JP6109514B2 - Biological information processing device - Google Patents

Description

  The present invention relates to a biological information processing apparatus.

  Various living body information is used for living body diagnosis. An electrocardiogram (for example, a standard 12-lead electrocardiogram) measured by an electrocardiograph is one of representative biological information, and is widely used for diagnosis of heart diseases and the like. The standard 12-lead ECG is attached to the chest of the subject and six lead ECGs (I, II, III, aVR, aVL, aVF) obtained from the four ECG electrodes attached to the limbs of the subject. 6 electrocardiograms (V1, V2, V3, V4, V5, V6) obtained from the 6 electrocardiographic electrodes. The heart disease of the subject can be diagnosed based on the waveform characteristics of the standard 12-lead electrocardiogram measured from the subject.

  One of the main causes of heart disease is arteriosclerosis. The same applies to cerebrovascular diseases and peripheral arterial diseases. With the rapid aging of society, prevention of arteriosclerotic diseases has become an important theme in the medical field, and it is important to detect arteriosclerosis early and treat it appropriately. In particular, peripheral arterial disease (PAD), which has recently been increasing, is a disease that causes blood flow disorder of the lower limb blood vessels mainly in the elderly as a result of the progress of arteriosclerosis, and is an important indicator for monitoring systemic atherothrombosis It has become.

  There is a blood pressure pulse wave inspection apparatus as a biological information processing apparatus used for diagnosis of arteriosclerosis. The blood pressure pulse wave inspection apparatus can perform a blood flow disorder inspection of the lower limb blood vessels and a whole body arterial extensibility inspection by measuring biological information such as blood pressure and pulse waves. In the former test, an index indicating arterial clogging (arterial occlusion index) is calculated as the test result, and in the latter test, an index indicating arterial hardness (arteriosclerosis index) is calculated as the test result. In the following description, for convenience, a general term for an arterial occlusion index and an arteriosclerosis index is referred to as an “arterial condition index”. A generic term for blood flow disorder tests and arterial extensibility tests performed by measuring blood pressure and pulse waves is called “blood pressure pulse wave test”.

  Here, some examples of the arterial condition index will be described. Note that the measurement method and calculation method of each index are not limited to those described here, and various methods may be used.

  An index used in the examination of the blood flow disorder of the lower limb blood vessel is, for example, ABI (Ankle Brachial Index).

  ABI is a value obtained by dividing the value of the systolic blood pressure of the ankle by the value of the systolic blood pressure of the upper arm, and is sometimes called API or ABPI. As an index similar to ABI, there is an index called TBI (Toe Brachial Index). TBI is a value obtained by dividing the value of the systolic blood pressure of the toe (toe) by the value of the systolic blood pressure of the upper arm, and is sometimes referred to as TPI or TBPI.

  As an index used in the examination of arterial extensibility, for example, aortic PWV (Pulse Wave Velocity) (see, for example, Non-Patent Document 1) and baPWV (brachial-ankle Pulse Wave Velocity: brachial-ankle pulse wave velocity) (for example, non-patent document) Patent Document 2), CAVI (Cardio-Ankle Vascular Index) (for example, see Non-Patent Document 3), and the like.

  PWV is a pulse wave velocity, and is a value having a velocity unit obtained by dividing the value of the distance between two different points on the blood vessel by the value of the time difference between the pulse waves at the two points. For measuring the pulse wave, for example, various types of pulse wave sensors such as an air conduction type, a photoelectric type, an air bag type, an amorphous type, and a tonometry type are used. Further, the aorta, which is an elastic artery, may be adopted as a target site for PWV measurement, and the PWV measured in the aorta is referred to as the aorta PWV. There are mainly two methods for measuring the aortic PWV.

In one aorta PWV measurement method, for example, the aorta PWV is obtained by the following equation (1).
PWV = (b + c−a) / ΔT (1)
Here, ΔT is the time difference between the pulse wave rising portion at the carotid artery portion and the pulse wave rising portion at the femoral artery portion, a is the distance from the suprasternal fossa to the carotid artery portion, and b is C is the distance from the umbilicus to the femoral artery.

In the other aorta PWV measurement method, for example, the aorta PWV is obtained by the following equation (2).
PWV = D × 1.3 / (ΔT + Tc) (2)
Here, ΔT is a time difference between the pulse wave rising portion in the carotid artery portion and the pulse wave rising portion in the femoral artery portion, and Tc is from the start of the heart II sound (heart sound generated when the aortic valve is closed). It is the time to the notch of the pulse wave in the carotid artery, and D is the linear distance from the right edge of the 2nd intercostal sternum where the heart sound microphone for measuring heart II sound is placed to the femoral artery Yes, 1.3 is an anatomical correction value.

