JP6281892B2 - Menopause disorder evaluation apparatus and program therefor - Google Patents

Description

  The present invention relates to a menopausal disorder evaluation apparatus and method. More specifically, by adopting an index that is highly related to menopause than the electrocardiogram information analysis value related to sympathetic and parasympathetic nerve information obtained by analyzing electrocardiogram information, it is an objective method to detect climacteric disorder. It relates to a device for evaluating the possibility.

  In general, it is known that a woman's blood estrogen concentration rapidly decreases from 45 to 55 years old, and accordingly, various symptoms called menopause are exhibited. One of the symptoms is autonomic nervous system modulation such as hot flash. As a score indicating the severity of the menopausal disorder, a simplified menopause index (SMI) is known (Non-Patent Documents 1-3). However, this method largely depends on the subjectivity of the individual patient, and there is a need for an objective evaluation method for evaluating and diagnosing climacteric disorder and an index of its severity.

  On the other hand, as a method for measuring autonomic nerve balance activity, a method called a heart rate variability power spectrum analysis method is known (Non-Patent Documents 4 and 5). Many of the conventional measurement methods only perform measurements at rest, and only a few of the analytical values obtained from them are used, and many of them only look at the autonomic nervous function from a specific aspect. . However, in the same way, even in the measurement method using the electrocardiogram information analysis value, it is possible to obtain more accurate information on autonomic nerve activity by adding a stimulus such as standing load at the time of measurement and performing more complicated analysis There is. Based on such an idea, as shown in Patent Document 1, Non-Patent Document 6, and Non-Patent Document 7, a technique related to a radar chart type balance evaluation method for an autonomic nerve function has been proposed.

JP-A-7-155303

Chen JT, Kotani K. An inverse relation between the Simplified Menopausal Index and biological antioxidant potential.Climacteric 2013, 16 (2), 288-291. (Doi: 10.3109 / 13697137.2012.696291) Epub. August 24, 2012. Ikeda H, Inoue T, Uemura S, Kaibara R, Tanaka H, Node K. Effects of candesartan for middle-aged and elderly women with hypertension and menopausal-like symptoms.Hypertens Res. 2006; 29 (12): 1007-12. Suka M, Taniuchi A, Kudo Y, Sato S, Yoshida K, Ishizuka B. Self-assessed health and menopausal symptoms among 50-year-old Japanese women: cross-sectional surveys in Northern Kawasaki in 1998 and 2008. Menopause. 2010; 17 (1): 166-73. Heart rate variability: standards of measurement, physiological interpretation and clinical use.Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996; 93 (5): 1043-65 Stauss HM. Heart rate variability. Am J Physiol Regul Integr Comp Physiol. 2003; 285 (5): R927-31. Yukio Goto, Zenichi Yasuda, Politics Yanagimoto, Evaluation of Autonomic Nervous Function by Radar Chart Display, Autonomic Nerve 31, 660-667 "Psychosomatic autonomic balance", 468 pages, Yukio Goto (Author), Shinko Trading Co., Ltd.

  The present invention has been made in view of the above-mentioned problems and limitations of the prior art, and is based on electrocardiogram information analysis values related to sympathetic and parasympathetic nerve information obtained by analyzing electrocardiogram information. It is an object of the present invention to provide an apparatus and a method for evaluating automatically.

  As a result of intensive studies to solve the above problems, the present inventor has found that the following inventions meet the above object, and have reached the present invention.

  The present invention relates to an electrocardiogram information measuring means for measuring electrocardiogram information at rest, an electrocardiogram information storage means for storing electrocardiogram information measured by the electrocardiogram information measurement means, and an electrocardiogram information stored in the electrocardiogram information storage means at rest. The analysis means for analyzing the electrocardiogram RR interval standard deviation is compared with the resting electrocardiogram RR interval standard deviation of the subject and the average resting electrocardiogram RR interval standard deviation obtained by the analyzing means previously obtained as an average value of a group of healthy subjects. It is a menopausal disorder evaluation apparatus characterized by having a discriminating means for discriminating the possibility of menopause and a display means for displaying a result discriminated by the discriminating means.

  The present invention has electrocardiogram information measuring means for measuring electrocardiogram information at rest. The electrocardiogram information is information recorded so that the state of the electrical activity of the heart can be formed into a graph. The configuration of the electrocardiogram information measurement means generally includes a biological electrode unit that is brought into contact with a measurement site of a subject, an amplifier circuit that amplifies a detection minute signal detected from the electrode unit, and a detection unit that detects the amplified signal. Is. At this time, at least the sensitivity with which the R wave of the electrocardiogram can be sufficiently detected and the generation interval of the R wave (in order to be able to analyze the electrocardiogram information analysis value as an index of sympathetic nerve and parasympathetic nerve information) Hereinafter, it is required that the change with time of “RR interval”) can be acquired as time-series data (so-called QRS wave or the like).

  In the present invention, resting refers to the state of the subject in a state in which the electrocardiogram is stable, and the postures are roughly divided into a supine position, a sitting position, and a standing position. A preferred resting posture of the present invention is a supine position, and more preferably a closed eye-rested supine position on a bed. This posture is a posture in which the electrocardiogram is easily measured and the electrocardiogram is easily stabilized.

  These measurements are preferably performed under conditions determined at the time of measurement of the healthy subject group and at the time of measurement of the subject. Here, it is preferable to adjust the conditions, considering the gender, age, time zone to be measured, weight, height, time after meal, presence of exercise immediately before measurement, respiratory pace, etc. Is preferable. Among these, it is particularly important that the age of the person to be measured and the time zone for measurement are fixed. Specifically, for example, the measurement time is 13:00 to 15:00, the breathing at the time of measurement is 15 times per minute, and the age of the person to be measured is 40 to 60 years old. More preferably, the age of the healthy group is preferably information obtained from healthy individuals whose absolute value of the age difference from the age of the subject is 5 years old or less (particularly preferably 3 years old or less).

  Next, the present invention includes electrocardiogram information storage means for storing electrocardiogram information measured by the electrocardiogram information measurement means. The electrocardiogram information storage means for storing the electrocardiogram information measured by the electrocardiogram information measurement means is typically an electronic computer having a memory unit as the storage means, and an electrocardiogram information analysis that serves as an index of sympathetic nerve and parasympathetic nerve information Any device capable of storing electrocardiogram information for analyzing values is sufficient.

  Furthermore, the present invention has an analysis means for analyzing a resting electrocardiogram RR interval standard deviation from the electrocardiogram information stored by the electrocardiogram information storage means. Here, the resting electrocardiogram RR interval standard deviation analyzed by the analyzing means is the standard deviation of the RR interval at rest, and if the fluctuation of the RR interval at rest is small, the activity inherent in the subject is considered to be low. Is. In the present invention, this is the main electrocardiogram information analysis value. Moreover, this is proposed to be measured as one of the indicators of the sympathetic and parasympathetic states in the cited documents 6 and 7, and is also called vagus nerve activity or intrinsic vitality. It may be abbreviated as “SDRR (sup)” because of analysis.

