JPH09299353A - Vapor phase system respiratory function testing system for total health care in view of respiratory function and health care method using it - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enable life style control from a viewpoint of respiratory function by providing a testing system with a testing means for a ventilating function index and/or a gas exchange function index, a testing means for a metabolic function index, a kinetic load means, and a testing means for a gas transport function index. SOLUTION: A first testing means 1 measures, operates, analyzes and displays a testee's ventilating function index and a gas exchange function index, a second testing means 2 measures, operates, analyzes and displays a testee's metabolic function index, and a third testing means 3 measures, operates and displays a testee's gas transport function index. The kinetic load means 4 is connected to the second testing means. A blood pressure measuring means 5 measures the blood pressure at the time of exercise, and a fourth testing means 7 measures, operates, analyzes and displays a ventilating function index. Further, data from each means is transferred to the arithmetic processing part 1a of the first detecting means 1 to be operated.

Description

Detailed Description of the Invention

[0001]

FIELD OF THE INVENTION The present invention is in the field of public health. More specifically, the present invention relates to a method for comprehensive health management mainly based on lifestyle management from the viewpoint of respiratory function and a gas phase respiratory function testing system therefor. In addition, the present invention also relates to a method of health management from the viewpoint of metabolic function.

[0002]

2. Description of the Related Art It is estimated that the elderly population will further increase in the 21st century to exceed 25% of the population, the diseases of the elderly will further increase, and it is expected that the bedridden elderly will exceed 1 million. Measures for health, medical care, and welfare for persons are urged. Therefore, when considering the maintenance and promotion of the health of the elderly in the 21st century, from the end of the 20th century to the beginning of the 21st century, the respiratory function (ventilation, gas exchange, gas transport), including gas exchange and oxygen consumption, was mainly used by middle-aged and elderly people. ,
It is necessary to maintain and improve health from the viewpoint of metabolism.

Conventionally, there has been a pneumoconiosis measure (measure against occupational diseases) as a health management from the viewpoint of respiratory function which has been promoted in the field of respiratory organs. It does not focus on maintenance and promotion.

At present, a testing device for independently measuring the ventilation capacity, the gas exchange function, and the exhaled gas is widely used in the clinical field. In addition, a physical fitness measuring system for health and physical fitness has been developed.

The present inventor has found that the FEV which is an index of ventilation capacity.
_1% (also called 1 second rate) and R _AT (also called coefficient slope index)
And 2D coordinates are displayed, and a method and apparatus for comprehensively and accurately evaluating airway hyperresponsiveness and airway obstruction from the display position have been completed. Japanese Patent Laid-Open No. 7-222732 discloses the method and apparatus.

Furthermore, the present inventor displays FEV _1% and R _AT in two-dimensional coordinates, and establishes a health management zone on the two-dimensional coordinates in advance and lifestyle management related to airway obstruction by matching the coordinate display. We have found a method to evaluate the ventilation capacity for the treatment (Japanese Patent Application No. 6-317272).

The inventor of the present invention separately expresses the descending leg of the maximum expiratory flow volume curve quantitatively, and uses the gas exchange function as an index C.
We have completed a comprehensive method of ventilation and gas exchange functions and a three-dimensional display device for that purpose, which can be displayed and evaluated three-dimensionally in association with O lung diffusion capacity. Japanese Patent Application Laid-Open No. 6-205761 discloses a method and an apparatus thereof.

Furthermore, the inventor of the present invention has obtained PEV _1% and R _AT, and P ′ _CO , P ′, which are indices of gas exchange function, from the inspection system data which is substantially the same as the inspection system which obtains exhalation data.
_{CO (22), D 'LCO} , D' LCO (22), D 'LCO / V' A, D '
Method and apparatus for obtaining or calculating _LCO / V ' _{A (22)} and SPO ₂ and displaying these indexes in three-dimensional coordinates in a three-dimensional manner to comprehensively evaluate ventilation and gas exchange functions for lifestyle management Was completed. Japanese Patent Application No. 6-317273
Discloses the method and apparatus.

[0009]

[Problems to be Solved by the Invention]
Methods for assessing respiratory functions such as gas exchange functions to help lifestyle management are being established. However,
A system and method for evaluating the metabolic function in addition to the ventilation function and the gas exchange function and performing comprehensive health management have not yet been known. The present invention has been made in view of such circumstances, and has a respiratory function (especially including a metabolic function).
It is an object of the present invention to provide a gas phase respiratory function test system for comprehensive health management, which mainly includes lifestyle management, and a method for performing comprehensive health management using the system.

[0010]

According to the present invention, there is provided a first inspection means having an arithmetic processing unit for measuring, calculating, analyzing and displaying a ventilation function index and / or a gas exchange function index of a subject, and the arithmetic processing. Second test means for measuring, calculating and displaying the metabolic function index of the subject, exercise load means connected to the second test means, on which the subject exercises, and the gas of the subject. Measuring transport function indicators,
Provided is a gas phase respiratory function testing system for comprehensive health management, which is characterized by including a third testing means for calculating. The gas phase respiratory function testing system may further include one or more of the following means. (1) Fourth inspection means for measuring, calculating, analyzing, and displaying the ventilation function index of the subject; (2) Muscle strength measuring means for measuring the muscle strength of the subject; (3) Blood pressure measuring means for measuring the blood pressure during exercise of the subject. . Preferably, the muscle strength of the subject is grip strength. Here, preferably, the ventilation function index is FEV _1% or R _AT , and the gas exchange index is D _LCO , D _LCO / V _A , D ′.
_LCO / V _'A, P' is a _{CO (22),} and _{D 'LCO / V' A (} 22) from one or more selected from the group consisting of metabolic function indicator _{V 'O2, V' CO2,} AT and It is one or more selected from the group consisting of R, and has a gas transport function of SPO ₂ . More preferably, the gas exchange index is _{P'CO (22)} or D' _LCO / _{V'A (22)} . Preferably, in the gas phase respiratory function testing system, the exercise load means is a treadmill load device or an ergometer load device.

According to the present invention, (a) the X-axis positive direction of the three-dimensional Cartesian coordinate system is the first ventilation function index, the X-axis negative direction is the gas transport function index, and the Y-axis positive direction is the second ventilation function index. Forming a three-dimensional space related to the respiratory function with the function index, the Y-axis negative direction as the metabolic function index, the Z-axis positive direction as the gas exchange index, and the Z-axis negative direction as the muscle force, and (b) the three-dimensional space. Is divided into eight, and the divided space surrounded by the X-axis positive direction, the Y-axis positive direction, and the Z-axis positive direction is the first space, and the divided space surrounded by the X-axis positive direction, the Y-axis positive direction, and the Z-axis negative direction is the second space. , X-axis positive, Y-axis negative,
The divided space surrounded by the Z-axis positive direction is the third space, and the divided space surrounded by the X-axis positive, Y-axis negative, and Z-axis negative directions is the fourth space, and the X-axis negative, the Y-axis positive, and the Z-axis positive direction. The divided space surrounded by is the fifth space, and the divided space surrounded by the X-axis negative, Y-axis positive, and Z-axis negative directions is the sixth space, and the divided space is surrounded by the X-axis negative, Y-axis negative, and Z-axis positive directions. Let the space be the 7th space, and the positive X axis,
The divided space surrounded by the negative direction of the Y axis and the negative direction of the Z axis is the eighth space, and (c) the first ventilation function index, the second ventilation function index, the gas exchange index, the gas transport function index from the expiratory data of the subject. , Determining the metabolic function index, measuring the muscle force of the subject, displaying the index and the muscle force value in the three-dimensional Cartesian coordinate system in three-dimensional coordinates, and identifying the space to which the subject belongs, and (d) three-dimensional. Comprehensive health care from the viewpoint of respiratory function, comprising the steps (a) to (d) above in which the subject comprehensively evaluates respiratory function from the result of coordinate display and the characteristics of the space to which the subject belongs Method is provided. Here, preferably, the first ventilation function index is R _AT , the second ventilation function index is FEV _1% , and the gas exchange function indexes are D _LCO , D _LCO / V _A , D ′ _LCO / V ′ _A , P ′ _{CO ( twenty two)}
And D is selected from the group consisting of _{'LCO / V' A (22} ), metabolism indicators V _'O2, V' _CO2, selected from the group consisting of AT, and R, the gas transport function index is SPO _2. More preferably, the gas exchange function index is _{P'CO (22)} or D' _LCO / _{V'A (22)} and the metabolic function index is _V'O2 . Preferably, the muscle strength of the subject is grip strength.

According to the invention, the overall health management method as viewed from the respiratory function, instead of step (c), (C'1) R _AT from the subject's breath data, F
Further, EV _1% was calculated, and the muscle strength of the subject was measured, the index was two-dimensionally displayed on the X-axis-Y-axis plane, and (C′2) the preset (A) health on the two-dimensional coordinate plane, (B) lifestyle management, (C) screening and (D1
-3) Matching the health management zone consisting of each disease management zone and the two-dimensional coordinate display obtained in step (C′1), and when the result is the (A) zone, the index and the muscle strength value are calculated as follows. Displaying 3D coordinates in 2 spaces,
The steps consisting of (C'1) and (C'2) can be executed.

