JPS62500077A - Technology to obtain waveform information related to individual blood pressure - Google Patents

Abstract

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

Description

[Detailed description of the invention] Technology for obtaining waveform information related to an individual's blood pressure The present invention generally relates to a blood pressure evaluation method. In particular, the present invention relates to non-invasive techniques for measuring various types of waveform information related to blood pressure.

The most reliable method currently known for obtaining information about an individual's blood pressure. Most of the methods require invasive procedures. Such a procedure is routine In extreme conditions such as during heart surgery where the work cannot be performed as It is held at the base. Unless the conditions are too strict, the systolic (maximum) and Blood pressure information including diastolic and diastolic (minimum) blood pressure can be obtained non-invasively. today Two well-known non-invasive techniques are used, one of which is auscultation. and the other is based on vibrometry. these The non-invasive technique uses a standard arm cuff that is familiar to most people. . However, in the auscultation method, the cuff is first pressurized and then depressurized. systole and diastole by listening to the sounds (Korotkoff sounds) produced during systole and diastole. blood pressure was measured, whereas in the oscillometric method, the cuff was first inflated and then decompressed. The change in cuff pressure caused by the change in blood pressure during the test is actually measured.

As will become clear below, various embodiments of the invention are based on vibrometry. It is. To fully understand these examples, to obtain blood pressure information non-invasively. No. 3,903,872 (the Link patent).

The patents taken by reference are based on, inter alia, the technology detailed below. A method of obtaining an individual's diastolic blood pressure is disclosed.

Also incorporated by reference are U.S. Pat. No. 711 (Link et al.) describes the use of vibrometry to obtain an individual's systolic blood pressure. A non-invasive technique for this purpose has been disclosed. These techniques are discussed below. .

The above-mentioned patents of Mr. Link and Mr. Link et al. and other patents owned by the applicant Although the various procedures disclosed prima facie satisfy the intended purpose, it is an object of the present invention to An easier and more reliable technique for obtaining various forms of information about a person's blood pressure. The aim is to provide techniques.

A more specific object of the invention has hitherto been obtained only by invasive means. This method is used to non-invasively create a waveform that closely approximates an individual's true blood pressure waveform. The aim is to provide a simple and highly reliable technology that is different from what has existed up until now.

Another specific object of the invention is a novel method for measuring and calculating the mean arterial blood pressure of an individual. The purpose is to provide a method.

As described in detail below, the above object is achieved by vibrometry. child According to the technology of The cuff of a human being, particularly a human being, or generally a mammal (hereinafter referred to as a patient), the patient's systolic blood pressure. Pressure is increased to a level such as 180 Torr. Also, this pressure It is thought to completely occlude the patient's artery within the tube. Then reduce cuff pressure to zero. During this time, the cuff will (1) respond to changes in blood pressure within the patient's arteries; , (2) In combination with changes in cuff pressure, the pressure is continuously increased in an oscillating state. Change. During this procedure, the cuff pressure is known at all times and the cuff pressure oscillations This change can be easily measured using, for example, an oscilloscope. These 2 parameters in conjunction with information obtained from the method disclosed in the above-mentioned U.S. patent. By using the technology of the present invention described below, The above objectives can be achieved.

In this regard, this is initially addressed by a pressure cuff, typically 5 inches wide. Note that it completely surrounds the 5 inch long artery. The arm tissue is For example, the volume of an artery changes due to the pulsating flow of blood because it is almost incompressible. As the air volume changes, the air volume of the air bladder in the cuff adjacent to the arm changes correspondingly. this sky Slight but accurate change in air volume? l11 Determinable pressure change is air occurs in In this way, pulsatile changes in cuff bladder pressure result in pulsatile changes in arterial volume. Equal change is the essence of vibrometry.

For a more complete understanding of the various techniques of the present invention, FIGS. The background technology will be described in more detail in connection with this.

FIG. 1 (corresponding to FIG. 6 of U.S. Pat. No. 3,903,872) shows an enlarged view of the patient. Assuming the tension pressure is 80 Torr, the measured pressure of the cuff is 90 Torr to 80T. Successive cuff pressure and time pulses (cuff The shape of the pulse (pulse) is schematically shown.

Figure 1A corresponds to the cuff pulses in Figure 1 from cuff pressure 160 Torr to zero. 2 schematically shows a series of all cuff pulses.

Figure 2 shows the arterial volume or cuff volume (V), in other words the volume of the patient's artery within the cuff. (measured by the volume of the cuff) and wall pressure (P) across the artery wall within the cuff. A curve representing the relationship between These two curves are based on the original vibration measurement method based on the above patent. This is to explain the theory.

Figures 3 and 4 are based on the above-mentioned Link patent and Link et al. patent. The first in a manner that represents the technique for obtaining a given systolic and diastolic blood pressure of a patient. 1 schematically shows the cuff curve of the figure.

Figure 5 shows the compliance curve of the patient's artery, that is, the ratio to the arterial wall pressure Pw. This diagram schematically shows a curve representing ΔV/ΔP, where ΔV is a given constant change in blood pressure. is the incremental change in arterial volume corresponding to ΔP. This curve becomes clear below As shown in Figure 2, the cuff volume, that is, the artery volume curve (V/P curve) is formed by integration. In order to do so, it is determined first.

