WO2015008427A1

WO2015008427A1 - Circulatory organ function determination device

Info

Publication number: WO2015008427A1
Application number: PCT/JP2014/003199
Authority: WO
Inventors: 朋哉日下部; 和宏井出
Original assignee: パナソニックＩｐマネジメント株式会社
Priority date: 2013-07-16
Filing date: 2014-06-16
Publication date: 2015-01-22
Also published as: JP2015019692A; JP6226289B2; CN105377123B; CN105377123A

Abstract

A circulatory organ function determination device is provided with: a measurement unit (2) that automatically measures the blood vessel hardness of a subject (h) with an interval between measurements; and a determination unit (3) that determines the functional status of a circulatory organ of the subject (h) from the state of change in the measured value of blood vessel hardness that is measured by the measurement unit (2). The circulatory function determination device is additionally provided with an output unit (4) that outputs the determination result of the functional status of the circulatory organ by the determination unit (3). By using a circulatory organ function determination device that is configured in this manner, it is possible to determine the functional state of the circulatory organ of the subject (h) from the state of change in the measured value of blood vessel hardness because the blood vessel hardness of the subject (h) is automatically measured with an interval between measurements.

Description

Cardiovascular function judgment device

The present invention relates to a cardiovascular function determination device.

As a circulatory function determination device, a device that determines the functional state of the circulatory organ of the subject based on the measurement result of the blood pressure after measuring the blood pressure of the subject is known. Patent Document 1 discloses that the blood pressure of a measurement subject is measured a plurality of times every predetermined time.

Japanese Patent Laid-Open No. 2-55033

By the way, in recent years, it has been found that vascular hardness, which is an index independent of blood pressure, is also closely related to the functional state of the circulatory organ.
An object of the present invention is to provide a circulatory function determination device that can determine the functional state of the circulatory system based on the blood vessel hardness.

An apparatus for determining circulatory function according to one aspect includes a measurement unit that automatically measures a vascular hardness of a measurement subject at intervals, and a state of fluctuation in a measurement value of the vascular hardness measured by the measurement unit. A determination unit that determines a functional state of the circulatory organ of the measurement subject; and an output unit that outputs a determination result of the functional state of the circulatory organ by the determination unit.

In this circulatory function judgment device, the blood vessel hardness of the subject is automatically measured at intervals, so the functional state of the subject's circulatory device is determined from the state of fluctuation of the measured values of the blood vessel hardness. Can be determined.

According to this circulatory function determination apparatus, the functional state of the circulatory system can be determined based on the blood vessel hardness.

The block diagram which shows the structure of a circulatory organ function determination apparatus. The time chart which shows the raise aspect of the compression pressure at the time of measuring vascular hardness and blood pressure at intervals. The graph which shows the raise aspect of the compression pressure at the time of measuring vascular hardness and blood pressure. The graph which shows transition of the amplitude of a pulse wave with respect to the change of the cuff pressure during a pulse wave detection period. The graph which shows the transition of the area of each pulse wave which arises synchronizing with the change of the cuff pressure during a pulse wave detection period. The graph which plotted the data pair which combined the cuff pressure and the area of a pulse wave. (A) is a graph which shows the relationship between a cuff pressure and the area of a pulse wave, (b) is a graph which shows the relationship between a cuff pressure and a pulse wave area accumulation addition value. The graph which shows the relationship between a cuff pressure and a normalization accumulation addition value. The schematic diagram which shows the display area of a display part. The graph which shows the increase aspect of the compression pressure at the time of measuring vascular hardness and blood pressure, and the transition of the area of a pulse wave. The block diagram which shows the structure of a circulatory organ function determination apparatus. The time chart which shows the raise aspect of the compression pressure at the time of measuring vascular hardness and blood pressure at intervals. The graph which shows the envelope obtained from the area of each pulse wave during a pulse wave detection period. The graph which shows the envelope obtained from the area of each pulse wave during a pulse wave detection period. The time chart which shows the example of transition of the blood pressure and blood vessel hardness with time progress at the time of exercise | movement and a rest. The schematic diagram which shows the display area of a display part.

(First embodiment)
A first embodiment of the cardiovascular function determination device will be described below with reference to FIGS.
The cardiovascular function determination device shown in FIG. 1 can be worn by the person to be measured h, and is a portable device that does not interfere with the daily actions of the person to be measured h wearing the device. .

This circulatory organ function determination device includes a measuring unit 2 that automatically measures a blood vessel hardness of a person to be measured h at intervals, and a state of fluctuation in a measured value of the blood vessel hardness measured by the measuring unit 2 The determination unit 3 for determining the functional state of the cardiovascular device of the person to be measured h. Furthermore, the circulatory function determination apparatus also includes an output unit 4 that outputs a determination result of the functional state of the circulator by the determination unit 3. In the circulatory organ function determination device configured as described above, the blood vessel hardness of the person to be measured h is automatically measured at intervals, and therefore the person to be measured h is determined from the state of variation in the measured values of the blood vessel hardness. The functional state of the cardiovascular device can be determined.