According to the present invention, in the above-mentioned method for comprehensive health management from the viewpoint of respiratory function, R _AT , F is obtained from (C ″ 1) subject's exhalation data instead of the step (c).
Further, EV _1% was obtained, the muscle strength of the subject was measured, the index was two-dimensionally displayed on the X-axis-Y-axis plane, and (C ″ 2) the preset two-dimensional coordinate plane (A) health, (B) Lifestyle management, (C) Screening and (D1
-3) Matching the health management zone consisting of each zone of disease management with the two-dimensional coordinate display of step (C ″ ″ 1), and when the result is the zone (B), further, from the breath data of the subject, P ′ _{CO (22)} and / or D ′ _LCO
/ V ′ _{A (22)} is calculated, and one of the indexes is combined with the index and displayed in three-dimensional coordinates in the first space, and the steps (C ″ 1) and (C ″ 2) above are executed. can do. In the step (C ″ 2), the muscle strength value can be displayed in the second space in three-dimensional coordinates.

According to the present invention, in the above-mentioned method for comprehensive health care from the viewpoint of respiratory function, R _AT , FEV _{1% is obtained} from the breath data of the (C ″ ″ 1) subject instead of the step (C). Furthermore, the muscle strength of the subject is measured,
The index is two-dimensionally displayed on the X-axis-Y-axis plane, and (C ″ ″ 2) preset on the two-dimensional coordinate plane: (A) health, (B) lifestyle management, (C) screen. And the (D1-3) health control zone consisting of each disease control zone and the two-dimensional coordinate display of the step (C ″ ″ 1) are matched, and the result is the (C) or (D1-3) zone. At certain times, further from the subject's exhalation data, _{P'CO (22)} and / or D' _LCO /
V ′ _{A (22)} , and V ′ _O2 and / or AT, and additionally SPO ₂ are obtained, and each index is displayed in three-dimensional coordinates in the corresponding space formed in step (b). The steps consisting of ″ ″ 1) and (C ″ ″ 2) can be carried out. In the step (C ″ ″ 2), the muscle strength values are further measured in the second space, the fourth space, the sixth space, and the eighth space.
It is also possible to display three-dimensional coordinates in one or more spaces.

Further, according to the present invention, there is provided a method of health management from the viewpoint of metabolic function, wherein (a) an exercise mode corresponding to a subject's daily lifestyle is set, and (b) the set exercise mode is set. Converted into an exercise load amount, (c) the subject is exercised on the exercise means including the exercise load means for a predetermined time while applying the exercise load amount, and exhaled air is collected from the subject's mouth, (d) during exhalation the oxygen concentration is detected and 'calculates the _O2, (e) V' V based on the detected oxygen concentration consumed kinetic energy of the subject at the predetermined time from _O2 (E
₁ ) is calculated, (f) the consumed kinetic energy (E ₁ ) is converted into the estimated daily consumption energy (E ₂ ) of the subject, and (g) the estimated daily consumption energy (E ₂ ) is evaluated to obtain oxygen. Provided is a method for health management, which comprises giving a subject a prescription about exercise for improving consumption and a prescription for changing a nutritional requirement to manage the health of the subject.

The "respiratory function" used in this specification is roughly classified into "ventilation function", "gas exchange function", "gas transport function", and "metabolic function". As the index of "ventilation function", FV (maximum flow rate air flow curve) analysis and VT
% VC obtained through (maximum effort calling curve) analysis,
FEV _1% (1 second rate), R _AT (coefficient gradient index), dV / d
F etc. are mentioned. As an index of "gas exchange function",
D _LCO , D _LCO / V _A , D' _LCO / V ' _A , _{P'CO (22)} ,
D' _LCO / _{V'A (22) and the} like can be mentioned. "Gas transport function"
An example of the index is SPO ₂ . "Metabolic function"
_V'O2 , _V'CO2 , R (gas exchange ratio,
_{V 'CO2 / V' O2)} , AT, include further kinetic energy consumption (E ₁₎ and daily consumption estimated energy (E ₂₎ or the like. The correlation between the above functions in the "respiratory function" is as shown in FIG. Further, specifically, "ventilation function" is related to health management problems such as a predisposition change (airway hyperresponsiveness), a morphological change (airways and alveoli), hyperinflation, and peripheral airway obstruction. “Gas exchange function” represents the total gas exchange capacity and is related to the oxygen consumption requirement in peripheral tissues. "Gas transport function" is a function of O ₂ to peripheral tissues.
Related to the transportability of. "Metabolic function" is related to oxygen consumption and exercise (activity) energy consumption.

A method for comprehensive health care and a gas phase respiratory function testing system according to the present invention will be described in more detail with reference to FIGS.

[0018]

FIG. 2 is a block diagram showing a schematic configuration of a gas phase respiratory function testing system of the present invention. In the figure, 1 is a first inspection means capable of measuring, calculating, analyzing and displaying a ventilation function index and a gas exchange function index of a subject, and 2 is a second testing means capable of measuring, calculating, analyzing and displaying a metabolic function index of a subject. 3, 3 is a third inspection means capable of measuring, calculating and displaying the gas transport function index of the subject, 4 is exercise load means, 5 is blood pressure measuring means for measuring blood pressure during exercise, and 6 is muscle strength measuring means. Represent Reference numeral 7 represents a fourth inspection means capable of measuring, calculating, analyzing and displaying the ventilation function index. FIG.
The block diagram of 1 shows an example of the connection state of each means, but other connection modes are possible.

In this example, each means that requires calculation and analysis of the measurement data obtained from the subject may have an arithmetic processing unit for processing the data itself, but the data is first detected from each means. The data is transferred to the arithmetic processing unit 1a of the means 1 and arithmetic processing can be performed there. Similarly, the display of data may be provided with a display unit for displaying each unit, but after the data processing and various respiratory function indexes calculated from the data are collectively processed by the processing unit 1a, the display unit is displayed. It may be configured to (or print).

The first inspection means 1 measures the ventilation function means,
Computation, analysis, and display are possible, so it has a similar function.
Although the detection means 7 is not essential to the gas phase respiratory function inspection system of the present invention, it is preferable to use the fourth inspection means 7 in addition to the first inspection means 1 as described later.

The inspection / measurement device corresponding to the first inspection means 1 is an aerometer S / 9 (trade name) from Minato Medical Science Co., Ltd., and the inspection / measurement device corresponding to the second inspection means 2 is an aerometer AE. -280 (trade name) from Minato Medical Science Co., Ltd., an inspection corresponding to the third inspection means 3,
The measuring device is a pulse oximeter (trade name) from Nippon Kogaku Co., Ltd., and the blood pressure monitor corresponding to the blood pressure measuring means 5 is E.
It is commercially available from Minato Medical Science Co., Ltd. as BP-300. A grip strength meter, which is an example of the muscle strength measuring means 5, is commercially available from Takei Kiki Kogyo Co., Ltd. as a digital grip strength spine measuring device and a grip strength attachment. A bicycle ergometer, which is an example of the exercise load means 4, is commercially available from Combi Corporation as an ergometer 232C _XL .

The detailed structure of the fourth inspection means 7 is described in the above-mentioned Japanese Patent Application No. 6-317273. Examples described below,
See especially FIG. That is, the fourth inspection means 7 is composed of a spirometer, a memory, various calculation units, etc., and draws the subject's expiration data measured by the spirometer on an FV curve. Based on the descending leg of this FV curve and the exhalation data, the calculation unit determines, for example, FE among the ventilation function indexes.
V _1% and R _AT are calculated, and if necessary, these are graphically displayed on the fourth inspection means 7.

The detailed structure of the first inspection means 1 is also described in Japanese Patent Application No.
-317273. See examples below, particularly FIGS. That is, the first inspection means 1
, Spirometer, memory, gas mixing back,
It is composed of various arithmetic units and the like, and is similar to the fourth inspection means 7 in FEV.
_1%, with R _AT can be calculated, among the gas exchange function index, for _{example, P 'CO, D' LCO} , D 'LCO / V' A,
D' _LCO / _VA , _{P'CO (22)} can be determined by gas analysis. Any of these indicators can be displayed on the first inspection means 1.

A method for measuring and calculating a ventilation function index and a gas exchange function index by using the first inspection means 1 and the fourth inspection means 7 is also described in detail in Japanese Patent Application No. 6-317273. See the examples below.

According to the invention, the third inspection means 3 is further provided.
Can be used to measure _V'O2 (oxygen uptake) and _V'CO2 (carbon dioxide emission).

FIG. 3 shows an overall system diagram (block diagram) of an example of the _V'O2 , _V'CO2 measuring device by the breath-by-breath method. Such _V'O2 , V '
_{The CO2} measuring device 20 constitutes a main part of the gas phase respiratory function testing system of the present invention.

