TW200409614A - Analysis method about relationship of beating signal and heart function - Google Patents
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【發明所屬之技術領域】 本發明係關於一種分析方法,特別指一種將任意活動 狀態下血壓計畺測所得之脈動訊號進行處理以作為心臟機 能判斷指標之脈動訊號與心臟機能相關性分析方法。 5【先前技術】 心难病習稱「隱形頭號殺手」,然_般求診者於醫院 檢查出患有心臟病時,往往已近末期而治療不易。事實上 ,就目前全球醫療技術而言,心臟病之初期及中期往往難 以查覺,此-尚待突破之醫學盲點導致相當比例之心臟病 10 突發致苑案例。 相轅於心臟病之預防而言,近年來歸功於血壓計價格 不斷下降而更趨低廉,得以深入一般家庭成為居家保健基 本設備之一,使高血壓之預防警示人人皆可為之。血壓計 中又以耨作簡便之電子式血壓計尤受家庭個人所歡迎,電 15子式血壓計除量測收縮壓及舒張壓外,並同時能量測脈搏 數等脈搏訊號供量測者參考,然由於該脈搏訊號僅係電子 式血壓計所提供之一附屬功能,故通常未經進一步利用分 析而不受重視。 【發明内容】 2〇 目此’本發明之首—目的,即在提供-制用血屢計 量測之脈動訊號作為心臟機能判斷指標之脈動訊號與心臟 機能相闕性分析方法。 本發明之次一目的,在於提供一種適用於受試者任何 活動狀態之脈動訊號與心臟機能相關性分析方法。 200409614 於是,本發明脈動訊號與心臟機能相關性分析方法, 係用以將任意活動狀態下由一血壓計量測所得之一受試者 於—定時間陽距内之一脈動訊贵進行處理,以作為該受試 者心臟*能之參考指標,該方法包括:(1)將該脈動訊號 進行能量頻譜轉換;(2)將該轉換獲得之一能量頻譜正規 化;及G3)由該正規化之能量頻譜計算一預先定義之心臟 才曰數,_以該心臟指數供判斷該受試者心臟機能之參考指 標。 少曰 本發明並揭示一種利用脈動訊號判定心臟機能之方法 L括·( 1)將受试者之脈動訊號進行能量頻譜轉換; (2)將該轉換獲得之一能量頻譜正規化;及(3)由該正規化 之能量頻譜計算一預先定義之心臟指數;及(4)依據該心 臟指數判定該受試者之心臟機能狀態。 【實施方式】 15[Technical field to which the invention belongs] The present invention relates to an analysis method, and particularly to a method for analyzing the correlation between a pulsation signal and a heart function that processes a pulsation signal obtained by a sphygmomanometer under any activity state as a judgment indicator of the heart function. 5 [Previous technology] Difficulty is called "the invisible number one killer". However, when a patient is diagnosed with a heart disease at the hospital, it is often near the end of the period and treatment is not easy. In fact, in terms of current global medical technology, heart disease is often difficult to detect in the early and middle stages, and this-unresolved medical blind spot leads to a significant proportion of heart attacks. Compared with the prevention of heart disease, in recent years, due to the declining price of sphygmomanometers and becoming cheaper, it has been able to penetrate into ordinary households and become one of the basic home health care devices, so that everyone can prevent high blood pressure. Among the sphygmomanometers, the simple electronic sphygmomanometer is particularly popular among families. In addition to measuring systolic and diastolic blood pressure, the electric 15-type sphygmomanometer also measures pulse signals such as energy and pulse number. For reference, however, because the pulse signal is only a subsidiary function provided by the electronic sphygmomanometer, it is usually ignored without further utilization analysis. [Summary of the Invention] 20—The first purpose of the present invention is to provide a method for analyzing the correlation between the pulsation signal and the cardiac function by using the pulsation signal that is repeatedly measured for blood measurement as an indicator of cardiac function. A secondary object of the present invention is to provide a correlation analysis method of pulsation signals and cardiac function applicable to any active state of a subject. 200409614 Therefore, the correlation analysis method of the pulsation signal and the heart function of the present invention is used to process a pulsation signal of a subject within a certain period of time from a blood pressure measurement under any activity state, As a reference index of the subject's cardiac energy, the method includes: (1) performing energy spectrum conversion on the pulsation signal; (2) normalizing an energy spectrum obtained by the conversion; and G3) normalizing by The energy spectrum is used to calculate a pre-defined heart number. The heart index is used as a reference index for judging the heart function of the subject. The present invention discloses a method for determining cardiac function by using pulsation signals. The method includes: (1) subjecting the subject's pulsation signals to energy spectrum conversion; (2) normalizing an energy spectrum obtained by the conversion; and (3) ) Calculate a pre-defined cardiac index from the normalized energy spectrum; and (4) determine the subject's cardiac function status based on the cardiac index. [Embodiment] 15
