WO2011122125A1 - 血圧測定装置 - Google Patents
血圧測定装置 Download PDFInfo
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- WO2011122125A1 WO2011122125A1 PCT/JP2011/052764 JP2011052764W WO2011122125A1 WO 2011122125 A1 WO2011122125 A1 WO 2011122125A1 JP 2011052764 W JP2011052764 W JP 2011052764W WO 2011122125 A1 WO2011122125 A1 WO 2011122125A1
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- blood pressure
- value
- cuff
- detected
- control unit
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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
- A61B5/02233—Occluders specially adapted therefor
-
- 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
- A61B5/02141—Details of apparatus construction, e.g. pump units or housings therefor, cuff pressurising systems, arrangements of fluid conduits or circuits
Definitions
- the present invention relates to a blood pressure measuring device, and more particularly to a blood pressure measuring device that wraps and compresses a cuff around a measurement site during blood pressure measurement.
- Blood pressure is one of the indices for analyzing cardiovascular diseases, and risk analysis based on blood pressure is effective in preventing cardiovascular diseases such as stroke, heart failure and myocardial infarction.
- diagnosis has been performed based on blood pressure (anytime blood pressure) measured at a medical institution such as during a hospital visit or during a medical examination.
- blood pressure measured at home home blood pressure
- blood pressure monitors used at home have become widespread, and it is said that there are over 30 million units in each home in Japan.
- Japanese Patent Application Laid-Open No. 2005-305028, Japanese Patent Application Laid-Open No. 02-114934, and Japanese Patent Application Laid-Open No. 2008-188197 disclose such conventional problems. Discloses a technique for determining whether or not the cuff wrap strength is appropriate based on the amount of air sent to the cuff in the process of increasing the cuff pressure at the start of blood pressure measurement and the manner of increasing the cuff pressure. Has been.
- the present invention has been conceived in view of such circumstances, and it is an object of the present invention to detect and recognize a measurement subject when a cuff wrapping strength varies in a blood pressure measurement device. To do.
- the blood pressure measurement device is a blood pressure measurement device provided with a cuff that compresses a measurement site by being wound, and a sensor that detects the behavior of the cuff and a blood pressure index based on the output of the sensor
- a control unit that detects a detection amount of the sensor, the control unit further includes a storage unit that measures blood pressure based on the detection amount and stores a history of the detection amount detected by the control unit, and the control unit includes a sensor
- the cuff wrapping strength is evaluated by comparing the detection amount detected based on the output of this with the history of the detection amount stored in the storage unit.
- control unit detects an amount related to the volume change amount of the artery at the measurement site where the cuff is wound.
- control unit detects the pressure pulse wave amplitude of the artery at the measurement site where the cuff is wound.
- the storage unit stores the detected amount history in association with the blood pressure value history measured based on the detected amount.
- control unit evaluates the winding strength of the cuff on the measurement site by comparing the detected maximum value of the detected amount with the maximum value in the history of the detected amount stored in the storage unit.
- control unit corresponds to one or more blood pressure values of the highest blood pressure value, the average blood pressure, or the lowest blood pressure value for each of the detected detection amount and the history of the detection amount stored in the storage unit.
- the control unit corresponds to one or more blood pressure values of the highest blood pressure value, the average blood pressure, or the lowest blood pressure value for each of the detected detection amount and the history of the detection amount stored in the storage unit.
- control unit compares the detection value corresponding to the representative value of the blood pressure value measured based on the detection amount of each of the detection value in the detected detection amount and the history of the detection amount stored in the storage unit.
- the winding strength of the cuff on the measurement site is evaluated.
- control unit is a volume of the Korotkoff sound of the artery at the measurement site where the cuff is wound based on the output of the sensor.
- the winding strength of the cuff is evaluated.
- the person to be measured can recognize the presence or absence of variation in winding strength based on the result of the evaluation.
- FIG. 1 It is a figure which shows the external appearance of the blood pressure meter 100 which is 1st Embodiment of the blood-pressure measuring apparatus of this invention. It is a figure which shows roughly the use condition of the blood pressure meter of FIG. It is a functional block diagram which shows the structure of the blood pressure meter of FIG. It is a figure which shows an example of the pressure pulse wave amplitude which the pulse wave signal detection part of FIG. 3 detects. It is a figure which shows the other example of the pressure pulse wave amplitude which the pulse wave signal detection part of FIG. 3 detects. It is a flowchart of the blood-pressure measurement process performed in the sphygmomanometer of FIG. It is a figure which shows an example of the screen displayed on the display part of FIG.
- the cuff is an air bag and the measurement site around which the cuff is wound is assumed to be the upper arm, but the measurement site is not limited to the upper arm.
- FIG. 1 shows an appearance of a sphygmomanometer 100 which is a first embodiment of the blood pressure measurement device of the present invention.
