WO2019172569A1 - Moniteur de pression artérielle portable basé sur la photopléthysmographie et procédé de surveillance de la pression artérielle - Google Patents

Moniteur de pression artérielle portable basé sur la photopléthysmographie et procédé de surveillance de la pression artérielle Download PDF

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WO2019172569A1
WO2019172569A1 PCT/KR2019/002347 KR2019002347W WO2019172569A1 WO 2019172569 A1 WO2019172569 A1 WO 2019172569A1 KR 2019002347 W KR2019002347 W KR 2019002347W WO 2019172569 A1 WO2019172569 A1 WO 2019172569A1
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blood pressure
light
prt
pulse
flow meter
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PCT/KR2019/002347
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English (en)
Korean (ko)
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김득원
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주식회사 메딧
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A61B5/02108—Measuring pressure in heart or blood vessels from analysis of pulse wave characteristics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/026—Measuring blood flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/026—Measuring blood flow
    • A61B5/0261—Measuring blood flow using optical means, e.g. infrared light
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems

Definitions

  • BP blood pressure
  • PPG photoplethysmography
  • HR pulse rate
  • Cardiovascular Disease is a major cause of death along with stroke, and the death toll is on the rise, but it is difficult to anticipate and costly for health care for prevention and care. to be.
  • BPVariability is also an important factor in these conditions and has been shown in many studies and clinical results.
  • PTT pulse transit time
  • the wBPM uses an electrocardiogram (ECG), which measures the electrical signal of the heartbeat, and an optical device that measures changes in blood flow using optical devices, between the high and low points of the photometer.
  • ECG electrocardiogram
  • PTT Pulse Transit Time
  • PWV Pulse Wave Velocity
  • Figure 1 shows the overall shape of the pulse wave that can be measured by the optical blood flow meter (PPG) in the wrist and the form of the pulsation component (AC componet) that is pure blood flow fluctuation except the base component (DC component) in the overall form.
  • PPG optical blood flow meter
  • AC componet the form of the pulsation component
  • DC component the base component
  • Optical blood flow meters are initially limited to measuring the pulse wave to measure heart rate (HR) from changes in blood flow, but recently, the variation of the pulse wave itself using digital signal processing (DSP) technology is used.
  • the pulsation component (AC component) and the base component (DC component) representing the RN may be classified and reanalyzed.
  • the pulsation component is affected by the pulse component of arterial blood, and can be used as a basic data for measuring the blood pressure as well as the pulse rate, and the second derivative of other body state information, such as a pulsation waveform.
  • Vascular Aging information can be obtained from Second Derivative Waveform (SDPPG).
  • Base components are usually affected by skin and tissues, venous blood, and non pulsatilecomponent of arterial blood.
  • the photosensor assembly of an optical blood flow meter used as a human body wear type typically uses green light, red light, and near infrared light (LED) as a light source.
  • Photodiode (PD) is used to measure the change in reflected light intensity according to the blood flow, which is inversely related to the absorption coefficient.
  • the actual measurement shows a general and periodic change of the basal level due to breathing, but it is simplified here.
  • the optical blood flow meter reflects light toward human blood vessels, and the light receiving element measures the intensity of reflected and scattered light.In the systolic peak where blood flow increases due to heart contraction, blood pressure increases but light is absorbed by the blood so that the reflected light intensity It appears weak and the reflected light is strong during the relaxation period.
  • the output signal of the conventional optical blood flow meter is not reflected light intensity itself, but is inverted up and down (inversed PPG), so that the blood flow or blood pressure level is expressed in the form of pulse wave, high peak in the systolic phase and low valley in the diastolic phase. do. It can be seen that the signal amount display of a conventional photometer is based on this inverted form.
  • the periodic amplitude change of the pulsating component occurs on the base level.