本弩明之前述以及其他技術内容、特點與優點,於以 下配合參考圖式之一較佳實施例詳細說明中,將可清楚明 白。 首先如第-圖所示,本發明脈動訊號與心臟機能相關 性分析方法之較佳實施例,主要包括:_脈動量測步驟 11、一前段訊號去除步驟12、一頻域轉換步驟13、一能 量頻譜轉換㈣14、-正規化步驟15、—心臟指數定義 步驟16及一心臟指數計算步驟17、 本實施例中脈動量測步驟u係採用一每秒可偵測16 點脈動訊號之電子血壓計就受試者進行脈動量測,其讀取 20 200409614 5 之一完整原始訊號31圖形如第二圖所例示。於該圖中, 虛線代表壓力,一開始血壓計之脈壓帶因充氣泵之充氣而 使壓力升简’達简點後泵之變頻馬達停止運轉而逐漸洩氣 減壓;實線則代表量測所得之脈動訊號,前段脈動訊號 311因參雜有泵馬達之機械運轉干擾而含較多雜訊,待泵 馬達停止而無干擾後,後段脈動訊號312即下降且呈明顯 規律性兩利於後續分析。 10 自原始時域訊號31轉換至頻域中,所呈現之脈動訊 號頻譜分布狀況,將有助於進一步了解、判讀信號特徵及 潛藏意義。本實施例中經前段訊號去除步驟12去除前段 脈動汛譯;311後(理由於下詳述),頻域轉換步驟η係採 用快速傅立葉轉換(fast Fourier transform,FFT)演 开去,其運异式如以下[式一]所示,然其他可將時域訊號 31轉換至頻域之習知方法亦可適用。 15 [式一] k=0 _ .1π_ 其中,% = X〇 :原始時域訊號 X:;原訊號轉換至頻域之頻譜 N::輸入訊號點數 J : ^ ~ΐ η二0,1,· _. Ν-1 原訊號序列χ〇長度視每次量測脈搏血壓時門而異 9 20 200409614 本實施例中每秒係擷取16點,對x〇序列做蘭點之快 速傅立葉轉換,以獲得原訊號31轉換至頻域之頻譜X。 經本步,13之頻域斡換分析後,由於充氣泵馬達運轉之 干擾訊料人體脈動訊號,於頻域分布上有重疊現象而無 5法濾除,故須先經前段訊號去除步驟12將馬達運轉停止 、則之雨辱脈動訊號311捨去’而僅將馬達運轉停止後之後 - 段脈動砵號312進行頻域轉換處理。 - 能量頻譜轉換步驟Μ係將頻域轉換步驟13所獲得後 段脈動訊號312之頻譜X,與其共輛值c〇nj⑴相乘,以 10獲得X:之功率頻譜密度(PQWer speetrum如⑽挪,功 率頻譜窜度S即代表訊號於頻域中能量分布狀況,而可以 下述[式A]表示。第三a及三b圖即分別舉例說明一量測 所仵之缘段脈動訊號312,及由該後段脈動訊號312經步 b 驟13、14處理所得之能量頻譜圖。 S-X*conj(X) / n Γ [式二] 攀 其争,n : X之長度 為#估文试者之脈動訊號是否受其狀態影響,本發明 經研究比較發現,運動後之脈動雖然加快、能量加高、血 20壓變化,然就心臟指數(容下詳述)而t,由於其訊=特: 仍然存在甚至更為明顯,故可透過訊號值之正規化處理, 而無須等待受試者於靜止狀態下休息一段時間後再行量測 ,使本發明不論受試者處於何種狀態皆可隨時量測應用,Ί 而不影響計算結果。 w ’ 25 本實施例中正規化步驟15包含—能量正規化步驟 10 200409614 ίο 151及一頻率正規化步驟152。能量正規化步驟15丨係自 第三b®所示之功率頻譜密度圖中,選出最大基本波之振 幡,其對廉之頻率定義為第一主頻,通常位於lfe位置2 右(圖中0Hz之訊號僅代表未歸零之均值,無關振動), 而其他出現振幅較小者稱為諧波,依序定義為第二主頻及 第三主頻。將第一主頻之振幅定&麵(即本實施例能 量正規化之標準),而將各諧波之振幅除以第一主頻振幅 ,則可f楚觀察能量經正規化之振幅比例關係。 本貫施例中頻率正規化步驟152係將標準設定於心搏 每刀鐘PT,亦即每秒ι·33下,並如前述本實施例係採 用每秒可偵測16點脈動訊號之電子血壓計,故即擷取 21· 28脈動信號點。將電子血壓計量測之每分鐘脈搏數除 以頻率正規化標準8〇 乘上時間序列,即可顯示頻率 正規化綠之脈動情況。The foregoing and other technical contents, features, and advantages of the present invention will be made clear in the following detailed description of a preferred embodiment with reference to the accompanying drawings. Firstly, as shown in FIG. 1, a preferred embodiment of the correlation analysis method of the pulsation signal and cardiac function according to the present invention mainly includes: _ pulsation measurement step 11, a previous signal removal step 12, a frequency domain conversion step 13, a Energy Spectrum Conversion ㈣ 14, Normalization Step 15, Heart Index Definition Step 16 and a Heart Index Calculation Step 17, In this embodiment, the pulsation measurement step u is an electronic sphygmomanometer that can detect 16 pulsation signals per second A pulsation measurement was performed on the subject, which reads one of 20 200409614 5 a complete original signal 31 pattern as illustrated in the second figure. In the figure, the dashed line represents pressure. At the beginning, the pulse pressure band of the sphygmomanometer was increased by the inflation of the air pump. After the pressure point was reached, the pump's variable frequency motor stopped operating and gradually deflated. The solid line represents measurement. The obtained pulsation signal, the front pulsation signal 311 contains more noise due to the mechanical operation interference of the pump motor. After the pump motor is stopped without interference, the pulsation signal 312 at the rear section drops and shows regularity. This is beneficial for subsequent analysis. . 10 From the original time domain signal 31 to the frequency domain, the spectrum distribution of the pulsating signal presented will help to further understand and interpret the signal characteristics and hidden meaning. In this embodiment, the previous-stage pulsation is removed by the previous-stage signal removing step 12. After 311 (the reason is described in detail below), the frequency domain conversion step η is performed using a fast Fourier transform (FFT), and its operation is different. The formula is shown in the following [Formula 1], but other conventional methods that can convert the time domain signal 31 to the frequency domain can also be applied. 15 [Formula 1] k = 0 _ .1π_ where% = X〇: original time domain signal X :; frequency spectrum of original signal converted to frequency domain N :: input signal points J: ^ ~ ΐ η 2 0,1 , _. Ν-1 The length of the original signal sequence χ〇 varies depending on the gate of each measurement of blood pressure 9 20 200409614 In this embodiment, 16 points are acquired per second, and the fast Fourier transform of the blue point is performed on the x〇 sequence. To obtain the spectrum X converted from the original signal 31 to the frequency domain. After this step, after the frequency domain conversion analysis of 13, because of the interference signal of the pump motor, the human body pulsation signal overlaps in the frequency domain distribution and cannot be filtered out by 5 methods. Therefore, it is necessary to go through the previous signal removal step 12 to When the motor operation is stopped, the rain pulse signal 311 is discarded, and only after the