  A measurement example and an analysis method of electrocardiogram information for obtaining an electrocardiogram information analysis value of the present invention are shown in FIGS. 1 and 2 (see FIGS. 1 and 2 for non-patent documents 6 and 7). Here, R is known as the R wave of the electrocardiogram and refers to the first positive wave of the QRS wave. The RR interval is a time indicating the interval between R and R, and is generally expressed in units of 1/1000 second (msec).

  In the present invention, the value obtained by analyzing the electrocardiogram information in this way is called an electrocardiogram information analysis value, and this electrocardiogram information analysis value is analyzed from the QRS wave using the electrocardiogram information at rest or under load. Is the value to be For example, the average value of the RR interval, variation (standard deviation), minimum value, maximum value, high frequency component rate, low frequency component rate, and combinations thereof, and the increase / decrease when comparing between load and rest It is a concept that includes a ratio obtained by combining specific values. In the climacteric disorder evaluation apparatus and method of the present invention, this electrocardiogram information analysis value is appropriately selected and combined with a resting electrocardiogram RR interval standard deviation which is one of the electrocardiogram information analysis values and is an essential analysis value of the present invention. Therefore, it can be used for analysis as highly reliable information.

  Moreover, in this invention, it is calculated | required to compare with the average resting electrocardiogram RR interval standard deviation of the healthy subject group obtained by the said analysis means. It is preferable to collect in advance information on the average value of the group of healthy subjects such as the average resting electrocardiogram RR interval standard deviation. Here, the healthy group is a person who does not have symptoms of climacteric disorder, and preferably obtained by averaging the data of the subject to be evaluated and diagnosed as having the menopause disorder and the same generation group. Good. The human who does not have menopausal symptoms is preferably a healthy human who has no symptoms accompanied by a large change in electrocardiographic information other than the symptoms of menopause. For example, in the case of targeting women, the group of women of the same generation as the test subject is specifically preferably obtained as an average value of 40 or more women aged 60 to 60 measured. In addition, also when discriminating using the electrocardiogram information analysis value acquired by other analysis means such as an average electrocardiogram RR interval change during loading, it can be obtained from the above-mentioned female group data and obtained as the average value of the healthy subject group. preferable.

  Furthermore, in this invention, it is calculated | required that a test subject's resting electrocardiogram RR interval standard deviation is extract | collected. Here, the test subject means a human subject to be evaluated and diagnosed as having climacteric disorder. About this test subject, an electrocardiogram information measuring means, an electrocardiogram information storage means, and an analysis means obtain a resting electrocardiogram RR interval standard deviation.

  In this invention, it has the discrimination means which compares the average resting electrocardiogram RR interval standard deviation of a healthy person group, and a test subject's resting electrocardiogram RR interval standard deviation, and discriminate | determines the possibility of a menopause. As a result of studies on electrocardiogram information analysis values, which are indices relating to sympathetic nerves and parasympathetic nerves of healthy subjects and subjects, the present inventors have found that patients with climacteric disorder have a resting electrocardiogram RR interval standard deviation compared to normal subjects. Was found to be low. Moreover, it discovered that the menopausal disorder severity SMI value of the menopausal disorder patient, and the resting electrocardiogram RR interval standard deviation were inversely correlated. The present invention is based on these findings. The average resting electrocardiogram RR interval standard deviation of this healthy group is compared with the resting electrocardiogram RR interval standard deviation of the subject, and the resting electrocardiogram RR interval standard deviation of the subject is determined. When it is low, the greatest feature is that it has a discriminating means for discriminating that the subject has a possibility of menopause. Further, the determining means may be a determining means for determining the degree of the climacteric disorder severity SMI value from the value of the subject's resting electrocardiogram RR interval standard deviation.

  Specifically, this discrimination means is a ratio of the standard deviation ECG RR interval standard deviation of the subject and the average rest ECG RR interval standard deviation of healthy subjects (resting ECG RR interval standard deviation / average resting ECG RR interval). (Standard deviation) may be shown as a numerical value as it is or after further processing, and discrimination may be performed in a state associated with the possibility of suspected climacteric disorder and its severity (SMI). Thus, by digitizing the possibility and severity, it becomes useful as an indicator of necessity for more detailed diagnosis and judgment and determination of treatment policy and the like. Moreover, since the actual therapeutic effect can be grasped by improving the value, it is also useful as an index that is easily felt by doctors and patients.

  For example, this discriminating means is the ratio of the subject's resting electrocardiogram RR interval standard deviation to the average resting electrocardiogram RR interval standard deviation of healthy subjects (resting electrocardiogram RR interval standard deviation / average resting electrocardiogram RR interval standard deviation). Is preferably a discriminating means for discriminating that there is a possibility of climacteric disturbance when it is smaller than 1. This ratio is more preferably 0.9 or less, and further preferably 0.8 or less, in order to further improve the reliability of the evaluation result of the present apparatus. Moreover, although a lower limit is 0 or more, it is preferable to set it as 0.1 or more. If this ratio is too small, there is a concern about the possibility of symptoms due to other diseases, etc., and it is often not appropriate to make a judgment as climacteric disorder. On the other hand, if the ratio is larger than this ratio, there is a possibility of an error due to individual differences and the influence of physical condition at the time of measurement, so the relationship with menopause may be unknown.

  And this invention has a display means which displays the result discriminate | determined by the said discrimination means. Since the result determined by the determining means can be confirmed by being displayed on a monitor or the like, a means for displaying the determination result is required. Here, the display means not only the display of characters, numerical values, symbols, etc. but also information presentation and discrimination by voice on a monitor connected to an electronic computer such as a personal computer that performs and displays these information processing. It is a concept including a mode in which a person can recognize the result such as printing the result on paper.

  In the present invention, the climacteric disorder evaluation apparatus further measures electrocardiogram information during loading by means of electrocardiogram information measuring means, the electrocardiogram information storage means stores electrocardiogram information during loading, and the analyzing means performs the electrocardiogram. The load ECG RR interval change amount is analyzed from the resting and load electrocardiogram information stored in the information storage means, and the discriminating means calculates the load average electrocardiogram RR interval change amount of the subject and the average value of the healthy subjects in advance. It can be achieved as a climacteric disorder evaluation apparatus for comparing the collected average electrocardiogram RR interval change amount during loading and determining the possibility of climacteric disorder together with the comparison result of the resting electrocardiogram RR interval standard deviation. In other words, in addition to the electrocardiogram RR interval standard deviation, the possibility of menopause can be more accurately evaluated by using the analysis means and the discrimination means as indices.

