2) is performed (step A5). Then, the processing unit 100 performs calibration data acquisition processing according to the calibration data acquisition program 811 stored in the storage unit 800 (step A7).

FIG. 5 is a flowchart showing the flow of calibration data acquisition processing.
First, the processing unit 100 determines the type of the pressurized sphygmomanometer 2 (step B1), and if it is determined that the type is the upper arm-mounted pressurized sphygmomanometer 2A (step B1; upper-arm mounted type), The wearing arms of the sonic sphygmomanometer 1 and the upper arm wearing pressure sphygmomanometer 2A are determined (step B3). When it is determined that the wearing arms are different (step B3; different), the processing unit 100 performs calibration data acquisition processing by the simultaneous method (steps B5 to B17).

  In the processing by this simultaneous method, the processing unit 100 determines whether or not the blood pressure measurement start confirmation button by the pressurized sphygmomanometer 2 of the operation unit 200 has been pressed (step B5). The processing unit 100 waits until the start confirmation button is pressed (step B5; No). When the processing unit 100 detects that the start confirmation button is pressed (step B5; Yes), it starts measuring the blood vessel diameter using ultrasound. The measurement result is stored in the calibration data 830 as blood vessel diameter measurement data 833 (step B7).

  Next, the processing unit 100 determines whether or not an end-of-blood pressure measurement confirmation button by the pressurized sphygmomanometer 2 of the operation unit 200 has been pressed (step B9). The processing unit 100 waits until the end confirmation button is pressed (step B9; No), and when it is detected that the end confirmation button is pressed (step B9; Yes), the measurement of the blood vessel diameter by the ultrasonic wave is ended. (Step B11).

  It takes about several tens of seconds to measure blood pressure with the upper arm-mounted pressure sphygmomanometer 2A. In a series of processing of steps B5 to B11, the blood vessel diameter measuring unit 110 continuously measures the blood vessel diameter from the start of blood pressure measurement by the upper arm-mounted pressure sphygmomanometer 2A to the end of blood pressure measurement. To do.

  After step B11, the processing unit 100 inputs a blood pressure measurement value from the upper arm pressure sphygmomanometer 2A via the first input unit 40, and stores the blood pressure measurement data 831 in the calibration data 830 (step B13). ).

  Next, the processing unit 100 determines a representative value of the blood vessel diameter (step B15). For example, the average value of the blood vessel diameter continuously measured by the blood vessel diameter measuring unit 110 during the period from the start of the blood pressure measurement by the upper-arm-mounted pressure sphygmomanometer 2A to the end of the measurement is calculated as a representative value. To decide. This representative value is determined for each of the diastolic blood vessel diameter and the systolic blood vessel diameter.

  The method for determining the representative value of the blood vessel diameter is not limited to this. For example, the blood vessel diameter at the same time that the upper arm-worn pressure sphygmomanometer 2A has determined as systolic blood pressure is determined as a representative value of the systolic blood vessel diameter, and the upper arm-worn pressure sphygmomanometer 2A is determined to be diastolic blood pressure. The blood vessel diameter at the time may be determined as a representative value of the diastolic blood vessel diameter. The upper arm-mounted pressure sphygmomanometer 2A determines the systolic blood pressure and the diastolic blood pressure based on the change in the pressure pulse wave. In this case, the determination time determined as the systolic blood pressure and the diastolic blood pressure is acquired from the upper arm-mounted pressure sphygmomanometer 2A, and the determination time is compared with the measurement time of the blood vessel diameter measuring unit 110 to obtain a representative value. What is necessary is just to select and determine a blood vessel diameter.

  Next, the processing unit 100 stores the characteristic value in which the blood pressure input value input in Step B13 and the representative value of the blood vessel diameter determined in Step B15 are associated with each other in the calibration data 830 as the characteristic value data 835 (Step S13). B17). Specifically, the systolic characteristic value in which the systolic blood pressure input from the pressurization sphygmomanometer 2 is associated with the representative value of the systolic blood vessel diameter, and the diastolic blood pressure input from the pressurization sphygmomanometer 2 and the diastole The diastolic characteristic values associated with the representative values of the blood vessel diameter are stored as characteristic value data 835, respectively. Thereby, the process by the simultaneous method is completed. Then, the processing unit 100 ends the calibration data acquisition process.

  On the other hand, when it is determined in step B1 that the type of the pressurized sphygmomanometer 2 is a wrist-worn type (step B1; wrist-worn type), or in the step B3, the wearing arm of the ultrasonic sphygmomanometer 1 and the pressurized sphygmomanometer 2 Are determined to be the same (step B3; same), the processing unit 100 performs calibration data acquisition processing by a time division method (steps B19 to B33).