The measurement unit 2 of the circulatory function determination device is provided with a bag-like cuff 5 that can be worn while being wrapped around the left upper arm that is a part of the body of the person to be measured h. Further, the measurement unit 2 is provided with a pressure control unit 7 and a pressure detection unit 8 connected to the cuff 5 via the tube 6. The pressure control unit 7 includes a pump and an exhaust valve connected to the tube 6, and can supply air to the cuff 5 through driving the pump and discharge air from the cuff 5 through opening the exhaust valve. It has become. The pressure control unit 7 changes the pressure (compression pressure P) inside the cuff 5 by controlling the supply and discharge of air to the cuff 5. On the other hand, the pressure detection unit 8 includes a pressure sensor that detects the compression pressure P, and converts the compression pressure P detected by the pressure sensor into a pressure signal composed of a digital signal by A / D conversion.

The measurement unit 2 is also provided with a pulse wave detection unit 9 and a blood pressure calculation unit 10 that receive the pressure signal output from the pressure detection unit 8. The pulse wave detection unit 9 is for detecting the amplitude of the pulse wave corresponding to the heartbeat generated at the portion (left upper arm) compressed by the cuff 5 in the person to be measured based on the pressure signal from the pressure detection unit 8. It is. The pulse wave detection unit 9 filters the pressure signal from the pressure detection unit 8 to remove a predetermined frequency component such as a direct current component from the pressure signal, thereby generating a pulse wave signal. The pulse wave detection unit 9 detects the amplitude of the pulse wave from the generated pulse wave signal, and stores the detected amplitude in the storage unit 11 in association with the compression pressure P. On the other hand, the blood pressure calculation unit 10 uses a predetermined algorithm such as an oscillometric method from the relationship between the pressure signal output from the pressure detection unit 8 and the amplitude value of the pulse wave detected by the pulse wave detection unit 9. The estimated values of the maximum blood pressure, the minimum blood pressure, and the average blood pressure of the person to be measured h are calculated. The blood pressure calculation unit 10 stores the calculated maximum blood pressure, minimum blood pressure, and average blood pressure estimated values in the storage unit 11. In addition, the measurement of the blood pressure of the person to be measured h in the measurement unit 2 is realized by calculating the estimated values of the maximum blood pressure, the minimum blood pressure, and the average blood pressure in the blood pressure calculation unit 10 as described above.

The measurement unit 2 is also provided with a data analysis unit 12 that analyzes the data stored in the storage unit 11 to determine the blood vessel hardness of the person to be measured h. The data analysis unit 12 outputs information regarding the obtained blood vessel hardness and information regarding the blood pressure stored in the storage unit 11 to the determination unit 3. In addition, the measurement of the blood vessel hardness of the person to be measured h by the measurement unit 2 is realized by obtaining the blood vessel hardness by the data analysis unit 12 as described above. Further, the measurement of the blood vessel hardness by the measurement unit 2 is performed a plurality of times during a continuous period of 24 hours or more. Further, every time the blood vessel hardness is measured by the measuring unit 2, the blood pressure is also measured by the measuring unit 2. Then, every time the blood vessel hardness is measured by the measuring unit 2 a plurality of times, the data analyzing unit 12 outputs information on the blood vessel hardness and information on the blood pressure to the determining unit 3.

The determination unit 3 of the circulatory function determination apparatus receives information on the measured blood vessel hardness and blood pressure from the data analysis unit 12 every time the measurement unit 2 measures the blood vessel hardness and blood pressure. The determination part 3 determines the magnitude of the disease risk of the circulatory organ as the functional state of the circulatory organ of the person h to be measured from the state of fluctuation of the measured values of the vascular hardness. Then, when the determination unit 3 determines the functional state of the circulatory organ (the magnitude of the disease risk) in this way, the determination result is output to the display unit 13 of the circulatory organ function determination device by the output unit 4. The display unit 13 has a display area 13a defined by blood vessel hardness and blood pressure, and displays the determination result of the degree of cardiovascular disease risk using the display area 13a.

Next, the operation of the circulatory function determination device will be described with reference to FIGS.
The cardiovascular function determination device is worn in a portable state with respect to the person to be measured h (FIG. 1), and the cuff 5 of the apparatus is wound around the upper arm of the person to be measured h. Then, the circulatory organ function determination device automatically performs measurement by the measurement unit 2 when a predetermined time (for example, 8:00, 12:00, 21:00) in the morning, noon, and night comes during a continuous period of 24 hours or more. In particular, the blood vessel hardness and blood pressure of the person to be measured h are measured. Thereby, the blood vessel hardness and blood pressure of the person to be measured h are automatically measured at intervals during a continuous period of 24 hours or more.

The measurement of the blood vessel hardness and blood pressure at the predetermined time is realized by temporarily increasing the compression pressure P by the cuff 5 with respect to the left upper arm portion of the person to be measured h by the pressure control unit 7, It is performed during the period of temporary increase of the compression pressure P. Therefore, as shown in FIG. 2, the compression pressure P is temporarily increased at a predetermined time for measuring the blood vessel hardness and blood pressure.