- FIG. 2 is a diagram schematically showing a use state of the sphygmomanometer 100 of FIG.
- blood pressure monitor 100 mainly includes apparatus main body 110 and cuff 150.
- the cuff 150 is wound around the measurement site 200.
- the apparatus main body 110 has a display unit 114 and an operation unit 115.
- the display unit 114 displays the measurement result of the blood pressure value, the measurement result of the pulse rate, and the like so as to be visible using numerical values, graphs, and the like.
- a liquid crystal panel or the like is used as this display unit 114.
- the operation unit 115 is provided with, for example, a power switch, a measurement start switch, and the like.
- the cuff 150 is intended to be wound around the measurement site of the measurement subject and has a belt-like outer shape.
- the cuff 150 accommodates an air bag 151 as a fluid bag for pressing the measurement site.
- the cuff 150 and the apparatus main body 110 are connected by an air pipe 140 as a connection pipe.
- the air tube 140 is made of a flexible tube, one end of which is connected to a blood pressure measurement air system component 131 provided in the apparatus main body 110 described later, and the other end is connected to the air bag 151 of the cuff 150 described above. ing.
- FIG. 3 is a functional block diagram showing the configuration of the sphygmomanometer 100.
- blood pressure measurement air system component 131 for supplying or discharging air to / from air bag 151 contained in cuff 150 via air tube 140 is provided inside apparatus main body 110 of sphygmomanometer 100. Is provided.
- the blood pressure measurement air system component 131 includes a pressure sensor 132 that detects the pressure in the air bladder 151, a pump 134 and a valve 135 for inflating and contracting the air bladder 151.
- an oscillation circuit 125, a pump drive circuit 126, and a valve drive circuit 127 are provided inside the apparatus main body 110 in association with the blood pressure measurement air system component 131.
- the pressure sensor 132 constitutes a sensor that detects the behavior of the cuff 150.
- the apparatus main body 110 includes a control unit 122 for centrally controlling and monitoring each unit, a memory unit 123A for storing a program for causing the control unit 122 to perform a predetermined operation, and various types such as a measured blood pressure value.
- a memory unit 123B for storing information
- a display unit 114 for displaying various types of information including blood pressure measurement results
- an operation unit 115 operated to input various instructions for measurement and a timing function
- the timer 129 and the power supply unit 124 for supplying power to the control unit 122 and each functional block are installed.
- the control unit 122 includes a processor such as a CPU (Central Processing Unit).
- the memory unit 123A and the memory unit 123B are configured by a storage medium. These may be realized by one storage medium, or each may be constituted by another storage medium.
- Storage media include CD-ROM (Compact Disc-Read Only Memory), DVD-ROM (Digital Versatile Disk-Read Only Memory), USB (Universal Serial Bus) memory, memory card, FD (Flexible Disk), hard disk, magnetic Tape, cassette tape, MO (Magnetic Optical Disc), MD (Mini Disc), IC (Integrated Circuit) card (excluding memory card), optical card, mask ROM, EPROM, EEPROM (Electronically Erasable Programmable Read-Only Memory), etc. And a medium for storing the program in a nonvolatile manner.
- the pressure sensor 132 detects the pressure in the air bladder 151 (hereinafter, appropriately referred to as “cuff pressure”), and outputs a signal corresponding to the detected pressure to the oscillation circuit 125.
- the pump 134 supplies air to the air bladder 151.
- the valve 135 opens and closes when maintaining the pressure in the air bag 151 or exhausting the air in the air bag 151.
- the oscillation circuit 125 outputs a signal having an oscillation frequency corresponding to the output value of the pressure sensor 132 to the control unit 122.
- the pump drive circuit 126 controls the drive of the pump 134 based on a control signal given from the control unit 122.
- the valve drive circuit 127 controls opening and closing of the valve 135 based on a control signal given from the control unit 122.
- the control unit 122 processes the signal output from the oscillation circuit 125, thereby detecting a pulse wave signal detection unit 122A that detects an arterial volume change superimposed on the cuff pressure as a pressure change (pressure pulse wave amplitude), and a pulse wave.
- the blood pressure measurement unit 122B that measures the blood pressure based on the pressure pulse wave amplitude detected by the signal detection unit 122A, and the current measurement by comparing the pressure pulse wave amplitude in the current measurement with the pressure pulse wave amplitude in the past measurement.
- an evaluation unit 122P for evaluating the winding strength of the cuff 150.
- the evaluation unit 122P displays the evaluation result on the display unit 114 and outputs it.
- An example of the pressure pulse wave amplitude detected by the pulse wave signal detector 122A is shown in FIG.
- FIG. 4 shows a change of the pulse wave signal SIG with time.