Moreover, baPWV is calculated | required by following Formula (3), for example.
baPWV = (La−Lb) / Tba (3)
Here, Tba is the time difference between the pulse wave rising part at the upper arm and the pulse wave rising part at the ankle, each measured using a cuff, and La is the distance from the aortic valve opening to the ankle. , Lb is the distance from the aortic valve opening to the upper arm.

In the case of CAVI, a cuff is attached to the upper arm and ankle (or popliteal area) to measure blood pressure and pulse wave, and a heart sound microphone is attached to the sternum to measure heart sounds. CAVI is obtained by the following equation (4), for example.
Here, Ps is the systolic blood pressure of the upper arm, Pd is the diastolic blood pressure of the upper arm, ρ is the blood density, and ΔP is Ps−Pd. Moreover, PWV is a pulse wave propagation velocity and is calculated | required by following Formula (5), for example.
Here, Tb is the time from the start of the heart II sound to the pulse wave notch in the upper arm, and Tba is the time difference between the pulse wave rising part in the upper arm and the pulse wave rising part in the ankle. , D is the straight line distance from the right intercostal intercostal space II where the heart sound microphone for measuring heart II sound is placed to the femoral artery, 1.3 is an anatomical correction value, and L2 is the femoral artery L3 is a linear distance from the knee joint central part to the ankle cuff wearing central part.

  For example, Patent Document 1 describes a biological information processing apparatus that displays waveforms such as measured heart sounds and pulse waves on a screen in real time. This device is necessary to calculate CAVI, such as the division points (feature points) in the heart waveform and pulse waveform, for example, the start of heart II sound, the notch of the pulse wave in the upper arm, and the rise of the pulse wave in the upper arm The rising part of the pulse wave at the head and ankle is detected, the time difference between these segment points is measured, and CAVI is calculated based on the measurement result. In addition, this apparatus evaluates the quality of the pulse waveform for each heartbeat, and displays the evaluation result on the screen together with the pulse waveform. Therefore, since the examiner (for example, a doctor) can check the quality of the measured pulse wave waveform in real time, the reliability of the CAVI calculation result based on this pulse wave or the like should be determined based on the displayed waveform quality. Can do.

JP 2008-168073 A

Yoshiaki Masuda, Hiroshi Kanai, “Fundamental and Clinical Arterial Pulse Waves”, Kyoritsu Shuppan, 15-19 pages, 2000 Toshio Ozawa, Yoshiaki Masuda, "Pulse wave velocity", Medical View, 28-29 pages Kohji Shirai, Junji Utino, Kuniaki Ohtsuka, Masanobu Takada, "A Novel Blood Pressure-independent Arterial Wall Stiffness Parameter; Cardio-Ankle Vascular Index (CAVI)", Journal of Atherosclerosis and Thrombosis, Vol.13, No.2

  By the way, when pulse disturbance occurs due to arrhythmia or body movement during the blood pressure pulse wave test, the quality of the waveform such as the pulse wave deteriorates in that time zone. Normally, when an operation for executing the calculation of the arteriosclerosis index is performed, the arteriosclerosis index is calculated using the latest waveform portion at that time. Therefore, in order to ensure the reliability of the calculation result of the arteriosclerosis index, it is necessary to perform an operation for executing the calculation of the arteriosclerosis index when the waveform quality is good. However, the waveform quality at the time when this operation is performed is not always good. In addition, the waveform quality at the previous time may be better than the waveform quality at the time when this operation was performed. In such a case, in order to improve the reliability of the calculation result of the arteriosclerosis index, it is necessary to restart the blood pressure pulse wave test from the beginning so that a better waveform quality can be obtained. This is troublesome for a person and a burden for a subject.

  The objective of this invention is providing the biological information processing apparatus which can improve the reliability of the calculation result of an arteriosclerosis parameter | index easily.