The subject 10 first rides on the treadmill 11 which is an exercise means, and moves forward (walks or runs) while adding the mouthpiece 12 (or mask) to his mouth.
I do. The treadmill 11 is provided with an exercise load device 13 and applies an appropriate exercise load based on the exercise load level (exercise mode) selected by the subject 10.
To supply. Usually, the exercise mode is reflected on the rotation speed or the inclination angle of a belt (not shown) on which the subject 10 walks or runs, and is loaded on the subject 10. Exhaled air of the subject 10 during exercise is distributed to the flow sensor 15 and the infrared CO ₂ sensor 16 via the sampling tube 14. In the infrared CO ₂ sensor 16, light in the wavelength range of carbon dioxide molecules in the exhaled breath is detected by the infrared absorption method,
It is electrically amplified and the carbon dioxide concentration is detected. The exhaled air that has passed through the infrared CO ₂ sensor 16 is subsequently guided to the zirconia O ₂ sensor 17, where the oxygen concentration is detected by the zirconia sensor. The sensors 15, 16
The oxygen concentration and carbon dioxide concentration data actually measured in 1 are sent to the microcomputer 18 once. On the other hand, part of the exhaled air passes through the flow sensor 15 connected in parallel with the infrared CO ₂ sensor 16, where the flow rate of the exhaled air is measured and the flow rate data is also sent to the microcomputer 18.

The microcomputer 18 corrects the time delay of the sensors 16 and 17 with respect to the flow rate of the expired gas, and _V'O2
And _V'CO2 are calculated. The _V'O2 and _V'CO2 values are displayed on the display 19 or output by other output means such as analog signal output, printer output, serial data output and the like. _V'E (ventilation volume) is also calculated through the same process as described above. The gas exchange ratio R can also be obtained from these measured values.

Furthermore, AT (anaerobic metabolism threshold) can also be determined by breath gas analysis. AT is defined as "the level of _V'O2 during exercise at the time when the aerobic energy production mechanism is added to the aerobic energy production", and increases the lactate concentration in muscle and arterial blood and the lactate / pyruvate ratio. reflect. AT can be determined by plotting the V _'E vs. V' _O2 and V _'CO2 vs. V' _O2. AT is also a useful index particularly for severity of heart failure, exercise prescription for rehabilitation and exercise therapy, and effect determination.

According to the present invention, in order to comprehensively evaluate the respiratory function (including ventilation, gas exchange, gas transport and metabolic function and also muscle strength) of a subject, a three-dimensional Cartesian coordinate system is used to relate the respiratory function. A three-dimensional space is formed, and this is divided into a plurality of parts, and the respiratory function index of the subject is displayed (plotted) in three-dimensional coordinates, which is performed based on the characteristics of the divided space to which the subject belongs and the result of the coordinate display.

Prior to the comprehensive evaluation by the respiratory function,
A group of subjects will be asked to submit a health questionnaire and tested for ventilation function. For this purpose, the FV waveform is analyzed after the FV measurement using the fourth inspection means 7, and the ventilation function index, for example, FEV _1% and R _AT is obtained. For this purpose, the ventilation function index can be obtained by using the first inspection means 1 instead of the fourth inspection means 7.

Here, such FEV _1% . Ventilation function indexes such as R _AT , as well as evaluation of muscle strength are collectively referred to as "evaluation of primary respiratory function". A method of two-dimensional health management using a ventilation function index is described in detail in Japanese Patent Application No. 6-317272, but will be briefly described below. For details, refer to the examples below.

As a result of the analysis of the FV waveform, the obtained R _AT , F
EV _1% is plotted on the X-axis and the Y-axis (two-dimensional display). FEV (g) as FEV _1% (forced lung dose 1 second rate)
FIG. 4 shows an example in which is adopted and plotted on the Y axis.
The health condition categories (zones) shown in Table 1 are displayed along the Y-axis on the same plane as this two-dimensional display.

[0034]

[Table 1]

The lifestyle referred to here is, for example, nutrition (dietary habits, amount of meal, green-yellow species), obesity, drinking, exercising,
Strength, smoking, occupation, stress, etc. may be mentioned.

The health condition zone display may be displayed by superimposing it on the two-dimensional display, or the zone display may be performed in advance and the two-dimensional display may be superposed on it.

For example, if the subject's two-dimensional display data is in zone A, it is determined that the subject is healthy, so it is not necessary to test the gas exchange function, gas transport function, and / or metabolic function. However, as a precaution, these features may be further tested.

If the two-dimensional display data of the subject is in zone B or below, that is, in B, C, D1-3, it is necessary to thoroughly manage the health of the subject as shown in Table 1, and the gas exchange function (secondary breathing) Function), and gas transport function,
Examine and evaluate metabolic functions (collectively referred to as tertiary respiratory function). The above-mentioned three-dimensional display is used to evaluate the secondary respiratory function and / or the tertiary respiratory function.

First, the three-dimensional Cartesian coordinates X, Y,
The Z axis is defined as shown in FIG. That is, the first ventilation function index is set in the X-axis positive direction (X1), and the X-axis negative direction (X2).
, The gas transport function index, the Y-axis positive direction (Y1) the second ventilation function index, the Y-axis negative direction (Y2) the metabolic function index, Z
The gas exchange index in the positive direction of the axis (Z1) and the negative direction of the Z axis (Z
The muscle strength is displayed in coordinates in 2). The three-dimensional space in which coordinates are displayed in this way is divided into eight according to the coordinate axes as shown in Table 2 below.

[0040]

[Table 2]

Each of the divided spaces 1 to 8 is characterized as shown in Table 2. Furthermore, more specifically, R _AT is used as the first ventilation function index, and FEV is used as the second ventilation function index.
_{Using 1%} as a gas exchange index, _{P'CO (22)} (carbon monoxide partial pressure range, oxygen consumption requirement) or D' _LCO / V '
_{A (22)} (carbon monoxide diffusion capacity) is used as an index for gas transport, and S
When PO ₂ is taken as V ₂ as a metabolic index and grip strength is taken as a muscle strength, the coordinate axes are shown in Table 3.

[0042]

[Table 3]

To move the two-dimensional display as shown in FIG. 4 to FIG. 5 according to the coordinate axis system of Table 3, R _AT on the X ₁ axis is −
It is necessary to plot as 1.0 (origin) to 1.0.

As an example of the three-dimensional coordinate display, the subject's 2
If the dimensional display data is in the zone A, then the muscle strength (grip strength) of the subject is measured by the muscle strength measuring means 6. When the obtained values were plotted on the Z2 axis, the above-mentioned FEV _1% , R _AT
It can be seen that this test subject is located in the second space together with the plot of.

If the subject's two-dimensional display data is in zone B, it is determined that the subject needs lifestyle management. Therefore, the gas exchange function of the subject is inspected by the first inspection means 1. At this time, the ventilation function (FE
V _1% , R _AT ) may be inspected and evaluated by the first inspection means 1. The gas exchange function index obtained, for example _{P'CO (22)} or D' _LCO / _{V'A (22)} , is plotted on the Z1 axis. Note that _{P'CO (22)} and D' _LCO / _{V'A (22)} are standardized weight values. Therefore, this subject can be compared and evaluated in the first space together with the plot of FEV _1% and R _AT . After measuring the muscle strength (grip strength), the evaluation in the second space is also performed. Specifically, each coordinate position enables a doctor and a subject to grasp and comprehensively evaluate the ventilation function and gas exchange function of the lungs.
That is, health guidance can be provided by grasping and evaluating the evaluation result in association with human ecological viewpoints such as a predisposition, a disease state, an environmental factor, and a lifestyle (first space). Ventilation function as well as gas exchange function (especially an index that reflects oxygen consumption)
By also adopting, it becomes possible to evaluate the lifestyle related to oxygen consumption in association with it. For example, _{P'CO (22)} has a correlation with lifestyles that presuppose oxygen consumption, such as obesity, drinking habits, and exercise habits. That is, P'in response to changes in lifestyle
_{CO (22)} value changes. Then, the doctor asks the subject for P ′ _{CO (22)}
From the change in value, it is possible to give effective guidance corresponding to the improvement of lifestyle.

As described above, the doctor can perform accurate diagnosis and health guidance for the subject, and, for example, even if the subject should stop smoking, or if he / she smokes, he eats a lot of vegetables. Since the ventilation function or the gas exchange function does not deteriorate during the operation, it becomes possible to provide detailed health guidance for such patients individually.

Further, the subject can understand and understand the ventilation function and the gas exchange function of the subject without medical knowledge, which can contribute to proactive and positive lifestyle improvement.

If the subject's two-dimensional display data is in zone C, it is determined that the subject needs to be screened. Furthermore, if the two-dimensional display data is in D1-3,
The subject is determined to be in need of disease management. In these cases, as in the case of zone B, the gas exchange function of the subject is inspected by the first inspection means 1. Here, the ventilation function (FEV _1% , R _AT ) may be inspected and evaluated by the first inspection means 1 again. The obtained gas exchange function index _{P'CO (22)} or D' _LCO / _{V'A (22)} is plotted on the Z1 axis, and the position of the subject is evaluated in the first space. Furthermore, the third inspection means 3
The gas transport function (SPO ₂ ) of the subject is measured at and plotted on the X2 axis. Then, X2 axis (SPO ₂ ), Y
In the fifth space surrounded by the 1-axis (FEV _1% ) and the Z1-axis (P ' _{CO (22)} ), the subject can be evaluated from the characteristics (Table 2),
Appropriate guidance (treatment) can also be provided. Separately, the subject is exercised by exerting an exercise load on the exercise load unit 4, and the second inspection unit 3
Is used to measure the metabolic function, for example, _V'O2 , and Y
Plot on two axes. Then, X2 axis (SPO
₂ ), Y2 axis (V ′ _O2 ), Z1 axis (P ′ _{CO (22)} ), in the 7th space, the subject can be evaluated from its characteristics (Table 2) and appropriate guidance (treatment) can be given. You can do it. Similarly, in the third space surrounded by the X1 axis (R _AT ), the Y2 axis (V ′ _O2 ), and the Z1 axis (P ′ _{CO (22)} ), it is possible to evaluate the subject from the characteristics. . Furthermore, evaluation in the second space, the fourth space, the sixth space, and the eighth space can be performed through measurement of muscle strength (grip strength).

