JP7133576B2 - Continuous blood pressure measurement system by phase difference method - Google Patents

Description

The present invention relates to a continuous blood pressure measurement system using a phase difference method.

Hypertension is the greatest risk factor for cardiovascular disease, especially stroke, and blood pressure assessment is of paramount importance for diagnosis and treatment. However, when blood pressure is examined by a direct method, there are about 100,000 blood pressure points per day, and the intraday variation is several tens of mmHg (References 1, 5).
For this reason, conventional methods always have the possibility of misdiagnosis such as white-night hypertension and masked hypertension.
At present, daily blood pressure measurement (Ambultatory Blood Pressure Monitoring: ABPM) using an upper arm cuff at the international reference site for blood pressure at intervals of 15 to 30 minutes has been put into practical use (Reference 2). , the number of samples to be measured is small (about 0.05%), and the cuff pressurization is highly invasive during sleep.

Recently, attempts have been made to measure systolic blood pressure (SBP) using pulse wave propagation time (C) and pulse wave velocity (PWV) obtained from ECG R waves and optical pulse waves from fingers and earlobes. (References 3 and 4), but the arteries are close to arterioles (the international standard for blood pressure to be measured in large arteries such as the brachial artery) and are far from the heart, so they are affected by hydrostatic pressure. (The error is approximately ±8 mmHg at a height of ±10 cm from the heart) (Reference 5). Moreover, the calibration has drawbacks such as requiring many constants (parameters).

In JP-A-7-313472, blood pressure fluctuation is monitored based on the pulse wave transit time, and when the blood pressure fluctuation is significant, the blood pressure value is measured using a pressurization cuff. The actual blood pressure measurement is a conventional measurement method using a pressurized cuff, and as described above, the cuff pressure has a great influence on the patient.
In JP-A-2017-109063, the physical properties of the object are obtained from the amount of frequency change that compensates for the phase difference between the incident light and the reflected light of the pulse wave waveform measured by one pulse wave sensor to zero. Although it is described that the systolic blood pressure value and the diastolic blood pressure value are obtained from the phenomenon in which the pulse wave is formed by contraction and dilation, there is no disclosure regarding the point of dealing with different blood pressure values depending on the measurement site.
In JP-A-50-33676, the systolic blood pressure, the diastolic blood pressure, etc. are determined from the difference in the values of a pressure pulse wave sensor provided near the heart and a volume pulse wave sensor placed at a predetermined distance. Although it is described that the measurement is performed, it utilizes a pressure pulse wave obtained by pressurizing a plurality of locations with a cuff, and does not disclose the fact that it corresponds to different blood pressure values depending on the measurement location.

Japanese Patent Application Laid-Open No. 11-318838 discloses pulse wave velocity information calculating means for calculating pulse wave velocity information related to the pulse wave velocity, heart rate information related to the heart rate of the living body, and heart rate information of the living body. circulatory information calculating means for calculating at least one of volume pulse wave area information related to the area of the volume pulse wave in the peripheral part; Velocity information (pulse wave transit time DT), heart rate information related to the heart rate of the living body (heart rate RR), and volume pulse wave area information related to the area of the volume pulse wave in the peripheral part of the body (volume pulse wave estimating the blood pressure value EBP of the living body EBP=α(1/DT)+βRR+γVR+δ (where α, β, and γ are coefficients, and δ is a constant) based on at least one of the wave area ratio VR). Have been described. In JP-A-11-318838, the pulse wave velocity (PWV) is obtained from the time difference between the rising edge of one pulse wave and the detection of the R wave. A configuration for measuring the estimated blood pressure is used, and the patient is burdened by the cuff pressure.

In addition, although it has not yet been realized in Japanese Patent Application Laid-Open No. 07-241288, the blood flow is measured by the Doppler method at different arterial blood vessel sites, and the pulse wave propagation velocity is obtained from the blood flow information. Although calculation of blood pressure is described, the measurement part of these blood flowmeters is used by embedding two ultrasonic probes in the body so as to be placed around the target blood vessel. However, the point of easily measuring blood flow is not disclosed.

Japanese Patent Application Laid-Open No. 11-76233 describes the use of an ultrasonic Doppler blood flowmeter to noninvasively measure the cross-sectional shape of a blood vessel, and to measure blood pressure accurately by taking into account the pulsation of the blood vessel wall. However, since the apparatus for obtaining blood flow information from a blood vessel tomogram using ultrasound processes ultrasound information obtained using a large number of ultrasound transducers, simple measurement is not disclosed.
Japanese Patent Application Laid-Open No. 2016-190022 discloses means for measuring blood pressure fluctuation values from a patient's video signal. Data and skin data of parts other than face image data are decomposed into images filtered for each RGB wavelength, and pulse waves are detected from luminance data of G (green) wavelength of each data, and different parts After obtaining the phase difference of the luminance data of the G (green) wavelength, the blood pressure fluctuation is calculated and estimated based on the pulse wave transit time, but from the face image and other skin parts non-contact Therefore, complicated processing steps are required, such as the need to adjust the scattering and attenuation of light reflected from the skin, and the shift in focus. has not been disclosed.

JP-A-7-313472 JP-A-50-33676 JP 2017-109063 A JP-A-11-318838 JP-A-7-241288 JP-A-11-76233

(Reference 1) Tochikubo O, et al: Variability of arterial blood pressure and classification of essential hypertension by multivariate statistical analysis. Jpn Cir J, 45(7), 781, 1981 (Reference 2) Tochikubo O, et al: A new compact 24-hour indirect blood pressure recorder and its clinical application. Jpn Heart J, 29(3), 257, 1988 (Reference 3) Lopez G, etal : Continuous Blood Pressure Monitoring in Daily life. J of Advanced Medichal Design, System and Manufacturiy, 4(1); 179, 2010 (Reference 4) Bilo, G, et al : Blood pressure Monitoring. 20: 291, 2015 (Reference 5) Osamu Kubo: Measurement and clinical evaluation of blood pressure, Medical Tribune (Tokyo), 1988 (Reference 6) Tochikubo O, et al : Relationship between 24-hour arterial and heart rate variation in normotensives, hypertensives and patients with Shy-Drager syndrome. Jpn Cir J, 51(5), 485, 1987 (Reference 7) Tochikubo O, et al : Mathematical evaluation of 24-hour blood-pressure variability in young, middle-aged and elderly hypertensive patients. Jpn Cir J, 51(10), 1123, 1987 (Reference 8) Tochikubo O, et al: Effects of insufficient sleep on blood pressure monitored by a new multibiomedical recoeder. Hypertension 27(6): 1318, 1996 (Reference 9) Tochikubo O, et al : Hemodynamic factors regulating blood pressure during sleep in patients with mild essential hypertension. Jpn Cir J, 61(1), 25, 1997 (Reference 10) Reming Ion Jw: The physiology of aorta and major artevies, Handb. Physical, chapter 24: 799, 1961 (Reference 11) W Chen, et al: Continuous estimation of systolic blood pressure using the pulse arrival time and intermittent calibration Med. Biol. Eng. Comput, 38: 569, 2000 (Reference 12) Yamakoshi K, Shimazu H, Togawa T: Indirect measurement of instantaneous arterial bloo pressure in the human finger by the vascular unloading technique. IEEE Trans Biomed Eng 27:150-155, 1980

Blood pressure is measured using a cuff fixed to the upper arm or finger, which puts a heavy burden on the patient due to the invasiveness of pressurization. Therefore, it is still difficult to continuously measure blood pressure because it is affected by a large hydrostatic pressure and fluctuates depending on the measurement position.
Further, as shown in Japanese Patent Application Laid-Open No. 07-241288, it has been proposed to obtain the blood pressure value by obtaining the pulse wave propagation velocity using an ultrasonic blood flow meter. The contact surface between the measurement probe and the skin must be interposed with water or hydrous gel. must continue to maintain a stable contact surface while holding

In addition, when measuring blood pressure at a fingertip or the like, which is less affected by pressurization, unless the height of the heart and the vicinity of the fingertip are the same, the blood pressure cannot be measured accurately.
Although devices for non-invasive blood pressure measurement have been proposed, for example, even if blood pressure is measured on the wrist or arm, the blood pressure value changes depending on the height of the blood pressure. By measuring the blood pressure in a state where the gauge is coming, it is only to maintain a subjective height, and it has not reached an accurate measurement.
In addition, artificial dialysis such as hemodialysis removes water through the blood during dialysis treatment, so the amount of water in the blood decreases too much, causing a sudden drop in blood pressure and affecting the prognosis of life. Continuous blood pressure measurement is required from the clinical point of view of hypertension, such as blood pressure monitoring.

In view of the above, the present invention provides an optical sensor (or a micro-pressure sensor, or a combination of an optical sensor and a micro-pressure sensor) for detecting a pulse wave corresponding to the diameter of a blood vessel in an international reference site such as the upper arm, The pulse wave corresponding to the thin blood vessels in the superficial part of the body obtained from the optical sensor and the thick blood vessel in the deep part of the body, or the pulse wave corresponding to the thick blood vessels in the deep part of the body such as the superficial temporal artery (optical measurement obtained pulse wave or pulse wave obtained by pressure change measurement), differential value calculating means for calculating a differential value of one or more orders of blood flow waveform, pulse obtained by the differential value calculating means Constructed by combining two feature point detection means for detecting feature points for each wave and blood pressure-related value measurement means for measuring blood pressure-related values based on the phase difference between the feature points obtained by the feature point detection means,
Furthermore, as a second method, an electrocardiogram signal detection means for detecting an electrocardiogram signal, an optical sensor for detecting a pulse wave corresponding to the diameter of a blood vessel, and a thin blood vessel in a shallow part of the body obtained from the optical sensor. Differential value calculating means for calculating a differential value of one or more orders of a pulse wave, feature point detecting means for detecting feature points of the pulse wave obtained by the differential value calculating means, and features obtained by the feature point detecting means By combining the points and the blood pressure-related value measuring means for measuring the blood pressure-related value based on the phase difference between the characteristic points of the electrocardiogram signal obtained by the electrocardiogram signal detection means, the upper arm or the like can be used without applying pressure to the living body. Realized continuous blood pressure measurement just by wearing it. Also, the calibration parameter has the advantage of being only one and can be estimated as shown below.
in the present invention. Clinically, the upper arm is the optimal position for blood pressure measurement, as the hydrostatic pressure (head pressure) is stable near the heart, and the upper arm is the most suitable position for blood pressure measurement, as international standards have set. It is more preferable for a small portable and wearable sphygmomanometer using optical pulse wave phase method that can be measured non-invasively at the site where a constant hydrostatic pressure can be determined (e.g., the ear). Blood pressure may be measured using the pulse waves of the superficial temporal artery, which passes up and down near the pericardial artery, and the superficial blood vessels of the auricle, such as those around the triangular sinus. Any location other than the tragus can be shown and at least a pulse wave can be detected.

That is, the feature of the present invention is
(1) Optically measuring pulse waves with two different wavelengths in the upper arm, which is close to the heart and has stable hydrostatic pressure (head pressure), or, as a second method, using a sphygmomanometer. Measuring an optical pulse wave signal of a specific wavelength and an electrocardiogram at the upper arm, which has become an international standard
(2) At the same site, using light with different wavelengths and different methods, the thin arterial pulse wave on the surface of the skin and the thick arterial pulse wave in the deep part (optical or micropressure sensor) are measured, and their temporal positions are measured. Blood pressure-related values and blood pressure values are estimated from phase differences and waveform differences. It may be pulse wave measurement by For example, as shown in FIG. 2(c), the pulse wave (pressure pulse wave) captured by the micropressure sensor has the same time phase as the IR pulse wave detected by infrared light, so mutual compatibility is possible. Alternatively, a micropressure sensor may be used to compensate for the time phase of the pulse wave (IR pulse wave) detected by infrared light.

(3) The daily blood pressure fluctuation value (Pi) consists of a different minimum value (Po) and fluctuation rate (φi) for each person (Pi = φi × Po). Po (fixed value) is determined (calibrated value Pc) from the blood pressure measurement value based on the conventional method, and blood pressure is continuously measured non-invasively and continuously in a state where there is little burden on the patient. It is to propose an ultra-compact continuous sphygmomanometer. This method has the advantage of being able to continuously estimate the blood pressure Pi using only the constant (parameter) of the Pc value calibrated by this method.

The measurement principle of the present invention will be described below.

Measuring principle

(1) Blood pressure fluctuation formula: Considering the daily blood pressure (blood pressure Pi at time i), the blood pressure of about 100,000 pieces / day has a unique minimum value (basal blood pressure Po), and when awake, the body and mind (Pi = Po + ΔPc or Po × φi, φi = rate of increase in blood pressure) due to the activity of , and the energy of this change is Cardiac Output: CO is 1 If SV is the stroke volume StrokeVolume and HR is the heart rate, CO = SV x HR). Reference 6, Reference 7, Reference 8, Reference 9).