  In the processing by the time division method, the processing unit 100 determines whether or not the blood pressure measurement start confirmation button by the pressurized sphygmomanometer 2 of the operation unit 200 has been pressed (step B19). The processing unit 100 waits until the start confirmation button is pressed (Step B19; No), and detects that the start confirmation button is pressed (Step B19; Yes), by the pressurization sphygmomanometer 2 of the operation unit 200. It is determined whether or not the blood pressure measurement end confirmation button has been pressed (step B21).

  The processing unit 100 waits until the end confirmation button is pressed (step B21; No). When the processing unit 100 detects that the end confirmation button is pressed (step B21; Yes), the blood vessel diameter measurement unit 110 uses ultrasonic waves. Measurement of the blood vessel diameter is started (step B23).

  The processing unit 100 stands by until a blood vessel diameter measurement result for a predetermined time (for example, 10 to 30 seconds) can be acquired (step B25; No). The measurement of the blood vessel diameter using sound waves is terminated (step B27).

  Thereafter, the processing unit 100 inputs a blood pressure measurement value from the upper arm-worn pressure sphygmomanometer 2A or the wrist-worn pressure sphygmomanometer 2B via the first input unit 40 or the second input unit 60, and blood pressure measurement data 831 is stored in the calibration data 830 (step B29).

  Next, the processing unit 100 determines a representative value of the blood vessel diameter (step B31). In this case, for example, the blood vessel diameter continuously measured by the blood vessel diameter measuring unit 110 during the predetermined time is averaged and determined as a representative value. This representative value is determined for each of the diastolic blood vessel diameter and the systolic blood vessel diameter.

  Thereafter, the processing unit 100 stores the characteristic value in which the blood pressure input value input in Step B29 and the representative value of the blood vessel diameter determined in Step B31 are associated with each other in the calibration data 830 as the characteristic value data 835 (Step S31). B33). Also in this case, each of the diastolic characteristic value and the systolic characteristic value is stored in the characteristic value data 835. Thereby, the process by a time division system is complete | finished. Then, the processing unit 100 ends the calibration data acquisition process.

  Returning to the main process of FIG. 4, after performing the calibration data acquisition process, the control unit 140 performs calibration data acquisition completion notification to notify the subject that the acquisition of calibration data has been completed (step A9). ).

  Next, the processing unit 100 determines whether or not it is the measurement timing of the blood vessel diameter (step A11). If it is determined that it is the measurement timing (step A11; Yes), the blood vessel diameter measurement unit 110 transmits the ultrasonic wave. Normal measurement of the used blood vessel diameter is performed (step A13). The blood vessel diameter measuring unit 110 stores the measurement result of the normal measurement in the blood vessel diameter logging data 850 (step A15).

  Thereafter, the processing unit 100 determines whether or not a blood pressure measurement instruction has been issued from the subject via the operation unit 200 (step A17). If it is determined that a blood pressure measurement instruction has been issued (step A17; Yes), the calibration unit 150 calibrates the correlation equation parameter using the latest characteristic value data 835 stored in the calibration data 830, The correlation equation parameter data 840 is stored (step A19). Specifically, based on the diastolic characteristic value and the systolic characteristic value stored in the characteristic value data 835, the stiffness parameter “β” in equation (1) is calculated and stored in the correlation equation parameter data 840. To calibrate.

  Next, the blood vessel diameter measuring unit 110 performs normal measurement of the blood vessel diameter using ultrasonic waves (step A21). Then, the blood pressure estimation unit 160 performs blood pressure estimation processing from the measurement result of the normal measurement to estimate the blood pressure of the subject (Step A23). Specifically, the blood pressure of the subject is estimated using the blood vessel diameter obtained by the normal measurement in step A21 and the correlation equation determined based on the correlation equation parameter calibrated in step A19. And the process part 100 displays the estimation result of a blood pressure on the display part 300 (step A25).

  Thereafter, the processing unit 100 determines whether it is the blood pressure counting timing (step A27). The blood pressure counting timing can be, for example, a time determined every day (for example, 9:00 at night). If it is determined that it is the blood pressure counting timing (step A27; Yes), the calibration unit 150 calibrates the correlation equation parameter using the characteristic value data 835 for the day stored in the calibration data 830, and performs correlation. It is stored in the equation parameter data 840 (step A29).

