WO2010071052A1 - 電子血圧計 - Google Patents
電子血圧計 Download PDFInfo
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- WO2010071052A1 WO2010071052A1 PCT/JP2009/070542 JP2009070542W WO2010071052A1 WO 2010071052 A1 WO2010071052 A1 WO 2010071052A1 JP 2009070542 W JP2009070542 W JP 2009070542W WO 2010071052 A1 WO2010071052 A1 WO 2010071052A1
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- pressure
- cuff
- unit
- measurement
- control
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/022—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
- A61B5/0225—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers the pressure being controlled by electric signals, e.g. derived from Korotkoff sounds
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/02108—Measuring pressure in heart or blood vessels from analysis of pulse wave characteristics
- A61B5/02116—Measuring pressure in heart or blood vessels from analysis of pulse wave characteristics of pulse wave amplitude
Definitions
- the present invention relates to an electronic sphygmomanometer, and more particularly to an electronic sphygmomanometer that detects a change in blood vessel volume as a cuff pressure change, that is, an amplitude of a pressure pulse wave, and calculates a blood pressure value using the detected amplitude of the pressure pulse wave.
- pulse wave amplitude the amplitude of the pressure pulse wave
- the cuff wound around a part of the living body is pressurized or depressurized so that the volume change of the cuff transmitted from the volume change of the compressed blood vessel is regarded as the pressure change of the cuff, that is, the pulse wave amplitude. This is a method for calculating.
- Patent Document 1 a volume change characteristic of the cuff with respect to the pressure of the cuff is prepared in advance, and a signal of the change in pressure of the cuff is converted into a volume change and is used. A method for measuring blood pressure values is described.
- the volume change characteristic changes infinitely depending on how the cuff is wound, the thickness of the arm, the softness of the human body, and the like. Further, the volume change characteristics of the pump, the valve, and the cuff change depending on the temperature, humidity, or secular change. Therefore, it is difficult to correctly convert the cuff pressure change signal into the volume change by the method of acquiring the volume change characteristic in advance.
- the present invention has been made to solve the above-described problems, and its purpose is to accurately calculate the blood pressure value even if the cuff is wound or the thickness of the arm is different. It is to provide an electronic blood pressure monitor that can.
- An electronic sphygmomanometer includes a cuff for winding around a measurement site, a pressure adjustment unit for adjusting the pressure in the cuff, and a pressure sensor for detecting a cuff pressure signal indicating the pressure in the cuff. And a first generating unit for generating a constant volume change in the cuff and a first pressure control for changing the pressure in the cuff in a specific direction by controlling the driving of the pressure adjusting unit.
- the pressure control unit a generation processing unit that performs processing for giving a constant volume change to the cuff by controlling the driving of the generation unit during the period in which the first pressure control is performed,
- a measurement control unit for measuring a pressure change characteristic with respect to a volume change from a cuff pressure signal obtained when processing is performed, and measuring a pulse wave amplitude from the cuff pressure signal; and a measurement
- the on the basis of the pressure variation characteristic includes a correction processing unit for correcting the measured pulse wave amplitude, based on the pulse wave amplitude after correction, and a blood pressure calculation portion for calculating a blood pressure value.
- the generation processing unit continuously generates a volume change with a period different from the period of the heart rate of the measurement subject during the period of the first pressure control, and the measurement control unit performs the first pressure control.
- the acquisition unit for acquiring the cuff pressure signal in time series and the filtering process on the acquired cuff pressure signal to separate the pulse wave amplitude and the pressure change characteristic Including a separation unit.
- the first pressure control is decompression control
- the heart rate is calculated based on the cuff pressure signal during pressurization control before shifting to decompression control.
- the generation processing unit generates a volume change at regular intervals during the period of the first pressure control, and the measurement control unit outputs the cuff pressure output in a specific section in which the volume change is given to the cuff. From the signal, the pulse wave amplitude is measured from the first measurement processing unit for measuring the pressure change characteristic and the cuff pressure signal output during the first pressure control period and other than the specific section. And a second measurement processing unit.
- the first pressure control unit gradually increases the first pressure. Take control.
- the generation processing unit generates a volume change in a section from the maximum point of the cuff pressure signal to the next rising point.
- the cuff includes a fluid bag for blood pressure measurement, and a blood blocking part disposed upstream of the fluid bag, and a second cuff for changing the pressure in the cuff in a direction opposite to the specific direction.
- a second pressure control unit that performs pressure control; and a blood pressure prevention unit for blocking the measurement site using the blood pressure prevention unit only during the period of the first pressure control.
- the volume change is continuously generated during the pressure control period, and the measurement control unit performs the first measurement for measuring the pressure change characteristic from the cuff pressure signal output during the first pressure control period.
- a processing unit and a second measurement processing unit for measuring the pulse wave amplitude from the cuff pressure signal output during the second pressure control period are included.
- the ischemic part is a fluid bag for ischemia.
- the generation unit includes a cylinder and a drive unit for driving the cylinder.
- the drive unit includes a stepping motor.
- the pressure change characteristic is measured, and the pulse wave amplitude is corrected based on the measured pressure change characteristic. Therefore, the blood pressure value can be calculated with high accuracy regardless of how the cuff is wound and the thickness of the arm.
- FIG. 1 is an external perspective view of an electronic blood pressure monitor according to Embodiment 1 of the present invention.
- (A), (B) is a figure which shows the typical example of the pressure change with respect to the fixed volume change by the difference in the thickness of a measurement site
- (A), (B) is a figure which shows the typical example of the pressure change with respect to the fixed volume change by the difference in how to wind a cuff.
- It is a block diagram showing the hardware constitutions of the electronic blood pressure monitor which concerns on Embodiment 1 of this invention.