First, referring to Figure 1, this figure shows three different cuff pressures, specifically 90To rr, the volume of the pressurizing force cuff at cuff pressures of 80 Torr and 70 Torr Three successive waveforms 10h, 10i and 10j corresponding to the changes are schematically shown. Ru. In fact, as shown in Figure 1A, the cuff pressure starts at 160 Torr. A large number of waveforms (hereinafter referred to as cuff pulses) are generated until the cuff pressure reaches zero. generated. By generating these waveforms at known cuff pressures, the patient deflates. Diastolic and diastolic blood pressure can be measured according to the above patent. about this will be explained in detail below, but first, each waveform has the systolic rise S at one end. r, with a diastolic fall Dd at the opposite end, and a maximum amplitude A. It is important to pay attention to

The systolic rise Sr is very consistent and varies from one cuff pulse 10 to another. The diastolic fall Dr and amplitude A are as follows: It varies from pulse to pulse for reasons stated. Disclosed in the above-mentioned patents of Mr. Link and Mr. Link et al. It is because of these changes that diastolic and systolic blood pressure can be measured using the developed technique. It is something that In particular, it is clear that the patient's diastolic blood pressure is equal to the cuff pressure. When the diastolic fall of the generated cuff pulse is different from any other cuff pulse. The slope is steeper than the diastolic fall of . Therefore, the fall of diastole is shown in Figure 1. Assuming the maximum slope at cuff pulse 10i, these waveforms can be The resulting patient will have a diastolic blood pressure of 80 Torr. At the same time as this , find which cuff pulse shows the maximum amplitude A, and then increase the cuff pressure. By finding the cuff pulse that is half the amplitude of the patient's systolic blood pressure can be measured. The cuff pressure to generate this hand amplitude pulse is , equal to the patient's systolic blood pressure. To fully understand these features, please refer to the references above. Figures 2 through 5 will now be explained along with the patents of Mr. Nk and Mr. Link et al.

Now, to explain why the cuff pulse shown in Figure 1 occurs due to changes in cuff pressure. To explain the curve shown in Figure 2, the generally S-shaped curve shown in Figure 6 12 is the wall pressure across the patient's dynamic WX wall within the limits of the attached cuff. The horizontal axis represents Pw and the arterial volume within the cuff is measured by the internal volume of the cuff itself. It is shown in a horizontal/vertical seat system with the vertical axis representing the volume V.

In order to fully understand this V/P curve (hereinafter referred to as the river artery or cuff curve m), For this purpose, it is important to keep in mind Pw (7) constant a. at a given time The wall pressure Pw of the patient's artery at that time is determined by the pressure applied to the cuff from the blood pressure Pb in the patient's artery at that time. It is equal to the force Pc. Therefore, it becomes 5th order.

Pw = Pb - Pc (1) For purposes of illustration, pressure shall be measured in Torr (mmtlg) and on the vertical axis The portion of the horizontal axis further to the right represents positive wall pressure, while the portion of the horizontal axis to the left of the vertical axis Let represent negative wall pressure. As a result, no pressure is applied to the cuff (e.g. , Pc=0), the pressure Pw at any time is equal to the patient's blood pressure at that time. Become.

When pressurizing the turnip, the pressure Pv decreases (moves to the left along the horizontal axis).

When the cuff pressure Pc is equal to the blood pressure pb at a given time, then the current pressure P w equals zero (eg, vertical axis). At some point, the cuff pressure will lower your blood pressure. When the pressure increases beyond the limit, the pressure Pν at that time becomes negative (moving further to the left on the horizontal axis) do).

Remembering the definitions of the vertical axis V and the horizontal axis Pw, the generally S-shaped The interpretation of the cuff curve 12 will be explained.

We assume that this curve represents the characteristics of the particular patient being diagnosed. Ru. That is, the volume of the patient's artery within the cuff, and by extension the cuff itself, follows this S-shaped curve. Assuming that it changes along this curve and changes only along this curve as Pw changes. Set.

Hereinafter, referring to FIG. This shows that the corresponding cuff pressure Pc can be formed. Therefore, for the time being, in Figure 2 Assume that the arterial curve shown corresponds to a patient consisting of:

With the following explanation in mind, the arterial curve in Figure 2 will be discussed below. First of all , assume that no pressure is applied to the patient's cuff and therefore PC is zero. This results in , the pressure Pw becomes equal to the patient's blood pressure pb. In this regard, blood pressure pb is diastolic blood pressure)) b(D) and systolic blood pressure pb(s) changes over time It is important to note this point. For purposes of illustration, these values are known and, in particular, the patient's Assume that the diastolic blood pressure is 8 Q Torr and the systolic blood pressure is 120 Torr. . Therefore, when no pressure is applied to the cuff, the pressure P is equal to Pb(D) and Pb (S),! : i.e. between 80 Torr and 120 Torr. They vibrate back and forth together. This 40 Torr measurement band is shown by the dotted line]4 in Figure 2. , which in practice corresponds to the patient pulse pressure ΔP, which in this case is equal to 40 Torr. It represents.

