WO2017169786A1 - Programme de criblage continu de dilatabilité artériolaire de doigt, dispositif de criblage continu de dilatabilité artériolaire de doigt et procédé de criblage continu de dilatabilité artériolaire de doigt - Google Patents

Programme de criblage continu de dilatabilité artériolaire de doigt, dispositif de criblage continu de dilatabilité artériolaire de doigt et procédé de criblage continu de dilatabilité artériolaire de doigt Download PDF

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WO2017169786A1
WO2017169786A1 PCT/JP2017/010414 JP2017010414W WO2017169786A1 WO 2017169786 A1 WO2017169786 A1 WO 2017169786A1 JP 2017010414 W JP2017010414 W JP 2017010414W WO 2017169786 A1 WO2017169786 A1 WO 2017169786A1
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finger
reperfusion
pulse wave
npv
blood
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PCT/JP2017/010414
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English (en)
Japanese (ja)
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豪一 田中
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北海道公立大学法人札幌医科大学
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Priority to JP2018508996A priority Critical patent/JP6850493B2/ja
Publication of WO2017169786A1 publication Critical patent/WO2017169786A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A61B5/022—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers

Definitions

  • the present invention relates to a finger arteriole dilatability continuous examination program, a finger arteriole dilatability continuous examination apparatus, and a finger arteriole dilatability continuous examination method suitable for examining signs of early arteriosclerosis in small blood vessels of the finger arteries. Is.
  • endothelial function of blood vessels causes a disorder at the earliest stage of arteriosclerosis, and thus is promising for the diagnosis at the preclinical stage of lifestyle-related diseases such as cardiovascular diseases and diabetes.
  • the most standard test method used in clinical practice around the world is a reactive hyperemia after the forearm is driven for 5 minutes and then released. Evokes. Then, the blood flow-dependent dilation response that reaches a maximum approximately one minute after reperfusion is measured with an ultrasonic diagnostic apparatus, and the maximum rate of increase in the diameter of the brachial artery (% FMD) is measured.
  • the delayed response after 90 seconds later than the initial response after reperfusion assessed by the FMD method is evaluated, and the pulse wave amplitude is increased during reactive hyperemia using fingertip pulse waves.
  • the so-called peripheral arterial tonometry test (Endo-PAT method) for evaluating (PAT ratio) has been commercialized in Israel, and its clinical application is spreading.
  • the evaluation means for evaluating the vascular endothelial function level from the difference between the pulse wave peak value and the pulse wave base value, the pulse before the upper arm blood transfusion, and after the blood flow is resumed evaluation means for evaluating the vascular endothelial function level from the ratio (AI) of the reflected wave component to the systolic pressure of the wave, and the vascular endothelial function level using the vascular aging age index (AG) as the pulse wave feature quantity of the acceleration pulse wave.
  • AI ratio
  • AG vascular aging age index
  • the Endo-PAT method described above although it is clear that the pulse wave of the finger artery is affected by both the organic stiffness (original hardness) of the examination finger blood vessel and the blood pressure at the time of the examination, There is a problem that their influence is not considered at all.
  • the delayed reaction evaluated by the Endo-PAT method reaction in 90 to 150 seconds after reperfusion
  • the initial reaction reaction in 30 to 60 seconds after reperfusion
  • the vascular endothelial function described above relaxes vascular smooth muscle as a physiological function of nitric oxide generated from vascular endothelial cells during reactive hyperemia.
  • vascular compliance softness of the blood vessel
  • both the pulse wave amplitude and the total volume of the blood vessel increase, while the vascular resistance decreases and the average blood pressure decreases. That is, a comprehensive hemodynamic reaction is induced during reactive hyperemia, but the FMD method targets only the arterial volume, and the Endo-PAT method and Patent Document 1 target only the pulse wave amplitude. Therefore, only one cross section of the hyperemia reaction can be evaluated.
  • the present inventor proposed in Japanese Patent Application No. 2014-539849 an invention for evaluating an increase in compliance in the finger arteriole during reactive hyperemia as an index (FCR ratio) indicating the vasodilator response of the finger artery.
  • FCR ratio index
  • FCR method comprehensive hemodynamic evaluation is possible in that the pulse wave amplitude, the total blood vessel volume, and the blood pressure (pulse pressure and average blood pressure) are all measured.
  • a finger clamp that tightens the finger with a finger cuff is performed to measure the average blood pressure and the pulse pressure.
  • the “original method” that uses the measured values for pulse pressure essential for calculation of vascular compliance requires a large and expensive continuous blood pressure monitor. For this reason, although introduction for testing and research purposes is possible, it is practically difficult to introduce a continuous blood pressure monitor into a general hospital or the like. Also, even if a continuous blood pressure meter is introduced and measured, the number of units is limited, and the measurement time per person is long. Not possible and impractical.
  • the “simple method” using the estimated value of the pulse pressure assumes that there is no blood pressure fluctuation (the estimated value of the pulse pressure is constant) in one sequence by the finger clamp. For this reason, when the actual blood pressure fluctuation is small, the FCR ratio can be calculated with the same accuracy as the “original method”. However, when the actual blood pressure fluctuation is large, an error may occur in the calculated value of the FCR ratio.
  • the present invention has been made based on the background art as described above, and can easily and accurately examine signs of early arteriosclerosis in the small blood vessels of the finger arteries without measuring blood pressure. It is an object of the present invention to provide a finger arteriole dilatability continuous examination program, a finger arteriole dilatability continuous examination device, and a finger arteriole dilatability continuous examination method.
  • a digital microarterial dilatability continuous inspection program for continuously inspecting a vasodilator response for each heartbeat, wherein the test finger for inspecting the vasodilator response and the control finger for standardizing the vasodilator response are A resting pulse wave storage unit for storing a resting pulse wave, which is pulse wave data when compressed in a predetermined sequence at rest before blood, and re-operation after driving the test finger or the arm on the test finger side
  • a reperfusion pulse wave storage unit that stores a reperfusion pulse wave that is pulse wave data when the fingers are continuously pressed at a constant pressure; the resting pulse wave and the reperfusion pulse Based on the wave, said For a finger, the NPV natural logarithm conversion value (lnNPV), which is the natural logarithm of the normalized pulse wave volume (NPV) obtained
  • the computer functions as a cuff pressure data storage unit that stores the cuff pressure of each cuff that presses each finger in a predetermined sequence during the previous rest, and the vasodilation response index calculation unit includes the following (i) to (iv ).
  • the cuff pressure data storage unit is included, and the vasodilation response index calculation unit performs the following processes (i) to (iv): It may function as a part.
  • An NPV line calculation unit for calculating an NPV line that is a regression line with the value (lnNPV); (Iii) Based on the NPV line of each finger, for each finger, the NPV natural logarithm conversion value (lnNPV) when the cuff pressure is a predetermined ratio of the mean blood pressure at rest is calculated before resting
  • An NPV estimated value calculating unit for calculating an NPV estimated value;
  • NPVI i NT i -NC i Formula (1)
  • each symbol represents the following.
  • the computer functions as a cuff pressure data storage unit that stores the cuff pressure of each cuff that sometimes presses each finger in a predetermined sequence, and the vasodilator response index calculation unit includes the following (i), (v) to ( It may function as the processing unit of vii).
  • the cuff pressure data storage unit is included, and the vasodilation response index calculation unit includes the following (i), (v) to ( It may function as the processing unit of vii).
  • (I) Based on the resting pulse wave, the cuff pressure at the time when the normalized pulse wave volume (NPV) is maximum in each compression trial at rest is specified, and the specified cuff pressure is determined for each finger.
  • the problem of calculating an expansion distance index (DI), which is one of vascular dilation response indices, is solved.
  • the vasodilation response index calculation unit may function as a processing unit (viii) or (ix) below.
  • (Viii) Regression analysis of a data pair of the blood volume (BV) at rest before blood transduction and the NPV natural logarithm conversion value (lnNPV) at rest before blood transfusion, and for each finger, the blood volume (BV ) And the NPV natural logarithm conversion value (lnNPV), a BN line calculation unit that calculates a BN line that is a regression line;
  • DI i Extension distance index (DI) at i-th beat after reperfusion
  • DT i perpendicular distance from the data point (BV, lnNPV) at the i-th beat after reperfusion on the test finger side to the BN line of the test finger at rest before blood driving
  • DC i after reperfusion on the control finger side data points in i beat (BV, lnNPV) from occlusion of the artery perpendicular distance drawn to BN line of control fingers before resting SGNT i: test finger side data points in the i th beat after reperfusion (BV, lnNPV) Is 1 (expanded) when is positioned at the upper right relative to the BN line of the inspection finger, and becomes 1 (contraction) when positioned at the lower left.
  • DI i Extension distance index (DI) at i-th beat after reperfusion
  • DT i perpendicular distance from the data point (BV, lnNPV) at the i-th
  • the problem of calculating a simple distance index (SI) which is one of the vasodilator response indices is solved.
  • the vasodilation response index calculation unit may function as a processing unit (x) below.
  • (X) SI calculation unit for calculating a simple distance index (SI), which is one of the vasodilation response indexes, by the following formula (4); SI i ST i * SGNS i (4) However, each symbol represents the following.
  • SI i Simple distance index (SI) at the i-th beat after reperfusion
  • ST i Linear distance connecting the data point (BV, lnNPV) at the i th beat after reperfusion on the examination finger side and the data point (BV, lnNPV) at the i th beat after reperfusion on the control finger side
  • SGNS i Positive / negative discriminant value that is 1 when the expansion distance index (DI i ) at the i-th beat after reperfusion is positive, and -1 when it is negative
  • the subject of calculating the NB reactivity index (NBI) which is one of the vasodilatory reaction indexes as one aspect of the finger arteriole dilatability continuous test program and the finger arteriole dilatability continuous test apparatus according to the present invention
  • the vasodilation response index calculation unit may function as a processing unit (xi) below.
  • NBI Di NPVI i -BVI i Formula (5a)
  • NBI Ri NPVI i / BVI i + k (5b)
  • NBI Di NPVI vs.