- It is a functional block diagram which shows the function structure of the electronic blood pressure meter in Embodiment 1 of this invention.
- (A)-(F) is a figure showing the concept of the blood-pressure measurement method in Embodiment 1 of this invention.
- Embodiment 1 of this invention It is a flowchart which shows the blood-pressure measurement process in Embodiment 1 of this invention.
- A)-(D) are the figures for demonstrating the correction process of the pulse wave amplitude in Embodiment 1 of this invention.
- (A), (B) is a figure which shows the detection timing of the pulse wave amplitude and pressure change characteristic in Embodiment 2 of this invention.
- (A), (B) is a figure which shows the other example of the detection timing of the pulse wave amplitude and pressure change characteristic in Embodiment 2 of this invention.
- Embodiment 3 of this invention It is a figure which shows the detection timing of the pulse wave amplitude and pressure change characteristic in Embodiment 3 of this invention. It is a block diagram showing the hardware constitutions of the electronic blood pressure meter which concerns on Embodiment 3 of this invention. It is a functional block diagram which shows the function structure of the electronic blood pressure meter in Embodiment 3 of this invention. It is a flowchart which shows the blood-pressure measurement process in Embodiment 3 of this invention.
- FIG. 1 is an external perspective view of a sphygmomanometer 1 according to Embodiment 1 of the present invention.
- the sphygmomanometer 1 calculates a blood pressure value by applying a predetermined algorithm to the pulse wave amplitude (pressure pulse wave amplitude).
- a sphygmomanometer 1 includes a main body 10, a cuff 20 that can be wound around a predetermined measurement site (for example, an upper arm) of a person to be measured, and an air tube 31 that connects the main body 10 and the cuff 20. Is provided. On the surface of the main body 10, there are arranged a display unit 40 made of, for example, liquid crystal and an operation unit 41 for receiving instructions from a user (typically a person to be measured).
- the operation unit 41 includes, for example, a power switch 41A that accepts an input of an instruction for turning on or off the power supply, a measurement switch 41B that accepts an instruction to start measurement, and a setting switch that accepts instructions related to various setting processes 41C and a memory switch 41D for receiving an instruction to read and display a past stored value.
- the operation unit 41 may further include an ID switch (not shown) that is operated to input ID (Identification) information for identifying the measurement subject.
- a constant volume change is generated in the cuff at each measurement (during pressurization or decompression), and in addition to the pulse wave amplitude accompanying the change in the internal pressure of the blood vessel,
- the pressure change characteristic (hereinafter referred to as “pressure change characteristic”) is measured.
- FIG. 2 (A) and 2 (B) are diagrams showing typical examples of pressure change characteristics with respect to a constant volume change due to a difference in thickness of a measurement site.
- FIG. 2A it is assumed that a constant volume change is given to the cuff during pressurization or decompression.
- FIG. 2B shows a difference in pressure change characteristics due to a difference in thickness of the measurement site when a constant volume change is given to the cuff.
- the pressure change characteristic 501 when the measurement site is thinner than the standard has a relatively larger amplitude of the pressure change than the pressure change characteristic 502 when the measurement site is thicker than the standard, and both have different change rates.
- FIG. 3 (A) and 3 (B) are diagrams showing typical examples of pressure change characteristics with respect to a constant volume change due to a difference in how the cuff is wound.
- FIG. 3A it is assumed that a constant volume change is given to the cuff during pressurization or decompression.
- FIG. 3B shows a difference in pressure change characteristics due to a difference in how the cuff is wound when a constant volume change is applied to the cuff.
- the pressure change characteristic 511 when the cuff is tightly wound around the measurement site has a relatively larger pressure change amplitude than the pressure change characteristic 512 when the cuff is loosely wound around the measurement site.
- a constant volume change is generated in the cuff at each measurement (during pressurization or decompression), and the pulse wave amplitude accompanying the volume change of the blood vessel and the pressure change characteristic with respect to the constant volume change are measured. To do. Then, the pulse wave amplitude is corrected using the measured pressure change characteristic, and a blood pressure value is calculated by applying a predetermined algorithm to the corrected pulse wave amplitude value.
- FIG. 4 is a block diagram showing a hardware configuration of sphygmomanometer 1 according to Embodiment 1 of the present invention.
- the cuff 20 of the sphygmomanometer 1 includes an air bag 21.
- the air bag 21 is connected to the air system 30 via the air tube 31.
- the main body unit 10 includes an air system 30, a central processing unit (CPU) 100 for centrally controlling each unit and performing various arithmetic processes, and a predetermined amount for the CPU 100.
- a memory unit 42 for storing a program for operating and various data, a non-volatile memory (for example, a flash memory) 43 for storing measured blood pressure, a power source 44 for supplying power to the CPU 100, and a timing It includes a clock unit 45 that operates and a data input / output unit 46 for receiving data input from the outside.
- the air system 30 includes a pressure sensor 32 for detecting the pressure (cuff pressure) in the air bag 21, a pump 51 for supplying air to the air bag 21 to pressurize the cuff pressure, and the air bag 21. And a valve 52 that is opened and closed to exhaust or enclose the air.
- the main body 10 further includes an oscillation circuit 33, a pump drive circuit 53, and a valve drive circuit 54 in relation to the air system 30.
- the pressure sensor 32 is, for example, a capacitance type pressure sensor, and the capacitance value changes depending on the cuff pressure.
- the oscillation circuit 33 outputs an oscillation frequency signal corresponding to the capacitance value of the pressure sensor 32 to the CPU 100.
- the CPU 100 detects a pressure by converting a signal obtained from the oscillation circuit 33 into a pressure.
- the pump drive circuit 53 controls the drive of the pump 51 based on a control signal given from the CPU 100.