  • the conventional blood pressure measurement method which consists of an electrocardiogram and an optical blood flow meter and mainly measures blood pressure using pulse wave transmission time (PTT) and pulse wave movement speed (PWV), has a human body for measuring an electrocardiogram when measuring blood pressure.
  • Abnormal BP Variability is necessary because it requires two hands to touch the device at the same time to form part of the circuit, which is inadequate or inconvenient for Ambulatory BP Monitoring, and thus becomes an intermittent measurement method instead of constant monitoring. Or intensive monitoring of bioperiodic mutations.
  • Blood pressure estimating method using pulse wave propagation time (PTT) and blood pressure estimating method using only volume pulse pulse using reflected wave arrival time ( ⁇ TDVP) are both simple because they estimate blood pressure only as a single component of the extension of the vessel wall. There are many problems that need to be solved.
  • the pulse wave measurement which is the basis of blood pressure measurement, needs to be accurate and precise. As the signal reaches the end of the human body, the signal weakens and there are many factors that confuse the signal. It can be a negative factor in signal interpretation.
  • the present invention is to solve or alleviate the problems in the conventional blood pressure measurement described above, a blood pressure measurement method and a measuring device for continuously measuring and observing the blood pressure without the operation for a separate measurement in a human body wearable type
  • the purpose is to provide.
  • An object of the present invention is to provide a measuring method and a measuring device capable of precise and effective blood pressure measurement, rather than inaccurate or rough blood pressure measurement.
  • the present invention it is possible to eliminate the inconvenience of measuring the blood pressure due to the mounting of the cuff or clamp, and to measure the measurement method and measuring device that can measure the accurate blood pressure despite the physical characteristics or variations of the wearer It aims to provide.
  • Body wear-type blood pressure measuring method of the present invention for achieving the above object is
  • pulse waves are measured by a photo blood flow meter (PPG),
  • Pulsed wave analysis distinguishes the incident wave caused by cardiac contraction and the reflected wave from the back branch or end of blood vessel in the body part
  • the pulse return time (PRT) is calculated by using the separated incident wave and the reflected wave waveform.
  • the pulse wave analysis may be performed through a waveform that differentiates the pulse wave.
  • the blood pressure is expressed by Equation 1 or Equation 1 obtained by multiplying the proportional constant a by the pulse pressure PA obtained through the measuring device by the program built into the measuring device and multiplying the proportional constant b by the PRT obtained through the measuring device. It can be calculated by the equation of 1 plus the constant e on the right side.
  • the blood pressure includes a green light in the irradiation light of the optical blood flow meter in order to include the human light absorbance as a blood pressure calculation factor, and has absorbance (GI) or reflectivity of the red light or infrared light (or reflectance). It can be obtained as a correction value of the blood pressure obtained through.
  • the corrected value is calculated by Equation 2 or Equation 2 by adding constant e to the right side of Equation 2 by adding the blood pressure obtained from the pulse pressure and the PRT as the index by multiplying the absorbance or reflectance of green light by the proportional constant c. It may be.
  • the blood pressure is a ratio between the pulse wave level and the pulse pressure of the valley portion of the optical blood flow meter or the ratio of the pulse wave level of the valley portion and the peak portion of the peak portion to include the influence of the pulse wave base as the blood pressure calculation factor.
  • IR I DIA / I SYS .
  • the corrected value may be obtained by Equation 3, which is obtained by multiplying the ratio obtained by multiplying the ratio and the proportional constant d by the blood pressure obtained by the pulse pressure and the PRT, or by Equation 3 with the constant e added to the right side.
  • the blood pressure is a constant on the right side in the following Equation 4 or Equation 4. It can be represented by an equation plus e.
  • the blood pressure may be obtained by adding a value obtained by multiplying a measured value related to this factor by a proportional constant corresponding thereto to the blood pressure obtained by the pulse pressure and the PRT as an indicator to include other effects as the blood pressure calculation factor.