- the pulse wave signal SIG in FIG. 4 shows the change of the pulse wave when the cuff pressure is constant.
- the pulse wave signal SIG of FIG. 4 takes the amplitude PX as the maximum value, and changes so as to repeat the same pattern at regular intervals.
- the operation unit 115 includes a power switch 115A that switches on / off the power supply to the sphygmomanometer 100, a measurement switch 115B that is operated when the sphygmomanometer 100 starts blood pressure measurement, and a blood pressure measurement operation that is being performed.
- a stop switch 115C operated to stop the operation, a user selection switch 115D for selecting a person to be measured of the sphygmomanometer 100, and data such as a blood pressure value and a pulse rate stored in the memory unit 123B on the display unit 114 It includes a record call switch 115E that is operated for display.
- the memory unit 123B stores blood pressure values and pulse rate measurement results for each person to be measured.
- the stored measurement results are displayed on the display unit 114 so as to be visible using numerical values, graphs, and the like by operating the recording call switch 115E.
- the pressure pulse wave signal does not appear when the cuff pressure is less than a certain value, and the pressure pulse wave signal appears when the cuff pressure exceeds a certain value. Thereafter, as the cuff pressure increases, the pressure pulse wave amplitude increases as a whole while repeating a constant change pattern. Then, after reaching the maximum value, as the cuff pressure increases, the pressure pulse wave amplitude decreases as a whole while repeating a constant change pattern. When the cuff pressure becomes a predetermined value or more, the pressure pulse wave amplitude cannot be obtained.
- a set of change patterns is indicated by P1.
- blood pressure is measured based on the pressure pulse wave amplitude.
- the cuff pressure at which the pressure pulse wave amplitude rapidly increased is set as the maximum blood pressure value, and the pressure pulse wave amplitude is The rapidly reduced cuff pressure is set as the minimum blood pressure value, and the cuff pressure at which the pressure pulse wave amplitude has a maximum value is set as the average blood pressure value.
- Fig. 5B shows the pressure pulse wave amplitude when the cuff pressure is changed in the same range as in Fig. 5A.
- the cuff 150 is loosely wound around the measurement site as compared with the state shown in FIG.
- the pressure pulse wave amplitude is also shown.
- 5A shows the pressure pulse wave amplitude when the cuff 150 is wound around the measurement site with an appropriate strength.
- the pressure pulse wave amplitude shown in FIG. 5B has the same tendency of the change of the pressure pulse wave amplitude with respect to the change of the cuff pressure.
- the amplitude value is generally smaller than the pressure pulse wave amplitude shown in (A).
- the pressure pulse wave amplitude as a whole becomes larger than appropriate.
- the value of the pressure pulse wave amplitude becomes smaller than when winding is appropriate.
- the pressure pulse wave amplitude value corresponding to the same cuff pressure (or cuff pressure showing the same characteristics such as the highest blood pressure value, the lowest blood pressure value, and the average blood pressure value) for a plurality of measurements is used. Based on this, the manner of winding the cuff 150 around the measurement site is evaluated.
- the blood pressure value data shown as Table 1 includes an ID for specifying each data set, a measurement date and time, information for specifying a person to be measured (user), a blood pressure value, a pulse rate, and pressure pulse wave amplitude data stored separately. Is stored in association with each other (pressure pulse wave amplitude data).
- the blood pressure value may be, for example, a maximum blood pressure value, a minimum blood pressure value, or an average blood pressure value, or a cuff pressure when the pressure pulse wave amplitude takes a maximum value.
- the pressure pulse wave amplitude data shown as Table 2 shows the change pattern of the pressure pulse wave amplitude as shown with reference to FIGS. 5A and 5B for a plurality of predetermined cuff pressures. It is shown.
- each pressure pulse wave amplitude data includes pressure pulse wave amplitudes for a plurality of cuff pressures (blood pressures).
- each pressure pulse wave amplitude data only needs to include at least the pressure pulse wave amplitude used in “evaluation of the winding strength” in the blood pressure measurement process described later. That is, for example, in the evaluation of the winding strength, the pressure pulse wave amplitude corresponding to the maximum blood pressure value obtained by the current blood pressure measurement is compared with the pressure pulse wave amplitude corresponding to the maximum blood pressure value stored as a history. In this case, the pressure pulse wave amplitude data corresponding to at least the maximum blood pressure value in each measurement time may be stored in the pressure pulse wave amplitude data.
- the pressure pulse wave amplitude stored as the history is compared with the maximum value of the pressure pulse wave amplitude obtained by the current blood pressure measurement, the pressure pulse wave amplitude
- the data only needs to store at least the maximum value of the pressure pulse wave amplitude at each measurement time.
- the information for identifying each pressure pulse wave amplitude data is attached to the pressure pulse wave amplitude data of each measurement time as “PulseWave1” in Table 2.
