WO2015001961A1 - 電子血圧計 - Google Patents

電子血圧計 Download PDF

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Publication number
WO2015001961A1
WO2015001961A1 PCT/JP2014/066192 JP2014066192W WO2015001961A1 WO 2015001961 A1 WO2015001961 A1 WO 2015001961A1 JP 2014066192 W JP2014066192 W JP 2014066192W WO 2015001961 A1 WO2015001961 A1 WO 2015001961A1
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WO
WIPO (PCT)
Prior art keywords
envelope
blood pressure
pressure
pulse wave
amplitude
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2014/066192
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English (en)
French (fr)
Japanese (ja)
Inventor
広幸 木下
佐藤　博則
小椋　敏彦
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Omron Healthcare Co Ltd
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Omron Healthcare Co Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
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Publication date
Application filed by Omron Healthcare Co Ltd filed Critical Omron Healthcare Co Ltd
Priority to CN201480038109.2A priority Critical patent/CN105358049B/zh
Priority to DE112014003096.1T priority patent/DE112014003096T5/de
Publication of WO2015001961A1 publication Critical patent/WO2015001961A1/ja
Priority to US14/964,187 priority patent/US10130270B2/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording for evaluating the cardiovascular system, e.g. pulse, heart rate, blood pressure or blood flow
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A61B5/022—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
    • A61B5/02225—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers using the oscillometric method
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient; User input means
    • A61B5/742—Details of notification to user or communication with user or patient; User input means using visual displays

Definitions

  • the present invention relates to an electronic sphygmomanometer, and more particularly to an electronic sphygmomanometer that measures the blood pressure of a measurement site by an oscillometric method.
  • Patent Document 1 Japanese Patent Application Laid-Open No. 2006-247216
  • a pulse wave signal representing the pulse wave of the measurement site superimposed on the cuff pressure signal is taken out, and a blood pressure value (contraction) is determined by a predetermined algorithm using an envelope for the pulse wave signal amplitude (pulse wave amplitude) sequence.
  • systolic blood pressure including Systolic Blood Pressure
  • diastolic blood pressure Diastolic Blood Blood Pressure
  • blood pressure is not always constant, and changes every moment due to various factors such as physical influences such as exercise and breathing, mental influences such as tension and anxiety, and influences of the external environment such as temperature.
  • physical influences such as exercise and breathing
  • mental influences such as tension and anxiety
  • influences of the external environment such as temperature.
  • the envelope curve described above includes such respiratory changes.
  • the calculated blood pressure value varies depending on the respiratory cycle and the calculated blood pressure value may vary.
  • FIG. 13 and FIG. 14 show an envelope for the amplitude sequence of the pulse wave signal (original envelope before smoothing) when the respiratory cycle (that is, the cycle of respiratory change) is 4 seconds and 8 seconds, respectively.
  • EV O and envelope EV N smoothed by moving average using data of N points (N is a natural number) within a range of ⁇ 15 mmHg for each measurement point are shown.
  • Threshold levels Ths and Thd are set on the high-pressure side and the low-pressure side with respect to the maximum peak of those envelopes.
  • the envelope includes multiple respiratory changes.
  • the calculated pressure represents a substantially average blood pressure value.
  • the envelope includes only one respiratory change (in this example, the cuff pressure is about 100 mmHg).
  • the pressures at the points Xs ′ and Xd ′ at which the smoothed envelope EV N crosses the threshold levels Ths and Thd are the upper limit line EV U and the lower limit line V L taking into account respiratory changes, and the threshold levels Ths and Thd. Is off the center of the point that crosses For this reason, it cannot be said that the calculated pressure is an average blood pressure value.
  • the calculated blood pressure value may vary. For this reason, the test subject is repeating the measurement several times in an attempt to know the average blood pressure value as much as possible. As a result, there is a problem that the measurement of blood pressure is troublesome and burdensome for the subject.
  • an object of the present invention is to provide an electronic sphygmomanometer capable of calculating an average blood pressure value taking into account respiratory changes.