However, systolic blood pressure (SBP) is greatly influenced by arterial elasticity (E), and diastolic blood pressure (DBP) is strongly influenced by total peripheral vascular resistance R. That is, the casual blood pressure (Pi) that fluctuates on a daily basis is a function f of the intrinsic constant Po and the fluctuating SV, HR, and E (References 6, 7, 8, and 9).

Pi = f (SV, HR.R, E) x Po ........ {1} formula

・・・・｛２｝式
の関係が示され(文献１０）、Ｅoは、血圧が近傍零の時の動脈弾性Ｅ、ｈ＝動脈壁圧、ρ＝血液密度、ｒ＝動脈半径であり、さらに動脈弾性（Ｅ）と血圧Ｐiには、

Ｅ＝Ｅoｅ^γＰi [γ＝Coefficient,0.016～0.018]

の関係にあり、｛２｝式とこの式により、全ての1日の血圧は、Ｐi＝Ｐo＋ΔＰｉ(ΔＰｉはＰoからの上昇量、Ｐｅ＝推定血圧estimated blood pressure、ΔＰｉはＰＷＶで推測）と推測される（文献１１）。 (2) According to the Moens-Korteweg equation

. . . {2} formula is shown (Reference 10), Eo is arterial elasticity E when blood pressure is near zero, h=arterial wall pressure, ρ=blood density, r=arterial radius, Furthermore, for arterial elasticity (E) and blood pressure Pi,

E=Eoe ^γPi [γ=Coefficient, 0.016 to 0.018]

From the formula {2} and this formula, the blood pressure for all days is estimated as Pi = Po + ΔPi (ΔPi is the amount of increase from Po, Pe = estimated blood pressure, ΔPi is estimated by PWV) (Reference 11).

Pi = Po + ΔPi can also be converted to the formula Pi = Po × φi (φi = blood pressure increase rate, φi = 1 + ΔPi / Po),

Pi=φi×Po……{1}' formula (φi=blood pressure increase rate, Po is diastolic blood pressure eigenvalue)

Po is considered to be an eigenvalue with little day-to-day variation for each individual (reference 8), and therefore each individual's constant (Pc corresponding to Po) is required for estimating each blood pressure in a day.
Based on this premise, the measurement principle will be described below (the measurement block diagram is shown in FIG. 1).

(3) Estimation of blood pressure (ΔPi or φi) by optical pulse wave phase difference In Moens-korteweg (equation {2}), PWV increases as arterial wall elasticity E increases and wall thickness h increases. The smaller the r (thinner the artery), the faster the PWV.
The conventional method measures the time (C) between the peak of the R wave of the electrocardiogram and the rising point of the peripheral pulse wave shown in FIG. ).

In the pulse wave phase contrast method, the pulse wave of a superficial thin artery (minimum radius r, r ₂ ) (reflected pulse wave with long wavelength green light: G pulse wave) and the deep The time width of the rising point of the pulse wave of the large artery (transmissive pulse wave with infrared light: IR pulse wave or micropressure sensor) and the inflection point (b ₁ and b ₂ in FIG. 2 (1)) (Cbb in FIG. 2(1)) is measured. An example of actual measurement is shown in FIG. The rising point may be the bottom value instead of the inflection point. At least, the phase difference at a characteristic point that is common to both pulse waves is sufficient.
Cbb is considered to propagate faster according to the formula {2} when the arterial diameter (r) becomes narrower with an increase in blood pressure (larger R in the formula {1}) (r ₂ ≤ r ₁ ).

On the other hand, when the arterial diameter becomes narrower, the rising point (inflection point) (b ₂ ) of the green (G) pulse wave and the time Tu (Up-Stroke Time) of the systolic peak P ₂ become the time required to expand the narrow artery. (more details are shown in Supplementary Note 1).

と流出する速度

から、

の式が成り立つ

。
従って、高血圧で細小動脈内径ｒは減少すれば細動脈抵抗が増して

も減少し、

が低下するので、生体に必要な血流を保つ波高変化（ΔＶ）を得るためには、Δｔが延長することになる。
即ちＴｕ（ΔＶの最大値を得るΔｔの総和）が延長する。
(Additional note 1) The volume pulse wave change (ΔV) is caused by the difference between the volume of blood flowing into and out of the artery.
The micro-arterial volume (ΔV = pulse wave height) in a micro-time (Δt) is the velocity of blood flowing into the artery

and outflow velocity

from,

The formula of

.
Therefore, if the arteriole inner diameter r decreases due to high blood pressure, the arteriole resistance increases.

also decreases,

is reduced, Δt is extended in order to obtain the wave height change (ΔV) that maintains the blood flow necessary for the living body.
That is, Tu (the sum of Δt that obtains the maximum value of ΔV) is extended.

・・・・｛３｝式
That is, Tu/Cbb is considered useful as an indicator of blood pressure elevation. Since the rise difference between the IR pulse wave and the G pulse wave is as small as several tens of milliseconds and tends to cause errors in measurement, it is actually possible to obtain from P ₁ P ₂ , b ₁ , P ₁ , and Tu, which are easy to measure. [FIG. 2(1), P ₁ P ₂ =Cbb+Tu-b ₁ P ₁ to Cbb=P ₁ P ₂ +b ₁ P ₁ -Tu]

・・・{3} formula

Experimentally, PWi is found to correlate with PWV _ECG obtained from a conventional electrocardiogram (Fig. 10).
FIG. 10 shows an example of correlation measurement between PWi (Pulse Wave index) and electrocardiography PWV (Pulse Wave Velocity).
PWV (Pulse Wave Velocity) indicates the pulse wave velocity, and the pulse wave velocity determined from the electrocardiogram is indicated as PWV _ECG .
In addition, a high correlation is observed between SBP (systolic blood pressure) and PWi in this case (Fig. 11).
FIG. 11 shows an example of correlation measurement between PWi and SBP.
Next, an estimation formula DBPe for DBP (diastolic blood pressure) and an estimation formula SBPe for SBP (systolic blood pressure) were obtained experimentally. The method is to measure the G (obtained by the output of the green illuminant) and IR (obtained by the output of the infrared illuminant) pulse wave by the optical pulse wave phase method on the left upper arm, and at the same time, The blood pressure of the conventional method was measured on the right upper arm with an automatic sphygmomanometer, a hypothetical model formula was created, and the coefficients of the model formula were determined.

としても良い。 The formula {3} for PWi is that in hypertension, the main cause is an increase in the peripheral vascular resistance R. Therefore, since the arteriolar resistance, that is, the arterial diameter, is small, Tu is large, while Cbb is small, so the higher the blood pressure, the more (Fig. 4 shows the state when calculating Cbb and Tu by finding the inflection point with the PC program. The program is equipped with an AD converter in hardware, for example, and the second derivative processing of the pulse wave to obtain a digital signal after
Note that Tu (Up-Stroke Time (Utime)) is indicated by the time interval (U ₂ ) between point _{b 2} and point P ₂ in _FIG . 3, but the time interval (U ₂ ) is also proportional to the time interval (U ₁ ) between points b ₁ and P ₁ , so the time Tu is the geometric mean of U ₁ and U ₂ .

It is good as

In _FIG . ₄ , b1 is the rising inflection point of the IR pulse wave (blood flow in a thick artery deep in the body by infrared light), b2 is the rising inflection point of the G pulse wave, and _Cbb is the _point between b1 and b2. The time widths P ₁ and P ₂ indicate the respective vertices, and Tu indicates the time width of b ₂ and P ₂ .
If the point of inflection cannot be detected from the original waveform using a digital signal, the point of inflection may be obtained by calculating the peak value by second-order differentiation. A pulse wave from a micropressure sensor may be used instead of the IR pulse wave.
The occasional blood pressure Pi in the formula {1} is
Pi = φi × Po, φi = f(SV, HR, R, E)

Therefore, there is a possibility that R (arterial inner diameter r) and E can be estimated by PWV or PWi, and SV and HR can be estimated by analyzing the pulse waveform.

However, since the pulse wave cannot measure the absolute value of SV, the infrared pulse wave (IR pulse wave) in FIG. Measure the ratio (Vs/Vd) of the maximum inflow velocity (Vs) (1301) and the outflow average velocity (Vd) (1303),
F=Vs/(Average of Vd)-1 --- Find the formula {5}.
Vs: height from rising point to apex ₍ height of _b1 , P2)
Average of Vd: average pulse wave descent velocity after aortic closure (shaded area (1/8 of both sides excluded because waveform is not stable))
1302 in the figure is the time phase when the aortic valve is closed. Average of Vd: Average pulse wave descent velocity after aortic closure (The non-shaded portions at both ends are excluded because the waveform is not stable.
An IR pulse wave (a pulse wave obtained by transmitting infrared light) shows a volume pulse wave waveform, and its second derivative pulse wave 1300 represents arterial inflow and outflow velocities (FIG. 5).
The relationship between the pulse pressure PP and SV is shown in Equation {4} (Roff: Systoric Run off)

PP=E(SV−Roff)=E・Roff(SV/Roff−1)……{4} formula

SV indicates Stroke Volume, and Roff indicates outflow velocity.
Here, SV is related to blood inflow velocity and Roff is related to outflow velocity. Then (average of Vs/Vd) can be considered an exponent F related to SV/Roff.

F = Vs / (average of Vd) - 1 ...... {5} formula

Since F does not include an absolute value, it can be measured even with a pulse wave.
A model estimation formula for the blood pressure Pi using the formulas {1}, {3}, and {4} is shown in the formula {6}.

Pi = f (SV, HR, R, E) x Pc = [F x HR] ^β x PWi ^α x Pc ...... {6} Equation Pc is a constant that differs from person to person.
F = Vs / Vd - 1 and F × HR is the change in blood flow (CO),
Let α and β be a common constant.
[F × HR] ^β × PWi ^α of formula {6}
corresponds to the blood pressure increase rate φi described in (1).
It is exemplified that the value of α converges at 1/4 when examined in a large number of cases.
Although the theoretical explanation is not yet available, according to the Hagen-Poiseulle law, the average blood pressure Pi is correlated with 1/r ⁴ , and the blood pressure is r ₁ /r, where r ₁ is the radius of large arteries and r ₂ is the radius of small arteries. The higher the value of ₂ , the greater the increase. A thick artery is an artery that pulsates, and a thin artery is a blood vessel that cannot be measured by a micropressure sensor such as a skin blood vessel.

From the equation {2}, PWV ² is greatly affected by r ₁ /r ₂ . In particular, r ₂ greatly increases PWV even with slight vasoconstriction compared to thick arteries because the inner diameter of arteries is small (that is, Cbb is extremely small). What is sought is the Pi of the large artery, which requires some correction.
As a correction means, the value was estimated in the experiment α (supplementary note 2).

(Additional note 2) For example, if the ratio of r ₁ /r ₂ is 2, the blood pressure will be 16 times higher in the Poiseulle formula, but if it is raised to the 1/4th power, it will be doubled. Assuming that the _Kortewerg 's pulse wave velocity is proportional to blood pressure (Reference 11), α ( _1/2 to 1 /4 (0.25 to 0.5)) is necessary.
Regarding the coefficient β, the diastolic blood pressure DBP converges to around 0.1, and the {7} formula is obtained.
DBPφi = [F × HR] ^0.1 × PWi ^α・・・・・・・・{7} formula

Actual measurement is performed by a PC (computer) program (for example, based on the digital data of the original waveform as shown in FIG. 4), and from b ₁ and b ₂ to Cbb (time difference between b ₂ and b ₁ ), Cbp (b ₁ and P ₂ ), or P ₁ P ₂ , b ₁ P ₁ , Tu (time difference between b ₂ and P ₂ ), F and HR were automatically calculated. FIG. 12 shows a calculation example of changes in DBP and α and β.

On the other hand, regarding the systolic blood pressure SBP, since β=0.001, which is almost zero, only PWi ^α was used.