FIG. 3 shows how the compression pressure P changes during the temporary increase of the compression pressure P for measuring the blood vessel hardness and blood pressure. At this time, the pressure control unit 7 increases the compression pressure P to the first pressure PA, and then decreases the increase speed of the compression pressure P. Furthermore, the pressure control unit 7 increases the compression pressure P to the second pressure PB higher than the first pressure PA, and then decreases the compression pressure P. The first pressure PA and the second pressure PB are set according to general blood pressure. Therefore, during the period in which the pressure control unit 7 increases the compression pressure P from the first pressure PA to the second pressure PB (pulse wave detection period TX), the compression pressure P changes to a pulse wave corresponding to the heartbeat of the measurement subject h. It fluctuates with it.

During the pulse wave detection period TX, the pressure (cuff pressure C) acting on the upper arm of the person h to be measured by the cuff 5 gradually changes from the low pressure side to the high pressure side of the horizontal axis in FIG. The cuff pressure C here corresponds to a value obtained by removing the influence of the pulse wave from the compression pressure P shown in FIG. In other words, the change of the compression pressure P with respect to the cuff pressure C when the cuff pressure C gradually changes from the low pressure side to the high pressure side as described above corresponds to the pulse wave. At this time, the pulse wave signal generated by the pulse wave detector 9 corresponds to the change in the compression pressure P with respect to the cuff pressure C that gradually changes from the low pressure side to the high pressure side as described above.

When the cuff pressure C changes from the low pressure side to the high pressure side during the pulse wave detection period TX, the amplitude of the pulse wave detected from the pulse wave signal by the pulse wave detection unit 9 is a pulse wave (corresponding to the heartbeat ( The transition is made as indicated by the solid line in FIG. 4 according to W1, W2,..., Wn) of FIG. The transition of the amplitude of the pulse wave at this time corresponds to the change mode of the pulse wave during the change of the cuff pressure C from the low pressure side to the high pressure side. Then, from the relationship between the amplitude value of the pulse wave detected by the pulse wave detector 9 and the pressure signal output from the pressure detector 8, the blood pressure calculator 10 determines the blood pressure of the person to be measured h.

4, the areas A1, A2,..., An of the pulse waves W1, W2,..., Wn represent the magnitudes of the corresponding pulse waves W1, W2,. The areas A1, A2,..., An are calculated by adding the pulse wave signals in the period in which the pulse waves W1, W2,. The data analysis unit 12 includes the cuff pressures C (pressures P1, P2,..., Pn) when the pulse waves W1, W2,..., Wn are generated during the pulse wave detection period TX, and the pulse waves W1, W2. ,..., Wn areas A1, A2,..., An are combined and handled as a data pair of pressure and area.

FIG. 5 shows the transition of the areas A1, A2,..., An of the pulse waves W1, W2,..., Wn generated in synchronization with the change of the cuff pressure C from the low pressure side to the high pressure side during the pulse wave detection period TX. ing. FIG. 6 shows the data pairs in which the pressures P1, P2,..., Pn and the areas A1, A2,..., An are combined, with the cuff pressure set on the horizontal axis and the pulse wave area on the vertical axis. It is plotted on the graph. From the relationship between the cuff pressure C and the areas A1, A2,..., An shown in FIG. 5, an envelope L1 as shown by a solid line in the figure is obtained. This envelope L1 draws a chevron shape according to the minute change (slow increase) of the cuff pressure C during the pulse wave detection period TX. The shape of the envelope L1 shows a characteristic change for each individual, and further shows a change depending on the blood vessel hardness of each individual.

The data analysis unit 12 is obtained by cumulatively adding the areas A1, A2,..., An of the pulse waves W1, W2,..., Wn shown in FIG. Pulse wave area cumulative addition values B1, B2,..., Bn are calculated. The data analysis unit 12 calculates each cuff pressure C (pressure P1, P2,..., Pn) when the pulse waves W1, W2,..., Wn are generated during the pulse wave detection period TX, and the pulse wave area accumulated addition value. B1, B2,..., Bn are combined to form a data pair of the pressure and the pulse wave area cumulative addition value. Further, the data analysis unit 12 adds the pulse wave area accumulated addition value Bn when the areas A1, A2,... An of all the pulse waves W1, W2,. The pulse wave area cumulative addition values B1, B2,..., Bn are normalized.

FIG. 8 shows the relationship between the normalized cumulative addition values D1, D2,..., Dn obtained by this normalization and the corresponding cuff pressures C (pressures P1, P2,... Pn). As can be seen from FIG. 8, from the relationship between the cuff pressure C and the normalized cumulative addition values D1, D2,..., Dn, an envelope L2 as shown by the solid line in FIG. As the cuff pressure C changes from the low-pressure side to the high-pressure side, the envelope L2 increases rapidly after first continuing a small increase, and the degree of increase gradually decreases after the rapid increase.

