WO2013038552A1

WO2013038552A1 - Autonomic nervous function evaluation device and method, and computer program

Info

Publication number: WO2013038552A1
Application number: PCT/JP2011/071161
Authority: WO
Inventors: 信幸寺田; 俊成秋元; 雅樹郷間; 木村　義則; 敦也伊藤; 俊太郎森
Original assignee: パイオニア株式会社; 学校法人東洋大学
Priority date: 2011-09-15
Filing date: 2011-09-15
Publication date: 2013-03-21
Also published as: JP5914499B2; JPWO2013038552A1

Abstract

The objective of the present invention is to evaluate autonomic nervous function with higher precision by detecting blood flow state. The autonomic nervous function evaluation device (10) is provided with: a detection means (12) for detecting the blood flow state of a subject when (i) the subject transitions, while holding breath, from a first position which is a position before stress is placed to cause a change in the blood flow state to a second position which is a position after stress is placed to cause a change in the blood flow state and (ii) the subject keeps holding breath for at least a prescribed amount of time after transitioning to the second position; and an evaluation means (14) for evaluating the autonomic nervous function of the subject on the basis of the blood flow state of the subject detected by the detection means.

Description

Autonomic nerve function evaluation apparatus and method, and computer program

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. However, when a person (or any living body) stands up suddenly or keeps standing after standing up, 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.

Several devices for evaluating such orthostatic hypotension have been proposed. For example, in 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). There has been proposed 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).

However, in the apparatus disclosed in Patent Document 1, it is necessary to measure the blood pressure of the subject in order to evaluate the autonomic nervous function. Therefore, while performing the evaluation, the region of the subject to which the blood pressure detection unit is attached is measured. It is necessary to squeeze continuously. This can increase the burden on the subject. In addition, the part where the blood pressure detection unit can be attached may be limited.

Therefore, as described in 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 technique for measuring and evaluating orthostatic hypotension has been disclosed, and is expected as a technique for 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.

JP 2006-102265 A

However, 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.

Examples of problems to be solved by the present invention include the above. 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.

In order to solve the above problems, the first autonomic nervous function evaluation apparatus applies (i) a load that changes the blood flow state from the first posture before applying a load that changes the blood flow state while stopping breathing. (Ii) detection means for detecting a blood flow state of the subject who continues to stop breathing for at least a predetermined time after the transition to the second posture, and the subject detected by the detection means Evaluation means for evaluating the autonomic nervous function of the subject based on the blood flow state.

In order to solve the above-described problem, the second autonomic nervous function evaluation device (i) determines the blood flow state from the first posture before applying a load that changes the blood flow state while stopping breathing. By instructing to shift to the second posture after applying the load to be changed, and (ii) indicating means for instructing to stop breathing for at least a predetermined time after shifting to the second posture; Detecting means for detecting at least one of the blood flow state of the subject while the instruction is issued and the blood flow state of the subject after the instruction by the instruction means is issued, and the detection detected by the detection means Evaluation means for evaluating the autonomic nervous function of the subject based on the blood flow state of the subject.

In order to solve the above problems, the first autonomic nervous function evaluation method provides (i) a load for changing the blood flow state from the first posture before giving a load for changing the blood flow state while stopping breathing. And (ii) a detection step of detecting a blood flow state of the subject who continues to stop breathing for at least a predetermined time after the transition to the second posture, and before the transition to the second posture. An evaluation step of analyzing the blood flow state of the subject detected by the detection step with reference to the blood flow state of the subject.

In order to solve the above problems, the second autonomic nervous function evaluation method (i) gives a load for changing the blood flow state from the first posture before giving a load for changing the blood flow state while stopping breathing. And (ii) an instruction step for instructing to stop breathing for at least a predetermined time after shifting to the second posture, 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 An evaluation step of analyzing the blood flow state of the subject detected by the detection step on the basis of the flow state.

In order to solve the above-described problem, the computer program causes the computer to function as the first or second autonomic nerve function evaluation apparatus described above.