motor operation is stopped-the segment pulse signal 312 is subjected to frequency domain conversion processing. -The energy spectrum conversion step M is the frequency spectrum X of the post-pulse signal 312 obtained in the frequency domain conversion step 13 multiplied by its total vehicle value c0nj⑴ to obtain the power spectral density of X: (PQWer speetrum such as The frequency spectrum shift S represents the energy distribution of the signal in the frequency domain, and can be expressed by the following [Formula A]. The third a and three b diagrams respectively illustrate a measurement of the edge pulsation signal 312, and The energy spectrum of the latter pulsation signal 312 processed in steps b and 13 of step 14. SX * conj (X) / n Γ [Equation 2] To compete, the length of n: X is the #pulse signal of the tester Whether or not it is affected by its state, the present invention has found through research and comparison that although the pulsation after exercise is accelerated, the energy is increased, and the blood pressure changes, the t of the heart index (described below in detail) is t, because its news = special: still exists It is even more obvious, so the signal value can be normalized without having to wait for the subject to rest for a period of time before measuring, so that the present invention can measure at any time regardless of the state of the subject Apply, 影响 without affecting calculation results w '25 In this embodiment, the normalization step 15 includes an energy normalization step 10 200409614 151 and a frequency normalization step 152. The energy normalization step 15 is based on the power spectrum density chart shown in the third b®, and the maximum basic value is selected. The vibration of the wave is defined as the first main frequency, which is usually located to the right of the lfe position 2 (the 0Hz signal in the figure only represents the mean value that has not been returned to zero, and has nothing to do with vibration). Harmonics are sequentially defined as the second main frequency and the third main frequency. The amplitude of the first main frequency is determined on the & plane (that is, the energy normalization standard in this embodiment), and the amplitude of each harmonic is divided by the first With a main frequency amplitude, you can observe the normalized amplitude ratio relationship of energy. In the present embodiment, the frequency normalization step 152 is to set the standard to the heartbeat per knife clock PT, which is ι · 33 per second. And as mentioned above, this embodiment uses an electronic sphygmomanometer that can detect 16 pulse signals per second, so 21 · 28 pulse signal points are captured. Divide the number of pulses per minute measured by the electronic blood pressure measurement by the frequency normalization standard 80 times the time series to display the frequency Normalize the pulsation of green.
15 第四至六圖即用以舉例說明經正規化步驟15之效果 。第四“中包含-正常受試者^靜止狀態心搏8〇下/分 量測所得之後段脈動訊號312(上圖),及—由該後段脈動15 The fourth to sixth diagrams are used to illustrate the effect of step 15 after normalization. The fourth "contains-normal subjects ^ resting state heartbeat 80 beats / minute measurement of the post-pulsation signal 312 (above), and-from the post-pulsation
訊號312經步驟13、14虛理所爲夕处曰 4 7处理所付之能量頻譜圖(下圖), 該能量頻譜圖顯示之第一主嘀垢祚奶&〜 c 罘王頻振v田約马2·8χ1〇5。第四b 20 圖則為將第四a圖經正規化 主頻振幅為5x105之結果。 調整為心搏80下/分且第一 同琿,第五a圖中則包含第四a 試者於運動過後心搏12〇下/分量 312(上圖)及一能量頻譜圖(下圖) b圖之同一正常受 〉則所得之後段脈動訊號 ’該能量頻譜圖顯示之 11 200409614 =主f振巾田約為6 lxlQ5。第五b圖職將第五 與第四b圖採相同正招 口、、工 隹:則正規化標準,即調整為心搏8G下/分且 ^ 頒振幅為5x1妒後之結果。The signal 312 is processed by steps 13 and 14. The energy spectrum paid for the 7th processing is shown in the figure below (the figure below). This energy spectrum shows the first main scale 嘀 milk & ~ c 罘 王 frequency 振 v 田 约Horse 2.8x105. The fourth b 20 picture is the result of normalizing the fourth a picture with a main frequency amplitude of 5x105. Adjusted to a heart rate of 80 beats / min and the first peer, and the fifth a picture contains the fourth a's heart rate after exercise 120 o / component 312 (above) and an energy spectrum diagram (below) The same normal reception in b)> The obtained pulsation signal at the subsequent stage 'The energy spectrum shows 11 200409614 = the main f vibration field is about 6 lxlQ5. Fifth b map post will use the same positive slogan, and work as the fifth and fourth b map: then the normalization standard, that is, adjusted to a heart rate of 8G / min and ^ awarded the result of 5x1 jealousy.