SBP.phi.i= ^PWi.alpha . Eq. {8} FIGS. 12 and 13 show actual measurement examples.
FIG. 12 is an example of an experimentally obtained estimation formula (DBPe) regarding DBP fluctuations.
FIG. 13 shows an example of model equation estimation (SBPe) for variation of SBP.
[DBPφi, ie, ^PWiα ×(F×HR) ^0.1 and SBPφi, ie, ^PWiα , correspond to the rate of increase in blood pressure φi of DBP and SBP shown in the measurement principle (1). ]

Continuous blood pressure measurement using optical pulse wave phase method

Since the optical pulse wave method cannot directly measure the absolute value of blood pressure, initial calibration is required.
To calibrate the DBP, obtain the measured DBP (y-axis) of the contralateral upper arm and the measured value (x-axis) of the DBPφi of formula {7}, and use the slope (y/x) as the P _CD coefficient (corresponding to Po) .
After that,

^DBPe = PCD x _PWiα x [F x HR] ^0.1

The estimated DBP value (DBPe) is automatically calculated by the function of ((1) in FIG. 9).
Similarly, SBP also obtains the slope coefficient P _CS based on the equation {8}, and thereafter,

SBP e =P _CS ×P Wi ^α

function, the estimated value (SBPe) of SBP is automatically calculated, and SBP is continuously calculated by the phase difference method ((2) in FIG. 9).

In the optical pulse wave phase method of the present invention, it is preferable to perform initial correction, but at least when only the amount of change is measured, calibration may not be necessary.

Regarding the measuring device,

The measurement device based on the present invention includes a device that uses an upper arm optical pulse wave phase method that uses an IR pulse wave using infrared rays and a G pulse wave from a green LED, and a simple type that replaces the IR pulse wave with an ECG (electrocardiogram). and a combination of the pulse wave of the superficial temporal artery around the ear and the G pulse wave of the auricle by a green LED.

(1) Optical pulse phase method continuous blood pressure measuring device The method of (1) is to measure the upper arm in principle, but it can also be applied to other arterial sites such as the head.
Basically, an IR (around 850 nm) pulse wave measurement unit inside the upper arm, or a micropressure sensor with an air cuff attached to it, and a Green (around 524 mm) pulse wave measurement unit on the extensor side of the upper arm (G) pulse wave measurement unit, power supply It consists of a circuit and a Bluetooth (registered trademark) transmitter, and the measurement results are displayed on a tablet or smartphone (Fig. 8).

ＤＢＰｅ＝ＳＢＰｅ－ＰＰｅ (2) Simplified optical pulse wave phase method continuous blood pressure measurement device

As the simple method described above, electrocardiogram ECG is used instead of IR pulse wave, and blood pressure is measured by the following formula from pulse wave transit time (C _ECG ) and upstroke time (Tu) of G pulse wave in the conventional method.

This method uses only C _ECG and Tu, and by pulsing, the analysis is simplified by using the following equation. (Fig. 17 shows the configuration of a simplified optical pulse wave phase-difference continuous sphygmomanometer using electrocardiogram ECG.) This formula for obtaining the pulse pressure PPe is given by Cbb obtained from the IR pulse wave and the G pulse wave. can also be applied. Pcs and Pcp are obtained by calibrating from the slope of the measured value and the estimated value (when α is 0.25).
SBPe=Pcs×(Tu/C _ECG ) ^0.25

DBPe = SBPe - PPe

Almost the same accuracy as the device in (1) was obtained (Figs. 14, 15, and 16).
FIG. 14 shows an example of correlation with SBP(Tu/C _ECG ) ^1/4 by a simplified method using an electrocardiogram.
FIG. 15 shows an example of estimating the pulse pressure PP by a simple method using an electrocardiogram.
FIG. 16 shows an example of diastolic blood pressure (DBP) estimation by a simple method using an electrocardiogram.

When estimating a blood pressure value from a combination of pulse wave detection means based on a green luminous body and an electrocardiogram, the following equation is shown.

・・・・・（９）
Estimated systolic blood pressure SBPe

(9)

・・・・・（１０）

心電図と緑光脈波の組み合わせによる推定収縮期血圧と実測収縮期血圧及び推定拡張期血圧と実測拡張期血圧についての関係を示す図を図２８及び図２９に示す。
図２８（個人間についての推定収縮期血圧と実測収縮期血圧の関係）において、計測回数ｎとする。ｒは、これ以降（１５）式で示す。
（ｎ＝４８）
ｒ＝０．８５
ｙ＝ｘ－１．５

図２９（個人間についての推定拡張期血圧と実測拡張期血圧の関係）において、
（ｎ＝４８）
ｒ＝０．７１
ｙ＝ｘ－０．５

Estimated diastolic blood pressure DBPe

(10)

28 and 29 show the relationship between the estimated systolic blood pressure and the measured systolic blood pressure and the estimated diastolic blood pressure and the measured diastolic blood pressure obtained by combining the electrocardiogram and the green light pulse wave.
In FIG. 28 (relationship between estimated systolic blood pressure and measured systolic blood pressure between individuals), the number of times of measurement is n. Hereafter, r is represented by equation (15).
(n=48)
r = 0.85
y = x - 1.5

In FIG. 29 (relationship between estimated diastolic blood pressure and measured diastolic blood pressure for individuals),
(n=48)
r = 0.71
y = x - 0.5

・・・・（１１）
When the blood pressure value is estimated from the combination of the pulse wave detection means based on the green light emitter and the pulse wave detection means based on the red light emitter, the following equation holds.

(11)

・・・・（１２）
The estimated diastolic blood pressure value is

(12)

ＲＲは校正心拍間隔 ＨＲは、ここでは校正心拍数 ＲＲ＝６０/ＨＲ
ＲＲｉは心拍間隔：ＨＲｉは、ここでは心拍数 ＲＲｉ＝６０/ＨＲｉ
SBP ₀ : basal systolic blood pressure value, DBP ₀ : basal diastolic blood pressure value

RR is the calibrated heart rate interval HR is the calibrated heart rate here RR = 60/HR
RRi is the heartbeat interval: HRi is the heart rate here RRi=60/HRi

ｎ＝４８
ｒ＝０．７２

図３１は、個人間における実測推定拡張期血圧と推定拡張期血圧の関係を示し、基底拡張期血圧値ＤＢＰ₀ は実測したＤＢＰ値と変動係数Φ_Di から

は下降曲線係数であり、図２０で示す血圧測定の場合は、それを心拍数で補正している。
図３１より
ｎ＝４８
ｒ＝０．６５
ｙ＝ｘ

Fig. 30 and Fig. 30 show the relationship between the estimated systolic blood pressure and the measured systolic blood pressure and the estimated diastolic blood pressure and the measured diastolic blood pressure by combining the pulse wave based on the red light emitting body and the pulse wave based on the green light emitting body. 31.

FIG. 30 shows the relationship between measured estimated systolic blood pressure and estimated systolic blood pressure among individuals,

The basal systolic blood pressure value SBP ₀ is obtained from the actually measured SBP value and the coefficient of variation Φ _si

n=48
r = 0.72

FIG. 31 shows the relationship between the measured estimated _diastolic blood pressure and the estimated _diastolic blood pressure between individuals.

is a descending curve coefficient, and in the case of the blood pressure measurement shown in FIG. 20, it is corrected by the heart rate.
From Fig. 31 n = 48
r = 0.65
y=x

Head position continuous blood pressure measurement

In addition to noninvasive continuous blood pressure measurement in the upper arm, the present invention uses a relatively shallow artery (superficial temporal artery) 2003 passing near the auricle 2001 shown in FIG. A case where the arteries of the arteries 2001 are defined as small arteries and the blood pressure value is estimated from the pulse waves or blood flow waveforms of these arteries is also included.

・・・・（１３）
を用いる。ＳＢＰ₀：基底血圧値として血流波形ＱｍｉｎとＱｍａｘは、図２１（ｃ）で示す脈波の最低値Ｑｍｉｎ 最高値Ｑｍａｘ、Ｔｕ及びＣｂｂは、図２１（ａ）：緑色光源で計測した脈波と（ｂ）：レーザーで計測した脈波あるいは血流波形のそれぞれで示す脈波等の立ち上がり時間 For continuous head position blood pressure measurements, the SBP (systolic blood pressure) and DBP (diastolic blood pressure) estimates are as follows.
The estimated value of SBP, SBPe, is

(13)
Use SBP ₀ : The blood flow waveform Qmin and Qmax as the basal blood pressure value are the minimum value Qmin and the maximum value Qmax, Tu and Cbb of the pulse wave shown in FIG. and (b): rise time of pulse wave, etc. indicated by pulse wave or blood flow waveform measured by laser

・・・・（１４）
を用いる。ＲＲは、心拍間隔である。ＤＢＰ／ＳＢＰとΦ_Diには相関があって

であり比例するが、非線形なので、この非線形性をβ係数で補正

し、ＳＢＰｅとＤＢＰ₀からＤＢＰｅを推定している。
図２２（ｃ）で示す血流波形、脈波波形において

・・・・（１５）
とする。

The estimated value of DBP, DBPe, is

(14)
Use RR is the heartbeat interval. There is a correlation between DBP/SBP and Φ _D i

is proportional but nonlinear, so this nonlinearity is corrected by the β factor

, and DBPe is estimated from SBPe and DBP ₀ .
In the blood flow waveform and pulse waveform shown in FIG.

(15)
and

Calculation of actual systolic blood pressure SBPe and diastolic blood pressure DBPe estimates is
As an initial setting,
1. Blood pressure is measured using a commercially available sphygmomanometer on the upper arm. Let the obtained systolic blood pressure be SBP and diastolic blood pressure be DBP.
2. Tu and Cbb shown in FIGS. 21(a), 21(b) and 21(c), Qmin and Qmax of the blood flow waveform, and heartbeat intervals are measured using the measuring instruments shown in FIGS. 20(b) and 20(c).
3.1. and 2. SBP ₀ and β are obtained by substituting Tu, etc. obtained in (13) and (14) into the equations (13) and (14).

を変動係数（ｆａｉＳ）とする、実測したＴｕ、Ｃｂｂ、Ｑｍｉｎ、Ｑｍａｘ値から変動係数を求め、実測した収縮期血圧ＳＢＰとの関係を図２４で示す。 (13) in the formula

is the coefficient of variation (faiS), the coefficient of variation is obtained from the actually measured Tu, Cbb, Qmin, and Qmax values, and the relationship with the actually measured systolic blood pressure SBP is shown in FIG.

ＳＥ＝５％ ＳＢＰ₀の推定誤差変動５％

この算出した基底収縮期血圧ＳＢＰ₀（＝８０mmHｇ）と実測したＴｕ値等を（１３）式に代入して得られた推定収縮期血圧ＳＢＰｅと実測した収縮期血圧ＳＢＰとの関係を図２５に示す。図２５より
ｒ＝０．８６
ｙ＝ｘ－０．６

実測値との測定誤差（ＳＤ）は、±７mmＨｇであった。

(13) Calculate the basal systolic blood pressure SBP ₀ from the equation and FIG. 24 r=0.86
y=79x

SE = 5% SBP ₀ estimated error variation 5%

FIG. 25 shows the relationship between the estimated systolic blood pressure SBPe obtained by substituting the calculated basal systolic blood pressure SBP ₀ (=80 mmHg) and the actually measured Tu value into the equation (13) and the actually measured systolic blood pressure SBP. show. From Fig. 25 r = 0.86
y = x - 0.6

The measurement error (SD) from the actual value was ±7 mmHg.

とし、

とする。
両辺に対数をとり、βを求める式を形成する。

実測した拡張期血圧ＤＢＰと実測した収縮期血圧ＳＢＰの比ＤＢＰ/ＳＢＰとΦ_Diとの関係からベータを求めた。図２６に結果を示す。
ｒ＝０．８
ｙ＝１．８３ｘ＋０．０６
β＝１．８７±０.１５
βの推定誤差変動 ＳＥ＝±８％

βの値を約１．８３とし、式１４で示す推定拡張期血圧と実測した拡張期血圧との関係を図２７に示す。
ｒ＝０．６９
ｙ＝０．６５６ｘ＋２９

結果、推定拡張期血圧と実測した拡張期血圧との誤差（ＳＤ）は、４．３mmHgであった。


(14) In the formula,

year,

and
Take the logarithm on both sides to form the equation for β.

Beta was obtained from the relationship between the ratio DBP/SBP of the measured diastolic blood pressure DBP and the measured systolic blood pressure SBP and Φ _Di. The results are shown in FIG.
r = 0.8
y=1.83x+0.06
β=1.87±0.15
Estimation error variation of β SE = ±8%

Assuming that the value of β is about 1.83, FIG. 27 shows the relationship between the estimated diastolic blood pressure and the measured diastolic blood pressure shown in Equation 14. In FIG.
r = 0.69
y=0.656x+29

As a result, the error (SD) between the estimated diastolic blood pressure and the measured diastolic blood pressure was 4.3 mmHg.

Continuous blood pressure display

SBP ₀ and β obtained in 3. and Tu and Cbb and Qmin, Qmax and RR values measured from the previous waveform are substituted into equations (13) and (14) to continuously calculate systolic blood pressure, Estimated diastolic blood pressure values SBPe and DBPe are obtained. If the calculation time from the previous waveform is insufficient, it is preferable to perform the calculation from the previous waveform.