  • the sensing light intensity of the light receiving element is checked and subtracted or the difference value is multiplied by the proportional constant in the absence of the irradiation light. Can be obtained.
  • the distortion of the PPG pulse wave due to the operation of the wearer of the measuring apparatus may be excluded by linking the change of the PPG pulse wave generated by the movement of the user with the motion signal of the accelerometer having three-dimensional degrees of freedom.
  • the proportional constants mentioned above measure blood pressure and related factors (PA, PRT, GI, IR) multiple times for various measurement subjects and substitute them in the above formula to derive the most appropriate proportional constant value.
  • PA blood pressure
  • PRT blood pressure
  • GI blood pressure monitor
  • IR optical blood flow meter
  • blood pressure is not distinguished from systolic blood pressure, diastolic blood pressure, and average blood pressure, but in principle, all of them can be derived in the same way, so it is not distinguished here and is simply expressed as blood pressure (BP).
  • BP blood pressure
  • This process can be accomplished through statistical techniques such as multivariate statistics techniques and computer simulations.
  • artificial neural networks that embody these techniques through machine learning or deep learning based on this type of data. It can also be derived by having the application program review the measured data (blood pressure and related factors) that are test data.
  • the optical blood flow meter which can measure a pulse wave
  • this optical blood flow meter is a red or near-infrared light source which can irradiate light toward a body in contact with a body, and a light reflected from a body
  • a light receiving element is provided, and the incident wave and the reflected wave are distinguished by analyzing the pulse wave formed by the detection signal of the light receiving element, the PRT is detected using the peak signal of each wave, and the pulse pressure PA is multiplied by the first coefficient and the PRT
  • a processor and a program for deriving a blood pressure value through a calculation process including multiplying and summing a second coefficient.
  • the program for deriving the blood pressure value through the measurement result of the optical blood flow meter in the measuring device of the present invention is based on one of the above-described Equations 1 to 4 or an equation in which the constant e is added to the right side of these equations. It may be.
  • the proportional constants and constants (a, b, c, d, e) measure blood pressure and related factors (PA, PRT, GI, IR) several times for various measurement subjects, Substituting the most appropriate proportional constant values by substituting them, the blood pressure was measured by another precise sphygmomanometer, and at the same time the relevant factors were measured by an optical blood flow meter, and the process of finding the proportional constant was artificial neural network. network) algorithm may be applied through a program.
  • the measuring device of the present invention may be provided with a communication device to transmit and record the measured blood pressure value to a separate server in a wireless manner through a communication network.
  • the measuring device of the present invention may be provided with a storage and display device for recording and storing the measured blood pressure values continuously for at least a predetermined period so as to grasp the change trend (pattern).
  • the measuring device of the present invention compares the measured blood pressure value or the recent change in blood pressure value with a predetermined criterion to warn the wearer with an alarm device or show it as a display device, and to warn or display the medical institution or guardian in charge through a communication device. It can be configured to deliver.
  • the measuring device of the present invention has a short near infrared band light source for measuring pulse pressure and PRT as a related factor for deriving blood pressure values, and reflects attenuation of light in the short near infrared band due to skin color of the wrist part to be measured.
  • a short near infrared band light source for measuring pulse pressure and PRT as a related factor for deriving blood pressure values, and reflects attenuation of light in the short near infrared band due to skin color of the wrist part to be measured.
  • it may have a green light source.
  • a separate light receiving element for the green light source may be disposed in the blood pressure measuring device, but the light of the red light or the near infrared light source and the light of the green light source may be time-divisionally separated from each other by hardware or a program in the blood pressure measuring device.
  • the light receiving device may be configured to distinguish whether the detection light is green light, red light or near infrared light.
  • the present invention it is possible to recognize the trend of blood pressure by continually measuring and observing blood pressure conveniently and easily without a separate operation for measuring the wearer's blood pressure, thereby increasing the possibility of appropriate blood pressure management to the wearer.
