JPH09220204A - Automatic sphygmomanometer with electrocardiographic induction waveform detecting function - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a stable electrocardiographic induction waveform without mixing any noise generated by the strain of muscles of arm of a person to be measured by providing a 1st supporting stand for supporting one arm, which is protruded from a through hole, of the person to be measured and a 2nd supporting stand for supporting the other arm as a whole. SOLUTION: On a casing 10, a through hole 14 is provided for inserting a right arm 12 of the person to be measured and inside the casing, a belt 16 equipped with a cuff 15 on its inner peripheral surface is arranged while being held cylindrical. Besides, in the back direction of the through hole 14, a 1st arm rest 17 for supporting the right arm 12, which is protruded from the through hole 14, of the person to be measured is provided while being inclined upward and, at the top end part of that arm rest, a 1st electrode 18a is arranged for detecting the electrocardiographic induction waveform generated with the active potential of the myocardia of the person to be measured. Besides, on the left side face of the casing 10, a 2nd arm rest 19 for supporting a left arm 13 of the person to be measured is horizontally provided and, at the top end of the arm reset, a 2nd electrode 18b is similarly arranged.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an automatic blood pressure measuring device with an electrocardiographic induction waveform detecting function for detecting an electrocardiographic induction waveform generated according to an action potential of a myocardium of a subject.

[0002]

2. Description of the Related Art As an automatic blood pressure measurement device for measuring a blood pressure of a subject, for example, in the process of changing the compression pressure of a cuff wound around a part of a living body, the device is synchronized with a heartbeat of the cuff. There is known an automatic blood pressure measurement device that detects a generated pulse wave and determines a blood pressure value of a living body by a well-known oscillometric method based on a change in the amplitude of the pulse wave. For example, this is the automatic blood pressure measurement device described in Japanese Patent Application Laid-Open No. 6-292660.

By the way, in addition to the above automatic blood pressure measuring device, a first electrode for detecting an electrocardiographically induced waveform is provided, and a first support for supporting one arm of the subject projected from the cuff. A stand and a second electrode for detecting an electrocardiographic waveform,
By providing the second support for supporting the other arm of the measurement subject, for example, an artery of a living body based on an electrocardiographically induced waveform detected from both arms of the measurement subject at the same time as the blood pressure measurement. An automatic blood pressure measuring device with an electrocardiographically induced waveform detection function capable of measuring the propagation velocity of a pulse wave propagating inside has been considered.

[0004]

However, in such an automatic blood pressure measuring device with an electrocardiographically induced waveform detection function, an excess is added to the muscles of the arm of the subject who is supported by the first support base and the second support base. When force is applied and tension occurs, noise due to myoelectric potential occurs and it becomes difficult to detect a stable electrocardiographically induced waveform.For example, based on the electrocardiographically induced waveform, the pulse wave propagating in the artery of the living body is detected. When the propagation velocity is measured, the measurement accuracy will be significantly reduced.

The present invention has been made in view of the above circumstances, and an object of the present invention is to eliminate the mixing of noise caused by the strain of the arm muscles of the subject,
An object of the present invention is to provide an automatic blood pressure measurement device with an electrocardiographic induction waveform detection function capable of detecting a stable electrocardiographic induction waveform.

[0006]

The gist of the present invention for achieving the above-mentioned object is to provide an automatic through hole having a cuff for pressing the upper arm of the subject at the time of blood pressure measurement. In the blood pressure measurement device, (a) a longitudinal support surface for supporting one arm of the measurement subject protruding from the through hole from the elbow to the tip of the arm is provided. A first support table provided on the back side of the through hole and provided with a first electrode on the support surface for detecting an electrocardiographically induced waveform generated with the action potential of the myocardium of the measurement subject;
(B) The other arm of the person to be measured is provided on the side opposite to the through hole having a longitudinal support surface for supporting the entire arm from the elbow to the tip of the arm, and supports the same. And a second support base having a second electrode for detecting an electrocardiographically induced waveform generated along with the action potential of the myocardium of the subject on the surface.

[0007]

According to this structure, since the first support base and the second support base support the entire space between the elbows of both arms of the subject and the tip of the arm, the elbows and arms can be supported. Since the muscles up to the tip of the body are constantly kept in a relaxed state, the muscles of the arm of the person to be measured, to which the electrodes for electrocardiographic induction waveform detection are brought into contact, do not get tense due to excessive force. , It is possible to detect a stable electrocardiographically induced waveform because noise caused by myoelectric potential is less likely to occur.
For example, when the propagation velocity of the pulse wave propagating in the artery of the living body is measured based on the electrocardiographically induced waveform, the measurement accuracy can be kept good.