It is a block diagram which shows the structure of the autonomic-nerve function evaluation system of a present Example. It is a flowchart which shows the flow of operation | movement of the autonomic-nerve function evaluation system of a present Example. It is a top view which shows an example of the initial image currently displayed on the display before the evaluation test of an autonomic nerve function is started. It is a top view which shows an example of the image which shows the attitude | position control instruction | indication which an attitude | position control output part outputs in FIG.2 S103. It is a graph which shows the variation | change_quantity of the blood flow rate when changing crouching time, and the variation | change_quantity of average blood pressure. It is a graph which shows the time change of mean blood pressure, earlobe blood flow, and heart rate when changing the crouching time. It is a top view which shows an example of the image which shows the respiration control instruction | indication and posture control instruction | indication which a respiration control output part and a posture control output part cooperate in step S107 of FIG. It is a graph which shows each time change of the blood flow rate of the biological body when not breathing, and the blood flow rate of the biological body when not breathing. It is a top view which shows an example of the image which shows the respiration control instruction | indication and posture control instruction which a respiration control output part and a posture control output part cooperate and output in step S108 of FIG. It is a graph which shows the aspect of calculation of the reduction rate of the blood flow rate which is an example of a parameter, and the recovery time of the blood flow rate. It is a top view which shows an example of the image which shows the evaluation result which an autonomic nerve function evaluation result output part outputs in step S110 of FIG.

Hereinafter, embodiments of the autonomic nervous function evaluation apparatus and method and the computer program will be described in order.

(Embodiment of autonomic nervous function evaluation apparatus)
The autonomic nervous function evaluation apparatus of the first embodiment is (i) a second posture after giving a load that changes the blood flow state from a first posture before giving a load that changes the blood flow state while stopping breathing. And (ii) detection means for detecting a blood flow state of the subject who continues to stop breathing for at least a predetermined time after the transition to the second posture, and based on the blood flow state of the subject detected by the detection means And an evaluation means for evaluating the autonomic nervous function of the subject.

According to the autonomic nerve function evaluation apparatus of the first embodiment, 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.

Particularly in the first embodiment, the detection means (i) transitions from the first posture to the second posture while stopping breathing, and (ii) the blood flow of the subject who continues to stop breathing for at least a predetermined time after shifting to the second posture. Detect state. 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). In other words, 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. On the other hand, 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. In other words, 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. Therefore, when the subject in the first posture shifts to the second posture, the blood flow state of the subject changes. As described above, in the first embodiment, 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. However, in the first embodiment, as an example of the “first posture”, for example, (i) 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) (Ii) a squatting posture, or (ii) 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. For example, supine postures that support the weight of the subject. Similarly, in the first embodiment, as an example of the “second posture”, for example, 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.

In order for the detection means to detect the blood flow state of the subject in such a state, the autonomic nervous function evaluation apparatus may directly or indirectly instruct the subject to realize such a state. Good. Alternatively, in order for the detection means to detect the blood flow state of the subject in such a state, 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. In any case, the detection means is not limited to the specific state described above by any method (that is, (i) the first posture is changed to the second posture while stopping breathing, and (ii) the transition to the second posture is at least a predetermined time. The blood flow state of the subject who realizes the state of continuing to stop breathing) is detected.

Thereafter, 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 is based on the blood flow state of the subject who (i) shifts from the first posture to the second posture while stopping breathing and (ii) stops breathing for at least a predetermined time after shifting to the second posture. Evaluate the subject's autonomic function. 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). And (i) analyzing the blood flow state of the subject who continues to stop breathing for at least a predetermined time after shifting to the second position and (ii) after shifting to the second position while stopping breathing. The autonomic nervous function of the subject may be evaluated. 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.

Here, in the first embodiment, the detection means is in a specific state (i.e., (i) shifts from the first posture to the second posture while stopping breathing and (ii) at least a predetermined time after shifting to the second posture. It is possible to detect the blood flow state of the subject who is in the state of continuing to stop breathing). If the detection means tries to detect a blood flow state of a subject who is not in a specific state, the influence of the subject's breathing is superimposed on the detected blood flow state as a noise component (in other words, a noise component or an unnecessary component). May have been. Therefore, if the evaluation unit evaluates the autonomic nervous 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. However, in the first embodiment, as described above, the detection means shifts from the first posture to the second posture while (ii) stops breathing and (ii) after shifting to the second posture. The blood flow state of the subject who is in the state of continuing to stop breathing for at least a predetermined time can be detected. Therefore, the inconvenience that the influence of the subject's breathing is superimposed on the detected blood flow state can be substantially or almost eliminated. As a result, the evaluation means can evaluate the autonomic nerve function based on the blood flow state in which little or no effect of such respiration is 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. In other words, the autonomic nervous function evaluation apparatus according to the first embodiment evaluates the autonomic nervous function based on the blood flow state of the subject who is not in a specific state (that is, the blood flow state on which the influence of respiration is superimposed). Compared with the device, the autonomic nervous function can be evaluated with higher accuracy.

In one aspect of the autonomic nervous function evaluation apparatus of the first embodiment, the subject is instructed to shift from the first posture to the second posture while stopping breathing, and after the transition to the second posture. And an instruction means for instructing to stop breathing for at least the predetermined time, and the detection means outputs the blood flow state of the subject and the instruction by the instruction means while the instruction by the instruction means is being issued. By detecting at least one of the blood flow states of the subject after being performed, the breathing is stopped and the first posture is shifted to the second posture, and the breathing is continued for at least the predetermined time after the transition to the second posture. The blood flow state of the subject to be stopped is detected.

According to this aspect, prior to the detection of the blood flow state of the subject by the detection means, the instruction means shifts the subject from the first posture to the second posture while stopping breathing (i). In addition, it is possible to instruct directly or indirectly to realize (ii) a state where breathing continues to be stopped for at least a predetermined time after shifting to the second posture. 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. And (i) detecting the blood flow state of the subject who is in the state of continuing to stop breathing for at least a predetermined time after shifting from the first posture to the second posture and (ii) after shifting to the second posture) it can.

The autonomic nervous function evaluation apparatus according to the second embodiment gives the subject a load that changes the blood flow state from the first posture before giving a load that changes the blood flow state while stopping breathing (i). An instruction is given to shift to the subsequent second posture, and (ii) an instruction means for instructing to stop breathing for at least a predetermined time after shifting to the second posture, and an instruction by the instruction means is issued Detecting means for detecting at least one of the blood flow state of the subject in between and the blood flow state of the subject after the instruction by the instruction means is issued, 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.

According to the autonomic nervous function evaluation apparatus of the second embodiment, the instruction unit performs a specific state (i.e., (i) while stopping breathing) before the detection unit detects the blood flow state of the subject. It is instructed directly or indirectly to shift from the first posture to the second posture and (ii) to keep breathing for at least a predetermined time after shifting to the second posture. Note that “blood flow state”, “first posture”, and “second posture” have the same meaning as those terms in the first embodiment. In addition, 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.

Thereafter, 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. Here, 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 test subject is a specific state (i.e., (i) a state where the breathing is stopped and the first posture is shifted to the second posture, and (ii) the breathing is continued for at least a predetermined time after the transition to the second posture. ) Is presumed to be the blood flow state of the subject.

Thereafter, 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 substantially (i) transitions from the first posture to the second posture while stopping breathing, and (ii) keeps breathing for at least a predetermined time after shifting to the second posture. Based on the state, the autonomic nervous function of the subject can be evaluated. 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.

In one aspect of the autonomic nervous function evaluation apparatus according to the second 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 breathing is stopped and the first posture is shifted to the second posture and the breathing is stopped for at least the predetermined time after the transition to the second posture. The blood flow state of the subject is detected.

According to this aspect, 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. The blood flow state of the subject in this state (i.e., (i) the first posture is shifted to the second posture while stopping breathing and (ii) the breathing is stopped for at least a predetermined time after the transition to the second posture). Can be detected.

In another aspect of the autonomic nervous function evaluation apparatus according to the first and second embodiments, the blood flow state of the subject after the transition to the second posture is before the transition to the second posture for the predetermined time. It is determined according to the time required to return to the blood flow state of the subject.

For example, the evaluation means uses the blood flow state of the subject before the transition to the second posture as a reference, and the blood flow state of the subject before the blood flow state of the subject after the transition to the second posture transitions to the second posture. The autonomic nervous function may be evaluated by analyzing the blood flow state of the subject before returning to step 1. In this case, according to this aspect, for example, the subject's breathing is stopped until the blood flow state of the subject after the transition to the second posture generally returns to the blood flow state of the subject before the transition to the second posture. You can continue. Therefore, the evaluation means can evaluate the autonomic nerve function based on the blood flow state in which the influence of the subject's respiration is not superimposed. Therefore, the autonomic nerve function evaluation apparatus of the first embodiment can enjoy the various effects described above more reliably.

In the first and second embodiments, the state “the blood flow state of the subject after the transition to the second posture returns to the blood flow state of the subject before the transition to the second posture” is “the second posture. The blood flow state of the subject after shifting to “a” may include a state in which “the blood flow state of the subject before shifting to the second posture” becomes the same. Alternatively, the state “the blood flow state of the subject after the transition to the second posture returns to the blood flow state of the subject before the transition to the second posture” is “the blood of the subject after the transition to the second posture” It may include a state in which the “flow state” and “the blood flow state of the subject before moving to the second posture” are approximate (for example, the difference is close to a predetermined value or less).

In another aspect of the autonomic nervous function evaluation apparatus according to the first and second embodiments, the predetermined time is a time that falls within a range of approximately 15 seconds to approximately 20 seconds.

According to this aspect, as will be described in detail later with reference to the drawings, inconveniences in which the influence of the subject's respiration is superimposed on the blood flow state detected by the detection means can be substantially or almost eliminated.

In another aspect of the autonomic nervous function evaluation apparatus according to the first and second embodiments, the instruction means includes: (i) the blood flow state of the subject after shifting to the second posture shifts to the second posture If the blood flow state of the subject before returning is not returned, the instruction to continue to stop breathing is continued, and (ii) the blood flow state of the subject after the transition to the second posture is the second posture After returning to the blood flow state of the subject before shifting to, the instruction to continue to stop breathing is stopped, thereby instructing the subject to stop breathing for at least the predetermined time after shifting to the second posture.

According to this aspect, even if the predetermined time is not clearly set in advance, the instruction means monitors the blood flow state of the subject so as to substantially stop breathing for a predetermined time. The subject can be instructed. Such an effect can be realized because the “predetermined time” in the present embodiment is the blood flow state of the subject before the transition to the second posture of the subject after the transition to the second posture. This is because it is determined according to the time required to return.

In another aspect of the autonomic nervous function evaluation apparatus according to the first and second embodiments, the first posture is a squatting posture and the second posture is a standing posture.

According to this aspect, the detection means shifts from the squatting position to the standing position while stopping the breathing (ii) while stopping breathing and (ii) continues to stop breathing for at least the predetermined time after shifting to the standing position. The blood flow state of the subject in the (state) can be detected. As a result, the evaluation means can evaluate the autonomic nervous function based on such a blood flow state.

In the present embodiment, 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). On the other hand, in the present embodiment, the “squatting posture” 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. That is, 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.

In another aspect of the autonomic nervous function evaluation apparatus according to the first and second embodiments, the apparatus further includes a determination unit that determines whether or not the subject stops breathing, and the subject stops the breathing by the determination unit. (I) the detection means detects the blood flow state of the subject, and (ii) the evaluation means, based on the blood flow state of the subject, the autonomic nervous function of the subject. To evaluate.

According to this aspect, since the autonomic nervous function of the subject who has stopped breathing is evaluated, it can be ensured that the accuracy of the evaluation is relatively high.

(Embodiment of autonomic nervous function evaluation method)
The autonomic nervous function evaluation method according to the first embodiment includes (i) a second posture after giving a load for changing the blood flow state from a first posture before giving a load for changing the blood flow state while stopping breathing. And (ii) a detection step for detecting a blood flow state of the subject who continues to stop breathing for at least a predetermined time after the transition to the second posture, and a blood flow state 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 as a reference.

According to 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.

Incidentally, in response to the various aspects of the autonomic nervous function evaluation apparatus of the first embodiment described above, the autonomic nervous function evaluation method of the first embodiment can also take various aspects. Moreover, although 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 | position, Similarly to the evaluation means included in the autonomic nervous function evaluation apparatus of the first embodiment, the autonomic nervous function may be evaluated based on the blood flow state of the subject detected by the detection process. Alternatively, in the evaluation step, 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.

In the autonomic nervous function evaluation method of the second embodiment, (i) the second posture after giving a load for changing the blood flow state from the first posture before giving a load for changing the blood flow state while stopping breathing And (ii) an instruction step for instructing to stop breathing for at least a predetermined time after the transition to the second posture, and the subject's while the instruction by the instruction step is being issued 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 And an evaluation step of analyzing the blood flow state of the subject detected by the detection step.

According to 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.

Incidentally, in response to the various aspects of the autonomic nerve function evaluation apparatus of the second embodiment described above, the autonomic nerve function evaluation method of the second embodiment can also take various aspects. Moreover, although 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 | position, Similarly to the evaluation means included in the autonomic nervous function evaluation apparatus of the second embodiment, the autonomic nervous function may be evaluated based on the blood flow state of the subject detected by the detection process. Alternatively, in the evaluation step, 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.

(Embodiment of computer program)
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.

Incidentally, in response to the various aspects of the autonomic nervous function evaluation apparatus of the first embodiment described above, the computer program of the first embodiment can also adopt various aspects. Further, 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).

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.

Incidentally, in response to various aspects of the autonomic nervous function evaluation apparatus of the second embodiment described above, 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).

Such an operation and other advantages of the present embodiment will be further clarified from examples described below.

As described above, the autonomic nervous function evaluation apparatus according to the first embodiment includes detection means and evaluation means. The autonomic nervous function evaluation apparatus according to the second embodiment 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.

Hereinafter, embodiments of an autonomic nervous function evaluation apparatus and a computer program will be described with reference to the drawings. In addition, below, description is advanced about the autonomic-nervous function evaluation system 1 provided with the autonomic-nerve evaluation apparatus 10. FIG.

(1) Configuration of Autonomic Nerve Function Evaluation System 1 With reference to FIG. 1, the configuration of the autonomic nerve function evaluation system 1 of the present embodiment will be described. FIG. 1 is a block diagram illustrating a configuration of an autonomic nervous function evaluation system 1 according to the present embodiment.

As shown in FIG. 1, 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. Or the control part 11, the calculation part 12, the instruction | indication output part 13, and the evaluation part 14 may be logically implement | achieved by the software which operate | moves on CPU (Central * Processing * Unit), for example.

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.

As will be described later, in this embodiment, for example, the autonomic nervous function of the living body 900 is evaluated based on the blood flow rate. In other words, in this embodiment, the pulse rate does not have to be directly related to the evaluation of the autonomic nervous function of the living body 900 itself. For this reason, 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. In this embodiment, 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). However, the instruction output unit 13 may output a predetermined instruction in another manner. For example, 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. For example, 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. For example, 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.

In the present embodiment, 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. On the other hand, in the present embodiment, 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). At this time, it is preferable that 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). ). However, 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).

Note that at least a part of 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. Instead of the device 10, 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. For example, in the present embodiment, 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. Alternatively, 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. Specifically, for example, 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.

(2) Operation of Autonomic Nerve Function Evaluation System 1 Subsequently, the flow of operation of the autonomic nerve function evaluation system 1 of the present embodiment will be described with reference to FIG. FIG. 2 is a flowchart showing an operation flow of the autonomic nerve function evaluation system 1 of the present embodiment.

As shown in FIG. 2, when the blood flow waveform output device 20 outputs the blood flow waveform of the living body 900 even before the evaluation test of the autonomic nervous function is started, the calculation unit 12 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.

Thereafter, the control unit 11 determines whether or not at least one of the blood flow rate and the pulse rate calculated in Step S101 is a normal value (Step S111). 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.

As a result of the determination in 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.

On the other hand, as a result of the determination in 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).

Here, an example of the initial image displayed on the display 30 before the evaluation test of the autonomic nervous function is started will be described with reference to FIG. 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.

As shown in FIG. 3, 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. 3, in the text box showing the current evaluation test state, an instruction sentence “Please press the evaluation test start button when performing an evaluation test of the autonomic nervous function” is described. Has been. In this state, for example, when the living body 900 undergoing the evaluation test (or an operator handling the autonomic nervous function evaluation apparatus 10) presses the operation button for instructing the start of the evaluation test, an operation for instructing the start of the evaluation test is performed. It is determined that it was done.

Note that the example of the image shown in FIG. 3 is merely an example, and an image other than the image shown in FIG. 3 may be displayed on the display 30.

In FIG. 2 again, 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. In other words, the autonomic nervous function evaluation apparatus 10 substantially stands by until an instruction to start an evaluation test is given.

On the other hand, as a result of the determination in 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 thereafter maintain the squatting posture for the minimum squatting time (or longer than the minimum squatting time). (Step S103). For example, 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.

Here, with reference to FIG. 4, an example of an image indicating the posture control instruction output by the posture control output unit 132 in step S103 of FIG. 2 will be described. 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.

As shown in FIG. 4, 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. Is different. In the example shown in FIG. 4, 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. ". Thereafter, with the passage of time, the notation “XX seconds” in the instruction sentence “Please continue squatting for XX seconds later” is gradually decremented. The living body 900 who sees such an instruction crouches at the timing when the instruction sentence “i) crouch” is displayed, and (ii) after that, according to the instruction sentence “Continue crouching for ** seconds,” It will continue to crouch for the minimum crouching time (ie, maintain a crouching posture).

The “minimum squatting time” used here is preferably set in advance from the following viewpoints. Hereinafter, the setting of the minimum squatting time will be described with reference to FIGS. 5 and 6. 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 crouching posture as a reference (that is, 0 seconds), and thereafter a time for maintaining the crouching posture (that is, a time during which crouching is continued) is 0 seconds, 15 Seconds, 30 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 change amount of the blood flow rate 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 if the time for continuing squatting is set to 0 seconds, 15 seconds, 30 seconds, 45 seconds, and 60 seconds, there is a large or characteristic amount of change in blood flow. It can be seen that there is no significant difference.

On the other hand, 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. 5 (b), 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. I understand. That is, when 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). On the other hand, when looking at the graph shown in FIG. 5 (b), 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. I understand. That is, when the time for continuing squatting is set to 45 seconds and 60 seconds, 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.

In this embodiment, 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). That is, the blood flow state of the living body 900 that is in the squatting posture (that is, before the transition to the standing 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. Then, 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.

Subsequently, 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. On the other hand, when the squatting time is set to 60 seconds, 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. This corresponds to a graph when the living body 900 shifts from the squatting posture to the standing posture at the time of 90 seconds, and thereafter the living body 900 maintains the standing posture. As shown in FIG. 6, when the squatting time is set to 60 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. On the other hand, as shown in FIG. 6, when the squatting time is set to 30 seconds, 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).

Here, when the living body 900 receives an evaluation test by the autonomic nervous function evaluation system 1 of the present embodiment, 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). That is, when an evaluation test is performed, it is assumed that it is preferable to stabilize the blood flow state of the living body 900 before the posture is changed from the squatting posture to the standing posture. In other words, it is considered preferable to stabilize the blood flow state of the living body 900 before shifting to the standing posture as a reference in the evaluation test so as not to affect the suitable evaluation. Then, according to the graph shown in FIG. 6, it is understood that 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. .

Therefore, in this embodiment, it is preferable that the minimum squatting time is set to 45 seconds or more. Alternatively, the minimum squatting time may be set to 60 seconds or more.

Needless to say, 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.

In FIG. 2 again, 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). In addition, 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). Here, for example, 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.

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.

On the other hand, as a result of the determination in 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.

As described above, 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.

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.

On the other hand, 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. The respiratory control instruction and the posture control instruction for instructing the living body 900 to stop breathing only for the minimum respiratory stop time (or more than the minimum respiratory time) after starting up at a predetermined timing while stopping breathing and rising. (Step S107). In other words, 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). For example, 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.

Here, with reference to FIG. 7, 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 S107 of FIG. 2 will be described. 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.

As shown in FIG. 7, 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. In comparison, the text boxes indicating the status of the current evaluation test are different. In the example shown in FIG. 7, 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”. Then, as time passes, the notation “XX seconds” in the instruction sentence “Please keep breathing for XX seconds while standing” is gradually decremented. The living body 900 who sees such an instruction rises while stopping breathing at the timing when the instruction sentence “i) Please stop breathing and stand up” is displayed. (Ii) After that, ○ Continue to stop breathing for 2 seconds ”and continue to stop breathing for the minimum breathing stop time while standing.

In addition, 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. Alternatively, 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). Alternatively, 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.

The “minimum breathing stop time” used here is preferably set in advance from the following viewpoints. Hereinafter, the setting of the minimum breathing stop time will be described with reference to FIG. 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. In addition, the graph shown in FIG. 8 is a graph based on the data derived | led-out as a result of experiment of this inventor.

As shown in FIG. 8, in the case of breathing (that is, when breathing is not stopped), the blood flow rate of the living body 900 is breathed as compared to the case where there is no breathing (that is, when breathing is stopped). It can be seen that it fluctuates with that (that is, fluctuation has occurred). FIG. 8 shows an example of changes in blood flow when breathing at approximately 0.25 Hz (that is, breathing once every 4 seconds).

In this embodiment, 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.

Here, in this embodiment, 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. Based on the mode of change, 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. According to the experiments by the inventors of the present application, 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). Here, “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. "To the extent that the blood flow state of the living body 900 after shifting to the standing posture can be substantially identified with the blood flow state of the living body 900 before shifting to the standing posture". "Return" state or "Return to the extent that the difference between the blood flow state of the living body 900 after shifting to the standing posture and the blood flow state of the living body 900 before shifting to the standing posture is below a predetermined value" It is a broad purpose that can include. On the other hand, it is estimated that the limit time during which a human being as an example of the living body 900 can keep breathing easily is also approximately 20 seconds. For this reason, the time required for measuring the blood flow state of the living body 900 after shifting to the standing posture (that is, the minimum respiratory stop time) is 10 to 20 seconds (or 15 to 20 seconds). It is preferable that the time falls within this range.

However, it goes without saying that the minimum respiratory stop time that falls within the range of 10 to 20 seconds (or 15 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.

In FIG. 2 again, after that, 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.

As a result of the determination in 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. In this case, 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.

On the other hand, as a result of the determination in 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.

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.

On the other hand, 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).

Here, with reference to FIG. 9, 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 will be described. 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.

As shown in FIG. 9, 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. In comparison, the text boxes indicating the status of the current evaluation test are different. In the example shown in FIG. 7, 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.

In FIG. 2 again, after that, 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). In consideration of calculation of parameters by the autonomic nerve function parameter calculation unit 141 in 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.

In the present embodiment, 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. Hereinafter, with reference to FIG. 10, 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.

As shown in FIG. 10, the average value of the blood flow rate of the living body 900 while maintaining the squatting posture is F _ave, and the minimum value of the blood flow rate after the transition to the standing posture is F _min . Then, the maximum decrease amount ΔF of the blood flow after the transition to the standing posture is F _ave −F _min . In this case, the blood volume decrease rate, which is an example of a parameter, is defined as ΔF / F _ave × 100 = (F _ave −F _min ) / F _ave × 100 [%]. Moreover, 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 [%].

Note that the parameters shown in FIG. 10 are merely examples, and other parameters calculated for the autonomic function and based on the blood flow state calculated by the calculation unit 11 may be used. Needless to say.

In FIG. 2 again, 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). For example, 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. Thus, 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. On the other hand, 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. Thereafter, when the evaluation results of both the blood volume reduction rate and the blood volume recovery time are “0 (good)”, 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)". Alternatively, 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).

Note that 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.

Thereafter, 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). For example, 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. However, 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.

Here, with reference to FIG. 11, an example of an image indicating the evaluation result output by the autonomic nervous function evaluation result output unit 142 in step S110 of FIG. 2 will be described. 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.

As shown in FIG. 11, 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. In the example shown in FIG. 11, 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. In the text box indicating the result of the 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.

In FIG. 2 again, after that, 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.

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.

On the other hand, as a result of the determination in 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.

As described above, according to the autonomic nerve function evaluation system 1 of the present embodiment, 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. Therefore, when 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. However, in this embodiment, as described above, 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. As a result, 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. In other words, the autonomic nervous function evaluation system 1 according to the present embodiment 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.

In addition, the autonomic nervous function evaluation system 1 may detect a change in breathing using frequency analysis of blood flow. In this case, the autonomic nerve evaluation system 1 may notify the fact and prompt the remeasurement (that is, the retest) when the respiratory change is detected after standing.

In addition, in this embodiment, 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). For example, if the living body 900 before taking the squatting posture has exercised with a relatively large amount of exercise, if there is little time for the living body 900 to maintain the squatting posture, the state immediately before shifting to the standing posture There is a possibility that the blood flow state of the living body 900 is not stable (that is, fluctuation due to movement has occurred). Therefore, when 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. In other words, when 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. Depending on the activity status, the evaluation results may vary. However, in the present embodiment, as described above, 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. That is, by maintaining the squatting posture for a minimum squatting time before the living body 900 shifts to the standing posture, the activity state of the living body 900 before taking the squatting posture is reduced to an extent that does not affect the evaluation result. Can do. Therefore, the disadvantage that the influence of the activity state of the living body 900 before taking the squatting posture is superimposed on the calculated blood flow state can be substantially or almost eliminated. As a result, 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. 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. In other words, the autonomic nervous function evaluation system 1 according to the present embodiment 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.

In the above description, 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. However, the instruction output unit 13 does not necessarily output a predetermined instruction. In this case, 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. In this case, the autonomic nervous function evaluation apparatus 10 may not include the instruction output unit 13.

In the above description, 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. . However, 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. It is not necessary to output a breath control instruction and a posture control instruction for instructing to stop breathing for the minimum breathing stop time (or more than the minimum breathing time) after standing up and standing up. In this case, the operation from 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. Alternatively, 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). While outputting the instruction, it is not necessary to output a 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. In this case, 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.

In the above description, 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. . However, 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. More specifically, for example, 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. Similarly, as long as 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. However, when using the alternative posture of the squatting posture or the 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.

Alternatively, instead of the operation of “transitioning from the squatting posture to the standing posture”, an operation in which the position of the head of the living body 900 moves from the lower side to the upper side with respect to the direction of gravity may be used. In this case, the posture when the position of the head of the living body 900 is relatively lower than the gravity direction 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”. More specifically, 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 changed. 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.

In addition, the present invention can be appropriately changed without departing from the gist or idea of the present invention that can be read from the claims and the entire specification, and an autonomic nervous function evaluation apparatus and method with such a change, and a computer program Is also included in the technical idea of the present invention.