  • the present invention it is possible to eliminate the inconvenience of measuring blood pressure due to the mounting of the cuff or clamp, and to measure the accurate blood pressure despite the physical characteristics or variation factors of the wearer.
  • FIG. 1 is a graph showing the overall shape of the pulse wave that can be measured by the optical blood flow meter (PPG) on the wrist and the pulsation component (AC componet) which is the pure blood flow fluctuation except the base component in the overall form;
  • PPG optical blood flow meter
  • AC componet pulsation component
  • FIG. 2 is a conceptual diagram of a box-shaped configuration showing a schematic configuration of an embodiment of the present invention
  • Figure 3 is a bottom view showing the bottom of an embodiment of the blood pressure measuring device of the present invention based on an optical blood flow meter
  • FIG. 4 is a conceptual cross-sectional view schematically showing a cross section taken along line AA ′ of FIG. 3;
  • Fig. 5 is a graph showing an example of the form of one period of the pulsating component of the pulse wave in the upper arm (forearm), the wrist, the finger, and the form in which the incident wave and the reflected wave are divided;
  • FIG. 6 is an explanatory diagram showing the degree of penetration of light of each wavelength band to a body part in the present invention.
  • FIG. 2 is a schematic conceptual view showing a schematic configuration of an embodiment of the present invention
  • Figure 3 is a bottom view showing the bottom of an embodiment of the blood pressure measuring device of the present invention based on an optical blood flow meter
  • Figure 4 is a AA 'line of Figure 3 Conceptual cross-sectional view schematically showing the cross section cut along.
  • the blood pressure measuring apparatus includes three light emitting diodes corresponding to three light sources 30: 31, 32, and 33 and scatters and reflects light after the light from the light sources 30 is irradiated onto the body part.
  • Two photodiodes as a light receiving element 20 for generating an electrical signal, two transimpedance amplifiers (TIA: 11) arranged in a path for acquiring a signal for output signal processing of the light receiving element 20, a programmable gain amplifier (Programmable Gain Amplifier (PGA) 13), Analog-to-Digital Convertor (ADC: 15).
  • PGA Programmable Gain Amplifier
  • ADC Analog-to-Digital Convertor
  • the converted output signal through these is input to the processor 70 and undergoes a process of obtaining information for blood pressure measurement from the pulse wave waveform.
  • the processor 70 may be divided into a digital signal processor (DSP) 73 and a micro controller unit (MCU) 71.
  • the processor 70 also controls a controller or driver (LED driver) 17 that emits a light signal by using a light emitting diode, and a storage device (memory) 90 and a communication device 80 are connected to the processor.
  • the processor performs operations such as turning on the light source, classifying the output of the light-receiving element, analyzing waveforms for calculating blood pressure, and substituting the blood pressure-related factors obtained through the predetermined calculation equation.
  • the optical sensor assembly 10 having the light source 30 and the light receiving element 20 is not directly shown, but is located on the bottom of the blood pressure measuring device, similar to the wrist watch.
  • Three light sources 30 are installed in the optical sensor assembly 10, and two light receivers 20 are installed on each of the left and right light sources.
  • the light source 30 includes a green light source 31 in the 530 nm wavelength range, a red light source 32 in the 660 nm wavelength range, and a short near infrared light source 33 in the 940 nm wavelength range.
  • the light receiving elements 20 on both the left and right sides use a silicon (Si) wafer-based photodiode.
  • the light source may be provided with two green light sources and near infrared light sources, or only two of the green light sources and the red light sources, and the near infrared light sources may also be light sources of different wavelength bands.
  • Such selection is a common criterion for detecting blood flow most accurately and clearly, but in reality, consideration may be made for development ease and commercialization, such as cost, device stability, and degree of commercialization.
  • Placing the light receiving element 20 on both sides of the light source 30 may increase the total signal by increasing the number so that the detection ability of the light receiving element may not be sufficient. It makes sense. In particular, considering that the pulse of the upper arm, which is used for the accurate measurement of blood pressure in general, is much stronger than the pulse of the wrist and the signal is clear, it is meaningful as such an operation to increase the signal to noise ratio or signal accuracy.
