JPH06205761A - Total evaluation for ventilation/gas exchange function, three-dimensional display method, and device - Google Patents

Abstract

PURPOSE:To start the correct diagnosis and health care by three-dimensionally displaying the flow air quantity curve of expiration, CO2 pulmonary diffusing capacity, and alveolar air quantity on the rectangular coordinate system. CONSTITUTION:The three-dimensional rectangular coordinate system is constituted of multiple two-dimensional coordinate planes D1, D2, D3, D4 in time series based on the downward curue (postmaximum) of the flow air quantity curve of expiration and the vertical axis 37 perpendicular to the two-dimensional coordinate planes. The alveolar air quantity VA' is obtained from the CO2 pulmonary diffusing dovnward curve (postmaximum) the dilution of He. DLCO'/VA' or DLCO/VA indicating the gas exchange function is displayed on the vertical axis 37. The quadratic equation y=a0+a1x+a2x<2> is applied to the downward curve of each flow air quantity curve for display on the three-dimensional rectangular coordinate system constituted of DLOC'/VA' or DLOC/VA with the coefficient a1 of the primary term and the coefficient a2 of the secondary term. The first line corresponding to the upward or dowrward protruded bent shape of the dounrard curre and the second line corresponding to the double irregular bent shape of the downward curve are displayed on the two-dimensional coordinate planes of a1 and a2. Positions of a1 and a2 on the two-dimensional coordinate planes are compared with the first and second lines to evaluate the ventilation capability.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a comprehensive evaluation and three-dimensional display method and apparatus for ventilation / gas exchange functions.

[0002]

2. Description of the Related Art Heretofore, no method and device for stereoscopically displaying a ventilation function and a gas exchange function have been proposed.

In a typical prior art, the maximum flow volume curve of expiratory air, called the flow volume curve (abbreviated as ME).
FV) is calculated, the total volume is divided into four equal parts, and the flow rate at each volume is recorded.

[0004]

In such a prior art, it is impossible to quantitatively grasp the flow rate air volume curve particularly over the entire descending leg.

It would be convenient for physicians and patients to be able to see and assess lung ventilation and gas exchange functions at a glance.

The object of the present invention is to obtain a quantitative grasp over the entire descending limb of the flow volume curve to functionally obstruct the airway such as bronchial asthma and bronchitis, and obstruct the airway due to the destruction of the alveolar wall. The degree of airway obstruction resulting from emphysema, and the progress of restrictive ventilation disorders in the lungs, and the comprehensive gas exchange function by D _LCO measurement. It is an object of the present invention to provide a novel three-dimensional display method and device for a ventilation / gas exchange function, which makes it easy for a patient to grasp at first glance.

[0007]

According to the present invention, a flow volume curve of expiratory air of a subject is obtained in time series, and the same CO lung diffusion function D _LCO ′ or D _{LOC as} the inspection system of each flow volume curve is obtained. And V _A ′ from the dilution of the alveolar air volume V _A or He at that time, and D _LCO ′ / V _A ′ or D _LCO / V _A is calculated, and the quadratic curve of each flow volume curve is quadratic. Formula (y = a0 +
a1 · x + a2 · x ² ) and the coefficient a of the first-order term
1 and the coefficient a2 of the quadratic term, and further, the D _LCO ′
/ V _A ′ or D _LCO / V _A together with a three-dimensional Cartesian coordinate system consisting of the coefficient a1 of the first-order term, the coefficient a2 of the second-order term, and the value D _LCO ′ / V _A ′ or D _LCO / V _A. In the two-dimensional coordinate plane of the coefficient a1 of the first-order term and the coefficient a2 of the second-order term, the first line corresponding to the bent shape of the convex or downward convex of the descending leg and the double line of the descending leg. The second line corresponding to the bent shape of the unevenness is expressed, and the position of the coefficient of the first order term and the coefficient of the second order term on the two-dimensional coordinate plane is
And the second line, the ventilation capacity is evaluated, and the ventilation / gas exchange function is comprehensively evaluated by comparing the gas exchange capacity according to the value D _LCO ′ / V _A ′ or D _LCO / V _A. It is a comprehensive evaluation and three-dimensional display method of ventilation and gas exchange functions, which is characterized by the following.