  • NBI R i NPVI to BVI ratio index (NBI R ) at i th beat after reperfusion
  • NPVI i Normalized pulse wave volume index (NPVI) at i-th beat after reperfusion
  • BVI i Blood volume index (BVI) at the i-th beat after reperfusion k: Constant determined by experiment
  • a finger arterial dilatation ability continuous inspection method for continuously inspecting a vasodilator response of a finger artery at every heartbeat, wherein each finger of an inspection finger for inspecting the vasodilator response and a control finger for standardizing the vasodilator response ,
  • resting pulse wave memory step to memorize resting pulse wave which is pulse wave data when compressed in a predetermined sequence at rest before blood pumping, and after driving the examination finger or the arm on the examination finger side
  • a reperfusion pulse wave storage step for storing a reperfusion pulse wave, which is a pulse wave data when the fingers are continuously pressed at a constant pressure, and the resting pulse wave and the reperfusion Based on time pulse wave
  • an NPV natural logarithm conversion value lnNPV
  • a blood volume (BV), which is a natural logarithm of the obtained value, for each heartbeat, the NPV natural logarithm conversion value (lnNPV) and / or each finger at rest and reperfusion of each finger Based on the blood volume (BV) at rest and reperfusion, a vasodilation response index calculation step for calculating a vasodilation response index representing the vasodilation response at an arbitrary heart rate after reperfusion And a flop.
  • a cuff pressure data storage step for storing the cuff pressure of each cuff that presses each finger in a predetermined sequence at the time of previous rest, and the vasodilation response index calculation step includes the following (i) to (iv) May have substeps.
  • An NPV estimated value calculating step for calculating an NPV estimated value (Iv) an NPVI calculating step of calculating a normalized pulse wave volume index (NPVI), which is one of the vasodilatory reaction indexes, by the following equation (1);
  • NPVI i NT i -NC i Formula (1)
  • each symbol represents the following.
  • a cuff pressure data storage step for storing the cuff pressure of each cuff that sometimes presses each finger in a predetermined sequence, and the vasodilation response index calculating step includes the following (i), (v) to (vii) ) Sub-steps may be included.
  • a mean resting blood pressure estimating step for estimating a mean or median value of rest as a mean resting blood pressure prior to blood transfusion;
  • V Regression analysis of a data pair of the cuff pressure at rest before blood transfusion and the blood volume (BV) at rest before blood transfusion, and for each finger, the cuff pressure and the blood volume (BV)
  • a BV line calculating step for calculating a BV line which is a regression line;
  • Vi Based on the BV line of each finger, for each finger, the blood volume (BV) when the cuff pressure is a predetermined ratio of the mean blood pressure at rest is used as an estimated BV value before resting
  • Vii a BVI calculating step of calculating a blood volume index (BVI) which is one of the vasodilatory reaction indexes according to the following formula (2);
  • BVI i BT i -BC i (2)
  • each symbol represents the following.
  • the vasodilation response index may include the following substeps (viii) and (ix).
  • DI i Extension distance index (DI) at i-th beat after reperfusion
  • DT i perpendicular distance from the data point (BV, lnNPV) at the i-th beat after reperfusion on the test finger side to the BN line of the test finger at rest before blood driving
  • DC i after reperfusion on the control finger side
  • Perpendicular distance drawn from the data point (BV, lnNPV) at the i-th beat to the BN line of the control finger before resting after blood driving SGNT i Data point (BV, lnNPV) at the i-th beat after reperfusion on the test finger side Is 1 (expanded) when is positioned at the upper right relative to the BN line of the inspection finger, and becomes 1 (contraction) when positioned at the lower left.
  • the vasodilation response index may include the following sub-step (x).
  • SI calculating step for calculating a simple distance index (SI), which is one of the vasodilatory reaction indexes, according to the following formula (4); SI i ST i * SGNS i (4) However, each symbol represents the following.
  • SI i Simple distance index (SI) at the i-th beat after reperfusion
  • ST i Linear distance connecting the data point (BV, lnNPV) at the i th beat after reperfusion on the examination finger side and the data point (BV, lnNPV) at the i th beat after reperfusion on the control finger side
  • SGNS i Positive / negative discriminant value that is 1 when the expansion distance index (DI i ) at the i-th beat after reperfusion is positive, and -1 when it is negative
  • the index calculation step may include a substep (xi) below.
  • NBI Di NPVI i -BVI i Formula (5a)
  • NBI Ri NPVI i / BVI i + k (5b)
  • each symbol represents the following.
  • NBI Di NPVI vs.
  • NBI R i NPVI to BVI ratio index (NBI R ) at i th beat after reperfusion
  • NPVI i Normalized pulse wave volume index (NPVI) at i-th beat after reperfusion
  • BVI i Blood volume index (BVI) at the i-th beat after reperfusion k: Constant determined by experiment
  • the fingers used as the inspection finger and the control finger are the same fingers in both hands or different fingers in one hand. There may be.
  • the cuff pressure during reperfusion is The constant pressure is preferably the same as the value of a predetermined ratio of the resting average blood pressure before blood pumping or a value close to the diastolic blood pressure of the upper arm measured in advance.
  • the present invention it is possible to easily and accurately examine signs of early arteriosclerosis in the small blood vessels of the finger arteries without measuring blood pressure.
  • FIG. 1 It is a block diagram which shows one Embodiment of the finger arteriole dilatability continuous examination apparatus and finger arteriole dilatability continuous examination program which concern on this invention.
  • it is a graph which shows the relationship of the cuff pressure, NPV, and BV with respect to the time passage at the time of trying compression by the sequence at the time of rest before blood transport.
  • It is a figure which shows the finger clamp protocol by the lamp
  • Example 1 it is a graph which shows the comparison result of FRHI of Endo-PAT method, and NPVI, DI, and SI which concern on this invention. In Example 1, it is the table
  • Example 1 it is a graph which shows the fall of the vasodilator ability of the diabetic patient group with respect to the healthy youth group in the area for 90 to 150 seconds after reperfusion.
  • Example 1 it is a graph which shows the underestimation and overestimation of DI, NPVI, and SI with respect to FRHI.
  • Example 2 it is a graph which shows the vasodilator response parameter
  • 12 is a graph for explaining a precondition for simulation in the third embodiment.
  • Example 3 it is a graph which shows the simulation result which contrasts the sensitivity of NPVI, DI, and SI at the time of vasodilation.
  • Example 4 it is a graph which shows the correlation of the test value of both methods (constant pressure clamp A method) and Endo-PAT method.
  • Example 5 it is a graph which shows the vasodilation response parameter
  • Example 6 a table showing vasodilator response indicator (NPVI, BVI, DI, SI , NBI D, NBI R) the correlation between the stress-related metrics.
  • Example 9 it is a graph which shows the correlation of the test value of one method (constant pressure clamp B method) and Endo-PAT method.
  • the finger arteriole dilatability continuous inspection program, the finger arteriole dilatability continuous inspection device, and the finger arteriole dilatability continuous inspection method according to the present invention are proposed by the present inventor for early arteriosclerosis in the small blood vessels of the finger arteries. It is suitable for calculating various vasodilatory reaction indexes, which are new indexes for evaluating signs.
  • NPV natural logarithm conversion value (lnNPV) which is the natural logarithm of wave amplitude (normalized pulse wave volume: NPV), and aim only at pulse wave without using blood pressure as follows
  • NPV natural logarithm conversion value
  • the continuous inspection of the dilated arterioles according to the present invention is a method of reactive hyperemia that occurs on the distal side from the site of blood transfusion after blood recirculation of the proximal part of the arm or finger for a certain period of time. In this phenomenon, the vasodilator response of the finger artery is continuously examined every heartbeat.
  • the finger arteriole dilatability continuous examination apparatus 1 of the present embodiment mainly includes a finger compression means 2 for compressing a finger, a pulse wave detection means 3 for detecting a pulse wave,
  • storage means 4 and the arithmetic processing means 5 are comprised by computers, such as a personal computer.
  • each constituent means will be described in more detail.
  • the finger compression means 2 compresses the subject's finger artery with a desired pressure value.
  • the finger pressing means 2 includes a pair of cuffs 21 and 21 that are attached to the finger and press the finger with air pressure, and an air pump 22 that sends air into the cuffs 21 and 21.
  • the cuffs 21 and 21 are configured to be detachable by hook-and-loop fasteners or the like, and are attached to the inspection fingers for inspecting the vasodilation response and the control fingers for standardizing the vasodilation response. It is designed to compress the artery.
  • the air pump 22 is automatically controlled by a cuff pressure control unit 51, which will be described later, and sends air to the cuffs 21 and 21 so as to press each of the inspection finger and the control finger in a predetermined sequence. .
  • the vasodilatory reaction according to the present invention is susceptible to the effects of sympathetic nervous tension, arrhythmia, and the like. For this reason, in order to remove the influence, the pulse wave of the control finger is measured and standardized simultaneously with the inspection finger.
  • one and the other of the same fingers in both hands are used as the inspection finger and the control finger, respectively.
  • the present invention is not limited to this configuration, and different fingers in one hand may be used as the inspection finger and the control finger, respectively. .
  • the pulse wave detection means 3 detects a volume pulse wave indicating a volume change in the finger artery.
  • the pulse wave detection means 3 includes a photoelectric sensor 31 that detects the amount of light, and a pulse wave amplifier 32 that amplifies an output signal from the photoelectric sensor 31 and outputs the amplified signal as pulse wave data. Yes.
  • photoelectric volume pulse wave data FPG is detected as pulse wave data, but the present invention is not limited to this.
  • the photoelectric sensor 31 includes a light emitting unit 31a such as an LED (Light Emitting Diode) fixed to a fingernail, and a light receiving unit 31b such as a photodiode disposed on the ventral side of the finger at a position facing the light emitting unit 31a. And the amount of light transmitted from the light emitting unit 31a and transmitted through the finger is detected by the light receiving unit 31b.
  • the pulse wave amplifier 32 outputs the amplified pulse wave data to a pulse wave data storage unit 42 described later.
  • the cuff 21 is integrated with the light receiving unit 31b.