The patient's actual blood pressure waveform 15 is V/Pw in FIG. 2 within the pulse pressure band 14. Superimposed on the coordinate system. As you can see, this waveform is a series of real blood It consists of pressure pulses 16, each pulse corresponding to one beat of the patient's heart. There is.

Each pulse starts at a minimum pressure (the patient's diastolic pressure) and begins at the onset of systole. It increases sharply along the tip, which is Sr, and eventually reaches the maximum pressure (the patient's systolic blood pressure). along the posterior edge, including the dicrotic notch and the diastolic fall Dd. The pressure decreases to the minimum pressure again. At these times, the patient's blood pressure is at its minimum (immediately (i.e., at the expansion end of pulse 16), the volume of the patient's artery and, therefore, the cuff. The volume is fixed at the value indicated by V1 (Pw = 80) by the arterial curve. Ru. On the other hand, when the patient's blood pressure is at its maximum value (at the systolic end of each blood pressure pulse 16), the The pulse curve shows the arterial volume and therefore the cuff volume at V2 (Pw = 120). Fixed at a slightly higher value. Therefore, for each heartbeat, the cuff pressure Pc Assuming zero, the volume V (volume of the cuff) moves between the values v1 and V2, and this As shown in Fig. 1A, at cuff pressure Pc=O, the result is as shown in Fig. 1. A corresponding series of cuff pulses 10q is generated. Therefore, whether the patient's blood pressure is at its minimum value As the arterial volume increases from v to its maximum value, the arterial volume generally corresponds to When l increases to vl and the patient's blood pressure falls again to the minimum value, the arterial decreases from vl to vl in a generally corresponding manner. Therefore, the second Each of the arterial pulses]-0 in the figure has a systolic rise Sr and a diastolic fall Dd. Corresponding to the systolic rise and diastolic fall of each blood pressure pulse 16.

Explained how cuff pulse 10q depends on the volume curve at cuff pressure O However, how the arterial curve changes the arterial pulse with the application of cuff pressure. explain. Assume here that the cuff pressure is 5QTorr. of these conditions Under the pressure Pv oscillates back and forth between 30 Torr and 70 Torr. 3 The value of 0 Torr is 50 Torr while the diastolic pressure Pb(D) is 80 Torr. is determined by subtracting the cuff pressure Pc of , and the value of 70 Torr is Subtract the cuff pressure Pc of 5QTorr from the systolic blood pressure pb(s) of 120Torr. Determined by subtracting. Therefore, the entire 40 Torr band is ′, it is only shifted to the left by an amount equal to 5QTorr. . Under these conditions, pressure PW moves forward along the steeper part of the arterial curve. After oscillating, the volume of the patient's artery, and thus the volume of the cuff, changes between values V3 and V4. make it vibrate. This forms an arterial pulse 101 at Pc of 50 Torr. be done. The amplitude of each cuff pulse 101 may be greater than the amplitude of each cuff pulse 10q. Please be careful. This is the 40 Torr band 1 at a cuff pressure of 50 Torr. 4' is located at a part of the volume gradient that is steeper than zone 14 at zero cuff pressure. be. In fact, by increasing the cuff pressure Pc and decreasing the pressure Pw), the pressure When moving the band to the left on the horizontal axis, first move it along the steep part of the arterial curve. Continue moving and then move along the less steep section. Therefore, correspond to The amplitude A of the cuff pulse IOQ, IOL, etc. (see Figures 1 and 1A) is first , increases to a maximum value and then decreases again. When cuff pressure Pc is 100 , to the left so that the entire pressure band of 4QTorr spans the same distance on each side of the vertical axis. shifted.

This is indicated by 14''. This allows the maximum amplitude of the stream (Δvma A corresponding cuff pulse Log of x) is formed.

For example, when moving further to the left at a cuff pressure Pc of 160 Torr, 40Torr The entire band of rr is shifted a considerable distance to the left of the vertical axis, as shown at 14''', and the volume (amplitude of the corresponding cuff pulse 10a) becomes very small. cuff pressure Increasing to a still larger value moves the band further to the left, eventually increasing the volume V The change in will be very small. From a physical point of view, this means a blockage of the artery. Taste. In other words, the cuff pressure P is sufficiently higher than the blood pressure pb to collapse the artery wall. c is added. In the opposite case, i.e., when cuff pressure Pc is zero, the movement No external constraints are imposed on the pulse, and the arteries are free based only on the internal blood pressure Pb. changes back and forth. Between these extremes, the amplitude A of the cuff pulse 10 (e.g. Δ V) increases to a maximum value as described above and then decreases again. The above-mentioned link et al. It is this part of the volume curve that is used to measure a patient's systolic blood pressure under a patent. This characteristic will be explained with reference to FIGS. 3 and 4.

Note, as mentioned above, that as blood pressure increases, arterial volume increases. . This increase in arterial volume reduces the air volume of the cuff bladder, which causes Air pressure in the cuff bladder increases. Therefore, as blood pressure increases, cuff air pressure increases. To increase. This can be summarized as follows.

Blood pressure increases → arterial volume increases → cuff air volume decreases → cuff air pressure increases therefore.