The "pulse wave corresponding to the diameter of the blood vessel" in the present invention means, for example, the thick arterial blood vessel 21 and the thin arterial blood vessel 22 in the peripheral direction in the blood vessel network 20 shown in FIG. Depending on the type and arrangement of the light source and light receiving element, deep and shallow areas are classified and measured. Even a micropressure sensor can measure the pulse wave of a large artery.
As shown in FIG. 2(2), thick blood vessels and thin blood vessels do not necessarily have to be connected.
It is not necessary for the thick blood vessels to be deep and the thin blood vessels to be shallow. , which is filled with an inert gas and sealed, and is used to detect pressure pulse waves.
Since the pressure pulse wave can be detected when the skin surface is pressurized to some extent, it can be detected by uniformly pressurizing the upper arm with a predetermined pressure with a strip.
The predetermined pressure is, for example, 20 mmHg or more, and is a pressure (fine pressure) that tightens the belt-shaped body attached to the upper arm and tightens the upper arm to the extent that the detection sensor in the bag-shaped body can capture the signal. indicates the degree to which the user is immune to invasive pressure.
Therefore, it is preferable to gradually increase the tightening force of the belt-shaped body on the upper arm until the pulse pressure wave can be detected, and the state in which the tightening force is stopped can be formed.
For example, when the sensor signal output by the sensor that converts the pressure signal of the pressure sensor into an electrical signal becomes pulse-like (for example, when the pulse-like amplitude value is greater than a predetermined value after a certain period of time), Alternatively, a circuit for recognizing appropriate pressure may be provided, and an output signal from this circuit may be used to form a light-emitting portion that emits light to detect appropriate tightening of the strip.
An “optical sensor” indicates, for example, a combination of a light-emitting diode that emits light of a selected wavelength and a phototransistor that forms a light receiving portion.

A "reflective optical sensor" is, for example, one in which a light-emitting diode and a light-receiving phototransistor are mounted on a single substrate. Although it is exemplified that it is arranged on the living body contact surface in a state, it may be separately mounted on a different substrate.
"The pulse wave corresponding to thin blood vessels in the shallow part of the body obtained from the optical sensor" is obtained by a reflective pulse wave sensor using a light source, such as a green LED, that transmits to a shallow part inside the body. A pulse wave signal obtained from a superficial peripheral vessel is shown. It should be noted that there are cases where it is sufficient to be able to detect a pulse wave of a thin blood vessel in a shallow portion with a wavelength in the vicinity thereof, not limited to green.

The "pulse wave corresponding to the thick blood vessel deep in the body" in the "differential value calculating means for calculating the differential value of one or more orders of the pulse wave corresponding to the thick blood vessel deep in the body" is, for example, using an infrared light emitting diode A pulse wave electric signal detected by a transmissive pulse wave sensor, which is an infrared transmission signal obtained by arranging a light-emitting part and a light-receiving part so as to roughly face each other in a living body and passing through a deep artery in the living body. is a pulse wave signal obtained by receiving

In the case of transmissive transmission, the light emitting unit and the light receiving unit are arranged facing each other, but they do not necessarily have to face each other. Sometimes.
Also, other wavelengths may be used as long as the pulse waves of deep arteries can be detected without being limited to infrared rays. Alternatively, the pulse wave of an artery with pulsation by a micropressure sensor may be used.
The 'differential value calculating means for calculating a differential value of one to a plurality of orders' uses, for example, two analog differentiating circuits to form a second-order differential waveform and detect a time phase corresponding to an inflection point. Alternatively, the waveform is digitized using an AD converter, the amplitude value of the secondary differential waveform is converted into a digital signal value, and the time phase of the inflection point is detected from the values before and after the digital signal value. One to multiple orders indicate orders, for example, first order differentiation, second order differentiation, third order differentiation, and fourth order differentiation, and it is sufficient to use differentiation means of orders that can detect feature points.
Time phase refers to the case where the time at which a characteristic portion appears in the original waveform is included in the rising or falling timing of the pulse when the original waveform is converted into a pulse. The timing at which the characteristic portion appears can be obtained by detecting the rise or fall.

The feature points of the ``feature point detection means for detecting feature points for each pulse wave obtained by the differential value calculation means'' are, for example, inflection points, peak points (P), and bottoms in differential values of one to multiple orders. Point (b), which indicates the R wave in the case of an electrocardiogram, indicates acquisition of coordinates.
In the case of an inflection point, the differential value of one or more orders is 0, and before and after that, in addition to finding the place where the polarity of the coordinate value is reversed, differentiation processing is not performed, and is indicated by b ₁ and b ₂ in FIG. In some cases, it may be possible to detect a region such as a region where the slope of the waveform is flat compared to the slopes before and after it.

"Based on the phase difference" in the "blood pressure-related value measuring means for measuring the blood pressure-related value based on the phase difference between the feature points obtained by the feature point detecting means" means, for example, a differential wave or a different differential wave indicates the time interval or duration between the feature points of .
The blood pressure-related value is exemplified by the systolic blood pressure change rate SBPφi, the diastolic blood pressure change rate DBPφi, etc., in addition to the blood pressure value. Even if the blood pressure conversion is not performed, it may be possible to use it as it is, for example, in the case of obtaining the change in blood pressure increase/decrease in chronological order.

INDUSTRIAL APPLICABILITY The present invention can obtain continuous blood pressure and blood pressure-related values without invading a living body such as pressurization, and enables continuous blood pressure measurement in a smaller and simpler manner.

The figure which shows one Example of this invention. The figure for demonstrating this invention. The figure for demonstrating this invention. The figure for demonstrating this invention. The figure for demonstrating this invention. The figure for demonstrating this invention. The figure for demonstrating this invention. The figure for demonstrating this invention. The figure for demonstrating this invention.

The figure which shows the correlation measurement example of PWi (Pulse Wave index) and electrocardiography PWV (Pulse Wave Velocity,). The figure which shows the correlation measurement example of PWi and SBP. FIG. 10 is a diagram showing an example of an experimentally obtained estimation formula (DBPe) regarding fluctuations in DBP in the present invention; The figure which shows the model formula estimation (SBPe) example regarding the fluctuation|variation of SBP in this invention. FIG. 4 is a diagram showing an example of correlation with SBP(Tu/CECG) 1/4 by a simple method using an electrocardiogram; FIG. 4 is a diagram showing an example of estimating pulse pressure PP by a simple method using an electrocardiogram; FIG. 4 is a diagram showing an example of estimating diastolic blood pressure (DBP) by a simple method using an electrocardiogram; The figure for demonstrating this invention. The figure for demonstrating this invention. The figure for demonstrating this invention.

The figure which shows the other Example of this invention. The figure which shows the other Example of this invention. FIG. 5 is a diagram for explaining the operation of another embodiment of the present invention; FIG. 5 is a diagram for explaining the operation of another embodiment of the present invention; FIG. 4 is a diagram showing the relationship between the measured systolic blood pressure value and the coefficient of variation Φsi; The figure which shows the relationship between an estimated systolic blood pressure value and a measured systolic blood pressure value. FIG. 4 is a diagram for explaining a coefficient β; The figure which shows the relationship between an estimated diastolic blood pressure value and a measured diastolic blood pressure value. The figure which shows the relationship between an estimated systolic blood pressure value and a measured systolic blood pressure value. The figure which shows the relationship between an estimated diastolic blood pressure value and a measured diastolic blood pressure value. The figure which shows the relationship between an estimated systolic blood pressure value and a measured systolic blood pressure value. The figure which shows the relationship between an estimated diastolic blood pressure value and a measured diastolic blood pressure value.

According to the present invention, blood pressure-related values and blood pressure values can be measured simply by wearing a belt-shaped body provided with an LED with a wavelength of 524 μm, typified by green, and an LED with a wavelength of 850 nm, typified by near-infrared, on the surface in contact with the skin on the upper arm. Since values are measured continuously and there is no invasiveness such as pressurization, it is possible to reduce the burden on the patient during blood pressure measurement.
That is, the blood flow in deep arterial blood vessels 21 (arterial diameter r ₁ ) in the blood vessel network 20 as shown in FIG. 2B and the thin arterial blood vessels 22 (arterial diameter r ₂ ) to non-invasively measure superficial arterial intravascular blood flow.
The diameter of shallow thin arteries (r ₂ ) and the diameter of deep thick arteries (r ₁ ) have a relationship of r ₂ <<r ₁ .
The blood vessel network 20 shown in FIG. 2(b) is a simplified example for explanation, and when measuring not only thick and thin portions of the same blood vessel but also thick and thin portions of a separate arterial blood vessel network. There is also

As shown in FIGS. 2(a) and 3, a value related to the temporal difference of the secondary differential waveform obtained by performing secondary differentiation from the obtained pulse wave waveform (for example, the rising portion of the secondary differential wave is shown Inflection points b ₁ and b ₂ and peak values P ₁ and P ₂ of the secondary differential wave are detected, and the blood pressure value and the blood pressure-related value are preferably obtained in real time from these time phase differences. .
FIG. 3 shows an electrocardiogram waveform 31, a deep arterial blood flow secondary differential waveform 33, and a superficial arterial blood flow secondary differential waveform 32. FIG.
A blood pressure-related value is a value related to a blood pressure value, and indicates, for example, an amount of change, a rate of change, or the like, and can be applied when used as time-series data.
The amount of change in blood pressure is used, for example, in the diagnosis and management of hypertension, and in monitoring and continuously measuring changes in patient blood pressure during hemodialysis treatment, and the present invention is also applicable to these cases. be.

The circuit for converting to a second-order differential waveform in the present invention is, for example, a circuit in which two analog differentiation circuits are connected, AD-converts the pulse wave waveform into a digital signal, and then performs second-order differentiation by digital processing by a computer. can be
A deep biological pulse wave measuring unit for measuring thick blood vessels in the deep part of the living body and a shallow biological pulse wave measuring unit for measuring thin blood vessels in the shallow part of the living body are preferably combined into one unit. In addition to the one attached to the band-like body, it may be the one in which the individual measurement parts are attached to separate band-like bodies.

By arranging the deep and superficial pulse wave measurement units in one band and attaching it to the upper arm of the living body, it is close to the heart area and the hydrostatic pressure (hydrohead pressure) is stable. It is possible to detect a pulse wave signal with high accuracy.

FIG. 1 is a diagram showing one embodiment of the present invention.
In FIG. 1(a),
Reference numeral 101 denotes a green (G) light-receiving portion, which mainly includes a light-receiving phototransistor, a photodiode, and other light-receiving semiconductor elements for receiving reflected light from a green LED.
Reference numeral 102 denotes a green (G) light emitting portion, which is composed of a light emitting diode (LED) having a wavelength of green (524 μm) or the like, other light emitting elements, or the like.
Since the green (G) light receiving part 101 and the green (G) light emitting part 102 form a reflective pulse wave sensor, the green (G) light receiving part 101 and the green (G) light emitting part 102 are adjacent to each other on one substrate. An integrated type mounted in such a state is exemplified.
Reference numeral 103 denotes an infrared (IR) light receiving portion, for example, a light receiving phototransistor, photodiode, or other light receiving semiconductor for receiving light transmitted through an infrared light emitting diode (LED) having a wavelength of 850 nm. A filter for efficiently receiving outside light may be provided.

Reference numeral 104 denotes an infrared (IR) light emitting unit, which is composed of a light emitting diode (LED) that emits light having a near infrared wavelength of 850 nm and other light emitters.
Since the infrared (IR) light receiving unit 103 and the infrared (IR) light emitting unit 104 form a transmissive type, the light emitting element and the light receiving element mounted on individual substrates are attached to the surface of the living body to be measured. It is arranged so as to sandwich or face a thick blood vessel in the deep part.
Reference numeral 105 denotes a green pulse wave differentiating means for performing secondary differentiation processing on the green received light signal converted into an electrical signal to form and output a green secondary differential signal.
The green pulse wave differentiating means 105 is composed of, for example, two analog differential circuits or a computer unit that stores two differential processing code routines and executes the stored codes to process digital signals.

An infrared pulse wave differentiating means 106 has the same configuration as the green pulse wave differentiating means 105 and outputs the formed infrared secondary differential pulse wave to the characteristic part detecting means 107 .
Reference numeral 107 denotes characteristic portion detection means, which inputs the secondary differential pulse wave signals output from the green pulse wave differentiation means 105 and the infrared pulse wave differentiation means 106, respectively, and detects characteristic values such as inflection points and peak values. It is for detection, and is formed by an analog or digital signal processing circuit. The digital signal processing circuit is configured by, for example, a computer that operates by executing a program, and outputs characteristic values.
Reference numeral 108 denotes blood pressure information detection means, which is formed by an ASIC composed of a computer that operates by executing a program and a gate array, and detects blood pressure based on the above-described explanation of the principle from the characteristic values output from the characteristic portion detection means 107. Output relevant values and blood pressure values.
This output is displayed on a computer monitor, blood pressure monitor, etc., and may also be an input signal for an AI processing circuit such as machine learning.

