JPH03503498A - Respiratory status diagnosis and equipment for that purpose - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed description of the invention] TECHNICAL FIELD The present invention relates to the diagnosis of respiratory conditions and devices therefor.

The present invention is particularly different from alternative diagnostic methods for bronchitis and is particularly useful for the diagnosis of asthma in children. It has been devised and developed to date primarily for the purpose of Previous research (19 British Medical Journal, July 29, 1978 issue; Brtisk medical.

Josrnal, pp. 331-332), it is impossible to detect asthma in children. , and the diagnosis may be delayed, especially in children under 4 years of age, especially those in preschool age. It has been shown that the most common cause of that delay is instead being diagnosed with chiculitis. There is. This results in lack of treatment and unnecessary use of antibiotics.

Antibiotics are rarely appropriate for asthma, resulting in hyperresonant airways It can further damage the bronchi.

You can use a stethoscope as in the past, or even measure peak respiratory flow @PFR. This condition cannot be satisfactorily elucidated even with the use of other instruments. For example, for school-going children, simple Bronchitis does not necessarily present with some degree of bronchial muscle spasm ( may result in decreased PFR and signal associated dysfunction, and In children, PFR cannot be accurately monitored due to lack of response.

A transducer that outputs an electrical signal indicative of breathing sounds is used, and such signal is Determination of respiratory status by methods that include the use of instruments that analyze for characteristics of dysfunction. Various proposals have been made to improve diagnosis. However, these Is the proposal a result of regular clinical practice? Not brought.

The purpose of the present invention is to improve this overall situation, and to this purpose Follow the method of the last mentioned form, but at least part of the inspiratory/expiratory cycle. The open phase signal is effectively chained and requires less signal analysis (approximately 5 KH, The form of a spectrum that shows the frequency components and the relative strengths of those components over a range of It will be held in

The combination of signal provision and analysis may be useful during the development of the present invention for daily clinical practice. was found to be necessary to provide a result that corresponds to an unreasonable extent. . At the same time, this finding explains why prior art proposals with similar objectives are actually unsatisfactory. It shows whether there is only one ρ.

For example, a proposal based on piggyback technology is I3I! Apply the transducer to the wall in various ways. As a result, the breathing sounds attenuated to approximately 2 KHz, and the signal from the transducer decreased to the sound pressure level. does not show the frequency spectrum of the sound provided in response to the signal, and analysis of the signal only m- showed breathing sounds.

According to the invention, exhalation sounds are generally more pronounced during exhalation than during inspiration; Preferably, the signal is effectively provided during the exhalation phase. Furthermore, the sound is 1 The sound generated from forced exhalation is a It is preferable that

The transducer also generates significant noise due to the transmission of sound through the body set W&. applied near the mouth to provide an effective direct response to breath sounds without attenuation of It is preferable that

For the above preferred aspects of the invention, the transducer is suitable for a mouthpiece of a given configuration. Located in This mouthpiece clearly facilitates proper positioning of the transducer. It is clear. In addition, when using a mouthpiece, it can be used both between patients and within the same patient. It can facilitate standardization of one diagnostic condition between different time points, and it is possible to This is true in some cases.

Preferably, the signal analysis provides a visual indication, and this is done when the time and frequency are Acting as each coordinate in a dimensional plot, the intensity of one frequency component is a Every time.

A color or a variable that effectively acts as another coordinate in the display. Sendai is good no matter what shape it is fitted in. Intensity as visible concentration fluctuations above a given limit value indicating a significant level of noise, as in the case shown. It is appropriate to display the ingredients only when the product is used.

Although the present invention has been described with emphasis on the diagnostic method, the present invention is also applicable to the implementation of this method. Apparatus for administering the same are equally contemplated.

In any case, the following detailed explanation provided as an example with reference to the attached drawings will help you to understand the scope of this book. Be able to fully understand the invention.

FIG. 1 is a schematic diagram illustrating an embodiment of a device implemented in accordance with the present invention and employed during initial development. The diagrams and figures 2 through 9 were obtained by using the apparatus shown in figure 1. FIG. 3 is a diagram showing plots of various displays, respectively.