- the valve drive circuit 54 performs opening / closing control of the valve 52 based on a control signal given from the CPU 100.
- the pump 51, the valve 52, the pump drive circuit 53, and the valve drive circuit 54 constitute an adjustment unit 50 for adjusting the cuff pressure.
- the device for adjusting the cuff pressure is not limited to these.
- the data input / output unit 46 reads and writes programs and data from, for example, a removable recording medium 132.
- the data input / output unit 46 may be able to transmit and receive programs and data from an external computer (not shown) via a communication line.
- the main body 10 further includes a generation unit 60 for causing the cuff 20 to generate a constant volume change.
- the generation unit 60 includes a cylinder 61 for adjusting the volume in the cuff 20 at a high speed, a motor (for example, a stepping motor) 62 for driving the cylinder 61, and a motor drive circuit 63 for driving the motor 62.
- a motor for example, a stepping motor
- a motor drive circuit 63 for driving the motor 62.
- the cylinder 61 is connected to the air bladder 21 through the air tube 31.
- a piston (not shown) in the cylinder 61 is driven in the axial direction of the cylinder 61 by the motor 62. Thereby, the volume in the cylinder 61 changes. As a result, the volume in the air bag 21 changes.
- production unit 60 is not limited to such an apparatus, as long as a fixed volume change can be generated.
- the cuff 20 includes the air bag 21, the fluid supplied to the cuff 20 is not limited to air, and may be a liquid or a gel, for example. Or it is not limited to fluid, Uniform microparticles, such as a microbead, may be sufficient.
- FIG. 5 is a functional block diagram showing a functional configuration of the sphygmomanometer 1 according to the first embodiment of the present invention.
- FIG. 5 shows a functional configuration of a decompression measurement method, that is, a method of calculating a blood pressure value based on a cuff pressure signal obtained at the time of decompression.
- the CPU 100 functions as a pressurization control unit 102, a decompression control unit 104, a generation processing unit 106, a measurement control unit 108, a correction processing unit 114, and a blood pressure calculation unit 116. And an output processing unit 118.
- a pressurization control unit 102 functions as a pressurization control unit 102, a decompression control unit 104, a generation processing unit 106, a measurement control unit 108, a correction processing unit 114, and a blood pressure calculation unit 116.
- an output processing unit 118 In FIG. 5, only peripheral hardware that directly exchanges signals with each unit of the CPU 100 is shown for the sake of simplicity.
- the pressurization control unit 102 performs pressurization control of the cuff 20. Specifically, the pump 51 is driven by sending a control signal to the pump drive circuit 53, and the process of sending air into the air bladder 21 is performed.
- the decompression control unit 104 performs decompression control of the cuff 20 at a predetermined speed, for example. Specifically, the valve 52 is driven by transmitting a control signal to the valve drive circuit 54, and the process of sealing and discharging the air sent into the air bladder 21 is performed.
- the pressure reduction control represents a control for changing the pressure in the cuff 20 in a specific direction (that is, the downward direction), and the pressure control is a direction opposite to the specific direction in the pressure in the cuff 20. In other words, the control is changed in the upward direction.
- the generation processing unit 106 performs processing for giving a constant volume change to the cuff 20 (the air bag 21 thereof) by controlling the driving of the generation unit 60 (motor driving circuit 63) during the period when the pressure reduction control is performed. To do.
- the volume change is continuously generated at a cycle different from the cycle of the heart rate of the measurement subject.
- the heart rate of the person to be measured may be calculated by a known method at the time of pressurization control, for example, or a past (for example, previous) measurement result may be used.
- a numerical value that cannot exist as a heart rate cycle may be set in advance as a cycle different from the heart rate cycle of the subject.
- the measurement control unit 108 performs control to measure the pulse wave amplitude and the pressure change characteristic with respect to a certain volume change based on the cuff pressure signal (detected by the pressure sensor 32) obtained from the oscillation circuit 33.
- the measurement control unit 108 includes a signal acquisition unit 110 and a separation processing unit 112.
- the signal acquisition unit 110 acquires the cuff pressure signal in time series during the period of pressure reduction control.
- the cuff pressure signal obtained during the decompression control period is a combination of the pulse wave amplitude and the pressure change amplitude with respect to the constant volume change.
- the cuff pressure signal detected by the pressure sensor 32 includes not only a change in the internal pressure of the blood vessel but also a pressure change corresponding to a certain volume change.
- the separation processing unit 112 performs filtering on the cuff pressure signal acquired by the signal acquisition unit 110 to separate the pulse wave amplitude and the pressure change characteristic.
- the correction processing unit 114 corrects the measured pulse wave amplitude based on the measured pressure change characteristic.
- the blood pressure calculation unit 116 calculates a blood pressure value, for example, a maximum blood pressure and a minimum blood pressure, based on the corrected pulse wave amplitude.
- the output processing unit 118 performs a process of outputting the calculated blood pressure value. For example, the blood pressure value is displayed on the display unit 40 or the blood pressure value is stored in the flash memory 43.
- each functional block described above may be realized by executing software stored in the memory unit 42, and at least one of these functional blocks is realized by hardware. Also good.
- FIGS. 6 (A) to 6 (F) are diagrams showing the concept of the blood pressure measurement method in Embodiment 1 of the present invention.
- FIG. 6 (A) shows the change in the arterial pressure along the time axis.
- FIG. 6B shows a change in volume along the same time axis as that in FIG.
- a constant volume change as shown in FIG. 6B is given to the cuff 20 during the decompression of the cuff 20.
- the cuff pressure signal acquired through the oscillation circuit 33 has a waveform as shown in FIGS.
- FIG. 6D shows a partially enlarged view of a portion 401 of the cuff pressure signal in FIG. As shown in FIG. 6D, a pressure change with respect to a constant volume change is superimposed on the cuff pressure signal.