Next, the operation shown in FIG. 1A will be described with reference to FIG. 2 and the like.
Green (G) light receiving unit 101 and green (G) light emitting unit 102 are mounted on one substrate to form a reflective pulse wave sensor, for example, green (G) light emitting unit 606a in FIG. As indicated by the green (G) light receiving portion 606b, a reflective type is formed and is brought into contact with the surface of the living body.
The green (G) light-emitting part 102 and the green (G) light-receiving part 101 are integrally formed in a state that they are adjacent to each other or separated from each other by 60 to 80 mm to form a measuring device. or formed separately.

The infrared (IR) light receiving unit 103 and the infrared (IR) light emitting unit 104 transmit light to the living body as shown by the infrared (IR) light emitting unit 603 and the infrared (IR) light receiving unit 604 in FIG. A mold is placed and contacted to measure a pulse wave, and a green pulse wave sensor and an infrared pulse wave sensor are configured and placed in contact with the skin of the living body. Since the infrared (IR) light receiving unit 103 and the infrared (IR) light emitting unit 104 obtain biological signals by transmitting them, as shown in FIG. It is preferable that an infrared (IR) light emitting section 603 and an infrared (IR) light receiving section 604 are arranged in the center.

As described above, the upper arm is preferable as the placement site on the living body, and a more accurate and stable pulse wave can be measured. It is preferable that the green pulse wave sensor be placed at a site near the surface of the skin to measure thin arteries in the peripheral direction, as shown at 22 in FIG. 2(b).

The infrared (IR) pulse wave sensor is preferably placed at a position deeper in the body than indicated by 21 in FIG. 2(b) to measure blood flow in large arteries.
The green light emitted from the green (G) light emitting unit 102 passes through the skin surface and is reflected by the thin artery near the skin surface indicated by 22 in FIG. is received, converted into an electrical signal, and input to the green pulse wave differentiating means 105 .
This input signal (not shown) is amplified and filtered through analog or digital filters and amplifiers.
The green pulse wave signal output from the green (G) light receiving unit 101 is differentiated twice by the green pulse wave differentiating means 105 to form a secondary differential pulse wave signal. The signal is input to feature detection means 107 .

A secondary differential signal of the green pulse wave signal is indicated by 01 in FIG. 2(a), and a secondary differential signal of the infrared pulse wave signal is indicated by 02 in FIG. 2(a).
The infrared pulse wave signal output from the infrared (IR) light receiving unit 103 is differentiated twice by the infrared pulse wave differentiating means 106 and is input to the characteristic portion detecting means 107 .
Characteristic portion detection means 107 obtains inflection points b ₁ and b ₂ of the infrared second order differential signal and the green second order differential pulse wave signal.
The inflection point is, for example, the point where the secondary differential signal waveform becomes ₀ as shown in _FIG . can be asked for.

From these points of inflection, the PWi value is determined by the above equation {3}, and SBPφi=PWi ^0.25 corresponding to the systolic blood pressure value is determined by the equation 8 to output the blood pressure related data.
Furthermore, if necessary, the blood pressure value is output based on the SBP calibration straight line shown in FIG. 9(2).
It is preferable that the calibration straight line shown in FIG. 9(2) is formed at the time of initialization using the system shown in FIG. 18, for example, and stored as digital data in a memory or the like.
As for the diastolic blood pressure DBP, the diastolic blood pressure is obtained by calculating DBPφi based on the above equation 7 and correlating it with the calibration diagram shown in FIG. 9(1).

The blood pressure-related value may be used when the amount of change is required, and depending on the situation, the blood pressure value may be obtained by preparing a calibration diagram shown in FIG. 9 in advance.
The obtained blood pressure-related value and blood pressure value may be displayed on a computer monitor or used as input data for a separately provided artificial intelligence algorithm, for example, if necessary.

FIG. 1(b) is another embodiment of the present invention. Parts having the same configuration as those in FIG.
Reference numeral 109 in FIG. 1(b) denotes an electrocardiogram input unit, which is composed of an electrocardiograph having at least one pair of electrodes. are configured.
The electrode is exemplified by a structure in which a fabric electrode provided with a conductive member or a conductive member such as Ag/AgCl is attached to a support sheet made of vinyl or plastic, and an adhesive interface forming means is laminated. This is a preferred embodiment in that discomfort due to sticky components remaining on the skin can be eliminated by using cloth electrodes instead of a shaped interface forming means.

The electrocardiograph may be versatile as long as it can detect at least the peak time phase of the R wave.
110 is an electrocardiogram differentiating means, which is composed of a differentiating circuit, a computer that executes a differentiating program, etc., and differentiates the electrocardiographic signal to form a pulse having an R-wave peak time phase. The number of times of differentiation should be the number of times that time phase detection is good.
Reference numeral 111 denotes characteristic part detection means, which is composed of a comparator circuit, a computer having an R-wave phase detection program, etc., and detects a pulse including an R-wave phase from the differential electrocardiogram signal input from the electrocardiogram differentiation means 110, and other signals. is output.

The operation of the embodiment shown in FIG. 1(b) will be described with reference to FIGS. 17(b) to 17(d).
Based on the formulas (9) and (10), the blood pressure (basal blood pressure) SBPo and DBPo specific to the person is calculated.
That is, using an existing sphygmomanometer, blood pressure values SBP and DBP are measured, and Tu, C _ECG
, and in the diastolic phase, after obtaining the values of RR and RRi, etc., the basal blood pressures SBPo and DBPo are calculated based on the equations (9) and (10).
Although this value is basically constant, it is preferable to calculate the value a plurality of times and obtain the average value in consideration of measurement errors and the like. Basal blood pressure values are measured and calculated at least once a day. Also, instead of continuous blood pressure measurement, only SBP ₀ and DBP ₀ may be determined.
The electrocardiogram input unit 109 receives, for example, electrocardiogram signals indicated by infrared (IR) pulse waveforms (b-1) and (c-1) in FIG. The signal is input through the conductive member 172b for the electrocardiogram, is amplified and filtered as an electrical signal, and is input to the electrocardiogram differentiating means 110. FIG.
The electrocardiogram differentiating means 110 forms a differentiated wave shown in FIG. 17(c-2). Differentiation may include the peak time (R) of the R wave so that it can be easily detected, and secondary differentiation processing may be performed.

The differentiated electrocardiogram signal is input to the characteristic part detection means 111 to form a pulse in which the R wave appearance time information (time phase) is included in the rise or fall.
The green light emitted from the green (G) light emitting section 102 is reflected through the blood in thin arteries in the shallow part of the skin, and the reflected green light is received by the green (G) light receiving section 101, which is shown in FIG. pulse wave electrical signals shown by green (G) pulse wave waveforms (b-2) and (c-4) in , are output to the green pulse wave differentiating means 105 .
The green pulse wave differentiating means 105 performs second order differentiation on this pulse wave signal to form a second order differential waveform shown in FIG.

The characteristic portion detecting means 111 forms a pulse including the time phases of points b and P (FIG. 17(c-6)) from this second-order differential waveform.
Furthermore, the characteristic part detection means 111 detects the pulse including the electrocardiogram R wave time phase shown in FIGS. 17(c-3) and (c-6), and the inflection points b and P A pulse including the time phase is output to blood pressure information detection means 108 .

The blood pressure information detecting means 108 detects the blood pressure value of the pulse including the electrocardiogram R wave time phase and the pulse wave pulse including the b time phase and the P time phase related to the green light, which are input as shown in FIG. Calculate and output values.

FIG. 1(c) is provided with a new pressure sensor for measuring the pressure pulse wave, and the same components as those in FIG. 1(a) are denoted by the same symbols, and descriptions thereof are omitted.
Numeral 112 is a micro-pressure detection unit, which is configured, for example, by sealing air and gas in a sealed vinyl or plastic bag and mounting a pressure sensor on the inner surface of the bag. An electric lead wire extending from the pressure sensor extends to the outside of the bag-shaped body, and an output signal output from the pressure sensor is transmitted to the micro pressure differentiating means 113 .
The micropressure detection unit 112 is arranged, for example, so as to overlap with the infrared light receiving unit 103 .
113 is a differential pressure differentiation means, which is formed by a signal processor such as a computer that incorporates a program and operates according to the program, differentiates the pressure sensor signal from 112 second order and outputs a second order differential value. It outputs to the part detection means 114 .
Reference numeral 114 denotes characteristic portion detection means, which, like 107 and 111, is formed of a signal processor such as a computer that incorporates a program and operates according to the program.

This embodiment is preferably used by being worn on the upper arm, and an embodiment in that case is shown in FIGS. 6 and 7 and will be described.
FIG. 6(a) is a cross-sectional view taken along the line XX' of FIG. 7 showing a state in which a band-shaped body 601 is attached to the upper arm of a living body or the like. FIG. 6(b) is another embodiment different from FIG. 6(a), but the cross section is the same as XX' in FIG.
FIG. 6(c) also shows an embodiment of the present invention that is used by being attached to the upper arm as in FIGS. 6(a) and 6(b), but FIG. 6(c) further includes a micropressure sensor.

In FIG. 6(a),
Reference numeral 601 denotes a belt-like body made of vinyl, plastic, cloth, or the like, which surrounds the living body indicated by the supporter and fixes it at that position. made up of states.
Due to the stretchability of the belt-like body 601, for example, the upper arm is pressed from the surroundings, but the force is preferably such that the sensor in the belt-like body 601 does not move.

A housing 602 is made of plastic, metal, or the like, and accommodates therein a wireless communication antenna, an electric circuit board, a battery, and the like.
The electric circuit includes CPU, GPU, memory, media for continuous storage such as micro SD card,
In addition, in the housing 602, infrared light, WiFi, Bluetooth (registered trademark) for wirelessly transmitting the pulse wave electric signal obtained from the light receiving unit that detects green light and infrared light to the outside. Transmit and receive electronic circuit modules are built in.
An infrared (IR) light emitting unit 603 is composed of an LED, a light emitting diode, or the like that outputs infrared light at a wavelength of 850 nm.

Reference numeral 604 denotes an infrared (IR) light receiving portion, which is composed of a phototransistor, a photodiode, and the like.
A black sheet 605 is made of black rubber, resin, or a sheet material having plastic flexibility. Eliminate other light.
A green light sensor unit 606 is composed of a green (G) light emitting portion 606a and a green (G) light receiving portion 606b. (G) The light is received by the light receiving portion 606b.

Reference numeral 607 denotes an electrical connection portion for green light, which is composed of an electrical lead wire, a connection connector, and the like, and supplies an electrical signal to the green (G) light emitting portion 606a and reflects light from the green (G) light receiving portion 606b. It is a connection part for transmitting an optical electrical signal to a circuit inside the housing 602 .
Reference numeral 608 denotes an electric connection portion for infrared light emission, which is composed of an electric lead wire 610 for outputting infrared light, a connector, and the like, and is a conductive connection portion for outputting electricity to the infrared (IR) light emission portion 603 . be.

Reference numeral 609 denotes an electric connection portion for infrared transmitted light, which is composed of an electric lead wire 611 for transmitting an infrared light reception signal, a connector, and the like, and outputs a red light from an infrared (IR) light reception portion 604 . It is a connecting portion for transmitting an externally transmitted electric signal to the housing 602 .
Reference numeral 610 denotes an infrared light output electrical lead wire for transmitting electrical output to the infrared light emitting section, which electrically connects the infrared light emitting electrical connection section 608 and the infrared (IR) light emitting section 603. It is for
A reference numeral 611 denotes an electric lead wire for receiving infrared light for transmitting an electric output from the infrared light receiving portion to the housing 602, and includes an electric connection portion 608 for infrared light emission and an infrared (IR) light emitting portion 603. to electrically connect the

The operation of the embodiment shown in FIG. 6(a) will be described.
The belt-like body 601 is, for example, formed in a cylindrical shape having elasticity like a supporter, and as shown in FIG.
An infrared pulse wave sensor consisting of an infrared (IR) light emitting portion 603 and an infrared (IR) light receiving portion 604 is mounted in the direction of the armpit so that it is transparent to the deep thick artery 6d. It is preferable in terms of pulse wave detection.
However, depending on the condition of the subject's arteries, the infrared (IR) light emitting section 603 and the infrared (IR) light receiving section 604 may be arranged on the outer side of the upper arm.