  • the light receiving unit 31b is disposed on the belly of the finger, and the light emitting unit 31a is fixed to the fingernail near the fingernail. It is fixed by winding and fastening with a hook-and-loop fastener. For this reason, it is not necessary to prepare a plurality of sizes of cuffs 21 having different diameters, and one type of cuff 21 can be optimally attached to the finger diameters of a plurality of subjects.
  • the light emitting unit 31a and the light receiving unit 31b are in close contact with the finger, and the optical path shift accompanying the progress of finger compression is minimized.
  • the storage unit 4 stores various data and functions as a working area when the arithmetic processing unit 5 performs arithmetic processing.
  • the storage means 4 is composed of a hard disk, ROM (Read Only Memory), RAM (Random Access Memory), flash memory, and the like.
  • a program storage unit 41 for storing the active continuity inspection program 1a, a resting pulse wave storage unit 42, a reperfusion pulse wave storage unit 43, and a cuff pressure data storage unit 44 are provided.
  • the finger arteriole dilatability continuous inspection program 1a of this embodiment is installed. Then, the digital arterial dilatability continuous examination program 1a is executed by the arithmetic processing means 5 so that the computer functions as each component described later.
  • the utilization form of the finger arteriole dilatability continuous examination program 1a is not limited to the above configuration.
  • the finger arteriole dilatability continuous examination program 1a is stored in a computer-readable non-transitory recording medium such as a CD-ROM or DVD-ROM, and directly read from the recording medium and executed. May be.
  • the resting pulse wave storage unit 42 stores the pulse wave data detected by the pulse wave detecting means 3 at the time of resting before blood pumping.
  • the resting pulse wave storage unit 42 is a resting wave that is pulse wave data when the finger of the examination finger and the control finger are compressed in a predetermined sequence by the finger pressing means 2 at rest before blood pressure. Memorize the pulse wave.
  • the reperfusion pulse wave storage unit 43 stores the pulse wave data detected by the pulse wave detection means 3 at the time of reperfusion after blood pumping.
  • the reperfusion pulse wave storage unit 43 keeps each finger of the inspection finger and the control finger at a constant pressure at the time of reperfusion after the arm on the inspection finger side is driven with a predetermined pressure for a predetermined time.
  • the pulse wave at the time of reperfusion which is the pulse wave data when the compression is continued, is stored.
  • the blood feeding method is not limited to both the above-described methods, and different fingers in one hand may be used as the inspection finger and the control finger (one method).
  • this one-piece method blood is pumped against the proximal part of the inspection finger.
  • the control finger it is preferable to select a finger that is not easily affected by reactive hyperemia induced by the test finger and is affected by sympathetic nerve tension common to the test finger.
  • the second finger (index finger) is an inspection finger, it is the first finger (thumb), fourth finger (ring finger), and fifth finger (small finger) that are less likely to have reactive hyperemia. It is the first finger (thumb) that has a high level of common reaction by the nerve.
  • the cuff pressure data storage unit 44 stores data related to the cuff pressure when the cuff 21 compresses the finger artery of each finger.
  • the cuff pressure data storage unit 44 stores the cuff pressures of the cuffs 21 and 21 attached to the fingers, respectively, at the time of resting before blood transduction and at the time of reperfusion. .
  • the vasodilation response index calculation unit 54 calculates the expansion distance index (DI) or the simple distance index (SI) as the vasodilation response index, the value of the cuff pressure is unnecessary.
  • the data storage unit 44 may not function.
  • the arithmetic processing means 5 is composed of a CPU (Central Processing ⁇ Unit) and the like, and by executing the finger arteriole dilatability continuous examination program 1a, as shown in FIG.
  • the unit 52, the BV calculation unit 53, and the vasodilation response index calculation unit 54 function.
  • each component will be described in more detail.
  • the cuff pressure control unit 51 automatically controls the air pump 22 and freely adjusts the cuff pressure by the cuffs 21 and 21.
  • the cuff pressure control unit 51 changes the cuff pressure from 0 to a constant speed for 25 seconds including the time when the amplitude of the pulse wave is maximum, as shown in FIG.
  • the finger compression means 2 is automatically operated so that the trial operation of releasing the compression for 5 seconds is made into one sequence, and this sequence is repeated for 6 trials (total 3 minutes) for each finger of the inspection finger and the control finger. Control.
  • the cuff pressure control unit 51 always acquires cuff pressure data during a compression trial and stores it in the cuff pressure data storage unit 44.
  • the arm on the inspection finger side is held for a predetermined time (5) in order to induce reactive hyperemia on the inspection finger.
  • a predetermined pressure synchronization + 50 mmHg.
  • the cuff pressure control unit 51 as shown in FIG. 3, at the time of reperfusion after releasing the blood transfusion, presses the finger of the examination finger and the control finger so as to keep pressing with a constant pressure. 2 is automatically controlled.
  • the constant pressure is the same as a value of a predetermined ratio of a resting average blood pressure before blood pumping, which will be described later.
  • the cuff pressure is about 70% of the resting average blood pressure.
  • the cuff pressure is increased from 0 at a constant speed for 25 seconds including the time when the amplitude of the pulse wave becomes maximum. Thereafter, a trial operation of releasing the pressure for 5 seconds is used as one sequence, and the lamp compression sequence method is employed in which this sequence is repeated 6 times (total 3 minutes) for each finger of the inspection finger and the control finger.
  • the sequence method is not limited to the lamp compression sequence method, and various sequence methods can be applied.
  • a constant pressure clamp A method in which a constant pressure CPfix is continuously applied to each finger of the examination finger and the control finger before blood transfusion may be applied in combination with the ramp compression sequence method.
  • the cuff pressure when the normalized pulse wave volume (NPV) is maximized is measured as a mean blood pressure (MBP) by a ramp compression sequence method.
  • MBP mean blood pressure
  • the value of a predetermined ratio (70%) of the average blood pressure measured for each of the examination finger and the control finger is set to a constant pressure CPfix, and each finger of the examination finger and the control finger before the blood pressure is transferred.
  • the tourniquet is released, it is continuously compressed with a constant pressure CPfix that is the same as the constant pressure CPfix applied before the tourniquet.
  • a constant pressure clamp B method in which a constant pressure CPfix is continuously applied to each finger of the inspection finger and the control finger before blood pressure may be applied.
  • the diastolic blood pressure of the upper arm is measured in advance before the examination.
  • the constant pressure clamp B method the pressure is close to the diastolic blood pressure of the upper arm measured in advance (for example, the upper arm diastolic blood pressure—10 mmHg), and the same pressure is used as the constant pressure CPfix for the examination finger and the control finger.
  • the tourniquet is released, it is continuously compressed with a constant pressure CPfix that is the same as the constant pressure CPfix applied before the tourniquet.
  • lnNPV NPV natural logarithm conversion value
  • ⁇ V ⁇ I / I
  • the transmitted light amount ( ⁇ I) corresponding to the pulsation change is determined by the amplitude of the alternating current component of the pulse wave.
  • the transmitted light amount (I) of the finger (tissue + blood) is determined by the average value of the DC component of the pulse wave at the same time.
  • the NPV calculation unit 52 for each finger, based on the resting pulse wave stored in the resting pulse wave storage unit 42 and the reperfusion pulse wave stored in the reperfusion pulse wave storage unit 43, An NPV natural logarithm conversion value (lnNPV) obtained by converting the normalized pulse wave volume (NPV) obtained by dividing the amplitude of the alternating current component of the pulse wave by the average value of the direct current component of the pulse wave to the natural logarithm is calculated for each heartbeat. It is supposed to be.
  • the light absorption amount (I t ) of only the finger tissue is the light absorption amount when it is assumed that no blood is present in the blood vessel, as shown in FIG.
  • the transmitted light amount (I) of the finger (tissue + blood) is determined by the average value of the DC component of the pulse wave.
  • the BV calculation unit 53 calculates a value obtained by dividing the light absorption amount (I t ) of only the finger tissue by the average value of the DC component of the pulse wave for each finger based on the resting pulse wave and the reperfusion pulse wave.
  • a blood volume (BV) which is a natural logarithm, is calculated for each heartbeat.
  • the vasodilation response index calculation unit 54 calculates only the normalized pulse wave volume index (NPVI) as the vasodilation response index, the value of the blood volume (BV) is not necessary, so BV calculation is performed.
  • the unit 53 may not function.
  • the vasodilation response index calculation unit 54 calculates only the blood volume index (BVI) as the vasodilation response index, the NPV natural logarithm conversion value (lnNPV) value is unnecessary, so the NPV calculation unit 52 functions. You don't have to.
  • ⁇ Average extinction coefficient of whole blood including arteries and veins
  • C Average concentration of whole blood
  • ⁇ I Transmitted light quantity (pulse wave volume) for pulsation change indicated by AC component of pulse wave
  • I transmitted light intensity
  • the vasodilation response index calculation unit 54 calculates the NPV natural logarithm conversion value (lnNPV) of the normalized pulse wave volume (NPV) at the time of resting and reperfusion of each finger and / or the blood at the time of resting and reperfusion of each finger. Based on the volume (BV), a vasodilator response index representing a vasodilator response at an arbitrary heart rate after reperfusion is calculated.
  • lnNPV NPV natural logarithm conversion value
  • the inventor of the present application aims to evaluate an increase in pulse wave amplitude and an increase in arterial volume due to relaxation of vascular smooth muscle in the finger arteriole during reactive hyperemia, and a normalized pulse wave volume index (NPVI), Five new vasodilator response indices were defined: Blood Volume Index (BVI), Dilation Distance Index (DI), Simple Distance Index (SI), and NB Reactivity Index (NBI).
  • NPVI normalized pulse wave volume index
  • BVI Blood Volume Index
  • DI Dilation Distance Index
  • SI Simple Distance Index
  • NBI NB Reactivity Index
  • Normalized pulse wave volume index is defined as the difference between the NPV natural logarithmic transformation value (lnNPV) at any heart rate after reperfusion and the NPV natural logarithmic transformation value (lnNPV) at rest before blood transfusion. Is.