  In order to acquire an electrocardiogram information analysis value such as an on-load average electrocardiogram RR interval change amount, the electrocardiogram information measurement means of the present invention can further include an electrocardiogram information measurement means for measuring electrocardiogram information at the time of load. Here, the electrocardiogram measuring apparatus itself at rest and under load may be the same, but it is required that each information can be distinguished and acquired. Here, the load is a state when the electrocardiogram also fluctuates when the human receives a certain stimulus (load) with respect to the above-mentioned rest, and this load is a load accompanying a change in posture in particular, It is roughly divided into posture change from the standing position to the standing position, and posture change from the sitting position to the standing position. In the present invention, the load due to the posture change from the supine position to the standing position is preferable, and more specifically, it refers to the load accompanying the posture change from the supine position to the state where the eyes are open and standing stationary. .

  The analysis means of the present invention can further analyze the load average electrocardiogram RR interval change amount. The on-load average electrocardiogram RR interval change amount is the difference between the average values of the RR intervals of the electrocardiogram acquired for a certain period of time at rest and on load. In Non-Patent Documents 6 and 7, this is introduced as the degree of sympathetic nerve excitement or sustained activation, and may be described as “mRR (sup-std)” and an abbreviation based on the analysis method.

  The present inventors have found that the average electrocardiogram RR interval change during loading is correlated with climacteric disorder following the resting electrocardiogram RR interval standard deviation. On the basis of this, the present invention compares the average electrocardiogram RR interval change amount during load of the healthy subject group with the test subject load average electrocardiogram RR interval change amount, and the subject load average electrocardiogram RR interval change amount is low And a discriminating means for discriminating that the subject has the possibility of menopause. Here, it is preferable that the average electrocardiogram RR interval change amount at the time of average load of the healthy person group is acquired in advance and is in a state where it can be easily used as a reference value. This determination is based on the ratio of the test subject's average electrocardiogram RR interval change during load and the average load electrocardiogram RR interval change during healthy subjects (average electrocardiogram RR interval change during load / average electrocardiogram RR interval change during average load). ) Is less than 1, it is preferably a discriminating means for discriminating that there is a possibility of menopause. This ratio is more preferably 0.3 to 0.7. If this ratio is too small, there is a concern about the possibility of symptoms due to other illnesses, etc., and it is often not appropriate to make a judgment as climacteric disorder. On the other hand, if this ratio is large, there is a possibility of an error due to individual differences and the influence of physical condition at the time of measurement, so the relationship with menopause may be unknown.

  In the present invention, the climacteric disorder evaluation apparatus further measures electrocardiogram information during loading by means of electrocardiogram information measuring means, the electrocardiogram information storage means stores electrocardiogram information during loading, and the analyzing means performs the electrocardiogram. From the electrocardiogram information at rest and load stored in the information storage means, an electrocardiogram RR interval maximum change amount at the time of loading is analyzed, and the discriminating means determines the maximum change amount of the electrocardiogram RR interval at the time of the subject and the average value of the healthy group in advance It is preferable to compare the maximum amount of change in the electrocardiogram RR interval during loading, and to determine the possibility of menopause together with the comparison result of the standard deviation of the electrocardiogram RR interval at rest.

  The analysis means of the present invention can analyze the maximum change in electrocardiogram RR interval during loading. The maximum change in electrocardiogram RR interval during load is that the heart rate increases when resting to load (decrease in RR interval), but the minimum RR interval when the heart rate increases and the RR interval during rest It is the difference from the average value. In Non-Patent Documents 6 and 7, this is introduced as the degree of sympathetic nerve stimulation or instantaneous response, and is described as “mRR (sup) −RRmin (std)” as an abbreviation based on the analysis method. is there.

  Further, when the discrimination of the electrocardiogram information analysis value is evaluated, the maximum change amount of the electrocardiogram RR interval during loading analyzed by the analysis means is the ratio (in the case of the climacteric disorder patient) when compared with the average value of the group of healthy subjects. Based on the finding that the ECG RR interval maximum change during load / ECG RR interval maximum change during load is often in the range of 0.6 to 0.95, for example, this ratio is used as an index as it is. Is something that can be done.

  The configuration for discriminating using these plural electrocardiogram information analysis values is based on each analysis value, and whether or not they are within the above-mentioned range or based on specific numerical values, the basics of patients with climacteric disorder As the target information, it is possible to perform the determination with higher reliability by excluding the influence of other medical conditions, temporary psychological state, physical condition and the like by combining the determination. In particular, the analysis means analyzes the load ECG average RR interval change amount and the load ECG RR interval maximum change amount by acquiring the electrocardiogram information at the time of load and comparing this with the comparison result of the resting ECG RR interval standard deviation. By identifying together, more sympathetic and parasympathetic information is collected, and the reliability of climacteric disorder evaluation is improved.

  The present invention uses at least the resting electrocardiogram RR interval standard deviation, the load average electrocardiogram RR interval change amount, and / or the load electrocardiogram RR interval maximum change amount of healthy subjects and menopausal patients as variables. Using a discriminant prepared in advance by multivariate analysis, the resting electrocardiogram RR interval standard deviation of the subject, the load average electrocardiogram RR interval change amount and / or the load electrocardiogram RR interval maximum change amount From the above, it is preferable to achieve as a menopausal disorder evaluation apparatus having a discrimination means for discriminating the possibility of menopause. By performing such multivariate analysis, it becomes possible to evaluate and diagnose climacteric disorder with higher reliability than the analysis result of a single electrocardiogram information analysis value. Also, depending on the method of multivariate analysis, a weighting index for the electrocardiogram information analysis value can be obtained.

Here, the multivariate analysis is a technique for summarizing the characteristics of multivariate data (other types of characteristic values) that are related to each other and integrating them according to the purpose.
For multivariate analysis,
(1) Multiple regression analysis and canonical correlation analysis used for finding prediction formulas (relational formulas) and estimating quantities,
(2) Cluster analysis and discriminant analysis used for specimen classification and quality estimation,
(3) Principal component analysis, factor analysis, etc. used for integrated organization (reduction) of multivariate, classification of variable, discovery of representative variable, etc. are included. Which of these methods is adopted can be selected according to the purpose.

  Also, the present invention is an electrocardiogram information measuring means for measuring resting electrocardiogram information, and a climacteric disorder evaluation method based on the electrocardiogram information stored by the storage means for storing the electrocardiogram information measured by the electrocardiogram information measuring means, Analyzing step of analyzing resting electrocardiogram RR interval standard deviation from electrocardiogram information stored by electrocardiogram information storage means, average resting electrocardiogram RR interval standard deviation of healthy subjects obtained by said analyzing step and resting electrocardiogram RR interval of subject It can also be achieved as a menopausal disorder evaluation method characterized by having a determination step for comparing the standard deviation to determine the possibility of climacteric disorder and a display step for displaying the result determined by the determination means. Here, each step is implemented as a step corresponding to the above-described means.