- the pulse wave amplitude (FIG. 6 (E)) due to the change in the internal pressure of the blood vessel It is separated into an amplitude of a pressure change due to a constant volume change, that is, a pressure change characteristic (FIG. 6F).
- FIG. 7 is a flowchart showing blood pressure measurement processing according to Embodiment 1 of the present invention.
- the processing shown in the flowchart of FIG. 7 is stored in advance in the memory unit 42 as a program, and the blood pressure measurement processing function is realized by the CPU 100 reading and executing this program.
- the pressurization control unit 102 pressurizes the cuff 20 (step S2).
- the pressurization control unit 102 calculates the heart rate by a known method based on the output from the oscillation circuit 33 (step S4).
- the pressurization control unit 102 determines whether or not the pressure in the cuff 20 (cuff pressure) is a predetermined value (for example, 200 mmHg) (step S6). If it is determined that the cuff pressure has not reached the predetermined value (NO in step S6), the process returns to step S2 and the above process is repeated. When it is determined that the cuff pressure has reached a predetermined value (YES in step S6), the pressurization is stopped (step S8). In the present embodiment, the pressurization is stopped when the cuff pressure reaches a predetermined value. However, when the maximum blood pressure is estimated during the pressurization, as is conventionally done, The pressurization may be stopped.
- the decompression control unit 104 starts decompressing the cuff 20 (step S10).
- the generation processing unit 106 causes the cuff 20 to generate a constant volume change (step S12). Specifically, by transmitting a control signal to the motor drive circuit 63, the cylinder 61 is driven at a high speed, and a certain volume change is given to the air bag 21.
- a cycle different from the cycle of the heart rate of the measurement subject calculated in step S4 is selected.
- the signal acquisition unit 110 of the measurement control unit 108 acquires cuff pressure data (cuff pressure signal) detected by the pressure sensor 32 during pressure reduction (step S14).
- the acquired cuff pressure data is stored in the memory unit 42 in time series.
- the decompression control unit 104 determines whether or not the cuff pressure has reached a predetermined value (for example, 40 mmHg) (step S15). If it is determined that the cuff pressure has not reached the predetermined value (NO in step S15), the process returns to step S12 and the above process is repeated. If it is determined that the cuff pressure has reached a predetermined value (YES in step S15), the pressure reduction control is terminated and the process proceeds to step S16. In this embodiment, the pressure reduction control is terminated when the cuff pressure reaches a predetermined value. However, when the blood pressure can be calculated (for example, below the minimum blood pressure value estimated during pressurization). Or the like when the amplitude value becomes smaller than a predetermined value).
- a predetermined value for example, 40 mmHg
- step S16 the separation processing unit 112 of the measurement control unit 108 separates the pulse wave amplitude and the pressure change characteristic by filtering the time-series cuff pressure data obtained in step S14. Specifically, for example, the pulse wave amplitude and the pressure change characteristic are extracted from the cuff pressure data by performing a filter process for cutting the high frequency component and a filter process for extracting the high frequency component in parallel. Can do.
- step S16 the pulse wave amplitude acquired in step S16 is corrected by the correction processing unit 114. Specifically, first, an envelope of the pulse wave amplitude value sequence is created (step S18), and the created envelope is corrected using the pressure change characteristic obtained in step S16 (step S20).
- step S18 an envelope of the pulse wave amplitude value sequence is created (step S18), and the created envelope is corrected using the pressure change characteristic obtained in step S16 (step S20).
- FIGS. 8A to 8D are diagrams for explaining the correction processing of the pulse wave amplitude in the embodiment of the present invention.
- FIG. 8A shows an example of the envelope 401 created in step S18.
- FIG. 8B shows an example of a line (hereinafter referred to as “characteristic line”) 402 indicating the pressure change characteristic acquired in step S16.
- the correction processing unit 114 detects the cuff pressure PCm corresponding to the maximum point 4011 of the envelope 401.
- the cuff pressure PCm corresponds to the mean blood pressure (MAP).
- the correction processing unit 114 corrects the envelope 401 so that the characteristic line 402 has a constant amplitude with reference to a point 4021 corresponding to the cuff pressure PCm on the characteristic line 402. That is, the envelope 401 is corrected so that the characteristic line 402 becomes a straight line 4022 passing through the point 4021.
- the envelope 403 after correction is shown in FIG. In the envelope 403 after correction, the side lower than the cuff pressure PCm is corrected upward, and the side higher than the cuff pressure PCm is corrected downward.
- the blood pressure calculation unit 116 calculates the systolic blood pressure (SYS) and the systolic blood pressure (DIA) based on the corrected envelope 403 (step S22). Specifically, it is calculated as follows. That is, a value obtained by multiplying the maximum point 4011 of the envelope 403 by a predetermined constant (for example, 0.5) is set as the threshold value TH1, and a value obtained by multiplying the maximum point 4011 by a predetermined constant (for example, 0.7) is set as the threshold value TH2. .
- the cuff pressure that is higher than the mean blood pressure (MAP) and corresponds to the point where the corrected envelope 403 and the threshold value TH1 intersect is determined as the maximum blood pressure (SYS).
- the cuff pressure that is lower than the average blood pressure (MAP) and corresponds to the point where the corrected envelope 403 and the threshold value TH2 intersect is determined as the minimum blood pressure (DIA).
- the blood pressure calculation unit 116 may further calculate the heart rate by a known method based on the pulse wave amplitude acquired by the separation process.
- the air in the air bladder 21 is exhausted (step S24), and the measurement result (maximum blood pressure, minimum blood pressure, heart rate) is displayed and recorded by the output processing unit 118 (step S26).