ίο 15 心搏弟βΓ a圖1包含—心肌病變之心、_患者於靜止狀態 " '下/分量測所得之後段脈動訊穿U 312(上圖)及一倉匕 量(下圖該能量頻譜圖顯示之第—主頻振幅㈣ ·_。第六b圖則為將第六a圖經舆第四卜五b圖採 化標準’即調整為心搏8〇下/分且第一主頻振幅 ‘Ί1(Π後之結果。於第六b圖中顯示,該心肌病變患者 之各主頻位置較第四b、五b圖所示之正常人難以辨識, 且各主葬間非零能量頻譜出現頻繁。 本發明經大量量測所得之分析結果顯示,一般無心臟 ::麵脈動能量頻譜圖中’可明顯讀出四至五個主要能 置分布(丨主頻),依個人心跳速率而異,1Hz附近通常為最 大月b里發生處,往咼頻處則能量漸減。除主要四、五個頻 '曰之外,無其他明顯易見之頻譜分布,在頻率軸上值多為 零。 而心臟疾病患者量得之脈動訊號經能量頻譜分析後, 於勺分辦之四至五個主頻之外,常有明顯可見然能量大小 不如主頻能量之若干頻譜出現。該等非零值頻譜之出現越 廣’代表類取之脈動訊號越不規則,而含有越多快速變動 之不穩定訊號,更嚴重者甚至不規則訊號能量極大,而無 法分辨逍主頻位置。是故,心臟疾病患者能量頻譜圖中, 除主頻之外,頻域上出現能量非零值數量多寡,與心血管 12 200409614 患病與否有極大關聯。 是故,藉由下述心臟指數定義 管步_ 17 我乂驟16及心臟指數計 -^驟Π,而將脈動訊號能量 間之關_划n κ w曰刀外結果與心騰機能 门之關如判蚜準則(criteria)量化5八^ ^ 撰寫為-程式軟體型彳公式化,使本發明可 ㈣式,配合—儲存㈣程絲體之 =:Γ、光碟片或硬碟)及一可執行該程式軟體之 =子㈣(如-電腦、個人數位助理機或醫用儀器),而自 迅速汁异判讀’供量測血壓者即時參考而無須等待其社 果。 ° ίοίο 15 Heart beat brother βΓ a Figure 1 contains-the heart of myocardial disease, _ patient in a resting state " 'down / component measured after the pulsation U 312 (above) and the volume of a bin (below) The energy spectrum chart shows the first-frequency amplitude ㈣ · _. The sixth b chart is the sixth a chart after the fourth and fifth b five b chart adopted the standard 'that is adjusted to a heart rate of 80 beats / min and the first The result of the main frequency amplitude 'Ί1 (Π). It is shown in the sixth figure that the main frequency position of the patient with myocardial disease is more difficult to identify than the normal person shown in the fourth and fifth b pictures. The frequency spectrum of zero energy appears frequently. The analysis results obtained by a large number of measurements of the present invention show that there is generally no heart :: the surface pulse energy spectrum chart can clearly read out the four to five main energy distributions (the main frequency), depending on individual heartbeat The rate varies, around 1Hz is usually the place where the maximum month b occurs, and the energy gradually decreases towards the frequency band. Except for the main four or five frequencies, there is no other clearly visible spectrum distribution, and there are many values on the frequency axis. It is zero, and the pulsation signals measured by patients with heart disease are analyzed by energy spectrum analysis. In addition to the five main frequencies, it is often obvious that certain spectrums with less energy than the main frequency energy appear. The wider the appearance of these non-zero-valued spectrums, the more irregular the pulsation signals, and the more rapid changes they contain. The unstable signals, even more serious ones, have even more irregular signals, which cannot be distinguished from the main frequency. Therefore, in the energy spectrum of heart disease patients, in addition to the main frequency, there are many non-zero energy quantities in the frequency domain. , And cardiovascular 12 200409614 is greatly related to the disease. Therefore, the following steps are used to define the tube step _ 17 I step 16 and the heart index meter-^ step Π, and the relationship between the pulse signal energy _ The division of n κ w between the result of the knife and the functioning gate of the heart is as a criterion of quantification 5 ^ ^ Written as-a program software type formula, so that the present invention can be used to cooperate-storage process silk body == Γ, CD-ROM or hard disk) and an executable software (such as a computer, personal digital assistant or medical instrument) that can execute the program software, and quickly interpret the difference from the blood supply for those who measure blood pressure immediately Reference without waiting for its social fruit ° ίο
15 .本f施例心臟指數^義步驟16中心臟指數(he奶. mdex)敎義如下。首先於步驟15所得能量頻譜密度圖 中’將D點至第-主頻定義為第_區間,第—主頻至第二 主頻間定義為第二區間,第二主頻至第三主頻間定義為: 三區間,第三主頻後仍有第四甚至第五主頻,明顯程度因 人而異,此處定義為第四區間。配合第七圖所示,當各段 區間内之能量頻譜分布狀況一旦符合下述[式三]之:件^15. In this example, the heart index (he milk. Mdex) in step 16 is as follows. First, in the energy spectrum density map obtained in step 15, 'point D to the -th main frequency is defined as the _th interval, and between the -th main frequency and the second main frequency is defined as the second interval, and the second main frequency to the third main frequency is defined as The interval is defined as: three intervals, the fourth and even fifth frequencies are still available after the third frequency, and the degree of obviousness varies from person to person. Here is defined as the fourth interval. As shown in Figure 7, when the energy spectrum distribution in each section meets the following [Formula 3]: ^
即定義於i點發生一具有意義之棘波。 若[s⑴-s(i-ι)>ν〇 或 s⑴—s(i—2)>v〇] 20 ^[S(r)-S(i + 1)> γ〇 ^ S(i)-S(i+2)> V〇] [式三] 其中,VG / 50,Pi為第一主頻振幅。而第一至第 四區間内所得之棘波數總合,即定義為心臟指數。 而後於心臟指數計算步驟17,將步驟16獲得之定義 13 200409614 用以計算前述第四b、五b及六w圖之心臟指數,可獲 付第四b、五b圖中之心臟指數皆為〇。易言之,同一名 受試者於運動前、後,其經正規化後之心搏及頻譜能量值 雖不同,然其心臟指數則相同,故心臟指數不因受試者於 5測量時之狀態所影響。至於第六匕圖中心臟疾病患者經正 規化後其心臟指數為23,而與第四b、五b圖中正常受試 -者明顯有異,故心臟指數確可作為心臟疾病之一量化客觀 • 之判斷指標。That is, a significant spike occurs at point i. If [s⑴-s (i-ι) > ν〇 or s⑴-s (i-2) > v〇 20 ^ [S (r) -S (i + 1) > γ〇 ^ S (i ) -S (i + 2) > V〇] [Equation 3] where VG / 50, Pi is the first main frequency amplitude. The total number of spikes in the first to fourth intervals is defined as the cardiac index. Then in step 17 of the calculation of the heart index, the definition 13 200409614 obtained in step 16 is used to calculate the heart index of the fourth b, fifth b and six w graphs. The heart index of the fourth b, five b graphs can be paid. 〇. In other words, although the same subject ’s normalized heartbeat and spectral energy values before and after exercise are different, their heart indices are the same, so the heart index is not the same as that of the subject at the time of 5 measurements. Affected by the status. As for the heart disease patient in the sixth dagger figure, after normalization, his heart index is 23, which is obviously different from the normal test subjects in the fourth and fifth b figures, so the heart index can indeed be used as one of the quantitative and objective heart diseases. • Judgment indicators.