- FIG. 6 is a flowchart of blood pressure measurement processing executed in the sphygmomanometer 100.
- the control unit 122 is realized by executing a program stored in the memory unit 123A (or a recording medium detachable from the apparatus main body 110).
- control unit 122 waits until operation is performed on power switch 115A. If it is determined that the operation has been performed, the process proceeds to step S20.
- step S20 the control unit 122 initializes the sphygmomanometer 100. Thereby, the internal pressure of the air bag 151 of the cuff 150 is initialized.
- step S30 the control unit 122 accepts input of information for selecting a user by operating the user selection switch 115D. If it is determined that the information for selecting the user has been input, the control unit 122 proceeds to step S40.
- step S30 the control unit 122 generates a new ID for the blood pressure value data shown in Table 1, and secures a storage area for the ID. Then, the date and time acquired from the timer 129 at that time is stored as the measurement date and time associated with the ID, and the information of the user who accepted the input of information at step S30 is stored as the user associated with the ID. .
- step S40 the control unit 122 waits until the measurement switch 115B is operated. If it is determined that the measurement switch 115B has been operated, the control unit 122 advances the process to step S50.
- step S50 the control unit 122 increases the cuff pressure by causing the pump 134 to send air to the air bag 151, and proceeds to step S60.
- step S60 the control unit 122 determines whether or not the cuff pressure has reached a predetermined pressure based on the output signal of the pressure sensor 132. Then, when it is determined that it has not yet reached, the control unit 122 returns the process to step S50, and when it is determined that it has reached, the process proceeds to step S70.
- step S70 the control unit 122 gradually reduces the cuff pressure by controlling the closed valve 135 to gradually open. Then, based on the pressure pulse wave signal superimposed on the signal detected by the pressure sensor 132 during such a decompression process, the control unit 122 calculates blood pressure (maximum blood pressure and minimum blood pressure) based on a predetermined procedure in step S80.
- step S90 the control unit 122 stores the pressure pulse wave amplitude at that time in the memory unit 123B, and proceeds to step S100.
- the pressure pulse wave amplitude stored in step S90 corresponds to the value of the pressure pulse wave amplitude with respect to the cuff pressure at that time in the pressure pulse wave amplitude data (see Table 2) shown in Table 2.
- step S100 the control unit 122 determines whether or not the calculation of the blood pressure has been completed. If it is determined that the calculation has been completed (YES in step S100), the process proceeds to step S110. On the other hand, if it is determined that the process has not been completed, the process returns to step S70.
- step S110 the control unit 122 compares the value of the pressure pulse wave amplitude obtained by the current measurement with the value of the pressure pulse wave amplitude obtained by the previous measurement and stored in the memory unit 123B. Based on the comparison result, information for evaluating the winding strength of the cuff 150 in the current measurement is generated, and the process proceeds to step S120.
- the aspect of comparison and evaluation here will be described later.
- step S120 the control unit 122 causes the blood pressure value obtained in step S80 to be displayed on the display unit 114 together with the evaluation information generated in step S110, and the process proceeds to step S130.
- step S130 the blood pressure value (maximum blood pressure value, minimum blood pressure value and / or average blood pressure value) determined in step S80 and displayed on the display unit 114 in step S120 is stored in the blood pressure value data (Table 1). End the measurement process.
- the obtained blood pressure value is stored in the memory unit 123 in association with the user who accepted the selection in step S30.
- control unit 122 controls the valve 135 to be fully opened together with the display of the blood pressure value in step S120 (or after the display), and removes air from the air bag 151.
- the control unit 122 first reads the value of the pressure pulse wave amplitude corresponding to the blood pressure value obtained by the current blood pressure measurement as the first value.
- the blood pressure value here may be, for example, a maximum blood pressure value, a minimum blood pressure value, or an average blood pressure value, or a cuff pressure when the maximum value of the pressure pulse wave amplitude is taken.
- the value of the pressure pulse wave amplitude stored in Table 2 in association with the measurement subject whose information is input in Step S30 in Table 1 is set to the second value. Read as value.
- the second value is read as the value of the pressure pulse wave amplitude obtained by the current blood pressure measurement, and when the value corresponding to the maximum blood pressure value is read, the blood pressure measurement so far Similarly, the value of the pressure pulse wave amplitude corresponding to the maximum blood pressure value is read as the value of.
- the value of the pressure pulse wave amplitude corresponding to the minimum blood pressure value is also read as the blood pressure measurement value so far.
- the value of the pressure pulse wave amplitude corresponding to the average blood pressure value is also read as the blood pressure measurement value so far.