Increase in blood pressure → Increase in cuff air pressure In FIG. 3, the same arterial curve 12 as in FIG. 2 is shown.

One superimposed pressure zone 141 ul+ at a cuff pressure Pc of 120 Torr have. Now, again, the patient's diastolic blood pressure is 80 Torr and Assume that the systolic blood pressure is 120 Torr and Pc is equal to the patient's systolic blood pressure. Ru. Under these conditions.

The pressure Pw is -40 Torr and zero pressure in zone 14 +111 as shown. It vibrates back and forth between. This results in a change in arterial volume ΔV (e.g., the corresponding A cuff pulse amplitude A) occurs, which corresponds to the maximum change in arterial volume (e.g. maximum cuff is equal to half of the pulse amplitude). Maximum change in volume ΔVmax (and therefore maximum The large cuff pulse amplitude Amax) is approximately 100 Torr cuff pressure Pc (e.g. Recall that the cuff pressure When Pc is equal to the patient's systolic blood pressure pb(s).

The amplitude A of the cuff pulse 10 generated by this is half of the maximum amplitude cuff pulse. It becomes the amplitude. Therefore, the patient's systolic blood pressure is initially, as in Figure 1A, Measured by producing a series of cuff pulses across the cuff pressure vector be able to. From these pulses, the one with the maximum amplitude Amax is determined. , then a cuff with half that amplitude (at higher cuff pressure) The pulse can be found. The cuff pressure Pc used to generate this pulse is Corresponds to the patient's systolic blood pressure. In other words, one evaluates the amplitude of various cuff pulses. By doing this, we can find the one corresponding to band 14 II II shown in Figure 3. be able to. Once this pulse is found, the cuff pressure associated with it is It is said to be equal to the patient's systolic blood pressure. This is US Pat. No. 4,000 of Link et al. No. 9,709 and No. 4°074.711, and these features are In Japan, means are provided to conduct these evaluations electronically.

Returning to FIG. 2, the actual blood pressure waveform 15 is 1, for example.

It is shown to have a uniform repetition rate of 60 pulses/min.

Note that each blood pressure pulse 16 forming this waveform is identical to the next pulse. I want to be understood. For purposes of explanation, we will assume both of these aspects of the waveform. Furthermore, each part As mentioned above, the pulse has its own systolic rise Sr and diastolic fall Dd. have. In addition, the arterial curve 12 is located at the extreme points of the diastole and systole of each pulse. Not only that, but also the relationship between V and Pw at each point on the waveform 15 of each blood pressure pulse 16. Please also note that it indicates the person in charge.

Therefore, the change in volume at two separate cuff pressures only along the fall of diastole ΔV can be measured. In this case, the measurement of zero using pressure zone 18 The pressure band 18 is measured relative to the cuff pressure Pc, and the pressure band 18 is the diastolic phase of each blood pressure pulse 16. It surrounds a small part of the descent. ΔV2' shifts the band to 18' and ΔV3' is measured for a cuff pressure Pc of 50 Torr by , a cuff pressure Pc of 80 Torr by shifting the zone to 18″ (e.g. measured against the patient's diastolic blood pressure). ΔV is the cuff pressure Pc when the patient is in diastole. Note that it is at its maximum when equal to blood pressure. Therefore, for each cuff pressure and measuring the volume change ΔV at the end of the diastolic slope of the patient's actual blood pressure waveform. The single cuff pressure that produces the maximum change corresponds to the patient's diastolic blood pressure. Become. The lowest pressure portion of the diastolic trailing edge Dd forming part of each pulse 16 is It is suitable for this purpose as it can be easily searched during each cycle of the waveform. like this What can be easily searched for is the systolic rise Sr, which can be easily distinguished each time it appears. This is because the lowest pressure portion is located immediately before. This procedure can be performed electronically. 3,903,872, as described in detail in the Link U.S. Pat. No. 3,903,872. It is.

In the above instructions for obtaining the patient's systolic and diastolic blood pressure, the patient's arterial curve is It was assumed that the curves correspond to those shown in FIGS. 2, 3, and 4. like this Although this assumption is valid, the patient's own volume can be calculated using the principle related to Figure 4. Curves can also be measured. In particular, the narrow band 18.18', etc. is the measurement band. and the volume change ΔV obtained from various cuff pressures Pc (e.g. cuff volume ) is plotted as shown in FIG. Therefore, the cuff pressure Pc In case B, the volume change ΔV is relatively small, which is due to the small ΔVl' in FIG. It is clear from this. As the cuff pressure Pc increases, the volume change ΔV increases to the maximum value It continues to increase up to (Δ■3' in FIG. 4) and then decreases. Expressed mathematically , this curve represents the incremental change in volume with incremental change in pressure, i.e. dV/dP (Figure 5). It represents. By integrating this curve, the cuff curves in Figures 2 to 4 can be obtained. A line or V/P curve can be obtained.

patient diastole based on the technology disclosed in the aforementioned Link and Link et al. patents. FIGS. 1 to 5 illustrate the known techniques for obtaining systolic blood pressure and systolic blood pressure. However, various features of the present invention will now be described with reference to FIGS. 6 to 9.

FIG. 6 schematically shows the actual blood pressure pulses for the following patients.