  • the vasodilation response index calculation unit 54 calculates the normalized pulse wave volume index (NPVI) as the vasodilation response index, the following processes (i) to (iv) are performed as shown in FIG. Functions as the sections 55 to 58.
  • NPVI i NT i -NC i Formula (1)
  • each symbol represents the following.
  • the estimated NPV values (NPVt 0 and NPVc 0 ) at rest before blood transduction are the regressions of the cuff pressure and the NPV natural logarithm transformation value (lnNPV). It is an estimated value of the NPV natural logarithm conversion value (lnNPV) for each inspection finger and control finger, which is calculated by substituting a constant pressure at the time of compression after release of blood pressure as a cuff pressure into a straight NPV line.
  • the NPV natural logarithm conversion value in all pulsations existing in the section where compression was continued at a constant pressure before blood pumping ( lnNPV) can be averaged for each examination finger and control finger, and the average value can be calculated as NPV estimated values (NPVt 0 and NPVc 0 ) at rest before blood transfusion. Therefore, by adopting the constant pressure clamp A method or the constant pressure clamp B method as an alternative to the lamp compression sequence method, the inspection is simplified and the inspection time is shortened.
  • the resting average blood pressure estimation unit 55 acquires the resting pulse wave from the resting pulse wave storage unit 42, and specifies the cuff pressure when the normalized pulse wave volume (NPV) in each compression trial at rest is maximum. . This is because the cuff pressure is equal to the average blood pressure. Then, the resting average blood pressure estimation unit 55 estimates the average value or median value of each cuff pressure (mean blood pressure) specified for all trials as the resting average blood pressure before the blood pumping, for each finger of the examination finger and the control finger. It is supposed to be.
  • the NPV line calculating unit 56 acquires the cuff pressure at rest before blood driving from the cuff pressure data storage unit 44, and also calculates the NPV natural logarithm conversion value (lnNPV) at rest before blood driving calculated by the NPV calculating unit 52. get. Since the linear relationship between the cuff pressure and the NPV natural logarithm transformation value (lnNPV) can be approximated by linear regression, the NPV line calculation unit 56 performs regression analysis on the acquired data pair (cuff pressure, lnNPV), The NPV line which is a regression line is calculated.
  • the NPV estimated value calculation unit 57 substitutes a predetermined ratio of the average blood pressure at rest as the cuff pressure for the NPV line of each finger calculated by the NPV line calculation unit 56. As a result, the NPV estimated value calculation unit 57 calculates an NPV estimated value (NPVt 0 and NPVc in FIG. 6) that is an NPV natural logarithm conversion value (lnNPV) when each finger is compressed with the cuff pressure at the time of rest before blood excretion. 0 ) is calculated. Then, the NPV estimated value of each finger can be used as a reference for the change of the NPV natural logarithm conversion value (lnNPV) at the time of recirculation.
  • the NPVI calculation unit 58 obtains the NPV estimated value at rest before blood transduction calculated by the NPV estimated value calculation unit 57, and the NPV natural logarithm conversion value (lnNPV) at the time of reperfusion calculated by the NPV calculation unit 52 To get.
  • the NPVI calculation unit 58 then calculates the NPV natural logarithm conversion value (lnNPV) at the i-th beat after reperfusion on the basis of the estimated NPV value before resting as shown in the equation (1) and FIG. ) Is calculated for each finger and then normalized by subtracting the change (NC i ) in the control finger from the change (NT i ) in the test finger, and the effects of sympathetic nerve tension and arrhythmia are removed.
  • the normalized pulse wave volume index (NPVI) is calculated.
  • the blood volume index (BVI) is defined as the difference between the blood volume (BV) at any heart rate after reperfusion and the blood volume (BV) at rest before the blood pump.
  • the vasodilation response index calculation unit 54 when calculating the blood volume index (BVI) as the vasodilation response index, the vasodilation response index calculation unit 54, as shown in FIG. 55 and processing units 59 to 61 of (v) to (vii) below.
  • the BV line calculation unit 59 acquires the cuff pressure at the time before resting from the cuff pressure data storage unit 44 and the blood volume (BV) at the time before resting calculated by the BV calculation unit 53. Since the linear relationship between the cuff pressure and the blood volume (BV) can be approximated by linear regression, the BV line calculation unit 59 performs regression analysis on the acquired data pair (cuff pressure, BV), and returns the regression for each finger. A straight BV line is calculated.
  • the BV estimated value calculation unit 60 substitutes a predetermined ratio of the average blood pressure at rest as the cuff pressure for the BV line of each finger calculated by the BV line calculation unit 59. Thereby, the BV estimated value calculation part 60 calculates the BV estimated value which is a blood volume (BV) at the time of being compressed with the said cuff pressure at the time of rest before a blood pressure for each finger.
  • the estimated BV value of each finger can be used as a reference for the change in blood volume (BV) during recirculation.
  • the BVI calculating unit 61 acquires the BV estimated value at rest before blood transduction calculated by the BV estimated value calculating unit 60 and also acquires the blood volume (BV) at the time of reperfusion calculated by the BV calculating unit 53. . Then, as shown in the above equation (2), the BVI calculating unit 61 uses each B finger estimated value of the blood volume (BV) at the i-th beat after reperfusion based on the estimated BV value before resting as a reference. Is calculated by subtracting the change (BC i ) in the control finger from the change (BT i ) in the test finger, and the blood volume index (BVI) from which the effects of sympathetic nerve tension, arrhythmia and the like are removed ) Is calculated.
  • the dilated distance index (DI) is defined as the length of the perpendicular (perpendicular distance) drawn from the data point (BV, lnNPV) at any heart rate after reperfusion to the BN line at rest before blood transfusion. .
  • the vasodilation response index calculation unit 54 calculates an expansion distance index (DI) as the vasodilation response index, as shown in FIG. 1, the processing units 62, (viii) and (ix) below, 63 is configured to function.
  • DI i Extension distance index (DI) at i-th beat after reperfusion
  • DT i perpendicular distance from the data point (BV, lnNPV) at the i-th beat after reperfusion on the test finger side to the BN line of the test finger at rest before blood driving
  • DC i after reperfusion on the control finger side
  • Perpendicular distance drawn from the data point (BV, lnNPV) at the i-th beat to the BN line of the control finger before resting after blood driving SGNT i Data point (BV, lnNPV) at the i-th beat after reperfusion on the test finger side Is 1 (expanded) when is positioned at the upper right relative to the BN line of the inspection finger, and becomes 1 (contraction) when positioned at the lower left.
  • the BN ray calculation unit 62 acquires the blood volume (BV) at rest before blood transduction calculated by the BV calculation unit 53, and the NPV natural logarithm conversion value at rest before blood transduction calculated by the NPV calculation unit 52. Obtain (lnNPV). Then, the BN line calculation unit 62 calculates a BN line for each finger as shown in FIG. 6 by performing regression analysis on the acquired data pair (BV, lnNPV).
  • the DI calculation unit 63 acquires the data point (BV, lnNPV) at the i-th beat after reperfusion calculated by the BV calculation unit 53 and the NPV calculation unit 52 for each finger. Then, as shown in FIG. 6, the DI calculation unit 63 calculates the perpendicular distance from each data point to the BN line calculated by the BN line calculation unit 62 for each finger. Further, the DI calculation unit 63 specifies the inspection finger side expansion / contraction determination value (SGNT i ) and the control finger side expansion / contraction determination value (SGNC i ) based on the position of each data point with respect to the BN line.
  • SGNT i inspection finger side expansion / contraction determination value
  • SGNC i control finger side expansion / contraction determination value
  • the DI calculation unit 63 calculates the control finger side expansion / contraction from the normal distance (DT i ) on the inspection finger side multiplied by the inspection finger side expansion / contraction discrimination value (SGNT i ). Normalization is performed by subtracting the perpendicular distance (DC i ) on the control finger side multiplied by the discriminant value (SGNC i ) to calculate an expansion distance index (DI) from which the influence of sympathetic nerve tension, arrhythmia, etc. has been removed. It is like that.
  • the reason why the extended distance index (DI) is defined as described above will be described with reference to FIG.
  • DI extended distance index
  • an increase in vascular tonus (tension) in the control finger causes a mutation in the lower left direction from the BN line.
  • the magnitude of the vasoconstriction at an arbitrary time (i th beat) can be evaluated by obtaining the perpendicular distance (DC i ) between the data point (BV, lnNPV) of the beat and the BN line. That is, the deviation from the BN line is due to vascular tonus fluctuations.
  • the magnitude of the vasodilation at an arbitrary time (beat i) is the data point (BV, lnNPV) of the beat.
  • To the BN line can be evaluated by obtaining a perpendicular distance (DT i ).
  • the increase in vascular tonus in the test finger appears as a variation from the BN line to the lower left direction, as in the control finger.
  • the normalized vasodilation response index representing true vasodilation in the examination finger is estimated by obtaining the difference between the perpendicular distance (DT i ) on the examination finger side and the perpendicular distance (DC i ) on the control finger side.
  • the expansion distance index (DI) is an index that is standardized by the decrease on the control finger side with respect to the decrease in vascular tone that occurs simultaneously. It should be noted that during reactive hyperemia, the mean blood pressure varies with hemodynamic variation of the finger, but the effect is movement on the BN line. Therefore, the expansion distance index (DI) is expected to be specific at a point that is independent and orthogonal to the variation in mean blood pressure.
  • the simple distance index (SI) is the length of a straight line (straight line distance) between the data point (BV, lnNPV) on the test finger side and the data point (BV, lnNPV) on the control finger side in an arbitrary heartbeat after reperfusion. ).
  • the vasodilation response index calculation unit 54 functions as a processing unit 64 of (x) below as shown in FIG. 1 when calculating a simple distance index (SI) as a vasodilation response index. It has become.