- the pressure pulse wave amplitude corresponding to the systolic blood pressure value or the like is read as the second value, and may be the immediately previous measurement result for the measurement subject whose information has been input in step S30. Alternatively, it may be a representative value such as an average value, a minimum value, or a maximum value of the measurement results of the most recent predetermined number of times (for example, 5 times).
- control unit 122 calculates a difference between the first value and the second value ([second value] ⁇ [first value]), and determines the winding strength based on the value of the difference REF. evaluate. For example, if the REF is “A” or less, the winding strength is appropriate, if the REF exceeds “A”, the winding strength is tight, and if the REF is less than “ ⁇ A”, it is evaluated that the winding strength is loose. To do.
- the evaluation of the winding strength may be performed in multiple stages. For example, an example in which evaluation is performed in seven stages will be described. If REF is “A1” or less, the winding strength is appropriate. If REF exceeds “A1” and is “A2” or less, the winding strength is slightly tight, and if REF exceeds “A2” and “A3” or less. If it is, the winding strength is tight. If the REF exceeds “A3”, the winding strength is quite tight. If the REF is lower than “ ⁇ A1” but “ ⁇ A2” or higher, the winding strength is slightly loose.
- FIG. 7 shows an example of a screen displayed on the display unit 114 in step S120.
- a screen 400 includes a systolic blood pressure value 402 (a numerical value “162”), a diastolic blood pressure value 403 (a numerical value “98”), a pulse value 404 (a numerical value “92”), A current date and time 401 and an evaluation display unit 40 including a plurality of blocks are displayed.
- the evaluation display unit 40 includes seven blocks corresponding to the above seven-step evaluation. Of the seven blocks, the block corresponding to the evaluation result is displayed in a different mode from the other blocks (shown with hatching in FIG. 7). In FIG. 7, the block immediately above the middle is displayed in a different manner, and an evaluation result of “slightly loose” is shown.
- the detection amount for the blood pressure index detected based on the output of the sensor is configured by the pressure pulse wave amplitude used for the evaluation of the winding strength.
- the pressure pulse wave amplitude is also information related to the volume change of the artery.
- the memory unit 123B that stores the blood pressure value data (Table 1) and the pressure pulse wave amplitude data (Table 2) constitutes a first storage unit and a second storage unit.
- the second storage unit is configured by a part that stores data associated with the ID of the measurement data during the blood pressure measurement process in the blood pressure value data.
- the first storage unit is configured by the part that stores the data associated with the ID of the previous measurement data in the blood pressure value data.
- the evaluation unit 122P that evaluates the winding strength of the cuff 150 by comparing the pressure pulse wave amplitude in the detection result of this time and the pressure pulse wave amplitude stored as the history allows the evaluation unit of the present invention to It is configured. Note that the evaluation unit 122P outputs the result of the evaluation to the display unit 114, for example, as the evaluation display unit 40 in FIG.
- the sphygmomanometer 100 which is an example of the blood pressure measurement device of the present embodiment performs blood pressure measurement according to the Korotkoff sound.
- the appearance configuration can be the same as that of the sphygmomanometer 100 of the first embodiment.
- FIG. 8 is a diagram schematically showing a usage state of the sphygmomanometer 100 of the present embodiment
- FIG. 9 is a functional block diagram of the sphygmomanometer 100 of the present embodiment.
- blood pressure monitor 100 of the present embodiment further includes microphone 80 in cuff 150 in addition to blood pressure monitor 100 of the first embodiment.
- the cuff 150 is wound around the measurement site 200, and the microphone 80 detects the Korotkoff sound generated when the artery in the measurement site 200 is tightened by the cuff 150.
- control unit 122 includes a sound detection unit 122C that detects sound output from the microphone 80, and a blood pressure measurement unit 122D that performs blood pressure measurement based on the sound detected by the sound detection unit 122C. Including.
- the blood pressure measurement according to the Korotkoff sound using the sound output from the microphone 80 can be employed, so that the description thereof will not be repeated.
- FIG. 10A shows a change in the volume (level) of the Korotkoff sound accompanying a change in the cuff pressure when the winding strength of the cuff 150 is appropriate.
- FIG. 10B shows a change in the volume (level) of Korotkoff sound accompanying a change in the cuff pressure when the winding strength of the cuff 150 is loose.
- the level of the Korotkoff sound increases as a whole as compared with an appropriate case.
- the wrapping strength of the cuff 150 is tight enough to prevent blood flow in the blood vessel, the level of Korotkoff sound will be reduced as a whole compared to the appropriate case.
- the control unit 122 first reads the Korotkoff sound level corresponding to the blood pressure value obtained in the current blood pressure measurement as the first value.
- the blood pressure value here includes, for example, a maximum blood pressure value, a minimum blood pressure value, or an average blood pressure value. Further, the blood pressure value here may be a cuff pressure when the maximum value of the Korotkoff sound level is taken.