Further, the present invention stores the descending leg of the flow volume curve of the expiratory air of the subject, and has the same CO lung diffusion function D _LCO ′ or D _LCO and the lung at that time as the inspection system of each flow volume curve. V _A ′ is obtained from the dilution of the cell volume V _A or He, and a memory for calculating and storing the value D _LCO ′ / V _A ′ or D _LCO / V _A and a descending leg stored in the memory are read, The descending leg is applied to a quadratic equation to derive the coefficient a1 of the first-order term and the coefficient a2 of the second-order term, and the value D
Operation means for reading and deriving _LCO '/ _VA ' or _DLCO / _VA , coefficient a1 of the first-order term and coefficient a2 of the second-order term
And said value D _LCO ′ / V _A ′ or D _LCO / V _A 3
A three-dimensional display device having a ventilation / gas exchange function, characterized in that the three-dimensional Cartesian coordinate system includes display means for displaying each coordinate position.

Further, according to the present invention, a quadratic equation (y = a0 + a1.x) is added to each descending leg of each of the plurality of flow volume curves of the expiratory air of the subject.
+ A2 · x ² ) and the coefficient a1 of the first-order term and the coefficient a2 of the second-order term are used, and the CO lung diffusion function D _LCO ′ or D _LCO and the same as the inspection system of each flow volume curve are used. The value of D _LCO ′ / V _A ′ or D _LCO / V _A is calculated by _obtaining V _A ′ from the dilution of the alveolar air volume V _A or He, and the coefficient a1 of the first-order term and the coefficient a2 of the second-order term are calculated. The value D
Ventilation characterized by displaying each coordinate position on a three-dimensional Cartesian coordinate system consisting of _LCO '/ _VA ' or _DLCO / _VA
It is a three-dimensional display device with a gas exchange function.

The present invention also provides a pipe held in the mouth of a subject, a mixed gas source for supplying a mixed gas containing CO, He, O ₂ and N ₂ , a flow meter, and a mixed gas source or flow meter for the pipe. A first switching valve for switching and connecting a bag, a bag, a second switching valve for venting exhaled air through the first switching valve and a flow meter to the atmosphere, or for guiding to the bag, and detecting respective concentrations of CO and He in the bag For controlling the first switching valve, and for controlling the second switching valve in response to the output of the flow meter, and in response to the outputs of the flow meter and each of the concentration detecting means, the descending limb of the flow air amount curve, a quadratic equation (y = a0 + a1 · x + a2 · x 2) using a first coefficient of order terms a1 and the second coefficient of order term a2 by applying a and CO pulmonary diffusing capacity D _LCO 'or D _LCO and alveolar air volume V _{A at} that time
Or V _A ′ is obtained from the dilution of He and the value D _LCO ′ /
V _A ′ or D _LCO / V _A ′ and D _LCO ′ / V _A ′ or D in response to the output of the calculation unit and the first order term coefficient a1 and the second order term coefficient a2 _LCO / _VA
A three-dimensional display device having a ventilation / gas exchange function, which includes a display means for displaying each coordinate position in a three-dimensional orthogonal coordinate system consisting of.

[0011]

According to the present invention, the maximum flow volume curve of the expiratory air of the subject is obtained, and the descending leg thereof is stored in the memory,
The descending leg stored in this memory is applied to a quadratic equation, and the coefficient of the primary term and the coefficient of the quadratic term of the quadratic equation are calculated. The coefficient of the first-order term and the coefficient of the second-order term correspond to the degree of bending of the descending leg of the flow volume curve. Therefore, it is possible to evaluate airway obstruction and lung restraint based on each of these coefficients.

According to the present invention, the CO lung in the same inspection system as the inspection system of each flow volume curve is perpendicular to the two-dimensional coordinate plane of the coefficient a1 of the first order term and the coefficient a2 of the second order term. _A value D obtained by _{calculating the} diffusion capacity D _LCO ′ or D _LCO and V _A ′ from the dilution of the alveolar air volume V _A or He at that time
_LCO '/ _VA ' or _DLCO / _VA is calculated and obtained, and this value is displayed on the other axis and displayed in the three-dimensional Cartesian coordinate system. By displaying each coordinate position on such a three-dimensional orthogonal coordinate system, the doctor and the patient can easily understand and evaluate the ventilation function and gas exchange function of the lungs at first glance. For physicians, it is possible to provide appropriate diagnosis and health guidance for the patient, for example, if the patient should stop smoking, or if he smokes a lot but eats a lot of vegetables. Since the function or the gas exchange function does not deteriorate, it becomes possible to provide detailed health guidance for such patients individually.