I 然f指出者,心臟指數並非以上述[式三]之定義為 1〇限,且斧參數Vq大小亦可調整,舉凡以上述能量頻譜密 度圖中之棘波或其他波形變化情形作為心臟指數之計算依 據者,皆屬本發明實質範疇。 以下為將本發明實際應用於國内某醫院之臨床實測 及分析結果。受試者包括於該醫院心臟内科門診中求診人 15數201人,其中經醫師診斷判定為心臟病患者53人,非 鲁心臟病患者148人。配合上述心臟指數之計算及臨床實際 診斷結果,可將心臟指數依以下分級,供作受試者心臟機 能正常與否之參考依據: 心_指數7以上:屬於心臟異常跳動頻率頻繁而明 2〇 顧’心脾收縮不規則’此為多種心臟病之特徵。 - 心、臟指* 4〜6:代表心臟具有異常跳動,屬於心臟病 高危險蛑或已罹患心臟疾病之特徵;及 心臟指數3以下:代表量測時心臟跳動頻率無異狀 ’心臟健康者心臟^曰數多為0。 14 zuu^uyoi^ 若再以經醫師判定 . 巾^疋為〜城病患者之53名受試者分析 ’其中包括瓣膜性疾、忘7 q 、、、 层病13例、心肌病變(包括心肌病變及 火)12例、心律不整7例、冠狀動脈疾病21例,其 :種疾病患者與其對應心臟指數之相關統計如以下表-所 7R 〇 声指數 種類I pointed out that the heart index is not based on the above [Formula 3] as the 10 limit, and the size of the axe parameter Vq can also be adjusted. For example, the spikes or other waveform changes in the above energy spectrum density chart are used as the heart index. The calculation basis is within the essential scope of the present invention. The following are the clinical measurement and analysis results of applying the present invention to a hospital in China. The subjects included 15 201 patients who were consulted in the cardiology department of the hospital, of which 53 were diagnosed by the physician as heart disease patients and 148 were non-Lu heart disease patients. With the calculation of the above-mentioned heart index and clinical diagnosis results, the heart index can be classified according to the following for reference of the normal or not of the heart function of the subject: Heart_index 7 or above: It belongs to the frequent and clear heart beat frequency. 2 Gu's irregular contraction of heart and spleen is a characteristic of many heart diseases. -Heart and dirty fingers * 4 ~ 6: It means that the heart has abnormal beating, which is a characteristic of high risk of heart disease or has suffered from heart disease; and the heart index is below 3: It means that there is no abnormal heart beating frequency during measurement. The heart number is mostly zero. 14 zuu ^ uyoi ^ If judged by a physician again, the analysis of 53 subjects with ~ urban disease patients included valvular disease, forgetting 7q, and 13 patients with sclerosis, myocardial disease (including myocardium Lesions and fire) 12 cases, arrhythmia 7 cases, and coronary artery disease 21 cases. The relevant statistics of patients with various diseases and their corresponding cardiac indexes are shown in the following table-7R
4〜6 7以上 —(百分比) (百分比) T(7.69%)~ 11 7 84.62%)4 ~ 6 7 or more — (percent) (percent) T (7.69%) ~ 11 7 84.62%)
冠狀動脈疾病 (33.33%) (28.57%) (38.10%) 14 ( 66.67%)* 總 計 _ _ · I 10* (18.87%) 14 ( 26.42%) 29 ( 54.72%) 43 ( 81.13%)' 表一各種疾病患者與其對應心臟指數之相關統計 10 由表一得知,於所有樣本中,瓣膜性疾病共13例, 其異常現象偵測率達84鳥加上疑似異常偵測率議 ,共達犯.31%。心肌病變之u個樣本中,異常現象偵 測率66.67%,加上疑似異常摘測率25%,可測得之比例達 91. 67% ’亦屬容易測得之狀況。心律不整樣本數共7例 ’其中疑似異常比例為5L U%、異常現㈣測率為 28.57% ,共85· 71%。冠狀動脈疾病之樣本數共a例。 15 200409614 其中異常現㈣測率38.10%,疑似異常镇測率28·57%, 二和66.67%,遺漏率較高而達33 33%,其原因容後詳 述。 θ於此並需敘明者,由於總樣本數僅53例,母體樣本 5量小,尽此母體計算偵測率,其獲得之百分比數字尚不足 以作為哞然之定論,而僅供參考。 、1F則就上述各種心臟疾病與其對應心臟指數之關 - 聯及可能原因依序分析: f先以心臟瓣膜性疾病而言,其可詳分為主動脈瓣 10異常、二尖瓣異常、肺瓣膜異常、三尖瓣異常、心房或心 室中隔缺損等,不同原因導致不同之脈動頻譜分布。舉例 而言,箬主動脈瓣因先天畸形或鈣化造成組織纖維化,導 致主動踩瓣狹窄,則當心臟收縮時,主動脈瓣之狹窄將阻 礙左心辱中之血液流入主動脈,視狹窄程度可能導致不同 15 嚴重私度。此時心臟將試圖彌補血液循環失調情況(代償 • 作用)’以期使左心室流至主動脈中之血液量不致過低。 因此心磾即有幾種應變方式: 一:、增加左心室收縮力量,此現象將導致左心室肌 壁增厚,因此可有更大力量推送血液;及 20 一、延長心臟收縮時間,心臟收縮時間較正常時間 長’期珠可使由左心室進入主動脈之血液量多。 以上述方式增加左心室工作量、增強左心室血壓, 使心臟不斷有力且快速收縮,然脈搏可能仍屬微弱,患者 則有疲倦、呼吸困難、頭暈、胸痛等症狀。而在如第八圖 16 200409614 所不其中一瓣膜性疾病患者心跳之擷取信號及能量頻譜分 析圖顯示’此量頻譜圖中可能因血液由左心室流入主動脈 日守笑到異常阻礙,流動遭受干擾而產生额外頻率信號;另 5 因〜肌收縮之時間或力量改變,亦可由此分析中觀察出異 苇,而其心臟指數為22。 苐九圖則顯示其中一心肌病變患者心跳之擷取信號 及能量頻譜分析圖,其心臟指數為22。 10 如第十圖所示一心律不整患者心跳之擷取信號及能 量頻譜分析圖,其心臟指數為5。心律不整之個案,其心 臟才曰數大夕洛在4至6間,百分比為57% ,心臟指數在7 、上者佔28.57% ,顯示心律不整雖可於本分析方法中摘 15 得異常,然能量頻譜分析圖僅出現幾個額外頻率分布,不 似瓣膜性疾病或心肌病變患者之案例有明顯混亂之頻率分 布,使心臟指數高達1〇或2〇以上。心律不整個案中,遺 漏百分比雖高$ 14·29%,然因總樣本數少,此數值不具 有太大統也⑤義。遺漏之案例為_ 75歲男子,其信號特 別微弱,於此分析中未能找出異狀。 20 如第十一圖所示一冠狀動脈性疾病患者心跳之擷取 信號及能量頻譜分析圖L指數4 8。冠狀動脈内灰 液流動之障礙,大多由動脈粥樣硬化弓丨起,動脈血管内膜 上沉積膽固醇、類脂質等,使管道變窄,冠狀動脈疾病中 亦包含少數先天性畸形或冠狀動脈異常擴張。當冠狀動脈 發生病變,無法正常供應錢氧氣與營養,便發生缺血性 心臟病。然缺血性心臟病患平日休息時,往往觀察不到, 17 ίοCoronary artery disease (33.33%) (28.57%) (38.10%) 14 (66.67%) * Total _ _ I 10 * (18.87%) 14 (26.42%) 29 (54.72%) 43 (81.13%) 'Table 1 Statistics on patients with various diseases and their corresponding cardiac indices10. According to Table 1, 13 cases of valvular disease were found in all samples, with an abnormality detection rate of 84 birds plus a suspected abnormality detection rate. .31%. Among the u samples of myocardial disease, the abnormality detection rate was 66.67%, and the suspected abnormality extraction rate was 25%. The measurable ratio was 91. 67% ′, which is also an easily measurable condition. There were 7 cases of arrhythmia samples. Among them, the proportion of suspected abnormalities was 5L U%, and the prevalence of abnormalities was 28.57%, a total of 85.71%. There were a total of samples of coronary artery disease. 