[0008]

Further preferably, in addition to the constituent features of the present invention, the first electrode is provided at the tip of the first support base.
The second electrodes are respectively provided at the tip of the second support base. By doing so, when the arm is brought into contact with the electrode, as a result, the entire area from the elbow to the tip of the arm is supported over the entire support surface of the support base. , It is possible to detect a stable electrocardiographically induced waveform because it is possible to prevent the noise caused by the myoelectric potential from being generated easily because the muscles of the arm do not get tense due to excessive force. When the propagation velocity of the pulse wave propagating in the artery of the living body is measured based on the electrocardiographically induced waveform, the measurement accuracy can be kept good.

Further, preferably, in addition to the constituent features of the present invention, the first support base and the second support base have a longitudinal concave curved surface-shaped support surface that is recessed from both widthwise end portions to the widthwise center portion. It is characterized by having respectively. By doing so, the arms of the person to be measured can be connected to the first support base and the second support base.
The support surface is flat because it is fixed to the widthwise central portions of the first support base and the second support base along the longitudinal concave curved surface that gently descends and descends from the widthwise both ends of the support base to the widthwise central portion. If it is a shape like, the extra force in the left-right direction that is needed to fix the arm to the electrode will not be applied and the muscles of the arm will not be tense, and the noise caused by myoelectricity will be less likely to occur. Since it becomes possible to detect a more stable electrocardiographically induced waveform, for example, when the propagation velocity of the pulse wave propagating in the artery of the living body is measured based on the electrocardiographically induced waveform, the measurement accuracy can be improved. You can keep good.

[0010]

DETAILED DESCRIPTION OF THE INVENTION An embodiment of the present invention will be described in detail below with reference to the drawings. FIG. 1 is a perspective view showing an automatic blood pressure measurement device 8 with an electrocardiographic waveform detection function.

In FIG. 1, a box 10 is provided with a through hole 14 into which a right arm 12 of a subject is inserted. In the through hole 14, a bag-shaped flexible cloth and a rubber bag are provided. A belt 16 which is provided with a cuff 15 formed on the inner peripheral surface thereof and held in a cylindrical shape is provided. Further, a first armrest 17 for supporting the right arm 12 of the measurement subject protruding from the through hole 14 is provided in the rear surface direction of the through hole 14 so as to be inclined upward, and the tip of the first armrest 17 is provided. the parts, in order to detect the ECG waveform generated in association with the action potential of the cardiac muscle of a subject, arranged such that the first electrode 18 _a is good contact to the wrist of the right arm 12 of the subject Has been done. The first armrest 17 is the first
Corresponding to the support base, this first armrest 17
From the elbow to the wrist such that the muscles from the elbow of the right arm 12 of the subject to the wrist are constantly kept relaxed so that a stable electrocardiographic waveform can be detected from the wrist of the subject. The support surface is provided with a gentle elongated concave curved surface that is recessed from both ends in the width direction to the center in the width direction for supporting the entire space.

A second armrest 19 for supporting the left arm 13 of the person to be measured is horizontally provided on the left side surface of the box body 10, and the tip of the second armrest 19 has the same shape. In order to detect the electrocardiographic induction waveform of the measurement subject, the second electrode _18b is arranged so as to be in good contact with the wrist of the measurement subject's left arm 13. The second armrest 19 corresponds to the second support table, and like the first armrest 17, the muscles of the left arm 13 of the measurement subject from the elbow to the wrist are constantly on the same side. It is provided with a support surface in the form of a long concave curved surface that is recessed from both ends in the width direction to the center in the width direction for supporting the entire area from the elbow to the wrist so as to be kept in a relaxed state. An operation switch 20, a stop switch 24, a printer 26, a card insertion slot 28, and the like are provided on an operation panel 20 of the box 10, and a systolic blood pressure indicator 32, a diastolic blood pressure indicator 34, a pulse Number display 36, time display 38
Are arranged respectively.