For a patient, even without medical knowledge, he / she can understand and understand the ventilation function and gas exchange function of the lung of the patient himself / herself, and contribute to the improvement of the active and proactive way of life. You can

According to the present invention, the coefficient of the first-order term and the coefficient of the second-order term obtained by the calculation are 2 on the display surface forming a two-dimensional coordinate plane with the coefficient of the second-order term on the horizontal axis and the coefficient of the first-order term on the vertical axis. The coordinate position consisting of the coefficient of the next term is displayed, and on this display surface, the first line corresponding to the curved shape of the convex or downward convex of the descending leg and the bent shape of the double concave and convex of the descending leg are displayed. , That is, the second corresponding to the shape that can be called double concave
By displaying the above line, it becomes easy to evaluate the airway obstruction and the like based on the coefficient of the first-order term and the coefficient of the second-order term obtained by the calculation. The first, second and fourth lines may be straight lines.

Further, according to the present invention, the transition state to emphysema can be judged by displaying the third line emphysema-like on the display surface. Furthermore, the fourth line at the time of an asthma attack can be displayed on the display surface to evaluate the degree of the asthma attack.

According to the experiments conducted by the inventor of the present invention, the descending leg of the flow volume curve is applied to the quadratic equation as described above to obtain the respective coefficients of the first-order term and the second-order term. It was confirmed that it is possible to fully understand the degree of bending. In order to improve the fitting accuracy of the multi-order equation for the descending leg of the flow volume curve, a regression equation of cubic or higher order, for example, 6th to 10th is applied, and the coefficient of each term is evaluated to obtain the descending leg. Although it is possible to grasp the degree of bending of the robot with higher accuracy, in practice, by applying the above-described quadratic equation to the descending leg, it is possible to achieve sufficient evaluation of airway obstruction, etc. Was confirmed.

The flow volume curve may be obtained by measuring the expiratory air of the subject over time, or alternatively, the flow volume curve previously measured and recorded and displayed on a recording paper or the like is optically measured. It may be read by a physical means and at least the descending leg thereof may be stored in the memory to perform the calculation.

Further in accordance with the present invention, CO, He, O ₂
A mixed gas source containing N and N ₂ , a flow meter, and first and second
A device equipped with a switching valve and a bag is used to determine the flow volume curve of the subject's exhaled air and at the same time the value D _LCO ′ / V _A ′.
_{Alternatively,} it becomes possible to simultaneously obtain the data required to calculate D _LCO / V _A , eliminating the time lag between each measurement, enabling accurate measurement with the same inspection system, and improving accuracy. You will be able to plan.

[0019]

1 is a front view of a display surface according to an embodiment of the present invention. A plurality of time-series two-dimensional coordinate planes D1, D2, D3, ..., Di and their two-dimensional coordinates based on the descending leg of the exhalation flow volume curve of the subject whose lung function is to be examined A vertical axis 37 perpendicular to the plane constitutes a three-dimensional orthogonal coordinate system. The vertical axis 37 indicates D _LCO ′ / V _A ′ or D _LCO / V _A, which will be described later, which represents the gas exchange function. With such a three-dimensional stereoscopic display, the ventilation function and the gas exchange function of the lungs can be accurately and easily associated and grasped and evaluated. Like this 3
The line represented in the dimensional Cartesian coordinate system is designated by the reference numeral 38 in FIG.

FIG. 2 shows the two-dimensional coordinate planes D1 to D1 in FIG.
2 shows a two-dimensional coordinate plane of one of Di. The measurement of the maximum expiratory flow rate / volume curve of, for example, the standing position of the subject is performed by sampling the flow rate for each 10 mL of volume. The liter may be represented by the symbol L. From the maximum flow rate PEFR to the residual volume RV at the maximum expiratory position, depending on the line 1 in which the descending leg is convex upward, the line 2 in downward convex, the straight line 3 and the line 4 of the double concave with double unevenness. For the first time, the present invention enables quantitative evaluation of the descending limb.

According to the present invention, the lines 1 to 4 of the descending leg are fitted to a quadratic equation, and the coefficient a1 of the primary term of the quadratic equation is used.
And the coefficient a2 of the quadratic term are represented as coordinate positions on the display surface of FIG. Although the constant term of the quadratic equation is also obtained at the same time, the constant term is originally considered to be 0 and is not used in the present invention.