15 200409614 Among them, the abnormal detection rate is 38.10%, the suspected abnormal detection rate is 28.57%, Erhe 66.67%, and the omission rate is high, reaching 33 33%. The reasons will be described in detail later. θ Here, it is necessary to explain. Because the total sample size is only 53 cases, the maternal sample size is small. As far as the math is used to calculate the detection rate, the percentage number obtained is not enough to be a conclusive conclusion, and it is for reference only. And 1F analyze the relationship between the above-mentioned various heart diseases and their corresponding heart indices and their possible causes in order: f First, in terms of heart valve diseases, they can be classified into 10 abnormalities of the aortic valve, abnormalities of the mitral valve, and lungs. Valve abnormalities, tricuspid valve abnormalities, atrial or ventricular septal defects, etc., cause different pulsation spectrum distributions for different reasons. For example, the iliac aortic valve causes tissue fibrosis due to congenital malformation or calcification, leading to active valve stenosis. When the heart contracts, the stenosis of the aortic valve will prevent the blood in the left ventricle from flowing into the aorta, depending on the degree of stenosis. May lead to 15 different levels of privacy. At this time, the heart will try to compensate for the blood circulation disorder (compensation • effect) 'in order to keep the amount of blood flowing from the left ventricle into the aorta not too low. Therefore, there are several ways to respond to heart palpitations: First, increase the left ventricular contractile force. This phenomenon will cause the left ventricular muscle wall to thicken, so that it can push the blood with greater force; and 20 I. Extend the systolic time, the heart contracts The time period is longer than normal. The period beads can make more blood flow from the left ventricle into the aorta. Increasing the workload of the left ventricle and increasing the blood pressure of the left ventricle in the above-mentioned manner keeps the heart constantly and rapidly contracting, but the pulse may still be weak, and the patient may have symptoms such as fatigue, dyspnea, dizziness, and chest pain. In the eighth figure 16 200409614, the heartbeat acquisition signal and energy spectrum analysis chart of a patient with valvular disease does not show that this amount of spectrum may be caused by blood flowing from the left ventricle into the aorta. Interference is caused to generate additional frequency signals; the other 5 due to changes in the time or strength of muscle contraction can also be observed in this analysis, and the heart index is 22. Figure 29 shows the heartbeat acquisition signal and energy spectrum analysis of one of the patients with cardiomyopathy. The heart index is 22. 10 As shown in the tenth figure, the heartbeat acquisition signal and energy spectrum analysis chart of an arrhythmia patient have a heart index of 5. In the case of arrhythmia, the heart number is between 4 and 6, with a percentage of 57%, and the cardiac index is 7 and the above accounted for 28.57%. It shows that although arrhythmia can be abnormal in this analysis method, 15 However, the energy spectrum analysis chart shows only a few additional frequency distributions. Unlike the cases of patients with valvular disease or myocardial disease, there are obviously chaotic frequency distributions, which makes the heart index as high as 10 or more. In the case of arrhythmia, although the omission percentage is higher than $ 14.29%, this value is not too systematic and significant because the total sample size is small. The missing case was a 75-year-old man whose signal was particularly weak, and no abnormalities were identified in this analysis. 20 As shown in Figure 11, a heartbeat acquisition of a patient with coronary artery disease and energy spectrum analysis chart L index 48. Obstacles to the flow of gray fluid in the coronary arteries are mostly caused by atherosclerotic arches. Cholesterol and lipids are deposited on the intima of the arterial blood vessels, which narrows the ducts. Coronary artery diseases also include a few congenital malformations or coronary artery abnormalities expansion. Ischemic heart disease occurs when coronary arteries become diseased and oxygen and nutrients cannot be supplied normally. However, patients with ischemic heart disease are often not observed during weekdays. 17 ίο
70 (63.64%) 200409614 而於病患心臟工作量增加時( 卩如運動裱境驟變及情緒起 伏)L肌可能因缺氧而導致心絞痛。 冠狀動脈性疾病之値案中, 木T丨貝凋到之百分出只違 抑.1% ,疑似異常為28 57¾ ,土伯、, • ^ 未债測到者高達33.33% 。由此數字顯示,冠狀動脈機能異常病患中,約六成以上 會產生異 常心肌收缩頻率,而古一 士、 缏,貝手@有二成以上於平日休息狀況 下則無法得知。 至於前述受試者非心、臟病患者之148人中,高⑽ 病心佔太夕數而共11G _,高血壓及非高血壓患者與其對 應心臟指數之相關統計如以下表二所示。 Μ指數 種類 南血壓患者 以上 (百分比 ιίΤΤΓτϊ%)70 (63.64%) 200409614 When the patient's heart workload is increased (such as sudden changes in sports environment and mood swings), L muscle may cause angina due to hypoxia. In the case of coronary artery disease, the percentage of T. mori withered was only 1%, the suspected abnormality was 28 57¾, and the number of undetected debts was as high as 33.33%. According to the figures, about 60% of patients with coronary artery dysfunction will have abnormal myocardial contraction frequency, but Gu Yishi, 贝, Bei hand @You 20% or more can not be known under weekday rest conditions. As for the 148 non-cardiac and visceral patients in the aforementioned subjects, Gao's diseased heart accounted for 11G_. The relevant statistics of hypertension and non-hypertension patients and their corresponding cardiac indexes are shown in Table 2 below. Μ Index Types Above South Blood Pressure Patients (Percent ιίΤΤΓτϊ%)