The housing 602 is formed with an electric circuit for transmitting/receiving an LED light receiving signal to the outside by wireless such as WiFi, infrared rays, or by wire, and further includes a battery unit such as a button battery.
The use is started by turning on a switch provided in the electric circuit, and also by turning on a membrane switch or the like which is turned on at the same time as mounting.
When the electrical circuitry within housing 602 is turned on, the electrical circuitry within housing 602 provides an electrical signal to infrared (IR) emitter 603 via infrared light output electrical lead 610, and further to red light. An electric signal serving as a bias is supplied to the infrared (IR) light receiving section 604 via an electric lead wire 611 for outputting external light.

An infrared (IR) light emitting unit 603 outputs infrared light having the wavelengths described above. It passes through a large deep artery and is received by an infrared (IR) light receiver 604 . This received light signal is converted into an electric signal and supplied to the electric circuit inside the housing 602 via the electric lead wire 611 .
If the electric circuit in the housing 602 is equipped with the circuit of the green pulse wave differentiating means 105 shown in FIG. signal.
This electric signal is transmitted to the operation terminal provided with the circuit of the green pulse wave differentiating means 105 shown in FIG. 1, such as the operation terminal 805 shown in FIG.

A green (G) light emitting portion 606a of the green light sensor unit 606 emits green light to the peripheral blood vessel 6s (22 in FIG. 2(b)), and the green (G) light receiving portion 606b receives the light. The received light signal is converted into an electrical signal, and a green pulse wave electrical signal is output to housing 602 .
If there is no circuit after the green pulse wave differentiation means 105 shown in FIG. 1 in the housing 602, the received pulse wave signals 01 and 02 shown in FIG. After being sampled in a few seconds, it is converted into digital numerical data and transmitted to the outside. The operation terminal 805 restores the input digital data to form an analog signal, which is then subjected to secondary differential processing.

Alternatively, if there is a secondary differential analog circuit in the housing 602, the secondary differential signal may be sampled and transmitted to the operation terminal 805. In this case, blood pressure-related values and blood pressure values are quickly calculated. can.
FIG. 6B has the same basic configuration as that of FIG. IR) shows a configuration provided with an adjusting contraction member for adjusting the transmission distance between the light emitting portion 603 and the light receiving portion 604 for infrared (IR) light.
Therefore, the parts having the same configurations as those in FIG.

A heat dissipation member 612 is made of a metal material such as aluminum or titanium, and is electrically non-conductive with the infrared (IR) light emitting unit 603 .
Reference numeral 613a denotes a support sheet A, and 613b denotes a support sheet B, and their outer ends are connected to the infrared (IR) light receiving portion 604 and the heat dissipation member 612 (or the infrared (IR) light emitting portion 603). , crossed or superimposed in a stretchable state and slidable outwardly.

614 is a black sheet A, and 615 is a black sheet B, which are made of special rubber or plastic material having viscoelasticity and plasticity. B 613b, the support sheet A and the support sheet B move in both directions, and the black sheet A 614 and the black sheet B 615 move in the same way, so that the infrared (IR) light emitting part 603 and the infrared (IR) light emitting part 603 and the infrared (IR) light emitting part 603 move. The distance between the light receivers 604 is adjusted to optimize pulse wave measurement with infrared transmitted light.
Reference numeral 616 denotes an adjustment operation section, which is attached to either one or both of the support sheet A 613a and the support sheet B 613b, and protrudes in a shape that can be moved by the user's hand.
It is preferable that the distance between the infrared (IR) light emitting unit 603 and the infrared (IR) light receiving unit 604 is formed in a stretchable state. Alternatively, the support sheet and the black sheet may be in a fixed state.

Next, an embodiment of the present invention shown in FIG. 6(c) will be described.
Reference numeral 601 denotes a belt-like body made of cloth, plastic, or the like, which is open at both ends, and a connecting member 621, such as a planar fastener, which can be connected in a predetermined range to each of the both ends. is attached, surrounds the upper arm, and both connecting members are brought into contact with each other by shifting the position within the range of the connecting member, so that they are connected at that position, so that the amount of pressure applied to the upper arm can be adjusted.
A housing 602 is made of hard plastic or the like, and contains an electric circuit, a battery, and an antenna, etc. for wireless transmission. Membrane switches are arranged on the outer surface.

Housing 602 may also incorporate a pump for supplying air pressure to air cuff 619 .
An infrared (IR) light emitting unit 603 is formed of an infrared LED or the like.
A reference numeral 604 denotes an infrared (IR) light receiving portion, which is formed of an optical semiconductor such as a photodiode or a phototransistor.
A green light sensor unit 606 is, for example, a reflective sensor in which a green (G) light emitting portion 606a and a green (G) light receiving portion 606b are arranged adjacent to each other.
As shown in FIG. 8, the green light sensor unit 606 preferably has a configuration in which a light-emitting portion is formed in the center and a light-receiving portion is formed around it.

Numeral 617 is a projection for opening a vein, which is made of an elastic material such as silicone, and has a height of about 1 cm and is continuous in the short axis direction of the belt-like body 601 (vertical direction with respect to the upper arm around which the belt-like body 601 is wound). A side surface 617a along the long axis direction of the vein opening projection 617 (vertical direction with respect to the upper arm around which the belt-shaped body 601 is wound) is used to detect the closed state of the vein due to the pressing of the belt-shaped body 601 against the upper arm. It is for opening by part.
The vein-opening projection 617 is locally pressurized toward the skin by the pressing of the belt-shaped body 601, but a region where no pressure is applied is formed around the locally pressurized projection (617a). Therefore, along this site, the vein is opened, and the blockage of blood circulation is resolved without occluding the vein.

618 is a projection for light shielding, which is formed continuously in the direction of the short axis of the belt-shaped body 601 so that the output light of the infrared (IR) light emitting section 603 crawls on the surface of the skin and receives infrared (IR) light. It is cut off so as not to be supplied to the unit 604 .
An air cuff 619 is formed of a bag-shaped body made of plastic, resin, or the like, and has a pressure sensor arranged and fixed therein.
620 is an adjustment plug, and a valve or plug for adjusting the internal air pressure in the air cuff 619 to 20 to 30 mmHg, for example, is formed.
The adjustment plug 620 is a supply port for supplying air pressure from an external air pressure supply pump to the air cuff 619 through a conduit. is a stopcock or valve.

Reference numeral 621 denotes a connecting member, which preferably has a range of connecting surfaces, such as a planar fastener, and is capable of adjusting the pressure applied to the upper arm by a band-shaped body wrapped around the upper arm.
619a is a pressure sensor, an electronic device placed in the air cuff, which converts the air pressure value in the air cuff 619 into an electric signal and outputs it. connected to the electrical circuit of
An infrared (IR) light receiving portion 604 is placed on the surface of the air cuff 619 and joined to the surface thereof. A pulse wave based on a large artery received by 604 is detected synchronously, and the time phase of the pulse wave signal based on the infrared (IR) light receiving unit 604 is compensated.
FIG. 6 is a cross-sectional view taken along the line XX′ of FIG. 7 showing a state in which the band-shaped body 601 is attached to the upper arm of a living body or the like. The strip-shaped body 601 shown in FIG. 6 is exemplified as a ring-shaped strip or a strip-shaped strip with both ends open. A belt-like body having both ends open and capable of being appropriately pressurized is preferable.

Next, the operation of the embodiment shown in FIG. 6(c) will be described.
The belt-like body 601 is wrapped around the right arm or the upper arm of the left arm while gradually tightening it.
In a state in which the pressure sensor 619a detects a pressure pulse wave, the infrared light output from the infrared (IR) light emitting unit 603 is transparently irradiated to the deep artery 4d, and the infrared (IR) light receiving unit Light is received at 604 .

Since the output from the infrared (IR) light emitting unit 603 is transmitted along the skin surface of the living body, it is blocked by the light shielding protrusion 618, so that the amount of transmitted light received increases.
Further, since the pressure pulse wave is obtained from the pressure sensor 619a, the time phase of the pulse wave signal from the infrared light receiving sensor can be compensated for and detected by the time phase signal of the pressure pulse wave. can be reliably detected. The two signals are used to detect the pulse wave of a large artery, but there are cases where only the pressure pulse wave is sufficient.

Furthermore, the green light sensor unit 606 measures the blood flow in thin arteries in shallow parts of the body.
Electrical signals obtained from these sensors are input to an electrical circuit within housing 602 and processed.
FIG. 19 shows another example of light-shielding protrusions used for measuring blood flow in deep arteries.
Reference numeral 1901 denotes a belt-like body formed of a magic band or the like, which is a cuff-like rectangular belt-like body that is wound around the upper arm 19A and fixed by magic band joints arranged at both ends. Although a part of it is shown in the drawing, it is actually wound around the upper arm and fixed in the same manner as the strip 601 shown in FIG. 6(c).

An air bag 1902 is filled with air to apply a pressure of 10 to 20 mmHg toward the skin when the strip 1901 is surrounded by the upper arm. After filling, it may be sealed and optionally valved to allow refilling.
A light shielding projection 1903 is formed of an elastic material such as silicone or Teflon (registered trademark).
An infrared (IR) light emitting unit 1904 is formed of an infrared LED and is used for measuring blood flow in deep arteries.
A photoreceptor 1905 is formed of a phototransistor or the like, and serves to receive infrared light by reflecting deep arteries.

The light-shielding projections shown in FIG. 19 are for blocking part of the infrared light 19D that crawls along the surface of the skin of the living body, similar to the light-shielding projections 618 shown in FIG.
When the band-shaped body 1901 is wound around the upper arm 19H and fixed, the air pressure of the air bag 1902 pushes up the light shielding protrusion 1903 to locally press the skin 19H.
An infrared (IR) light emitter 1904 outputs an infrared ray 19C, irradiates the deep artery 19B, and the light receiving member 1905 receives the reflected return light.
At that time, the infrared light output from the infrared (IR) light emitting unit 1904 may be transmitted along the vicinity of the skin surface and received by the photoreceptor 1905, but is blocked by the air bag 1902 and the light shielding protrusion 1903. Only reflected light 19C that is blocked and originates from deep artery 19H can be received by photoreceptor 1905 .

FIG. 7 schematically shows a state in which this embodiment is actually worn on a human upper arm. Alternatively, it is rectangular in shape, wrapped around the upper arm, and fixed with a surface fastener or the like. The band-shaped body 601 is worn by pressing the upper arm to some extent, and the amount of pressure is exemplified by a force that prevents the band-shaped body from slipping down and a force that allows the pressure pulse wave to be detected.
At least, it is sufficient if the pressure on the upper arm is not the same as that of a conventional sphygmomanometer, but a pressure that enables pulse wave measurement.

The embodiment shown in FIG. 8 is a diagram schematically showing a state in which data is being transmitted and received to the outside.
In the embodiment shown in FIG. 8, the structure of the band 801 and the like uses the infrared light sensor structure shown in FIG. explanation is omitted.
Reference numeral 803 denotes a green light pulse wave sensor unit base material, which is configured using reflected light, and has a light emitting part and a plurality of light receiving parts arranged on one base material.

803 a is a green light emitting part, which is formed of an LED, a light emitting diode, etc., and is arranged in the central part of the green light pulse wave sensor unit base material 803 .
Green light receiving portions 803b to 803d are composed of phototransistors, photodiodes, etc. Three green light receiving portions of the same configuration are arranged around the green light emitting portion (indicated by 803b, 803c and 803d, respectively).
These green light receiving portions 803b, 803c, and 803d can select and use the light receiving electric signal of the optimum light receiving element from among the received light intensity that varies depending on the reflection position, or use the light receiving electric signal of the three light receiving elements. In some cases, an arithmetic mean value of the signal is taken. These light receiving elements may be of different types.

Into the housing 802, the light receiving electric signals output from the three light receiving portions 803b, 803c, and 803d are input, and the target pulse wave waveform is extracted by a filter or the like. electronic circuit module, etc.
Reference numeral 804 denotes a transmission medium, which represents a spatial transmission medium for wirelessly transmitting and receiving data to and from an external PC smartphone. Wireless is formed by WiFi, direct WiFi, Bluetooth (registered trademark), infrared light, and the like.
Reference numeral 805 denotes an operation terminal such as a smart phone, tablet, PC, mobile phone, etc., which processes received data, displays the data, or supplies the data directly to the light receiving unit.

The operation terminal 805 and the housing 802 only need to have a relationship in which data can be transmitted and received. When the housing 802 is used in a so-called wearable state, WiFi, infrared rays, and Bluetooth (registered trademark) are used as media. A wireless connection is preferred.