On the display surface of FIG. 2, the horizontal axis (ie X
(Axis) represents the coefficient a2 of the quadratic term, and the vertical axis (that is, the Y axis)
Represents the coefficient a1 of the first-order term, and the coordinates (a2, a1 ) Represents the coordinate position. 1 on such a two-dimensional coordinate plane
Based on the coordinate position composed of the coefficient a1 of the next term and the coefficient a2 of the second term, it is possible to quantitatively evaluate the airway obstruction. On the display surface shown in FIG. 2, a line 5 that is a first straight line corresponding to a bent shape that is convex upward or downward downward is drawn. A line 1 in which the descending leg of FIG. 3 is convex upward is a region 18 shown by hatching in FIG.
The 1-second rate, which is an index of airway obstruction, was 9
It shows a high value exceeding about 5%. Therefore, it cannot be evaluated at the rate of 1 second. The coordinate position is in the region 19 when the restraint of the lung is developing. This line 5 corresponds to the lines 1 and 2 of the descending leg in FIG. 3 described above.

Line 3 in FIG. 3 is a straight line, which corresponds to the vertical axis in FIG. 2 and the coefficient a2 of the quadratic term is zero. As described above, the line 4 in FIG. 3 has a bent shape with double unevenness, and corresponds to the line 6 which is the second straight line in FIG. The subject whose coordinate position is on the line 6 is often a nasal allergy patient. A healthy person who does not smoke is in the area indicated by reference numeral 7. A healthy person who is a smoker is in the area indicated by reference numeral 8. Furthermore, in the area indicated by reference numeral 9, measures need to be taken for recovery of lung function, eg smoking should be reduced when position 9a is applied and position 9b is applied. Occasionally, he will give instructions on health guidance regarding nutrition and exercise.

Thus, a straight line 1 passing through the origin is displayed on the display surface.
By drawing 0, 11, 12 each area 7, 8, 9
Can be easily determined. That is, in the present invention, it is possible to make a quantitative evaluation in consideration of the ventilation mechanical characteristics of the lung as compared with the evaluation of the 1-second rate.

A line 13 which is a third straight line similar to emphysema is further drawn on the display surface. As the destruction of the alveolar wall progresses, the coordinate position moves as indicated by the arrow 15 on the line 14, and it can be seen that the emphysema is completed near the line 13.

Further, a line 16 which is a fourth straight line during a bronchial asthma attack is drawn. As the seizure progresses, the coordinate position moves as indicated by arrow 17.

In this way, the flow volume curve shown in FIG. 3 is obtained, and a quadratic equation is applied to the lines 1 to 4 of the descending leg to obtain the coefficient a1 of the primary term and the coefficient a2 of the quadratic term.
By displaying it on the display surface of the two-dimensional coordinate plane shown in FIG. 2, it becomes possible to quantitatively evaluate the airway obstruction.

FIG. 4 shows the values obtained by _obtaining CO lung diffusion capacity D _LCO ′ or D _LCO as an index of the gas exchange function of the lung and V _A ′ from the dilution of the alveolar air volume V _A or He at that time. D
It is a figure for _{demonstrating} the method for calculating _| requiring _LCO '/ _VA ' or _DLCO / _VA .

The CO lung diffusion capacity D _LCO ′ or D _LCO is measured by a single breath method, which is also called a breath holting method. The subject inhales the mixed gas all at once from the maximum expiratory position RV to the maximum inspiratory position TLC, and stops breathing for exactly 10 seconds from the beginning of inspiration at this position. Thereafter, the maximum exhalation is rapidly performed, the first 750 mL is discarded, and the remaining exhaled gas is collected in the sample bag 39 (see FIG. 5 below) for gas analysis. The mixed gas is 0.3% CO, 10% H
e, a mixed gas of 20% O ₂ and 70% N ₂ .