FIG. 7 is a close-up of the actual blood pressure pulse of FIG. 6 generated non-invasively by the present invention. It is a diagram showing similar waveforms on a screen.

FIG. 8 shows an S-shaped cuff curve or artery similar to that shown in FIGS. 2-4. (pv) curve, but with an exaggeration along the vertical slope to reflect actual blood. Each large portion of the diastolic fall forming part of the pressure waveform is superimposed.

Figures 9 (a) to d) schematically show one blood pressure waveform with different blood pressure constants. show.

Figure 10 shows the exact approximation of the patient's actual blood pressure waveform and the patient's IP blood pressure waveform. FIG. 2 is a diagram schematically showing the configuration of a reservoir that forms a curve given to the pressure and the +trh pressure constant. Ru.

First, with reference to Figures 6 through 2 and 8, we will begin by referring to Figures 6 to 2 and 8, and explain how to treat individual patients without using invasive devices. A wave that closely approximates the actual blood pressure waveform (for example, blood pressure pulse 1G in Figure 2) A detailed description of the present invention for generating shapes will now be given. For purposes of explanation, the pulse waveform is assumed to be the actual blood pressure waveform. The blood flow in the affected line is indicated by reference numeral 20 in the graph of FIG. II-(vertical fall) is measured against time (horizontal axis). Above explanation ,) Mr. Komabini Link's special feature No. 3,903,872 and Mr. Link et al.'s Patent No. 4, No. 009,709 and No. 4,074, . By understanding the gist of No. 711, patients can First measure the diastolic and systolic blood pressure Pb(D) and pb(s) of the individual. As shown in Figure 6, the vertical minimum and maximum points on the pulse are Points are given and taken away. At the same time, the systolic tip of the actual pulse is Since it can be easily detected, its starting and ending points in the time direction (140 and tO ’) can also be easily detected.Therefore, using the same coordinate system in Figure 7 and as shown in Figure 6, non-invasively determine important features of blood pressure pulses and thus provide a useful approximation of the total pulse. The following describes how to do this. As shown in Figure 6, horizontal (time)! Ill may represent the patient's diastolic blood pressure. and 0 on the vertical axis position and indicate the start of the waveform. tO' is the #Y point of that waveform and the start of the next waveform. σ; 1 is the second point indicating the starting point, 1, above the time axis, the patient's contraction; A horizontal dotted line L1 can be drawn at the periodic blood pressure. one point on this horizontal line can be to'', which reaches the peak systolic blood pressure pb(s) time, which is readily apparent from the measured cuff pressure pulse. for example , see cuff pulse in FIG. The peak amplitude of each of these pulses is It corresponds to Pb(S) at times H and X in the reference frame.

Time and pressure axes (and P, points to and to', water corresponding to the patient's systolic blood pressure Flat dotted line L1. The graph also shows the portion toI+ on this horizontal line. Since the method for forming waveforms will be described below, all but one of Figure 4. This is similar to FIG. 8 and will be explained below. Explanation of Figure 4 above and Mr. Link's patent No. 3 As is clear from No. 903.872, the cuff pressure Pc is changed. The change in cuff volume caused by this In other words, within a constant band (for example, band 18.18'-etc. in Fig. 4), If so, the patient can be detected by detecting along the falling edge of diastole just before the rising edge of systole. A person's diastolic blood pressure can be measured electronically. Maximum change in arterial volume ΔV The cuff pressure Pc that produces max corresponds to the patient's diastolic blood pressure. this method The physical components for implementing this are disclosed in the '872 patent, which Take this as a reference -4-gero. These components support the patient's systolic rise. Detect the starting point and measure backwards from there e.g. 50 ms means acting as a signal generator to repeatedly form a measurement band of . At this time During this time, for each cuff pressure Pc, the change in cuff volume Δ■ is measured by the cooperative means. Ru. Also, determine the time when 8V is maximum, and calculate the cuff pressure Pc at this ΔVmax. A reading means is also provided. The cuff pressure at this time was 1.6 people's diastolic blood pressure. corresponds to

According to the present invention, instead of a single band as shown in FIG. 4, as shown in FIG. moving backward in time from the rise of systole at to' [a series of IJA The same measurement band, in particular t knee Δt/2 to 1. □+Δt/2; t2-Δt/ 2 to t2+Δt/2 and generally from tn−Δt/2 to tn+Δt The signal generator described above is used to create a measurement band of up to /2.

These bands are designated as 22.22', 22'', etc.

The signal generating means forming part of the components disclosed in the '872 patent include: These temporally different points, and thus separate bands 22, 22', 22'', etc. It can be easily used to form a , and can also be easily modified. Each measurement During the constant band 22, find the cuff pressure that causes the maximum change in cuff volume ΔVmax. The cuff pressure Pc is varied to maintain control. This cuff pressure is the patient's actual blood pressure, For example, corresponding to Pbl at time t1 of the patient's waveform, time t1 corresponds to band 22 is the temporary center point of Repeat this for measurement bands 22', 22'', etc. (preferably all in one operation) at times t2, t, 3 of the graph of FIG. , etc., pressure points Pb2, Pb3, etc. can be formed. time 2, t3, etc. are the temporal center points of their respective A;F regions. In Figure 8 shows only three such bands along the falling edge of diastole, but This can be extended entirely back to the start of the process (time to).