The transition of the envelope L2 reflects the change in the blood vessel volume during the pulse wave detection period TX. For example, when the blood vessel is hard, the change in the blood vessel volume with respect to the change in the cuff pressure C tends to be smaller than when the blood vessel is hard. Reflecting this tendency, the envelope L2 is compared with the case where the blood vessel is hard compared with the soft case. Therefore, it is difficult to change with respect to the change of the cuff pressure C. The data analysis unit 12 obtains the blood vessel hardness of the person h to be measured from the relationship between the cuff pressure represented by the envelope L2 in FIG. 8 and the normalized cumulative addition value using a predetermined algorithm. For example, the change amount of the normalized cumulative addition value based on the change per unit amount of the cuff pressure C, that is, the slope of the envelope L2 in FIG. 8 is obtained, and the vascular stiffness of the subject h is measured based on the slope of the envelope L2. I ask for it.

As can be seen from FIG. 8, the slope of the envelope L2 differs depending on the magnitude of the cuff pressure C. This is because the constituent ratios of the constituent components (elastin, collagen, etc.) of the inner membrane, the inner membrane, and the outer membrane constituting the blood vessel wall are different for each membrane, and the degree of involvement in the extensibility of the blood vessels of each membrane. It is related to the change depending on the magnitude of the cuff pressure C. Incidentally, in normal blood vessels, elastin, which is a component with low rigidity, increases in the media, while collagen, which is a component with high rigidity, increases in the outer membrane. Further, in the region where the cuff pressure is low, the media is mainly involved in the extensibility of the blood vessel, while in the region where the cuff pressure is high, the adventitia is mainly involved in the extensibility of the blood vessel. Accordingly, the slope of the envelope L2 is obtained for each pressure region such as a low region, a medium region, and a high region of the cuff pressure, and the blood vessel hardness is obtained for each of these gradients, so that any portion of each film in the blood vessel is obtained. It becomes possible to examine in detail whether the is cured.

When the data analysis unit 12 obtains the blood vessel hardness of the person to be measured h, in other words, the measurement of the blood vessel hardness by the measurement unit 2 is performed during a continuous period of 24 hours or more at a predetermined time. Done automatically. Furthermore, when measuring the blood vessel hardness, the blood pressure of the person to be measured h is also measured. When the blood vessel hardness is measured every time a predetermined time is reached, the determination unit 3 determines the functional state of the circulatory organ of the measurement subject h (the circulatory device Determine the magnitude of disease risk). Specifically, the determination unit 3 determines whether (A) the blood pressure is within the normal range and (B) the blood vessel hardness is less than the reference value S1 for each set of the blood vessel hardness and blood pressure measured together. It is determined whether or not. In the determination of (A) above, if the blood pressure is less than the reference value S2, it is determined that the blood pressure is within the normal range, whereas if the blood pressure is greater than or equal to the reference value S2, it is determined that the blood pressure is not within the normal range. Is done.

Based on the results of the determinations (A) and (B) above for each set of vascular stiffness and blood pressure measured together, the determination unit 3 determines the degree of cardiovascular disease risk of the measurement subject h. Determine. That is, when the negative determinations in (A) and (B) above are made in all the sets of vascular hardness and blood pressure measured together, the disease risk of the circulatory system is the highest. Judging. On the other hand, when the determination in (A) and (B) above is made in all the sets of vascular hardness and blood pressure measured together, the disease risk of the circulatory system is the smallest. Judging.

It should be noted that the negative determinations in (A) and (B) above may be made by at least one of the sets of vascular hardness and blood pressure measured together. Furthermore, the negative determination in (A) or (B) may be made in at least one of the sets of vascular hardness and blood pressure measured together. In these cases, it is conceivable to determine the magnitude of the cardiovascular disease risk according to the measurement time of the measurement items (blood pressure, blood vessel hardness) that have been negatively determined.

Incidentally, in this embodiment, when an affirmative determination is made in (A) above and a negative determination is made in (B) above, depending on the blood pressure measurement time when the negative determination is made, the cardiovascular disease Determine the magnitude of the risk. For example, if the blood pressure measurement time when the negative determination is made in (B) above is the morning time zone (8:00 in this example), the cardiovascular disease risk is somewhat high, in other words, the subject h It is determined that there may be a disease that is not noticed by itself. This is because blood pressure generally tends to be low in the morning time zone, and when the blood vessel hardness is greater than or equal to the reference value S1, the blood pressure is somewhat large even in the normal range. This is because there is a disease risk.