  • an electronic sphygmomanometer provides: An electronic sphygmomanometer that measures the blood pressure of a measurement site by an oscillometric method, A cuff pressure control unit capable of changing the pressure of the cuff attached to the measurement site; A pressure detector for detecting a cuff pressure signal representing the pressure of the cuff; Taking out a pulse wave signal representing a pulse wave of the measurement site superimposed on the cuff pressure signal, and acquiring a pulse wave amplitude string acquisition unit for acquiring a string of amplitudes indicated by the pulse wave signal; A first envelope creation unit that creates a first envelope connecting the amplitudes of the amplitude sequence acquired by the pulse wave amplitude sequence acquisition unit; An extreme point detection unit for detecting a local maximum point and a local minimum point in the first envelope; A maximum point envelope creation unit that creates a maximum point envelope connecting the amplitudes of the amplitude columns corresponding to the maximum points among the amplitude columns acquired
  • a threshold level setting unit Two pressure values at a point where the portion on the high pressure side of the maximum peak envelope and the maximum peak of the minimum point envelope crosses the first threshold level are obtained, and the average value of the two pressure values is obtained as the systolic blood pressure.
  • a systolic blood pressure calculator to calculate as Two pressure values at the point where the lower pressure side of the maximum peak envelope and the maximum peak of the minimum point envelope crosses the second threshold level are obtained, and the average value of the two pressure values is obtained as the diastolic blood pressure.
  • a diastolic blood pressure calculator that calculates as It is provided with.
  • the first envelope, the maximum point envelope, and the minimum point envelope are typically represented on a graph with the cuff pressure as the horizontal axis and the pulse wave amplitude as the vertical axis.
  • the cuff pressure control unit changes the pressure of the cuff attached to the measurement site during measurement.
  • the pressure detection unit detects a cuff pressure signal representing the cuff pressure.
  • the pulse wave amplitude sequence acquisition unit extracts a pulse wave signal representing the pulse wave of the measurement site superimposed on the cuff pressure signal, and acquires an amplitude sequence indicated by the pulse wave signal.
  • the first envelope creation unit creates a first envelope that connects the amplitudes of the amplitude sequence acquired by the pulse wave amplitude sequence acquisition unit.
  • the extreme point detection unit detects a local maximum point and a local minimum point in the first envelope.
  • the maximal point envelope creation unit creates a maximal point envelope connecting the amplitudes of the amplitude sequence corresponding to the maximal point among the amplitude sequences acquired by the pulse wave amplitude sequence acquisition unit.
  • the minimum point envelope creation unit creates a minimum point envelope connecting the amplitudes of the amplitude columns corresponding to the minimum points among the amplitude columns acquired by the pulse wave amplitude sequence acquisition unit.
  • the threshold level setting unit obtains a systolic blood pressure and a diastolic blood pressure in a first threshold level and a second threshold level at a predetermined ratio with respect to the maximum peak value in the first envelope. Is calculated and set.
  • the systolic blood pressure calculation unit calculates two pressure values at points where the portion on the high pressure side from the maximum peak of the maximum point envelope and the maximum peak of the minimum point envelope crosses the first threshold level (respectively, “two high pressures” The side pressure value is called “), and the average value of these two pressure values is calculated as the systolic blood pressure.
  • the diastolic blood pressure calculation unit calculates two pressure values at the points where the lower pressure side of the maximum peak envelope and the maximum peak of the minimum point envelope crosses the second threshold level (respectively “2 Two low pressure side pressure values "), and the average of these two pressure values is calculated as the diastolic blood pressure.
  • the difference between the maximum point envelope and the minimum point envelope includes respiratory variation. That is, the difference between the two high pressure side pressure values and the difference between the two low pressure side pressure values each include a respiratory variation. Therefore, the average value of the two high-pressure pressure values calculated by the systolic blood pressure calculation unit as systolic blood pressure, and the average value of the two low-pressure pressure values calculated by the diastolic blood pressure calculation unit as diastolic blood pressure are: It can be said that each is an average value in consideration of respiratory changes. Thus, according to this electronic sphygmomanometer, it is possible to calculate an average blood pressure value in consideration of respiratory change.
  • the calculated blood pressure values (systolic blood pressure and diastolic blood pressure) are displayed on, for example, a display (liquid crystal display or the like), the user (including the subject; the same applies hereinafter) takes into account the subject's respiratory change. You can know your average blood pressure. Therefore, the subject does not need to repeat the measurement multiple times. As a result, blood pressure can be easily measured for the subject, and the burden is reduced.
  • An electronic sphygmomanometer includes a display for displaying the calculated systolic blood pressure and diastolic blood pressure.