A biological information processing apparatus according to the present invention includes:
A pulse wave acquisition unit for acquiring the pulse wave of the subject;
An arithmetic processing unit for evaluating the waveform quality of the acquired pulse wave;
A display unit for displaying the waveform of the acquired pulse wave;
A storage unit for storing the acquired pulse wave,
The arithmetic processing unit displays a past pulse wave waveform stored in the storage unit on the display unit according to a user operation, and displays the past pulse wave displayed on the time axis in accordance with a user operation. The waveform quality evaluated with respect to the pulse wave in the selected quality check section is displayed on the display unit in part by the quality check section displaceable in
Furthermore,
When the pulse wave in the selected quality check section is determined as an arteriosclerosis index calculation target according to a user operation , the arithmetic processing unit is based on the determined waveform of the pulse wave in the quality check section. To calculate an arteriosclerosis index.

  According to the present invention, the reliability of the calculation result of the arteriosclerosis index can be easily improved.

The figure which shows the structure of the biometric information processing apparatus which concerns on one embodiment of this invention A flow chart showing an example of operation at the time of blood pressure pulse wave examination of the biological information processing apparatus of the present embodiment The flowchart which shows the operation example at the time of the biometric information test result report output of the biometric information processing apparatus of this Embodiment The figure which shows the example of a format of the biometric information test result report of this Embodiment (A) The figure for demonstrating the structure of the waveform display screen containing the pulse wave quality indicator of this Embodiment, (b) In the waveform display screen of (a), a pulse wave quality indicator is shown in real time by a pulse wave quality indicator. Figure showing the state (A) The figure for demonstrating the structure of the waveform display screen containing the waveform selection window of this Embodiment, (b) Shifting a quality check area on a time axis with a waveform selection window in the waveform display screen of (a). Figure showing the state

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

  FIG. 1 is a diagram schematically showing a configuration of a biological information processing apparatus according to an embodiment of the present invention.

  The biological information processing apparatus 1 shown in FIG. 1 is an apparatus having both a function as an electrocardiograph and a function as a blood pressure pulse wave inspection apparatus. Specifically, the biological information processing apparatus 1 includes an arithmetic processing unit 10, a display unit 70, a printing unit 75, a storage unit 80, a voice output unit 85, an input unit 90, an upper limb measurement control unit 101, and a lower limb measurement control unit. 102, a heart sound measurement unit 103, an electrocardiogram measurement unit 104, and a pulse wave measurement unit 105. Two cuffs 21R and 21L are connected to the upper limb measurement control unit 101 via hose 21h, and two cuffs 22R and 22L are connected to the lower limb measurement control unit 102 via hose 22h, respectively. The heart sound measuring unit 103 is connected to the heart sound microphone 23, the electrocardiogram measuring unit 104 is connected to the limb electrocardiographic electrode unit 24 a and the chest electrocardiographic electrode unit 24 b, and the pulse wave measuring unit 105. Are connected to amorphous pulse wave sensors 25a and 25b. The upper limb measurement control unit 101 and the lower limb measurement control unit 102 constitute a blood pressure pulse wave measurement unit 100 of the biological information processing apparatus 1.

  The arithmetic processing unit 10 includes a CPU (Central Processing Unit), a memory, and the like, and controls the operation of each unit in the apparatus by executing a biological information processing program stored in the memory by the CPU, and executes various tests. Perform the necessary computations.

  The display unit 70 is a display device such as a liquid crystal display, and displays a setting screen, operation guidance, a biological information test result report, or the like under the control of the arithmetic processing unit 10.

  The printing unit 75 is a printer device such as a thermal printer, and outputs a biometric information test result report by printing the biometric information test result report on a sheet according to the control of the arithmetic processing unit 10.

  The storage unit 80 is a storage device such as a hard disk, and stores inspection results and the like according to the control of the arithmetic processing unit 10.

  The audio output unit 85 is a speaker device, and outputs operation guidance or an alarm sound according to the control of the arithmetic processing unit 10.

  The input unit 90 is an input device such as a keyboard, a mouse, a button, or a touch panel, and outputs an input signal generated in accordance with a user operation to the arithmetic processing unit 10. Let the operation be performed.

  The pulse wave measurement unit 105 is an amorphous pulse wave measurement unit (pulse wave acquisition unit). The pulse wave measuring unit 105 includes a signal processing circuit that performs predetermined signal processing such as amplification on the detection signals detected by the amorphous pulse wave sensors 25a and 25b appropriately attached to the subject. The pulse wave measurement unit 105 measures the pulse wave by supplying the detection signal after the signal processing to the arithmetic processing unit 10 as a pulse wave signal of the subject. The pulse wave signal supply from the pulse wave measurement unit 105 to the arithmetic processing unit 10 may be continuously performed when the biological information processing apparatus 1 is turned on, or in response to a request from the arithmetic processing unit 10. It may be done. The pulse wave measurement by the pulse wave measurement unit 105 is preferably used when the arithmetic processing unit 10 obtains the aorta PWV. In this case, one of the amorphous pulse wave sensors 25a and 25b is attached to the subject's carotid artery, and the other is attached to the subject's femoral artery.