Since CO is taken in the lungs, F _ACO decreases with time, but He is not taken in the lungs, so it does not change with time. If the calling He concentration is F _AHe , t = 0
F _ACO (0) in is _{calculated as} F _ACO (0) = F _ICO · F _AHe / F _IHe (1) By definition, D _LCO = V ″ _CO / P _ACO (2). V ″ _CO is the first derivative of V _CO . Substituting V ″ _CO = −dV _CO (t) / dt P _ACO = P _ACO (t) (3) into this equation, dV _CO (t) / dt = −D _LCO · P _ACO (t) (4) Here, since V _CO (t) = F _ACO (t) · V _A (t) (5), dV _CO (t) / dt = F _ACO (t) · dV _A (t ) / Dt + V _A (t) · dF _ACO (t) / dt (6), and if V _A (t) = constant (7), then dV _A (t) / dt = 0 (8) Therefore, dV _CO (t) / dt = _VA · dF _ACO (t) / dt (9) Also, P _ACO (t) = (P _B −47) F _ACO (t)… (10) Substituting into the above equation

[0031]

[Equation 1]

This is the Krogh equation. If t is seconds,

[0033]

[Equation 2]

Substituting the above equation (1) into FACO (0),

[0035]

[Equation 3]

The unit of V _A is mlSTPD, and when t = 10 seconds, D _LCO (ml · min ⁻¹ · torr ⁻¹ ) can be calculated.

Although D _LCO is calculated by the equation (13), there are two methods for _obtaining V _A. The first Determination is, D intake air amount at the time of _LCO measuring residual capacity measured in advance in (V _I) (RV)
Is added to obtain the alveolar volume (V _A ). Since inhalation is normally performed from the RV position to the TLC position, V _I has a value substantially equal to inspiratory vital capacity and V _A has a value substantially equal to total lung capacity (TLC). The second method is to measure V _A by the following formula from the dilution of He when measuring D _LCO . In this case, in order to distinguish it from the normal V _A , it is generally expressed as V _A ′.

The _{relationship of} F _IHe (V _I −V _D ) = F _AHe · V _A ′ (14) is established. From this, the _{V A '= F IHe (V} I -V D) / F AHe ... (15). In this case, V _D is extremely smaller than V _I , so that V _I −V _D ≈V _I (16)

[0039] determine the 'V _A in _{= V I · F IHe / F} AHe ... (17)' V A. When _V'is substituted for V _A in the equation (13), it is distinguished from normal D _LCO as D _LCO ′.

FIG. 5 is an overall system diagram of one embodiment of the present invention. In order to make a simultaneous measurement of the ventilation function and the gas exchange function of the subject, and thus in the same test system,
The subject holds the tube 21 in his mouth. The mixed gas is supplied from the mixed gas source 40 to the first switching valve 41. A flow meter 22 for measuring the flow rate of the exhaled air is connected to the first switching valve 41, and the output of the flow meter 22 is given to the processing circuit 23.
The flow rate and the air volume are sampled and read over time. The exhalation from the flow meter 22 is transmitted from the conduit 42 to the second
Guided to the switching valve 43, the second switching valve 43 dissipates the exhaled air from the conduit 42 to the atmosphere from the conduit 44 or to the flexible sampling bag 39 via the conduit 45. The use concentration of the expired air in the bag 39 is detected by the use concentration detecting means 46, and the concentration of He is detected by the He concentration detecting means 47, and the outputs of the respective concentration detecting means 46, 47 are given to the processing circuit 23. To be

FIG. 6 is a flow chart for explaining the operation of the processing circuit 23 shown in FIG. Step n
1 to step n2, the first switching valve 41 is switched from the first position 41a to the second position 41b, and the subject
In the state of being held in the mouth, the mixed gas from the mixed gas source 40 is sucked all at once from the maximum expiratory position RV to the maximum supply level TLC, and the breathing is stopped at this position for exactly 10 seconds from the beginning of the supply. Next, in step n3, the first switching valve 41 is switched to the first position 41a, at which time the second switching valve 43 is set to the first position 43a, and the maximum switching is rapidly performed. At this time, in step n4, the passage of time of the flow rate of the exhalation by the flow meter 22 is measured and stored in the memory 24.
In step n5, 750 mL of the exhaled breath is measured, and the 750 mL portion of the exhaled air is emitted to the atmosphere from the first position 43a of the second switching valve 43 via the pipe line 44. In the next step n6, the second switching valve 43 is moved to the second position 43b.
In step n7, 1000 mL of the remaining exhaled gas is stored in the bag 39 via the pipe 45, and at that time also, in step n8, the measured value of the flow meter 22 is measured with time and stored. Store at 24. At step n9, at step n7 1000
After the measurement of mL, the first position 43a is switched to allow the remaining exhaled air to diffuse into the atmosphere, and at this time, the flow meter 22
The measured value of is stored in the memory 24 from the processing circuit 23. In this way, the volume and the flow rate are stored in the memory 24 in association with each other.