  Next, the blood pressure estimation unit 160 performs blood pressure estimation processing from the blood vessel diameter logging data 850 to estimate the blood pressure of the subject (step A31). Specifically, using the blood vessel diameter at each measurement time stored in the blood vessel diameter logging data 850 and the correlation equation defined based on the correlation equation parameter calibrated in step A29, the subject's at each measurement time is measured. Estimate blood pressure retrospectively. And the process part 100 graphs the time series change of the estimation result of a blood pressure, displays it on the display part 300 (step A33), and complete | finishes a main process.

  When it is determined in step A3 that it is not the time to acquire calibration data (step A3; No), the processing unit 100 proceeds to step A11. Further, when it is determined in step A11 that it is not the blood vessel diameter measurement timing (step A11; No), the processing unit 100 proceeds to step A17.

  When it is determined in step A17 that the blood pressure measurement instruction has not been given (step A17; No), the processing unit 100 proceeds to step A27. Further, when it is determined in step A27 that it is not the blood pressure aggregation timing (step A27; No), the processing unit 100 returns to step A3.

4). According to the present embodiment, the blood vessel diameter measurement for measuring the blood vessel diameter of the subject artery at the first portion of the subject in which the subject artery is running and the subject at the second portion different from the first portion. The blood pressure measurement for measuring the blood pressure of the person is performed simultaneously or in time division depending on whether or not the second part is a part where the target artery is running.

  Specifically, in the ultrasonic sphygmomanometer 1, the blood vessel diameter measuring unit 110 (blood vessel cross-section index value measuring unit) measures the blood vessel diameter of the radial artery (target artery) at the left wrist (first part) of the subject. To do. In addition, the control unit 140 measures the blood pressure of the subject with the pressurized sphygmomanometer 2 (external blood pressure measurement device) at a second part (upper right arm part, left upper arm part or right wrist part) different from the left wrist part. Controls blood pressure measurement guidance notification that prompts the execution of measurement and measurement execution by the blood vessel diameter measurement unit 110. Then, the control unit 140 performs the measurement by the pressure sphygmomanometer 2 and the blood vessel diameter measurement unit 110 according to whether or not the part where the pressurized sphygmomanometer 2 is attached is a part where the radial artery of the left arm is running. Control is performed so that measurement is performed simultaneously or in a time-sharing manner.

  When the ultrasonic sphygmomanometer 1 and the pressurized sphygmomanometer 2 are mounted on the same arm, blood pressure is measured by applying pressure to the upper arm during blood pressure measurement, so the blood vessel diameter must be correctly measured at the wrist. Can not be. Therefore, in this case, blood vessel diameter measurement at the wrist and blood pressure measurement at the upper arm are performed in a time-sharing manner. In contrast, when the ultrasonic sphygmomanometer 1 and the pressurized sphygmomanometer 2 are mounted on different arms, the blood pressure measurement by the pressurized sphygmomanometer 2 does not affect the vascular diameter measurement by the vascular diameter measurement unit 110. The blood vessel diameter measurement at the wrist and the blood pressure measurement at the upper arm can be performed simultaneously.

  The calibration unit 150 calibrates parameters related to blood pressure estimation processing for estimating blood pressure from the blood vessel diameter, using the measurement result obtained by the blood vessel diameter measurement unit 110 and the measurement result obtained by the pressurized sphygmomanometer 2. By performing the blood pressure estimation process using the parameters calibrated in this way, it is possible to correctly estimate the blood pressure of the subject.

5. Modifications Embodiments to which the present invention can be applied are not limited to the above-described embodiments, and can be changed as appropriate without departing from the spirit of the present invention. Hereinafter, modified examples will be described.

5-1. In the above embodiment, the embodiment in which the blood vessel diameter is used as the blood vessel cross-sectional index value has been described. However, the blood vessel cross-sectional area may be used as the blood vessel cross-sectional index value. The correlation characteristic between the blood vessel cross-sectional area and the blood pressure can be similarly defined by replacing the blood vessel diameter “D” with the blood vessel cross-sectional area “S” in the formula (1), for example.

  In this case, using the measurement result by the blood vessel cross-sectional area measurement and the measurement result by the blood pressure measurement, the parameter (for example, the stiffness parameter) related to the blood pressure estimation process for estimating the blood pressure from the blood vessel cross-sectional area is set as in the above embodiment. Just calibrate.

5-2. Measurement target artery In the above embodiment, the measurement target artery has been described as the radial artery of the wrist, but other arteries may of course be the measurement target artery. For example, a limb artery other than the radial artery may be used as the measurement target artery.