When each functional index obtained from the subject has time dependency, that is, the index during exercise is examined over time,
When measured, the obtained three-dimensional coordinate display is not a point but a three-dimensional function.

As described above, the health management zone, R _AT , and FE
We have explained in detail how to perform comprehensive health care by evaluating ventilation, gas exchange function, gas transport function, and metabolic function stepwise from matching with V _1% two-dimensional display. It is also possible to change the order of index measurement and inspection. Also, when the two-dimensional display of the subject's primary respiratory function is in zone A or B, the examination of the tertiary respiratory function (other than muscle strength) was not performed, but the latter function was examined and the three-dimensional coordinate display was performed. However, it is also possible to evaluate, and a method including all of these possible changes and modifications is also included in the technical scope of the method for comprehensive health care in view of the respiratory function of the present invention.

A part of the present invention also includes a method of health management from the viewpoint of specific metabolic function.

According to the present invention, besides the above-mentioned metabolic function index, the estimated daily consumption energy is calculated and used as the most important index among the metabolic function indexes.

Prior to the present invention, attempts have been made to calculate the estimated daily consumption energy. However, this was mainly about so-called nutritional guidance, in which the nutritional amount required for one day was calculated back from the estimated daily consumption energy and the food to be consumed to satisfy it was determined.

According to such a conventional technique, the estimated daily consumption energy (E ₃ ) is expressed by the following equation (1). "Illustration,
Mechanism and application of exercise ”, Shoichi Nakano, Ito Dental Publishing Co., Ltd.,
See page 236 (1993).

E = B (1.25R + 0.95S) + BΣ (RMR) T (1) However, E: estimated daily consumption energy (kcal) B: basal metabolic rate (kcal / hour) S: sleep time R: 24th-sleeping time T: Living work time of each RMR: Energy metabolism amount Further, the basal metabolism amount B in the formula (1) is obtained from the formula (2).

B = b × a (kcal / hour) (2) where a: estimated by height and weight b: basal metabolism reference value by sex and age Therefore, in formula (1) and formula (2) Known parameter values of (eg, energy metabolism rate of different exercises)
Can be used to calculate the subject's specific estimated daily energy consumption (E ₃ ). According to the above-mentioned review, if the subject is a 30-year-old man (height 168 cm, weight 62 kg, basal metabolism 63.1 kcal / hour) and spends one day in the lifestyle shown in Table 1 below, the daily consumption is estimated. Energy (E
₃ ) is E = 63.1 kcal / hour (1.25 × 17)
Time + 0.95 x 7 hours) + 63.1 kcal / hour (0.3 x 11 hours + 2.4 x 1 hour + 1.0 x 1.5)
Time +1.8 x 0.5 hours +0.2 x 3 hours) = 230
It becomes 9.5 kcal.

[0057]

[Table 4]

The problem with calculating the estimated daily consumption energy (E ₃ ) in this way is that approximate values are mostly used for the parameters in the calculation formulas (for example, formulas (1) and (2)). It means that In addition, since it is assumed that the subject is a virtual and average person based on height and weight, the metabolic function of the subject should be considered for the sick person or the person with metabolic disorder (obesity, diabetic patients, etc.) whose metabolic function is deteriorated. The individual differences of the above are not taken into consideration.

In contrast to this, however, when the gas phase respiratory function test system of the present invention is used, the daily energy consumption (E ₂ ) peculiar to the individual subject, which reliably reflects the metabolic function of the subject, is considerably reduced. It can be measured and calculated with accuracy. As described above, the subject's V ′ _O2 can be actually measured when the subject is exercised on an exercise means such as a treadmill or a bicycle ergometer. (L / m) unit of the V _'O2 value 4.8 as the motion calorie consumption
It corresponds to 5.0 kcal / m. Therefore, the exercise energy consumption (E ₁ ) per unit time of the subject who exercised on the exercise means can be calculated from the measured V ′ _O2 value.

Therefore, in order to obtain the estimated daily consumption energy (E ₂ ) using the gas phase respiratory function testing system of the present invention, an appropriate number of stages (for example, 4) based on the subject's daily lifestyle is used. (6 stages), and an appropriate amount of exercise load is determined for each mode. As an example, the daily life style may be divided into each item and the exercise mode corresponding to each item may be set as obtained in Table 1 above. Next, the time required for each mode is calculated based on the daily lifestyle thus divided. This work can also be calculated as a time corresponding to the lifestyle segmented as shown in Table 1. Here, the total time of all modes is set to a time in the range of about 15 to 30 minutes.
Each exercise mode thus obtained, the required time of each mode, and the exercise load amount set for each mode are programmed in the gas phase respiratory function inspection system of the present invention, particularly in the exercise means 11 and the exercise load device 13. To do. When the subject 10 exercises on the exercise means 11 according to this program for a predetermined period of time while being exercised, the gas phase respiratory function test system of the present invention is based on the above-mentioned principle.
Oxygen concentration in the exhaled air of
₁ ) is calculated and displayed on the display 19. That is, when the programmed exercise of the subject 10 for one cycle (predetermined time) is completed, the exercise consumption energy (E ₁ ) consumed by the subject in the predetermined time is calculated, accumulated, and displayed on the inspection system. .

The exercise energy consumption (E ₁ ) displayed in this manner is the energy consumption of the subject's daily life condensed in a predetermined short time (for example, 20 minutes). If the (E ₁ ) value is calibrated as 24 hours, the estimated energy consumption (E
₂ ) can be calculated. In short, according to the present invention, the subject's 10 daily life style is simulated (simulated test) by applying an exercise load to the subject 10 using the gas phase respiratory function test system. The estimated daily consumption energy (E ₂ ) obtained in this manner is compared with the estimated daily consumption energy (E ₃ ) obtained by the above-mentioned conventional technique and consumed based on the actually measured metabolic function value of the subject. Since the energy is calculated, the reliability is remarkably improved, and the individual difference of the subject whose metabolic function is significantly deteriorated is sufficiently reflected in the estimated daily consumption energy.

In the present invention, the obtained estimated daily consumption energy (E ₂ ) of the subject is an important index for performing health guidance such as lifestyle management and health management of the subject.

Therefore, the estimated daily consumption energy (E
₂ ) Based on nutrition, obesity, exercise, for example,
The subject can be advised on the proper nutritional requirements, and the subject's nutritional intake is estimated to be the daily energy consumption (E ₂ ).
If the amount is more than the amount, an appropriate exercise prescription can be given to such a subject.

Although a specific method for managing health by linking the ventilation function index and the gas exchange function index with lifestyle habits has already been explained, how to comprehensively manage health including the gas transport function index and the metabolism function index As shown in Table 5 below, each respiratory function index and lifestyle may be associated and evaluated.

[0065]

[Table 5]

The test of the respiratory function of the subject using the gas phase respiratory function test system according to the present invention can be carried out by, for example, a screening method, a dock method, a detailed examination method, an individual examination method or the like. Which of these examination methods is suitable for the subject can be evaluated by preliminarily evaluating the ventilation function index and the gas exchange function index, and the doctor can advise the subject of the appropriate examination method.

The method of health management from the viewpoint of the respiratory function of the present invention can be applied not only to the management of the test subject (one individual) but also to the management of one group of test subjects (group).
The measured data may be statistically processed (multiple regression analysis, discriminant analysis) according to a conventional method.

[0068]

EXAMPLES Some examples of the two-dimensional coordinate display and the three-dimensional coordinate display of the respiratory function according to the present invention will be described more specifically with reference to the following examples.

1. Synthesis of FV Waveform FIG. 6 is a block diagram showing an electrical configuration of a spirometer or the like for obtaining an FV curve of the subject's expiration. A subject whose lung function is to be examined, for example, in a standing position, inhales as much as possible, holds his nose in his mouth, holds a tube 121, and supplies exhaled air to a flow meter 122 as soon as possible. Processing circuit 1 realized by a microcomputer or the like
Reference numeral 23 is a visual display means 1 that responds to the output of the flow meter 122, calculates and stores the flow rate and the air volume with the passage of time, and the result is obtained by using a cathode ray tube or a liquid crystal display element.
25, and if necessary, it is recorded on the recording paper 127.

On the other hand, the processing circuit 123, instead of the data sent from the flow meter 122, a flow volume curve previously drawn on the recording paper 127, a reading device 128 such as a digitizer.
It is also possible to read in and digitize data. The flow rate is measured, for example, for every 10 ml of air volume, and the flow rate is calculated.

FIG. 7 is a flow chart for explaining the operation of processing circuit 123 shown in FIG. From step m1 to step m2, the passage of time of the flow rate measured by the flow meter 122 is measured, and in the next step m3, the air volume and the flow rate are associated and stored in the memory 124. In step m4, the flow rate and the air volume are graphed, and in step m5, these are recorded on the recording paper 127. At step m6, the series of operations is finished.