DESCRIPTION OF SYMBOLS 10 Autonomic nerve function evaluation apparatus 11 Control part 12 Calculation part 121 Blood volume calculation part 122 Pulse calculation part 13 Instruction output part 131 Respiration control output part 132 Posture control output part 14 Evaluation part 141 Autonomic nerve function parameter calculation part 142 Autonomic nerve function evaluation Result output unit 20 Blood flow waveform output device 30 Display 40 Respiration detection device 900 Living body

Claims

(i) while stopping breathing, the first posture before applying the load for changing the blood flow state to the second posture after applying the load for changing the blood flow state, and (ii) the second posture Detecting means for detecting the blood flow state of the subject who continues to stop breathing for at least a predetermined time after shifting to
An autonomic nerve function evaluation apparatus comprising: an evaluation unit that evaluates the autonomic nerve function of the subject based on the blood flow state of the subject detected by the detection unit.
Instructing means to instruct the subject to shift from the first posture to the second posture while stopping breathing and to continue to stop breathing for at least the predetermined time after shifting to the second posture. In addition,
The detection means detects at least one of the blood flow state of the subject while the instruction by the instruction means is issued and the blood flow state of the subject after the instruction by the instruction means is issued, 2. The blood flow state of the subject that stops the breathing for at least the predetermined time after the transition from the first posture to the second posture and stops the breathing is detected while stopping breathing. The autonomic nervous function evaluation apparatus described in 1.
(I) Instructing the subject to shift from the first posture before applying the load that changes the blood flow state to the second posture after applying the load that changes the blood flow state while stopping breathing And (ii) instruction means for instructing to stop breathing for at least a predetermined time after shifting to the second posture;
Detection means for detecting at least one of the blood flow state of the subject while the instruction by the instruction means is issued and the blood flow state of the subject after the instruction by the instruction means is issued;
An autonomic nerve function evaluation apparatus comprising: an evaluation unit that evaluates the autonomic nerve function of the subject based on the blood flow state of the subject detected by the detection unit.
The detection means detects at least one of the blood flow state of the subject while the instruction by the instruction means is issued and the blood flow state of the subject after the instruction by the instruction means is issued, 4. The blood flow state of the subject is detected while shifting from the first posture to the second posture while stopping breathing and continuing to stop breathing for at least the predetermined time after shifting to the second posture. The autonomic nervous function evaluation apparatus described in 1.
The predetermined time is determined according to a time required for the blood flow state of the subject after the transition to the second posture to return to the blood flow state of the subject before the transition to the second posture. The autonomic nerve function evaluation apparatus according to claim 1, wherein
2. The autonomic nervous function evaluation apparatus according to claim 1, wherein the predetermined time is a time that falls within a range of 15 to 20 seconds.
The instruction means (i) breathes when the subject's blood flow state after the transition to the second posture has not returned to the subject's blood flow state before the transition to the second posture. (Ii) stop breathing after the subject's blood flow state after shifting to the second posture returns to the subject's blood flow state before shifting to the second posture The autonomic nervous function evaluation apparatus according to claim 2, wherein the subject is instructed to stop breathing for at least the predetermined time after shifting to the second posture by stopping the instruction to continue.
The autonomic nervous function evaluation apparatus according to claim 1, wherein the first posture is a squatting posture and the second posture is a standing posture.
A determination means for determining whether or not the subject stops breathing;
When it is determined by the determination means that the subject stops breathing, (i) the detection means detects the blood flow state of the subject, and (ii) the evaluation means is the blood of the subject. The autonomic nerve function evaluation apparatus according to claim 1, wherein the autonomic nerve function of the subject is evaluated based on a flow state.
(i) while stopping breathing, the first posture before applying the load for changing the blood flow state to the second posture after applying the load for changing the blood flow state, and (ii) the second posture A detection step for detecting a blood flow state of the subject who continues to stop breathing for at least a predetermined time after transition to
An autonomic nervous function evaluation method comprising: an evaluation step of analyzing the blood flow state of the subject detected by the detection step on the basis of the blood flow state of the subject before transitioning to the second posture.
(i) While stopping breathing, instructing to shift from the first posture before applying the load for changing the blood flow state to the second posture after applying the load for changing the blood flow state, and (ii) An instruction step for instructing to stop breathing for at least a predetermined time after shifting to the second posture;
A detection step of detecting at least one of the blood flow state of the subject while the instruction by the instruction step is issued and the blood flow state of the subject after the instruction by the instruction step is issued;
An autonomic nervous function evaluation method comprising: an evaluation step of analyzing the blood flow state of the subject detected by the detection step with reference to the blood flow state of the subject before transitioning to the second posture.
A computer program for causing a computer to function as the autonomic nervous function evaluation apparatus according to claim 1.