5-3. In the above embodiment, the blood vessel diameter measurement method has been described as a measurement method using ultrasonic waves. However, the blood vessel diameter measurement method is not limited to this. For example, a technique may be adopted in which reflected light from the target artery when receiving light of a predetermined wavelength from the light emitting element toward the target artery is received and signal processing is performed to measure the blood vessel diameter of the target artery. .

5-4. In the above embodiment, the cuff sphygmomanometer that measures blood pressure using the oscillometric method has been described as an example of the blood pressure measuring device, but the blood pressure measuring device is not limited to this. For example, a sphygmomanometer that measures blood pressure using the tonometry method or volume compensation method, which is a continuous method, or a sphygmomanometer that measures blood pressure using the auscultation method (Korotkoff method), which is a kind of intermittent method. A blood pressure measurement device may be used.

5-5. Combination of Ultrasonic Sphygmomanometer and Pressurized Sphygmomanometer FIG. 6 is an explanatory diagram of a combination of an ultrasonic sphygmomanometer and a pressurized sphygmomanometer. A table in which an ultrasonic sphygmomanometer, a pressurized sphygmomanometer, these wearing arms, and blood vessel diameter and blood pressure measurement methods are associated with each other is illustrated. In the sphygmomanometer of the type that is worn on the neck, the wearing arm does not pose a problem with the pressurization sphygmomanometer, so “-(none)” is defined in the corresponding wearing arm column. In addition, since the ultrasonic blood pressure monitor and the pressurized blood pressure monitor cannot be simultaneously attached to the same part, “-(none)” is defined in the corresponding measurement method column.

  Ultrasound sphygmomanometer is a wrist-worn ultrasonic sphygmomanometer that can be worn on the wrist, an upper-armed ultrasonic sphygmomanometer that can be worn on the upper arm, and a cervix that can be worn on the neck A neck-mounted ultrasonic sphygmomanometer can be considered. Further, as the pressure sphygmomanometer, an upper arm-mounted pressure sphygmomanometer and a wrist-mounted pressure sphygmomanometer can be considered.

  The combination of the wrist-worn ultrasonic sphygmomanometer and the upper arm-worn pressure sphygmomanometer and the combination of the wrist-worn ultrasonic sphygmomanometer and the wrist-worn pressure sphygmomanometer are as described in the above embodiment.

  In the combination of the upper arm-mounted ultrasonic sphygmomanometer and the upper arm-mounted pressure sphygmomanometer, the measurement method is “simultaneous” when the mounted arms are different. In the combination of the upper arm-worn ultrasonic sphygmomanometer and the wrist-worn pressure sphygmomanometer, the measurement method is “simultaneous” when the worn arms are different, and the measurement method is “time division” when the worn arms are the same.

  In the combination of the neck-mounted ultrasonic sphygmomanometer and the upper arm-mounted pressure sphygmomanometer, the measurement method is “simultaneous” or “time division”. The same applies to a combination of a neck-worn ultrasonic sphygmomanometer and a wrist-worn pressure sphygmomanometer.

5-6. Correlation Characteristics In the above-described embodiment, the case where the correlation expression represented by Expression (1) is applied as an example of the correlation expression representing the correlation characteristics between the blood vessel diameter and the blood pressure has been described. However, the correlation formula of the formula (1) is merely described as an example, and it is needless to say that other correlation formulas may be applied. The type of correlation equation may be linear or non-linear.

For example, a correlation equation represented by the following equation (2) may be applied as a correlation equation obtained by approximating a blood vessel diameter and blood pressure with a linear relationship.
P = E · D + B (2)
However, E = (Ps−Pd) / (Ds−Dd)
B = Pd−E · Dd

  Here, “Ps” is systolic blood pressure, and “Pd” is diastolic blood pressure. “Ds” is the systolic blood vessel diameter, and “Dd” is the diastolic blood vessel diameter. “E” is an elastic coefficient representing the elasticity of the blood vessel, and “B” is an intercept of the correlation equation.

  When blood pressure estimation processing is performed by applying Equation (2), the elasticity coefficient “E” and intercept “B” 2 in Equation (2) above are used using the calibration data acquired in the calibration data acquisition processing. One parameter should be calibrated.

  As in the above embodiment, the expression (2) can be applied by replacing the blood vessel diameter “D” with the blood vessel cross-sectional area “S”.

  Further, the correlation characteristic data stored in the storage unit 800 is not necessarily the data of the correlation formula, and is data in which the correlation characteristic between the blood vessel cross-sectional index value (blood vessel diameter or blood vessel cross-sectional area) and blood pressure is defined in a table format. Of course, a (look-up table) may be used.