4〜6 (百分比 26~~( 23.64%)4 ~ 6 (Percentage 26 ~~ (23.64%)
非向I血壓 非心臟:病患者 31 (81.58%) _ _ mmmmm ι 101 (68.24%) 5 ( 13.16%) 2 ( 5.26%) (ϊίΑ2%)' 總計 31 ( 20.95%) 16 ( 10.81%) 表二高血壓及非高血壓患者與其對應心臟指數之統計 由表二可知,高血壓族群心臟指數大於4之比例為 15 36.37%,較非高血壓者18· 42%高。易言之,高血壓病患之 心肌收縮頻率疑似異常或異常之比例較一般人高。事實上 局jk壓族群為心血管疾病罹患之高危險群之一,且其中少 數已有徵兆。第十二圖所示為其中一非心臟病且非高血壓 18 200409614 ’其心臟指數為〇, 前述第八至十一圖之 病患心跳擷取信號及能量頻譜分析圖 其規則且清楚顯示之主要頻率分布與 混亂情形有明顯區別。 綜上所述,本發明較習知技術具有下述優點:Non-I blood pressure and non-heart: sick patients 31 (81.58%) _ _ mmmmm 101 (68.24%) 5 (13.16%) 2 (5.26%) (ϊ 2%) 'Total 31 (20.95%) 16 (10.81%) Table The statistics of the second and second hypertension and non-hypertensive patients and their corresponding cardiac indexes can be seen from Table 2. The proportion of the heart index of the hypertension group greater than 4 is 15 36.37%, which is higher than the non-hypertensive 18.42%. In other words, the frequency of myocardial contractions in patients with hypertension is suspected to be abnormal or higher than in the general population. In fact, the local population is one of the high-risk groups for cardiovascular disease, and a few of them have already shown signs. The twelfth figure shows one of the non-heart disease and non-hypertension 18 200409614 'its heart index is 0, the heartbeat acquisition signal and energy spectrum analysis chart of the patients in the aforementioned eighth to eleven are regular and clearly displayed The main frequency distribution is clearly different from the chaotic situation. In summary, the present invention has the following advantages over the conventional technology:
、本务明直接將由非侵人式之血壓計量測所得而 -般未再予利用之脈動訊號,經簡單處理後作為判定受試 者心臟機能之參考依據,而無須其他任何額外甚至昂貴之 脈動或心搏量測儀器設備,故可謂_經濟、安全、簡便而 可大量推廣深人普及至—般家庭,供使用者於日常量測血 ίο 壓之際’-制知其㈣機能㈣而作為㈣㈣或就診 參考。 二、以第四a、五a圖之正常受試者及第六a圖之心 肌病變患者脈動能量頻譜圖差異所顯示,該心肌病變患者 能量頻譜圖各主頻位置較正常人者難以辨識,且各主頻間 15非零能量頻譜出現頻繁’故可以脈動能量頻譜圖作為判定 受试者疋否具心臟疾病之初步依據。2. This service will directly use the pulsation signal which is generally unused and measured by non-invasive blood pressure measurement. After simple processing, it will be used as the reference basis for judging the heart function of the subject without any additional or even expensive Pulsation or heartbeat measuring instruments and equipment, so it can be described as _ economical, safe, simple and can be widely promoted and popularized to ordinary families, for users to measure blood on a daily basis. As a reference for doctors or doctors. 2. As shown by the differences in the pulse energy spectrum of normal subjects in the fourth a and fifth a and the myocardial disease patients in the sixth a, the main frequency positions of the energy spectrum of the myocardial disease patients are more difficult to identify than normal people. And 15 non-zero energy spectrums appear frequently between each main frequency, so the pulse energy spectrum can be used as a preliminary basis for judging whether the subject has heart disease.
二、藉由將能量頻譜圖進一步經正規化處理,其呈現 之心臟指數特徵無論受試者係於休息或運動後狀態下皆為 一致,使本發明不論受試者處於何種活動狀態、時間、地 2〇 點皆可隨時量測應用而不影響結果,相較大多數習知技術 需於特定狀態下測量人體生理數據之限制,本發明顯具高 度使用彈性。 四、如前所述,本發明可以一程式軟體配合一電腦自 動迅速詩算,供受試者即時參考而無須長時間等待其判讀 19 200409614 結果,對受試者而言可及早預防或就診 即時採取對應之診斷治療程序,使受試者健康可 能j之t實際應用準確性上,可由本發明㈣.臟機 病;致"]視心臟病原因種類而異,並非所有心臟疾 病白w錢收縮或脈_率異f,於前述樣本中辦得之 :均測出率則約8G% ’足證本發明確具相當實祕及可 靠度。Second, by further normalizing the energy spectrum, the characteristics of the heart index presented are the same regardless of whether the subject is in a state of rest or after exercise, so that the present invention is independent of the activity state and time of the subject. Both the ground and the ground can be measured and applied at any time without affecting the results. Compared with the limitation that most conventional technologies need to measure human physiological data in a specific state, the present invention is highly flexible. 4. As mentioned above, the present invention can automatically and quickly calculate a program software in conjunction with a computer for the subject's immediate reference without having to wait for a long time for his interpretation. 19 200409614 Results, for the subject, early prevention or immediate medical consultation Corresponding diagnosis and treatment procedures can be adopted to make the subject's health possible. The accuracy of the practical application can be determined by the present invention. Visceral organ disease; Causes vary according to the type of heart disease. Not all heart diseases are worthless. The contraction or pulse rate is different in f, which can be done in the aforementioned samples: the average measured rate is about 8G%, which proves that the present invention is quite reliable and reliable.