  The electrocardiogram measurement unit 104 (electrocardiogram acquisition unit) performs predetermined signal processing such as amplification on detection signals detected by the electrocardiogram electrode unit 24a for limbs and the electrocardiogram electrode unit 24b for chest that are appropriately worn on the subject. A signal processing circuit to be applied; The electrocardiogram measurement unit 104 measures the electrocardiogram by supplying the detection signal after the signal processing to the arithmetic processing unit 10 as an electrocardiogram signal of the subject. The limb electrocardiogram electrode portion 24a typically includes four electrocardiogram electrodes attached to the right wrist, the left wrist, the right ankle, and the left ankle, respectively. The electrocardiographic electrodes for both ankles are preferably formed so as not to be hindered by the cuffs 22R and 22L attached to the lower limbs. In addition, the electrocardiogram electrode portion 24b for the chest is typically composed of six electrocardiogram electrodes that are respectively attached to six locations on the chest. The supply of the electrocardiogram signal from the electrocardiogram measurement unit 104 to the arithmetic processing unit 10 may be continuously performed when the power of the biological information processing apparatus 1 is turned on, or in response to a request from the arithmetic processing unit 10. May be.

  The heart sound measurement unit 103 (heart sound acquisition unit) includes a signal processing circuit that performs predetermined signal processing such as amplification on the detection signal detected by the heart sound microphone 23 appropriately attached to the subject. The heart sound measuring unit 103 measures the heart sound by supplying the detection signal after the signal processing to the arithmetic processing unit 10 as the heart sound signal of the subject. The heart sound signal supply from the heart sound measuring unit 103 to the arithmetic processing unit 10 may be continuously performed when the power of the biological information processing apparatus 1 is turned on or in response to a request from the arithmetic processing unit 10. May be.

  The blood pressure pulse wave measurement unit 100 including the upper limb measurement control unit 101 and the lower limb measurement control unit 102 also serves as an oscillometric blood pressure measurement unit and an air bag type pulse wave measurement unit (pulse wave acquisition unit). .

  The upper limb measurement control unit 101 performs pressure signal 111R, 111L, a signal processing circuit that performs predetermined signal processing such as amplification on detection signals from the pressure sensors 111R, 111L, and supply / exhaust to the cuff 21R, cuff 21L. A pump and an exhaust valve; and a CPU for controlling the air supply / exhaust operation. The measurement control unit 101 for the upper limbs introduces air into the rubber sac 21aR and 21aL of the cuff 21R and cuff 21L via the hose 21h, whereby the internal pressure of the cuff 21R and 21L (hereinafter, the cuff pressure is referred to as “cuff pressure”). And the cuff pressures of the cuffs 21R and 21L are reduced by discharging air from the rubber pouches 21aR and 21aL. The cuff 21R indicates a cuff appropriately attached to the upper right arm, and the cuff 21L indicates a cuff appropriately attached to the left upper arm. The target value of the cuff pressure after pressurization is different for pulse wave measurement and blood pressure measurement, and can be set individually.

  In the case of pulse wave measurement, the measurement control unit 101 for the upper limbs detects fluctuations in the cuff pressures of the cuffs 21R and 21L after pressurization as pulse wave signals by the pressure sensors 111R and 111L, and calculates the detected pulse wave signals. Supplied to the unit 10. The pulse wave measurement is performed in response to a request from the arithmetic processing unit 10. In the pulse wave measurement, only one of the two cuffs 21R and 21L may be used, or both may be used.

  In the case of blood pressure measurement, the upper limb measurement control unit 101 detects the cuff pressure of the cuffs 21R and 21L with the pressure sensors 111R and 111L during decompression, and uses the cuff pressure with the most significant increase in amplitude as the systolic blood pressure. While detecting, the cuff pressure with the most remarkable vibration reduction is detected as the diastolic blood pressure. Then, the upper limb measurement control unit 101 supplies blood pressure signals indicating the detected systolic blood pressure and diastolic blood pressure to the arithmetic processing unit 10. Blood pressure measurement is performed in response to a request from the arithmetic processing unit 10. When there is a request from the arithmetic processing unit 10, normally, the right blood pressure measurement using only the cuff 21R and the left blood pressure measurement using only the cuff 21L are sequentially performed, but these blood pressure measurements are performed in parallel. It may be done.