  • SI i Simple distance index (SI) at the i-th beat after reperfusion
  • ST i Linear distance connecting the data point (BV, lnNPV) at the i th beat after reperfusion on the examination finger side and the data point (BV, lnNPV) at the i th beat after reperfusion on the control finger side
  • SGNS i Positive / negative discriminant value that is 1 when the expansion distance index (DI i ) at the i-th beat after reperfusion is positive, and -1 when it is negative
  • the SI calculation unit 64 obtains the blood volume (BV) at rest before blood transduction calculated by the BV calculation unit 53, and also calculates the NPV natural logarithm conversion value at rest before blood transduction calculated by the NPV calculation unit 52 ( lnNPV). Then, as shown in FIG. 6, the SI calculation unit 64 connects the data points (BV, lnNPV) of each finger at the i-th beat after reperfusion with a straight line, and calculates the straight line distance (ST i ) between the data points. calculate.
  • the SI calculation unit 64 specifies a positive / negative discrimination value (SGNS i ) based on the expansion distance index (DI i ) of the i-th beat after reperfusion calculated by the DI calculation unit 63. Then, the SI calculation unit 64 multiplies the linear distance (ST i ) between the data points for each finger by the positive / negative discrimination value (SGNS i ) as shown in the above equation (4), thereby obtaining a simple distance index ( SI) is calculated.
  • the NB reactivity index (NBI) includes the NPVI vs. BVI difference index (NBI D ) defined by the difference between the normalized pulse wave volume index (NPVI) and the blood volume index (BVI), and the normalized pulse wave volume index.
  • NBI D NPVI vs. BVI difference index
  • BVI R NPVI to BVI ratio index
  • the vasodilation response index calculation unit 54 functions as the processing unit 65 of the following (xi) as shown in FIG. 1 and below when calculating the NB reactivity index (NBI) as the vasodilation response index. It is supposed to be.
  • NBI Di NPVI i -BVI i Formula (5a)
  • NBI Ri NPVI i / BVI i + k (5b)
  • NBI Di NPVI vs.
  • NBI R i NPVI to BVI ratio index (NBI R ) at i th beat after reperfusion
  • NPVI i Normalized pulse wave volume index (NPVI) at i-th beat after reperfusion
  • BVI i Blood volume index (BVI) at the i-th beat after reperfusion k: Constant determined by experiment
  • the NBI calculation unit 65 acquires the normalized pulse wave volume index (NPVI i ) at the i-th post-reperfusion pulse calculated by the NPVI calculation unit 58 and the i-th post-reperfusion i calculated by the BVI calculation unit 61. Obtain blood volume index (BVI i ) at the beat. Then, the NBI calculating unit 65 subtracts the blood volume index (BVI i ) from the normalized pulse wave volume index (NPVI i ) as shown in the above formula (5a), thereby obtaining the NB reactivity index (NBI) as the NB reactivity index (NBI). NPVI vs. BVI difference index (NBI D ) is calculated.
  • the NBI calculation unit 65 divides the normalized pulse wave volume index (NPVI i ) by the blood volume index (BVI i ) as shown in the above formula (5b), thereby obtaining the NBI).
  • the NPVI to BVI ratio index (NBI R ) is calculated.
  • the normalized pulse wave volume index is calculated based on the NPV natural logarithm conversion value (lnNPV)
  • the blood volume index (BVI) is calculated based on the blood volume (BV)
  • the expansion distance The index (DI), simple distance index (SI), and NB reactivity index (NBI) are calculated based on the NPV natural logarithm conversion value (lnNPV) and blood volume (BV), respectively.
  • FIG. 7 shows a comparison result between the FRHI (Framingham-Reactive-Hyperemia Index) and the FCR ratio according to the FCR method of the prior application.
  • FRHI Fringham-Reactive-Hyperemia Index
  • the expansion distance index (DI) and the simple distance index (SI) are not only increased in pulse wave amplitude due to relaxation of vascular smooth muscle, but also increase in arterial volume. It can be said that the comprehensiveness is superior to the FRHI related to the Endo-PAT method.
  • the expansion distance index (DI) is superior to other evaluation indexes in that it is not affected by the mean blood pressure, and thus has a specificity in the endothelial function (a property of purely evaluating only the endothelial function). It can be said that.
  • the simple distance index (SI) can weight the indirect effect of the endothelial function due to the fluctuation of the average blood pressure. It can be said that it is superior to the evaluation index.
  • the normalized pulse wave volume index (NPVI), the extended distance index (DI), and the simple distance index (SI) according to the present invention analyze hemodynamic influencing factors by comparing their fluctuation patterns with each other. It can be said that it is superior to the conventional evaluation index in that it can be evaluated.
  • the normalized pulse wave volume index (NPVI), blood volume index (BVI), dilatation distance index (DI), simple distance index (SI) and NB reactivity index (NBI) are the transmural pressure and By substituting the relationship with the compliance with the relationship between the blood volume (BV) and the NPV natural logarithm conversion value (lnNPV), there is no error due to the blood pressure measurement because the blood pressure measurement is unnecessary. Further, the normalized pulse wave volume index (NPVI), blood volume index (BVI), dilatation distance index (DI), simple distance index (SI) and NB reactivity index (NBI) according to the present invention are necessary for the estimation. Since accurate pulse wave data can be measured continuously and accurately for each heartbeat, it can be said that it is superior to the FCR ratio in that it can be estimated continuously and accurately for each heartbeat.
  • the present invention can be said that it is more economical than the Endo-PAT method using a disposable cuff in that the cuff that presses the finger can be used repeatedly.
  • the present invention can be extended not only to both methods using the same finger in both hands as an inspection finger and a control finger, but also to one method using different fingers in one hand as an inspection finger and a control finger. It can be said that this method is superior to the Endo-PAT method using both methods as a standard.
  • the finger artery elasticity index (FEI) is used. By measuring arterial Elasticity Index, the influence of stiffness can be corrected by the finger artery elasticity index (FEI).
  • the finger artery elasticity index (FEI) is calculated for both the test finger and the control finger using the pulse wave data and cuff pressure data measured at the time of rest before blood transfusion according to the test protocol according to the present invention. It is also possible.
  • the digital arterial dilatability continuous examination method according to the present invention can be independent of the arterial stiffness, which is an influencing factor, and is superior to the Endo-PAT method.
  • the finger artery elasticity index (FEI) is expressed as a linear regression gradient (n) in the following equation (c).
  • ln (NPV) ln (bn) ⁇ n ⁇ Pr Formula (c)
  • b constant Pr: relative cuff pressure (difference between cuff pressure when the amplitude of the pulse wave is maximum and each cuff pressure)
  • the reason why the vasodilator response target is not a large blood vessel such as the brachial artery but a small blood vessel of the finger is as follows. That is, there is a physiological hypothesis that systemic arteriosclerosis progresses from small blood vessels. In addition, it is suitable for clinical diagnosis of microvascular disorders such as diabetes and hypertension, and is applied to these earliest diagnoses.
  • the photoelectric sensor 31 and the cuff 21 are attached to each of the subject's examination finger and control finger in advance.
  • the cuff 21 is integrated with the light receiving unit 31b and is wound around the finger, it is not necessary to prepare a plurality of sizes of cuffs 21 having different diameters. Wearing that is most suitable for finger diameter becomes possible.
  • the light emitting unit 31a and the light receiving unit 31b are in close contact with the finger, and the optical path shift accompanying the progress of finger compression is minimized.
  • the finger artery elasticity index (FEI) originally developed by the present inventor is measured. .
  • FEI finger artery elasticity index
  • the vasodilator response index according to the present invention is also independent of the stiffness of the artery, which is an influencing factor on the vascular endothelial function.
  • the cuff pressure control unit 51 uses the finger pressing means 2 to press each finger of the inspection finger and the control finger with the above-described sequence or the above-described constant pressure.
  • pulse wave data is measured by the pulse wave detecting means 3 and stored in the resting pulse wave storage unit 42 as a resting pulse wave (step S1: resting pulse wave storage step).
  • step S1 resting pulse wave storage step.
  • the light emitting unit 31a of the photoelectric sensor 31 emits light
  • the light receiving unit 31b detects the amount of light transmitted through the finger tissue or blood vessel.
  • hemoglobin in blood has a strong absorption spectrum for light in a certain wavelength band.
  • the transmitted light of the living body when the light of the wavelength band is irradiated changes in accordance with the amount of hemoglobin that changes with the volume fluctuation of the blood vessel. Therefore, the pulse wave is detected by amplifying the transmitted light amount detected by the light receiving unit 31b by the pulse wave amplifier 32.
  • the cuff pressure control unit 51 uses the finger pressing means 2 to place each finger of the inspection finger and the control finger in the resting state before the blood pumping or the above-described sequence.
  • the cuff pressure of each cuff that presses each finger is stored in the cuff pressure data storage unit 44 during the compression trial with the constant pressure (step S2: cuff pressure data storage step).
  • step S2 cuff pressure data storage step.
  • step S3 blood-feeding step
  • step S4 reperfusion pulse wave storage step
  • the reason why the constant pressure (CP70 in FIG. 3) at the time of reperfusion after blood transfer is set as the predetermined ratio of the above-mentioned average blood pressure at rest will be described.
  • the blood volume (BV) changes from about 0 to 1.0
  • the NPV natural logarithm conversion value (lnNPV) is from 1.0 to 1.6. It changes to about. That is, the data point (BV, lnNPV) on the BN line moves in the lower right direction when the cuff pressure is low, and conversely moves in the upper left direction when the cuff pressure is high.
  • the blood volume (BV) is about 0.5, and the natural logarithm of NPV.
  • the conversion value (lnNPV) was about 1.2, which was found to be an approximately middle portion of the above-described fluctuation range of the BN line.
  • the data point (BV, lnNPV) for each beat may exceed the fluctuation range of the BN line.
  • NPVI normalized pulse wave volume index
  • BVI blood volume index
  • DI expansion distance index
  • SI simple distance index
  • NBI NB reactivity index
  • the value around 70% of the average blood pressure at rest is a cuff pressure slightly lower than the diastolic blood pressure as described above.
  • the pulse wave waveform is deformed.
  • the cuff pressure is too smaller than the diastolic blood pressure, the pulse wave amplitude decreases, and the SN (signal-noise) ratio decreases. Therefore, by setting the constant pressure at the time of reperfusion after blood pumping to around 70% of the average blood pressure at rest, it is considered that the SN ratio is kept high and the pulse waveform is difficult to deform.