  By creating and using a program for causing a computer to execute each step of the climacteric disorder evaluation method, electrocardiogram information measuring means for measuring electrocardiogram information at rest, and electrocardiogram information measured by the electrocardiogram information measuring means This can be achieved by the presence of an electronic computer (computer) that processes this program based on the electrocardiogram information stored by the storage means for storing the program.

  In addition, it is preferable to perform a more reliable diagnosis by using a program that performs further analysis and discrimination based on electrocardiogram information at rest and during loading. For example, by incorporating such a program into a conventionally known radar chart type autonomic balance analysis software or the like, an apparatus and method for evaluating a symptom of concern can be improved.

  With such a configuration, the present invention provides a menopausal disorder evaluation apparatus, a menopausal disorder evaluation method, and a program thereof that can evaluate the possibility of menopause.

  According to the present invention, the possibility of menopause can be evaluated by an objective method. Further, since it can be evaluated in a short time and information useful as an index of the severity can be acquired, it is also useful as an index as to whether or not a further detailed diagnosis is performed. The evaluation results of the present invention are also useful for more detailed treatment and prevention of menopause.

It is a figure explaining the method of analyzing sympathetic nerve information and parasympathetic nerve information from the electrocardiogram of this invention. It is a figure explaining the method of analyzing sympathetic nerve information and parasympathetic nerve information from the electrocardiogram of this invention. It is a block diagram which shows the climacteric disorder evaluation apparatus concerning one Example of this invention. It is a figure which shows the actual measurement example regarding the climacteric disorder evaluation apparatus of this invention. It is a figure which shows the correlation with the actual measurement example regarding the climacteric disorder evaluation apparatus of this invention, and the severity of climacteric disorder. It is an example of the result of having evaluated the climacteric disorder patient with the climacteric disorder evaluation apparatus of the present invention. It is another example of the result of having evaluated the climacteric disorder patient with the climacteric disorder evaluation apparatus of this invention. It is another example of the result of having evaluated the climacteric disorder patient with the climacteric disorder evaluation apparatus of this invention. It is another example of the result of having evaluated the climacteric disorder patient with the climacteric disorder evaluation apparatus of this invention. It is an example which discriminate | determined the patient of the menopausal disorder and the healthy subject by the multivariate analysis which is one of the aspects of this invention.

  Preferred embodiments of the present invention will be illustratively described below with reference to the drawings. The description of the embodiment and the constituent elements described below is an example (representative example) of an embodiment of the present invention, and the present invention is not limited to the following contents unless it exceeds the gist.

  First, an example of the menopausal disorder evaluation apparatus of the present invention will be described with reference to FIG. In FIG. 3, the menopausal disorder evaluation apparatus A according to the present invention includes an electrocardiogram information measuring unit 1, a control unit 60, and a display unit 502. Here, the control unit 60 includes an input unit 101, a storage unit 20, an analysis unit 3, a determination unit 4, and a display control unit 501 that is a part of the display unit 5. The display unit 5 includes a display control unit 501 and a display unit 502.

  As shown as the electrocardiogram information measuring means 1 in FIG. 3, the climacteric disorder evaluation apparatus of the present invention has an electrocardiogram information measuring means for measuring an electrocardiogram. The electrocardiogram information measuring means 1 is attached to the measurement subject and measures the electrocardiogram information. The electrocardiogram information measuring means 1 measures at least electrocardiogram information at rest, and preferably also measures electrocardiogram information at load.

  The electrocardiogram information measured by the electrocardiogram information measurement means 1 is stored as digitally processed data that can be converted into electrocardiogram information such as QRS waves in the electrocardiogram information storage means of the storage means 20 via the input means 101 shown in FIG. The The storage means 20 can further store a value such as an average electrocardiogram RR interval standard deviation collected as an average value of a group of healthy subjects in advance, a calculation formula used in the analysis means, and the determination means. It can also be used as external storage means. For example, a hard disk device or the like that has a large capacity and can be accessed at high speed is adopted as the storage means 20.

  Next, the electrocardiogram information is analyzed in the analysis means 3 based on the electrocardiogram information stored in the electrocardiogram information storage means of the storage means 20 (analysis step). For example, in the case of the resting electrocardiogram RR interval standard deviation which is the main electrocardiogram information analysis value of the present invention, the analysis unit 3 reads the resting electrocardiogram information of the subject stored in the storage unit 20 and the RR from the electrocardiogram information. The standard deviation of the interval is analyzed.

  The data analyzed by the analyzing means 3 is then discriminated by the discriminating means 4 and evaluated for the possibility of climacteric disorder (discrimination step). The discriminating means 4 compares the electrocardiogram information analysis value analyzed by the analysis means 3 with the average electrocardiogram information analysis value of the healthy group. For example, when determining the standard deviation of the resting electrocardiogram RR interval, the standard deviation of the resting electrocardiogram RR interval analyzed by the analyzing means 3 is collected as the average value of the group of healthy subjects previously stored in the storage means 20. Compare the average resting electrocardiogram RR interval standard deviation to determine the possibility of menopause. Specifically, this possibility can be determined by simply determining the value of the subject / average of the healthy group as a numerical value of the ratio, or it can be determined from the result of the comparison to the level of possibility. It is something to do.

  The result determined by the determining means 4 is displayed by the display means 5 (display step). As described above, the display unit 5 includes the display control unit 501 and the display unit 502 in the apparatus shown in FIG. The display control unit 501 has a function of controlling display on the display unit 502.

  In the present invention, in addition to the configuration for analyzing and discriminating the resting electrocardiogram RR interval standard deviation obtained from the resting electrocardiogram information, the configuration for analyzing and discriminating the other ECG information analysis values at rest or load as an index In addition, an evaluation apparatus that can more reliably evaluate whether a subject is a patient with high possibility of climacteric disorder, a healthy person, or a patient who should be concerned about other symptoms. be able to. In other words, comparing the average ECG RR interval during loading and the maximum amount of ECG RR interval during loading together with the comparison result of the standard deviation of the resting ECG RR interval, the possibility of more reliable menopause Can be determined. Specifically, the analysis means 3 performs a plurality of analyzes of the resting and load electrocardiogram information stored in the storage means 20, and those analysis results are preliminarily averaged by the determination means 4 in the average value of the group of healthy subjects. Compared with those stored in the table, the comparison results are arranged separately so that it can be confirmed which judgment index (respectively lower than the average value) is satisfied, or comparison of resting ECG RR interval standard deviation By combining the result with the comparison result of the average ECG RR interval during loading (by formulating the conditional expression to identify whether each requirement is satisfied and showing the result, etc.), the difference is made depending on the possibility of climacteric disorder It is something that is determined.