  The measurement control unit 102 for the lower limbs performs supply / exhaust to the pressure sensors 121R and 121L, a signal processing circuit that performs predetermined signal processing such as amplification on detection signals from the pressure sensors 121R and 121L, and the cuff 22R and cuff 22L. A pump and an exhaust valve; and a CPU for controlling the air supply / exhaust operation. The measurement control unit 102 for the lower limbs pressurizes the cuff pressure of the cuffs 22R and 22L by introducing air into the rubber sac 22aR and 22aL of the cuff 22R and cuff 22L via the hose 22h, and air from the rubber sac 22aR and 22aL. The cuff pressures of the cuffs 22R and 22L are reduced. The cuff 22R indicates a cuff that is properly attached to the right ankle, and the cuff 22L indicates a cuff that is appropriately attached to the left ankle. The target value of the cuff pressure after pressurization is different for pulse wave measurement and blood pressure measurement, and can be set individually. Since the operation of the lower limb measurement control unit 102 during pulse wave measurement and blood pressure measurement is the same as that of the upper limb measurement control unit 101, detailed description thereof is omitted here.

  The configuration of the biological information processing apparatus 1 has been described above.

  When performing a blood pressure pulse wave test, the biological information processing apparatus 1 operates, for example, according to the procedure shown in FIG.

  When an instruction to execute a blood pressure pulse wave test is input from the user (that is, the examiner) to the arithmetic processing unit 10 by operating the input unit 90, the blood pressure pulse wave measuring unit 100, the heart sound measuring unit 103, and the electrocardiogram measurement are input from the arithmetic processing unit 10. A request to execute measurement of the corresponding biological signal is output to each unit 104.

  The blood pressure pulse wave measurement unit 100, the heart sound measurement unit 103, and the electrocardiogram measurement unit 104 that have received this request supply the pulse wave signal, the heart sound signal, and the electrocardiogram signal detected from the subject to the arithmetic processing unit 10, respectively (Step) S11). In addition, the electrocardiogram measured here may not be a standard 12-lead electrocardiogram but may include only a specific lead (for example, lead II).

  The arithmetic processing unit 10 performs analysis processing of an electrocardiogram waveform, an electrocardiogram, and a pulse waveform based on various biological signals supplied from the blood pressure pulse wave measurement unit 100, the heart sound measurement unit 103, and the electrocardiogram measurement unit 104, and these waveforms. And the control which displays the analysis process result on the screen of the display part 70 in real time is performed.

  Here, in the analysis processing, detection of waveform segmentation points (for example, the start of the heart II sound, the pulse wave notch on the upper arm, the pulse wave rise on the upper arm, and the pulse wave rise on the ankle) is detected. (For example, refer patent document 1) and the measurement of the time difference between the detected division points are performed for every heartbeat. Then, as a quality check (quality evaluation) of the waveform (particularly pulse wave waveform), the degree of variation (for example, standard deviation) of the measured time difference is calculated in a predetermined quality check section. The quality check section is a period including at least a plurality of heartbeats so that the degree of variation in time difference is obtained, and the length thereof can be selected from, for example, 5 seconds, 8 seconds, and 16 seconds. That is, when the user arbitrarily selects the length of the quality check section by operating the input unit 90, the input unit 90 causes the arithmetic processing unit 10 to set the length of the quality check section according to the selection operation. The longer the quality check section, the higher the reliability of the quality check. The shorter the quality check section, the smaller the memory area in the storage unit 80 required for the quality check. The real-time display of the waveform quality check result will be described later.

  Further, pulse pressure measurement and the like are also performed as analysis processing. The electrocardiogram, heart sound and pulse wave biological signals supplied to the arithmetic processing unit 10 and the result of the analysis processing in the arithmetic processing unit 10 are stored in the storage unit 80 as the test result of the blood pressure pulse wave test.

  During the execution of the measurement of the electrocardiogram, the heart sound, and the pulse wave, the user can input an instruction to execute the waveform selection process to the arithmetic processing unit 10 by operating the input unit 90 at any timing. When an instruction to execute the waveform selection process is input, the arithmetic processing unit 10 stops the supply of various biological signals from the blood pressure pulse wave measuring unit 100, the heart sound measuring unit 103, and the electrocardiogram measuring unit 104. In addition, a predetermined waveform selection process is executed (step S12). When the waveform selection process is completed, that is, when a waveform is selected, the process flow proceeds to step S13. Details of the waveform selection processing will be described later. If an instruction to end the waveform selection process is selected by the user operating the input unit 90 before the waveform is selected, the process flow returns to step S11.