5-7. Calibration timing In the above-described embodiment, the calibration data acquisition process is performed at a predetermined time. However, the calibration data acquisition timing can be set as appropriate. For example, the characteristics of the subject artery of the subject may change due to a sudden change in temperature. Therefore, the temperature at the time of blood pressure measurement is stored, and the calibration data is acquired with the timing when the temperature difference between the temperature at the previous measurement and the temperature at the current measurement exceeds a predetermined threshold as the acquisition timing of the calibration data. It is good as well.

5-8. Communication method In the above embodiment, the ultrasonic sphygmomanometer and the pressurized sphygmomanometer are connected by wire. However, the ultrasonic sphygmomanometer and the pressurized sphygmomanometer are each provided with a wireless communication unit, and wireless communication is used. The blood pressure measurement value may be acquired from the pressure sphygmomanometer.

1 ultrasonic sphygmomanometer, 1A first part, 1B second part, 2 pressure sphygmomanometer,
2A Upper arm pressure sphygmomanometer, 2B Wrist pressure sphygmomanometer, 11 Hinge part,
12 operation buttons, 13 liquid crystal display, 14 speakers, 15 strips,
20 ultrasonic sensor unit, 40 first input unit, 60 second input unit,
100 processing unit, 200 operation unit, 300 display unit, 400 sound output unit,
500 communication unit, 600 clock unit, 800 storage unit

Claims (6)

A blood vessel cross-sectional index value measurement for measuring a blood vessel diameter or a blood vessel cross-sectional area (hereinafter collectively referred to as “blood vessel cross-sectional index value”) of the target artery at a first site of a subject in which the target artery is running; The blood pressure measurement for measuring the blood pressure of the subject at a second part different from the first part is performed simultaneously or at a time depending on whether or not the second part is a part where the target artery is running. To do the division,
Using the measurement result by the blood vessel cross-section index value measurement and the measurement result by the blood pressure measurement, calibrating a parameter related to blood pressure estimation processing for estimating blood pressure from the blood vessel cross-section index value;
A blood pressure estimation parameter calibration method including: The target artery is the radial artery;
The first part is a wrist;
The second part is the upper arm,
The blood vessel cross-section index value measurement and the blood pressure measurement are performed simultaneously or in time division depending on whether the first part and the second part are the same arm,
The blood pressure estimation parameter calibration method according to claim 1. In the blood vessel cross-section index value measurement, for a predetermined time, measure the blood vessel cross-section index value of the target artery,
In the blood pressure measurement, systolic blood pressure and diastolic blood pressure are measured,
Calibrating the parameters
From the measurement result of the blood vessel cross-section index value measurement during the predetermined time, obtaining a systolic blood vessel cross-section index value and a diastolic blood vessel cross-section index value;
Calibrating the parameters based on the systolic blood pressure and the diastolic blood pressure, the systolic vascular cross-sectional index value and the diastolic vascular cross-sectional index value;
including,
The blood pressure estimation parameter calibration method according to claim 1 or 2. After performing the blood pressure estimation parameter calibration method according to any one of claims 1 to 3, performing normal measurement for measuring a blood vessel cross-sectional index value of the target artery in the first site;
Using the parameter calibrated by the blood pressure estimation parameter calibration method, estimating the blood pressure by performing the blood pressure estimation process from the measurement result of the normal measurement;
Blood pressure measurement method including A blood vessel cross-section index value measurement unit that measures a blood vessel diameter or a blood vessel cross-sectional area, and a control unit that controls the measurement time of the blood pressure measurement device;
A first transmission unit that transmits a measurement instruction from the control unit to the blood vessel cross-section index value measurement unit provided in the first site;
A second transmission unit that transmits a measurement instruction from the control unit to the blood pressure measurement device provided in a second part different from the first part;
A calibration unit that calibrates parameters related to blood pressure estimation processing for estimating blood pressure from a blood vessel cross-section index value using the measurement result by the blood vessel cross-section index value measurement unit and the measurement result by the blood pressure measurement device ,
The time when the control unit issues a measurement instruction to the first transmission unit is different from the time when the measurement unit issues a measurement instruction to the second transmission unit.
Blood pressure measuring device, characterized in that   The blood pressure measurement device is a pressure sphygmomanometer that is provided at a position closer to the heart than the position of a blood vessel measured by the blood vessel cross-section index value measurement unit and is used during calibration by the calibration unit.
  The blood pressure measurement device according to claim 5,

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