FIG. 2 is a block diagram for explaining a circuit configuration of the automatic blood pressure measuring device 8. In the figure, cuff 1
5 is connected to a pressure sensor 40, a switching valve 42, and an air pump 44 via a pipe 46.
2 includes three states: a pressure supply state in which the supply of pressure into the cuff 15 is allowed, a slow discharge state in which the cuff 15 is gradually discharged, and a rapid discharge state in which the cuff 15 is rapidly discharged. It is configured to be switchable. Further, the cuff 15 is provided on the inner peripheral surface, and the belt 16 is wound in a cylindrical shape.
Is fixed at one end and the other end is a DC motor 48 with a reduction gear.
It is configured to be tightened by the drum 50 driven by the. The pressure sensor 40 detects the pressure in the cuff 15 and supplies a pressure signal SP representing the pressure to the static pressure discrimination circuit 52 and the pulse wave discrimination circuit 54, respectively.

The static pressure discriminating circuit 52 includes a low-pass filter, discriminates a cuff pressure signal SK representing a steady pressure included in the pressure signal SP, ie, a cuff pressure, and converts the cuff pressure signal SK into an A / D converter 56. To the electronic control unit 58 via The pulse wave discrimination circuit 54 includes a band-pass filter, and a pulse wave signal S which is a vibration component of the pressure signal SP.
The pulse wave signal SM ₁ to discriminate the M ₁ in frequency A / D
The electric power is supplied to the electronic control device 58 via the converter 60. The cuff pulse wave represented by the pulse wave signal SM ₁ is a pressure vibration wave generated from an unshown brachial artery and transmitted to the cuff 15 in synchronization with the heartbeat of the subject, and includes the cuff 15 and the pressure sensor 4.
0 and the pulse wave discrimination circuit 54 function as a pulse wave sensor.

The electronic control unit 58 includes a CPU 62, R
The CPU 62 is configured by a so-called microcomputer including an OM 64, a RAM 66, and an I / O port (not shown). The CPU 62 processes an input signal according to a procedure stored in the ROM 64 in advance while using the temporary storage function of the RAM 66. To output drive signals and display signals. That is, at the time of blood pressure measurement, the CPU 62 drives the DC motor 48 with a speed reducer in accordance with a predetermined procedure to wind the cuff 15 around the upper arm of the living body, and the air pump 4
4, the upper arm is compressed by the cuff 15 and then the switching valve 42 is driven to gradually reduce the compression pressure of the cuff 15, and the pulse wave signal SM ₁ and the cuff pressure obtained in the slow down process. Based on the signal SK, a blood pressure value is determined by an oscillometric method, and the blood pressure value is displayed on the systolic blood pressure display 32 and the diastolic blood pressure display 34, and simultaneously stored in the blood pressure value storage area 69 of the storage device 68. The storage device 68 is a magnetic disk,
It is constituted by a well-known storage device such as a magnetic tape, a volatile semiconductor memory, or a nonvolatile semiconductor memory.

The electrocardiographic induction device 70 includes the right arm 12 of the subject.
Pair of electrodes 1 brought into contact with the wrist of the left arm 13 and the wrist of the left arm 13
The electrocardiographically induced waveform indicating the action potential of the myocardium, that is, the so-called electrocardiogram is continuously detected through 8, and the signal SH indicating the electrocardiographically induced waveform is supplied to the electronic control unit 58.

FIG. 3 is a flow chart for explaining the main part of the control operation of the electronic control unit 58. In step SA1 (the step is omitted hereinafter) in the figure, it is determined whether or not the magnetic card 74 is inserted into the card insertion slot 28 of the card reading device 72. If the determination in step SA1 is denied, this routine is ended. If the determination is affirmed, the magnetic card 74 is determined in SA2.
Is read.

At SA3, it is determined whether the read ID signal is registered in the storage area of the storage device 68 in advance. If the determination in SA3 is negative, that is, if the ID signal recorded in the magnetic card 74 is not registered, SA15 described below is executed and the magnetic card 74 is sent out from the card insertion port 28. However, when the determination in SA3 is affirmed, that is, when the magnetic card 7
If the ID signal recorded in No. 4 has already been registered,
In A4, it is determined whether the activation switch 22 for measuring blood pressure has been operated.

If the determination at SA4 is negative, the process is kept waiting until the determination becomes affirmative. However, if the determination in SA4 is affirmative, first in SA5, the switching valve 42 is switched to the pressure supply state and the air pump 44 is driven to set the cuff pressure P to the preset target cuff pressure P ₁ (for example, After the pressure is increased to about 180 mmHg), the air pump 44 is stopped. Then, at SA6,
When the switching valve 42 is switched to the slow exhaust pressure state, the slow pressure reduction in the cuff 15 is started.