  • the user looks at the display content of the display, and thereby calculates the calculated systolic blood pressure and diastolic blood pressure, that is, the average blood pressure value taking into account the subject's respiratory fluctuation. Easy to recognize.
  • the electronic sphygmomanometer includes an envelope correction unit that corrects the first envelope by removing a singular point from the amplitude column in which the first envelope is generated. To do.
  • “singularity” is defined as follows. Among the amplitude columns in which the first envelope is generated, when a certain noted amplitude value is far beyond a predetermined reference from the amplitude values arranged before and after the amplitude, Let the noted amplitude be a singular point.
  • the envelope correction unit corrects the first envelope by removing the singular point from the amplitude column in which the first envelope is generated.
  • the extreme point detection unit, the maximum point envelope generation unit, the minimum point envelope generation unit, and the threshold level setting unit perform the above-described processing using the corrected first envelope.
  • the systolic blood pressure calculation unit and the diastolic blood pressure calculation unit calculate systolic blood pressure and diastolic blood pressure, respectively, using the results of these processes. Therefore, the accuracy of the calculated blood pressure value is increased.
  • a smoothing unit is provided for smoothing the maximum point envelope and the minimum point envelope.
  • the smoothing unit smoothes the maximum point envelope and the minimum point envelope, respectively. Accordingly, the systolic blood pressure calculation unit calculates the systolic blood pressure using the smoothed maximum point envelope and the smoothed minimum point envelope. The diastolic blood pressure calculation unit calculates the diastolic blood pressure using the smoothed maximum point envelope and the smoothed minimum point envelope. In this case, noises of the two high pressure side pressure values and the two low pressure side pressure values are reduced, and the accuracy of the calculated blood pressure values (the systolic blood pressure and the diastolic blood pressure) is increased.
  • FIG. 1 is a diagram showing a schematic block configuration of an electronic sphygmomanometer according to an embodiment of the present invention. It is a figure which shows the rough operation
  • FIG. 5A is a diagram illustrating a cuff pressure signal detected through the pressure sensor of the electronic sphygmomanometer.
  • FIG. 5A is a diagram illustrating a cuff pressure signal detected through the pressure sensor of the electronic sphygmomanometer.
  • 5B is a diagram illustrating a signal (HPF output) extracted from the cuff pressure signal through a high-pass filter. It is a figure which expands the signal of Drawing 5 (B) about a decompression process, and illustrates it as a pulse wave signal showing a pulse wave of a measured part. It is a figure which shows the row
  • FIG. 1 shows a schematic block configuration of an electronic sphygmomanometer (the whole is denoted by reference numeral 1) according to an embodiment of the present invention.
  • the sphygmomanometer 1 includes a cuff 20, a main body 10, a CPU (Central Processing Unit) 100 as a control unit, a display 50, a memory 51 as a storage unit, an operation unit 52, a power source, Part 53, pump 32, valve 33, and pressure sensor 31.
  • the main body 10 includes an oscillation circuit 310 that converts the output from the pressure sensor 31 into a frequency, a pump drive circuit 320 that drives the pump 32, and a valve drive circuit 330 that drives the valve 33, which are mounted on the main body 10. .
  • the display 50 includes a display, an indicator, and the like, and displays predetermined information according to a control signal from the CPU 100.
  • the operation unit 52 includes a power switch 52A that receives an input of an instruction for turning the power supply unit 53 on (ON) or OFF (off), a measurement switch 52B for receiving an instruction to start blood pressure measurement, and a measurement stop It has a stop switch 52C for receiving an instruction and a user selection switch 52D for selecting a user to be a subject from a plurality of registered users.
  • These switches 52 ⁇ / b> A, 52 ⁇ / b> B, 52 ⁇ / b> C, 52 ⁇ / b> D input an operation signal according to an instruction from the user to the CPU 100.
  • the memory 51 stores program data for controlling the sphygmomanometer 1, data used for controlling the sphygmomanometer 1, setting data for setting various functions of the sphygmomanometer 1, and blood pressure value measurement results Store data etc.
  • the memory 51 is used as a work memory when the program is executed.
  • the CPU 100 operates as a cuff pressure control unit according to a program for controlling the sphygmomanometer 1 stored in the memory 51, and performs control for driving the pump 32 and the valve 33 in accordance with an operation signal from the operation unit 51. . Further, the CPU 100 calculates a blood pressure value based on a signal from the pressure sensor 31 and controls the display device 50 and the memory 51.