The output unit 4 outputs the determination result to the display unit 13 when the determination unit 3 determines the magnitude of the disease risk of the circulatory organ of the person to be measured h. The display unit 13 displays the determination result of the cardiovascular disease risk magnitude in the display area 13a. The display area 13a is divided into four areas E1 to E4 as shown in FIG. 9, for example. The region E1 corresponds to a situation in which the vascular hardness is less than the reference value S1 and the blood pressure is less than the reference value S2 among the vascular hardness and blood pressure measured together. The region E2 corresponds to a situation in which the vascular hardness is less than the reference value S1 and the blood pressure is greater than or equal to the reference value S2 among the vascular hardness and blood pressure measured together. The region E3 corresponds to a situation in which the vascular hardness is equal to or higher than the reference value S1 and the blood pressure is lower than the reference value S2 among the vascular hardness and blood pressure measured together. The region E4 corresponds to a situation in which the vascular hardness is the reference value S1 or more and the blood pressure is the reference value S2 or more among the vascular hardness and blood pressure measured together.

The display unit 13 sets the measured blood vessel hardness and blood pressure as a set of data, and sets each set of data together with the measurement time (measurement time zone) as one of the regions E1 to E4, that is, the same data. In the region corresponding to the blood vessel hardness and blood pressure. When the above data is displayed in the area E3, there may be a disease that the subject h himself / herself does not notice, so a text message such as “Caution!” Is displayed in the area E3, etc. It is preferable to give some warning to the person to be measured h. In this way, by displaying the data, the text message for warning, and the like in the display area 13a of the display unit 13, the determination result of the magnitude of cardiovascular disease risk determined by the determination unit 3 is displayed. .

According to the first embodiment, the following effects can be obtained.
(1) Since the blood vessel hardness of the person to be measured h is automatically measured at intervals by the circulatory function determination device, the circulatory organ of the person to be measured h is determined based on the fluctuation state of the measured values of the blood vessel hardness. It is possible to determine the functional state of

(2) The measurement of the blood vessel hardness by the measuring unit 2 is automatically performed when a predetermined time is reached during a continuous period of 24 hours or more. Thereby, the blood vessel hardness is automatically measured a plurality of times at intervals during a continuous period of 24 hours or more. And the magnitude | size of the disease risk of the said circulatory organ is determined from the state of the fluctuation | variation of the vascular hardness measured in multiple times in this way as a functional state of the circulatory organ of the to-be-measured person h. For this reason, the magnitude of cardiovascular disease risk can be determined from the state of vascular stiffness fluctuation measured at predetermined intervals within the day.

(3) The cardiovascular function determination device is worn in a portable state with respect to the person to be measured h (FIG. 1), and the cuff 5 is wound around the upper arm of the person to be measured h. It is possible to measure vascular hardness and blood pressure simply by doing so. Therefore, blood vessel hardness and blood pressure can be measured together at a predetermined time during a continuous period of 24 hours or longer without interfering with the daily behavior of the subject h. Moreover, since the measurement of the blood vessel hardness and blood pressure is automatically performed, the measurement of the blood vessel hardness and blood pressure at the time does not forget.

(4) When the measurement unit 2 temporarily compresses the upper arm, which is a part of the body of the subject h, with the cuff 5 in order to measure the blood vessel hardness of the subject h, the measurement unit 2 Blood pressure is also measured based on the resulting pulse wave. When the situation occurs in which the blood pressure is within the normal range and the blood vessel hardness is greater than or equal to the reference value S1 among the blood pressure and blood vessel hardness measured together, the determination unit 3 generates the time (measurement time). The degree of cardiovascular disease risk of the person to be measured h is determined based on the above. For this reason, for example, when the blood pressure measurement time when the blood vessel hardness is determined to be equal to or greater than the reference value S1 is in the morning time zone (8:00 in this example), the cardiovascular disease risk is somewhat high, In other words, it is possible to determine that there is a possibility that the patient h himself / herself is not aware of the disease. Here, in the morning time zone, the blood pressure generally tends to be low, and if the blood vessel hardness is equal to or higher than the reference value S1, even if the blood pressure is within the normal range, the blood pressure is of a certain level. There is a disease risk. It is possible to determine a disease risk that is difficult to notice only by measuring the blood pressure.

(5) When the determination unit 3 determines the magnitude of the cardiovascular disease risk, the output unit 4 outputs the determination result to the display unit 13. The display unit 13 has a display area 13a defined by blood vessel hardness and blood pressure, and displays the determination result of the degree of cardiovascular disease risk using the display area 13a. Therefore, as described in (3) above, when the determination unit 3 accurately determines the magnitude of the cardiovascular disease risk, the determination result can be displayed in an easy-to-understand manner using the display area 13a of the display unit 13. it can.

(Second Embodiment)
Next, a second embodiment of the cardiovascular function determination device will be described with reference to FIG.
In this second embodiment, when the upper arm portion of the person to be measured h is temporarily pressed by the cuff 5 to measure the blood vessel hardness of the person to be measured h, this occurs in the same portion during pressurization of the compressed portion. When the pulse wave reaches the maximum level, the compression of the upper arm by the cuff 5 is terminated. In this case, when the cuff 5 starts temporary compression of the upper arm of the person to be measured h, the compression pressure P changes as shown in FIG. Then, when the temporary compression of the upper arm by the cuff 5 is terminated at the timing T1 when it is determined that the pulse wave has reached the maximum level, the compression pressure P gradually decreases accordingly. Note that the decision that the pulse wave has reached the maximum level will be smaller after the pulse wave reaches the maximum level, and when the pulse wave becomes smaller than the previous pulse wave, Made.