- the measurement data in which measurement values (maximum blood pressure, minimum blood pressure, heart rate) are associated with the date and time at the time of measurement are stored in a record format.
- step S24 may be performed in parallel with the processes of steps S16 to S22.
- the pressure change characteristic is extracted for each measurement. Therefore, the pressure change characteristic reliably reflects the degree of winding of the cuff 20 and the influence of secular changes such as the pump 51, the valve 52, and the cuff 20.
- the blood pressure value is calculated after correcting the pulse wave amplitude due to the change in the internal pressure of the blood vessel based on such pressure change characteristics. Therefore, the blood pressure value can be accurately measured regardless of the winding condition of the cuff 20 and the secular change of the pump 51, the valve 52, the cuff 20, and the like.
- the envelope is created based on the waveform (pulse wave amplitude) from which the influence of the pressure change on the constant volume change is removed by applying the filter. It may be created based on the amplitude of the pressure signal.
- the decompression measurement method has been described as an example, but the pressurization measurement method is also applicable.
- a constant volume change may be generated during the pressurization control period, and the cuff pressure signal may be acquired during the pressurization control period.
- a constant volume change is generated in a period different from the period of the heart rate of the measurement subject during the period of pressure control (decompression control) for measuring the pulse wave amplitude.
- the pressure change characteristic was extracted by performing a filter process to the cuff pressure data on which the pressure change with respect to a fixed volume change was superimposed.
- a constant volume change is generated at regular intervals (intermittently) during the pressure control period in which the pulse wave amplitude is measured. Then, by measuring the amplitude value of the cuff pressure signal with and without the volume change, the pressure change characteristic is measured without performing the filtering process.
- step pressure reduction by performing stepwise pressure control (so-called step pressure reduction), when the pressure in the cuff is the same pressure value, the cuff pressure signal is measured when there is a constant volume change and when there is no constant volume change.
- the pulse wave amplitude and the pressure change characteristic are calculated from the two types of measured cuff pressure signals.
- FIGS. 9A and 9B are diagrams showing detection timings of pulse wave amplitude and pressure change characteristics in Embodiment 2 of the present invention.
- FIG. 9A shows a cuff pressure as a control value along the time axis.
- FIG. 9B shows a cuff pressure signal (mainly pulse wave) along the same time axis as FIG. 9A.
- a section TA is a period for detecting a pulse wave. That is, the section TA represents the detection period of the cuff pressure signal used for calculating the pulse wave amplitude.
- the section TB is a period for generating a constant volume change. Therefore, the section TB represents the detection period of the cuff pressure signal used for calculating the pressure change characteristic.
- the section TA is a section from the start to the end of a pulse wave of one beat (from the rising point of the pulse wave to the rising point of the next pulse wave), and the section TB is the next pulse of the section TA.
- a section of the wave is a section from the start to the end of a pulse wave of one beat (from the rising point of the pulse wave to the rising point of the next pulse wave), and the section TB is the next pulse of the section TA.
- a pressure change characteristic (a line indicating the pressure change) can be obtained.
- the section TA only needs to include at least one rising point of the pulse wave or the rising point of the next pulse wave and the maximum point of the pulse wave in between.
- the section TB may be a section that does not include the rising point of the pulse wave of one beat and the rising point of the next pulse wave and the maximum point of the pulse wave between them. Therefore, when the section TA includes from the rising point of one pulse wave to the rising point of the next pulse wave as shown in FIG. 9B, the section TB is included in the section TA. Also good. That is, in the present embodiment, the pulse wave amplitude measurement and the pressure change characteristic measurement are performed in series, but these may be performed in parallel.
- the time represented by the section TB is a time shorter than the cycle of the heart rate, and may be determined in advance or may be determined every measurement.
- cuff pressure data that can be used to calculate the pulse wave amplitude and the pressure change characteristic is collected until the pulse wave amplitude and the pressure change characteristic are measured.
- the pressure in the cuff is maintained.
- the pressure is reduced by a predetermined pressure. As a result, the pulse wave amplitude and the pressure change characteristic can be acquired during the decompression period without filtering the cuff pressure signal.
- FIG. 10A shows a cuff pressure as a control value along the time axis.
- FIG. 10B shows a cuff pressure signal (mainly a pulse wave) along the same time axis as FIG.
- TA # period in which the pulse wave is detected
- TB # a period in which a certain volume change is generated
- FIG. 11 is a functional block diagram showing a functional configuration of the sphygmomanometer 1 according to the second embodiment of the present invention.
- FIG. 11 also shows the functional configuration of the reduced pressure measurement method.
- symbol is attached
- CPU 100 replaces decompression control unit 104, generation processing unit 106, and measurement control unit 108 of the first embodiment with decompression control unit 104A and generation processing unit 106A, respectively. And a measurement control unit 108A.
- the decompression control unit 104A performs stepwise decompression control, that is, step decompression.
- the generation processing unit 106A generates a constant volume change at regular intervals during the decompression control period. In the present embodiment, it is preferable that the start timing for generating a constant volume change is the same cycle as the cycle of the heart rate of the measurement subject.
- the measurement control unit 108A includes a first measurement unit 210 and a second measurement unit 212 instead of the signal acquisition unit 110 and the separation processing unit 112.
- the first measurement unit 210 measures pressure change characteristics from a cuff pressure signal output in a specific section (section TB in FIG. 9) in which a constant volume change is applied to the cuff 20.
- the second measuring unit 212 is based on the cuff pressure signal output during the decompression control period and other than the specific section (that is, the section where the constant volume change is not given (section TA in FIG. 9)). Measure pulse wave amplitude.
- FIG. 12 is a flowchart showing blood pressure measurement processing according to Embodiment 2 of the present invention.