The processing circuit 23 is provided with a visual display means 25 using a cathode ray tube or a liquid crystal display element, and the display surface 26 thereof can display the above-mentioned FIGS. Further, when the flow amount curve already measured is drawn on the recording paper 27, the recording paper 27 is supplied to the reading means 28 for optically reading and the flow amount air recorded on the recording paper 27 is supplied. It is also possible to read the quantity curve and store it in the memory 24.

The processing circuit 23 detects the peak position of the descending leg of the flow volume curve stored in the memory 24 in step n10, and obtains the maximum flow rate PEFR at that time and the air volume V1 at that time. At step n11, relative volume or absolute volume is selected for the volume of the flow volume curve. The relative volume R is shown in Equation 18.

R = VCX / VC1 (18) Here, VC1 is the volume from the volume V1 at the peak of the descending leg to the maximum expiratory position (RV position) in FIG. 7, VC1 = VC-V1 ... (19) VCX is those points A (PEFR position), B (RV position)
The amount of energy going back from the RV position during the period is shown. Therefore, the above-mentioned relative volume represents the degree of volume when the volume VC1 at the time of the descending leg is set to 1.0 and the RV position is set to zero. By adopting such relative volume, it is possible to relatively evaluate the descending limb among many subjects. The absolute volume is a volume specific to each subject, and an evaluation for each subject can be performed by performing a calculation based on the absolute volume.

After the combination of the relative air volume R and the flow rate corresponding thereto is obtained in this way, a quadratic equation is fitted from the obtained relative air volume and the flow rate in step n12. This quadratic equation is given by the following equation 20.

[0046] The y In y = a0 + a1 · x + a2 · x 2 ... (20) equation 20 is a flow x is the relative air amount R.
a0 is a constant.

At step n13, the value obtained as a result of calculating the coefficient a1 of the first-order term and the coefficient a2 of the second-order term of the quadratic equation fitted to the descending leg is adopted, and at the next step n14, it is shown in FIG. Coordinate position on display surface (a2, a1)
Is displayed. When the absolute volume is selected in step n11, x in Expression 20 is set to the absolute volume.

FIG. 8 shows a display screen by the display means 25. Reference numeral 29 indicates the steps n12 and n1 described above.
3 is the coordinate position of the coefficients a1 and a2 obtained in 3.

FIG. 9 shows another form of the display surface displayed by the display means 25. On the display surface of the display means 25, the flow volume curve 30 of each subject and the quadratic equation 31 fitted to it are displayed.

At step n14, the values D _LCO ′ / V _A ′ and D _LCO / V _A are calculated and obtained, and at step n15,
A three-dimensional display as shown in FIG. 1 is performed. In this way, by measuring the ventilation function and the gas exchange function in time series using FIG. 5, three-dimensional display can be performed as shown in FIG. The three-dimensional display shown in FIG. 1 is achieved by the display means 25.

Referring to FIG. 5, the value D is plotted on the vertical axis 37.
_LCO '/ _VA ' or _DLCO / _VA can take values from 0 to 10 and these ranges define, for example, a total of five ranges W1 to W5. The range W1 where the value is large is the safe period of the airway system function, the next range W2 is the period of airway system function change, and the range W3 below that is the transition period to emphysema. The range W4 further below is the stage of emphysema formation, and the last range W5 is the stage of completion of emphysema. Each of such ranges W1 to W5 is 2 as shown in FIG.
It substantially corresponds to the range of reference marks W11 to W15 on the dimensional coordinate plane. In FIG. 2, for example, the range W11 to the intersection point with the line 12 on the line 5 is the safe period.
The range W2 along the line 48 from the line 12 to the horizontal axis which is the coefficient a2 of the quadratic term is the period of functional change in the airway system of emphysema, and the horizontal axis of the coefficient a2 and the line 16
A shaded region W13 surrounded by the lines 48 and 14 is a transitional period to emphysema. Further, a shaded area W14 surrounded by the lines 16, 13, 13, and 48 indicates the completion stage of emphysema, and the subsequent range W15 on the line 13 is
Represents the stage of completion of emphysema. Therefore, by looking at such a three-dimensional line 38 drawn by the respective two-dimensional coordinate planes D1 to Di and the vertical axis 37 in FIG. 1, it is possible to easily grasp the situation of emphysema, for example. For example, ranges W1, W2; W11, in FIG. 1 and FIG.
In W12, the ventilation capacity changes almost linearly, and the deterioration of the gas exchange capacity does not intensify.