As described above, the blood vessel hardness and blood pressure can be measured even when the temporary compression of the upper arm by the cuff 5 is terminated at the timing T1 when it is determined that the pulse wave has reached the maximum level. For example, the pulse wave after reaching the maximum level is estimated as follows. That is, in the first measurement of the blood vessel hardness, the upper arm of the person to be measured h is temporarily compressed by the cuff 5 as in the first embodiment, and the change in the compression pressure P and the magnitude of the pulse wave at that time are measured. Remember the relationship with changes. Then, in the second and subsequent measurements of the vascular hardness, it is determined that the pulse wave has reached the maximum level, and after the temporary compression of the upper arm by the cuff 5 is completed, the change in the stored compression pressure P is performed. The pulse wave after reaching the maximum level is estimated using the relationship between the amplitude of the pulse wave and the change in the magnitude of the pulse wave. Then, the estimated pulse wave is used for measurement of blood vessel hardness and blood pressure.

In addition, there is a possibility that a pulse wave greatly different from the pulse wave at the time of the first blood vessel hardness measurement may be generated, such as the pulse wave becoming unstable in the blood vessel hardness measurement after the second time. In this case, it is determined that the pulse wave in the first blood vessel hardness measurement is determined to have reached the maximum level and the pulse wave in the second and subsequent blood vessel hardness measurements has been determined to have reached the maximum level. There is a possibility that a difference equal to or greater than a predetermined determination value may occur with the timing T1. Under such circumstances, in order to ensure the accuracy of the measured blood vessel hardness and blood pressure, even in the second and subsequent blood vessel hardness measurements, the cuff 5 is measured in the same manner as the first blood vessel hardness measurement. It is preferable to perform temporary compression of the upper arm by the step even after the maximum level of the pulse wave.

According to the second embodiment, the following effects can be obtained in addition to the effects (1) to (5) of the first embodiment.
(6) In the second and subsequent vascular hardness measurements, at the timing T1 when it is determined that the pulse wave has reached the maximum level, the temporary compression of the upper arm by the cuff 5 is terminated, and the compression is performed. The burden on the body of the person to be measured h can be reduced.

(7) In addition, as described above, by ending the temporary compression of the upper arm by the cuff 5, it is possible to shorten the execution period of the compression, and at the same time, a circulatory function determination device for performing the compression. Energy consumption can be reduced.

(Third embodiment)
Next, with reference to FIG.11 and FIG.12, 3rd Embodiment of a circulatory organ function determination apparatus is described.

FIG. 11 shows a circulatory function determining apparatus according to the third embodiment. This circulatory organ function determination device includes a sensor, for example, an acceleration sensor 14 that detects the body motion of the person to be measured h. The acceleration sensor 14 is preferably attached to the measurement subject h integrally with the cuff 5, but may be attached to the measurement subject h separately from the cuff 5.

The cardiovascular function determination device detects whether or not the person to be measured h is in a sleep state based on the body motion of the person to be measured h detected by the acceleration sensor 14. And the method of temporarily compressing the upper arm by the cuff 5 for measuring the blood vessel hardness is changed depending on whether or not the person to be measured h is in a sleep state.

For example, as shown in FIG. 12, when it is not detected that the person to be measured h is in an active state, the upper arm is temporarily compressed by the cuff 5 as in the first embodiment. On the other hand, when it is detected that the person to be measured h is in a sleeping state, when the upper arm is temporarily compressed by the cuff 5, the increasing speed of the compression pressure P is made slower than that in the first embodiment. To do.

According to the third embodiment, the following effects can be obtained in addition to the effects (1) to (5) of the first embodiment.
(8) When the blood vessel hardness is measured during sleep of the person to be measured h, the speed of temporary compression of the upper arm by the cuff 5 for measuring the blood vessel hardness can be reduced. For this reason, it is possible to suppress the temporary compression of the upper arm portion by the cuff 5 from leading to the stimulation of the person to be measured h, and the stimulation from disturbing the sleep of the person to be measured h.

(Fourth embodiment)
Next, a fourth embodiment of the cardiovascular function determination device will be described with reference to FIGS.

The circulatory function determination device according to the fourth embodiment includes the acceleration sensor 14 as in the third embodiment. When the body motion of the person to be measured h is detected by the acceleration sensor 14, the apparatus removes the influence of the body movement of the person to be measured h from the information regarding the change of the pulse wave for measuring the blood vessel hardness. It has a function.

Examples of the information regarding the change mode of the pulse wave for measuring the blood vessel hardness include an envelope L1 obtained based on the pulse wave when the upper arm is temporarily compressed by the cuff 5. If the person h to be measured moves the body during the measurement of the blood vessel hardness, the envelope L1 may be affected by the body movement of the person h to be measured as shown in FIG. Here, when the body movement of the person to be measured h is detected by the acceleration sensor 14, if the influence as described above appears on the envelope L1, it is determined that the cause of the influence is the body movement of the person to be measured h. it can. In this case, when the body motion of the person to be measured h is detected by the acceleration sensor 14, the influence of the body motion of the person to be measured h is removed from the envelope L1 as shown in FIG.