  In addition, it is preferable that an evaluation apparatus that can be evaluated with higher reliability can be obtained by adding another configuration using the electrocardiogram information analysis value during rest and load as an index.

  Another function of the analysis means 3 of the present invention is to analyze the data obtained for a predetermined heart rate for the RR interval at rest or load, and for the specific analysis, the above-described rest RR interval is described. Examples include standard deviation, load average RR interval change, load RR interval maximum change, and those described later. The analysis result obtained by this analysis means is an index of the radar chart introduced in the above-mentioned non-patent documents 6 and 7, which is known as a general analysis method for the sympathetic nerve information and parasympathetic nerve information. Including

  Still another function of the analyzing means 3 may be to analyze a resting heart rate variability power spectrum high frequency component ratio. The resting heart rate variability power spectrum high frequency component ratio is the high frequency band power (HF) / full frequency band power at rest, that is, the ratio of the high frequency component to the total fluctuation. In Non-Patent Documents 6 and 7, this is introduced as relative vagal activity or parasympathetic nerve function, and may be described as “HF / Total (sup)” and an abbreviation based on the analysis method. .

  The analyzing means 3 can analyze the resting average electrocardiogram RR interval. The resting average electrocardiogram RR interval is the RR interval of the resting electrocardiogram, and is an increase / decrease index of the heart rate. In other words, it is determined that the smaller the resting heart rate, the more dominant the parasympathetic nerve. In Non-Patent Documents 6 and 7, this is introduced as parasympathetic nerve dominance or resting heart rate, and may be described as “mRR (sup)” and an abbreviation based on the analysis method.

  The analysis means 3 can analyze the heart rate variability power spectrum low frequency component ratio during loading. The load heart rate variability power spectrum low frequency component ratio is the low frequency band power (LF) / full frequency band power at the time of load, that is, the ratio of the low frequency component to the total fluctuation, Become. In Non-Patent Documents 6 and 7, this is introduced as relative sympathetic nerve activity or sympathetic nerve function, and may be described as “LF / Total (std)” and an abbreviation based on the analysis method. .

  Here, the sympathetic nerve is an autonomic nerve that is generally said to be an active nerve, and is considered to be dominant during excitement or activity. The amount of change in the load average electrocardiogram RR interval that is considered to be an indicator of these. In some cases, the on-load electrocardiogram RR interval maximum change amount and the on-load heart rate variability power spectrum low-frequency component ratio are collectively referred to as sympathetic nerve information.

  The parasympathetic nerve is an autonomic nerve that is generally said to be a resting nerve and is dominant when relaxing or resting. The resting electrocardiogram RR interval standard deviation, which is considered to be an indicator of these, is resting. The heart rate variability power spectrum high-frequency component ratio and the resting average electrocardiogram RR interval may be collectively referred to as parasympathetic information.

  Based on these sympathetic nerve information and parasympathetic nerve information, S / P ratio can be obtained as an index of the balance between sympathetic nerve information (hereinafter “S”) and parasympathetic nerve information (hereinafter “P”). In the invention, as one of the electrocardiogram information analysis values, the analysis means 3 that also performs this analysis may be used. This S / P ratio is a particularly useful index when one of the variables when performing multivariate analysis or when determining the original autonomic state of the subject. Specifically, this S / P ratio is the sum of the load average electrocardiogram RR interval change amount, the load electrocardiogram RR interval maximum change amount and the load heart rate variability power spectrum low frequency component ratio (as a ratio with the standard group). The total value of the resting electrocardiogram RR interval standard deviation, the resting heart rate variability power spectrum high frequency component ratio, and the resting average electrocardiogram RR interval (the sum as a ratio with the standard group) is parasympathetic information. It is a value that can be obtained by determining the ratio to (preferably).

  Here, the present inventors analyzed the ratio of the resting heart rate variability power spectrum high-frequency component analyzed by these analysis means 3 when compared with the average value of the healthy group in the case of menopausal patients (subjects). It was found that the resting heart rate variability power spectrum high-frequency component ratio / average healthy heart rate variability power spectrum high-frequency component ratio of the healthy group is often in the range of 0.6 to 1.1. Further, when the average ECG RR interval at rest analyzed by the analysis means 3 is compared with the average value of the healthy group in the case of patients with climacteric disorder, the ratio (average ECG RR interval at rest of subject / healthy group) The average resting average electrocardiogram RR interval) is often in the range of 0.6 to 1.1. Furthermore, when the heart rate variability power spectrum low frequency component ratio analyzed by the analysis means 3 is compared with the average value of the healthy group in the case of the climacteric disorder patient, the ratio (the heart rate variability power spectrum of the subject under load) It has been found that the low-frequency component ratio / average load heart rate variability power spectrum low-frequency component ratio of healthy subjects group is often in the range of 0.9 to 1.2.

  In the present invention, such an electrocardiogram information analysis value is used in combination with an indicator having a small difference between a group of healthy subjects and a patient with climacteric disorder, so that the patient has menopause with higher reliability. The possibility can be judged. If these values are also significantly different from the healthy group, it is necessary to consider the possibility of medical conditions other than menopause.

  Further, in the present invention, based on the values obtained by these analysis means 3, it may be determined by image recognition that determines the similarity of the shape of the figure as a figure like a radar chart graph. . At this time, the image recognition to determine the similarity of the shape of the figure, the sympathetic nerve information and the parasympathetic nerve information of the patient with the possibility of climacteric disorder is generally lower than the value of the healthy person, The resting electrocardiogram RR interval standard deviation, the load average electrocardiogram RR interval change amount, and the load electrocardiogram RR interval maximum change amount decrease. From this, for example, it is possible to use the discriminating means 4 for identifying a pattern for judging the similarity of the overall shape when a radar chart is used.

  In addition, when performing multivariate analysis, for example, a group of healthy subjects is group A, a patient who is known to have climacteric disorder is group B, and a calculation formula for multivariate analysis that separates group A and group B is rested. ECG RR interval standard deviation, load average ECG RR interval change, load ECG RR interval maximum change, load heart rate variability power spectrum low frequency component ratio, rest heart rate variability power spectrum high frequency component ratio, rest average ECG An electrocardiogram information analysis value such as the RR interval can be analyzed and obtained as a variable. Here, in addition to the analysis value selected in the above-described configuration, a value obtained by further combining the values to be analyzed can be included as one of the variables of the multivariate analysis. A value obtained from the value can also be a variable. As a specific example, S / P ratio for obtaining a ratio of sympathetic nerve information and parasympathetic nerve information can be obtained and used as a variable. Or, an SMI (Simified Menopausal Index) value, which is an index of the severity of a patient with climacteric disorder, and an expression that serves as an index for judging the severity by analyzing the value analyzed by the analysis means as a variable You can ask for it. Again, this is a concept including a combination of a plurality of indices such as the above-mentioned S / P ratio, and these may be used. By using as a means of discriminating such a group of healthy subjects, a group of patients with climacteric disorder, and the severity of the patient as a teacher data, it is possible to determine which group the subject belongs to, This is useful because the severity can be determined and the accuracy can be increased.