However, as described below, 1. For example, systolic blood pressure points and dicrotic notches Exclude areas along pulse segments where the slope is zero. In this way, Find all intermediate points between to and to' (except at zero slope) Can be done.

Measurement band 22 . 22', etc., this procedure will only be accurate. For example, If the constant band is placed at the zero slope position of the waveform in FIG. 6 at time t4, then As a result, the slope of the cuff pressure pulse occurring at time t4 also changes to all values of the cuff pressure. In contrast, it becomes zero. In such a case, when the slope of the true waveform becomes zero, The sensitivity of the method is also zero. Excluding all these zero slope points on the waveform, the general The other position on the waveform at time n is such that the slope of the cuff pressure pulse is at time tn. Determined by observing the typical cuff pressure Pc(n) that is maximum at You can Next, this [0 cuff pressure Pc(n)] is set as an effective point on the waveform. as time t. can be plotted against. This is measured in this way In Figure 7, dotted lines indicate waveform regions where the It is clear that

The above discussion explains how to accurately determine the actual blood pressure waveform of a particular patient without invasive devices. This shows whether close approximation is possible.

This is an important diagnosis for physicians, especially when a patient's waveform is irregular. It becomes a means of disconnection. This is No. 98, which schematically shows many waveforms with different average values. This is best illustrated in Figure d. The average pressure Pb (m) of the blood pressure waveform is This fraction is equal to the sum of the blood pressure Pb(D) and a certain fraction of the pulse pressure.

It is the difference between the patient's systolic blood pressure pb(s) and diastolic blood pressure. Equation 2A shows this 1 and Equation 2B shows this in a convenient shorthand notation.

Pb (m) = Pb (D) + K (Pb (S) - Pb (D)) (2A) M = D + K (SD) (2B) The average pressure M is calculated by integrating the waveform (its amplitude pressure P) over time T (width of the waveform). Therefore, it can be calculated as follows.

Keeping in mind the above equation, the waveform in Figure 9a corresponds to the K value (which is commonly referred to as the blood pressure constant). ) can be shown to be approximately 0.50. The waveform in Figure 9b is 0.6 The waveform in Figure 9c approximates the value of 0.2. Ru. Furthermore, the waveform of Figure 9d approximates a value of 0.33. This latter waveform is It closely matches a healthy blood pressure waveform, and therefore some known diagnostic devices use the K value. By setting 0.33, the average blood pressure can be calculated. In this way, Assuming that the patient's diastolic and systolic blood pressure = 0.33, the waveform in Figure 9d is can occur. Of course, if the actual blood pressure constant of a particular patient is, for example, 0.6 0 or 0.20, it is very dangerous to do this. However, According to another feature of the present invention, the approximate waveform shown in FIG. 7 can be generated. This eliminates all guess work regarding the patient's mean blood pressure and blood pressure constant K. be able to. In practice, once the approximate waveform is determined, the deviation is electronically integrated and In addition to being able to calculate the average pressure Pb (M), which will help the teacher, from this, the blood pressure constant K can be easily calculated. Suitable means for performing these various calculations can be easily constructed. Ru.

From the various aspects of the present invention described above, the diastolic and systolic blood pressure of a patient can be measured non-invasively. In addition to providing the patient's actual blood pressure waveform, mean blood pressure, and blood pressure constant, It is possible to provide a diagnostic means that closely approximates the diagnosis. This means A suitable cuff means is shown in FIG. 10 and indicated generally by the reference numeral 30. It is equipped with This cuff means is placed around the patient's arm in a normal operating manner. , maintained at various pressure levels from zero pressure to, for example, 160 Torr.

The resulting cuff pulses are monitored by transducer 34. capacity Suitable easily installed electronic means 35 receive these pulses and interpret this information. Link and link the patient's diastolic and systolic blood pressure with the arterial pressure/volume curve. It can be obtained based on the patent of Mr. Nk et al. Further, the means 35 is shown in FIGS. 6 to 6. From Figure 8, time t1, t2. t3. Easy to generate intermediate pressure in etc. Using the circuit available at and readily available circuits for drawing. Further, the means 35 The time to calculate the mean blood pressure Pb (M) and the blood pressure constant from the waveform of It also has roads.

Engraving (no changes to the content) Sword pressure Aj Rusu to coal Pc (.C) 10q Q FIG. -2 0 pHl/ALL　”　PBLOOD　-PCUFFFIG, -5 FIG, -10 FIG.-9 1.Indication of incident PCT/US 85/Ol 1213. A person who makes supplement i'F. Relationship to the case: Applicant 5. Date of amendment order: August 5, 1986 6. Subject of amendment: Article 184 of the Patent Law 5 For patent use in writing pursuant to the provisions of paragraph 1 1 # 1 person's fear translation of the drawing 7. Contents of the amendment as shown in the attached sheet No change in the content of the translation of the drawing) International procurement report

Claims (18)