In pulmonary emphysema, although the effective vascular bed due to alveolar destruction decreases and D _LCO ′ decreases, in bronchial asthma,
Since the alveoli are not destroyed, D _LCO ′ is not lowered. According to an experiment conducted by the present inventor, for example, a person aged 53 years old who has smoked 20 to 25 cigarettes every day for 15 years up to the age of 40 years, stopped smoking at the age of 40 years, and 13 years have passed since then, is shown in FIG. At the coordinate position indicated by reference numeral 51. Also, the 40-year-old who has continued to smoke for 22 years from the age of 18,
It is at the coordinate position indicated by reference numeral 52 in FIG. Alternatively, for example, a 40 year old who has been smoking for 22 years is at coordinate position 53. The above-mentioned 53-year-old person had the flow volume curve shown by the line 2 in FIG. 3 before stopping smoking, and the curve became the curve shown by the line 54 in FIG. 3, and the ventilation function was improved. I understand. At this time, the one second amount and the vital capacity FVC increase, and the one second rate increases.

FIG. 10 is a perspective view of a three-dimensional display device 55 having a ventilation / gas exchange function according to another embodiment of the present invention. The support column 56 having the axis line along the vertical axis 37 described above in connection with FIG. 1 extends vertically, and a rigid seat D1 is provided at an intermediate position thereof.
2, D12, D13, ... D1j are fixed, and the respective coefficients a1 and a2 are shown in the respective sheets D11 to D1j.
The two-dimensional coordinate plane of is displayed. Thus, the support column 56 and the sheets D11 to D1j constitute the three-dimensional orthogonal coordinate system shown in FIG. A flexible string or a plastically deformable cord 57 is attached through these sheets D11 to D1j penetrating them. Such a display device 5
5 and using the display device 55 shown in FIG. 10, it is easy for the doctor and the patient to grasp and evaluate the ventilation function and the gas exchange function of the lungs at a glance, and Axial direction of the column 56 (vertical direction in FIG. 10)
It is also possible to grasp the transitional state along with time.

[0054]

As described above, according to the present invention, a flow volume curve of expiratory air of a subject is obtained, and CO lung diffusion capacity D _LCO ′ or D _{LCO of the} same examination system and the alveolar air volume at that time are obtained. Finding V _A ′ from the dilution of V _A or He,
Since the value D _LCO ′ / V _A ′ or D _LCO / V _A is calculated and the three-dimensional display is performed on the Cartesian coordinate system in this way, accurate diagnosis and health guidance by the doctor are possible, and for the patient. Even if they do not have medical knowledge, they will be able to grasp the condition of the patient himself and help the health guidance such as improving the way of life.

[Brief description of drawings]

FIG. 1 is a perspective view showing a display state by a display means 25 according to an embodiment of the present invention.

FIG. 2 is a front view of a display surface forming a two-dimensional coordinate surface according to an embodiment of the present invention.

FIG. 3 is a diagram showing a flow volume curve of expiratory air of a subject.

FIG. 4 is a diagram for explaining a single breathing method.

FIG. 5 is a system diagram showing an overall configuration of an embodiment of the present invention.

6 is a flowchart for explaining the operation of the processing circuit 23 shown in FIG.

FIG. 7 is a diagram showing a flow volume curve for explaining relative air volume.

8 is a diagram showing a screen displayed on the display surface 26 of the display means 25. FIG.

9 is a diagram showing a display image displayed on the display surface 26 of the display means 25. FIG.

FIG. 10 is a perspective view of a display device 55 according to another embodiment of the present invention.