- the same step number is attached
- steps S102 to S114 are inserted between steps S8 and S15 instead of steps S10 to S14. Further, step S16 is deleted.
- the pressure reduction control unit 104A opens the valve 54 to reduce the pressure in the cuff 20 (step S102).
- the decompression control unit 104A determines whether or not the predetermined pressure has been reduced from the pressure value at the start of decompression (step S104).
- the cuff 20 is depressurized until the pressure difference reaches a predetermined pressure (NO in step S104).
- the pressure reduction is stopped (step S106). That is, the valve 54 is closed.
- the second measurement unit 212 measures the pulse wave by acquiring the cuff pressure signal (step S108), and calculates the pulse wave amplitude (step S110).
- the pulse wave measurement period is from when the decompression is stopped until the next pulse wave rising point is detected, as shown in a section TA in FIG. 9B.
- the generation processing unit 106A at a specific timing (for example, after a predetermined msec from the maximum point of the pulse wave), for a certain period (section TB in FIG. 9B).
- a constant volume change is generated in the cuff 20 (step S112).
- the pressure change characteristic is calculated by measuring the amplitude of the pressure change with respect to the constant volume change from the cuff pressure signal detected during the period in which the volume change is generated (section TB) (step S114).
- step S15 the decompression control unit 104A determines whether the cuff pressure has reached a predetermined value as described above (step S15). Until the predetermined value is reached (NO in step S15), the processes in steps S102 to S114 are repeated. If it is determined that the cuff pressure has reached a predetermined value (YES in step S15), the process proceeds to step S18.
- step S16 of the first embodiment since the period for generating the constant volume change is limited to the fixed section (section TB), the separation process in step S16 of the first embodiment is not necessary.
- the correction processing unit 114 creates an envelope based on the pulse wave amplitude calculated in step S110, and the created envelope is used as the pressure change calculated in step S114. Correct using characteristics.
- the correction method itself is the same as in the first embodiment.
- the pulse wave amplitude and the pressure change characteristic are calculated during the pressure reduction control. It may be calculated. That is, if the cuff pressure signal measured during the pressure reduction control is used for calculation of the pulse wave amplitude and the pressure change characteristic, these calculation timings do not matter.
- a constant volume change is generated continuously or intermittently during the period of pressure control (decompression control) for measuring the pulse wave amplitude.
- the pressure change characteristic is measured in a period different from the period of pressure control in which the pulse wave amplitude is measured.
- FIG. 13 is a diagram showing the detection timing of the pulse wave amplitude and the pressure change characteristic in the third embodiment of the present invention.
- FIG. 13 shows the cuff pressure as the control value along the time axis.
- the pressure change characteristic is acquired during the pressurization period, and the pulse wave amplitude is acquired during the decompression period. Note that the pressurization rate and the depressurization rate are preferably the same.
- FIG. 14 is a block diagram showing a hardware configuration of sphygmomanometer 1A according to Embodiment 3 of the present invention.
- the same components as those shown in FIG. 4 are denoted by the same reference numerals as those in FIG. Therefore, description thereof will not be repeated.
- cuff 20 in the present embodiment includes an air bladder 21A for ischemia in addition to air bladder 21 for blood pressure measurement.
- the air bag 21A for ischemia is disposed so as to be positioned upstream of the artery from the air bag 21 when the cuff 20 is attached to the measurement site.
- the pressure sensor 32, the oscillation circuit 33, the pump 51, the valve 52, the pump drive circuit 53, and the valve drive circuit 54 that are included in a general blood pressure monitor are referred to as a first adjustment / detection unit 300.
- the main body 10 further includes a second adjustment / detection unit 300 ⁇ / b> A having the same configuration as the first adjustment / detection unit 300.
- the second adjustment / detection unit 300A includes a pressure sensor 32A, an oscillation circuit 33A, a pump 51A, a valve 52A, a pump drive circuit 53A, and a valve drive circuit 54A.
- the pressure sensor 32A, the pump 51A, and the valve 52A are connected to the ischemic bladder 21A via the air tube 31A.
- the operation of each unit included in the second adjustment / detection unit 300A is the same as the operation of each unit included in the first adjustment / detection unit 300.
- the cuff 20 is provided with the air bag 21A for ischemia.
- the present invention is not limited to this as long as the measurement site can be ischemic.
- FIG. 15 is a functional block diagram showing a functional configuration of a sphygmomanometer 1A according to Embodiment 3 of the present invention.
- FIG. 15 also shows the functional configuration of the reduced pressure measurement method.
- symbol is attached
- CPU 100 newly includes an ischemia processing unit 301. Further, instead of the generation processing unit 106 and the measurement control unit 108 of the first embodiment, a generation processing unit 106B and a measurement control unit 108B are included, respectively.
- the pressurization control represents control for changing the pressure in the cuff 20 in a specific direction (that is, the upward direction), and the pressure reduction control represents the pressure in the cuff 20 opposite to the specific direction. This represents control that is changed in the (downward direction).
- the ischemic treatment unit 301 uses the ischemic bladder 21A to inhibit the measurement site only during the pressurization control period.
- the ischemia processing unit 301 is connected to the pump drive circuit 53A, the valve drive circuit 54A, and the oscillation circuit 33A.
- the pump 51A is driven while detecting the pressure in the air bladder 21A via the oscillation circuit 33A, and when the pressure in the air bladder 21A is not changed, the driving of the pump 51A is stopped.
- the generation processing unit 106B generates a constant volume change, for example, continuously during the pressurization control period.
- the period of volume change in the present embodiment may be a predetermined period.
- the measurement control unit 108B includes a first measurement unit 310 and a second measurement unit 312.
- the first measurement unit 310 measures the pressure change characteristic from the cuff pressure signal output during the pressurization control period.