  • the artery position may be disposed so as not to match the position of the light source 30 and one light receiving element 20.
  • the problem may be given to cover the problem so that even one light receiving element 20 can receive the reflected and scattered light signals well.
  • a hemispherical convex lens 60 is formed on the LED constituting the red light source 32 used as a light source in the center to increase the focusing speed of the light irradiated toward the body part, and the light drawn from the outside on the photodiode as the light receiving element 20.
  • a DOE (diffractive optical elements) lens 50 which is a kind of condenser lens, is installed.
  • the photodiode is installed in a larger area than the LED in order to increase the amount of received light, and when the hemispherical convex lens 60 is installed thereon, the height is considerable, so that the DOE lens 50 is installed because it is difficult to shorten the blood glucose measurement device. It is.
  • a light source module may be located in the optical sensor assembly in which a light receiving element is positioned in the center and a plurality of light sources emitting light of different wavelengths are collected at both sides of the light receiving element.
  • the light source modules at both sides may be the same light source module forming the light configuration of the same wavelengths, or may be different light source modules forming the light configuration of different wavelengths.
  • the light receiving element in the center distinguishes light having different wavelengths.
  • the recognition module should be used and the analysis module should be prepared for the classification module.
  • both light source modules use the same light source module
  • light having a plurality of wavelengths emitted from both light source modules is incident on the body part of the measurement object, reflected or scattered, and is input to the light receiving device.
  • the light receiving element may use a silicon wafer (Si) wafer-based photodiode or an indium gallium arsenide (InGaAs) wafer-based photodiode according to the wavelength of light emitted from the light source of the light source module, and the detection signal is appropriately sized to be analyzed in the analysis module. It is preferable to adjust the light receiving area of the photodiode or to adjust the sensitivity of the light receiving device so as to appear.
  • the light receiving element senses the combined amount of light from both light source modules, and thus receives approximately twice as much light as the two light receiving elements receiving light from one light source module and is less sensitive to the external environment.
  • the reflection and scattered light from the body part may be slightly different due to a small difference in the body part, and the average value is detected because the reflected light from two different parts of the body part is summed and detected. As a result, variation according to body parts may be reduced, and thus may have an effect of increasing stability of a test value.
  • the blood pressure measuring device in the form of a wrist band or wrist watch adds other functions in addition to the optical noninvasive continuous vital sign monitoring function, for example, a digital thermometer or a 3D accelerometer function. You can monitor other physical conditions, physical condition of the body, falls, etc., and correlate it with Vital Sign Trend to detect Unexpected Fluctuation and alert the wearer through the warning device. It can also serve to alert the guardian or medical personnel and provide attention signals through the embedded communications device and the surrounding communications network.
  • the blood pressure measuring device is filled in the cuff of the blood pressure measuring object and the power is turned on to activate the optical blood flow measuring function.
  • the pulse wave is measured using a cuff of the wrist by irradiating light to the cuff of the light source continuously or at a short time period (so that the measurement can be made longer than the pulse period). Acquire.
  • This measurement uses a red or near-infrared light source that can penetrate relatively deep into the human body and send a significant amount of reflected or scattered light to the light-receiving device, which can relatively clearly represent and reflect changes in arterial blood flow in the pulse wave signal.
  • Analysis of the pulse wave of such a blood pressure measuring device shows the time between peaks and peaks, the difference in the amount of signal between the peak representing the blood pressure elevated by the heart contraction and the valley lowered by the cardiac relaxation, the time between the incident wave and the reflected wave peak at the measurement position.
  • the parts by the base are not important in the pulse wave analysis, so that DC and AC can be distinguished, and processing and analysis showing separate reflection and incident waves from AC can be performed, and the differential wave form of the pulse wave for the changed part is obtained and analyzed. Can be done.