Subsequently, in SA7, the pulse wave signal SM
₁ is read, and it is determined whether or not one pulse wave is detected. If this determination is negative, SA7 is repeatedly executed, but if the determination is positive, the blood pressure value determination routine of SA8 is executed. In this blood pressure value determination routine, the systolic blood pressure value S is determined according to the well-known oscillometric blood pressure value determination algorithm based on the change in the amplitude of the pulse wave that is sequentially detected in the process of gradually reducing the cuff pressure P.
BP ₁ , minimum blood pressure value DBP ₁ , and average blood pressure value MBP
_{While 1} is determined, the pulse rate HR ₁ is determined based on the pulse wave generation interval.

Next, in SA9, the maximum blood pressure value SBP
₁And the minimum blood pressure DBP₁Determine whether or not
Is done. If this judgment is denied, SA7 to SA
9 is repeatedly executed, but if this judgment is affirmed
In the following SA10, the systolic blood pressure measured above
Value SBP₁, Diastolic blood pressure DBP₁, Mean blood pressure value MB
P ₁, And pulse rate HR₁And the measurement date and time are stored in the storage device 68.
Is stored in the blood pressure value storage area 69 of each subject.
Maximum blood pressure indicator 32, minimum blood pressure indicator 34, pulse rate table
Each is displayed on the indicator 36.

Next, at SA11, as shown in FIG. 4, a time difference TD _RP from the R wave of the electrocardiographically induced waveform to the lower peak point of the cuff pulse wave is detected. Then, in SA12, the propagation velocity V _M1 of the cuff pulse wave is calculated based on the time difference TD _RP actually detected in Formula 11 stored in SA11. In Expression 1, L is a distance (m) from the left ventricle to the pressed portion of the pressure sensor 40 via the aorta, and T _{PE P} is a precursor from the R wave of the electrocardiographically induced waveform to the lower peak point of the cuff pulse wave. It is the departure time (sec).
As the distance L and the pre- _ejection time T _PEP , values experimentally obtained in advance are used.

[0023]

## EQU1 ## _VM1 = L / ( _TDRP - _TPEP )

Subsequently, in SA13, the switching valve 42 is switched to the rapid exhaust pressure state, so that the rapid exhaust pressure in the cuff 15 is started. Then, in the subsequent SA14, the systolic blood pressure value SBP _{1 and the} like are displayed and output on the recording paper by the printer 26. Then, by executing SA15, the magnetic card 74 is sent out from the card insertion slot 28.

As described above, according to the present embodiment, the first armrest 17 (corresponding to the first support base) and the second armrest 19 (corresponding to the second support base) allow the elbows of both arms of the subject to be measured. To the tip of the arm, the muscles from the elbow to the tip of the arm are constantly kept in a relaxed state.
It is possible to detect a stable electrocardiographically induced waveform, because the muscles of the arm of the person being touched do not get tense due to excess force, and noise due to myoelectric potential is less likely to occur. Therefore, the above-mentioned time difference TD _RP is detected very accurately, and as a result, the measurement accuracy of the propagation velocity V _M1 calculated based on the time difference TD _RP is kept very good.

Further, according to this embodiment, since the electrode 18 _a is provided at the tip of the first armrest 17 and the electrode 18 _b is provided at the tip of the second armrest 19, the arm is fixed to the electrode 18. When they are brought into contact with each other, as a result, the entire area from the elbow to the wrist is supported over the entire supporting surfaces of the first armrest 17 and the second armrest 19, so that the arm of the person to be measured is Since the muscle is not tense due to excessive force and noise due to myoelectric potential is less likely to occur, it becomes possible to detect a more stable electrocardiographically induced waveform. Therefore, the above-mentioned time difference TD _RP
Is detected very accurately, and as a result, the measurement accuracy of the propagation velocity V _M1 calculated based on the time difference TD _RP is kept very good.

Further, according to the present embodiment, the both arms of the person to be measured are along the longitudinal concave curved surface that gently descends and descends from the widthwise both ends of the first armrest 17 and the second armrest 19 to the widthwise central portion. 1st armrest 1
7 and the second armrest 19 are fixed to the central portion in the width direction, so that an extra force in the left-right direction necessary for fixing the arm to the electrode 18 is applied when the supporting surface is a flat surface. Since the muscles of the person are not tense and the noise caused by the myoelectric potential is less likely to occur, it is possible to detect a more stable electrocardiographically induced waveform, so that the above-mentioned time difference TD _RP becomes very accurate. Detected, resulting in a time difference TD
The measurement accuracy of the propagation velocity V _M1 calculated based on _RP is kept very good.