- the second measuring unit 312 measures the pulse wave amplitude from the cuff pressure signal output during the decompression control period.
- FIG. 16 is a flowchart showing blood pressure measurement processing according to Embodiment 3 of the present invention.
- the same step number is attached
- step S ⁇ b> 202 when compared with the flowchart of FIG. 7, the process of step S ⁇ b> 202 is first inserted. Inserted. Moreover, the process of step S210 is inserted between step S8 and step S10. Further, instead of the processing of step S12 and step S14, the processing of step S218 and step S220 is executed.
- the ischemic treatment unit 301 inflates the ischemic air bladder 21A to inhibit the blood flow in the measurement site, which is the compressed range by the air bladder 21, upstream.
- the process to perform is performed (step S202). As a result, no pulse wave amplitude is generated in the air bladder 21 due to a change in the internal pressure of the artery.
- the generation processing unit 106B When the measurement site is blocked and the cuff is pressurized (step S2), the generation processing unit 106B generates a certain volume change in the air bag 21 (step S206). During the pressurization period, the first measurement unit 310 acquires a cuff pressure signal (cuff pressure data) via the oscillation circuit 33 (step S207). Then, the first measurement unit 310 calculates (acquires) the pressure change characteristic from the acquired cuff pressure signal (step S208). In the present embodiment, since the upstream side of the air bladder 21 is blocked during pressurization, the amplitude itself of the acquired cuff pressure signal can be measured as a pressure change characteristic.
- the ischemic treatment unit 301 ends the ischemia by exhausting the air in the ischemic air bladder 21A (step S210).
- the second measurement unit 312 acquires a cuff pressure signal (cuff pressure data), that is, a pressure pulse wave through the oscillation circuit 33, similarly to the normal blood pressure measurement process (step S10). S218). Then, the amplitude of the acquired pressure pulse wave (pulse wave amplitude) is calculated (step S220).
- the acquired cuff pressure signal represents a pressure pulse wave.
- the correction processing unit 114 creates an envelope based on the pulse wave amplitude calculated in step S220, and the created envelope is used as the pressure change calculated in step S208. Correct using characteristics.
- the correction method itself is the same as in the first embodiment.
- the pressure change characteristic (the amplitude of the pressure change with respect to a certain volume change) and the pulse wave amplitude are calculated during the pressurization control and the decompression control, respectively.
- the cuff pressure signal detected during each control is used for the calculation of the pressure change characteristic and the pulse wave amplitude, these calculation timings do not matter.
- 1,1A electronic sphygmomanometer 10 main body, 20 cuff, 21 (for blood pressure measurement) air bag, 21A blood pressure prevention air bag, 30 air system, 31, 31A air tube, 32, 32A pressure sensor, 33, 33A oscillation circuit , 40 display unit, 41 operation unit, 41A power switch, 41B measurement switch, 41C setting switch, 41D memory switch, 42 memory unit, 43 flash memory, 44 power supply, 45 timekeeping unit, 46 data input / output unit, 50 adjustment unit, 51, 51A pump, 52, 52A valve, 53, 53A pump drive circuit, 54, 54A valve drive circuit, 60 generating unit, 61 cylinder, 62 motor, 63 motor drive circuit, 100 CPU, 102 pressure controller, 104, 104A decompression control unit, 106, 106 , 106B generation processing unit, 108, 108A, 108B measurement control unit, 110 signal acquisition unit, 112 separation processing unit, 114 correction processing unit, 116 blood pressure calculation unit, 118 output processing unit, 132 recording medium,