10 1510 15
六、於上述樣本中,經醫師診斷為心臟正常者,藉本 發明所較結果仍有近32%者予以質疑(特別為高域 患者)’故本發明彳貞_定心_之標準似較醫師嚴格, 而可發揮預先警示病人可能罹患心臟病之效能。 惟以上所述者,僅為本發明之較佳實施例而已,當不 能以此限定本發明實施之範圍,即大凡依本發明申請專利 fe圍及發明說明書内容所作之簡單等效變化與修飾,皆應 仍屬本發明專利涵蓋之範圍内。 【圖式簡單說明】 弟一圖為本發明脈動訊號與心臟機能相關性分析方法 較佳實施例之步驟流程圖; 弟一圖為该罕父佳貫施例之一脈動量測步驟所獲得之一 2〇 完整原始訊號圖; 第三a及三b圖分別為一量測所得之後段脈動訊號圖 ,及由該後段脈動訊號經一能量頻譜轉換步驟所得之能量 頻譜圖; 第四a圖為一正常受試者於靜止狀態心搏下/分量 20 200409614 測所得之後段脈動訊號及能量頻譜圖,第四b圖為第四a 圖經頻率正規化及能量正規化之結果; 第五a圖為該正常受試者於運動遁後心搏120下/分 量測所得之後段脈動訊號及能量頻譜圖,第五b圖為第五 5 a圖經頻率正規化及能量正規化之結果; 第六a圖為一心肌病變之心臟病患者於靜止狀態心搏 65下/分量測所得之後段脈動訊號及能量頻譜圖,第六b 圖為第六a圖經頻率正規化及能量正規化之結果; 第七圖為該較佳實施例之一心臟指數定義步驟各參數 10 不意圖, 第八圖為一瓣膜性疾病患者心跳之擷取信號及能量頻 講分析圖; 第九圖為一心肌病變患者心跳之擷取信號及能量頻譜 分析圖; 15 第十圖為一心律不整患者心跳之擷取信號及能量頻譜 分析圖; 第十一圖為一冠狀動脈性患者心跳之擷取信號及能量 頻譜分析圖,及 第十二圖為一非心臟病患者心跳之擷取信號及能量頻 20 讀分析圖。 21 200409614 【圖式之主要元件代表符號簡單說明】 11 .........脈動量測步驟 12 ......…前段訊號去除步驟 13………頻域轉換步驟 14………能量頻譜轉換步驟 15.........正規化步驟 151……能量正規化步驟 152……頻率正規化步驟 16………心臟指數定義步驟及 17..........u臟指數計算步驟 31 .........原始訊號 311……前段脈動訊號 312……後段脈動訊號 226. In the above samples, those diagnosed by the physician as having a normal heart are still questioned by nearly 32% of the results compared with the present invention (especially for patients with high domains). 'The standard of the present invention's _zhenxin_ seems to be relatively Physicians are rigorous and can play a role in warning patients in advance of possible heart disease. However, the above are only the preferred embodiments of the present invention. When the scope of implementation of the present invention cannot be limited in this way, that is, the simple equivalent changes and modifications made according to the scope of the patent application and the description of the invention, All should still fall within the scope of the invention patent. [Simplified description of the figure] Diyi diagram is a flowchart of the steps of the preferred embodiment of the method for analyzing the correlation between the pulsation signal and the cardiac function of the present invention; Diyi diagram is obtained from the pulsation measurement step of the Han Jiajiaguan embodiment A complete original signal diagram of 20; the third a and three b diagrams are a measured pulsation signal diagram of the subsequent stage, and the energy spectrum diagram obtained from the latter pulsation signal through an energy spectrum conversion step; the fourth a diagram is A normal subject's heartbeat / component 20 at the resting state 20 200409614 measured the pulsation signal and energy spectrum of the latter segment, and the fourth graph b is the result of the fourth a graph after frequency normalization and energy normalization; the fifth a graph For the normal subjects, the pulse signal and energy spectrum of the latter segment measured at 120 beats / component after the post-exercise heart beat, and the fifth b diagram is the result of the fifth 5a diagram after frequency normalization and energy normalization; Figure 6a is a pulsation signal and energy spectrum of a heart disease patient with a heartbeat of 65 beats / component measured at rest. Figure 6b is the frequency normalization and energy normalization of Figure 6a. Results; the seventh picture is One of the preferred embodiments is that the parameters of the heart index definition step 10 are not intended. The eighth picture is a heartbeat acquisition signal and energy frequency analysis chart of a valve disease patient. The ninth picture is a heartbeat acquisition signal of a cardiac disease patient. And energy spectrum analysis chart; 15 The tenth chart is the heartbeat acquisition signal and energy spectrum analysis chart of an arrhythmia patient; the eleventh graph is the heartbeat acquisition signal and energy spectrum analysis chart of a coronary patient, and the tenth The second figure is a 20-read analysis of the heartbeat acquisition signal and energy frequency of a non-cardiac patient. 21 200409614 [Brief description of the main components of the diagram] 11 ......... pulse measurement step 12 ......... the previous signal removal step 13 ......... frequency domain conversion step 14 ... ... energy spectrum conversion step 15 ...... normalization step 151 ... energy normalization step 152 ... frequency normalization step 16 ......... heart index definition step and 17 ........ ..u dirty index calculation step 31 ......... original signal 311 ... pulse signal 312 in front ... pulse signal 22 in back
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