  • the power supply unit 53 supplies power to the CPU 100, the pressure sensor 31, the pump 32, the valve 33, the display 50, the memory 51, the oscillation circuit 310, the pump drive circuit 320, and the valve drive circuit 330.
  • the pump 32 supplies air to the fluid bag 22 in order to pressurize the pressure (cuff pressure) in the fluid bag 22 contained in the cuff 20.
  • the valve 33 is opened and closed in order to discharge or enclose the air in the fluid bag 22 to control the cuff pressure.
  • the pump drive circuit 320 drives the pump 32 based on a control signal given from the CPU 100.
  • the valve drive circuit 330 opens and closes the valve 33 based on a control signal given from the CPU 100.
  • the pressure sensor 31 and the oscillation circuit 310 function as a pressure detection unit that detects the pressure of the cuff.
  • the pressure sensor 31 is, for example, a piezoresistive pressure sensor, and is connected to the fluid bag 22 contained in the pump 32, the valve 33, and the cuff 20 via the cuff air tube 39.
  • the oscillation circuit 310 oscillates based on an electrical signal value based on a change in electrical resistance due to the piezoresistive effect from the pressure sensor 31 and outputs a frequency signal having a frequency corresponding to the electrical signal value of the pressure sensor 31 to the CPU 100. Output to.
  • a cuff When measuring blood pressure according to a general oscillometric method, the following operations are generally performed. That is, a cuff is wound around the measurement site (arm or the like) of the subject in advance, and at the time of measurement, the pump / valve is controlled so that the cuff pressure is higher than the maximum blood pressure and then gradually reduced. In the process of reducing the pressure, the cuff pressure is detected by a pressure sensor, and the fluctuation of the arterial volume generated in the artery at the measurement site is extracted as a pulse wave signal.
  • systolic blood pressure systolic blood pressure
  • diastolic blood pressure diastolic blood pressure
  • the blood pressure value of the subject is measured by the CPU 100 by the oscillometric method according to the flow of FIG.
  • the sphygmomanometer 1 starts blood pressure measurement as shown in FIG.
  • the CPU 100 initializes the processing memory area and outputs a control signal to the valve drive circuit 330.
  • the valve drive circuit 330 opens the valve 33 and exhausts the air in the fluid bag 22 of the cuff 20. Subsequently, control for adjusting 0 mmHg of the pressure sensor 31 is performed.
  • the CPU 100 When the blood pressure measurement is started, the CPU 100 first closes the valve 33 via the valve drive circuit 330 and then drives the pump 32 via the pump drive circuit 320 to perform control to send air to the fluid bag 22. . As a result, the fluid bag 22 is inflated and the cuff pressure is gradually increased (step ST101).
  • step ST102 When the cuff pressure is increased and reaches a predetermined pressure (YES in step ST102), the CPU 100 stops the pump 32 via the pump drive circuit 320, and then gradually turns the valve 33 via the valve drive circuit 330. Control to release. Thereby, the fluid bag 22 is contracted and the cuff pressure is gradually reduced (step ST103).
  • the predetermined pressure is a pressure sufficiently higher than the systolic blood pressure of the subject (for example, the systolic blood pressure + 30 mmHg), and is stored in the memory 51 in advance or the CPU 100 performs the systole during the pressurization of the cuff pressure.
  • the blood pressure is estimated and determined by a predetermined calculation formula (see, for example, JP-A-2001-70263).
  • a target target pressure reduction speed is set during the pressurization of the cuff, and the CPU 100 controls the opening degree of the valve 33 so as to be the target pressure reduction speed (see the same publication).
  • the pressure sensor 31 detects a cuff pressure signal (indicated by the symbol Pc) indicating the pressure of the cuff 20 through the cuff 20. Based on the cuff pressure signal Pc, the CPU 100 applies blood pressure values (systolic blood pressure and diastolic blood pressure) by applying an algorithm described later by the oscillometric method (step ST104).
  • the calculation of the blood pressure value is not limited to the decompression process, and may be performed in the pressurization process.
  • the CPU 100 displays the calculated blood pressure value on the display device 50 (step ST106), and performs control to store the blood pressure value in the memory 51 (step ST107).
  • the CPU 100 opens the valve 33 via the valve drive circuit 330 and performs control to exhaust the air in the fluid bag 22 of the cuff 20 (step ST108).