  • DSP digital signal processing
  • the transimpedance amplifier (TIA) circuit is first used to remove noise and to convert and amplify the current signal of the light receiving element into a voltage signal.
  • a programmable gain amplifier (PGA) offset value (corresponding to bias) and an analog-to-digital converter to analyze the level of the DC component from the signal of the signal and remove the DC component from the PPG signal.
  • Convertor In order to take full advantage of the resolution of the ADC, the gain can be stored in memory and reflected in the blood pressure calculation.
  • FIG. 5 shows the shape of the peak portion of the total pulse wave (composite wave due to the superposition of the incident wave and the reflected wave) on the upper arm (forearm), wrist, and finger, and the incident wave (simple peak with a large peak) and the reflected wave.
  • An example of the form divided by (the simplest waveform with the smallest peak) is shown.
  • the pulse return time (PRT) is calculated using the separated incident wave and the reflected wave waveform.
  • the pulse wave propagation speed is obtained by dividing this distance D by PTT. It increases when the arterial stiffness or stiffness is about 6m / sec and 14m / sec in the 60s.
  • the basic expression of blood pressure can be obtained by using pulse pressure and PRT as basic blood pressure factors (factor).
  • the green light source is operated together with the red light source or the short near infrared light source to measure the light absorption due to the skin color at the cuff region, and also calculate the mutual ratio of DC component and AC component in the pulse wave waveform.
  • This value can be used to compensate for variations in blood pressure caused by factors that affect the base components of the pulse wave, such as skin, muscle tissue, blood vessel walls, and body fluids in the wrist. This correction is intended to offset the effect of the individual physical characteristics on the measurement of conventional photometers so that accurate blood pressure values can be obtained.
  • the present invention is based on an optical blood flow meter, and the light irradiated to the body is absorbed, reflected or scattered at each part of the body so that a substantial portion of the reflected and scattered light is input to the light receiving device. Therefore, the light input to the light receiving element may vary depending on the physical characteristics of the subject.
  • the blood pressure measuring device of the present invention is produced to measure blood pressure universally, and when it is not tailored to individual characteristics, the measured and calculated blood pressure values are not measured without considering the physical characteristics of the subject. May not be able to indicate the correct blood pressure of the individual.
  • 6 is a conceptual diagram for explaining that the penetration depth or the light absorption degree of the layer structure of the human body part for each wavelength of light is different.
  • measurement using the green light absorbed relatively well by body tissues can be used as a reference that also shows the physical light absorption (IG) of the individual to be measured, and reflects this in the blood pressure calculation.
  • IG physical light absorption
  • the measurement target is a large and fat person
  • the amount of light entering the body from the light source, reflected or scattered, and entering the light receiving element will be reduced, and the base level (DC level) will be increased in the signal amount.
  • the IR (I DIA / I SYS ) value will also be higher, and the measured blood pressure may be higher than the actual value.
  • I DIA is the signal value strength of the diastolic phase
  • I SYS is the signal value strength of the systolic phase
  • IR value is the ratio between them. Therefore, in this case, considering the base component, the blood pressure value should be lowered and displayed as in the case of reflecting light absorption.
  • the blood pressure calculation formula will be the same as the equation (5) in which the constant e is added to the right side of the equation (4) or (4) in the basic equation, such as the above equation (1).
  • the proportional constant a will be positive because a high pulse pressure usually increases the blood pressure.
  • b will be a negative value. If the green light absorption (IG) is high or the specific gravity (IR) of the base is high, the blood pressure may be higher than the actual value. Therefore, the values of the proportional constants c and d are generally negative. would.
  • Such a blood pressure calculation formula is built into the blood pressure measuring apparatus of the present invention as a kind of program, and when the pulse wave analysis result and the green light absorption measurement result are put into the calculation formula, the blood pressure value is calculated by a predetermined proportional constant or constant.