FIG. 9 is a calibration diagram for calculating blood pressure values from measured blood pressure-related values, and is prepared at the start of measurement or in advance. The creation method is based on the explanation of the principle described above.
This calibration chart is used when obtaining the blood pressure, and may not be used when obtaining the amount of change.
FIG. 9(2) is a diagram used for systolic blood pressure measurement, and FIG. 9(1) is a diagram used for diastolic blood pressure measurement.
When obtaining a drawing for calibration prepared in advance, a sphygmomanometer for calibration (preferably a home-use sphygmomanometer wrapped around the upper arm) is placed on the upper arm opposite to the arm on which the embodiment of the present invention is worn. , and the relationship between the actually measured blood pressure value SBP and the systolic blood pressure change rate SBPφi is formed based on the items of the principle explanation described above for calibration as shown in FIG. 9(2). Similarly, the diastolic blood pressure forms a corresponding relationship for calibration as shown in FIG. 9(1).
The drawing for calibration shown in FIG. 9 is created using the system shown in FIG. 18, for example.

FIG. 17 shows an embodiment of measuring a blood pressure value and a blood pressure-related value from an electrocardiogram and a pulse wave using a green luminous body according to the present invention.
Reference numeral 171 denotes an electrocardiogram electrode cover, which is preferably made of cloth, and is surrounded by the upper arm and has a main electrode conductive member 172a in contact with the skin.

172a is a main electrode conductive member, which is an electrode for electrocardiogram detection.
172b is a counter electrode conductive member, which is an electrode for electrocardiogram detection. The main electrode conductive member 172a and the counter electrode conductive member 172b are formed by a combination of each conductive member and a fabric support sheet that can be surrounded, and do not use a commonly used adhesive gel. There is no discomfort such as stickiness of the skin or the residue of the gel remaining.
Reference numeral 173 denotes a belt-like body, and a connecting member such as a surface fastener is formed in the longitudinal direction so that it can be wound and fixed in accordance with the thickness of the upper arm.
The belt-like body 173 is composed of a sphygmomanometer cuff or the like for placing the green (G) pulse wave sensor 174 in contact with the skin surface and fixing the main body 175 to the upper arm.

Reference numeral 173a denotes an electric lead wire for the main electrode, which is for electrically connecting the conductive member 172a for the main electrode and the main body 175; Reference numeral 173b denotes an electric lead wire for the counter electrode, which is for electrically connecting the electrically conductive member 172b for the counter electrode and the main body 175. As shown in FIG.
Reference numeral 174 denotes a green (G) pulse wave sensor that emits green light, an example of which is shown in FIG.
Reference numeral 175 denotes a main body, in which an AD converter, a peak detection circuit, a transmitter/receiver, a differentiating circuit, a temporal pulse forming circuit, etc. are incorporated in a lightweight plastic case.
1st, 2nd and 3rd order differential waveforms are formed, pulses corresponding to each time phase are formed, and radio waves are sent to the outside.
A unit for wireless transmission such as infrared is included.

Reference numeral 176 denotes a wireless medium, which indicates infrared rays in the case of transmission and reception of infrared rays, and radio waves in the case of WiFi and Bluetooth (registered trademark).
Reference numeral 177 denotes an operation terminal, which is formed by a smartphone, a tablet computer, a notebook computer, a desktop computer, etc., receives data transmitted from the main body 175, processes it, and outputs blood pressure related data and blood pressure value estimated data. Generate, display, and store.

Next, the operation of the embodiment shown in FIG. 17(a) will be described with reference to FIGS. 17(b) to 17(d). A band-shaped body 173 is wrapped around the upper arm to fix the counter electrode conductive member 172b, the green (G) pulse wave sensor 174, and the main body 175 to the upper arm.
The electrocardiogram electrode cover part 171 is surrounded and fixed to the other upper arm, and the main electrode conductive member 172a is abutted and fixed to the skin surface.
The operation of the main body is started, and the electrocardiogram waveforms shown in FIGS. 17(b-1) and (c-1) are detected from the main electrode conductive member 172a and the counter electrode conductive member 172b. 17(b-2) and (c-2) are detected from the sensor 174 and differentiated to the desired order. FIG. 17(c-2) shows the differential waveform of the electrocardiogram, and FIG. 17(c-5) shows the third-order differential waveform of the G pulse waveform.

ＤＢＰｅ＝ＳＢＰｅ－ＰＰｅ As for the differential waveform (secondary) of the electrocardiogram, the comparator circuit outputs a pulse having an R wave phase (R) (FIG. 17 (c-3)), and from the third differential waveform of the G pulse wave, the minimum value ( A pulse having rising and falling phases b) and (P) is formed, modulated while maintaining the phases, and output to the operation terminal 177 via infrared or radio.
In the operation terminal 177, for example, a blood pressure value (estimated value) or a blood pressure-related value is calculated based on the above measurement principle from the received pulse having a time phase.
An example of calculation of the calculated values SBPe (systolic blood pressure), PPe (pulse pressure), and DBPe (diastolic blood pressure) is shown below.
L = distance from aorta to upper arm (m)
C (C _ECG ) = pulse wave transit time (s)
PWV=L/C _ECG (PWV: pulse wave velocity)
Tu = UP stroke time of green (G) pulse wave
Pc = constant for each individual
Pcs = constant for SBP
Pcp = Constant of PP

SBPe=Pcs×(Tu/C _ECG ) ^1/4

DBPe = SBPe - PPe

An example of a system for calculating continuous blood pressure values is shown in FIG.
FIG. 18 shows a system for presumably calculating actual blood pressure from two pulse waves having different wavelengths, and shows an example of creating a relationship diagram for initial calibration using a calibration sphygmomanometer.

In FIG. 18, reference numeral 1801 denotes a relay unit, which includes a connector and an electric circuit board housed in a housing made of lightweight plastic. This is the part for collecting electrocardiogram signals and outputting them to the measurement unit.
1802 is a green pulse wave sensor, which is a reflective chip-shaped sensor in which a green light emitting part made of a green LED for detecting a green pulse wave signal and a green light receiving part made of a phototransistor are mounted on a single substrate, It is positioned inside the band 1804 to contact the skin surface on the outside of the upper arm.

1803a is an infrared light receiving part, formed of an infrared light receiving phototransistor, etc., 1803b is an infrared light emitting part, formed of an infrared light emitting LED, forming a biotransmissive pulse wave sensor, It is positioned medially to contact the skin surface on the inner side of the upper arm.
Reference numeral 1804 denotes a belt-like body, which is made of flexible plastic or the like, and is attached in the longitudinal direction with a connecting member such as a surface fastener that can be adjusted to the thickness of the upper arm and can be wrapped and fixed. .
1805a is a main electrode for an electrocardiogram, which is formed of a cloth electrode Ag/AgCl to form a main electrode. The electrocardiogram main electrode 1805a is arranged in the pressurization cuff of the calibration blood pressure measuring unit 1806 or its surroundings so as to come into contact with the living body. It is preferable that the electrocardiogram main electrode 1805a be arranged in a portion that is not subject to fluctuations (artifacts) due to pressure invasion of the blood pressure measurement cuff.

1805b is an electrocardiogram counter electrode, which is formed of a cloth electrode Ag/AgCl to form a counter electrode. Note that the distinction between the main pole and the counter pole is just an example, and the reverse is also possible. 1805a connected near the calibration blood pressure measuring unit 1806 may be more stable at the counter electrode than at the main electrode due to the influence of pressurization.
Reference numeral 1806 denotes a blood pressure measurement unit for calibration, which is composed of a home-use sphygmomanometer using a general pneumatic pressurization cuff, an ABPM (Ambulatory Blood Pressure Monitoring) 24-hour sphygmomanometer, etc., and periodically measures the blood pressure value. and output the pneumatic pressure and pressure pulse wave.
A connector 1806a is formed of a conduit through which air pressure can be transmitted or an electric lead wire, and is appropriately selected and used as required.
Reference numeral 1807 denotes a pressure gauge which inputs the pneumatic pressure and the pressure pulse wave electric signal obtained from the calibration sphygmomanometer through the connector 1806a to obtain the central pressure pulse wave, the upper end pressure, the central pressure and the upper end pulse wave value, respectively. obtain. This pressure gauge is set as required, and may be installed in the blood pressure measurement unit 1806 for calibration.
These values are conveyed to AD converter 1809 by separate channels.

1808 is a biosignal measurement unit, which inputs an electrocardiogram electrical signal, an infrared (IR) pulse wave signal, and a green (G) pulse wave electrical signal obtained from each electrode and sensor, and amplifies and filters the electrical signal. The signals are converted into signals and output to an AD converter 1809 via an infrared (IR) pulse wave electric lead wire 1801a and a green (G) pulse wave electric lead wire 1801b.
An electrocardiogram electric signal, an infrared (IR) pulse wave signal, and a green (G) pulse wave signal are input through separate channelized transmission lines, and output to the AD conversion unit 1809 in a state in which individual signal processing can be performed. be done.
An AD converter 1809 converts the input analog signal into a digital electrical signal, and inputs the input signal to the signal processing unit 1810 as one electrical signal while maintaining the channel state.
A signal processing unit 1810 is formed by a computer and incorporates a program for processing signals for each channel, and further incorporates a program for calculating calibration data.

Next, the operation shown in FIG. 18(a) will be described with reference to FIGS. 18(b-1), (b-2) and (b-3).
A green pulse wave sensor 1802, an infrared light receiving part 1803a, an infrared light emitting part 1803b, and an electrocardiogram counter electrode 1805b are attached to a strip 1804 wrapped around one upper arm 18A, and each sensor is abutted and fixed to the skin surface.
The main electrode 1805a for electrocardiogram and the blood pressure measuring unit 1806 for calibration are attached to the other upper arm 18B so as to surround them.
The green pulse wave sensor 1802 irradiates a green light-emitting body from the skin surface to a thin artery close to the skin, and after receiving the reflected return light at the light receiving part of the green pulse wave sensor 1802, a biosignal as a green pulse wave electric signal. It is output to a measurement unit 1808 via an infrared (IR) pulse wave electrical lead wire 1801a.

Infrared signals emitted from the infrared light receiving portion 1803a and the infrared light emitting portion 1803b pass through large arteries and blood vessels in the body, and the transmitted light is received by the infrared light receiving portion 1803a and converted into electrical signals. is output to the biological signal measurement unit 1808 via the green (G) pulse wave electrical lead wire 1801b.
The electrocardiogram main electrode 1805a and the electrocardiogram counter electrode 1805b detect an electrocardiogram signal, which is sent to the repeater 1801 via the electrical lead wires 1805c and 1805d, and further to the biosignal measuring unit via the electrocardiogram signal electrical lead wire 1801c. output to 1808.

The biological signal measurement unit 1808 amplifies and filters these electrical signals as analog signals, and the infrared pulse wave shown in FIG. 18 (b-1), the green pulse wave shown in (b-2), and (b- 3) is converted into an electrocardiogram signal and output to the AD converter 1809 .
AD converter 1809 converts these signals into digital signals and outputs them to signal processing unit 1810 .

Also, the pressure values output from the blood pressure measurement unit 1806 for calibration are converted into values of systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) (obtained from pressure pulse wave, etc.) by the pressure gauge 1807. converted into a digital signal through the AD converter 1809 and output to the signal processing unit 1810 .
An example of the operations performed in the signal processing unit 1810 is shown.
First, the calibration blood pressure measurement unit 1806 obtains the actual blood pressure (SBP/DBP·HR) and determines the basal blood pressure B. FIG.

The PWV, Tu, and Cbb values shown in FIG. 18(b-1) and thereafter are calculated, and the blood pressure values (actual blood pressure values) measured by the blood pressure measurement unit 1806 for calibration are obtained at any time.
At the same timing, the phase difference between the infrared pulse wave and the green pulse wave is set as a variable x. xi indicates the phase difference at any time.
If the basal blood pressure constant is b, the actual blood pressure (y) is
y=ax+b or y=bx ⁿ (n indicates a power number)
Substitute the initial value _y0 of the measured actual blood pressure and the initial value _x0 of the phase difference variable at the same time into this equation.
y0 ⁼ _ax0 + _{by0 = bx0n}
a=(y ₀ −b)/x ₀ , b=y ₀ /x ₀ ⁿ (a1)

Furthermore, the actual blood pressure y _i at an arbitrary time i is given by the phase difference variable x _i :
y _i =ax _i +b (a2)
is indicated by

After obtaining a and b from equations a1 and a2, the blood pressure is estimated at any time.

Next, an embodiment for estimating a blood pressure value from pulse waves in a thick artery existing in a relatively shallow region around the ear and a thin artery in the auricle will be described with reference to FIGS. 20, 21, 22, and 23.
FIG. 20(b) is an embodiment including a partial cross section of a headset-type blood pressure measuring device,
Reference numeral 2002 denotes a green pulse wave detection unit that contacts the auricle and detects pulse waves in thin blood vessels. Instead of the configuration, the sensor may be arranged at the auricle portion of a convex ear pad corresponding to the shape of the inside of the ear.