  • FIG. 3 exemplifies elements configured by the CPU 100 (software) of the electronic sphygmomanometer 1 for calculating the blood pressure value.
  • the elements for calculating the blood pressure value are the pulse wave amplitude string acquisition unit 61, the first envelope creation unit 62, the second envelope creation unit 64, the blood pressure value calculation unit 65, the extreme points.
  • a detection unit 63, a maximum point envelope generation unit 64, a minimum point envelope generation unit 65, a threshold level setting unit 66, a systolic blood pressure calculation unit 67, and a diastolic blood pressure calculation unit 68 are included.
  • FIG. 4 shows the flow of processing when the blood pressure value is calculated using these elements in FIG.
  • the envelope correction unit 71 and the smoothing processing unit 72 indicated by a broken line frame in FIG. 3 are excluded.
  • the pulse wave amplitude train acquisition unit 61 in FIG. 3 receives the cuff pressure signal Pc detected by the pressure sensor 31 and superimposes it on the cuff pressure signal Pc, as shown in FIG. A pulse wave signal SM representing the pulse wave of the measurement site is extracted.
  • the cuff pressure signal Pc corresponds to a pressure that rises (pressurization process) or decreases (decompression process) substantially linearly with time. It is a signal on which a fluctuation component accompanying an arterial volume change is superimposed.
  • the pulse wave amplitude train acquisition unit 61 extracts a fluctuation component (HPF output) as shown in FIG. 5B from the cuff pressure signal Pc through a high pass filter (HPF), and outputs it as a pulse wave signal SM as shown in FIG. To do.
  • the pulse wave signal SM starts to increase in about 12 seconds from the start of the measurement, reaches a maximum in about 16 seconds, and increases to about 16 seconds. Almost disappeared in 20 seconds.
  • the pulse wave amplitude string acquisition unit 61 acquires a string AL of the amplitude indicated by the pulse wave signal SM (hereinafter referred to as “pulse wave amplitude” as appropriate).
  • the pulse wave amplitude column AL has a cuff pressure as a horizontal axis and an amplitude (peak value) AM 1 , AM 2 ,..., AM i ,. Represented as:
  • the first envelope creating unit 62 in FIG. 3 performs the operation on the pulse wave amplitude sequence AL acquired by the pulse wave amplitude sequence acquisition unit 61.
  • a first envelope EV1 that connects the amplitudes is created.
  • the first envelope EV1 has irregularities due to respiratory changes.
  • FIG. 8 shows, for reference, when the subject's respiratory cycle is known, an amplitude column is generated for each phase ⁇ 1, ⁇ 2,..., ⁇ 5 of the respiratory cycle from the pulse wave amplitude column AL of the pulse wave signal SM.
  • envelopes EV ⁇ 1, EV ⁇ 2,..., EV ⁇ 5 are respectively obtained for the amplitude columns for the phases ⁇ 1, ⁇ 2,.
  • the phases ⁇ 1, ⁇ 2,..., ⁇ 5 are different from each other by 60 °, where one breathing cycle is 360 °.
  • EV ⁇ 5 corresponds to an envelope when the respiratory variation shows a maximum
  • EV ⁇ 2 corresponds to an envelope when the respiratory change shows a minimum.
  • the upper limit line and lower limit for the respiratory fluctuation are taken into account when the respiratory fluctuation shows the maximum and the envelope when the respiratory fluctuation shows the minimum, respectively. Can be considered a line.
  • the pole detection unit 63 in FIG. 3 detects the maximum point Lmax and the minimum point Lmin in the first envelope EV1, respectively, as shown in FIG.
  • the maximum point Lmax and the minimum point Lmin each form a row of a plurality of points.
  • the maximal point envelope creation unit 64 in FIG. 3 applies to the amplitude column corresponding to the maximal point Lmax in the pulse wave amplitude sequence AL acquired by the pulse wave amplitude sequence acquisition unit 61. As shown in FIG. 9, a maximum point envelope EVmax connecting the amplitudes is created.
  • the minimum point envelope creation unit 65 in FIG. 3 applies the amplitude sequence corresponding to the minimum point Lmin in the pulse wave amplitude sequence AL acquired by the pulse wave amplitude sequence acquisition unit 61 to FIG. As shown in the figure, a minimum point envelope EVmin connecting these amplitudes is created.
  • the threshold level setting unit 66 in FIG. 3 obtains the systolic blood pressure BPsys and the diastolic blood pressure BPdia, respectively, in proportion to the value of the maximum peak EV1P in the first envelope EV1.
  • the first threshold level Ths and the second threshold level Thd are calculated and set.
  • the first threshold level Ths is set to 40% of the value of the maximum peak EV1P
  • the second threshold level Thd is set to 50% of the value of the maximum peak EV1P.
  • the systolic blood pressure calculation unit 67 in FIG. 3 is on the higher pressure side than the maximum peaks EVmaxP and EVminP of the maximum point envelope EVmax and the minimum point envelope EVmin.
  • Two pressure values Pc1 and Pc2 at a point where the portion crosses the first threshold level Ths are obtained, and an average value (Pc1 + Pc2) / 2 of the two pressure values is calculated as the systolic blood pressure BPsys.
  • the maximum point envelope EVmax and the minimum point envelope EVmin correspond to the upper limit line and the lower limit line of respiratory change, respectively. Therefore, it can be said that the average value (Pc1 + Pc2) / 2 of the two high-pressure side pressure values and the average value (Pc3 + Pc4) / 2 of the two low-pressure side pressure values are average values taking into account respiratory changes.
  • this electronic sphygmomanometer 1 it is possible to calculate an average blood pressure value in consideration of respiratory change.
  • the calculated blood pressure values (systolic blood pressure BPsys and diastolic blood pressure BPdia) are displayed on the display 50. Therefore, the user can know the average blood pressure value in consideration of the subject's respiratory change. Therefore, the subject does not need to repeat the measurement multiple times. As a result, blood pressure can be easily measured for the subject, and the burden is reduced.
  • the first threshold level Ths is set to 40% of the value of the maximum peak EV1P
  • the second threshold level Thd is set to 50% of the value of the maximum peak EV1P.
  • the present invention is not limited to this.
  • the ratio of the threshold level to the value of the maximum peak EV1P is changed so that the first threshold level Ths is 50% of the value of the maximum peak EV1P, and the second threshold level Thd is 70% of the value of the maximum peak EV1P. It is good.
  • the threshold level ratio may be set based on the value of the maximum peak EV1P in the first envelope EV1, the value of the maximum peak EVmaxP in the maximum point envelope EVmax or the maximum peak EVminP in the minimum point envelope EVmin.
  • the threshold level ratio may be set based on the value of.
  • a difference (Pc1 ⁇ Pc2) between the two high pressure side pressure values Pc1 and Pc2 with respect to the calculated systolic blood pressure BPsys is set in a predetermined ratio (for example, in a range of several to 10%).
  • a difference (Pc3 ⁇ Pc4) between the two low pressure values Pc3 and Pc4 with respect to the calculated diastolic blood pressure BPdia is a predetermined ratio (for example, several to 10%). If it exceeds the threshold value (set in the range of%), the CPU 100 will display the calculated blood pressure values (systolic blood pressure BPsys and diastolic blood pressure BPdia) on the display 50. You may be alerted by displaying the message “Recommended”.
  • this may be notified by, for example, an alarm sound.
  • Such notification makes it possible for the user to easily recognize that there is a possibility that correct measurement has not been performed, and that it is necessary to perform re-measurement after a certain time.
  • the blood pressure value is calculated using all the elements in FIG. That is, the pulse wave amplitude sequence acquisition unit 61, the first envelope generation unit 62, the second envelope generation unit 64, the blood pressure value calculation unit 65, the extreme point detection unit 63, the maximum point envelope already described in the first example.
  • the line creation unit 64, the minimum point envelope creation unit 65, the threshold level setting unit 66, the systolic blood pressure calculation unit 67, and the diastolic blood pressure calculation unit 68 an envelope correction unit indicated by a dashed frame in FIG. 71 and the smoothing processing unit 72 function.
  • FIG. 10 shows the flow of processing when blood pressure values are calculated using all the elements in FIG.
  • the process of FIG. 10 has a flow generally similar to the process of FIG.
  • processing for performing correction (singular point removal correction) RA for removing singular points from the amplitude column AL in which the first envelope EV1 is generated by the envelope correction unit 71, and a smoothing processing unit 72 processing for performing smoothing ALS1 and ALS2 on the maximum point envelope EVmax and the minimum point envelope EVmin, respectively, is added.