  • the proportional constant or constant of the calculation formula is used to measure blood pressure and related factors (PA, PRT, GI, IR) multiple times for various measurement subjects and substitute them in the above formula to derive the most appropriate proportional constant value. Can be obtained in such a way.
  • the blood pressure is measured by another precise blood pressure monitor, and at the same time by measuring the relevant factors with an optical blood flow meter such as that adopted in the blood pressure monitor of the present invention, put these values into a calculation formula to make a plurality of equations and simultaneously It goes through the process of finding proportional constant that can be satisfactorily satisfied.
  • This process can be accomplished through statistical techniques such as multivariate statistics techniques and computer simulations.
  • artificial neural networks that embody these techniques through machine learning or deep learning based on this type of data.
  • the algorithm application program can be derived by reviewing (learning) the measured data (blood pressure and related factors) which are the test data.
  • the present invention justifies the idea or paradigm that only PPG can be used to calculate blood pressure by optical method, and influences on the blood pressure value of secondary elements such as light absorption or base in using optical method. Was removed using appropriate standardization.
  • the artificial neural network used is a logical foundation in artificial intelligence that obtains a method for solving a problem by deep learning. Recently, the neural network is developed and a detailed description thereof will be omitted.
  • the built-in processor of the blood pressure measuring device puts the measured value into a calculation formula to calculate blood pressure.
  • the measuring device can be made.

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

Abstract

L'invention concerne : un procédé de surveillance de la pression artérielle dans lequel une impulsion est mesurée à partir d'une partie corporelle au moyen d'une photopléthysmographie (PPG), une onde incidente due à la systole et à la diastole et une onde réfléchie revenant d'une extrémité ou d'un point de branchement du côté arrière du vaisseau sanguin de la partie corporelle sont distinguées au moyen d'une analyse d'impulsion, le temps d'arrivée de l'onde réfléchie (PRT) est calculée au moyen des formes d'onde de l'onde incidente et de l'onde réfléchie distinguées, et la pression artérielle est calculée à l'aide de la pression d'impulsion (Pa) et les PRT entre un point haut et un point bas dans l'impulsion de la photopléthysmographie en tant qu'indicateur de pression artérielle (BP); et un moniteur de pression artérielle formé de façon à être approprié à cet effet. La présente invention permet la reconnaissance de la dérive de la pression artérielle au moyen d'une surveillance pratique et continue de la pression artérielle sans opération séparée pour surveiller la pression artérielle d'un porteur, et augmente ainsi la possibilité de gestion de la pression artérielle appropriée pour le porteur et, selon un aspect, la pression artérielle peut être surveillée avec précision indépendamment des facteurs de variation ou des caractéristiques physiques du porteur.
PCT/KR2019/002347 2018-03-05 2019-02-27 Moniteur de pression artérielle portable basé sur la photopléthysmographie et procédé de surveillance de la pression artérielle WO2019172569A1 (fr)

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KR1020180025951A KR20190105421A (ko) 2018-03-05 2018-03-05 광혈류 측정기 기반의 인체착용형 혈압 측정장치 및 혈압 측정방법
KR10-2018-0025951 2018-03-05

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WO2023088819A1 (fr) 2021-11-17 2023-05-25 Bayer Aktiengesellschaft Système d'alerte précoce pour patients souffrant d'hypertension
WO2023117560A1 (fr) 2021-12-20 2023-06-29 Bayer Aktiengesellschaft Outil pour l'identification de mesures contre l'hypertension et pour leur surveillance

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2023088819A1 (fr) 2021-11-17 2023-05-25 Bayer Aktiengesellschaft Système d'alerte précoce pour patients souffrant d'hypertension
WO2023117560A1 (fr) 2021-12-20 2023-06-29 Bayer Aktiengesellschaft Outil pour l'identification de mesures contre l'hypertension et pour leur surveillance

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