According to the fourth embodiment, the following effects can be obtained in addition to the effects (1) to (5) of the first embodiment.
(9) Due to the body motion of the person to be measured h during the measurement of the vascular hardness, information on the change mode of the pulse wave for measuring the vascular hardness (in this example, the envelope L1) is affected by the body motion. However, the influence can be removed. Therefore, even if the person to be measured h moves his / her body during the measurement of the blood vessel hardness, the operating state of the circulatory organ can be accurately determined regardless of the body movement. For this reason, the cardiovascular function determination device can be used not only for confirming the magnitude of the cardiovascular disease risk, but also for monitoring the functional state of the cardiology during exercise such as running.

Incidentally, FIG. 15 is a time chart showing an example of changes in blood pressure and blood vessel hardness over time when exercise and rest are performed. When monitoring the functional state of the circulatory organ during exercise with the circulatory organ function determination device, the blood pressure and vascular stiffness during exercise shown in FIG. 15 are measured by the same device. Further, the function state of the circulatory organ is determined based on the blood vessel hardness and the like, and the result of the determination is displayed. When using a circulatory function determination device for monitoring the functional state of the circulatory organ during exercise, the measurement interval of the vascular stiffness should be set longer than when using it to confirm the magnitude of the circulatory disease risk. It is preferable to set it short, for example, to set it at intervals of several minutes.

(Other embodiments)
In addition, each said embodiment can also be changed as follows, for example.
In the circulatory function determination device of the fourth embodiment, between the exercise mode for monitoring the functional state of the circulatory system during exercise and the risk determination mode for confirming the magnitude of the circulatory disease risk, A function for switching the operation mode may be installed.

In the third embodiment, instead of detecting the sleep state of the person to be measured h using the acceleration sensor 14, the time zone in which the person to be measured h is in the sleep state is estimated, and the person to be measured is in the same time zone It may be determined that h is sleeping. In this case, it is not necessary to provide the acceleration sensor 14.

In the first to fourth embodiments, the slight change in the compression pressure P in the pulse wave detection period TX is not limited to a slight increase due to pressurization, but may be a slight decrease due to decompression. In the second embodiment in this case, when the upper arm portion of the person to be measured h is temporarily pressed by the cuff 5 in order to measure the blood vessel hardness of the person to be measured h, the pressure is reduced during the decompression of the pressed portion. When it is determined that the pulse wave generated in the portion has reached the maximum level, the compression is terminated.

In the first embodiment, as the state of fluctuation of the vascular hardness measured a plurality of times at intervals, an affirmative determination is made in (A) above regarding the vascular hardness and blood pressure measured together, and ( The occurrence time (measurement time) when the negative determination in B) occurs was considered in determining the functional state of the circulatory organ (the degree of cardiovascular disease risk). Instead, the frequency of occurrence of a situation in which a positive determination is made in (A) above and a negative determination in (B) above is made for the vascular hardness and blood pressure measured together, and the functional state of the circulatory system (circulation) May be taken into account when determining the risk of illness of the vessel.

In the first embodiment, the blood vessel hardness and blood pressure measured together with at least one of the reference value S2 used for the determination of (A) and the reference value S1 used for the determination of (B). It may be changed according to the measurement time.

In the first embodiment, as a state of the fluctuation of the vascular hardness measured a plurality of times at intervals, the variation pattern in units of 24 hours of the vascular hardness and the blood pressure measured together is expressed as a circulatory organ. May be taken into account in determining the functional state of the disease (the degree of cardiovascular disease risk). For example, diabetic patients tend to have hard blood vessels compared to healthy individuals, particularly in the morning hours. Furthermore, in the case of a diabetic patient, the blood vessel hardness also fluctuates with the fluctuation of the blood glucose level in units of 24 hours. In addition, blood vessel hardness and blood pressure may fluctuate in units of 24 hours under the influence of autonomic nerve malfunction and the like. In order to cope with these, in order to determine the functional state of the circulatory system (the degree of the disease risk of the circulatory system), the variation pattern of each set of vascular stiffness and blood pressure measured together in units of 24 hours is determined. It is also conceivable to apply the above determination to the above analysis model.

FIG. 16 is a schematic diagram illustrating an example of the display unit 13 that can display the determination result of the functional state of the circulatory system (the magnitude of the circulatory disease risk). In this case, the display unit 13 shows a variation pattern of each set of vascular hardness and blood pressure measured together in units of 24 hours, that is, variation represented by [1] → [2] → [3] in the figure. It is conceivable to display the pattern together with the measurement time (measurement time zone). Furthermore, as a result of judging the functional status of the circulatory system (the degree of cardiovascular disease risk), the pattern “[1] → [2] → [3] continues. There is a suspicion of about 20% diabetes. It is conceivable to display a text message such as “” on the display unit 13.