  • correction singular point removal correction
  • FIG. 11 exemplifies a correction RA (singular point removal correction) RA method for removing singular points from the amplitude column AL in which the first envelope EV1 is created.
  • This singular point removal correction RA is intended to remove a non-periodic component different from the respiratory fluctuation caused by the body movement of the subject during blood pressure measurement from the first envelope EV1.
  • the amplitude of a certain noticed amplitude (hereinafter referred to as AM i ) is an amplitude (these are referred to as AM) arranged before and after the amplitude. i-1 and AM i + 1 )), the noticed amplitude AM i is defined as a singular point. Specifically, it is determined whether or not each point corresponding to each amplitude is a singular point by the following three equations. First, the amplitude AM i is AM i ⁇ (AM i ⁇ 1 + AM i + 1 ) / 4 (1) If it satisfies, the amplitude AM i is set as a singular point. The right side of the equation (1) has a meaning of 0.5 times the average value of the amplitudes AM i ⁇ 1 and AM i + 1 arranged in front and rear.
  • the amplitude AM i is (AM i ⁇ 1 + AM i + 1 ) / 4 ⁇ AM i ⁇ 3 (AM i ⁇ 1 + AM i + 1 ) / 4. ... (2) If it satisfies, the amplitude AM i is not a singular point.
  • the right side of the equation (2) has a meaning of 1.5 times the average value of the amplitudes AM i ⁇ 1 and AM i + 1 arranged in front and rear.
  • the amplitude AM i is 3 (AM i ⁇ 1 + AM i + 1 ) / 4 ⁇ AM i (3) If it satisfies, the amplitude AM i is set as a singular point.
  • the amplitude AM 6 is determined as a singular point.
  • the amplitude AM 15 is 3 (AM 14 + AM 16 ) / 4 ⁇ AM 15 and satisfies the formula (3), so that it is determined as a singular point.
  • the amplitude column AL it is determined that the remaining amplitude is not a singular point.
  • the amplitude AM i is replaced by the average value (AM i ⁇ 1 + AM i + 1 ) / 2 of the amplitudes AM i ⁇ 1 and AM i + 1 arranged in front and rear.
  • the first envelope EV1 is corrected smoothly (interpolation method). Note that the amplitude AM i may be simply removed.
  • the envelope after this singular point removal correction RA is represented as a second envelope EV2.
  • this singular point removal correction RA non-periodic components different from respiratory fluctuations due to the body movement of the subject during blood pressure measurement are removed from the first envelope EV1. be able to.
  • the second envelope EV2 after this singular point removal correction RA is used. This increases the accuracy of the calculated blood pressure value.
  • FIG. 12 shows how the systolic blood pressure and the diastolic blood pressure are calculated using the smoothed maximum point envelope EVmaxS and the smoothed minimum point envelope EVminS.
  • these smoothed maximum point envelope EVmaxS and minimum point envelope EVminS are smoothed ALS1, such as a known moving average, respectively, with respect to the maximum point envelope EVmax and the minimum point envelope EVmin. It can be obtained by applying ALS2 (see, for example, JP-A-05-317274).
  • the threshold level setting unit 66 in FIG. 3 has a predetermined ratio with respect to the value of the maximum peak EV2P in the second envelope EV2.
  • the first threshold level Ths ′ and the second threshold level Thd ′ are calculated and set.
  • the first threshold level Ths ′ is set to 40% of the value of the maximum peak EV2P
  • the second threshold level Thd ′ is set to 50% of the value of the maximum peak EV2P.
  • the systolic blood pressure calculation unit 67 in FIG. 3 is on the higher pressure side than the maximum peaks EVmaxSP and EVminSP of the smoothed maximum point envelope EVmaxS and the minimum point envelope EVminS.
  • Two pressure values Pc1 ′ and Pc2 ′ at a point where the portion crosses the first threshold level Ths ′ are obtained, and an average value (Pc1 ′ + Pc2 ′) / 2 of the two pressure values is calculated as the systolic blood pressure BPsys ′.
  • the measurement site is the arm, but is not limited thereto.
  • the part to be measured may be a wrist or a leg.
  • the electronic sphygmomanometer of the present invention may not only measure blood pressure values but also measure other biological information such as a pulse rate.

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PCT/JP2014/066192 2013-07-01 2014-06-18 電子血圧計 Ceased WO2015001961A1 (ja)

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