The device shown in Figure 1 can be connected to the mouthpiece lO and the input side of the tape recorder 120. and a microphone 11 of high performance. Tape recorder output is analog-digital A computer controlled by a recording program indicating %15 via converter 13 The data is supplied to the storage device of the computer 14.

The data stored in the computer is analyzed by the analysis program specified in step 16. It is controlled and supplied to an X-Y plotter 17 in the form of a pen recorder.

The mouthpiece is a disposable form such as that used in peak expiratory flow meters. So, the microphone is near the exhalation from the mouthpiece, but on the machine: It is a handheld type that is used in undesired positions. For further development, 1 minute is possible. in the side wall of the tubular instrument for use with disposable mouthpieces. Incorporating a small microphone or other suitable electroacoustic transducer and the instrument is adapted to be excessively cleanable. like that The development is shown in FIG. 1 through converter 11α.

Development also requires a dedicated microprocessor or, more economically, a microprocessor. Any suitable commercially available package with specialized knotware for directly handling the output of the It may also include the use of a computer.

In any case, the output of -Q iclophon is for computer processing including analysis. The analysis converts the data from the time domain to the frequency domain. The transformation involves a fast Fourier transform. In particular, said transformation is a series of multiple close intervals. At each instant, a series of multiple similarly closely spaced frequencies in the range 00-5KH provides a signal indicating the strength of the microphone output at each of the numbers. last signal is supplied to the pen recorder until it exceeds a predetermined threshold indicating noise. This provides a so-called Z plot. This plot is stored along with the paper includes multiple traces extending across the paper, the traces being spaced sequentially across the paper, The traces are also spaced sequentially across the paper, showing time in seconds as an X-coordinate image. is shown as a Y locus image with a frequency f1 in KHg, and each trace is the inverse of the frequency component. Visible as two coordinates by including lateral vibrations with amplitudes proportional to Generate change.

In early development, the above analyzes and plots included forced exhalation and 72 traces were provided for the breathing time of the cord.

FIG. 2 shows a plot as described above for a normal adult male (40 years old). meaning A significant characteristic is a relatively high frequency that is well distributed over the entire frequency range of the plot. It can be seen that a spectral energy band exists. These bands are the plot's Another arrow below the 5 time axis identified by adding a horizontal border after the occurrence The marked line.

It shows approximately 0.55 of the time between the occurrence of said band, which is actually the peak exhalation time. Show time. The band is actually a simple organ mode of vibration in nature of the bronchial tree. Calculated to correspond to acoustic frequencies, the bands are constantly repeated in a series of exhalations. It turned out that it was possible.

Figures 3 to 5 show similar treatments for an adult female (38 years old) with asthma. Show cut. These plots are for no medication, aerosol spray, respectively. Administer bronchial tree (salbsgatnoLJ) for 120 minutes .

and breath-related conditions after two months of regular use of such medication. It is something.

The characteristics with heavy g1 in these plots are shown in Fig. 3 compared to Fig. 2. Significant reduction in spectral energy band? The area near IKBg and 2.5f#g Only two bands are generated in , and these bands are of high intensity. No. In the 4th factor, these two Q%F are repeated, although the intensity is reduced. 91 Another band occurs just below 4KHz. In Figure 5, the plot is It can still be compared with that in Figure 2.

So far, the interesting point that can be gleaned from comparing these plots is that for one frequency An upward shift in spectral energy is associated with improved asthma status. Is Rukoto. This means that asthma produces high-frequency wheezing sounds. This is in contrast to the generally accepted view that the force ξ, but in fact the frequency shift is down. This understanding suggests that the intensity of breath sounds increases at low frequencies. I can see that it comes from this.

It was also found that the plots shown in Figures 3 to 5 are repeated. ing.