[Claims] 1. A waveform that approximates the actual blood pressure pulse in a particular artery of a given mammal, The non-linearity of a large number of such pulses that form over a specific time period occurring one after the other. An invasive method in which each pulse has diastolic and systolic pressure points; One edge defines the rise of systole and the second edge includes the fall of diastole. The above method is a) by non-invasive means i) diastolic and systolic pressure points of said actual blood pressure pulse ii) said actual blood pressure pulse the start and end points of the pulse; and iii) various fixed points before the end point of the pulse. a plurality of intermediate pressure points on said actual blood pressure pulse at a time point; at least some of the pressure points are located at the diastolic trailing edge of the actual blood pressure pulse; All said intermediate points are located on the positive or negative slope portion of said actual pulse. and is not located in the zero slope part of the actual pulse mentioned above. Measure pressure points, b) the diastolic and systolic pressure points, the starting and ending points, and the intermediate pressure; Using emphasis, i) minimum and maximum amplitude points corresponding to the above diastolic and systolic pressure points, respectively; ii) start and end points corresponding to the start and end points of the pulse; iii) drawing a waveform having a plurality of midpoints each corresponding to the midpoint of the pulse; A non-invasive method characterized by: 2. The diastolic and systolic pressure points of the actual blood pressure pulse plotted above, the starting point and Claim 1, wherein the waveform is formed using only the end point and the intermediate point. Method described. 3. Determine the average value of the above waveform and form an approximate average value of the above actual blood pressure pulse A method as claimed in claim 1, comprising the steps. 4. Determine the blood pressure constant of the above waveform and approximate the blood pressure constant for the above actual blood pressure pulse. 2. A method according to claim 1 for forming. 5. Some of the intermediate points are located at the systolic rise of the actual blood pressure pulse. and the part of the above actual pulse between the rise of systole and the fall of diastole. 2. A method according to claim 1, wherein the method is located along the 6. A waveform that approximates the actual blood pressure pulse in a particular artery of a given mammal, The non-linearity of a large number of such pulses that form over a specific time period occurring one after the other. An invasive method in which each pulse has diastolic and systolic pressure points; The posterior border defines the systolic rise and the anterior border contains the diastolic fall. The above method is a) by non-invasive means i) diastolic and systolic pressure points of said actual blood pressure pulse ii) said actual blood pressure pulse the beginning and end of the pulse; and iii) the diastolic phase prior to the end of the pulse. Among the above actual blood pressure pulses appearing at various fixed points in the fall Measure the pressure point between b) the diastolic and systolic pressure points, the starting and ending points, and the intermediate pressure; Using emphasis, i) minimum and maximum amplitude points corresponding to the above diastolic and systolic pressure points, respectively; ii) start and end points corresponding to the start and end points of the pulse; iii) a plurality of intermediate points each corresponding to the intermediate point of the pulse and an end point of the waveform; iv) the leading edge defined by the starting point and the maximum amplitude point of the waveform; construct a waveform with a trailing edge defined by c) This allows the drawn waveform to approximate the shape and average value of the actual blood pressure waveform. A non-invasive method characterized by: 7. A waveform that approximates the actual blood pressure pulse in a particular artery of a given mammal, The non-linearity of a large number of such pulses that form over a specific time period occurring one after the other. An invasive method in which each pulse has diastolic and systolic pressure points; The edge contains the diastolic fall and the posterior edge serves as the systolic rise, above The method is a) by non-invasive means i) diastolic and systolic pressure points of said actual blood pressure pulse ii) said actual blood pressure pulse the beginning and end of the pulse; and iii) the diastolic phase prior to the end of the pulse. Among the above actual blood pressure pulses appearing at various fixed points in the fall Measure the pressure point between b) Minimum corresponding graphically to the diastolic and systolic pressure points of the above actual blood pressure pulse. and a point of maximum amplitude and a starting point that corresponds graphically to the starting and ending points of said pulse. and the end point, and from the end point of the waveform to a second point that corresponds graphically to the above intermediate pressure point. a wave having a leading edge extending from the starting point of the waveform to the point of maximum amplitude shape, and this waveform approximates the blood pressure pulse. Method. 8. Two-axis Cartesian constellation with one axis representing pressure and the other axis representing time A pressure within a standard system that approximates the actual blood pressure pulse in a given mammalian particular artery. force vs. time waveform into a specific time period in which many such pulses occur one after the other. A non-invasive method of plotting over diastolic and systolic pulses, in which each pulse It has pressure points, with the anterior edge containing the diastolic fall and the posterior edge containing the systolic rise. and there is a dichrotic notch between them, the above method is a) Determine the diastolic and systolic pressure points of the above actual blood pressure pulse by non-invasive means. of the above waveform using these pressure points as the minimum and maximum amplitude of the waveform. constructing a first line and a first point representing minimum and maximum pressures, respectively, within the coordinate system; b) determining the start and end points of said actual blood pressure pulse by non-invasive means; , these end points are used as the end points of the above waveform, and the start and end points of the above waveform are is drawn on the first line in the coordinate system, c) at a number of fixed points along the trailing edge of diastole before the end of the pulse. determining by non-invasive means intermediate pressure points appearing on the actual blood pressure pulse; These intermediate pressure points appear in the above waveform at the same fixed point in time before the end point of the above waveform. This last mentioned intermediate pressure point can be placed in the above coordinate system using draw, and d) a second line defined by the end point and midpoint of said waveform and the opening of said waveform; A third line passing through the starting point and the first point above is drawn in the above coordinate system, thereby Complete the drawing of the above waveform by excluding the space between the second line and the third line, and The above line corresponds to the systolic rise of the actual blood pressure pulse, and the above second line corresponds to the actual blood pressure pulse. Corresponding to the falling edge of the diastolic phase of the pulse, the above space corresponds to the dichotic of the above actual pulse. A method characterized by being compatible with notches. 