In the first to fourth embodiments, the display mode of the display area 13a of the display unit 13 can be appropriately changed as long as the determination result of the functional state of the circulatory organ can be displayed.

In the first to fourth embodiments, instead of the display unit 13 or in addition to the display unit 13, the determination result of the functional state of the circulator is notified by sound from a speaker or stored in a memory. Or you may. In this case, the output unit 4 outputs the determination result of the functional state of the circulator to a speaker or a memory. If the determination result is stored in the memory, the determination result can be displayed on the display of the computer by removing the memory and connecting it to a computer or the like. In this case, since it is not necessary to provide the display unit 13 in the circulatory function determination device, the device can be further downsized and easily carried, and energy consumption for operating the display unit 13 can be suppressed. Can do.

In the first to fourth embodiments, the object around which the cuff 5 is wound is not limited to the upper arm part, but may be another part such as a wrist or a lower leg.
In the first to fourth embodiments, the blood vessel hardness is obtained through cumulative addition of the pulse wave area, but the blood vessel hardness may be obtained through cumulative addition of the pulse wave amplitude. Alternatively, the blood vessel hardness may be obtained through cumulative addition of feature quantities of a pulse wave that can be easily inferred by those skilled in the art, such as the maximum width, half width, or amplitude / half width of the pulse wave.

Claims

A measurement unit that automatically measures the blood vessel hardness of the measurement subject at intervals, and
A determination unit that determines a functional state of the subject's circulatory organ from a state of variation of the measurement value of the vascular hardness measured by the measurement unit;
An output unit that outputs a determination result of the functional state of the circulator by the determination unit;
A circulatory function determination device comprising:
The measurement unit compresses the body of the measurement subject and measures the blood vessel hardness of the measurement subject based on a change mode of a pulse wave generated in the compressed portion of the compressed portion during pressurization or decompression. The circulatory organ function determination apparatus according to claim 1.
The measurement unit measures a subject's blood vessel hardness a plurality of times during a continuous period of 24 hours or more,
The said determination part determines the magnitude | size of the disease risk of the said circulatory organ as the functional state of the said to-be-measured person's circulatory organ from the fluctuation | variation state of the blood vessel hardness measured in multiple times by the said measurement part. Cardiovascular function judgment device.
When the measurement unit compresses the subject's body to measure the subject's blood vessel hardness, it also measures blood pressure based on the pulse wave of the compressed portion,
The determination unit is configured to determine the measurement subject's time based on an occurrence time when a situation occurs in which the blood pressure is within a normal range and the blood vessel hardness is equal to or greater than a reference value among the blood pressure and the blood vessel hardness measured together. The cardiovascular function determination apparatus according to claim 3, which determines the magnitude of a cardiovascular disease risk.
When the measurement unit compresses the subject's body to measure the subject's blood vessel hardness, it also measures blood pressure based on the pulse wave of the compressed portion,
The determination unit determines whether the subject has a cardiovascular disease based on the frequency of occurrence of a situation in which the blood pressure is within a normal range and the blood vessel hardness is greater than or equal to a reference value among the measured blood pressure and blood vessel hardness. The cardiovascular function determination apparatus according to claim 3, wherein the risk level is determined.
The output unit outputs a determination result of the disease risk magnitude of the circulatory organ by the determination unit for a display unit having a display area defined by vascular hardness and blood pressure.
The said display part is a circulatory-function determination apparatus of Claim 4 or 5 which displays the determination result of the magnitude | size of the disease risk of the said circulatory organ using the said display area.
In the circulatory function determination device according to any one of claims 1 to 6,
The measurement unit compresses the body of the measurement subject and measures the blood vessel hardness of the measurement subject based on a change mode of a pulse wave generated in the compressed portion of the compressed portion during pressurization or decompression. The circulatory function judging device is characterized in that the compression is terminated when the pulse wave reaches a maximum level.
In the circulatory function determination device according to any one of claims 1 to 6,
A sensor for detecting the physical movement of the measurement subject;
The measurement unit compresses the body of the measurement subject and measures the blood vessel hardness of the measurement subject based on a change mode of a pulse wave generated in the compressed portion of the compressed portion during pressurization or decompression. A circulatory function determination device characterized in that it changes the manner in which the subject's body is compressed when the sensor detects that the subject is in a sleep state and when it is not detected. .
In the circulatory function determination device according to any one of claims 1 to 6,
A sensor for detecting the physical movement of the measurement subject;
The measurement unit compresses the body of the measurement subject and measures the blood vessel hardness of the measurement subject based on a change mode of a pulse wave generated in the compressed portion of the compressed portion during pressurization or decompression. When the body motion of the measurement subject is detected by the sensor, the influence of the physical motion of the measurement subject is removed from the information regarding the change mode of the pulse wave for measuring the blood vessel hardness. A circulatory function judging device characterized by the above.