  And this invention has the display means 5 which displays the result discriminate | determined by the discrimination means 4. FIG. As described above, since the result determined by the determining unit 4 can be confirmed by being displayed on a monitor or the like, the display unit 5 for displaying the determination result is necessary. Similarly, as a preferable aspect of the present invention, it is possible to provide a display unit that also shows the results corresponding to the added discrimination unit.

  Thus, the climacteric disorder evaluation apparatus A of the present invention shown in FIG. 3 measures electrocardiogram information at rest (preferably further under load) from the subject using the electrocardiogram information measuring means 1, for example, and the electrocardiogram. Information is stored in the storage means 20 via the input means 101, and the electrocardiogram information stored in the storage means 20 in the analysis means 3 is analyzed as a resting electrocardiogram RR interval standard deviation or the like (analysis step) and analyzed in the discrimination means 4 Compare the resting electrocardiogram RR interval standard deviation analyzed by means 3 and the mean resting electrocardiogram RR interval standard deviation as the mean value of the healthy subjects previously stored in the storage means 20 to determine the possibility of menopause. (Determination step), the test result is displayed on the display unit 502 based on the control by the display control means 501 (display step). It is possible to diagnose the possibility of menopause.

  EXAMPLES Hereinafter, although an Example demonstrates this invention further in detail, this invention is not limited to a following example, unless the summary is changed.

  As an electrocardiogram information measuring means, using a heart rate variability analysis system (HRV analyzer Biovie1000 manufactured by NEC and AD card type converter), an electrocardiogram RR interval signal continuously input online from a subject is subjected to A / D conversion in 12 bits, Various spectral values were calculated and used as ECG information. The electrocardiogram information was stored in the storage means of the electronic computer.

  In the actual measurement, first, breathing was performed 15 times per minute, and measurement was performed for 60 seconds when the patient was on the bed with the eyes resting in the supine position (electrocardiogram information at rest). Then, after getting out of the bed and the electrocardiogram waveform was stabilized in the state where the eyes were not standing upright, the measurement was similarly performed for 90 seconds (electrocardiogram information during loading). The total measurement time for this operation was within about 5 minutes.

  As analysis software for the heart rate variability analysis system, radar chart type autonomic balance analysis software was used. This quantifies the sympathetic nerve information and the parasympathetic nerve information of the present invention, and corresponds to the means for analyzing electrocardiogram information in the apparatus of the present invention.

[Analysis means]
The analysis conditions of each analysis means in the present embodiment are shown below. In the present embodiment, the following (IIIa-1) to (IIIf-1) are included in the configuration for obtaining each electrocardiogram information analysis value so that the relationship with the result corresponding to each analysis can be easily understood. Explanation will be made using symbols.
[Analyzing means (IIIa-1)]
An analysis was performed in which the standard deviation of the RR interval at rest for 60 seconds was the ECG RR interval standard deviation at rest (SDRR (sup)).
[Analyzing means (IIIb-1)]
The difference between the value obtained by analyzing the average value of RR intervals at 60 seconds at rest (mRR (sup)) and the value obtained by analyzing the average value of RR intervals at 90 seconds at load (mRR (std)) Analysis using the time-average electrocardiogram RR interval change amount (mRR (sup-std)) was performed.
[Analyzing means (IIIc-1)]
The difference between the value obtained by analyzing the average value of the RR interval at 60 seconds at rest (mRR (sup)) and the minimum value (RRmin (std)) of the RR interval at 90 seconds at (after) load is expressed as load Analysis was performed with the maximum change in the time electrocardiogram RR interval.
[Analyzing means (IIId-1)]
The analysis was performed with the value obtained by analyzing the ratio of the high frequency component to the total power spectrum at rest as the high frequency component ratio (HF / Total (sup)) at rest.
[Analyzing means (IIIe-1)]
The analysis was performed using the value obtained by analyzing the average value of the RR interval at 60 seconds at rest as the average electrocardiogram RR interval at rest (mRR (sup)).
[Analyzing means (IIIf-1)]
The analysis was performed with the value obtained by analyzing the ratio of the low frequency component to the total power spectrum at the time of load as the low frequency component ratio (LF / Total (std)) of the heartbeat fluctuation power spectrum at the time of load.

[Healthy person]
Forty women aged 40 to 60 years who had no menopausal condition were considered as healthy groups.

[Person with climacteric disorder]
Forty men aged 40-60 years who have a menopausal condition were included in the menopausal disorder patient group. In addition, the patient of a menopausal disorder is a patient who also evaluated the severity of menopausal disorder (Simplied Menopause Index: SMI).

[Example 1]
The evaluation results of the healthy group and the climacteric disorder group are shown in FIGS.
In the radar chart of FIG. 4, the resting electrocardiogram RR interval standard deviation (SDRR (sup)) of the analyzing means (IIIa-1) is the lower left, and the load average electrocardiogram RR interval change amount (mRR ()) of the analyzing means (IIIb-1). sup-std)), the electrocardiogram RR interval maximum change amount (mRR (sup) -RRmin (std)) during loading of the analyzing means (IIIc-1) is the upper right, and resting heart rate fluctuation of the analyzing means (IIId-1) The power spectrum high frequency component ratio (HF / Total (sup)) is in the lower right, the average ECG RR interval at rest of the analysis means (IIIe-1) (mRR (sup)) is in the lower direction, and the analysis means (IIIf-1) is loaded The heart rate variability power spectrum low frequency component ratio (LF / Total (std)) is shown in the upper left. Further, in the radar chart diagram, it is a display as a ratio when the average value of the group of healthy subjects is 100.

  When the mean values of the healthy group and the climacteric disorder patient group were compared, it was clear that the circadian disorder patient group significantly decreased the standard deviation of the resting electrocardiogram RR interval analyzed by the analysis means (IIIa-1) (P <0.001).

  Further, FIG. 5 shows a plot of the relationship between the resting electrocardiogram RR interval standard deviation and the SMI. As shown in FIG. 5, there were few patients with climacteric disorder exceeding 31.6, which is the average of the healthy group, and this proved that it was useful to use this as an index. Further, a significant (P = 0.167) inverse correlation is observed between SDRR (sup) and SMI.