Figures 6 and 7 show the effects of pancreatitis under conditions comparable to those shown in Figures 3 and 4. A plot is shown for a female child (age 9) of breath, showing the spectrum from low to high frequencies. Tor energy has shifted as well. These plots are also repeated. weak call It is unreasonable to increase the gain of the recorder in order to be able to respond to qi. Note that this does not affect the relative nature of the bands. It should be seen.

The remaining figures 8 and 9 are also in corresponding situations to those of figures 3 and 4. Here is a plot for an adult male (58 years old) who has both asthma and bronchitis. . Although it does not affect the components related to asthma in the patient's condition, it does not affect the components related to bronchitis. tracheal dysfunction is closely related to bronchodilation that cannot be reversed It can be seen that this plot has both similarities and differences with the previous plot.

Thus, bronchodilation reduces the spectral intensity in Figure 9 compared to Figure 8. However, in both cases, the high-energy separation over one frequency range is I can't easily recognize the obi.

The overall results shown in Figures 2 through 9 are that asthma is present. It is possible to aid diagnosis in detecting the presence of asthma and in distinguishing asthma from bronchial disease. It shows the basis for what will happen tomorrow.

In the foregoing description, it is clear that the invention, particularly with respect to the apparatus, may be implemented in various ways. It was revealed that. The device shown in Figure 1 is a device that allows for the relationship between the sound characteristics of breath and the state of breathing. The basis for the correlation can be examined in more detail than in the past. It was chosen to provide the flexibility to As a result, such correlation The goal is to develop devices that are suitable for regular use based on what is currently known. and such equipment can be dedicated and therefore simplified and convenient to use. Profits are doubling.

Although we have shown one aspect of such a development, other possibilities include, for example, 9 1! Equipped with an averaging function that allows the display to take into account multiple actuations by a person. , including broadening the frequency range for analysis.

Note table flat 3-503498 (4) Special table Hei 3-503498 (5) international search report

Claims (10)

[Claims] 1. Those who provide data useful in diagnosing respiratory disorders including asthma and bronchitis In the method, the effect during breathing extends through at least one phase of the exhalation/inhalation cycle. The goal is to generate a continuous electrical signal representing the patient's breathing sounds, and then monitor that signal. analysis of its frequency fraction in the range up to at least 5 KHz and the relative strength of the component. A method of providing data, the method comprising: indicating a degree. 2. 2. The method of claim 1, wherein the signal A method of providing data characterized by occurrences during phases. 3. The method according to claim 2, wherein the exhalation phase is forced exhalation. A method of providing data characterized by: 4. The method according to claim 1, 2 or 3, wherein the signal is The sound is generated by detecting the sound near the mouth. How to provide data. 5. 5. The method of claim 4, wherein the signal is A microphone or other electroacoustic device in a breathing tube A method of providing data characterized in that it is generated by a transducer. 6. 6. The method of claim 5, wherein the device is hand-held by the patient and providing data characterized in that it includes a separable mouthpiece for a patient; Method. 7. In the method according to any one of claims 1 to 6, The frequency components indicated by the raw time, respectively, on a two-dimensional visible display showing the raw time of said components; The relative intensity of the color, contrast or other A method of providing data characterized in that it is displayed by variation of a parameter. 8. In the method according to any one of claims 1 to 7, the signal is repeatedly generated for a series of breathing cycles of the patient, and the signal is or its components averaged in said cycle prior to or following analysis. A method of providing data characterized by: 9. An apparatus for carrying out the method according to any one of claims 1 to 8. Place. 10. a tubular device through which the patient breathes; effectively continued during respiration through at least one phase of the exhalation/inhalation cycle a variable operable to generate an electrical signal indicative of breath sounds from the patient in an embodiment; means including a converter and connected to said generating means and capable of generating up to at least 5 KHz. said signal to indicate the frequency components of said signal over a range and the relative strengths of said components; means operable to perform a spectral analysis of the signal; a visible display of said component connected to said analysis means, the coordinates of said component being respectively indicating frequency and time, and another parameter being variable to indicate said intensity. means operable to provide a display in the form of a two-dimensional array of A respiratory diagnostic device comprising: