WO2019188768A1

WO2019188768A1 - Device and method for analyzing shunt murmur, and computer program and storage medium

Info

Publication number: WO2019188768A1
Application number: PCT/JP2019/012047
Authority: WO
Inventors: 太郎中島; 祐介曽我
Original assignee: パイオニア株式会社
Priority date: 2018-03-29
Filing date: 2019-03-22
Publication date: 2019-10-03
Also published as: JP7175304B2; JPWO2019188768A1

Abstract

According to the present invention, devices (1, 2) for analyzing a shunt murmur are provided with: an acquisition means (11) for acquiring shunt murmur information indicating a shunt murmur at a site to be measured in a living body where a shunt is formed; and calculation means (12, 13, 14) for (i) calculating intermittence that is information indicating the degree of intermittence of the shunt murmur, on the basis of the acquired shunt murmur information, and (ii) calculating a vascular resistance index at the site where the shunt is formed, on the basis of the calculated intermittence.

Description

Shunt sound analysis apparatus and method, computer program, and storage medium

The present invention relates to a technical field of a shunt sound analyzing apparatus and method, a computer program, and a storage medium for storing the computer program for analyzing a shunt sound and detecting an index relating to a shunt formation site.

As this type of device, for example, at least one of sound, vibration of the blood circuit and blood pressure is converted into an electric signal, and the electric signal is converted into a frequency-sound pressure system by frequency analysis. An apparatus that extracts only a frequency band in which a frequency component is present and performs pulse measurement has been proposed (see Patent Document 1).

Japanese Patent No. 4257260

For example, during dialysis treatment, blood may be extracted from a patient after a shunt formed by anastomosis between a vein near the wrist and an artery is formed. A blood vessel in the vicinity of a shunt (hereinafter referred to as “shunt formation site” as appropriate) is often narrowed due to, for example, blood coagulation. For this reason, doctors and nurses, for example, auscultate shunt sounds (that is, noise generated when blood flows from arteries to veins) or measure the blood flow volume at the shunt formation site by echo examination. In many cases, the state of the formation site is grasped and evaluated. However, when auscultating the shunt sound, the evaluation of the state of the shunt part varies for each auscultator, and objective evaluation is difficult. In the case of echo inspection, it is necessary to acquire a certain level of technology.

The present invention has been made in view of the above problems, for example, and does not depend on the skill of the user, and a shunt sound analysis apparatus and method that can easily detect an objective index related to a shunt formation site, It is an object to provide a computer program and a storage medium.

In order to solve the above-described problem, the first shunt sound analyzer of the present invention obtains shunt sound information indicating a shunt sound of a shunt formation site of a living body to be measured, and (i) the acquired Calculating a discontinuity that is information indicating the discontinuity of the shunt sound based on the shunt sound information, and (ii) calculating a vascular resistance index of the shunt formation site based on the calculated discontinuity And comprising.

In order to solve the above-described problem, the second shunt sound analyzer of the present invention obtains shunt sound information indicating a shunt sound of a shunt formation site of a living body to be measured, and the acquired shunt sound. Based on the information, the discontinuity, which is information indicating the discontinuity of the shunt sound, and the calculation means for calculating the intensity of the shunt sound, and the vascular resistance index of the shunt formation site based on the calculated discontinuity Output means for outputting an index indicating the degree of stenosis related to the shunt formation site, the first information and second information related to the blood flow rate of the shunt formation site based on the calculated intensity as components. Is provided.

The shunt sound analysis method of the present invention is a shunt sound analysis method used in a shunt sound analysis apparatus for analyzing a shunt sound in order to solve the above-described problem, and the shunt sound analysis portion of a living body that is a measurement target is subjected to shunt sound analysis. An acquisition step of acquiring shunt sound information to be shown; and (i) calculating an intermittent degree which is information indicating an intermittent degree of the shunt sound based on the shunt sound information acquired by the acquisition step; and (ii) the calculated And a calculation step of calculating a vascular resistance index of the shunt formation site based on the intermittent degree.

In order to solve the above problems, the computer program of the present invention obtains shunt sound information indicating a shunt sound of a shunt formation site of a living body to be measured by a computer mounted on a shunt sound analyzer, (I) Based on the acquired shunt sound information, an intermittent degree, which is information indicating the degree of intermittent shunt sound, is calculated. (Ii) Based on the calculated intermittent degree, the vascular resistance of the shunt formation site It functions as calculation means for calculating an index.

The storage medium of the present invention stores the computer program of the present invention in order to solve the above problems.

The operation and other advantages of the present invention will be clarified from the embodiments to be described below.

It is a block diagram which shows the structure of the shunt sound analyzer based on 1st Example. It is a figure which shows a detection concept. It is a figure which shows an example of the frequency contained in a shunt sound. It is a figure which shows an example of the relationship between a discontinuity degree and a vascular resistance index. It is a block diagram which shows the structure of the shunt sound analyzer based on 2nd Example. It is a figure which shows an example of the relationship between a blood flow rate and a vascular resistance index. It is a block diagram which shows the structure of the shunt sound analyzer which concerns on the modification of 2nd Example. It is a figure which shows an example of the relationship between intensity | strength and a discontinuity degree.

Embodiments relating to shunt sound analysis apparatus and method, computer program, and storage medium will be described.

(Shunt sound analyzer)
<First Embodiment>
The shunt sound analysis apparatus according to the first embodiment includes: (i) acquisition means for acquiring shunt sound information indicating a shunt sound of a shunt formation site of a living body to be measured; and (i) based on the acquired shunt sound information. And (ii) calculating means for calculating a vascular resistance index of the shunt-forming site based on the calculated discontinuity, and calculating a discontinuity that is information indicating the discontinuity of the shunt sound. .

The “shunt sound” is a blood flow sound acquired in the vicinity of a shunt formation site for taking blood out of the body, and is a sound synchronized with the pulse of the living body to be measured. The acquisition of the shunt sound may be performed using various sensors such as a microphone (that is, an example of an acquisition unit), and the acquisition method is not limited.

“Intermittentity” does not simply mean information indicating the degree to which the shunt sound is interrupted, but is composite information including various parameters that cause discontinuity that is used as an index when evaluating the shunt formation site. Alternatively, it means information in which a plurality of parameters related to a sense of intermittentness are integrated.

As the “parameter related to the degree of discontinuity”, for example, a change in volume (for example, maximum volume and minimum volume) in one cycle of the passage of time of the shunt sound (in other words, one cycle of the pulsation of the living body to be measured: one heartbeat interval) Volume)) and the like.

The vascular resistance index (Resistance Index) is an index for evaluating how much the blood flow velocity in the diastole has decreased with respect to the blood flow velocity in the systole. This vascular resistance index is often used for diagnosis of the state of the shunt formation site (for example, the state of stenosis).

According to the inventor's research, it has been found that there is a relatively high correlation between the degree of continuity and the vascular resistance index. In the shunt sound analysis device, the vascular resistance index is calculated from the degree of discontinuity by using the correlation. Specifically, in the shunt sound analyzer, for example, the vascular resistance index is calculated from the discontinuity using a function representing the above correlation or a function for converting the discontinuity into a vascular resistance index.

The shunt sound analyzer automatically calculates the vascular resistance index as long as the shunt sound can be acquired. According to the shunt sound analysis device, for example, compared to a case where a vascular resistance index is obtained by an echo test, the vascular resistance index (ie, an example of an objective index related to a shunt formation site) is not dependent on the skill of the user. Can be easily detected.

In one aspect of the shunt sound analysis apparatus, the calculation means calculates the vascular resistance index based on the calculated continuity level and reference information indicating a relationship between the continuity level and the vascular resistance index. . According to this aspect, the vascular resistance index can be obtained relatively easily from the intermittent degree.

In another aspect of the shunt sound analysis device, the calculation means (i) performs a predetermined analysis process on the acquired shunt sound information to acquire data indicating a time change for each frequency of the sound, ii) The intermittent degree is calculated based on data corresponding to a predetermined frequency band among the acquired data.

According to the inventor's research, it has been found that, for example, if there is a constricted portion, a harmonic component is included in the shunt sound. On the other hand, the frequency band related to the sound component due to the shunt formation site included in the shunt sound and the frequency band related to the harmonic component are clearly different. For this reason, as described above, if the discontinuity is calculated based on data corresponding to a predetermined frequency band (that is, a frequency band related to the sound component caused by the shunt formation site), the discontinuity with the influence of the harmonic component suppressed. The degree can be calculated. As a result, the reliability of the vascular resistance index calculated by the shunt sound analyzer can be improved.