  • the NPV calculating unit 52 performs NPV naturalization of the normalized pulse wave volume (NPV) in each finger.
  • a logarithmic conversion value (lnNPV) is calculated for each heartbeat (step S5: NPV calculation step).
  • the NPV natural logarithm conversion value (lnNPV) of the test finger at rest before and after reperfusion, and the NPV of the control finger at rest before and after reperfusion A natural logarithm conversion value (lnNPV) is calculated for each heartbeat.
  • the BV calculation unit 53 performs blood volume (BV) in each finger based on the resting pulse wave measured in step S1 and the reperfusion pulse wave measured in step S4. Is calculated for each heartbeat (step S6: BV calculation step).
  • step S6 BV calculation step.
  • the vasodilation response index calculation unit 54 performs vasodilation at any heart rate after reperfusion based on the NPV natural logarithm conversion value (lnNPV) at rest and reperfusion of each finger calculated in step S5.
  • a vasodilation response index representing a reaction is calculated (step S7: vasodilation response index calculation step).
  • a vasodilation response index indicating the vasodilation response of the finger artery is calculated continuously and accurately for each heartbeat.
  • the vasodilation response index calculation unit 54 calculates the normalized pulse wave volume index (NPVI) as the vasodilation response index in the vasodilation response index calculation step described above. I will explain.
  • the resting average blood pressure estimation unit 55 estimates the resting average blood pressure for each of the examination finger and the control finger based on the resting pulse wave (step S11: resting mean blood pressure estimation step).
  • the NPV line calculation unit 56 performs regression analysis on the data pair of the cuff pressure and the NPV natural logarithm conversion value (lnNPV) at the time of resting prior to blood pressure, and calculates the NPV line for each finger (step S12: NPV line calculation step) ).
  • the NPV estimated value calculation unit 57 performs cuff pressure at a predetermined ratio of the resting average blood pressure for each finger based on the resting average blood pressure calculated in step S11 and the NPV line calculated in step S12.
  • the NPV estimated value when the pressure is applied is calculated (step S13: NPV estimated value calculating step).
  • the NPVI calculation unit 58 performs normalization based on the NPV natural logarithm conversion value (lnNPV) at the time of reperfusion calculated at step S5 and the NPV estimated value at the time of rest before blood transduction calculated at step S13.
  • a pulse wave volume index (NPVI) is calculated (step S14: NPVI calculation step).
  • the NPV natural logarithm conversion value (lnNPV) at rest before blood pressure is estimated based on the relationship between the cuff pressure and the NPV natural logarithm conversion value (lnNPV) without using the blood pressure and the blood volume (BV), and the NPV A normalized pulse wave volume index (NPVI) is calculated that represents the variation of the NPV natural logarithmic transformation value (lnNPV) after reperfusion with reference to the estimated value.
  • the resting average blood pressure estimation unit 55 estimates the resting average blood pressure for each of the examination finger and the control finger based on the resting pulse wave (step S21: resting average blood pressure estimation step).
  • the BV line calculation unit 59 performs a regression analysis on the data pair of the cuff pressure and the blood volume (BV) at the time of resting before blood pressure, and calculates a BV line for each finger (step S22: BV line calculation step).
  • the BV estimated value calculation unit 60 uses the resting average blood pressure calculated in step S21 and the BV line calculated in step S22 for each finger for a predetermined ratio of the resting average blood pressure cuff pressure.
  • the BV estimated value when the pressure is applied is calculated (step S23: BV estimated value calculating step).
  • the BVI calculating unit 61 calculates the blood volume index (BVI) based on the blood volume (BV) at the time of reperfusion calculated in step S6 and the estimated BV value at the time of rest before blood transduction calculated in step S23. ) Is calculated (step S24: BVI calculation step).
  • step S24 BVI calculation step.
  • the blood volume (BV) at rest before the thrombus is estimated from the relationship between the cuff pressure and the blood volume (BV), and the BV estimated value is calculated.
  • a blood volume index (BVI) representing a change in blood volume (BV) after reperfusion as a reference is calculated.
  • the vasodilation response index calculating unit 54 calculates the expansion distance index (DI) as the vasodilation response index in the vasodilation response index calculation step described above. I will explain.
  • the BN line calculation unit 62 calculates a BN line for each finger by performing regression analysis on the data pair (BV, lnNPV) at rest before blood pressure (step S31: BN line calculation step).
  • the DI calculation unit 63 calculates the perpendicular distance from the data point (BV, lnNPV) at the i-th beat after reperfusion calculated in step S5 and step S6 to the BN line calculated in step S31. (Step S32: perpendicular distance calculation step). Further, the DI calculation unit 63 specifies the inspection finger side expansion / contraction determination value (SGNT) and the control finger side expansion / contraction determination value (SGNC) based on the position of each data point with respect to the BN line (step S33: expansion). -Shrinkage discrimination value specifying step).
  • the DI calculation unit 63 calculates the control finger side expansion / contraction discriminant value from the normal distance (DT) on the inspection finger side multiplied by the inspection finger side expansion / contraction discriminant value (SGNT).
  • the extension distance index (DI) is calculated by subtracting the perpendicular distance (DC) on the control finger side multiplied by (SGNC) (step S34: DI calculation step).
  • the vasodilation response index calculation unit 54 calculates a simple distance index (SI) as a vasodilation response index
  • SI simple distance index
  • the SI calculation unit 64 connects the data points (BV, lnNPV) of each finger at the i-th beat after reperfusion with a straight line, and calculates the straight line distance (ST) between the data points.
  • ST straight line distance
  • the SI calculation unit 64 specifies a positive / negative discriminant value (SGNS) based on the expansion distance index (DI) of the i-th beat after reperfusion calculated in step S34 (step S42: positive / negative discriminant value specifying step). .
  • SGNS positive / negative discriminant value
  • the SI calculation unit 64 multiplies the linear distance (ST) between the data points for each finger by the positive / negative discrimination value (SGNS) as shown in the above equation (4), thereby obtaining the simple distance index (SI).
  • step S43 SI calculation step.
  • the vasodilation response index calculation unit 54 is a specific example when the vasodilation response index calculation unit 54 calculates an NB reactivity index (NBI) as the vasodilation response index.
  • NBI NB reactivity index
  • the sub-steps will be described with reference to FIG.
  • the NBI calculation unit 65 calculates the NB reactivity index (NBI) based on the normalized pulse wave volume index (NPVI) and the blood volume index (BVI) at an arbitrary heart rate after reperfusion (step S51: Rest) Time average blood pressure estimation step).
  • the NBI calculation unit 65 is NPVI vs. BVI difference index (NBI D ) defined by the difference between the normalized pulse wave volume index (NPVI) and the blood volume index (BVI).
  • the NPVI to BVI ratio index (NBI R ) defined by the ratio of the normalized pulse wave volume index (NPVI) and the blood volume index (BVI) is calculated as shown in the above equation (5b). May be.
  • the following effects can be obtained. 1. It is possible to easily and accurately examine signs of early arteriosclerosis in the small blood vessels of the finger artery without measuring blood pressure. 2. By substituting the relationship between transmural pressure and compliance for each heartbeat with the relationship between blood volume and NPV natural logarithm conversion value (lnNPV), blood pressure measurement is not required, and the effect of blood pressure fluctuations can be continued with only the pulse wave. Can be estimated. 3. Since a predetermined constant pressure is continuously applied to each finger during reperfusion without interruption, myogenic vasoconstriction can be prevented and the accuracy of the examination can be improved. 4).
  • NPVI normalized pulse wave volume index
  • the simple distance index (SI) is highly comprehensive in that it includes not only an increase in pulse wave amplitude due to relaxation of vascular smooth muscle but also an increase in arterial volume, and an indirect effect of endothelial function due to fluctuations in mean blood pressure. The highest sensitivity can be obtained as an endothelial function test. 8).
  • the effect of decreasing transmural pressure due to a decrease in mean blood pressure increases the normalized pulse wave volume index (NPVI) while decreasing the blood volume index (BVI).
  • NPVI normalized pulse wave volume index
  • BVI blood volume index
  • the NB reactivity index (NBI) like NPVI, comprehensively reflects vasodilatation weighted by both vascular tone and blood pressure reduction, but the normalized pulse wave volume index (NPVI) and blood volume index (BVI).
  • NPVI normalized pulse wave volume index
  • BVI blood volume index
  • DI dilated distance index
  • SI simple distance index
  • NBI NB responsiveness index
  • the conventional FMD method evaluates only the initial response after reperfusion, and the conventional Endo-PAT method evaluates only the delayed response after reperfusion. Both responses can be assessed in a single test.
  • the FMD method requires an expensive ultrasonic diagnostic apparatus, requires skill for image analysis, and cannot exclude the subjectivity of the examiner, but according to the present invention, the biological reaction to be measured is only the pulse wave, It is excellent in objectivity, small, light, safe and inexpensive, and easy to operate.
  • the cuff part necessary for the Endo-PAT method can only be used for one inspection, whereas according to the present invention, the cuff 21 can be used repeatedly, and the same can be applied to a plurality of subjects. The cuff 21 can be optimally mounted, and the running cost can be reduced. 13.
  • the inspection can be simplified and the inspection time can be shortened.
  • the constant pressure clamp A method and the constant pressure clamp B method are used, the normalized pulse wave volume index (NPVI), blood volume index (BVI), simple distance index (SI) and NB reactivity index (NBI) are Note that although an extension distance index (DI) can be calculated, it can be calculated. This is because the BN line cannot be obtained by the constant pressure clamp A method and the constant pressure clamp B method.
  • Example 1 the conventional Endo-PAT method was performed, and at the same time, the finger arteriole dilatability continuous inspection method according to the present invention was performed, and an experiment was performed to confirm the degree of coincidence between them.
  • FRHI Frazier-responsive hyperemia index
  • NPVI NPVI
  • DI NPVI
  • SI vasodilator response index
  • the FRHI related to the Endo-PAT method was measured with the left and right second fingers of each subject.