9. Blood pressure constant related to the actual blood pressure pulse in a particular artery of a given mammal A non-invasive method of approximating K, comprising: a) the diastolic and systolic pressure points, D and S, respectively, are determined by non-invasive means; b) A waveform that approximates the actual pulse is formed by non-invasive means, c) Find the average value M of the above waveform, and d) Solve the following equation K=(M-D/S-D) A method characterized by: 10. Average value related to the actual blood pressure pulse in a particular artery of a given mammal A non-invasive method of approximating M, the method comprising: a) generating a waveform approximating the actual pulse; and b) integrate the above waveform and solve the following equation, ▲ mathematical formula, chemical formula, table, etc. There is▼ However, M is the above average value, T is the time width of the above waveform, and P is the pressure amplitude of the waveform. A method characterized in that 11. A waveform that approximates the actual blood pressure pulse in a particular artery of a given mammal. , a large number of such pulses form over a certain period of time occurring one after the other A non-invasive device in which each pulse has diastolic and systolic pressure points; the rim defining the systolic rise and the trailing edge containing the diastolic slope; teeth, a) Non-invasively i) diastolic and systolic pressure points of said actual blood pressure pulse ii) said actual blood pressure pulse the start and end points of the pulse; and iii) various fixed points before the end point of the pulse. a plurality of intermediate pressure points on said actual blood pressure pulse at a time point; at least some of the pressure points are located at the diastolic trailing edge of the actual blood pressure pulse; Since all the above midpoints are located on the positive or negative slope part of the above actual pulse An intermediate pressure that is not located in the zero slope part of the actual pulse above. means for measuring the point; b) the diastolic and systolic pressure points, the starting and ending points, and the intermediate pressure; In response to the force points, i) the minimum and maximum corresponding to the diastolic and systolic pressure points, respectively; large amplitude point ii) start and end points corresponding to the start and end points of the pulse; iii) drawing a waveform having a plurality of midpoints each corresponding to the midpoint of the pulse; A non-invasive device characterized in that it comprises means for: 12. The diastolic and systolic pressure points of the actual blood pressure pulse plotted above, the starting point and Claim 10, wherein the waveform is formed using only the end point and the intermediate point. Equipment described in Section. 13. Determine the average value of the above waveform and form an approximate average value of the above actual blood pressure pulse. 12. A device according to claim 11, comprising means for: 14. Determine the blood pressure constant of the above waveform and approximate the blood pressure constant for the above actual blood pressure pulse. 12. Apparatus according to claim 11, comprising means for forming a number. 15. Some of the intermediate points are located at the systolic rise of the actual blood pressure pulse. and the portion of the above actual pulse between the rising edge of systole and the falling edge of diastole. 12. A device as claimed in claim 11, located along. 16. A waveform that approximates the actual blood pressure pulse in a particular artery of a given mammal. , a large number of such pulses form over a certain period of time occurring one after the other It is a non-invasive device, each pulse has diastolic and systolic pressure points, and The one edge contains the diastolic slope and the posterior edge acts as the systolic rise, above The device is a) Non-invasively i) diastolic and systolic pressure points of said actual blood pressure pulse ii) said actual blood pressure pulse the beginning and end of the pulse; and iii) the diastolic phase prior to the end of the pulse. Multiple intermediate pressure points on the above actual blood pressure pulse appearing at fixed times in the slope a means of measuring b) Minimum corresponding graphically to the diastolic and systolic pressure points of the above actual blood pressure pulse. and a point of maximum amplitude and a starting point that corresponds graphically to the starting and ending points of said pulse. and an end point, and a series of second points corresponding diagrammatically from the end point of the waveform to said intermediate pressure point. and a trailing edge that extends from the start of the waveform to the point of maximum amplitude of the waveform. and means for forming a waveform having a waveform. 17. Blood pressure determination relative to the actual blood pressure pulse in a particular artery of a given mammal A non-invasive device that approximates a) the diastolic and and b) non-invasive means of determining the systolic and systolic pressure points, D and S, respectively; a non-invasive means of generating a waveform approximating a pulse of c) means for finding the average value M of the above waveform, and d) means for solving the following equation. K=(M-D/S-D) A device characterized by comprising: 18. Average value related to the actual blood pressure pulse in a particular artery of a given mammal A non-invasive device for approximating M, comprising: a) generating a waveform approximating the actual pulse; a non-invasive means of forming; b) A means for integrating the above waveform and solving the following equation, ▲Mathematical formula, chemical formula, table, etc. There is▼ However, M is the above average value, T is the time width of the above waveform, and P is the pressure amplitude of the waveform. A device characterized by: