WO2013038551A1 - Dispositif et procédé d'évaluation de la fonction nerveuse autonome, et programme informatique - Google Patents

Dispositif et procédé d'évaluation de la fonction nerveuse autonome, et programme informatique Download PDF

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Publication number
WO2013038551A1
WO2013038551A1 PCT/JP2011/071160 JP2011071160W WO2013038551A1 WO 2013038551 A1 WO2013038551 A1 WO 2013038551A1 JP 2011071160 W JP2011071160 W JP 2011071160W WO 2013038551 A1 WO2013038551 A1 WO 2013038551A1
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Prior art keywords
posture
blood flow
subject
flow state
instruction
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PCT/JP2011/071160
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English (en)
Japanese (ja)
Inventor
信幸 寺田
俊成 秋元
雅樹 郷間
木村　義則
敦也 伊藤
俊太郎 森
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パイオニア株式会社
学校法人東洋大学
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Application filed by パイオニア株式会社, 学校法人東洋大学 filed Critical パイオニア株式会社
Priority to JP2013533422A priority Critical patent/JP5914498B2/ja
Priority to PCT/JP2011/071160 priority patent/WO2013038551A1/fr
Publication of WO2013038551A1 publication Critical patent/WO2013038551A1/fr

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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
    • A61B5/026—Measuring blood flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/40—Detecting, measuring or recording for evaluating the nervous system
    • A61B5/4029—Detecting, measuring or recording for evaluating the nervous system for evaluating the peripheral nervous systems
    • A61B5/4035—Evaluating the autonomic nervous system

Definitions

  • the present invention relates to, for example, an autonomic nervous function evaluation apparatus and method for evaluating the autonomic function of a subject and a computer program technical field.
  • Blood pressure is adjusted by the autonomic nerve so that it does not change suddenly even when the heart or blood vessels are automatically activated.
  • the autonomic nerve may not be able to follow the sudden change in body posture. In this case, transient cerebral circulatory failure occurs, and as a result, the person may feel dizzy or faint.
  • Such a phenomenon is caused by the fact that blood does not spread sufficiently in the blood vessels of the brain at the highest part of the body due to gravity due to standing, and is called orthostatic hypotension.
  • Patent Literature 1 a blood pressure is measured before and after the load by attaching a blood pressure detection unit to the subject's tragus and applying a load to the subject (for example, a load that shifts the posture of the subject from standing to standing).
  • a load for example, a load that shifts the posture of the subject from standing to standing.
  • an apparatus for evaluating an autonomic nervous function that causes orthostatic hypotension from a value that is, a change in blood pressure value caused by shifting the posture of a subject from a supine position to a standing position).
  • Non-Patent Document 1 instead of measuring blood pressure, measuring the blood flow state of the head (for example, blood flow), the ischemic state of the head due to the standing posture change is measured.
  • a method of measuring and evaluating orthostatic hypotension is disclosed, and is expected as a method of evaluating autonomic nervous function while solving the problems of the device disclosed in Patent Document 1.
  • Non-Patent Document 1 also argues that there is a correlation between the blood pressure change amount and the blood flow change amount due to the standing posture change.
  • Non-Patent Document 1 discloses specific conditions for evaluating the autonomic nervous function that causes orthostatic hypotension by measuring the blood flow state (for example, the test subject's blood flow state when measuring the blood flow state). No conditions etc. regarding the state are disclosed. For this reason, the autonomic nervous function that causes orthostatic hypotension cannot be evaluated with high accuracy simply by measuring the blood flow state of the subject when standing up instead of simply measuring the blood pressure. There is a possibility. In other words, there is a possibility that the evaluation of orthostatic hypotension obtained by simply measuring the blood flow state unconditionally is not a reliable evaluation of the autonomic nervous function.
  • An object of the present invention is to provide an autonomic nervous function evaluation apparatus and method, and a computer program capable of evaluating an autonomic nervous function with higher accuracy by detecting a blood flow state.
  • the first autonomic nervous function evaluation apparatus changes the blood flow state from the first posture after maintaining the first posture before applying a load for changing the blood flow state for at least a predetermined time.
  • an evaluation means for detecting a blood flow state of the subject who shifts to the second posture after the load is applied, and an autonomic nervous function of the subject is evaluated based on the blood flow state of the subject detected by the detecting means.
  • the second autonomic nervous function evaluation apparatus instructs the subject to maintain the first posture before applying a load for changing the blood flow state for at least a predetermined time and An instruction means for instructing to shift from the first posture to a second posture after applying a load for changing a blood flow state after maintaining one posture for at least the predetermined time; and an instruction by the instruction means is issued Detecting means for detecting at least one of the blood flow state of the subject while being instructed and the blood flow state of the subject after the instruction is given by the instruction means, and the blood flow state of the subject detected by the detecting means And an evaluation means for evaluating the autonomic nervous function of the subject.
  • the first autonomic nervous function evaluation method changes the blood flow state from the first posture after maintaining the first posture before applying a load for changing the blood flow state for at least a predetermined time.
  • the detection step of detecting the blood flow state of the subject who shifts to the second posture after applying the load, and the detection step detected based on the blood flow state of the subject before the shift to the second posture And an evaluation step for analyzing the blood flow state of the subject.
  • the second autonomic nervous function evaluation method instructs the subject to maintain the first posture before applying a load for changing the blood flow state for at least a predetermined time and An instruction step for instructing to shift from the first posture to a second posture after applying a load to change the blood flow state after maintaining one posture for at least the predetermined time, and an instruction by the instruction step is issued A detecting step of detecting at least one of the blood flow state of the subject while the subject is instructed, and the blood flow state of the subject after being instructed by the instruction step, and blood of the subject before the transition to the second posture And an evaluation step of analyzing the blood flow state of the subject detected by the detection step on the basis of the flow state.
  • the computer program causes the computer to function as the first or second autonomic nerve function evaluation apparatus described above.
  • the autonomic nervous function evaluation apparatus has applied the load for changing the blood flow state from the first posture after maintaining the first posture for at least a predetermined time before applying the load for changing the blood flow state.
  • the detection means detects the blood flow state of the subject.
  • the “blood flow state” may be any state (for example, a parameter, a measured value, or other quantitative value or qualitative value) that can specify the blood flow of the subject.
  • An example of such a “blood flow state” is, for example, blood flow.
  • the detection means detects the blood flow state of the subject who shifts from the first posture to the second posture after maintaining the first posture for at least a predetermined time.
  • the “first posture” is intended to indicate the posture of the subject before giving a load for changing the blood flow state of the subject (for example, a load of standing up).
  • the “first posture” means the posture of the subject before the load for changing the blood flow state of the subject is given to the subject.
  • the “second posture” is intended to indicate the posture of the subject after applying a load for changing the blood flow state of the subject.
  • the “second posture” indicates the posture of the subject after the load for changing the blood flow state of the subject is given to the subject.
  • the first posture and the second posture are so-called postures having a relative relationship, that is, postures before and after applying a load that changes the blood flow state.
  • the subject is crouching in a state in which his / her foot is generally bent (that is, the weight of the subject is only in the state in which the foot is substantially bent)
  • a squatting posture or a sitting posture in which the subject places the buttocks on the ground or a support to support the subject's weight, or (iii) a subject places the back or abdomen on the ground or a support.
  • supine postures that support the weight of the subject.
  • the subject stands with the legs substantially extended (that is, the weight of the subject is supported by the legs with the legs substantially extended).
  • A) standing posture for example, the subject is crouching in a state in which his / her foot is generally bent (that is, the weight of the subject is only in the state in which the foot is substantially bent)
  • a squatting posture or a sitting posture in which the subject places the buttocks on the ground or a support to support the subject's weight, or (iii) a subject places the back or
  • the autonomic nervous function evaluation apparatus may directly or indirectly instruct the subject to realize such a state. Good.
  • the subject using the autonomic nervous function evaluation apparatus confirms a manual or the like that includes instructions for realizing such a state After that, you may act voluntarily to realize such a state.
  • the detection means detects the blood flow state of the subject who realizes the specific state described above by any method (that is, the state in which the first posture is maintained for at least a predetermined time and then transitions from the first posture to the second posture). To detect.
  • the evaluation means evaluates the autonomic nervous function of the subject based on the blood flow state of the subject detected by the detection means. That is, the evaluation means evaluates the subject's autonomic nervous function based on the blood flow state of the subject who shifts from the first posture to the second posture after maintaining the first posture for at least a predetermined time. At this time, for example, the evaluation means uses the blood flow state of the subject after the transition to the second posture on the basis of the blood flow state of the subject before the transition to the second posture (that is, the blood flow state detected by the detection means). Then, the subject's autonomic nervous function may be evaluated by analyzing the blood flow state of the subject who transitions from the first posture to the second posture after maintaining the first posture for at least a predetermined time. Such analysis may include, for example, analysis of the change rate or change time of the blood flow state, analysis of the recovery rate or recovery time of the blood flow state, and the like.
  • the detection means detects the blood flow state of the subject in a specific state (that is, a state in which the first posture is maintained for at least a predetermined time and then transitions from the first posture to the second posture). can do. If the detection means tries to detect a blood flow state of a subject who is not in a specific state, the detected blood flow state is the same before taking the first posture (or before moving to the second posture). ) There is a possibility that the influence caused by the activity state of the subject is superimposed as a noise component (in other words, a noise component or an unnecessary component).
  • the blood flow state detected by the detection means may include not only the component due to the autonomic nerve function but also the component due to the activity state of the subject before taking the first posture. is there. Therefore, when the evaluation unit evaluates the autonomic nerve function based on the blood flow state on which the influence caused by the activity state of the subject before taking the first posture is superimposed, the reliability of the evaluation result is relatively lowered. It can be done.
  • the detection means detects the blood of the subject in a specific state (that is, a state in which the first posture is maintained for at least a predetermined time and then transitions from the first posture to the second posture).
  • the flow state can be detected. That is, by maintaining the first posture for at least a predetermined time before the subject shifts to the second posture, the activity state of the subject before taking the first posture can be made small enough not to affect the evaluation result. it can.
  • the evaluation means can evaluate the autonomic nervous function based on a blood flow state in which the influence of the activity state of the subject before taking the first posture is hardly or not superimposed. Accordingly, it is possible to suitably suppress a decrease in reliability of the evaluation result of the autonomic nerve function by the evaluation unit.
  • the autonomic nervous function evaluation apparatus of the first embodiment is a blood flow state in which the influence of the subject's activity state before taking the first posture is superimposed on the blood flow state of the subject who is not in a specific state. ), The autonomic nervous function can be evaluated with higher accuracy than other devices that evaluate the autonomic nervous function.
  • the information processing apparatus further includes instruction means for instructing to shift from the first posture to the second posture, and the detection means is based on the blood flow state of the subject and the instruction means while the instruction by the instruction means is being issued.
  • the instruction unit prior to the detection of the blood flow state of the subject by the detection unit, performs the second operation from the first posture to the subject after maintaining the specific state (that is, the first posture for at least a predetermined time).
  • a state of transition to a posture can be instructed directly or indirectly. Therefore, the detection means detects a blood flow state of at least one subject while the instruction by the instruction means is issued and after the instruction by the instruction means is issued.
  • the blood flow state of the subject in a state where the first posture is maintained for at least a predetermined time and then transitions from the first posture to the second posture) can be detected.
  • the autonomic nervous function evaluation apparatus instructs the subject to maintain the first posture before applying a load for changing the blood flow state for at least a predetermined time and at least the first posture at the predetermined Instruction means for instructing to shift from the first posture to the second posture after applying a load for changing the blood flow state after maintaining the time, and the subject's while the instruction by the instruction means is being issued Based on the blood flow state and at least one of the blood flow state of the subject after the instruction by the instruction unit is issued, and the subject based on the blood flow state of the subject detected by the detection unit And an evaluation means for evaluating the autonomic nervous function.
  • the instruction unit maintains a specific state (that is, the first posture for at least a predetermined time) with respect to the subject prior to the detection unit detecting the blood flow state of the subject. And then instructing directly or indirectly to realize the state of transition from the first posture to the second posture).
  • a specific state that is, the first posture for at least a predetermined time
  • first posture for at least a predetermined time
  • second posture in the second embodiment have the same meaning as those terms in the first embodiment.
  • the same words as those described in the autonomic nerve function evaluation apparatus of the first embodiment have the same meaning in the autonomic nerve function evaluation apparatus of the second embodiment unless otherwise specified. is doing.
  • the detection means detects the blood flow state of at least one subject while the instruction by the instruction means is being issued and after the instruction by the instruction means has been issued.
  • the detection means detects if the detection means detects the blood flow state of the subject during at least one of the time when the instruction by the instruction means is given and after the instruction by the instruction means is given.
  • the blood flow state of the subject is estimated to be the blood flow state of the subject in a specific state (that is, a state in which the first posture is maintained for at least a predetermined time and then the first posture is changed to the second posture).
  • the evaluation means evaluates the subject's autonomic nervous function based on the blood flow state of the subject detected by the detection means, similarly to the evaluation means of the first embodiment. That is, the evaluation means can substantially evaluate the autonomic nervous function of the subject based on the blood flow state of the subject who shifts from the first posture to the second posture after maintaining the first posture for at least a predetermined time. it can. Therefore, the autonomic nerve function evaluation apparatus of the second embodiment can preferably enjoy the same effects as those enjoyed by the autonomic nerve function evaluation apparatus of the first embodiment.
  • the detection unit is configured so that the blood flow state of the subject while the instruction by the instruction unit is issued and the instruction by the instruction unit are issued. By detecting at least one of the blood flow states of the subject, the blood flow state of the subject that transitions from the first posture to the second posture after maintaining the first posture for at least the predetermined time is detected.
  • the detection means can be identified relatively easily if the blood flow state of at least one subject is detected while the instruction by the instruction means is issued and after the instruction by the instruction means is issued. It is possible to detect the blood flow state of the subject in the state (that is, the state in which the first posture is maintained for at least a predetermined time and then the first posture is shifted to the second posture).
  • the predetermined time is determined according to the time required for the subject's blood flow state to settle in a desired resting state.
  • the evaluation unit returns the blood flow state of the subject after the transition to the second posture to the blood flow state of the subject before the transition to the second posture on the basis of the blood flow state of the subject before the transition to the second posture.
  • the autonomic nervous function may be evaluated by analyzing the blood flow state of the subject during the period up to.
  • the influence of the activity state of the subject before taking the first posture can be suitably excluded from the blood flow state of the subject before shifting to the second posture serving as the reference. . Therefore, the evaluation means can evaluate the autonomic nerve function based on the blood flow state in which the influence of the activity state of the subject before taking the first posture is not superimposed. Therefore, the autonomic nerve function evaluation apparatus of the first embodiment can enjoy the various effects described above more reliably.
  • the “desired rest state” for example, an appropriate state may be appropriately set.
  • the blood flow state of the subject when the subject has been at rest for a certain period of time can be a “desired rest state”.
  • the predetermined time is at least 45 seconds.
  • the predetermined time is at least 60 seconds.
  • the first posture is a squatting posture and the second posture is a standing posture.
  • the detection means can detect the blood flow state of the subject in a specific state (that is, a state in which the first posture is maintained for at least a predetermined time and then the first posture is shifted to the second posture). it can.
  • the evaluation means can evaluate the autonomic nervous function based on such a blood flow state.
  • the “standing posture” refers to a posture in which the subject is standing or standing in a state where the legs are substantially extended (that is, the weight of the subject is supported by the feet with the legs substantially extended).
  • the attitude refers to a posture in which the subject is crouched with his / her legs folded in general (that is, a posture in which the weight of the subject is supported by his / her legs with the feet folded). It is the purpose to show. At this time, it is preferable that the subject in the “squatting posture” supports the weight of the subject with only the feet.
  • a posture in which a part other than the subject's foot (for example, a buttocks or a back) is in contact with the ground while supporting the subject's weight with the foot in a state where the foot is substantially bent is a “squatting posture” of the present embodiment. May not be included.
  • At least one of the blood flow state and the pulse rate of the subject is stable while maintaining the first posture for at least the predetermined time.
  • the autonomic nerve function can be evaluated with higher accuracy.
  • the autonomic nerve function evaluation method of the first embodiment it is possible to suitably enjoy the same effects as the various effects that can be enjoyed by the above-described autonomic nerve function evaluation apparatus of the first embodiment. That is, it is possible to appropriately evaluate the subject's autonomic nervous function by referring to the analysis result of the blood flow state in the evaluation process.
  • the autonomic nervous function evaluation method of the first embodiment can also take various aspects.
  • the evaluation process with which the autonomic nerve function evaluation method of 1st Embodiment is provided analyzes the blood-flow state detected by the detection process on the basis of the blood-flow state of a test subject before shifting to a 2nd attitude
  • the autonomic nervous function may be evaluated based on the blood flow state of the subject detected by the detection process.
  • the autonomic nerve function may be evaluated by analyzing the blood flow state detected by the detection step on the basis of the blood flow state of the subject before shifting to the second posture.
  • the autonomic nervous function evaluation method instructs the subject to maintain the first posture before applying a load for changing the blood flow state for at least a predetermined time and at least the first posture at the predetermined
  • the detection step of detecting at least one of the blood flow state and the blood flow state of the subject after the instruction by the instruction step is issued, and the blood flow state of the subject before transitioning to the second posture
  • an evaluation step of analyzing the blood flow state of the subject detected by the detection step is performed by the detection step.
  • the autonomic nerve function evaluation method of the second embodiment it is possible to suitably enjoy the same effects as the various effects that can be enjoyed by the above-described autonomic nerve function evaluation apparatus of the second embodiment.
  • the autonomic nerve function evaluation method of the second embodiment can also take various aspects.
  • the evaluation process with which the autonomic-nervous function evaluation method of 2nd Embodiment is equipped is analyzing the blood-flow state detected by the detection process on the basis of the blood-flow state of a test subject before transfering to a 2nd attitude
  • the autonomic nervous function may be evaluated based on the blood flow state of the subject detected by the detection process.
  • the autonomic nerve function may be evaluated by analyzing the blood flow state detected by the detection step on the basis of the blood flow state of the subject before shifting to the second posture.
  • the computer program according to the first embodiment causes the computer to function as the autonomic nervous function evaluation apparatus according to the first embodiment described above (including various aspects thereof). According to the computer program according to the first embodiment, the first program described above. Effects similar to the various effects that can be enjoyed by the autonomic nervous function evaluation apparatus of the embodiment can be suitably enjoyed.
  • the computer program of the first embodiment can also adopt various aspects.
  • the computer program of the first embodiment may be recorded on, for example, a computer-readable recording medium (for example, an optical disk such as a CD, DVD, or BD, a semiconductor memory, or a magnetic disk such as a hard disk).
  • a computer-readable recording medium for example, an optical disk such as a CD, DVD, or BD, a semiconductor memory, or a magnetic disk such as a hard disk.
  • the computer program according to the second embodiment causes the computer to function as the autonomic nervous function evaluation device according to the second embodiment described above (including various aspects thereof). According to the computer program according to the second embodiment, the second program described above. Effects similar to the various effects that can be enjoyed by the autonomic nervous function evaluation apparatus of the embodiment can be suitably enjoyed.
  • the computer program of the second embodiment can also adopt various aspects.
  • the computer program of the second embodiment may be recorded on a computer-readable recording medium (for example, an optical disk such as a CD, DVD, or BD, a semiconductor memory, or a magnetic disk such as a hard disk).
  • the autonomic nervous function evaluation apparatus includes detection means and evaluation means.
  • the autonomic nervous function evaluation apparatus includes an instruction unit, a detection unit, and an evaluation unit.
  • the autonomic nervous function evaluation method of the first embodiment includes a detection step and an evaluation step.
  • the autonomic nervous function evaluation method according to the second embodiment includes an instruction process, a detection process, and an evaluation process.
  • the computer program of the first embodiment causes a computer to function as the autonomic nervous function evaluation device of the first embodiment.
  • the computer program of the second embodiment causes a computer to function as the autonomic nerve function evaluation device of the second embodiment. Therefore, the autonomic nervous function can be evaluated with higher accuracy by detecting the blood flow state.
  • FIG. 1 is a block diagram illustrating a configuration of an autonomic nervous function evaluation system 1 according to the present embodiment.
  • the autonomic nerve function evaluation system 1 of the present embodiment is a system that performs an evaluation test for evaluating the autonomic function of a living body 900 such as a human being who is a subject.
  • the autonomic nerve function evaluation system 1 includes an autonomic nerve function evaluation device 10, a blood flow waveform output device 20, a display 30, and a respiration detection device 40.
  • the autonomic nervous function evaluation apparatus 10 includes a control unit 11, a calculation unit 12 corresponding to a specific example of “detection unit”, an instruction output unit 13 corresponding to a specific example of “instruction unit”, and an “evaluation unit”. And an evaluation unit 14 corresponding to one specific example.
  • the control unit 11, the calculation unit 12, the instruction output unit 13, and the evaluation unit 14 may be physically realized by, for example, a dedicated IC chip.
  • indication output part 13, and the evaluation part 14 may be logically implement
  • the control unit 11 controls the operation of the entire autonomic nervous function evaluation apparatus 10.
  • the calculation unit 12 calculates the blood flow state of the living body 900. At this time, the calculation unit 12 calculates the blood flow state of the living body 900 based on the blood flow waveform of the living body 900 output from the blood flow waveform output device 20 (for example, a waveform signal indicating a temporal change in blood flow). It is preferable to do.
  • the calculation unit 12 includes, for example, a blood flow calculation unit 121 and a pulse calculation unit 122 as processing blocks physically or logically realized therein.
  • the blood flow rate calculation unit 121 calculates the blood flow rate of the living body 900 which is an example of the blood flow state of the living body 900 based on the blood flow waveform of the living body 900 output from the blood flow waveform output device 20. More specifically, for example, the blood flow rate calculation unit 121 may calculate an average value of a blood flow waveform over a predetermined period as the blood flow rate.
  • the pulse calculation unit 122 calculates the pulse rate of the living body 900 as an example of the blood flow state of the living body 900 based on the blood flow waveform of the living body 900 output from the blood flow waveform output device 20. More specifically, for example, the pulse calculation unit 122 may calculate the frequency of the waveform corresponding to the pulse in the blood flow waveform (that is, the reciprocal of the period of the blood flow waveform) as the pulse rate. However, the pulse calculation unit 122 may calculate the pulse rate using another calculation method such as fast Fourier transform.
  • the autonomic nervous function of the living body 900 is evaluated based on the blood flow rate.
  • the pulse rate does not have to be directly related to the evaluation of the autonomic nervous function of the living body 900 itself.
  • the calculation unit 12 may not include the pulse volume calculation unit 122.
  • the instruction output unit 13 outputs a predetermined instruction to the living body 900 whose autonomic nervous function is to be evaluated by the autonomic nervous function evaluation apparatus 10.
  • the instruction output unit 13 outputs a predetermined instruction as an image displayed on the display 30 (for example, an image indicating the predetermined instruction with characters, graphics, or the like).
  • the instruction output unit 13 may output a predetermined instruction in another manner.
  • the instruction output unit 13 may output a predetermined instruction as sound output from a speaker (for example, sound for notifying the predetermined instruction).
  • the instruction output unit 13 includes a respiratory control output unit 131 and a posture control output unit 132 as processing blocks physically or logically realized therein.
  • the respiration control output unit 131 outputs a respiration control instruction for instructing the breathing mode of the living body 900 as a predetermined instruction while the autonomic nervous function evaluation test by the autonomic nervous function evaluation system 1 is being performed.
  • the breathing control output unit 131 includes an instruction to stop breathing, an instruction to stop breathing for a predetermined time (more specifically, a minimum breathing stop time described later), an instruction to resume breathing, and the like. Outputs breath control control instructions.
  • the posture control output unit 132 outputs a posture control instruction for instructing the posture of the living body 900 as a predetermined instruction while the autonomic nervous function evaluation test by the autonomic nerve function evaluation system 1 is being performed.
  • the posture control output unit 132 stands on the living body 900 from an instruction or a squatting posture for maintaining a squatting posture (that is, a squatting posture) for a predetermined time (more specifically, a minimum squatting time described later).
  • Posture control instructions including an instruction to shift to a posture (that is, a standing posture), an instruction to maintain a standing posture, and the like are output.
  • the “standing posture” is a specific example of the “second posture” and is a posture in which the living body 900 stands or stands up with its legs substantially extended (that is, feet) Is a posture in which the weight of the living body 900 is supported by a foot) in a state in which is generally extended.
  • the “squatting posture” is a specific example of the “first posture”, and the living body 900 is crouching in a state where the foot is generally bent (that is, the foot is generally bent). The posture of supporting the weight of the living body 900 with the foot in the state).
  • the living body 900 in the “squatting posture” supports the weight of the living body 900 with only the feet. That is, a posture in which a part other than the foot (eg, a buttocks, a back part, etc.) of the living body 900 is in contact with the ground while supporting the weight of the living body 900 with the foot in a state in which the foot is generally bent, It does not have to be included in the “posture”.
  • the evaluation unit 14 evaluates the autonomic nervous function of the living body 900 based on the blood flow calculated by the blood flow calculation unit 121 and the like.
  • the evaluation unit 14 includes an autonomic nerve function parameter calculation unit 141 and an autonomic nerve function evaluation result output unit 142 as processing blocks physically or logically realized therein.
  • the autonomic nerve function parameter calculation unit 141 calculates an autonomic nerve function parameter for evaluating the autonomic nerve function based on the blood flow rate calculated by the blood flow rate calculation unit 121.
  • the specific operation of the autonomic nerve function parameter calculation unit 141 will be described in detail later (see FIG. 2 and the like).
  • the autonomic nerve function evaluation result output unit 142 evaluates the autonomic nerve function of the living body 900 based on the autonomic nerve function parameter calculated by the autonomic nerve function parameter calculation unit 141. In addition, the autonomic nerve function evaluation result output unit 142 outputs the result of the evaluation of the autonomic nerve function of the living body 900. In the present embodiment, the autonomic nerve function evaluation result output unit 142 displays the result of the autonomic nerve function evaluation on an image displayed on the display 30 (for example, an image indicating the result of the autonomic nerve function evaluation in characters, graphics, or the like). ).
  • the autonomic nervous function evaluation result output unit 142 may output the result of evaluating the autonomic nervous function of the living body 900 in another manner (for example, voice or the like).
  • the specific operation of the autonomic nervous function evaluation result output unit 142 will be described in detail later (see FIG. 2 and the like).
  • the evaluation unit 14 for example, both the autonomic nerve function parameter calculation unit 141 and the autonomic nerve function evaluation result output unit 142, or only the autonomic nerve function evaluation result output unit 142 is used.
  • a device outside the autonomic nerve function evaluation device 10 may be provided.
  • the blood flow waveform output device 20 detects the blood flow waveform of the living body 900 and outputs the detected blood flow waveform to the autonomic nerve function evaluation device 10 (particularly, the calculation unit 12).
  • An example of the blood flow waveform output device 20 is a laser blood flow meter that detects a blood flow waveform using a laser Doppler flowmetry method, for example.
  • the display 30 is a device that displays a predetermined image.
  • the display 30 is an image (in other words, a screen) for indicating an operation state of the autonomic nervous function evaluation system 1 or an image (screen) indicating a respiratory control instruction output from the respiratory control output unit 131. ),
  • An image (screen) indicating a posture control instruction output from the posture control output unit 132, an image (screen) indicating an evaluation result of the autonomic function output from the autonomic function evaluation result output unit 142, and the like indicate.
  • the respiration detection device 40 detects the respiration state of the living body 900.
  • the respiratory detection device 40 may directly detect the respiratory state of the living body 900 based on the output of a respirometer that is directly attached to the mouth or nose of the living body 900.
  • the respiratory detection device 40 may indirectly detect the respiratory state of the living body 900 based on an arbitrary biological reaction of the living body 900.
  • the respiration detection device 40 may detect the respiration state of the living body 900 based on the respiration component extracted by frequency analysis of the blood flow waveform output from the blood flow waveform output unit 20. Good.
  • FIG. 2 is a flowchart showing an operation flow of the autonomic nerve function evaluation system 1 of the present embodiment.
  • step S101 The blood flow state of the living body 900 (that is, blood flow rate, pulse rate, etc.) may be calculated (step S101).
  • the blood flow state of the living body 900 calculated before the evaluation test of the autonomic nervous function is started may be referred to by the evaluation unit 14 in the evaluation operation (step S109 and step S110 in FIG. 2) described in detail later. Good. Note that the operation of step S101 is not necessarily performed.
  • Step S111 determines whether or not at least one of the blood flow rate and the pulse rate calculated in Step S101 is a normal value. For example, when the blood flow is greatly disturbed or the pulse rate is abnormally high, it is determined that at least one of the blood flow and the pulse rate is not a normal value.
  • step S111 when it is determined that at least one of the blood flow volume and the pulse rate is not a normal value (step S111: No), the cause that at least one of the blood flow volume and the pulse rate is not a normal value, It is also assumed that the blood flow meter worn by the living body 900 is abnormal. Therefore, the instruction output unit 13 instructs the living body 900 to reattach the blood flow meter (step S112). Thereafter, the operations after step S101 are performed again.
  • step S111 when it is determined that at least one of the blood flow volume and the pulse rate is a normal value (step S111: Yes), the control unit 11 is displayed on the display 30. It is determined whether or not an operation for instructing the start of the evaluation test has been performed on the initial image (initial screen) (step S102).
  • FIG. 3 is a plan view showing an example of an initial image displayed on the display 30 before the evaluation test of the autonomic nervous function is started.
  • the initial image displayed on the display 30 includes, for example, (i) the current date and time, (ii) the current blood flow rate and pulse rate of the living body 900, (iii) the start of the evaluation test, An operation button for instructing the end of the retest and the evaluation test, (iv) a text box indicating the status of the current evaluation test, and (v) the result of the evaluation test (specifically, details will be described later using FIG. 11).
  • the text box which shows the dizziness degree, the blood flow rate reduction rate, and the blood flow rate recovery time to be described) is included. In the example shown in FIG.
  • FIG. 3 is merely an example, and an image other than the image shown in FIG. 3 may be displayed on the display 30.
  • step S102 when it is determined that the operation for instructing the start of the evaluation test is not performed as a result of the determination in step S102 (step S102: No), the operations in step S101 and step S102 are repeated.
  • the autonomic nervous function evaluation apparatus 10 substantially stands by until an instruction to start an evaluation test is given.
  • step S102 when it is determined that an operation for instructing the start of the evaluation test has been performed (step S102: Yes), the posture control output unit 132 then squats at a predetermined timing. Thereafter, a posture control instruction for instructing the living body 900 to continue squatting only for the minimum squatting time (or more than the minimum squatting time) is output (step S103). In other words, the posture control output unit 132 outputs a posture control instruction for instructing the living body 900 to take a posture of squatting at a predetermined timing and then maintain the squatting posture for the minimum squatting time (or longer than the minimum squatting time). (Step S103).
  • the posture control output unit 132 crouches after x (where x is an arbitrary real number greater than or equal to 0) seconds and then continues to crouch as y (where y is an arbitrary real number greater than or equal to 0) seconds as the minimum crouch time.
  • An attitude control instruction for instructing 900 is output.
  • FIG. 4 is a plan view showing an example of an image indicating the posture control instruction output by the posture control output unit 132 in step S103 of FIG. 2
  • FIG. 4 is a plan view showing an example of an image indicating the posture control instruction output by the posture control output unit 132 in step S103 of FIG.
  • the image indicating the posture control instruction output by the posture control output unit 132 in step S ⁇ b> 103 of FIG. 2 is a text box indicating the state of the current evaluation test compared to the initial image shown in FIG. 3.
  • the text box indicating the current evaluation test status includes an instruction sentence “Please squat”, an instruction sentence “After that” and an arrow symbol, and “Please continue squatting for ** seconds”. Is written. Assuming that the minimum squatting time is y seconds, the notation “XX seconds” in the statement “Please continue crouching for XX seconds” is “y seconds when the directive text“ Please squat down ”is displayed. ".
  • FIG. 5 is a graph showing the amount of change in blood flow and the amount of change in average blood pressure when the squatting time is changed.
  • FIG. 6 is a graph showing temporal changes in mean blood pressure, earlobe blood flow, and heart rate when the squatting time is changed.
  • the graphs shown in FIGS. 5 and 6 are both graphs based on data derived as a result of experiments by the inventors of the present application. In this experiment, eight living bodies 900 are used as experimental bodies.
  • FIG. 5A shows a time when a living body 900 shifts from a standing posture to a squatting posture as a reference (that is, 0 seconds), and then a time for maintaining the squatting posture (that is, a time for which the squatting is continued) is 0 seconds, 15 Seconds, 30 seconds, 45 seconds, and 60 seconds are set, and after changing the squatting posture for the set time, the posture is changed to the standing posture, and the change amount of the blood flow of the living body 900 when the posture is changed from the squatting posture to the standing posture.
  • [A. u. ] Is shown. Looking at the graph shown in FIG. 5 (a), even when the crouching time is set to 0 seconds, 15 seconds, 30 seconds, 45 seconds, and 60 seconds, the change in the blood flow rate is large or characteristic. It can be seen that there is no significant difference.
  • FIG. 5B shows the time when a certain living body 900 shifts from the standing posture to the squatting posture as a reference (that is, 0 seconds), and thereafter the time during which the crouching posture is maintained is 0 seconds, 15 seconds, 30 seconds. Seconds, 45 seconds, and 60 seconds are set, and after changing to the standing posture after taking the squatting posture for the set time, the amount of change in the average blood pressure of the living body 900 when the posture is changed from the squatting posture to the standing posture [mmHg] Indicates. Looking at the graph shown in FIG.
  • the amount of change in mean blood pressure when the time to continue squatting is set to 0 seconds, 15 seconds, and 30 seconds is larger as the time to continue squatting becomes longer.
  • the time to continue squatting is set to 0 seconds, 15 seconds, and 30 seconds
  • the blood flow state of the living body 900 is not yet sufficiently stable (in other words, 0 seconds, 15 seconds, or 30 seconds). Even if crouching continues, there is a high possibility that the state of blood flow will change after that).
  • the amount of change in mean blood pressure when the time to continue squatting is set to 45 seconds and 60 seconds is almost constant regardless of the time to continue squatting.
  • the blood flow state of the living body 900 is sufficiently stable (in other words, if the squatting continues for 45 seconds or 60 seconds, It is estimated that there is a low possibility that the state of blood flow will fluctuate.
  • the autonomic nervous function of the living body 900 is evaluated based on the change in blood flow after the transition from the squatting posture to the standing posture based on the blood flow amount of the living body 900 in the squatting posture. Therefore, from the viewpoint of performing a highly accurate (in other words, highly reliable) evaluation, it is considered preferable that the blood flow state due to the transition from the squatting posture to the standing posture changes in a stable state. . Therefore, it is considered preferable that the blood flow state of the living body 900 in the squatting posture (that is, before shifting to the standing posture) is sufficiently stable (in other words, the fluctuation is small).
  • the blood flow state of the living body 900 that is in the squatting posture includes a noise component caused by the activity state (for example, exercise state) of the living body 900 before the squatting posture. It is considered preferable that is not superimposed.
  • the minimum squatting time is the time necessary for the blood flow state to change in a stable state due to the transition from the squatting posture to the standing posture (or the blood flow state of the living body 900 is sufficiently stabilized. It can be seen that it is preferably set according to the time required until For this reason, according to the graph shown in FIG. 5B, the squatting time (that is, the minimum squatting time) required for the blood flow state to change in a stable state from the squatting posture to the standing posture is It can be seen that it is preferably at least 45 seconds or longer.
  • FIG. 6 is a graph showing temporal changes in average blood pressure, earlobe blood flow, and heart rate when crouching time is set to 30 seconds and 60 seconds. More specifically, in the graph when the squatting time is set to 30 seconds, the living body 900 performs exercises such as gymnastics between 0 seconds and 30 seconds, and the living body 900 sits between 30 seconds and 60 seconds. The living body 900 is in the squatting position during 60 seconds to 90 seconds, and the living body 900 shifts from the squatting position to the standing position at 90 seconds, and thereafter the living body 900 changes to the standing position. It corresponds to the graph when maintaining.
  • the graph shows that the living body 900 performs exercises such as gymnastics between 0 seconds and 30 seconds, and the living body 900 is in a squatting position between 30 seconds and 90 seconds.
  • the blood flow state of the living body 900 is stable during the squatting posture (that is, between 30 seconds and 90 seconds) ( For example, it can be seen that heart rate fluctuation is relatively small.
  • the blood flow state of the living body 900 is very stable during the squatting posture (that is, between 60 seconds and 90 seconds). (For example, heart rate fluctuation is still relatively large).
  • the blood flow state of the living body 900 is not relatively stable before receiving the evaluation test (for example, A state where the heart rate is relatively high) is also assumed. From the viewpoint of performing a highly accurate evaluation (in other words, highly reliable) in consideration of such a state, as in the case shown in FIG. It is considered that it is preferable that a noise component due to an activity state (for example, an exercise state) of the living body 900 before the squatting posture is not superimposed on the blood flow state of the living body 900 (before the movement).
  • an activity state for example, an exercise state
  • the squatting time that is, the minimum squatting time necessary for sufficiently stabilizing the blood flow state of the living body 900 is preferably at least 60 seconds or more. .
  • the minimum squatting time is set to 45 seconds or more.
  • the minimum squatting time may be set to 60 seconds or more.
  • the minimum squatting time (that is, the minimum squatting time of 45 seconds or more or 60 seconds or more) derived as a result of the graphs shown in FIGS. 5 and 6 is merely an example. Therefore, if the blood flow state of the living body 900 can be sufficiently stabilized, an appropriate value of less than 45 seconds may be set as the minimum squatting time.
  • the calculation unit 12 refers to the calculation result of the calculation unit 12 to determine the blood flow rate and the pulse rate of the living body 900 that continues to maintain the squatting posture according to the posture control instruction output in step S103. At least one is calculated (step S104).
  • the control unit 11 refers to the calculation result of the calculation unit 12, so that at least one of the blood flow rate and the pulse rate of the living body 900 that maintains the crouching posture in accordance with the posture control instruction output in step S 103. Is determined to be stable (step S105).
  • the control unit 11 determines that at least one of the blood flow rate and the pulse rate is stable when the fluctuation amount during at least one of the blood flow rate and the pulse rate falls within a predetermined threshold. May be.
  • step S104 If it is determined as a result of the determination in step S105 that both the blood flow rate and the pulse rate are not stable (step S105: No), the operations in step S104 and step S105 are repeated. That is, whether or not at least one of the blood flow rate and the pulse rate in step S104 and at least one of the blood flow rate and the pulse rate in step S105 are stable until at least one of the blood flow rate and pulse rate is stabilized. The determination operation is repeated.
  • step S105 when it is determined that at least one of the blood flow rate and the pulse rate is stable (step S105: Yes), the control unit 11 performs the timing when the living body 900 squats (in other words, For example, it is determined whether or not the minimum squatting time has elapsed with the starting point of the attitude control instruction in step S103 (step S106). That is, the control unit 11 determines whether or not the living body 900 has maintained the squatting posture for the minimum squatting time.
  • the minimum squatting time is set to an appropriate value from the viewpoint that the blood flow state of the living body 900 can be sufficiently stabilized. Therefore, when the living body 900 keeps the squatting posture for the minimum squatting time (that is, when it is determined Yes in step S106), at least one of the blood flow rate and the pulse rate of the living body 900 is stable ( That is, it is assumed that there is a high possibility of being determined as Yes in step S105. On the other hand, when at least one of the blood flow rate and the pulse rate of the living body 900 is stable (that is, determined as Yes in step S105), the living body 900 continues to maintain the squatting posture for the minimum squatting time. It is assumed that there is a high possibility (that is, Yes is determined in step S106). Considering such a relationship between step S105 and step S106, one of step S105 and step S106 may not be performed.
  • step S106 If it is determined that the minimum squatting time has not elapsed as a result of the determination in step S106 (step S106: No), the operation in step S106 is repeated. That is, until the minimum squatting time elapses, the operation of determining whether or not the minimum squatting time has elapsed in step S106 is repeated.
  • step S106 when it is determined that the minimum squatting time has elapsed as a result of the determination in step S106 (step S106: Yes), the respiratory control output unit 131 and the posture control output unit 132 cooperate with each other.
  • Step S107 the breathing control output unit 131 and the posture control output unit 132 cooperate to shift from the squatting posture to the standing posture at a predetermined timing while stopping breathing, and after the transition to the standing posture, only the minimum breathing stop time.
  • a breathing control instruction and a posture control instruction for instructing the living body 900 to stop breathing (or longer than the minimum breathing time) are output (step S107).
  • the respiratory control output unit 131 and the posture control output unit 132 work together to stand up and stop breathing after X (where X is an arbitrary real number greater than or equal to 0 seconds), and also set the minimum respiratory stop time after rising.
  • Y (where Y is an arbitrary real number greater than or equal to 0) seconds
  • a breath control instruction and a posture control instruction for instructing the living body 900 to stop breathing are output.
  • FIG. 7 is a plan view showing an example of an image showing a respiratory control instruction and a posture control instruction that the respiratory control output unit 131 and the posture control output unit 132 cooperate to output in step S107 of FIG. 2
  • FIG. 7 is a plan view showing an example of an image showing a respiratory control instruction and a posture control instruction that the respiratory control output unit 131 and the posture control output unit 132 cooperate to output in step S107 of FIG.
  • the image showing the respiratory control instruction and the posture control instruction output in cooperation by the respiratory control output unit 131 and the posture control output unit 132 in step S107 of FIG. 2 is the initial screen shown in FIG.
  • the text boxes indicating the status of the current evaluation test are different.
  • the text box indicating the current evaluation test state includes an instruction sentence “Please stop breathing and stand up”, an instruction sentence “After” and an arrow symbol, and “Stand up, “Please continue breathing for ⁇ seconds”. If the minimum breathing stop time is Y seconds, the notation “XX seconds” in the instruction sentence “Please keep breathing for XX seconds while standing” is “Please stop breathing and stand up” When the instruction text is displayed, the notation is “Y seconds”.
  • the living body 900 may shift from a squatting position to a standing position by performing active standing up by using the muscle of the living body 900 itself.
  • the living body 900 performs, for example, passive standing up with the help of others (for example, passive standing up when the living body 900 sleeping on the electric bed automatically rises up with the power of the electric bed rising up).
  • the crouching posture may be shifted to the standing posture. In any case, the living body 900 shifts from the squatting posture to the standing posture using some method.
  • FIG. 8 is a graph showing temporal changes in the blood flow rate of the living body 900 when breathing is stopped and the blood flow rate of the living body 900 when breathing is not stopped.
  • the graph shown in FIG. 8 is a graph based on the data derived
  • FIG. 8 shows an example of changes in blood flow when breathing at approximately 0.25 Hz (that is, breathing once every 4 seconds).
  • the autonomic nervous function of the living body 900 is evaluated based on the change in blood flow after the transition from the squatting posture to the standing posture based on the blood flow amount of the living body 900 in the squatting posture. Therefore, from the viewpoint of performing highly accurate (in other words, highly reliable) evaluation, the blood flow state of the living body 900 after shifting to the standing posture is a noise component (for example, not caused by the autonomic nerve function) It is considered preferable that the breathing-related components shown in FIG. 8 are not superimposed. Then, it is preferable that the minimum respiratory stop time is set according to the time necessary for evaluating the autonomic nerve function by measuring the blood flow state of the living body 900 after shifting to the standing posture. I understand.
  • the state of the blood flow until the state of blood flow of the living body 900 after shifting to the standing posture returns to the state of blood flow of the living body 900 before shifting to the standing posture.
  • the autonomic nervous function is evaluated. Therefore, the time required for performing the evaluation test by measuring the blood flow state of the living body 900 after shifting to the standing posture is substantially the blood of the living body 900 after shifting to the standing posture. It can also be said that this is the time required for the flow state to return to the blood flow state of the living body 900 before shifting to the standing posture.
  • the time necessary for evaluating the autonomic nervous function by measuring the blood flow state of the living body 900 after shifting to the standing posture (that is, shifting to the standing posture).
  • the time required for the blood flow of the living body 900 to return to the blood flow state of the living body 900 before shifting to the standing posture is approximately 10 to 20 seconds (more) when the subject is a healthy person. Preferably, it has been found to be 15 to 20 seconds).
  • “return” means “return so that the blood flow state of the living body 900 after shifting to the standing posture is the same as the blood flow state of the living body 900 before shifting to the standing posture.
  • the minimum respiratory stop time that falls within the range of 10 to 20 seconds is merely an example. Therefore, if there is little or no noise component due to breathing in the blood flow state of the living body 900, the minimum breathing stop time is in the range of 10 to 20 seconds (or 15 to 20 seconds). An appropriate value other than the time that falls within the range may be set.
  • the respiration detection device 40 detects the respiration state of the living body 900 (step S113). Thereafter, the control unit 11 determines whether or not the living body 900 stops breathing based on the detection result of the respiration detection device 40 (step S114). That is, the control unit 11 determines whether or not the living body 900 appropriately stops breathing according to the breathing control instruction output in step S107.
  • step S114 when it is determined that the living body 900 does not stop breathing (step S114: No), it is also assumed that the blood flow rate of the living body 900 varies with respiration as described above. Is done.
  • a noise component that is not caused by the autonomic nerve function (for example, a component related to respiration shown in FIG. 8) may be superimposed on the blood flow state of the living body 900 after shifting to the standing posture. Therefore, it is estimated that it is difficult to perform highly accurate evaluation (in other words, high reliability). For this reason, in this case, the evaluation test of the autonomic nerve function is performed again. That is, the operations after step S103 are performed again.
  • step S114 when it is determined that the living body 900 stops breathing (step S114: No), the control unit 11 determines the timing at which the living body 900 rises (in other words, in step S107). It is determined whether or not the minimum respiratory stop time has elapsed from the timing at which the posture control instruction is output (step S115). That is, the control unit 11 determines whether or not the living body 900 has stopped breathing for the minimum breathing stop time or longer.
  • step S115 If it is determined that the minimum respiratory stop time has not elapsed as a result of the determination in step S115, the operation in step S114 is repeated.
  • step S115 if it is determined that the minimum respiratory stop time has elapsed as a result of the determination in step S115 (step S115: Yes), the respiratory control output unit 131 and the posture control output unit 132 stand in cooperation.
  • a breathing control instruction and a posture control instruction for instructing the living body 900 that breathing may be resumed are output (step S108).
  • FIG. 9 is a plan view showing an example of an image showing the respiratory control instruction and the posture control instruction that the respiratory control output unit 131 and the posture control output unit 132 cooperate to output in step S108 of FIG. 2
  • FIG. 9 is a plan view showing an example of an image showing the respiratory control instruction and the posture control instruction that the respiratory control output unit 131 and the posture control output unit 132 cooperate to output in step S108 of FIG.
  • the image showing the respiration control instruction and the posture control instruction output in cooperation by the respiration control output unit 131 and the posture control output unit 132 in step S108 of FIG. 2 is the initial screen shown in FIG.
  • the text boxes indicating the status of the current evaluation test are different.
  • an instruction sentence “Resume breathing while standing” is written in the text box indicating the state of the current evaluation test.
  • the living body 900 who has seen such an instruction will resume breathing while standing up at the timing when the instruction sentence “Resume breathing while standing” is displayed.
  • the autonomic nerve function parameter calculation unit 141 performs the autonomic nerve function based on the blood flow state of the living body 900 calculated by the calculation unit 11 while the operations from step S103 to step S109 are performed.
  • a parameter used for evaluating the value is calculated (step S109).
  • the calculation unit 11 performs operations from step S106 to step S108, although not explicitly shown in FIG. It is preferable to calculate the blood flow state of the living body 900 even while it is being performed.
  • the autonomic nerve function parameter calculation unit 141 calculates the blood flow reduction rate and the blood flow recovery time based on the blood flow calculated by the blood flow calculation unit 111 as an example of the parameter.
  • a blood flow reduction rate and a blood flow recovery time which are examples of parameters, will be described.
  • FIG. 10 is a graph showing an aspect of calculating a blood flow reduction rate and a blood flow recovery time, which are examples of parameters.
  • the average value of the blood flow rate of the living body 900 while maintaining the squatting posture is F ave
  • the minimum value of the blood flow rate after the transition to the standing posture is F min .
  • the maximum decrease amount ⁇ F of the blood flow after the transition to the standing posture is F ave ⁇ F min .
  • the recovery time of the blood volume which is an example of the parameter is the blood flow rate F aft after the transition to the standing posture when the transition to the standing posture is 0 second (after the transition to the standing posture)
  • the average value of the blood flow of the living body 900 while the average value F aft of the blood flow is maintained in the squatting posture is set to X of F ave (where X is, for example, 80 or more, preferably 90 or more, More preferably, it is defined as the time required to recover to the amount of [%].
  • the autonomic nerve function evaluation result output unit 142 evaluates the autonomic nerve function of the living body 900 based on the parameter calculated in step S109 (step S110).
  • the autonomic nervous function evaluation result output unit 142 individually performs an evaluation according to the blood volume reduction rate and an evaluation according to the blood volume recovery time, which are examples of parameters, and combines the individually performed evaluations.
  • the autonomic nervous function of the living body 900 may be evaluated. More specifically, the autonomic nervous function evaluation result output unit 142, for example, when the blood volume reduction rate is less than 50%, the evaluation based on the blood volume reduction rate is “0 (good)”. May be determined.
  • the autonomic nervous function evaluation result output unit 142 determines that the evaluation based on the blood volume reduction rate is “1 (bad)” when the blood volume reduction rate is 50% or more, for example. May be. For example, when the recovery time of the blood volume is less than 20 seconds, the autonomic nerve function evaluation result output unit 142 determines that the evaluation based on the recovery time of the blood volume is “0 (good)”. Also good. On the other hand, the autonomic nervous function evaluation result output unit 142 determines that the evaluation based on the blood volume recovery time is “1 (bad)”, for example, when the blood volume recovery time is 20 seconds or more. May be.
  • the autonomic nerve function evaluation result output unit 142 determines that the autonomic function of the living body 900 is “superior” It may be determined that “(vertigoness: low)”. Alternatively, the autonomic nerve function evaluation result output unit 142 determines that the autonomic nerve function of the living body 900 is in the case where the evaluation result of either the blood volume decrease rate or the blood volume recovery time is “1 (bad)”. You may determine with "good (vertigoness: medium)".
  • the autonomic nervous function evaluation result output unit 142 determines that the autonomic function of the living body 900 is “bad” when the evaluation results of both the blood volume reduction rate and the blood volume recovery time are “1 (bad)”. It may be determined that (vertigo: high).
  • the evaluation result of the autonomic nerve function described here is merely an example, and the autonomic nerve function evaluation result output unit 142 evaluates after further subdividing the blood volume decrease rate and the blood volume recovery time threshold value. May be performed. Alternatively, the autonomic nerve function evaluation result output unit 142 may perform evaluation by other methods.
  • the autonomic nervous function evaluation result output unit 142 outputs the result of the autonomic nervous function evaluation of the living body 900 (step S110).
  • the autonomic nerve function evaluation result output unit 142 outputs the result of the evaluation of the autonomic nerve function as an image displayed on the display 30 (for example, an image showing the result of the evaluation of the autonomic nerve function in characters, graphics, or the like). To do.
  • the autonomic nervous function evaluation result output unit 142 may not necessarily output the result of evaluating the autonomic nervous function of the living body 900.
  • FIG. 11 is a plan view showing an example of an image showing an evaluation result output by the autonomic nerve function evaluation result output unit 142 in step S110 of FIG. 2
  • FIG. 11 is a plan view showing an example of an image showing an evaluation result output by the autonomic nerve function evaluation result output unit 142 in step S110 of FIG.
  • the image showing the evaluation result output from the autonomic nervous function evaluation result output unit 142 in step S110 of FIG. 2 shows the state of the current evaluation test as compared with the initial image shown in FIG.
  • the text box and the text box indicating the result of the evaluation test are different.
  • an instruction sentence “The evaluation result of the autonomic nerve function is shown below” is described in the text box indicating the state of the current evaluation test.
  • the evaluation test indicates that the dizziness is “low”, the blood flow reduction rate is “30%”, and the blood flow recovery time is “14 seconds”. The results of are described.
  • the control unit 11 determines whether or not an operation for instructing the start of another evaluation test (that is, a retest) has been performed on the image (screen) displayed on the display 30. (Step S111). For example, when the living body 900 (or an operator handling the autonomic nervous function evaluation apparatus 10) that receives the evaluation test presses an operation button that instructs the start of the retest on the image shown in FIG. It is determined that an operation for instructing has been performed.
  • step S111 If, as a result of the determination in step S111, it is determined that an operation for instructing the start of another evaluation test (that is, a retest) has been performed (step S111: Yes), the operations in and after step S103 are repeated.
  • step S111 when it is determined that an operation for instructing the start of another evaluation test (that is, retest) has been performed (step S111: Yes), the autonomic nervous function evaluation system 1 The operation ends.
  • the calculation unit 11 shifts from a crouching posture to a standing posture while stopping breathing (ii) (ii) ) It is possible to calculate the blood flow state of the living body 900 in a state in which the breathing is stopped for at least the minimum breathing stop time even after the transition to the standing posture. If the calculation unit 11 tries to calculate the blood flow state of the living body 900 that is not in a specific state, the calculated blood flow state has a noise component (in other words, a noise component or an unnecessary component). ) May be superimposed.
  • the evaluation unit 14 evaluates the autonomic nerve function based on the blood flow state on which the influence of respiration is superimposed, the reliability of the evaluation result may be relatively lowered.
  • the calculation unit 11 shifts from a specific state (i.e., (i) from the squatting posture to the standing posture while stopping breathing, and (ii) after the transition to the standing posture. It is possible to calculate the blood flow state of the living body 900 in a state where breathing is stopped for the minimum breathing stop time or longer. Therefore, the disadvantage that the influence of the respiration of the living body 900 is superimposed on the calculated blood flow state can be substantially or almost eliminated.
  • the evaluation unit 14 can evaluate the autonomic nervous function based on the blood flow state in which little or no influence of such respiration is superimposed. Therefore, it is possible to suitably suppress a decrease in reliability of the evaluation result of the autonomic nerve function by the evaluation unit 14.
  • the autonomic nervous function evaluation system 1 evaluates the autonomic nervous function based on the blood flow state of the living body 900 that is not in a specific state (that is, the blood flow state on which the influence of respiration is superimposed). Compared with this system, the autonomic nervous function can be evaluated with higher accuracy.
  • the autonomic nervous function evaluation system 1 may detect a change in respiration using a frequency analysis of blood flow. In this case, the autonomic nervous function evaluation system 1 may notify the fact and prompt the remeasurement (that is, retest) when the respiratory change is detected after standing.
  • the calculation unit 11 detects the blood flow state of the living body 900 in a specific state (that is, a state in which the squatting posture is changed to the standing posture after maintaining the squatting posture for the minimum squatting time). can do. If the calculation unit 11 tries to calculate the blood flow state of the living body 900 that is not in a specific state, the calculated blood flow state includes the following values before taking a squatting posture (or before shifting to a standing posture): Similarly, there is a possibility that an influence caused by the activity state of the living body 900 is superimposed as a noise component (in other words, a noise component or an unnecessary component).
  • a noise component in other words, a noise component or an unnecessary component
  • the evaluation unit 14 evaluates the autonomic nervous function based on the blood flow state on which the influence caused by the activity state of the living body 900 before taking the squatting posture is superimposed, the reliability of the evaluation result is relatively It can fall.
  • the evaluation unit 14 evaluates the autonomic nerve function based on the blood flow state on which the influence due to the activity state of the living body 900 before taking the squatting posture is superimposed, the living body 900 before taking the squatting posture.
  • the evaluation results may vary.
  • the calculation unit 11 includes the living body 900 in a specific state (that is, a state in which the squatting posture is changed from the squatting posture to the standing posture after maintaining the squatting posture for the minimum squatting time). A blood flow state can be detected.
  • the evaluation unit 14 can evaluate the autonomic nerve function based on the blood flow state in which the influence of the activity state of the living body 900 before taking such a squatting posture is hardly or not superimposed.
  • the autonomic nervous function evaluation system 1 is configured so that the blood flow state of the living body 900 that is not in a specific state (that is, the blood flow state on which the influence of the activity state of the living body 900 before the squatting posture is superimposed). Compared with other systems that evaluate autonomic nervous function based on this, it is possible to evaluate autonomic nervous function with higher accuracy.
  • the instruction output unit 13 outputs a predetermined instruction such as a respiration control instruction and a posture control instruction, and as a result, the living body 900 changes the respiration mode and posture.
  • the instruction output unit 13 does not necessarily output a predetermined instruction.
  • the living body 900 voluntarily changes the breathing mode and posture by browsing an instruction described in a manual such as an instruction manual (in other words, regardless of the instruction of the instruction output unit 13). May be.
  • the autonomic nervous function evaluation apparatus 10 may not include the instruction output unit 13.
  • the instruction output unit 13 (i) posture control instruction for instructing to continue squatting for a minimum squatting time (or more than the minimum squatting time) after squatting at a predetermined timing, and (ii) Both breathing control instructions and posture control instructions are output for instructing to continue breathing for the minimum breathing stop time (or more than the minimum breathing time) after standing up at a predetermined timing while stopping breathing.
  • the instruction output unit 13 outputs a posture control instruction for instructing to continue squatting for a minimum squatting time (or longer than the minimum squatting time) after squatting at a predetermined timing, while stopping breathing at a predetermined timing.
  • step S107 to step S108 in FIG. 2 may not be performed. That is, when an operation for instructing the start of the evaluation test is performed (step S102 in FIG. 2: Yes), after the posture control instruction for instructing the posture control output unit 132 to stand up on the living body 900 is output. Then, the operations after step S109 in FIG. 2 are performed.
  • the instruction output unit 13 rises at a predetermined timing while stopping breathing, and after initiating the breathing control instruction and posture control for instructing to stop breathing for the minimum breathing stop time (or more than the minimum breathing time).
  • step S103 the operation from step S103 to step S106 in FIG. 2 may not be performed. That is, when the minimum squatting time has elapsed (step S106 in FIG. 2: Yes), the posture control output unit 132 outputs a posture control instruction for instructing the living body 900 to squat, and then step S107 in FIG. Subsequent operations are performed.
  • a crouching posture and a standing posture are illustrated as postures that the living body 900 takes. That is, when the living body 900 shifts from the squatting posture to the standing posture, a load for changing the blood flow state of the living body 900 is applied to the living body 900, and as a result, the blood flow state of the living body 900 is changed. .
  • any posture of the living body 900 before the load for changing the blood flow state of the living body 900 is applied may be used as an alternative posture of the squatting posture.
  • the living body 900 supports the weight of the living body 900 with the buttocks on the ground or the support body, or the living body 900 places the back or abdomen on the ground or the support body.
  • a supine posture or the like that supports the weight of 900 may be used as an alternative posture of the squatting posture.
  • the posture of the living body 900 has been given a load for changing the blood flow state of the living body 900, it may be used as an alternative posture of the standing posture.
  • the appropriate time suitable for the alternative posture of the squatting posture or the alternative posture of the standing posture is used as the above-mentioned minimum squatting time or minimum breathing time. It is preferably set.
  • an operation of moving the position of the head of the living body 900 from the lower side to the upper side with respect to the direction of gravity may be used instead of the operation of “transitioning from the squatting posture to the standing posture”.
  • the posture when the position of the head of the living body 900 is relatively lower than the direction of gravity is an example of a first posture that replaces the “squatting posture”.
  • the posture in the case of being on the upper side relative to the direction of gravity is an example of the second posture instead of the “standing posture”.
  • the living body 900 sleeping on the electric bed performs passive standing or the like to raise the upper body of the living body 900 by borrowing the force that the electric bed automatically rises, so that the position of the head of the living body 900 is It is good also as a posture change in the case of being on the upper side relative to the direction of gravity. Also in this case, it is preferable that an appropriate time suitable for the alternative posture of the squatting posture or the alternative posture of the standing posture is set as the above-described minimum squatting time and minimum breathing time.
  • the present invention can be appropriately changed without departing from the gist or idea of the invention that can be read from the claims and the entire specification, and an autonomic nervous function evaluation apparatus and a computer program accompanied by such changes are also included in this book. It is included in the technical idea of the invention.

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  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
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Abstract

La présente invention concerne l'évaluation de la fonction du système nerveux autonome avec une plus grande précision par détection de l'état de la circulation sanguine. Le dispositif d'évaluation de la fonction nerveuse autonome (10) est doté de : un moyen de détection (12) destiné à détecter l'état de la circulation sanguine d'un sujet lorsque le sujet passe d'une première position à une seconde position qui est une position après contrainte imposée pour entraîner une modification de l'état de la circulation sanguine, après que le sujet est resté, pendant au moins une durée définie, dans la première position qui est une position avant qu'une contrainte ne soit imposée pour entraîner une modification de l'état de circulation sanguine ; et un moyen d'évaluation (14) destiné à évaluer la fonction nerveuse autonome du sujet sur la base de l'état de la circulation sanguine du sujet détecté par le moyen de détection.
PCT/JP2011/071160 2011-09-15 2011-09-15 Dispositif et procédé d'évaluation de la fonction nerveuse autonome, et programme informatique WO2013038551A1 (fr)

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PCT/JP2011/071160 WO2013038551A1 (fr) 2011-09-15 2011-09-15 Dispositif et procédé d'évaluation de la fonction nerveuse autonome, et programme informatique

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Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103445767A (zh) * 2013-08-30 2013-12-18 邝建 传感监测交互控制全自动自主神经功能检测仪及检测方法
WO2016133088A1 (fr) * 2015-02-17 2016-08-25 日本電信電話株式会社 Dispositif d'identification de posture séquentielle et dispositif, procédé et programme d'acquisition d'informations relative a la fonction autonome
WO2017130414A1 (fr) * 2016-01-29 2017-08-03 パイオニア株式会社 Dispositif de sortie d'informations, procédé de sortie d'informations, et programme informatique
JP2017158718A (ja) * 2016-03-08 2017-09-14 パイオニア株式会社 評価装置、出力方法、並びにコンピュータプログラム
JP2018161245A (ja) * 2017-03-24 2018-10-18 株式会社日立ハイテクノロジーズ 情報処理装置、情報処理方法および情報処理プログラム
JP2020073078A (ja) * 2020-02-05 2020-05-14 パイオニア株式会社 情報出力装置
US11998360B2 (en) 2015-02-17 2024-06-04 Nippon Telegraph And Telephone Corporation Device and method for sequential posture identification and autonomic function information acquisition

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006102265A (ja) * 2004-10-06 2006-04-20 Terumo Corp 自律神経機能評価装置および評価方法

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2006102265A (ja) * 2004-10-06 2006-04-20 Terumo Corp 自律神経機能評価装置および評価方法

Non-Patent Citations (2)

* Cited by examiner, † Cited by third party
Title
HIDEYUKI MUKAE: "A Study of The Spontaneous Rhythmic Skin Blood Elow Fluctuation as an Index of The Autonomic Nervous Activity", JAPANISE JOURNAL OF PHYSIOLOGICAL ANTHROPOLOGY, vol. 13, no. 3, 25 August 2008 (2008-08-25), pages 137 - 146 *
TETSUYA FUJIKAWA ET AL.: "Measurement of Hemodynamics During Postural Changes Using a New Wearable Cephalic Laser Blood Flowmeter", CIRCULATION JOURNAL, vol. 73, 2009, pages 1950 - 1955 *

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103445767A (zh) * 2013-08-30 2013-12-18 邝建 传感监测交互控制全自动自主神经功能检测仪及检测方法
WO2016133088A1 (fr) * 2015-02-17 2016-08-25 日本電信電話株式会社 Dispositif d'identification de posture séquentielle et dispositif, procédé et programme d'acquisition d'informations relative a la fonction autonome
US11998360B2 (en) 2015-02-17 2024-06-04 Nippon Telegraph And Telephone Corporation Device and method for sequential posture identification and autonomic function information acquisition
WO2017130414A1 (fr) * 2016-01-29 2017-08-03 パイオニア株式会社 Dispositif de sortie d'informations, procédé de sortie d'informations, et programme informatique
JPWO2017130414A1 (ja) * 2016-01-29 2018-11-22 パイオニア株式会社 情報出力装置、情報出力方法、並びにコンピュータプログラム
JP2017158718A (ja) * 2016-03-08 2017-09-14 パイオニア株式会社 評価装置、出力方法、並びにコンピュータプログラム
JP2018161245A (ja) * 2017-03-24 2018-10-18 株式会社日立ハイテクノロジーズ 情報処理装置、情報処理方法および情報処理プログラム
JP7018640B2 (ja) 2017-03-24 2022-02-14 株式会社NeU 情報処理装置、情報処理方法および情報処理プログラム
JP2020073078A (ja) * 2020-02-05 2020-05-14 パイオニア株式会社 情報出力装置
JP2021184839A (ja) * 2020-02-05 2021-12-09 パイオニア株式会社 情報出力装置

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