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Abstract
Description
たとえば特開平5-329113号公報(特許文献1)には、カフの圧力に対するカフの容積変化特性を予め備えておき、カフの圧力変化の信号を容積変化へと換算しなおし、それを用いて血圧値を計測する方法が記載されている。
好ましくは、発生ユニットは、シリンダと、シリンダを駆動させるための駆動部とを含む。
(外観について)
はじめに、本発明の実施の形態1に係る電子血圧計(以下「血圧計」と略す)の外観について説明する。
ここで、本発明の概要について説明する。
(ハードウェア構成について)
図4は、本発明の実施の形態1に係る血圧計1のハードウェア構成を表わすブロック図である。
図5は、本発明の実施の形態1における血圧計1の機能構成を示す機能ブロック図である。なお、図5には、減圧測定方式すなわち、減圧の際に得られたカフ圧信号に基づいて、血圧値を算出する方式の機能構成が示されている。
(動作について)
図7は、本発明の実施の形態1における血圧測定処理を示すフローチャートである。図7のフローチャートに示す処理は、予めプログラムとしてメモリ部42に格納されており、CPU100がこのプログラムを読み出して実行することにより、血圧測定処理の機能が実現される。
次に、本発明の実施の形態2について説明する。
(機能構成について)
図11は、本発明の実施の形態2における血圧計1の機能構成を示す機能ブロック図である。図11にも、減圧測定方式の機能構成が示されている。なお、図5に示した機能ブロックと同様の処理を行なうものには同じ符号を付してある。したがって、それらについての説明は繰返さない。
図12は、本発明の実施の形態2における血圧測定処理を示すフローチャートである。なお、図7のフローチャートと同様の処理については同じステップ番号を付してある。したがって、それらについての説明は繰返さない。
次に、本発明の実施の形態3について説明する。
(ハードウェア構成について)
図14は、本発明の実施の形態3に係る血圧計1Aのハードウェア構成を表わすブロック図である。なお、図4に示した構成と同じものには、図4と同一の符号を付してある。したがって、それらについての説明は繰返さない。
図15は、本発明の実施の形態3における血圧計1Aの機能構成を示す機能ブロック図である。図15にも、減圧測定方式の機能構成が示されている。なお、図5に示した機能ブロックと同様の処理を行なうものには同じ符号を付してある。したがって、それらについての説明は繰返さない。
図16は、本発明の実施の形態3における血圧測定処理を示すフローチャートである。なお、図7のフローチャートと同様の処理については同じステップ番号を付してある。したがって、それらについての説明は繰返さない。
Claims (8)
- 測定部位に巻き付けるためのカフ(20)、
前記カフ内の圧力を調整するための圧力調整ユニット(50)と、
前記カフ内の圧力を示すカフ圧信号を検出するための圧力センサ(32)と、
前記カフ内に一定の容積変化を発生させるための発生ユニット(60)と、
前記圧力調整ユニットの駆動を制御することにより、前記カフ内の圧力を特定方向に変化させるための第1の圧力制御を行なう第1の圧力制御部(104,104A,102)と、
前記第1の圧力制御が行われている期間に、前記発生ユニットの駆動を制御することにより前記カフに一定の容積変化を与えるための処理を行なう発生処理部(106,106A,106B)と、
前記発生処理部の処理が行なわれている際に得られる前記カフ圧信号より前記容積変化に対する圧力変化特性を測定し、かつ、前記カフ圧信号より脈波振幅を測定する制御を行なうための測定制御部(108,108A,108B)と、
測定された前記圧力変化特性に基づいて、前記脈波振幅を補正するための補正処理部(114)と、
補正後の前記脈波振幅に基づいて、血圧値を算出するための血圧算出部(116)とを備える、電子血圧計。 - 前記発生処理部は、前記第1の圧力制御の期間中、継続的に、被測定者の心拍数の周期とは異なる周期で前記容積変化を発生させ、
前記測定制御部は、
前記第1の圧力制御の期間中に、時系列に前記カフ圧信号を取得するための取得部(110)と、
取得された前記カフ圧信号に対しフィルタ処理を実行することにより、前記脈波振幅と、前記圧力変化特性とに分離するための分離部(112)とを含む、請求の範囲第1項に記載の電子血圧計。 - 前記第1の圧力制御は、減圧制御であり、
前記心拍数は、前記減圧制御に移行する前の加圧制御中に、前記カフ圧信号に基づいて算出される、請求の範囲第2項に記載の電子血圧計。 - 前記発生処理部は、前記第1の圧力制御の期間中、一定の間隔で、前記容積変化を発生させ、
前記測定制御部は、
前記容積変化が前記カフに与えられている特定区間に出力された前記カフ圧信号より、前記圧力変化特性を測定するための第1の測定処理部(210)と、
前記第1の圧力制御の期間中であって前記特定区間以外の区間に出力された前記カフ圧信号より、前記脈波振幅を測定するための第2の測定処理部(212)とを含む、請求の範囲第1項に記載の電子血圧計。 - 前記第1の圧力制御部は、前記カフ内の圧力が同じ圧力値の場合に前記容積変化があるときとないときの前記カフ圧信号の振幅値を測定するために、段階的に前記第1の圧力制御を行なう、請求の範囲第4項に記載の電子血圧計。
- 前記発生処理部は、前記カフ圧信号の最大点から次の立ち上がり点までの区間に、前記容積変化を発生させる、請求の範囲第4項に記載の電子血圧計。
- 前記カフは、血圧測定用の流体袋(21)と、前記流体袋よりも上流側に配置された阻血部(21A)とを含み、
前記カフ内の圧力を前記特定方向とは逆の方向に変化させるための第2の圧力制御を行なう第2の圧力制御部(104)と、
前記第1の圧力制御の期間にのみ、前記阻血部を用いて前記測定部位を阻血するための阻血処理部(301)とをさらに備え、
前記発生処理部は、前記第1の圧力制御の期間中、継続的に、前記容積変化を発生させ、
前記測定制御部は、
前記第1の圧力制御の期間中に出力された前記カフ圧信号より、前記圧力変化特性を測定するための第1の測定処理部(310)と、
前記第2の圧力制御の期間中に出力された前記カフ圧信号より、前記脈波振幅を測定するための第2の測定処理部(312)とを含む、請求の範囲第1項に記載の電子血圧計。 - 前記発生ユニットは、シリンダ(61)と、前記シリンダを駆動させるための駆動部(62)とを含む、請求の範囲第1項に記載の電子血圧計。
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DE112009003737.2T DE112009003737B4 (de) | 2008-12-18 | 2009-12-08 | Elektronisches Blutdruckmessgerät |
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WO2017169924A1 (ja) * | 2016-03-29 | 2017-10-05 | 日本電気株式会社 | 血圧計、血圧測定方法及び血圧測定プログラム |
JPWO2017169924A1 (ja) * | 2016-03-29 | 2019-02-14 | 日本電気株式会社 | 血圧計、血圧測定方法及び血圧測定プログラム |
US11298031B2 (en) | 2016-03-29 | 2022-04-12 | Nec Corporation | Sphygmomanometer, blood pressure measurement method, and blood pressure measurement program |
JP7120001B2 (ja) | 2016-03-29 | 2022-08-17 | 日本電気株式会社 | 血圧計、血圧測定方法及び血圧測定プログラム |
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CN102256539B (zh) | 2013-06-19 |
JP5200913B2 (ja) | 2013-06-05 |
US20110251499A1 (en) | 2011-10-13 |
RU2525213C2 (ru) | 2014-08-10 |
US8622917B2 (en) | 2014-01-07 |
DE112009003737T5 (de) | 2012-11-08 |
RU2011129659A (ru) | 2013-01-27 |
CN102256539A (zh) | 2011-11-23 |
JP2010142418A (ja) | 2010-07-01 |
DE112009003737B4 (de) | 2024-01-11 |
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