  In step S13, the arithmetic processing unit 10 executes arithmetic processing (arteriosclerosis check) for obtaining an arteriosclerosis index (for example, CAVI) based on the selected waveform. The calculated arteriosclerosis index is stored in the storage unit 80 as a test result of the blood pressure pulse wave test.

  When the arteriosclerosis check is completed, the arithmetic processing unit 10 automatically outputs a blood pressure measurement execution request to the blood pressure pulse wave measurement unit 100.

  Upon receiving this request, the blood pressure pulse wave measurement unit 100 first performs right blood pressure measurement using the cuffs 21R and 22R (step S14), and then performs left blood pressure measurement using the cuffs 21L and 22L (step S14). S15). Receiving the supply of the blood pressure signal from the blood pressure pulse wave measuring unit 100, the arithmetic processing unit 10 executes a calculation process (arterial occlusion check) for obtaining an arterial occlusion index (for example, ABI) based on the blood pressure signal (step S16). . The calculated arterial occlusion index is stored in the storage unit 80 as a test result of the blood pressure pulse wave test.

  The biological information processing apparatus 1 can output a biological information test result report (hereinafter simply referred to as “report”), for example, according to the procedure shown in FIG. The arithmetic processing unit 10 acquires the test results of the electrocardiogram test and the blood pressure pulse wave test from, for example, the storage unit 80 (steps S21 and S22), and displays a report based on the test results on the screen of the display unit 70. Or printing can be performed by causing the printing unit 75 to print on the paper (step S23).

  That is, the arithmetic processing unit 10 acquires the test results of the electrocardiogram test and the blood pressure pulse wave test performed on the subject, and outputs a report on the screen or on the paper based on the acquired test result. Configure the report output section.

  FIG. 4 is a diagram illustrating a format example of an output report.

  The report shown in FIG. 4 is a “comprehensive report” in which the examination results of the electrocardiogram examination and the blood pressure pulse wave examination and the findings on these examination results are collectively recorded on one sheet.

The main structure of this report and its contents are as follows:
-ECG waveform display unit 151: ECG waveform-Blood pressure pulse wave information display unit 152: Blood pressure pulse wave information-Finding display unit 153: Findings for each test result of the ECG test and blood pressure pulse wave test-Arterial state index display unit 154: Artery Hardness index and arterial occlusion index / heart diagram display unit 155: heart illustration as a picture representing the heart (heart diagram)
-Human body diagram display unit 156: Human body illustration as a picture representing the human body (human body diagram)

  Here, the heart illustration displayed on the heart diagram display unit 155 includes an overall view showing the entire image of the heart, a cross-sectional view of the heart from above (horizontal plan view), and a cross-sectional view of the heart from the front (front view). 3). In the overall view, a portion where an abnormal electrocardiogram is expressed can be highlighted. Further, around the horizontal plan view, waveforms of V1, V2, V3, V4, V5, and V6 are arranged, and around the front view, I, II, III, aVR Induction, aVL induction, and aVF induction waveforms are arranged. The three-dimensional features of the heart state can be visualized by these heart illustrations and the arrangement of the electrocardiogram waveform around it.

  The human body illustration displayed on the human body diagram display unit 156 has a form in which the human body is viewed from the front so that the upper limb and the lower limb can be seen. Therefore, in this human body illustration, blood pressure and pulse wave measurement sites (that is, each cuff wearing site) can be shown. Further, the human body illustration is arranged such that the heart position thereof coincides with the position of the front view of the heart.

  The blood pressure pulse wave information displayed on the blood pressure pulse wave information display unit 152 includes a pulse wave waveform, a measured value of the pulse pressure, and a measured value of the blood pressure, and the right upper arm, the left upper arm, the right ankle, and the left ankle, respectively. Consists of measurements. The blood pressure pulse wave information is arranged around the human body illustration in association with these measurement sites.

  As described above, in this report, not only the ECG waveform obtained as a result of the standard 12-lead ECG test is arranged around the heart illustration but also the blood pressure pulse wave information obtained as a result of the blood pressure pulse wave test. Is arranged around the human body illustration in association with the measurement site. Therefore, it is easy to intuitively understand the blood circulation state of almost the whole body. Moreover, since the front view of the heart with an electrocardiogram waveform around it overlaps the heart position of the human body illustration with blood pressure pulse wave information around it, the display of these figures can be compactly summarized Can do.