[Explanation of symbols]

 21 pipe 22 flow rate system 23 processing circuit 24 memory 25 display means 26 display surface 37 vertical axis 39 bag 40 mixed gas source 41 first switching valve 43 second switching valve 46 CO concentration detecting means 47 He concentration detecting means 55 display device

Claims (4)

[Claims] 1. A CO2 diffusion function D _LCO ′ or D _LOC that is the same as the examination system of each flow volume curve and the alveolar volume V at that time are obtained while obtaining the flow volume curve of the expiratory air of the subject. V _A ′ is obtained from the dilution of _A or He and D _LCO ′ /
V _A ′ or D _LCO / V _A is calculated, and the quadratic expression (y = a0 + a1 ·
x + a2 · x ² ) and apply the coefficients a1 and 2 of the first-order term
Using the coefficient a2 of the next term, further, together with the D _LCO ′ / V _A ′ or the D _LCO / V _A , the coefficient a1 of the first order term, the coefficient a2 of the second order term, and the value D _LCO ′ / V _A ′ or It is expressed in a three-dimensional Cartesian coordinate system consisting of D _LCO / V _A , and on the two-dimensional coordinate plane of the coefficient a1 of the first-order term and the coefficient a2 of the second-order term, a bent shape that is convex above or below the descending leg. And the second line corresponding to the bent shape of the double concave and convex of the descending leg, and the position of the coefficient of the primary term and the coefficient of the quadratic term on the two-dimensional coordinate plane is Ventilation capacity is evaluated in comparison with the 1st and 2nd lines, and the ventilation / gas exchange function is comprehensively evaluated while comparing the gas exchange capacity according to the above-mentioned value D _LCO ′ / V _A ′ or D _LCO / V _A. Comprehensive evaluation and three-dimensional of ventilation and gas exchange functions characterized by Display method. 2. The CO pulmonary diffusion function D _LCO ′ or D _LCO and the alveolar volume V at that time, which store the descending leg of the expiratory flow volume curve of the subject and are the same as the examination system of each flow volume curve. _A memory for calculating V _A ′ from the dilution of _A or He and calculating and storing the value D _LCO ′ / V _A ′ or D _LCO / V _A , and the descending leg stored in the memory are read out and the descending leg is read. To a quadratic equation to derive the coefficient a1 of the first-order term and the coefficient a2 of the quadratic term, and to read out and derive the value D _LCO ′ / V _A ′ or D _LCO / V _A ; _A display means for displaying each coordinate position in a three-dimensional Cartesian coordinate system consisting of the coefficient a1 of the next term, the coefficient a2 of the quadratic term and the value D _LCO ′ / V _A ′ or D _LCO / V _A. A three-dimensional display device featuring ventilation and gas exchange functions. 3. A quadratic expression (y = a0 + a1 * x + a2 *) is added to each descending leg of each of the plurality of flow volume curves of the subject's exhalation.
x ² ), the coefficient a1 of the first-order term and the coefficient a2 of the second-order term are used, and the CO lung diffusion function D is the same as that of the inspection system of each flow volume curve.
_LCO 'or D _LCO and the alveolar volume _VA or He at that time
Of the first order term coefficient a1 and the second order term coefficient a2 and the value D _LCO ′ / V by calculating V _A ′ from the dilution of the above and calculating the value D _LCO ′ / V _A ′ or D _LCO / V _{A. A} three-dimensional display device with a ventilation / gas exchange function, in which each coordinate position is displayed on a three-dimensional orthogonal coordinate system consisting of _A'or D _LCO / V _A. 4. A pipe held in the mouth of a subject, a mixed gas source for supplying a mixed gas containing CO, He, O ₂ and N ₂ , a flow meter, and a mixed gas source or a flow meter switched to the pipe. The first switching valve to be connected, the bag, and the exhaled air through the first switching valve and the flow meter to the atmosphere,
Alternatively, the second switching valve for guiding to the bag, the concentration detecting means for detecting the respective concentrations of CO and He in the bag, the first switching valve, and the second switching valve in response to the output of the flow meter are controlled. Responsive to the outputs of the flow rate meter and the concentration detecting means, the quadratic equation (y = a0 + a1.x + a) is displayed on the descending leg of the flow volume curve.
2 · x ² ) and the coefficient a1 of the first-order term and the coefficient a2 of the second-order term are used, and the CO lung diffusion capacity D _LCO ′ or D
Calculating means for calculating from the dilution of the alveolar volume V _A or the He 'seeking the value D _LCO' V _A / V _A 'or D _LCO / V _A of _LCO and that time, in response to the output of the arithmetic means Then, the coefficient a1 of the first-order term, the coefficient a2 of the second-order term, and the value D _LCO ′ / V _A ′ or D
_A three-dimensional display device having a ventilation / gas exchange function, which comprises a display means for displaying each coordinate position in a three-dimensional orthogonal coordinate system composed of _LCO / _VA .