  Moreover, it can confirm that the patient with a menopausal disorder also has significantly reduced (P <0.01) the load average electrocardiogram RR interval change amount analyzed by the analysis means (IIIb-1). In addition, the electrocardiogram RR interval maximum change amount under load of the analyzing means (IIIc-1) was significantly decreased (P <0.05). Furthermore, (IIId-1) and (IIIe-1) were almost the same value. This means that when the decrease in (IIIa-1) and (IIIb-1) is significant, and when the decrease in (IIIc-1) is observed and the other indices remain unchanged, it is a climacteric disorder rather than another disease. This proves that it is effective to use in combination as an index for confirmation.

[Example 2]
6 to 9 and Tables 2 to 4 show the results when the four menopausal patients were evaluated as subjects with respect to the average value of the sympathetic nerve information and the parasympathetic nerve information created by the group of healthy subjects described above.

[Example 2-1]
Table 2 shows the result of comparing the values obtained by the analyzing means (IIIa-1) with the determining means (IVa-1) as the determining means. The discriminating means (IVa-2) indicates the possibility of menopause from the value obtained by the analyzing means (IIIa-1). The determination result of the determination means is shown in the table as the state where the display means is displaying.
The four menopausal patients who are subjects 1 to 4 have resting electrocardiogram RR interval standard deviation analyzed by (IIIa-1) smaller than the average value of the healthy group, and analysis means (IIIa-1), discrimination means As shown by (IVa-1) and (IVa-2), evaluation results were obtained indicating that there is a possibility of menopause.

[Example 2-2]
Table 3 shows the result of comparing values obtained by the analyzing means (IIIb-1) as the determining means (IVb-1) as the determining means together with the determining means (IVa-1). Further, the discriminating means (IVb-2) is a combination of the values obtained by the analyzing means (IIIa-1) and (IIIb-1) and indicates the high possibility of menopause. Here, the discrimination result of the discrimination means is also shown in the table as the state where the display means is displaying.

  The results of discriminating the analysis results of the analysis means (IIIa-1) and (IIIb-1) because the values analyzed by the analysis means (IIIb-1) were much lower than the average values for the patients of subjects 1, 2, and 4 This indicates that the possibility of menopause is high. Moreover, it is shown that the subject 3 also has a possibility of menopause sufficiently because the analysis results of the analysis means (IIIa-1) and (IIIb-1) are both lower than the average value, and the analysis means (IIIa-1) It was possible to evaluate with higher reliability than only the comparison result.

[Example 2-3]
Table 4 shows the discriminating means (IVc-1) for comparing values obtained from the analyzing means (IIIc-1). In addition, the discrimination results of the discrimination means (IVx-1) for comparing the values obtained from the analysis means (IIId-1), (IIIe-1), and (IIIf-1) are also shown. Further, the discriminating means (IVx-2) may be interpreted as sympathetic nerve information and parasympathetic nerve information from values obtained by the analyzing means (IIId-1), (IIIe-1), and (IIIf-1). This is an index for confirming the reliability of the electrocardiogram information analysis value.

  It was confirmed that the menopausal patients of subjects 1 to 4 showed no significant abnormality in the sympathetic nerve information and parasympathetic nerve information excluding the information concerning analysis means (IIIa-1) and (IIIb-1). However, since subjects 1 and 2 have a slightly low value of the maximum amount of change in the electrocardiogram RR interval during loading, this indicates that attention is required for more accurate evaluation. As described above, the discriminating means (IVc-1), (IVx-1) and (IVx-2) are further provided with the above-described discriminating means (IVa-1), (IVa-2), (IVb In combination with (-1) and / or (IVb-2), a more reliable evaluation result can be obtained.

  Moreover, it can also evaluate by providing the means which recognizes and discriminate | determines the radar chart shown in FIGS. 6-9 as an image.

  In addition, as a result of evaluating healthy persons with the same analysis means, discrimination means, it is not determined that there is a possibility of menopause, or even if it is determined, it is configured to determine multiple information in combination, The possibility was evaluated as low.

[Example 3]
By using the ECG RR interval standard deviation (SDRR (sup)) and the on-load average electrocardiogram RR interval change amount (mRR (sup-std)) between the healthy group and the menopausal disorder patient group described above, multivariate Analysis was performed.

[Multiple regression analysis to determine if patient]
Using the one-dimensional coordinate Z as the search space,
The discriminant analysis was performed using Z = a1 × 1 + a2 × 2 + a0, assuming that the healthy subject group is located at Z = + 1 and the patient group is located at Z = 0.
As a result, the coefficient (“a1”) of SDRR (sup) (“x1” in the above regression equation) obtained by the analysis unit (IIIa-1) is −0.0140 as the coefficient, and the analysis unit (IIIb-1). A regression equation of multivariate analysis was obtained with the coefficient (“a2”) of the obtained (mRR (sup-std) (“x2” in the above regression equation) being 0.0019 and a0 = 0.0799. FIG. 10 shows what kind of Z the healthy person group and the climacteric disorder patient group show by the discriminating means using the formula as a discriminant.

  Thus, since menopausal patients show a Z of less than 0.8, the probability of menopause is very low when it is 0.8 or more, and the closer to 0 at less than 0.8, the more likely the menopause is It is possible to obtain an evaluation result that suggests a high value. Based on this result, other variables are also appropriately processed and adopted as variables, and by setting the discriminant space, the distribution of the healthy group and the group of patients with climacteric disorder are separated with higher accuracy. It is assumed that multivariate analysis can be performed.

  According to the apparatus of the present invention, it is possible to objectively evaluate the possibility of menopause that has been difficult to evaluate with a simple method objectively and with a certain degree of accuracy. Moreover, it can also be achieved as a method and a program for achieving this apparatus, which is industrially useful.

A. Menopause evaluation apparatus 1 ECG information measurement means 101 Input means 20 Storage means 3 Analysis means 4 Discriminating means 5 Display means 501 Display control means 502 Display unit 60 Control means

Claims (9)