Second Embodiment
The shunt sound analysis apparatus according to the second embodiment has an acquisition unit that acquires shunt sound information indicating a shunt sound of a shunt formation site of a living body to be measured, and a shunt sound based on the acquired shunt sound information. The calculation means for calculating the discontinuity, which is information indicating the discontinuity, and the intensity of the shunt sound, the first information related to the vascular resistance index of the shunt formation site based on the calculated discontinuity, and the calculation. And output means for outputting an index indicating the degree of stenosis related to the shunt formation site, the second information indicating the blood flow rate of the shunt formation site based on the strength.

According to the inventor's research, it has been found that there is a relatively high correlation between the intensity of the shunt sound and the blood flow volume. In the shunt sound analysis apparatus, second information related to the blood flow rate is obtained from the intensity of the shunt sound by using the correlation.

The “first information” is not limited to information indicating the vascular resistance index, but may be information indicating a physical quantity or a parameter related to the vascular resistance index. Similarly, the “second information” is not limited to information indicating the blood flow, but may be information indicating a physical quantity or a parameter related to the blood flow.

It is known that stenosis occurs in a blood vessel in which a shunt is formed, although the degree varies depending on the dialysis period of artificial dialysis. As treatment for stenosis, percutaneous transluminal angioplasty (PTA) is often performed using a balloon catheter. PTA is preferably performed at an appropriate time before the shunt is occluded. In many cases, the blood flow volume and the vascular resistance index are used as indices for determining the timing of performing PTA.

The shunt sound analyzer automatically outputs an index including the first information related to the vascular resistance index and the second information related to the blood flow volume as long as the shunt sound information can be acquired. By referring to the output index, it is possible to determine an appropriate time for performing PTA relatively easily. According to the shunt sound analysis device, for example, an objective index related to the shunt formation site can be easily detected without depending on the skill of the user as compared with the case where the vascular resistance index and the blood flow are obtained by an echo test, for example. be able to.

(Shunt sound analysis method)
A shunt sound analysis method according to an embodiment is a shunt sound analysis method used in a shunt sound analysis apparatus that analyzes a shunt sound, and acquires shunt sound information indicating a shunt sound of a shunt formation portion of a living body to be measured. An acquisition step; (i) based on the shunt sound information acquired in the acquisition step, calculates an intermittent degree that is information indicating the intermittent degree of the shunt sound; and (ii) based on the calculated intermittent degree, Calculating a vascular resistance index of the shunt formation site.

The shunt sound analysis method according to the embodiment is not dependent on the skill of the user, as compared with the case where the vascular resistance index is obtained by, for example, echo examination, as in the shunt sound analysis apparatus according to the first embodiment described above. The vascular resistance index can be easily detected. In the shunt sound analysis method according to the embodiment, various aspects similar to the various aspects of the shunt sound analysis apparatus according to the first embodiment described above can be employed.

(Computer program)
The computer program according to the embodiment includes: (i) the acquisition unit that acquires a shunt sound information indicating a shunt sound of a shunt formation site of a living body that is a measurement target; (Ii) calculating means for calculating a vascular resistance index of the shunt formation site based on the calculated intermittent degree based on the shunt sound information; To function as.

If the computer program according to the embodiment is executed by a computer, the above-described shunt sound analysis apparatus according to the first embodiment can be realized. As a result, according to the computer program, as in the shunt sound analysis apparatus according to the first embodiment described above, for example, compared to the case where the vascular resistance index is obtained by an echo test, without depending on the skill of the user, The vascular resistance index can be easily detected.

(Storage medium)
The storage medium according to the embodiment stores the computer program according to the above-described embodiment. If the storage medium in which the computer program is recorded, for example, a CD-ROM (Compact Disc Read Only Memory), a DVD-ROM (DVD Read Only Memory) or the like is read and executed by a computer, the above-described first storage medium is stored. A shunt sound analyzer according to an embodiment can be realized. As a result, according to the storage medium, as in the shunt sound analysis apparatus according to the first embodiment described above, compared to the case where the vascular resistance index is obtained by, for example, echo examination, without depending on the skill of the user, The vascular resistance index can be easily detected.

An embodiment relating to a shunt sound analyzer will be described with reference to the drawings.

<First embodiment>
A first embodiment of the shunt sound analysis apparatus will be described with reference to FIGS.

A shunt sound analyzer according to the first embodiment will be described with reference to FIG. FIG. 1 is a block diagram illustrating the configuration of the shunt sound analysis apparatus according to the first embodiment.

In FIG. 1, the shunt sound analysis device 1 includes a shunt sound input unit 11, an audio signal analysis processing unit 12, an intermittent parameter calculation unit 13, a vascular resistance index estimation unit 14, and a vascular resistance index estimated value display unit 15. Has been. The audio signal analysis processing unit 12, the intermittent degree parameter calculation unit 13, and the vascular resistance index estimation unit 14 constitute a calculation unit. The “vascular resistance index estimation unit 14” is appropriately referred to as “RI estimation unit 14”, and the “vascular resistance index estimation value display unit 15” is appropriately referred to as “RI estimated value display unit 15”.

The shunt sound input unit 11 is a sound around the shunt formation site of a living body (hereinafter referred to as “measured person” as appropriate) detected by the electronic stethoscope 20 (that is, a sound including a shunt sound). The analog signal shown is input. The shunt sound input unit 11 performs analog-digital conversion on the input analog signal at a predetermined sampling frequency Fs to calculate a shunt sound waveform. Note that the shunt sound input unit 11 may be formed integrally with the electronic stethoscope 20.

The audio signal analysis processing unit 12 performs N-point short-time Fourier transform on the value x (n) of the time n of the shunt sound waveform calculated by the shunt sound input unit 11 in units of length N frames ( Refer to the following formula). Here, the audio signal analysis processing unit 12 cuts out the frame having the length N using the window function w (k) having the length N.

“K = 0... N−1” means the frequency position (height) in units of N equal parts of the sampling frequency Fs.

The audio signal analysis processing unit 12 performs logarithmic transformation on the shunt sound waveform that has been subjected to the short-time Fourier transform, and calculates a time-frequency analysis waveform PLlog [n, k]. The time-frequency analysis waveform PLlog [n, k] is expressed by the following equation.

The discontinuity parameter calculation unit 13 detects one heartbeat interval (that is, one cycle of the subject's pulsation) from the time-frequency analysis waveform PLlog [n, k] based on, for example, a temporal change in volume. The discontinuity parameter calculation unit 13 further extracts data corresponding to a predetermined frequency band from the time-frequency analysis waveform PLlog [n, k] to obtain a volume change in one heartbeat interval. Specifically, intermittency parameter calculation unit 13, for example, by the following equation systolic maximum volume V _{max (i.e.,} 1 volume maximum value of the pulse interval) and diastolic minimum volume V _{min (i.e.,} minimum volume of one heart beat interval Value).

The intermittent degree parameter calculation unit 13 obtains the intermittent degree by the following formula based on the systolic maximum volume V _max and the diastolic minimum volume V _min . Note that ω ₁ and ω ₂ are weights corresponding to ρ ₁ and ρ ₂ , respectively.

Here, the predetermined frequency band will be described with reference to FIGS. FIG. 2 is a diagram showing a detection concept. FIG. 3 is a diagram illustrating an example of frequencies included in the shunt sound.

The shunt is often formed by anastomosing the vein near the wrist of the subject and the brachial artery. In this case, the electronic stethoscope 20 detects the sound of the anastomosis part (namely, shunt formation site | part) of FIG. The sound (that is, shunt sound) detected by the electronic stethoscope 20 includes, for example, a harmonic component due to stenosis in addition to the sound component due to the shunt formation site.

As shown in FIG. 3, the sound component due to the shunt formation site is detected as a sound in a relatively low frequency band such as 100 to 500 hertz. On the other hand, harmonic components often appear in a frequency band such as 400 to 800 hertz. Therefore, in the shunt sound analyzing apparatus 1, in order to reduce the influence of the harmonic component, for example, a frequency band of 100 to 300 hertz is set as the predetermined frequency band.

Returning to FIG. 1, the RI estimation unit 14 determines the blood vessel at the shunt formation site based on the intermittent degree obtained by the intermittent degree parameter calculation unit 13 and the first reference information that defines the relationship between the intermittent degree and the vascular resistance index. Estimate the resistance index.