  • the vasodilation response index according to the present invention was measured with the third finger on the left and right of each subject using a prototype equipped with a cuff that can be used repeatedly. The result is shown in FIG.
  • FIG. 16 is a graph showing the average value ⁇ standard error value of each index in the interval of 90 to 150 seconds after reperfusion regarding the decrease in vasodilatory capacity of the diabetic patient group relative to the healthy adolescent group.
  • FRHI no significant group difference was observed between the healthy adolescent group and the diabetic patient group.
  • DI, NPVI, and SI a significant decrease was observed between the healthy adolescent group and the diabetic patient group ( ⁇ 33%, ⁇ 51%, and ⁇ 54%, respectively). And was clearly distinguished.
  • FIG. 17 shows a graph of the average value ⁇ standard error of the underestimation and overestimation of DI, NPVI, and SI with respect to FRHI. As shown in FIG. 17, at least for NPVI and SI, a result suggesting superiority to the FRHI according to the Endo-PAT method was obtained.
  • the vasodilator response index according to the present invention reflects the increase in arterial volume in addition to the pulse wave amplitude, and the influence of blood pressure fluctuations It was suggested that comprehensive evaluation can be performed. Moreover, it was shown that the vasodilator response index according to the present invention has utility and superiority to FRHI in discrimination of arteriosclerotic diseases.
  • Example 2 27 diabetic patients in the above-mentioned Example 1 and 15 urological prostate cancer patients having the same age as the diabetic patient group and having no circulatory system disease were subjects, and blood vessels according to the present invention were used.
  • extended reaction indices NPVI, DI, and SI were calculated.
  • FIG. 18 the vasodilator response index of the diabetic patient group is significantly lower than that of the prostate cancer patient group, DI is ⁇ 53%, NPVI is ⁇ 58%, SI was -47%.
  • the vasodilator response index according to the present invention can easily and accurately detect signs of early arteriosclerosis in the small blood vessels of the finger arteries without measuring blood pressure. .
  • a simulation for comparing the sensitivity at the time of vasodilation was performed for three of NPVI, DI, and SI.
  • the origin (BVt 0 , lnNPVt 0 ) at rest before blood pressure and the S-th point of the i-th beat after reperfusion (
  • the angle formed by the straight line connecting BVt i and lnNPVt i ) with respect to the X axis (BV axis) is ⁇ .
  • a BN line (BV-lnNPV regression line) at the time of rest before blood transduction is moved in parallel and is a straight line passing through the S point (R ′ line).
  • the angle formed by the perpendicular drawn from the origin is ⁇ , and the angle formed by the perpendicular to the X axis (BV axis) is ⁇ .
  • SI DI / cos ( ⁇ )
  • NPVI DI ⁇ sin ( ⁇ ) / cos ( ⁇ )
  • the following three relational expressions hold for the relative sensitivity of NPVI, DI, and SI.
  • SI / DI 1 / cos ( ⁇ )
  • FIG. 20 shows the results of calculating the above three ratios (SI / DI, NPVI / DI, SI / NPVI) when ⁇ is 30 degrees.
  • SI the above three ratios
  • NPVI / SI sin ( ⁇ ) is NPVI ⁇ SI because 0 ⁇ ⁇ / 2.
  • DI / SI cos ( ⁇ ) satisfies DI ⁇ SI because 0 ⁇ ⁇ / 2. Therefore, as shown in FIG. 20, it can be said that SI is theoretically the best in sensitivity to vasodilation.
  • NPVI / DI increases as the decrease in mean blood pressure increases.
  • the increase in BV prevails over lnNPV, so the angle ⁇ decreases and NPVI / SI decreases greatly (NPVI ⁇ SI).
  • DI / SI decreases (DI ⁇ SI) regardless of whether the blood pressure decreases or increases on the straight line orthogonal to the R ′ line. That is, it was confirmed that DI, SI, and NPVI have a predetermined fluctuation pattern with respect to blood pressure fluctuations.
  • the normalized pulse wave volume (NPV) increases as shown in FIG. 20, but the blood volume (BV) decreases.
  • NPV normalized pulse wave volume
  • BV blood volume
  • increases in these normalized pulse wave volume (NPV) and blood volume (BV) have a weighting effect, and the increase in the NPVI vs. BVI difference index (NBI D ) and the NPVI vs. BVI ratio index (NBI R ) Strengthened. Therefore, it was confirmed that the sensitivity of the NPVI to BVI difference index (NBI D ) and the NPVI to BVI ratio index (NBI R ) is improved when blood vessels are dilated due to endothelial function.
  • Example 4 an experiment was performed to confirm the coexistence validity of the Endo-PAT method for both methods using the constant pressure clamp A method.
  • both methods were performed on the left and right third fingers of each subject, and at the same time, the Endo-PAT method (Endo-PAT2000) was performed on the left and right second fingers. did.
  • the normalized pulse wave volume (NPV) calculated from the photoelectric volume pulse wave before and after releasing the blood pressure in the reactive hyperemia after the forearm is driven for 5 minutes
  • the normalized pulse wave volume index (NPVI) according to the present invention was calculated by normalizing with the normalized pulse wave volume (NPV) of the non-traumatic control finger on the opposite side.
  • the estimated value of NPV at the time before resting was calculated using the above-described sequence by the constant pressure clamp A method. The result is shown in FIG.
  • Example 5 an experiment was conducted to confirm the clinical usefulness of both methods using the constant pressure clamp A method.
  • the constant pressure clamp A method was used in the same manner as in Example 4 for 14 diabetic patients with reported endothelial dysfunction and progression of arteriosclerosis and 19 prostate cancer patients as controls. Both methods were performed using the sequence according to.
  • NPVI normalized pulse volume index
  • BVI blood volume index
  • DI dilated distance index
  • SI simple distance index
  • the blood volume index (BVI) and dilatation index (DI) of diabetic patients are significantly lower compared to the blood volume index (BVI) and dilatation index (DI) of prostate cancer patients. Value.
  • the normalized pulse wave volume index (NPVI) and simple distance index (SI) no significant difference was observed between diabetic patients and prostate cancer patients.
  • the blood volume index is higher than the normalized pulse wave volume index (NPVI) or simple distance index (SI) representing pulsation.
  • NPVI normalized pulse wave volume index
  • SI simple distance index
  • BVI extended distance index
  • DI extended distance index
  • Example 6 an experiment was conducted to confirm the applicability to stress evaluation for both methods using the constant pressure clamp A method.
  • Example 6 the vasodilator response index according to the present invention was calculated using both methods, and the relationship among stress, lifestyle habits, and psychosocial factors was investigated among healthy female adolescents.
  • a significant partial correlation with the normalized pulse wave volume index (NPVI) ) Indicates body fat percentage ( ⁇ 0.40), anger expression in the heart of the condition-characteristic anger expression scale (STAXI-2) ( ⁇ 0.45), anger expression index not suppressed ( ⁇ 0.36) ), A language attack ( ⁇ 0.41) of the Buss-Perry aggression scale (BAQ: Buss-Perry Aggression Questionnaire).
  • the significant partial correlation (r) with the NPVI to BVI difference index (NBI D ) and the NPVI to BVI ratio index (NBI R ) as the NB reactivity index (NBI) is shown in Fat percentage (-0.43, -0.47), anger expression (-0.45, -0.46), anger expression index (STAXI-2), state-characteristic anger expression scale (STAXI-2) -0.40, -0.43), Buss-Perry aggressiveness scale (BAQ) verbal attack (NBI D ; -0.43), BAQ hostility (NBI R ; -0.40), BAQ synthesis ( -0.35, -0.43).
  • Example 6 a significant relationship was found between each index calculated by both methods and lifestyle-related and anger-related characteristics. Therefore, it is suggested that chronic enhancement of sympathetic nerve activity related to daily life (lifestyle) and mental stress may suppress vascular endothelial function and lead to early signs of arteriosclerosis. These results suggest the possibility of applying both methods to stress assessment of healthy subjects.
  • the NPVI vs. BVI difference index (NBI D ) and the NPVI vs. BVI ratio index (NBI R ) are more highly correlated than the normalized pulse wave volume index (NPVI), and are a stress evaluation index related to anger feelings. This suggests its usefulness.
  • the single method that can be inspected with only one hand is simpler than the both methods in which both hands are inspected, and thus is suitable for commercialization of the finger arteriole dilatability continuous inspection device according to the present invention. Therefore, in Examples 7 to 9 below, a series of experiments were conducted to verify the consistency with the Endo-PAT method performed with both hands in order to confirm the validity of the one method using the constant pressure clamp B method. It was.
  • NPVI normalized pulse wave volume index
  • Example 7 14 healthy adolescents were used as subjects.
  • the proximal part of the second finger of the left hand was driven, and in the Endo-PAT method, the forearm of the right hand was simultaneously driven for 5 minutes.
  • a pressure 10 mmHg lower than the diastolic blood pressure measured at the upper arm before the examination is determined, and the same pressure is applied to the examination finger and the control finger before, during, and after the release of blood pressure.
  • the estimated NPV value at rest before blood pressure was calculated using the constant pressure clamp B method with a constant pressure of brachial diastolic blood pressure ⁇ 10 mmHg.
  • Example 8 healthy young people were subjects, and only the proximal part of the second finger of the left hand was driven.
  • the end nodes of the left and right second fingers were measured by the Endo-PAT method, and the influence on the left and right fourth fingers was measured by the one-handed continuous method (adjacent four-finger condition).
  • the end node of the second finger on the left and right was measured by the Endo-PAT method, and the influence on the first and fifth fingers on the left and right was measured by the one-handed continuous method (adjacent). 1 & 5 finger condition).
  • the normalized pulse wave volume index (NPVI) by one method at rest before blood transduction was measured using the constant pressure clamp B method.
  • the average value of the normalized pulse wave volume index (NPVI) in the interval of 90 to 150 seconds after the release of the second finger blood transfusion is 0.41 in the above adjacent four finger condition, and is 0 in the above adjacent 1 & 5 finger condition. .28.