  Next, real-time display of waveforms and analysis processing results will be described with reference to FIG.

  FIG. 5A is a diagram illustrating a configuration of a waveform display screen of the display unit 70. On this waveform display screen, two pulse wave quality indicators are arranged on the upper part of the waveform display section where the waveforms of the electrocardiogram, heart sound and limb pulse waves measured from the subject are displayed in real time. The pulse wave quality indicator (for the left side) and the pulse wave quality indicator (for the right side) are measured on the subject's left side (site containing the aorta and left lower limb blood vessel) and right side (site containing the aorta and right lower limb blood vessel), respectively. This is a bar graph display means for indicating the waveform quality of the pulse wave. In this way, since the waveform quality of the pulse wave measured from the left and right sides can be individually displayed, even if the blood pressure pulse wave test is selectively performed only on one of the left side and the right side, The waveform quality of the pulse wave can be displayed. Each of the pulse wave quality indicators shown in the figure is divided into four areas (first, second, third and fourth areas) so that the quality can be expressed in four stages. However, the form of the pulse wave quality indicator is not limited to this, and can be implemented with various changes.

  When the measurement of the electrocardiogram, the heart sound, and the pulse wave of the limb is started, the display of waveforms of various biological signals is started on the waveform display screen having the above-described configuration. In the case of the air bag type blood pressure pulse wave measuring means, since air is gradually introduced into each cuff 21R, 21L, 22R, 22L from the start of measurement, the pulse wave waveform within the pulse wave waveform when a certain time has elapsed from the start of measurement. The calculation processing unit 10 can detect the division points. Therefore, as shown in FIG. 5B, when a certain time has elapsed from the start of measurement, a division line indicating the position of each division point detected for each heartbeat in the pulse waveform and the heart waveform is displayed. Become. In the figure, the first dividing line is a dividing line indicating the position of the start part of the heart II sound, the second dividing line is a dividing line indicating the position of the pulse wave rising part in the upper arm, and the third line A division line is a division line which shows the position of the notch part of the pulse wave in an upper arm, and a 4th division line is a division line which shows the position of the pulse wave rising part in an ankle.

  When each segment point is detected, the arithmetic processing unit 10 can measure the time difference between the segment points. In the present embodiment, the detected division points are the start part of the heart II sound, the pulse wave rising part at the upper arm, the notch part of the pulse wave at the upper arm, and the pulse wave rising part at the ankle, Of these, the time difference between any two points can be measured. For example, Tb which is the time difference between the start part of the heart II sound and the notch part of the pulse wave in the upper right arm or the left upper arm, the pulse wave rising part in the upper right arm or the left upper arm and the pulse wave in the right ankle or left ankle Examples include Tba, which is a time difference from the rising portion. The arithmetic processing unit 10 calculates the degree of variation of these time differences measured for each heartbeat in a preset quality check period, and turns on each pulse wave quality indicator according to the calculation result. In the case of the pulse wave quality indicator shown in the figure, when the degree of variation is very low, it is possible to express that the waveform quality of the pulse wave is very good by lighting all the first to fourth areas. Further, when the degree of variation is low to some extent, it is possible to express that the waveform quality of the pulse wave is good by lighting the first to third areas. Further, when the degree of variation is high to some extent, it is possible to express that the waveform quality of the pulse wave is poor by lighting the first and second areas. Further, when the variation degree is very high, it is possible to express that the waveform quality of the pulse wave is very poor by lighting only the first area.

  As described above, according to the present embodiment, since the waveform quality of the measured pulse wave is displayed in real time based on the degree of variation in the time difference between the division points, it is determined whether or not the pulse wave waveform is in a stable state. Can be distinguished at a glance. Therefore, during the measurement of the electrocardiogram, heart sound and pulse wave, the user looks at the display state of the pulse wave quality indicator and executes the arteriosclerosis check when the waveform quality is good or very good. It is possible to reliably calculate the curing index with high reliability.

  Next, the waveform selection process will be described with reference to FIG.