Here, the first reference information will be described with reference to FIG. 2 and FIG. FIG. 4 is a diagram illustrating an example of the relationship between the degree of discontinuity and the vascular resistance index.

In FIG. 2, in the echo examination, the vascular resistance index is obtained by examining the brachial artery. It should be noted that the relationship between the vascular resistance index and stenosis obtained by echo examination is relatively clear.

When constructing the first reference information, the detection of the shunt sound by the electronic stethoscope 20 and the echo inspection by the echo device are performed simultaneously. If the discontinuity and the vascular resistance index at the same time are associated with each other and plotted on a plane having the discontinuity and the vascular resistance index as axes, a result as shown in FIG. 4 is obtained, for example. Based on this result, for example, the approximate straight line “y = ax + b” is an example of the first reference information. The first reference information is stored in advance in the RI estimation unit 14, for example.

The RI estimated value display unit 15 displays the vascular resistance index estimated by the RI estimating unit 14. The display mode is not particularly limited.

The “shunt sound input unit 11” according to the embodiment is an example of the “acquisition unit” according to the present invention. The calculation unit configured by the “voice signal analysis processing unit 12”, the “intermittentness parameter calculation unit 13”, and the “blood vessel resistance index estimation unit 14” according to the embodiment is an example of the “calculation unit” according to the present invention. .

(Technical effect)
When the vascular resistance index is obtained by the echo device, for example, a certain skill is required for handling the probe of the echo device. On the other hand, in the shunt sound analyzing apparatus 1, the shunt sound may be detected by the electronic stethoscope 20. The handling of the electronic stethoscope 20 requires less skill than the handling of the echo device.

For example, as shown in FIG. 4, there is a relatively high correlation between the degree of discontinuity and the vascular resistance index. Therefore, it can be said that the reliability of the vascular resistance index estimated from the discontinuity degree in the shunt sound analyzer 1 is relatively high. The vascular resistance index is often used for stenosis diagnosis. In the shunt sound analysis apparatus 1, the estimated vascular resistance index is displayed to the user (for example, a doctor or the like) by the RI estimated value display unit 15, so that the diagnosis of stenosis by the user can be supported.

As described above, according to the shunt sound analysis apparatus 1, an objective index (here, a vascular resistance index) related to the shunt formation site can be easily detected without depending on the skill of the user.

<Modification>
(1) In the first embodiment described above, the intermittent degree is obtained based on the systolic maximum volume V _max and the diastolic minimum volume V _min , but the present invention is not limited to this. For example, (i) frequency centroid in one heartbeat section, (ii) volume change in one heartbeat section, (iii) minimum volume value in one heartbeat section, (iv) volume attenuation rate in one heartbeat section, (v) systole Distortion of volume change that occurs from the first to the diastole, (vi) difference between the maximum and minimum values (or maximum and minimum values) of the shunt sound in one heartbeat period at normal time, and the shunt in one heartbeat period at the time of measurement Ratio of difference between maximum value and minimum value (or maximum value and minimum value) of sound, (vii) minimum value of shunt sound in one heartbeat period at normal time, and minimum of shunt sound in one heartbeat period at the time of measurement The degree of intermittentness may be obtained based on the ratio to the value, (viii) distribution of shunt sound volume for each frequency obtained by performing frequency analysis on the shunt sound, and the like.

(2) The shunt sound analysis apparatus 1 is applicable not only to humans but also to dogs and cats, for example. When the shunt sound analysis device 1 is applied to, for example, a dog or a cat, reference information that defines the relationship between the degree of intermittentness and the vascular resistance index for the dog or the cat may be stored in the RI estimation unit 14 in advance. .

<Second embodiment>
A second embodiment of the shunt sound analyzer will be described with reference to FIGS. The second embodiment is the same as the first embodiment described above except that the configuration of the shunt sound analyzer is partially different. Therefore, in the second embodiment, the description overlapping with that of the first embodiment is omitted, and the common portions in the drawing are denoted by the same reference numerals, and only fundamentally different points are referred to FIG. 5 and FIG. To explain.

In FIG. 5, the shunt sound analysis device 2 includes an intensity parameter calculation unit 21, a blood flow rate estimation unit 22, in addition to a shunt sound input unit 11, an audio signal analysis processing unit 12, an intermittent degree parameter calculation unit 13, and an RI estimation unit 14. And the estimated value display part 23 is provided. The audio signal analysis processing unit 12, the intermittent parameter calculation unit 13, the RI estimation unit 14, the intensity parameter calculation unit 21, and the blood flow rate estimation unit 22 constitute a calculation unit. The “blood flow estimation unit 22” is appropriately referred to as “FV (Flow Volume) estimation unit 22”.