2002a is an LED for emitting green light, and 2002b is a light receiving element for green light composed of a photodiode and a phototransistor, preferably forming a chip-like integrated sensor.
Reference numeral 2002c denotes an electrical connection line, which is formed of conductive paths such as a printed wiring part or the like in addition to a conductive wire, and is connected to each of the green light emitting LED 2002a and the green light receiving element 2002b. It is for supplying the electric energy for light emission to the LED 2002a and for transmitting the photoelectrically converted reflected light receiving signal received from the green light receiving element 2002b to the processing device.
A transparent cover member 2002d is made of a plastic material or the like to prevent contact between the skin and the sensor.
In some cases, one of the two is combined into one as a ground.

Reference numeral 2004 denotes a sensor for laser pulse wave measurement, and a cross section taken along line xx' and yy' shown in FIG. It comprises a light-transmitting optical fiber end 2004a, a light-transmitting optical fiber 2004b, a light-receiving optical fiber end 2004c, and a light-receiving optical fiber 2004d. A cover member made of a resin material is arranged to cover the contact surface. The light-transmitting optical fiber 2004b is connected to the laser light emitting element 2004e and transmits the laser light to the light-transmitting optical fiber end 2004a.
The laser light emitted from the light-transmitting optical fiber end 2004a passes through the skin 2000, is reflected by the superficial temporal artery 2003, and receives the reflected light at the light-receiving optical fiber end 2004c. It is transmitted through the light-receiving optical fiber 2004d.
The light-receiving optical fiber 2004d is connected to the light-receiving semiconductor 2004f, and the light-receiving semiconductor 2004f converts the light-receiving signal into an electric signal. The laser pulse wave measurement sensor 2004 has a configuration in which a light source and a light receiving sensor are provided in the main body, but the present invention is not limited to this, and the end portion 2004a of the light transmitting optical fiber is connected to a sensor light emitter like a pulse wave sensor. , the light-receiving optical fiber end 2004c may be replaced with a sensor such as a photodiode, and the connected optical fibers may be replaced with electrical connection lines. The light-transmitting optical fiber end 2004a and the light-receiving optical fiber end 2004c may be in direct contact with the skin, via a translucent member, via a polarizing plate, or in combination.

2005 is an ear pad a, which is provided with a green pulse wave detector 2002 protruding inward and a laser pulse wave measuring sensor 2004, and preferably has a shape such that when the ear pad is brought into contact with the ear, the ear pad can be brought into contact with the ear without discomfort.
Reference numeral 2006 denotes a connector, which has elasticity such that the ear pad a 2005 and the auxiliary ear pad b 2007 press inward.
Reference numeral 2007 denotes an auxiliary ear pad b, which has a disk shape or other shape that can be worn for a long time while applying internal pressure to the ear so that the ear pad a 2005 can be brought into contact with the ear.

2008 is a multi-core lead wire for signal processing, part of which is formed by an optical fiber bundle and the other by an electric lead wire.
Note that the multi-core lead wire 2008 may be unnecessary if there is an external control device, but if the electric device can be stored around the headset band.
The laser pulse wave measurement sensor 2004 shown in FIG. Multiple transmit and receive laser light pulse wave sensors 2004' with paired fiber optic ends may be

FIG. 20(e) is used when it is not possible to accurately determine where the superficial temporal artery 2003 shown in FIG. It shows a sensor 2004' that has a wide light receiving area and can reliably receive a pulse wave with a single contact.
2004a1, 2004a2, and 2004a3 are laser output ends A, B, and C, respectively, and are connected to a light transmission path 2004d1 made of an optical fiber for connection to the laser light emitting element 2004e.
2004c1, 2004c2, and 2004c3 are laser receiving end portions A, B, and C, respectively, which are portions for receiving the reflected return light reflected by the superficial temporal artery 2003 .
2004d2 is a light receiving transmission section for connecting the light receiving semiconductor 2004f and each laser light receiving section. The light-transmitting optical transmission path 2004d1 and the light-receiving transmission path 2004d2 are composed of one or more. In the figure, the laser output end A2004a1 and the laser light receiving end A2004c1, the laser output end B2004a2 and the laser light receiving end B2004c2, and the laser output end C2004a3 and the laser light receiving end C2004c3 are each paired, but they are not necessarily pairs. For example, there may be one end portion irradiated with a laser beam and a plurality of light receiving portions. Also, the opposite may be true. Also, the number is not limited to three.

FIG. 21 is a block diagram showing signal processing means for processing pulse wave signals obtained from the headset type pulse wave detection unit shown in FIGS. 20(b), (c) and (d).
Reference numeral 2101 denotes a laser light irradiation unit that irradiates laser light, and is composed of a laser light source such as a laser diode.

Reference numeral 2102 denotes a laser light output section, which is composed of a semiconductor for receiving laser light, and performs signal processing by photoelectrically converting received light reflected from the skin.
A green light receiving/irradiating unit 2103 is composed of a green LED or the like.
Reference numeral 2104 denotes a green light receiving portion for photoelectrically converting reflected return light reflected from the skin into an electric signal.
Reference numeral 2105 denotes a first pulse wave signal feature point detector, which detects time information of the lowest point 22c and green lowest point 22a of the pulse wave signal receiving the laser beam shown in FIG. 22(b).
Reference numeral 2106 denotes a second pulse wave signal feature point detection unit for detecting time information from two points, the lowest green point 22a and the highest green point 22b, of the green light-receiving pulse wave signal shown in FIG. 22(a). is.

The blood flow waveform (pulse wave) signal receiving laser light shown in FIG. shows a waveform signal. FIG. 22(d) shows an electrocardiogram signal.
The DC component value is an arbitrary value, and the signal output from the laser beam receiver 2102 contains a DC component of the circuit constant. ).

In addition, the lowest point and the highest point of the blood flow waveform are detected in the output signal of the laser light reception 2102 containing the DC component, and the amplitude values thereof are output as the Qmin value and the Qmax value.
Numeral 2107 is a calculation means, which programs the calculation formulas shown in, for example, formulas 9 and 10 and stores them in the memory.
Calculation means 2017 calculates Cbb, Tu, Qmax, Qmin and RR values from the values obtained from each feature point, and calculates the values of the provisional basal systolic blood pressure SBP ₀ and the provisional basal diastolic blood pressure DBP ₀ . .

Based on the provisional basal systolic pressure and provisional basal diastolic pressure, the current estimated systolic pressure and estimated diastolic pressure are measured.
A blood pressure information output means 2108 outputs the blood pressure information to a monitor, a printer, etc., records it as data in a storage or a server, and transmits/receives it by WiFi, infrared rays, or BlueTooth (registered trademark).

Next, the operation of the embodiment shown in FIGS. 20 and 21 will be described.
A headset-type sensor for blood flow detection and pulse wave detection shown in FIG.
In this case, since the position of the superficial temporal artery 2003 is uncertain, the multiple laser probe shown in FIG. 20(e) may be used.
Since the site of the superficial temporal artery 2003 is often located near the joint (temporomandibular joint) between the maxilla and mandible, the sensor 2004 for laser pulse wave measurement is applied to the depressed site (concave) with the mouth open. It is preferable to make adjustments so that they are in contact with each other. For example, the ear pad 2005 may be made movable by rotation or sliding, and a configuration may be provided in which the laser pulse wave measurement sensor 2004 is positioned in a concave portion (temporomandibular joint region) that occurs when the mouth is opened and closed.
After the pulse wave sensor is attached, laser light output from the laser light emitting element 2004e (2101 in FIG. 21) shown in FIG. The skin 2000 is irradiated with the light, reflected by the superficial temporal artery 2003, and supplied to the light receiving semiconductor 2004f (2102 in FIG. 21) through the light receiving optical fiber end 2004c and the light receiving optical fiber 2004d. It is output to pulse wave signal feature point detection means 2105 .

Light emitted from the green LED emitted from the green pulse wave detection unit 2002 (2103 in FIG. 21), after being irradiated to the thin blood vessels in the auricle, the reflected return light is reflected by the green light receiving element 2002b (2104 in FIG. 21). , converted into an electrical signal, and transmitted to 2106 in FIG.
At 2105, the time information of the lowest point 22c of the pulse wave signal receiving the laser beam shown in FIG. 22(b) is detected.
Furthermore, in 2106, time information is detected from two points, the green lowest point 22a and the green highest point 22b, of the green-light-receiving pulse wave signal shown in FIG. , a provisional basal blood pressure value is calculated, an estimated systolic blood pressure and an estimated diastolic blood pressure are calculated and output to the blood pressure information output means 2108, and the respective values are displayed and stored.

FIG. 23 shows actually measured pulse waves (blood flow) waveforms, 23a is the output waveform of 2104, and 23b is the output waveform of 2102. FIG.
In addition, since the temporary base blood pressure value generated by the computing means 2107 uses the waveform one or more times before the pulse wave, a temporary recording memory (RAM) is incorporated.
The computing means 2107 and its peripherals are preferably composed of a computer.
Also, the temporary base systolic blood pressure and base diastolic blood pressure obtained by the computing means 2107 may be used as specific blood pressure values by averaging the obtained values. In addition, the blood flow wave measurement of the superficial temporal artery using laser light used in the present embodiment is not limited to laser light, and strain gauges, pressure sensors, and infrared LEDs may be used in some cases.

INDUSTRIAL APPLICABILITY The present invention can continuously measure blood pressure values and blood pressure-related values simply by being worn on the upper arm, and thus can be used for non-invasive blood pressure measurement. It can also be used as a monitor for

101 Green (G) light receiving unit 102 Green (G) light emitting unit 103 Infrared (IR) light receiving unit 104 Infrared (IR) light emitting unit 105 Green pulse wave differentiation means 106 Infrared pulse wave differentiation means 107 Characteristic part detection means 108 Blood pressure Information detection means 109 Electrocardiogram input unit 110 Electrocardiogram differentiation means 111 Characteristic part detection means

Claims (8)

A first sensor for detecting a pulse wave with a green LED as a light emitting part, a second sensor for detecting a pulse wave with an infrared LED as a light emitting part, one or more levels of the output signal of the first sensor A first differential value calculating means for calculating a differential value, a second differential value calculating means for calculating a differential value of one to a plurality of orders of the output signal of the second sensor, and the differential value obtained by the first differential value calculating means. A first feature point detection means for detecting a feature point from , a second feature point detection means for detecting a feature point from the differential value obtained by the second differential value calculation means , The time width (Cbb) from the feature point indicating the rise of the pulse wave signal to the feature point indicating the rise of the pulse wave signal obtained by the second feature point detection means and the pulse detected by the first feature point detection means The rate of change in systolic blood pressure SBPφi
SBPφi = PWi ^α (α: 0.25 to 0.5)
or
SBPφi=(Tu/Cbb) ^α
PWi (pulse wave index)
A continuous blood pressure measurement system comprising a blood pressure-related value measuring means for determining . 2. The continuous blood pressure measurement system according to claim 1 , wherein the wavelength of said green LED is 524 nm and the wavelength of said infrared LED is 850 nm . 2. The continuous blood pressure measurement system according to claim 1, wherein the first sensor and the second sensor are attached to a skin-contacting surface of a strip, and the strip is wrapped around the upper arm and fixed . The continuous blood pressure measurement system according to claim 1, wherein the first sensor forms a reflective type and the second sensor forms a transmissive type. The second sensor is electrocardiogram signal detection means for detecting an electrocardiogram signal,
The second differential value calculating means is electrocardiogram differentiation means for calculating a differential value of one to a plurality of orders of the electrocardiogram signal detected by the second sensor ,
The second feature point detection means is means for detecting a feature point (R wave) of the output electrocardiogram differential signal of the electrocardiogram differentiation means ,
The blood pressure-related value measuring means is set to the time width ( C _ECG ) and an estimated systolic blood pressure SBPe based on the time width (Tu) between the feature points from the feature point indicating the rise of the pulse wave signal detected by the first feature point detection means to the systolic peak
SBPe=Pcs×(Tu/C _ECG ) ^0.25
( PCS: Slope coefficient Slope between measured and estimated values of systolic blood pressure )
2. The continuous blood pressure measurement system according to claim 1, wherein . The electrocardiogram signal detection means has at least two electrodes, one of which is arranged and fixed on the skin surface of the upper arm, and the other electrode is arranged and fixed on the skin surface at positions facing each other across the heart. The continuous blood pressure measurement system according to claim 5 . 2. The continuous blood pressure measurement system according to claim 1, wherein said second sensor detects a pulse wave using a laser light source as a light emitting part . 8. The continuous blood pressure measurement system according to claim 7, wherein the second sensor is placed and fixed in contact with the superficial temporal artery site .

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