Electrocardiogram information measuring means for measuring resting electrocardiogram information and load electrocardiogram information ;
Electrocardiogram information storage means for storing the resting electrocardiogram information measured by the electrocardiogram information measurement means and the electrocardiogram information at the time of loading ;
An analysis for analyzing a resting electrocardiogram RR interval standard deviation from the electrocardiogram information stored in the electrocardiogram information storage means, and an average electrocardiogram RR interval change amount during loading from the electrocardiogram information at rest and load stored in the electrocardiogram information storage means. Means,
The test resting electrocardiogram RR interval standard deviation obtained by the analyzing means is compared with the average resting electrocardiogram RR interval standard deviation obtained in advance as an average value of the group of healthy subjects, and the subject's load average electrocardiogram RR interval variation A means for comparing an average electrocardiogram RR interval change amount at the time of loading, which is previously collected as an average value of a group of healthy subjects, and determining the possibility of menopause together with a comparison result of the resting electrocardiogram RR interval standard deviation ;
A climacteric disorder evaluation apparatus, comprising: a display unit configured to display a result determined by the determination unit. Electrocardiogram information measuring means for measuring resting electrocardiogram information and load electrocardiogram information ;
Electrocardiogram information storage means for storing the resting electrocardiogram information measured by the electrocardiogram information measurement means and the electrocardiogram information at the time of loading ;
An analysis for analyzing a standard ECG RR interval deviation at rest from the electrocardiogram information stored in the electrocardiogram information storage means, and a maximum change in the electrocardiogram RR interval at load from the electrocardiogram information at rest and load stored in the electrocardiogram information storage means. Means,
A comparison is made between the resting electrocardiogram RR interval standard deviation of the subject obtained by the analysis means and the average resting electrocardiogram RR interval standard deviation obtained in advance as an average value of the group of healthy subjects, and the subject's electrocardiogram RR interval maximum change amount during loading A means for comparing a mean change in electrocardiogram RR interval during loading with an average value obtained in advance as an average value of a group of healthy subjects, and determining a possibility of menopause together with a comparison result of the standard deviation of the electrocardiogram RR interval at rest ;
A climacteric disorder evaluation apparatus, comprising: a display unit configured to display a result determined by the determination unit.   In the climacteric disorder evaluation device, further, the electrocardiogram information measuring means measures the electrocardiogram information at the time of load, and the electrocardiogram information storage means stores the electrocardiogram information at the time of the load,
  The analysis means analyzes the maximum change in electrocardiogram RR interval during load from the electrocardiogram information during rest and load stored in the electrocardiogram information storage means,
  The determination means compares the maximum change amount of the electrocardiogram RR interval at the time of the test subject with the maximum change amount of the electrocardiogram RR interval at the time of loading which is previously obtained as an average value of the healthy subject group, and the comparison result of the standard deviation of the electrocardiogram RR interval at rest The apparatus for evaluating climacteric disturbance according to claim 1, wherein the possibility of climacteric disturbance is discriminated together. The discriminating means is a ratio of the subject's resting electrocardiogram RR interval standard deviation and the average resting electrocardiogram RR interval standard deviation of the healthy subject group (subject's resting electrocardiogram RR interval standard deviation / the mean resting electrocardiogram RR of the healthy subject group). The climacteric disorder evaluation device according to any one of claims 1 to 3, which is discrimination means for discriminating that there is a possibility of climacteric disturbance when the interval standard deviation) is smaller than 1. The discriminating means of the menopausal disorder evaluation device is configured to at least the resting electrocardiogram RR interval standard deviation, the load average electrocardiogram RR interval change amount, and / or the load electrocardiogram RR interval maximum between healthy subjects and menopause patients. Using a discriminant created in advance by performing multivariate analysis with the amount of change as a variable, the subject's resting electrocardiogram RR interval standard deviation, the load average electrocardiogram RR interval change amount and / or the load electrocardiogram 4. The climacteric disorder evaluation apparatus according to claim 3, which is a discriminating means for discriminating the possibility of climacteric disorder from the maximum change amount of the RR interval. Evaluating the menopausal disorder based on the electrocardiogram information stored by the electrocardiogram information measuring means for measuring the electrocardiogram information at rest and the electrocardiogram information at the time of loading and the electrocardiogram information measured by the electrocardiogram information measuring means on a computer A program for executing the program ,
An analysis for analyzing a resting electrocardiogram RR interval standard deviation from the electrocardiogram information stored by the electrocardiogram information storage means, and a load average electrocardiogram RR interval change amount from the rest and load electrocardiogram information stored in the electrocardiogram information storage means. Steps,
The average resting electrocardiogram RR interval standard deviation of the healthy group obtained by the analysis step is compared with the subject's resting electrocardiogram RR interval standard deviation, and the test subject's average ECG RR interval change amount and the average of the healthy group in advance A determination step of comparing the average electrocardiogram RR interval change amount at the time of loading as a value and determining the possibility of climacteric disorder together with the comparison result of the resting electrocardiogram RR interval standard deviation ;
Have a display step of displaying the result of determination by the determination step,
A program that causes a computer to execute each step. The menopause based on the electrocardiogram information stored by the electrocardiogram information measuring means for measuring the electrocardiogram information of the electrocardiogram information at rest and the electrocardiogram information at the time of load, and the storage means for storing the electrocardiogram information measured by the electrocardiogram information measurement means A program for causing a computer to execute a failure assessment,
Analysis for analyzing a standard deviation of the electrocardiogram RR interval at rest from the electrocardiogram information stored by the electrocardiogram information storage means, and a maximum change amount of the electrocardiogram RR interval at load from the electrocardiogram information at rest and load stored in the electrocardiogram information storage means. Steps,
The average resting electrocardiogram RR interval standard deviation of the healthy group obtained by the analysis step is compared with the subject's resting electrocardiogram RR interval standard deviation, and the subject's electrocardiogram RR interval maximum change during loading and the average of the healthy group in advance A determination step of comparing the average change in the electrocardiogram RR interval at the time of loading as a value and determining the possibility of menopause together with the comparison result of the standard deviation of the electrocardiogram RR interval at rest ;
Have a display step of displaying the result of determination by the determination step,
A program that causes a computer to execute each step.   In the climacteric disorder evaluation, the electrocardiogram information measuring means further measures an electrocardiogram at the time of loading, and the electrocardiogram information storage means causes the computer to execute the climacteric disorder evaluation based on the electrocardiogram information in which the electrocardiogram information at the time of loading is stored A program,
  The analysis step analyzes the maximum change in electrocardiogram RR interval during load from the electrocardiogram information during rest and load stored in the electrocardiogram information storage means;
  The determination step compares the maximum change amount of the electrocardiogram RR interval at the time of the test subject with the maximum change amount of the electrocardiogram RR interval at the time of the load that was previously collected as an average value of the healthy subject group, and the comparison result of the standard deviation of the resting electrocardiogram RR interval The program according to claim 6, wherein the program determines the possibility of menopause. In the climacteric disorder evaluation, the determination step includes at least the resting electrocardiogram RR interval standard deviation, the load average electrocardiogram RR interval change amount, and / or the on-load electrocardiogram RR interval between healthy subjects and menopausal patients. Using a discriminant prepared in advance by multivariate analysis using the maximum change amount as a variable, the subject's resting electrocardiogram RR interval standard deviation, the load average electrocardiogram RR interval change amount, and / or the load time The program according to claim 8, wherein the possibility of climacteric disorder is determined from an electrocardiogram RR interval maximum change amount and an electrocardiogram information analysis value.