The intensity parameter calculation unit 21 extracts data corresponding to a predetermined frequency band and corresponding to a predetermined period from the time-frequency analysis waveform PLlog [n, k] calculated by the audio signal analysis processing unit 12. Find the strength of the shunt sound.

Here, the predetermined frequency band is the same as the predetermined frequency band described in the description of the intermittentness parameter calculation unit 13. The predetermined period is set as a systole, for example. If the predetermined period is set as the systole, for example, a shunt sound synchronized with the heartbeat can be emphasized, and the influence of time variation in the diastole due to arrhythmia can be reduced. In the “systolic period”, one heartbeat section is detected from a temporal change in volume based on the time-frequency analysis waveform PLlog [n, k], and the first half of the detected one heartbeat section and / or the one heartbeat section is detected. The maximum value of the volume is set as 100%, for example, as a period of 80 to 100% volume.

Specifically, the intensity parameter calculation unit 21 obtains the intensity of the shunt sound by the following formula. In the following equation, “r1”, “r2”, “t1”, and “t2” are “lower limit frequency of target band”, “upper limit frequency of target band”, “start time of systole”, and “systole period”, respectively. End time ”.

The FV estimation unit 22 estimates the blood flow volume at the shunt formation site based on the shunt sound intensity obtained by the intensity parameter calculation unit 21 and the second reference information that defines the relationship between the shunt sound intensity and the blood flow volume. To do.

The second reference information may be set by the same method as the first reference information described above. That is, the blood flow rate of the brachial artery is measured by the echo device while detecting the shunt sound by the electronic stethoscope 20. For example, an approximate straight line is obtained based on the result of plotting on the plane around the intensity of the shunt sound and the blood flow volume in association with the intensity of the shunt sound and the blood flow volume at the same time. The obtained approximate curve may be used as the second reference information. The second reference information is stored in advance in the FV estimation unit 22, for example.

The estimated value display unit 23 displays the blood vessel resistance index estimated by the RI estimation unit 14 and the blood flow rate estimated by the FV estimation unit 22. As one mode of display by the estimated value display unit 23, for example, plotting the estimation results of the RI estimation unit 14 and the FV estimation unit 23 on a plane with the blood flow volume and the vascular resistance index as axes can be cited (see FIG. 6). ).

(Technical effect)
The range of blood flow volume and vascular resistance index as a criterion for determining whether or not to perform PTA for stenosis at a shunt formation site is empirically known. The criterion is, for example, 350 mL / min or less for blood flow, and 0.7 or more for vascular resistance index, for example.

If the user determines whether or not to perform PTA using only the blood flow, for example, the estimation result surrounded by the circle C1 in FIG. 6 may be overlooked. Similarly, if the user determines whether to perform PTA using only the vascular resistance index, for example, the estimation result surrounded by the circle C2 in FIG. 6 may be overlooked.

However, in the shunt sound analyzer 2, an estimation result having the vascular resistance index and the blood flow as components is obtained. For this reason, the user of the shunt sound analyzer 2 can determine whether or not to perform PTA using both the vascular resistance index and the blood flow rate. As a result, according to the shunt sound analyzer 2, for example, it is possible to suppress overlooking of the estimation results surrounded by the circle C1 and the circle C2 in FIG. That is, according to the shunt sound analysis device 2, it is possible to appropriately support a stenosis diagnosis by a user.

For example, the estimated value display unit 23 may estimate the stenosis to such an extent that PTA is recommended (in FIG. 6, the estimated blood flow is 350 mL / min or less and the vascular resistance index is 0.7 or more. If the configuration is such that the plot of (result) is changed (see “x” in FIG. 6), the diagnosis of stenosis by the user can be supported more appropriately.

<Modification>
The shunt sound analysis apparatus 3 (see FIG. 7) according to the modified example of the second embodiment may not include the RI estimation unit 14 and the FV estimation unit 22 of the shunt sound analysis apparatus 2 according to the second embodiment described above. . The shunt sound analyzer 3 outputs the intermittent degree and the intensity of the shunt sound instead of the vascular resistance index and the blood flow volume.