  • the average value of the normalized pulse wave volume index (NPVI) indicating the ripple effect of hyperemia is 0.004 for the fourth finger, -0.02 for the first finger, and-for the fifth finger- 0.05.
  • the normalized pulse wave volume index (NPVI) calculated from the second finger on the left and right is used as a reference (second finger reference NPVI), and the second finger on the inspection side is set to the right second finger on the control side.
  • NPVI normalized pulse wave volume index
  • the proximal node portion of the left second finger was driven, the terminal node portion of the left second finger was used as an examination site, and the terminal node portion of the left first finger was used as a control region.
  • the Endo-PAT method was simultaneously measured by driving the right forearm. Specifically, for the nine test subjects, the right fourth finger was the inspection finger and the left fourth finger was the control finger (PAT4 finger condition). For another nine subjects, the right fifth finger was used as the inspection finger and the left fifth finger was used as the control finger (PAT5 finger condition).
  • NPVI normalized pulse wave volume index
  • FRHI Frazier reactive hyperemia index
  • the proximal joint portion of the second finger is driven, and the terminal portion of the second finger is used as the examination site, so that the first finger or the fifth finger is used. It was shown that the adverse effect of the ripple effect of hyperemia on the control site is minimized by adopting the method using the last part of the control site as the control site. In addition, it was proved that the one method according to the present invention shows extremely high correlation even when it is performed simultaneously with the Endo-PAT method in which both hands are used to drive the arm.
  • the single method can be implemented with only one hand, so the inspection device can be further simplified.
  • the one method is optical measurement, it can be implemented with a simple cuff that can be used repeatedly, and is expected to be more useful than the Endo-PAT method.
  • the single method according to the present invention can be used as an alternative test for the Endo-PAT test that has already been established clinically useful.
  • the finger arteriole dilatability continuous examination program, the finger arteriole dilatability continuous examination apparatus, and the finger arteriole dilatability continuous examination method according to the present invention are not limited to the above-described embodiments and examples, and are appropriately selected. Can be changed.
  • the blood drive time for inducing reactive hyperemia is 5 minutes (standard method), but is not limited to this configuration, and can be easily reduced to about 3 minutes. (Simple method).
  • one and the other of the same fingers in both hands are used as inspection fingers and control fingers, respectively (both methods).
  • the present invention is not limited to this configuration. An inspection finger and a control finger may be used (one method).
  • a display table (for example, soft, normal, hard) indicating the vascular expansion response of the finger artery is stored in the storage unit 4 in correspondence with the numerical range of each vasodilation response index according to the present invention, and the vascular expansion is performed.
  • data indicating the vasodilation response of the finger artery may be output from a display unit or printing unit (not shown).
  • the early diagnosis method for arteriosclerosis targeting the small arteries as in the continuous inspection method for finger arteriole dilatability contributes to the improvement of the quality of life of the elderly, the disabled and the patients.
  • clinical cases where microarterial endothelial function tests are directly useful include diabetic retinopathy, retinal venous occlusion, age-related macular degeneration, cardiovascular heart failure, kidney disease, which is accompanied by microcirculation disorders and is a major cause of blindness
  • diabetic nephropathy that progresses to dialysis application, hypertension that accelerates arteriole sclerosis, and erectile dysfunction due to arteriosclerosis.
  • the pathology of small arteries appears to be an important indicator of preventive medicine since it appears at the earliest stage in the natural history of arteriosclerosis and precedes arteriosclerosis and thickening of large vessels. That is, the continuous examination for the dilatability of the finger arteriole according to the present invention, including the microarterial elasticity and stiffness test (FEI / FSI method) and the microarterial endothelial function test (FCR method) by the present inventor Useful for preclinical disease prediction, screening, diagnosis, and long-term follow-up of all lifestyle-related diseases including important diseases such as angina pectoris and myocardial infarction Extensive.
  • FEI / FSI method microarterial elasticity and stiffness test
  • FCR method microarterial endothelial function test
  • arteriosclerosis prevention strategies and health promotion have significant significance in national preventive and regional health care policies and nursing care welfare policies.
  • early diagnosis and intervention of arteriosclerosis at the preclinical stage spreads widely to not only core hospitals but also small and medium-sized clinics, it is possible to prevent a wide range of lifestyle-related diseases that are effective at the national level. Leads to realization.
  • the new testing method has no difference in clinical usefulness in terms of securing the principle advantage over existing testing, and it can be used for both hospital and home medical care. It is required that the patient's physical, mental and time burdens are light and easy for doctors and examiners to use.
  • the conventional endothelial function test requires a test time of 20 minutes or more for one test, which is a limitation on the spread as a health care device.
  • the finger arteriole dilatability continuous inspection method according to the present invention can be improved to a wearable inspection machine by miniaturization, weight reduction, and simplification.
  • the examination time is limited by a protocol that automatically operates without disturbing sleep at bedtime with little body movement. Can be released, and can be commercialized as a health care device useful for daily health management.
  • the future use and field of use of the digital arterial dilatability continuous examination method according to the present invention includes a very wide range of health promotion and health support sites, that is, a school health room for enrolling children and professionals. It can be used for health education and health management in health care facilities, commercial sports facilities, nursing care welfare facilities for the elderly, and evaluation of health foods and medicines.
  • the device can be further reduced in size and simplified, there is a possibility that it will be widely used for home use as an inexpensive health device incorporated in a sphygmomanometer.
  • the medical insurance system such as the FMD law and Endo-PAT law
  • it can contribute to a wide range of medical life industries such as medical care, welfare, education, and food health related to raising the quality of life (QOL) of the people.
  • Finger arteriole dilatability continuous inspection apparatus 1a Finger arteriole dilatability continuous test program 2 Finger compression means 3 Pulse wave detection means 4 Storage means 5 Arithmetic processing means 21 Cuff 22 Air pump 31 Photoelectric sensor 31a Light emitting part 31b Light receiving part 32 Pulse wave amplifier 41 Program storage unit 42 Resting pulse wave storage unit 43 Reperfusion pulse wave storage unit 44 Cuff pressure data storage unit 51 Cuff pressure control unit 52 NPV calculation unit 53 BV calculation unit 54 Vasodilator response index calculation unit 55 Rest Time average blood pressure estimation unit 56 NPV line calculation unit 57 NPV estimation value calculation unit 58 NPVI calculation unit 59 BV line calculation unit 60 BV estimation value calculation unit 61 BVI calculation unit 62 BN line calculation unit 63 DI calculation unit 64 SI calculation unit 65 NBI Calculation unit

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Abstract

L'invention concerne un programme de criblage continu de dilatabilité artériolaire de doigt, un dispositif de criblage continu de dilatabilité artériolaire de doigt, et un procédé de criblage continu de dilatation artériolaire de doigt grâce auquel il est possible de cribler simplement et de manière très précise des signes précoces de l'artériosclérose dans des microvaisseaux des artères des doigts sans mesurer la pression artérielle. Le programme de criblage continu de dilatabilité artériolaire de doigt effectue un criblage continu d'une réaction de dilatation de vaisseau sanguin dans les artères des doigts avec chaque battement de cœur pendant une hyperémie réactive, ledit programme amenant un ordinateur à fonctionner comme : une unité de stockage d'onde de pouls de repos qui stocke une onde de pouls de repos à partir de laquelle un doigt à cribler et un doigt témoin ont été pressés dans une séquence prédéterminée tout en étant dans un état de repos avant l'avascularisation ; une unité de stockage d'onde de pouls de reperfusion qui stocke une onde de pouls de reperfusion à partir de laquelle chaque doigt a été pressé en continu à une certaine pression pendant une reperfusion après une vascularisation ; une unité de calcul NPV qui calcule la valeur de transformation logarithmique naturelle NPV (lnNPV) de chaque doigt et/ou une unité de calcul de volume sanguin (BV) qui calcule le BV de chaque doigt ; et une unité de calcul d'indice de réaction de dilatation de vaisseau sanguin qui calcule un indice de réaction de dilatation de vaisseau sanguin sur la base du LNVP et/ou du BV.
PCT/JP2017/010414 2016-03-31 2017-03-15 Programme de criblage continu de dilatabilité artériolaire de doigt, dispositif de criblage continu de dilatabilité artériolaire de doigt et procédé de criblage continu de dilatabilité artériolaire de doigt WO2017169786A1 (fr)

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US11969260B2 (en) 2020-11-20 2024-04-30 Samsung Electronics Co., Ltd. Apparatus and method for detecting body component

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Publication number Priority date Publication date Assignee Title
JPH06165764A (ja) * 1990-10-23 1994-06-14 Sankyo Co Ltd 血管硬化度測定装置
WO2008105229A1 (fr) * 2007-02-28 2008-09-04 Sapporo Medical University Programme de mesure de l'élasticité de l'artère d'un doigt, dispositif de mesure de l'élasticité de l'artère d'un doigt et procédé de mesure de l'élasticité de l'artère d'un doigt
WO2014054788A1 (fr) * 2012-10-04 2014-04-10 北海道公立大学法人札幌医科大学 Procédé d'essai du pouvoir de dilatation artériolaire des doigts, dispositif d'essai du pouvoir de dilatation artériolaire des doigts, et programme d'essai du pouvoir de dilatation artériolaire des doigts

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH06165764A (ja) * 1990-10-23 1994-06-14 Sankyo Co Ltd 血管硬化度測定装置
WO2008105229A1 (fr) * 2007-02-28 2008-09-04 Sapporo Medical University Programme de mesure de l'élasticité de l'artère d'un doigt, dispositif de mesure de l'élasticité de l'artère d'un doigt et procédé de mesure de l'élasticité de l'artère d'un doigt
WO2014054788A1 (fr) * 2012-10-04 2014-04-10 北海道公立大学法人札幌医科大学 Procédé d'essai du pouvoir de dilatation artériolaire des doigts, dispositif d'essai du pouvoir de dilatation artériolaire des doigts, et programme d'essai du pouvoir de dilatation artériolaire des doigts

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11969260B2 (en) 2020-11-20 2024-04-30 Samsung Electronics Co., Ltd. Apparatus and method for detecting body component

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