FIG. 8 shows the FV obtained as described above.
It is a schematic example of a curve, and the flow rate F (l / sec) is plotted on the vertical axis,
The volume V (l) is plotted on the horizontal axis. The flow rate rapidly increases in the initial short time, reaches the flow rate maximum value PEFR, and thereafter relatively slowly decreases to the residual volume point B (RV) at the maximum expiratory position. The range from the maximum flow rate PEFR to the point B is called the descending leg, and the curves 101 to
It changes like the curve 104. For example, the subject who draws the curve 104 is often a nasal allergy patient.

The FV waveform synthesizing method for FV waveform analysis according to the present invention will be described in detail with reference to another schematic FV curve in FIG.

A curve 101 represents an FV curve (herein also abbreviated as FV) at the time of maximum exhalation from the maximum inspiration, as in FIG. A curve 105 represents an FV curve (herein also abbreviated as GV) at the time of maximum exhalation from rest inspiration (normal state).
Between the intersections 106 and 107 of the curves 101 and 105, the flow rate is GV> FV, and at the intersections 106 and 107, FV and GV are almost equal in flow rate. Point 108 on curve 101 indicates the point at which the exhalation is discontinued and the flow rate drops rapidly. This applies when the subject is short of breath or coughs. The end point 109 represents the residual volume at the maximum expiratory position, and the point 110 is the end point of the GV representing the residual volume at the rest expiratory position, which is behind the end point 109 of the FV on the horizontal axis.

Therefore, when the FV is interrupted as shown in FIG. 9 for some reason and does not draw a smooth curve, G
If V is present, F will be given without forcing the subject to exhale again.
V waveforms can be synthesized. That is, PEFR of curve 101
The FV is traced from the position 111 to the point 107, either FV or GV is traced from the point 107 to the point 108, and GV is traced from the point 108 to the point 110.

In this series of operations, FV and GV can be displayed on a chart as shown in FIG. 9, traced manually, and an ideal composite FV curve can be drawn, but individually measured FV and GV It is convenient to store the data for the above in the memory 124, recalculate them in the processing circuit 123, and then display the combined FV curve on the visual display means 125 such as a screen or recording paper. Also, one curve already drawn on the recording paper is read by the reading device 128, and is combined with the data of the other curve in the memory 124,
Similarly, it is possible to obtain a synthetic FV curve.

The advantages of the FV waveform synthesis method according to the present invention are:
If the GV curve from the quiet breath is obtained, the composite FV curve can be drawn even if the measurement fails during the flow rate, the volume, or the measurement for obtaining the FV curve from the maximum breath, during the measurement. F
To obtain the V-curve, without having to repeat the measurement,
An FV curve can be synthesized from a GV that a subject can easily obtain from an FV. Therefore, the number of maximum call measurements can be reduced, and the burden on the elderly and the sick can be reduced. In addition, it is not always necessary to make the call to the end, and it is expected that the measurement time can be shortened.

FIG. 10 shows an example of the actually measured FV and GV curves. In the figure, X is the intersection with GV in the rapid decay region of FV and corresponds to point 108 in FIG. Y represents the end point of GV, the maximum expiratory position, and corresponds to point 110 in FIG. In this example, a synthetic FV curve can be obtained by connecting FV to GV at X, just as in the case of FIG.

Further, based on the synthesized FV curve, dV
When the (volume) / dF (flow rate) index is calculated and plotted,
For example, as shown in FIG. 11, the dV / dF distribution curve 11
Get 2. FIG. 11 shows the dV / dF curve 112 and the measured FV.
A curve 101 and an approximated quadratic curve 113 (described later) are shown.
The example curves shown in FIGS. 10 and 11 are derived from the measured data shown in Tables 6 and 7, respectively.

[0080]

[Table 6]

[0081]

[Table 7]

As described above, synthesis of FV waveforms, further analysis, calculation of various parameters (for example, dV / dF), evaluation of lung function, and identification of factors of dysfunction,
Ultimately, health management including lifestyle will be possible. Hereinafter, the implementation of the present invention based on this concept will be described with reference to a few embodiments.

2. Approximation of FV Waveform to Quadratic Curve In FIG. 8, curves 101 to 1 showing descending legs of the FV curve.
04 can be approximated to a quadratic curve using the following equation (3).

[0084] y = a0 + a1 · X + a2 · x 2 ... (3) In the formula (3), y is the flow, x is the relative air amount R, a0 is a constant. The constant term a0 in the equation, the coefficient a1 of the first order term, and the coefficient a2 of the second order term are calculated, respectively, and plotted with a1 as the vertical axis and a2 as the horizontal axis, as shown in FIG. Lines 114 and 115 in the figure are based on the following data (Table 8). Line 116 shows a straight line during a bronchial asthma attack.

[0085]

[Table 8]

The calculation for obtaining a1 and a2 is performed according to FIG.
This is briefly described below. FIG. 13 shows the processing circuit 12 shown in FIG.
6 is a flowchart for explaining an operation when 3 is applied to coefficient determination. The process proceeds from step n1 to step n2, the elapsed time of the flow rate measured by the flow meter 122 is measured, and in the next step n3, the air quantity and the flow rate are associated and stored in the memory 124. The processing circuit 123 detects the peak position of the descending leg of the flow volume curve stored in the memory 124, and obtains the maximum flow rate PEFR at that time and the air volume V1 at that time (see FIG. 8). In step n5, relative volume or absolute volume is selected with respect to the volume of the flow volume curve. Relative volume R is
It is shown by equation (4).

R = VCX / VC1 (4) 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. 8, and VC1 = VC-V1 ... (5) 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 peak of the descending leg is 1.0 and the RV position is 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 corresponding flow rate is obtained in this way, in step n6, the quadratic equation of the equation (3) is calculated from the obtained relative air volume and the flow rate. Make a fitting.

At step n7, 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 n8, the value shown in FIG. The coordinate position + (a2, a1) on the displayed display surface is displayed. Thus, in step n9, a series of operations ends. When the absolute volume is selected in step n5, x in the equation (3) is the absolute volume.

The quadratic curve of the subject thus obtained is compared with the actually measured FV curve in FIG. In the figure, line 113 shows the calculated quadratic curve, curve 101
Is the measured curve.

It is possible to obtain a higher-order regression equation up to the tenth order and apply it to the descending leg. However, even if the quadratic regression equation is applied, for example, the sixth-order regression equation is applied, the approximation degree is Since there is almost no difference, in practice it is preferable to approximate by a simple quadratic equation.

[0092] 3. Calculation of R _AT Next, the coefficient slope index (R _AT ) is calculated. As described above, the first-order term coefficient a1 and the second-order term coefficient a2 of the equation (3) are calculated,
FIG. 14 shows a two-dimensional coordinate axis with a1 as the vertical axis and a2 as the horizontal axis. If the angle formed by the straight line OP connecting the origin O point P (a2, a1) and the horizontal axis (a2 axis) is θ, then θ = tan ⁻¹ (a1 / a2) (6). θ is expressed in degrees, and a coefficient gradient index (R _AT ) is expressed by the following equation that differs depending on whether the a1 and a2 are positive or negative.

R _AT = θ ° / 180 ° (a1> 0, a2> 0: Quadrant I) (7) R _AT = 1 + (θ ° / 180 °) (a1> 0, a2 <0: Second II Quadrant) (8) R _AT =-(1-θ ° / 180 °) (a1 <0, a2 <0: Quadrant III) (9) R _AT = θ ° / 180 ° (a1 <0, a2 > 0: Quadrant IV) (10) The 1-second rate FEV _1.0% (also abbreviated as FEV) is the expiratory volume in the first second when expiring as much as possible and expelling this as expiratory as quickly as possible. Since it is displayed as a ratio (percentage) to the total expiratory volume (forced vital capacity), it can be obtained by the spirometer described in FIG. The calculation of FEV, R _AT based on the data from the pyrometer will be outlined below with reference to FIG.

FIG. 15 is a flow chart for explaining the operation of the processing circuit 123 relating to FEV, R _AT shown in FIG. When starting at step p1, the clock in the processing circuit 123 starts, and at the same time, a signal is sent from the flow meter 122 for each 10 ml of exhaled breath. Step p2
In step p3, the flow rate for every 10 ml is calculated from the volume and time, and the volume and flow rate are stored in the memory 124 in step p3. In step p4, it is determined whether or not 1 second has elapsed. If 1 second has elapsed, in step p5 the volume up to that time is calculated as the amount of 1 second, and stored in the memory 124 in step p6. In step p9, it is determined whether or not the flow rate becomes 0. If the flow rate is 0, it is determined that the volume has reached the maximum expiratory volume remaining amount, and in step p10, the total expiratory volume (forced vital capacity) is calculated. , Are stored in the memory 124 in step p11. If the flow rate does not become 0 in step p9, steps p7 and p8 are repeated until the flow rate becomes 0. In step p12, an FV curve is obtained from the flow rate and the air volume stored in the memory 124, and this is recorded on the recording paper 127 in step p13. At step p14, the FV curve is approximated by a quadratic curve to obtain the coefficients of the first-order term and the second-order term,
Further, R _AT is obtained, and this is stored in the memory 24 in step p15.
To memorize. The FEV is obtained from the one second amount and the forced vital capacity stored in step p16. In step p17, this FEV and R _AT are graphed, and in step p18 this is recorded on the recording paper 127. At step p19, a series of operations ends. In addition, the visual display means 125 divides the screen into two parts, one side has the FV curve and the other side has the FEV and R _AT.
A graph showing the relationship with is displayed, and either one can be enlarged and displayed by the changeover switch.