- the level of the Korotkoff sound stored in Table 2 in association with the measurement subject whose information is input in Step S30 in Table 1 is set as the second value. Read.
- the second value is read as the value of the blood pressure measurement so far when the value corresponding to the highest blood pressure value is read as the level of the Korotkoff sound obtained in the current blood pressure measurement.
- the Korotkoff sound level corresponding to the maximum blood pressure value is read.
- the Korotkoff sound level corresponding to the minimum blood pressure value is also read as the blood pressure measurement values so far.
- the Korotkoff sound level corresponding to the average blood pressure value is also read as the blood pressure measurement values so far.
- the second value is the level of the Korotkoff sound corresponding to the systolic blood pressure value or the like, and may be the immediately previous measurement result for the measurement subject whose information has been input in step S30. Alternatively, it may be a representative value such as an average value, a minimum value, or a maximum value of the measurement results of the most recent predetermined number of times (for example, 5 times).
- control unit 122 calculates the difference between the first value and the second value ([second value] ⁇ [first value]), and determines the winding strength based on the value of the difference REF01. evaluate. For example, if REF01 is "B" or less, the winding strength is appropriate, if REF01 exceeds "B", the winding strength is tight, and if REF01 is less than "-B", the winding strength is evaluated as loose. To do.
- the evaluation of the winding strength may be performed in multiple stages. For example, an example in which evaluation is performed in seven stages will be described. If REF01 is "B1" or less, the winding strength is appropriate. If REF01 exceeds “B1” and “B2” or less, the winding strength is slightly tight. If REF01 exceeds "B2" and “B3” or less, If it is, the winding strength is tight. If REF01 exceeds “B3”, the winding strength is quite tight. If REF01 is lower than “ ⁇ B1” but “ ⁇ B2” or higher, the winding strength is slightly loose.
- the microphone 80 constitutes a sensor that detects the behavior of the cuff.
- the evaluation unit 122P that evaluates the winding strength of the cuff 150 by comparing the Korotkoff sound in the detection result of this time with the Korotkoff sound stored as the history constitutes the evaluation unit of the present invention. ing. Note that the evaluation unit 122P outputs the result of the evaluation to the display unit 114, for example, as the evaluation display unit 40 in FIG.
- the sphygmomanometer 100 which is an example of the blood pressure measurement device of the present embodiment, performs blood pressure measurement by detecting the arterial volume using a photoelectric sensor including a light emitting element and a light receiving element.
- the appearance configuration can be the same as that of the sphygmomanometer 100 of the first embodiment.
- FIG. 11 is a diagram schematically showing a usage state of the sphygmomanometer 100 of the present embodiment
- FIG. 12 is a functional block diagram of the sphygmomanometer 100 of the present embodiment.
- sphygmomanometer 100 includes, in addition to sphygmomanometer 100 according to the first embodiment, photoelectric sensor 70 including light emitting element 71 and light receiving element 72, and driving of the light emitting element.
- a circuit 73 and an arterial volume detection circuit 74 are included.
- the photoelectric sensor 70 constitutes a sensor that detects the behavior of the cuff 150.
- control unit 122 detects an arterial volume based on the output of the arterial volume detection circuit 74, and an arterial volume detection unit 122E that measures the blood pressure value based on the arterial volume detected by the arterial volume detection unit 122E. Measurement unit 122F.
- the light emitting element 71 irradiates light toward the radial artery of the portion extending through the measurement site 200 (for example, wrist in this embodiment), and is configured by, for example, an LED (Light Emitting Diode).
- the light receiving element 72 receives light transmitted through the radial artery of light emitted from the light emitting element 71 and / or reflected light, and is composed of, for example, a PD (Photo Diode).
- near-infrared light that easily passes through living tissue
- the light-emitting element 71 and the light-receiving element 72 emit and receive this near-infrared light.
- Each possible one is preferably used. More specifically, as the detection light emitted from the light emitting element 71 and received by the light receiving element 72, near infrared light having a wavelength near 940 nm is particularly preferably used.
- the detection light is not limited to the near-infrared light near 940 nm, and light near a wavelength of 450 nm, light near a wavelength of 1100 nm, or the like can be used.
- the light emitting element driving circuit 73 is a circuit for causing the light emitting element 71 to emit light based on a control signal from the control unit 122, and causes the light emitting element 71 to emit light by applying a predetermined amount of current to the light emitting element 71. is there.
- a current applied to the light emitting element 71 for example, a direct current of about 50 mA is used.
- the light emitting element driving circuit 73 a circuit that causes the light emitting element 71 to periodically emit light by supplying a pulse current to the light emitting element 71 at a predetermined duty is preferably used.
- the driving frequency of the light emitting element 71 is set to a frequency sufficiently higher (for example, about 3 kHz) than the frequency component (approximately 30 Hz) included in the fluctuation of the arterial volume to be detected, thereby detecting the arterial volume more precisely. It becomes possible to do.
- the arterial volume detection circuit 74 is a circuit for generating a voltage signal corresponding to the amount of received light based on the signal input from the light receiving element 72 and outputting the voltage signal to the control unit 122. Since the amount of light detected by the light receiving element 72 changes in proportion to the arterial volume, the voltage signal generated by the arterial volume detection circuit 74 also changes in proportion to the arterial volume. Is regarded as a voltage value fluctuation.
- the arterial volume detection circuit 74 includes processing circuits such as an analog filter circuit, a rectifier circuit, an amplifier circuit, an A / D (Analog / Digital) conversion circuit, and the like. Output as a converted voltage signal.
- FIG. 13A shows a change in the voltage signal (voltage value) output from the arterial volume detection circuit 74 in accordance with the change in the cuff pressure when the winding strength of the cuff 150 is appropriate.
- FIG. 13B shows a change in the voltage signal (voltage value) output from the arterial volume detection circuit 74 according to the change in the cuff pressure when the winding strength of the cuff 150 is loose.
- the output voltage value increases as a whole as compared with an appropriate case.
- the wrapping strength of the cuff 150 is tight enough to prevent blood flow in the blood vessel, the output voltage value is reduced as a whole as compared with an appropriate case.
- the control unit 122 first reads the voltage value corresponding to the blood pressure value obtained by the current blood pressure measurement as the first value.
- the blood pressure value here includes, for example, a maximum blood pressure value, a minimum blood pressure value, or an average blood pressure value. Further, the blood pressure value here may be a cuff pressure when the output voltage takes a maximum value.
- the memory unit 123B the voltage value stored in Table 2 in association with the measurement subject whose information is input in Step S30 in Table 1 is read as the second value.
- the second value is read as the voltage value obtained by the current blood pressure measurement, and when the value corresponding to the maximum blood pressure value is read, the value of the blood pressure measurement so far is also read. Similarly, the level of the voltage value corresponding to the maximum blood pressure value is read. When the value corresponding to the minimum blood pressure value is read, the voltage value corresponding to the minimum blood pressure value is similarly read as the blood pressure measurement value so far. When the value corresponding to the average blood pressure value is read, the voltage value corresponding to the average blood pressure value is also read as the blood pressure measurement value so far.
- the voltage value corresponding to the systolic blood pressure value or the like that is read as the second value may be the previous measurement result for the measurement subject whose information has been input in step S30, It may be a representative value such as an average value, a minimum value, or a maximum value of the latest predetermined number of times (for example, 5 times).
- control unit 122 calculates a difference between the first value and the second value ([second value] ⁇ [first value]), and determines the winding strength based on the value of the difference REF02. evaluate. For example, if REF02 is “C” or less, the winding strength is appropriate, if REF02 exceeds “C”, the winding strength is tight, and if REF02 is less than “ ⁇ C”, the winding strength is evaluated as loose. To do.
- the evaluation of the winding strength may be performed in multiple stages. For example, an example in which evaluation is performed in seven stages will be described. If REF02 is "C1" or less, the winding strength is appropriate. If REF02 exceeds “C1” and is “C2” or less, the winding strength is slightly tight. If REF02 is "C2" and exceeds "C3", If it is, the winding strength is tight. If REF02 exceeds “C3”, the winding strength is quite tight. If REF02 is lower than “ ⁇ C1” but “ ⁇ C2” or higher, the winding strength is slightly loose.
- Information related to the volume change of the artery is configured.
- the evaluation part of this invention is comprised by the evaluation part 122P which evaluates about the winding strength of the cuff 150 by comparing the voltage value in this detection result, and the voltage value memorize
- the evaluation unit 122P outputs the result of the evaluation to the display unit 114, for example, as the evaluation display unit 40 in FIG.
- a detection amount for a blood pressure index is detected based on information output from the sensor based on the behavior of the cuff, and the detection amount Is compared with the detected amount stored as the history, thereby evaluating the winding strength of the cuff.
- the person to be measured can recognize the presence or absence of variation in winding strength based on the result of the evaluation.
- 40 evaluation display section 70 photoelectric sensor, 71 light emitting element, 72 light receiving element, 73 light emitting element drive circuit, 74 arterial volume detection circuit, 80 microphone, 100 blood pressure monitor, 110 device main body, 114 display section, 115 operation section, 115A power supply Switch, 115B measurement switch, 115C stop switch, 115D user selection switch, 115E switch, 122 control unit, 122A pulse wave signal detection unit, 122B blood pressure measurement unit, 122C sound detection unit, 122D blood pressure measurement unit, 122E arterial volume detection unit , 122F blood pressure measurement unit, 122P evaluation unit, 123A, 123B memory unit, 124 power supply unit, 125 oscillation circuit, 126 pump drive circuit, 127 valve drive circuit, 129 timer, 131 air system component for blood pressure measurement, 1 Second pressure sensor, 134 pumps, 135 valve, 140 an air tube, 150 cuff 151 bladder 200 measurement site, 400 screen.