  When the waveform selection process is started in accordance with the operation by the user, as shown in FIG. 6A, the waveform display section of the waveform display screen displays the past (after the start of measurement execution) stored in the storage section 80. The waveform of each of the electrocardiogram, heart sound, and limb pulse wave is displayed. A waveform selection window is displayed so as to surround the waveform portion corresponding to the quality check section. The pulse wave quality indicator shows the waveform quality evaluated for the pulse wave in the portion surrounded by the waveform selection window. Thereby, the user can confirm the waveform quality of the portion surrounded by the waveform selection window in the past pulse wave. That is, the user can confirm at a glance the quality of the waveform to be calculated for the arteriosclerosis index. If the confirmed waveform quality is good, the user can select the waveform of the portion surrounded by the waveform selection window at that time by operating the input unit 90. In other words, the arithmetic processing unit 10 can partially select a past pulse wave waveform according to a user operation. When the waveform is selected and the waveform selection process is completed, the arteriosclerosis index is calculated based on this portion of the waveform.

  Note that the evaluation of the waveform quality of the portion of the pulse wave surrounded by the waveform selection window may be performed in real time during the pulse wave measurement, or may be performed during the waveform selection process. Further, the waveform quality used in the waveform selection process may not be the degree of variation in time difference between two different segment points (for example, between the notch portion and the rising portion). It may be the degree of variation in the time difference between the notch portions on the wave waveform. In this case, it is preferable to evaluate the waveform quality of each of the plurality of pulse waves in order to improve the quality evaluation accuracy.

  When the initially confirmed waveform quality is not good, the user arbitrarily performs an operation of sliding the knob of the scroll bar displayed at the bottom of the waveform display unit, as shown in FIG. The waveform displayed on the waveform display unit can be scrolled to the left and right, and thereby the quality check section can be shifted on the time axis. When the quality check section is shifted, the user can check the waveform quality of another portion newly surrounded by the waveform selection window with the waveform quality indicator. The user can arbitrarily select a portion having the best waveform quality among the past pulse wave waveforms by appropriately shifting the quality check section.

  Therefore, according to the present embodiment, the waveform quality can be confirmed retroactively before the execution of the arteriosclerosis check, and a portion having a desired waveform quality can be arbitrarily selected. Therefore, it is possible to reliably calculate the arteriosclerosis index with high reliability without performing the blood pressure pulse wave test again from the beginning after the blood pressure pulse wave test is once completed. That is, the reliability of the calculation result of the arteriosclerosis index can be easily improved.

  The embodiment of the present invention has been described above.

  The embodiment disclosed this time should be considered as illustrative in all points and not restrictive. The scope of the present invention is defined by the terms of the claims, rather than the description above, and is intended to include any modifications within the scope and meaning equivalent to the terms of the claims.

DESCRIPTION OF SYMBOLS 1 Biological information processing apparatus 10 Arithmetic processing part 21R, 21L, 22R, 22L Cuff 21aR, 21aL, 22aR, 22aL Rubber sac 21h, 22h Hose 23 Heart sound microphone 24a Limb electrocardiogram electrode part 24b Chest electrocardiogram electrode part 25a, 25b Amorphous type Pulse wave sensor 70 Display unit 75 Printing unit 80 Storage unit 85 Audio output unit 90 Input unit 100 Blood pressure pulse wave measurement unit 101 Measurement control unit for upper limb 102 Measurement control unit for lower limb 103 Heart sound measurement unit 104 Electrocardiogram measurement unit 105 Pulse wave measurement unit 111R, 111L, 121R, 121L Pressure sensor

Claims (2)

A pulse wave acquisition unit for acquiring the pulse wave of the subject;
An arithmetic processing unit for evaluating the waveform quality of the acquired pulse wave;
A display unit for displaying the waveform of the acquired pulse wave;
A storage unit for storing the acquired pulse wave,
The arithmetic processing unit displays a past pulse wave waveform stored in the storage unit on the display unit according to a user operation, and displays the past pulse wave displayed on the time axis in accordance with a user operation. The waveform quality evaluated with respect to the pulse wave in the selected quality check section is displayed on the display unit in part by the quality check section displaceable in
Furthermore,
When the pulse wave in the selected quality check section is determined as an arteriosclerosis index calculation target according to a user operation , the arithmetic processing unit is based on the determined waveform of the pulse wave in the quality check section. To calculate an arteriosclerosis index,
Biological information processing device. The arithmetic processing unit performs detection of segment points in the acquired pulse wave and measurement of a time difference between the detected segment points for each heart beat, and as a quality evaluation of the acquired pulse wave waveform, Calculating the degree of variation in the time difference between the division points measured every time in the quality check section;
The biological information processing apparatus according to claim 1 .