4. FEV and correlation thus determined was FEV and vertical and R _AT with R _AT, those displayed on the horizontal axis, a diagram 16. In this figure, since the predicted vital capacity VC _P is used as the FEV instead of the forced vital capacity, it is expressed as FEV (VC _P ). Here, the predicted vital capacity is different from the actual measured vital capacity, and is the vital capacity predicted from the age and height of the subject. In FIG. 16, line 117 shows a non-smoker and a healthy subject, and lines 118, 11
9 is a non-smoker of a subject who is apt to cause air conduction obstruction. In particular, the line 118 is of a type that tends to cause obstruction mainly in the upper airway. In general, each line shows a tendency that the airway obstructive lesion becomes worse as it goes down to the left and goes to the lower left. Further, the curve SA corresponds to a case where a healthy person (that is, a person who is unlikely to cause airway changes) smokes, and the curve SB corresponds to a case where a person who easily causes airway obstruction smokes.

In the area below the second inlaid eye (lower left in FIG. 16), the lesion has progressed, and the patient is hospitalized and needs treatment.

R _AT and FEV (VC _p ) shown in FIG.
An example of the data used to plot the relationship of
Shown in

[0098]

[Table 9]

As the vertical axis, F is used instead of FEV (VC _p ).
Adopt EV (g) (forced vital capacity) or FEV
If (t) (inspiratory spiratory capacity) is adopted, both are shown in FIG.
become that way. Lines 130, 131 and 13 in the figure
2 corresponds to lines 117, 118, and 119 in FIG. 16, respectively. Accordingly, line 120 represents that of a non-smoker, healthy subject. R _AT and F shown in FIG.
An example of the data used to plot the relationship with EV (g) or FEV (t) is shown in Table 10.

[0100]

[Table 10]

In FIG. 15, FEV is used as the amount of one second.
If (g), FEV (t), and FEV (VCp) are all calculated and stored in the memory in step 16, each FEV, R _AT graph can be arbitrarily obtained. For example, by pressing the function key, FEV (g) → F
It can be set to cycle from EV (t) to FEV (VCp). Therefore, the desired 1 second rate (FEV) and R _AT
The relationship between can be displayed in a graph, and detailed evaluation and analysis are possible.

5. Evaluation of ventilation function FEV, R _AT for lifestyle management according to the present invention
The use of the correlation of is further explained.

As described above, according to the structure of the present invention, F
The graph of the relationship between EV (for example, FEV (g)) and R _AT is displayed again. See FIG. As described above, this is useful for evaluation of air conduction obstruction and airway hyperresponsiveness, and enables lesion management of a subject.

Furthermore, based on FEV and R _AT ,
Zone it. Upper right area of line 20 and R _AT ≧ 0.2
The zone consisting of the above is defined as zone A. Subjects in this zone are in good health. FEV80 or above, R _AT
A portion excluding the zone A in the zone of ≧ 0 is defined as zone B. Subjects in this zone should change their lifestyle. A zone in which FEV is 70 or more and 80 or less and R _AT ≧ 0 and a zone in which FEV is 70 or more and R _AT ≦ 0 are defined as a zone C. Subjects in this zone require screening for disease. FEV5
The zone of 5 or more and 70 or less is defined as zone D ₁ . Subjects in this zone require disease management. FEV40
The zones of 55 or less and the FEV of 40 or less are defined as zones D ₂ and D ₃ , respectively. Subjects in this zone may need to be hospitalized, visited, and may need emergency treatment. In this way, ventilation capacity evaluation including lifestyle management can be performed.

6. Comprehensive Evaluation of Ventilation Function / Gas Exchange Function Next, a comprehensive evaluation of ventilation function and gas exchange function (also referred to as capacity) for health management by lifestyle management according to the present invention will be described.

The above-mentioned evaluation of the ventilation function is aimed at lifestyle management from the relationship between R _AT and FEV (ventilation function), and the gas exchange functions (P ′ _co , D ′ _LCO ,
_{D 'LCO / V' A,} P 'co (22), D' Lco (22), D 'LCO /
When V ′ _{A (22)} , SPO ₂ ) is added as a parameter and evaluated three-dimensionally, the respiratory function test index and the health care are more logically related.

FIG. 18 shows the 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, and the value. D is a diagram for explaining a method for obtaining by calculating the _'LCO / V _a' or D _LCO / V _a.

The CO lung diffusion ability D' _LCO or D _LCO is measured by a single breath method, which is also called a breath holding 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. 19 below) for gas analysis. The mixed gas is 0.3% CO, 10%
It is a mixed gas of He, 20% O ₂ and 70% N ₂ .

Since CO is taken in the lungs, F _ACO decreases with time, but since He is not taken in the lungs, 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 (11) By definition, D _LCO = V ″ _CO / P _ACO (12). V ″ _CO is the first derivative of V _CO . Substituting V ″ _CO = −dV _CO (t) / dt P _ACO = P _ACO (t) (13) into this equation, dV _CO (t) / dt = −D _LCO · P _ACO (t) (14) Here, since V _CO (t) = F _ACO (t) · V _A (t) (15), dV _CO (t) / dt = F _ACO (t) · dV _A (t ) / Dt + V _A (t) · dF _ACO (t) / dt (16), and if V _A (t) = constant (17), then dV _A (t) / dt = 0 (18) Therefore, dV _CO (t) / dt = _VA · dF _ACO (t) / dt (19) Moreover, P _ACO (t) = (P _B −47) F _ACO (t)… (20) Substituting into the above equation

[0110]

[Equation 1]

This is the Krogh equation. If t is seconds,

[0112]

[Equation 2]

Substituting the above equation (10) into FACO (0),

[0114]

(Equation 3)

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

Although D _LCO is calculated by the equation (23), there are two ways to obtain V _A. The first Determination, in addition residual capacity measured in advance in D intake air amount at the time of _LCO measurement (V _I) to (RV), determined amount of alveolar the (V _A). Normally RV to T
Since it is the inhalation up to the LC position, V _I becomes a value substantially equal to inspiratory vital capacity, and V _A becomes 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 ′ (24) holds. From this, the _{V A '= F IHe (V} I -V D) / F AHe ... (25). In this case, V _D is extremely smaller than V _I , so that V _I −V _D ≈V _I (26)

[0118] determine the 'V _A in _{= V I · F IHe / F} AHe ... (27)' V A. When _V'is substituted for V _A in the equation (23), it is distinguished from normal D _LCO as D' _LCO .

Carbon monoxide differential CO partial pressure _P'CO and P '
_{co (22)} is expressed by the following equations (28) and (29).

[0120]

(Equation 4)

P ′ _{CO (22)} = (P ′ _co / BMI) × 22 (29) In the above formula, BMI is an abbreviation for Body Mass Index and represents obesity, and weight (kg) / height (m) ² It is an index calculated by.

Therefore, P'co ₍₂₂₎ is also referred to as standard weight standardized P'co.

Similarly, D ′ _LCO and D ′ _LCO / V _A can be _{expressed by the} following equation (3
Standard weight can be standardized according to 0) and (31).

D ′ _{LCO (22)} = (D ′ _LCO / BMI) × 22 (30) D ′ _LCO / V ′ _{A (22)} = (D ′ _LCO / V ′ _A / BMI) × 22 (31) _{) D 'LCO (22),} D' LCO / V 'a (22) are each normal weight scaled D' _{LCO (22),} also referred to as _{D 'LCO / V' a (} 22).

Expression (28) represents the transition of the gas exchange state in the alveoli, and is the partial pressure difference of carbon monoxide per unit time, and the unit is mTorr / sec. The first term (0.
30 / F _ICO ) is a concentration of carbon monoxide in the intake gas of 0.
This is a term to be corrected to 30 (%). The second term (P _B -47)
Is the total dry gas pressure in the lungs. The first half of the third term, {F _ICO × F _AHe / F _IHe }, is the concentration of carbon monoxide in the lung at the initial _stage (t = 0), and F _ACO is the concentration of carbon monoxide in the lung at the end _stage . is there. To these (P _B -4
The product of 7) is the partial pressure of carbon monoxide in the lungs at the beginning and end. The numerator 10 of the fourth term is multiplied by 1000 to change the pressure from Torr to mTorr (millitorr),
Since the gas concentration is expressed in%, it is divided by 100, that is, 1000/100 = 10.

As described above, the equation (29) is the partial pressure difference of carbon monoxide per unit time, which is standardized to the standard weight, and the unit is m.
TORR / sec.

The first term of the equation (29) has an advantage that it can be compared with others by correcting P'co per unit BMI with height (m) and weight (kg).

FIG. 19 is an overall system diagram of a measuring device for a ventilation function and a gas exchange function, which constitutes a part of the present invention. The subject holds a tube 121 in his mouth to make simultaneous measurements of the subject's ventilation and gas exchange functions, and thus in the same test regime. The mixed gas is supplied from the mixed gas source 140 to the first switching valve 141. First switching valve 1
A flow meter 122 for measuring the flow rate of exhaled air is connected to 41, the output of the flow meter 122 is given to a processing circuit 123, and the flow rate and the air volume are sampled and read over time. The exhaled air from the flow meter 122 is sent to the conduit 142.
From the second switching valve 143.
43 dissipates the exhaled air from the conduit 42 to the atmosphere from the conduit 144 or guides it to the flexible sampling bag 139 via the conduit 145. The CO concentration of the exhaled air in the bag 139 is detected by the CO concentration detecting means 146, and H
The concentration of e is detected by the He concentration detecting means 147,
The outputs of the respective density detecting means 146, 147 are given to the processing circuit 123.

FIG. 20 shows the processing circuit 12 shown in FIG.
6 is a flowchart for explaining the operation 3; From step o1 to step o2, the first switching valve 141
Is switched from the first position 141a to the second position 141b, and the test subject holds the pipe 121 in his mouth and the mixed gas source 140
The mixed gas from the maximum expiratory position RV to the maximum inspiratory position TLC
Up to 1 point from the beginning of inhalation at this position
Stop breathing for 0 seconds. Next, in step o3, the first switching valve 141 is switched to the first position 141a, and at this time, the second switching valve 143 is set to the first position 143a, and the maximum ringing is rapidly performed. At this time, in step o4, the elapsed time of the flow rate of the expired gas is measured by the flow meter 122 and stored in the memory 124. In step o5, 750 mL of the exhaled breath is measured, and the 750 mL of the exhaled breath is released to the atmosphere from the first position 143a of the second switching valve 143 via the pipe 144. In the next step o6, the second switching valve 143 is switched to the second position 143b,
At step o7, 1000 mL of the remaining exhaled gas is stored in the bag 139 through the pipe line 145, and even then, at step o8, the measured value of the flow meter 122 is measured with time and stored in the memory 124. I'll do it. In step o9, 1000 in step o7
After the measurement of mL, the first position 143a is switched to to dissipate the remaining exhaled air to the atmosphere.
The measurement value of 22 is stored in the memory 124 from the processing circuit 123. In this way, the memory 1
Will be stored at 24.

The processing circuit 123 is provided with a visual display means 125 using a cathode ray tube or a liquid crystal display element, and the display surface 126 thereof can display the above-mentioned display drawings and the like. Further, when the flow amount curve which has already been measured is drawn on the recording paper 127, the recording paper 127
It is also possible to supply to the reading means 128 for optically reading and read the flow volume curve recorded on the recording paper 127 and store it in the memory 124.

The processing circuit 123 detects the peak position of the descending leg of the flow volume curve stored in the memory 124 in step o10, and obtains the maximum flow rate PEFR at that time and the air volume V1 at that time. In step o11, relative volume or absolute volume is selected for the volume of the flow volume curve.

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 flow rate in step o12.

At step o13, the coefficient gradient index R _AT is obtained by using the value obtained by 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. Calculate the one second rate FEV according to the following step o14. When the absolute volume is selected in step o11, the quadratic variable x becomes the absolute volume.

At step o15, D _LCO , D _LCO /
V _A , D' _LCO / V ' _A , _{P'CO (22)} , D' _LCO / V'
Parameters such as _{A (22)} are calculated, and in step o16, three-dimensional display as shown in FIG. 21 is performed. In this way, by measuring the ventilation function and the gas exchange function in time series using the steps of FIG. 20, a three-dimensional display can be performed as shown in FIG. The three-dimensional display shown in FIG.
Achieved by 5.

Like the display of FEV-R _AT , D _LCO , D _LCO
/ V _A , D' _LCO / V ' _A , _{P'CO (22)} , D' _LCO / V'
_{If A (22)} is stored in the memory at step o15, a three-dimensional display graph with each Z axis can be obtained. For example, by pressing the function key, D _LCO → D _LCO / VA → D ' _LCO / V'A → P'
Set to cycle _{CO (22)} → D' _LCO / V ' _{A (22)} .

According to the preferred embodiment of the present invention, the FEV and R _AT are first displayed in two dimensions before three-dimensional display of various parameters in step o16 of FIG. 20, and the zone to which the subject belongs is determined as described above. Identify. 3 depending on the zone
D _LCO , D _LCO / as the Z-axis parameter when displaying dimensions
_{V A, D 'LCO / V} ' A, P 'CO (22), and D' _LCO /
The most optimal gas exchange function index is selected from the group of V'A ₍₂₂₎ , and three-dimensional display is performed in step o16.

Therefore, in step o15, only the specific parameters can be calculated from the result of the two-dimensional display, and after calculating all the parameters, they are stored in the memory 124 to obtain the desired Z-axis parameters. It is possible to take out only that and complete the three-dimensional display. In any case, the desired Z-axis parameter (gas exchange function index) depends on the health group to which the subject belongs.
Can be selected.

Although the apparatus or method of the present invention has been described with reference to the embodiments, the scope of the present invention is not limited to the disclosed specific examples.

[0139]

As described above, according to the present invention, the spatial conceptualization of the respiratory function is performed based on the expiratory data of the subject, and each respiratory function index (ventilation function index, gas exchange function index, gas transport function index, metabolism Function indicators) and lifestyles are associated to comprehensively evaluate each function, and health management based on respiratory function can be performed.

Further, according to the present invention, the metabolic function index is calculated based on the breath data of the subject, the exercise energy consumption (E ₁ ) is calculated, and the estimated daily consumption energy (E ₂ ) is obtained. The estimated daily consumption energy (E ₂ ) thus obtained, unlike the approximate estimated daily consumption energy (E ₃ ) of the prior art, accurately reflects the metabolic function of the subject, and therefore this value is By using this, it becomes possible to accurately give health guidance including nutrition, obesity, exercise, etc. of the subject and guidance for lifestyle management.

More specifically, the oxygen consumption capacity of middle-aged and elderly people can be improved, and respiratory health including metabolic function can be managed, and lifestyle management can be performed.

In addition, grasping the initial values of young people regarding morphological changes and oxygen consumption supply ability based on allergic predisposition,
It is possible to evaluate the health risk.

Furthermore, the present invention is directed to health management activities (health education, health management, primary care, group management) of groups (regions, occupations, medical groups) whose main bodies are regional medical associations, regional industrial health centers, and municipal health centers. Contribute to the promotion of.
As a result, health management of the respiratory system including metabolism can greatly contribute to the maintenance and promotion of health for the middle-aged and the elderly as well as the prevention of diseases, and can be expected to reduce the national medical expenses.

[Brief description of drawings]

FIG. 1 is a diagram showing a correlation between respective functions such as a ventilation function and a metabolic function in a respiratory function.

FIG. 2 is a block diagram of a main part of the gas phase respiratory function testing system of the present invention.

FIG. 3 is a block diagram of an example of a V ′ _O2 and V ′ _CO2 measuring device.

FIG. 4 is a view in which a correlation diagram of FEV ₁ % (g) and R _AT is zoned and displayed.

FIG. 5 is a schematic diagram spatially conceptualizing the relationship between respiratory function and lifestyle.

FIG. 6 is a block diagram showing an electrical configuration of an apparatus for obtaining an FV curve.

FIG. 7 is a flowchart when operating the processing circuit 123 shown in FIG. 6 to display an FV curve.

FIG. 8 is a diagram schematically showing an FV curve of expiratory air of a subject.

FIG. 9 is a schematic diagram of synthesizing FV curves according to the present invention.

FIG. 10 is a diagram showing an example of both FV and GV curves.

FIG. 11 is a diagram showing an example in which an FV waveform is analyzed and synthesized according to the present invention.

FIG. 12 is a coefficient correlation diagram (a) of a quadratic regression equation according to the present invention.
It is a figure which shows 1, a2).

FIG. 13 is a flowchart when the processing circuit 123 is operated and a1 and a2 are calculated and displayed according to the present invention.

FIG. 14 is a diagram showing a relationship between a coefficient a1 of a first-order term, a coefficient a2 of a second-order term, and a coefficient gradient index R _AT of a quadratic curve according to the present invention.

FIG. 15 is a flowchart for operating the processing circuit 123 to calculate and display a1, a2, R _AT according to the present invention.

FIG. 16 shows FEV (VCp) and R _AT T according to the present invention.
It is the figure which displayed an example which shows the relationship of.

FIG. 17: FEV (g) or FEV according to the invention
It is the figure which displayed an example showing the relationship between (t) and R _AT . FIG.

FIG. 18 is a schematic diagram for explaining the tidal breathing method according to the present invention.

FIG. 19 is a system diagram showing an overall configuration of a respiratory function / gas exchange function measuring device according to the present invention.

FIG. 20 activates the processing circuit 123 to activate R _AT , FEV, D _LCO , D _LCO / V _A , D' _LCO / V 'in accordance with the present invention.
_{A, P 'CO (22)} , D' LCO / V ' calculates _{A (22),} further 3
It is a flow chart when displaying dimensions.

FIG. 21 is a three-dimensional view of a ventilation function index and a gas exchange function index according to the present invention.

[Explanation of symbols]

11 Exercise Means 12 Mouthpiece 13 Exercise Loader 14 Sampling Tube 15 Flow Sensor 16 Infrared CO ₂ Sensor 17 Zirconia O ₂ Sensor 18 Microcomputer 19 Display 20 Subject 21 _V'O2 , _V'CO2 Measuring Device 121 Tube 122 Flow System 123 processing circuit 124 memory 125 display means 126 display surface 127 recording paper 128 reader 140 mixed gas source 141 first switching means 143 second switching means 146 CO concentration detecting means 147 He concentration detecting means

Claims (20)

[Claims] 1. A first inspection means having a calculation processing unit for measuring, calculating, analyzing, and displaying a ventilation function index and / or a gas exchange function index of a subject, and the subject may be connected to the calculation processing unit. Second test means for measuring, calculating, and displaying the metabolic function index of No. 3, exercise load means connected to the second test means, on which the subject exercises, and third for measuring and calculating the gas transport function index of the subject A gas phase respiratory function inspection system for comprehensive health management, which is characterized by including an inspection means. 2. Further, the ventilation function index of the subject is measured,
The gas phase respiratory function testing system according to claim 1, further comprising a fourth testing means for calculating, analyzing and displaying. 3. The gas phase respiratory function testing system according to claim 1, further comprising a muscle strength measuring means for measuring the muscle strength of the subject. 4. The gas phase respiratory function testing system according to claim 1, further comprising blood pressure measuring means for measuring the blood pressure of the subject during exercise. 5. The ventilation function index is FEV _1% or R _AT , and the gas exchange indexes are D _LCO , D _LCO / V _A , D' _LCO / V '.
_{A, P 'CO (22)} , and D''is at A ₍₂₂₎ from one or more selected from the group consisting of metabolic function indicator V' _LCO / V _O2,
V _'CO2, is at least one selected from the group consisting of AT, and R and vapor phase system respiratory function testing system according to any one of claims 1 to 4 gas transport function is SPO _2,. 6. The gas exchange index is P ′ _{CO (22)} or D ′.
The gas phase respiratory function testing system according to claim 5, which is _LCO / V ' _{A (22)} . 7. The gas phase respiratory function testing system according to claim 1, wherein the exercise load means is a treadmill load device or an ergometer load device. 8. The gas phase respiratory function testing system according to claim 3, wherein the muscle strength of the subject is grip strength. 9. (a) The X-axis positive direction of the three-dimensional Cartesian coordinate system is used as a first ventilation function index, the X-axis negative direction is used as a gas transport function index, and the Y-axis positive direction is used as a second ventilation function index. The negative axis direction is the metabolic function index, the positive Z axis direction is the gas exchange index,
Forming a three-dimensional space related to the respiratory function by using the negative direction of the Z-axis as a muscular force, (b) dividing the three-dimensional space into eight parts, the X-axis positive, the Y-axis positive, and Z
The divided space surrounded by the positive axis direction is defined as the first space, the positive X axis,
A divided space surrounded by the Y-axis positive direction and the Z-axis negative direction is defined as a second space, and a divided space surrounded by the X-axis positive direction, the Y-axis negative direction and the Z-axis positive direction is defined as a third space, and the X-axis positive direction and the Y-axis negative direction are defined. The divided space surrounded by the Z-axis negative direction is defined as a fourth space, the divided space surrounded by the X-axis negative direction, the Y-axis positive direction, and the Z-axis positive direction is defined as a fifth space, and the X-axis negative direction, the Y-axis positive direction is defined.
The divided space surrounded by the Z-axis negative direction is the sixth space, the divided space surrounded by the X-axis negative, the Y-axis negative, and the Z-axis positive direction is the seventh space, and the X-axis positive, the Y-axis negative, and the Z-axis negative. The divided space surrounded by the directions is the eighth space, and (c) the first ventilation function index, the second ventilation function index, the gas exchange index, the gas transport function index, and the metabolic function index are obtained from the expiratory data of the subject. Further, measuring the muscle strength of the subject, displaying the index and the muscle strength value in the three-dimensional Cartesian coordinate system in three-dimensional coordinates to identify the space to which the subject belongs, and (d) the result displayed in the three-dimensional coordinates and the A comprehensive health management method from the viewpoint of respiratory function, comprising the steps (a) to (d) above for comprehensively evaluating the respiratory function of the subject from the characteristics of the space to which the subject belongs. 10. The first ventilation function index is R _AT , the second ventilation function index is FEV _1% , and the gas exchange function index is D _LCO , D _LCO /
_{V A, D 'LCO / V} ' A, P 'CO (22) and D' _LCO / V '
Is selected from the group consisting of _{A (22)} , and the metabolic function index is _V'O2 ,
V _'CO2, selected from the group consisting of AT, and R, Comprehensive health management method of gas transport function indicator viewed from the respiratory function of claim 9 wherein the SPO _2. 11. _A comprehensive respiratory function-based comprehensive view according to claim 10, wherein the gas exchange function index is _{P'CO (22)} or D' _LCO / _{V'A (22)} and the metabolic function index is _V'O2. How to manage your health. 12. The muscle strength is grip strength, as claimed in claim 10.
The method of comprehensive health management from the viewpoint of respiratory function described in 1. 13. Instead of the step (c), (C′1) R _AT and FEV _1% are obtained from the breath data of the subject, and the muscle strength of the subject is measured, and the index is the X-axis-Y.
Each of (A) health, (B) lifestyle management, (C) screening and (D1-3) disease management, which is two-dimensionally displayed on an axial plane and is preset on the two-dimensional coordinate plane (C'2). The health management zone consisting of zones and the two-dimensional coordinate display obtained in step (C′1) are matched, and when the result is the (A) zone, the index and the muscle strength value are displayed in the second space in three-dimensional coordinate display. 11. The method for total health management from the viewpoint of respiratory function according to claim 10, wherein the steps (C′1) and (C′2) above are executed. 14. Instead of the step (c), (C ″ 1) R _AT and FEV _1% are obtained from the breath data of the subject, and the muscle strength of the subject is measured, and the index is the X-axis-Y.
Two-dimensionally displayed on the axial plane, and (C ″ 2) preset on the two-dimensional coordinate plane, (A) health, (B) lifestyle management, (C) screening and (D1-3) disease management When the health management zone consisting of each zone and the two-dimensional coordinate display of step (C ″ 1) are matched, and the result is the zone (B), P ′ _{CO (22)} and / Or D' _LCO / V ' _{A (22)}
And combine one of the indicators with the above
The method for total health management from the viewpoint of respiratory function according to claim 11, wherein three-dimensional coordinates are displayed in a space, and the steps (C ″ 1) and (C ″ 2) above are executed. 15. The method of comprehensive health management according to claim 14, further comprising displaying the muscle strength values in the second space in three-dimensional coordinates in the step (C ″ 2). Instead of claim 16, wherein the (C) step, (C '''1) R AT from the subject's breath data, FEV _1%
Further, the muscle strength of the subject is measured, the index is two-dimensionally displayed on the X-axis-Y-axis plane, and (C ″ ″ 2) (A) Health preset on the two-dimensional coordinate plane, ( B) Lifestyle management, (C) Screening and (D1-
3) Matching the two-dimensional coordinate display of step (C ″ 1) with the health management zone consisting of each disease management zone, and when the result is the (C) or (D1-3) zone, the subject's breath is further exhaled. From the data _{P'CO (22)} and /
Or D' _LCO / V ' _{A (22)} , and _V'O2 , and / or
Or, AT and SPO ₂ are obtained, and each index is displayed in three-dimensional coordinates in the corresponding space formed in step (b). From the above (C ″ ″ 1) and (C ″ ″ 2) 12. The method for total health management from the viewpoint of respiratory function according to claim 11, which comprises the steps of: 17. In the step (C ″ ″ 2), the muscular strength value is further calculated as one of the second space, the fourth space, the sixth space and the eighth space.
The method for comprehensive health management according to the respiratory function according to claim 16, wherein three-dimensional coordinates are displayed in one or more spaces. 18. The method for total health management from the viewpoint of respiratory function according to claim 9, wherein steps (C) and (D) are performed by the gas phase respiratory function test system according to any one of claims 1 to 3. 19. A method of health management from the viewpoint of metabolic function, comprising: (a) setting an exercise mode corresponding to a subject's daily lifestyle, and (b) converting the set exercise mode into an exercise load amount. Then, (c) the subject is placed on the exercise means including the exercise load means,
While exercising for a predetermined time while applying the exercise load, exhaled breath is collected from the subject's mouth, (d) the oxygen concentration in the exhaled breath is detected, and _V'O2 is calculated based on the detected oxygen concentration, (e) ) V ′ _{O2 is used} to obtain the kinetic energy (E ₁ ) consumed by the subject at the predetermined time, (f) the kinetic energy (E ₁ ) consumed is converted into the estimated daily consumption energy (E ₂ ) of the subject, and (G) The above-mentioned method, characterized in that the estimated daily consumption energy (E ₂ ) is evaluated, the exercise prescription for improving oxygen consumption and the prescription for changing the nutritional requirement are given to the subject to manage their health. . 20. The method according to claim 19, wherein the steps (b) to (f) are carried out by the gas phase respiratory function testing system according to claim 5, wherein the method is based on metabolic function.