Abstract
Description
本発明の血圧測定装置の第1の実施の形態として、オシロメトリック方法に従って血圧を測定する血圧測定装置を示す。
図1は、本発明の血圧測定装置の第1の実施の形態である血圧計100の外観を示す。図2は、図1の血圧計100の使用状態を概略的に示す図である。
図3は、血圧計100の構成を示す機能ブロック図である。
血圧計100では、カフ圧の変化に伴って、圧脈波振幅が変化する。図5の(A)および(B)に、カフ圧の変化に伴う圧脈波振幅の変化を示す。
血圧計100では、メモリ部123Bに、過去の血圧測定において得られた血圧値や圧脈波振幅の値が、履歴として、被測定者ごとに記憶される。これらの記憶態様の一例を表1および表2に示す。
図6は、血圧計100において実行される血圧測定処理のフローチャートである。血圧計100では、制御部122が、メモリ部123A(または、装置本体110に対して着脱可能な記録媒体)に記憶されたプログラムを実行することにより実現される。
ステップS110における巻付強度の評価について、説明する。
図7に、ステップS120において表示部114に表示される画面の一例を示す。
[2-1.血圧計の構成]
本実施の形態の血圧測定装置の一例である血圧計100は、コロトコフ音に従って血圧測定を行なう。外観構成については、第1の実施の形態の血圧計100と同様とすることができる。
本実施の形態の血圧計100の評価部122Pによる、ステップS110(図6参照)における巻付強度の評価について、説明する。
[3-1.血圧計の構成]
本実施の形態の血圧測定装置の一例である血圧計100は、発光素子と受光素子とを含む光電センサを利用して、動脈容積を検出することにより、血圧測定を行なう。外観構成については、第1の実施の形態の血圧計100と同様とすることができる。
本実施の形態の血圧計100の評価部122Pによる、ステップS110(図6参照)における巻付強度の評価について、説明する。
Claims (8)
- 巻付けられることにより測定部位を圧迫するカフ(150)を備えた血圧測定装置(100)であって、
前記カフ(150)の挙動を検出するセンサ(132)と、
前記センサ(132)の出力に基づいて血圧の指標についての検出量を検出する制御部(122)とを備え、
前記制御部(122)は、前記検出量に基づいて血圧を測定し、
前記制御部(122)によって検出された検出量の履歴を記憶する記憶部(123B)をさらに備え、
前記制御部(122)は、前記センサ(132)の出力に基づいて検出された検出量を、前記記憶部(123B)に記憶された検出量の履歴と比較することにより、前記カフ(150)の巻付強度を評価する、血圧測定装置(100)。 - 前記制御部(122)は、前記カフ(150)が巻付けられる測定部位における動脈の容積変化量に関連する量を検出する、請求項1に記載の血圧測定装置(100)。
- 前記制御部(122)は、前記カフ(150)が巻付けられる測定部位における動脈の圧脈波振幅を検出する、請求項2に記載の血圧測定装置(100)。
- 前記記憶部(123B)は、前記検出量の履歴を、前記検出量に基づいて測定される血圧値の履歴と関連付けて記憶する、請求項1に記載の血圧測定装置(100)。
- 前記制御部(122)は、検出した前記検出量の最大値と、前記記憶部(123B)に記憶された検出量の履歴における最大値を比較することにより、前記カフ(150)の測定部位に対する巻付強度を評価する、請求項1に記載の血圧測定装置(100)。
- 前記制御部(122)は、検出した前記検出量と前記記憶部(123B)に記憶された検出量の履歴のそれぞれについての、血圧値の最高血圧、平均血圧または最低血圧のいずれか1つ以上の血圧値に対応した前記検出量を比較することにより、前記カフ(150)の測定部位に対する巻付強度を評価する、請求項1に記載の血圧測定装置(100)。
- 前記制御部(122)は、検出した前記検出量における検出値と前記記憶部(123B)に記憶された検出量の履歴のそれぞれの、前記検出量に基づいて測定した血圧値の代表値に対応する検出量を比較することにより、前記カフ(150)の測定部位に対する巻付強度を評価する、請求項1に記載の血圧測定装置(100)。
- 前記制御部(122)は、前記センサ(132)の出力に基づいて、前記カフ(150)が巻付けられる測定部位における動脈のコロトコフ音の音量である、請求項1に記載の血圧測定装置(100)。
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