Although one embodiment of the present invention has been described in detail with reference to the drawings, the present invention can be applied to other modes.

For example, in the above-mentioned embodiment, the electrocardiographically induced waveform was used only for calculating the pulse wave velocity, but for example, blood pressure measurement is automatically activated when the subject's heartbeat is stable. An electrocardiographically induced waveform may be used as a start condition for blood pressure measurement. Even in this case,
The more stable the electrocardiographic induction waveform is detected, the easier it is to determine the state in which the heartbeat is stable. As such, the electrocardiographically induced waveform detected through electrode 18 may be utilized in various other embodiments.

Further, in the above-described embodiment, the electrocardiographically induced waveform is detected from the electrode 18 which is brought into contact with the wrists of the subject's arms. However, the electrode 18 may be brought into contact with the back of the subject's hand. If the arm is brought into contact with the electrode 18, the first armrest 17 may be provided between the elbow and the wrist as a result.
Also, by being supported entirely over the entire supporting surface of the second armrest 19, the effect that extra force is applied to the arm to prevent tension is sufficiently exerted. Of course, the electrode 18 is not limited to such an installation place, and even if it is installed in any place on the supporting surface, the temporary effect of stably detecting the electrocardiographic induction waveform is sufficiently achieved. .

Further, in the above-mentioned embodiment, the first armrest 17 and the second armrest 19 are provided with the support surface in the shape of a long concave surface which is recessed from both ends in the width direction to the center in the width direction. Instead, it may be a polygonal support surface. Even with such a configuration, the arm is fixed to the electrode 18 at a fixed position, and therefore, an effect is exerted sufficiently in which an excessive force in the left-right direction is applied to the arm to prevent tension. Of course, the shape of the support surface is not limited to such a shape, and may be planar or cylindrical. Even with such a configuration, the temporary effect of stably detecting the electrocardiographically induced waveform is sufficiently achieved.

Also, in the above-described embodiment, the right arm 12
Is configured to be inserted into the through hole 14, but the left arm 13 may be separately configured to be inserted into the through hole 14, and the first armrest 17 is not provided so as to be inclined upward. It may be provided horizontally in the. In short, the muscles need to be constantly relaxed.

The present invention can be modified in various other ways without departing from the spirit of the invention.

[Brief description of drawings]

FIG. 1 is a perspective view illustrating an automatic blood pressure measurement device with an electrocardiographic induction waveform detection function according to an embodiment of the present invention.

FIG. 2 is a block diagram illustrating a circuit configuration of the embodiment of FIG. 1;

FIG. 3 is a flowchart illustrating a main part of a control operation of the electronic control device according to the embodiment of FIG. 1;

FIG. 4 is a time chart for explaining a time difference TD _RP obtained by the control operation of the embodiment of FIG. 1;

[Explanation of symbols]

8: Automatic blood pressure measurement device with electrocardiographic induction waveform detection function 12: Right arm 13: Left arm 14: Through hole 15: Cuff 17: First armrest (first support base) _18a : First electrode _18b : Second electrode 19 : 2nd armrest (2nd support)

Claims (3)

[Claims] 1. An automatic blood pressure measuring device with an electrocardiographically induced waveform detection function, which has a through hole provided on the inner peripheral surface thereof with a cuff for compressing the upper arm of the measurement subject during blood pressure measurement, wherein the measurement target protrudes from the through hole. Is provided on the back side of the through hole having a longitudinal support surface for supporting one arm of the person wholly from the elbow to the tip of the arm, and is provided on the support surface. A first support table having a first electrode for detecting an electrocardiographically induced waveform generated with the action potential of the myocardium of the subject, and the other arm of the subject from the elbow to the tip of the arm. An electrocardiographic induction that is provided on the opposite side of the through hole having a longitudinal support surface for supporting the whole area and that is generated on the support surface along with the action potential of the myocardium of the subject. A second support having a second electrode for detecting the waveform, and an electrocardiographically induced waveform. Function with automatic blood pressure measurement device out. 2. The electrocardiographic induction according to claim 1, wherein the first electrode is provided at a tip portion of the first support base, and the second electrode is provided at a tip portion of the second support base. Automatic blood pressure measurement device with waveform detection function. 3. The core according to claim 1, wherein each of the first support base and the second support base has a support surface having a longitudinally concave curved surface that is recessed from both ends in the width direction to a central portion in the width direction. Automatic blood pressure measurement device with electric induction waveform detection function.