As shown in FIG. 8, for example, the estimated value display unit 23 of the shunt sound analysis apparatus 3 performs calculations of the intermittent parameter calculator 13 and the intensity parameter calculator 21 on a plane having the intensity and the intermittent degree of the shunt sound as axes. The results (ie, discontinuity and shunt intensity) may be plotted.

According to the shunt sound analysis device 3, similarly to the shunt sound analysis device 2 described above, for example, it is possible to suppress the estimation result surrounded by each of the circle C3 and the circle C4 in FIG. 8 from being overlooked. That is, according to the shunt sound analysis device 3, it is possible to appropriately support a stenosis diagnosis by a user.

Also in this modified example, the estimated value display unit 23 displays the estimation result in which the stenosis to the extent that PTA is recommended is suspected (in FIG. 8, the estimation is included in the range where the intensity is X1 or less and the intermittent degree is Y1 or less. If the configuration is such that the plot of (result) is changed (see “x” in FIG. 8), the diagnosis of stenosis by the user can be supported more appropriately. X1 is a value corresponding to, for example, a blood flow rate of 350 mL / min in FIG. 6, and Y1 is a value corresponding to, for example, the vascular resistance index 0.7 in FIG.

The present invention is not limited to the above-described embodiments and examples, and can be appropriately changed without departing from the spirit or idea of the invention that can be read from the claims and the entire specification, and the shunt accompanying such a change. Sound analysis apparatuses and methods, computer programs, and storage media are also included in the technical scope of the present invention.

DESCRIPTION OF SYMBOLS 1, 2, 3 ... Shunt sound analysis apparatus, 11 ... Shunt sound input part, 12 ... Audio | voice signal analysis process part, 13 ... Intermittent parameter calculation part, 14 ... Vascular resistance index estimation part, 15 ... Vascular resistance index estimated value display 20, an electronic stethoscope, 21 an intensity parameter calculation unit 22, a blood flow estimation unit 23, an estimated value display unit

Claims

An acquisition means for acquiring shunt sound information indicating a shunt sound of a shunt formation site of a living body to be measured;
(I) Based on the acquired shunt sound information, an intermittent degree, which is information indicating the degree of intermittent shunt sound, is calculated. (Ii) Based on the calculated intermittent degree, the vascular resistance of the shunt formation site A calculation means for calculating an index;
A shunt sound analysis apparatus comprising:
The said calculation means calculates the said vascular resistance index based on the calculated intermittent degree and the reference information which shows the relationship between the said intermittent degree and the said vascular resistance index | exponent. Shunt sound analyzer.
The calculation means (i) performs a predetermined analysis process on the acquired shunt sound information to acquire data indicating a temporal change for each frequency of the sound, and (ii) a predetermined frequency of the acquired data The shunt sound analysis apparatus according to claim 1, wherein the degree of discontinuity is calculated based on data corresponding to a band.
An acquisition means for acquiring shunt sound information indicating a shunt sound of a shunt formation site of a living body to be measured;
Based on the acquired shunt sound information, a calculation means for calculating a discontinuity that is information indicating a discontinuity of the shunt sound and a strength of the shunt sound;
The first information related to the vascular resistance index of the shunt formation site based on the calculated intermittent degree and the second information related to the blood flow volume of the shunt formation site based on the calculated intensity are included as components. Output means for outputting an index indicating the degree of stenosis related to the shunt formation site;
A shunt sound analysis apparatus comprising:
A shunt sound analysis method used in a shunt sound analyzer for analyzing a shunt sound,
An acquisition step of acquiring shunt sound information indicating a shunt sound of a shunt formation site of a living body to be measured;
(I) Based on the shunt sound information acquired by the acquisition step, calculate an intermittent degree that is information indicating the intermittent degree of the shunt sound, and (ii) based on the calculated intermittent degree, the shunt forming part A calculation step of calculating a vascular resistance index of
A shunt sound analysis method comprising:
The computer installed in the shunt sound analyzer
An acquisition means for acquiring shunt sound information indicating a shunt sound of a shunt formation site of a living body to be measured;
(I) Based on the acquired shunt sound information, an intermittent degree, which is information indicating the degree of intermittent shunt sound, is calculated. (Ii) Based on the calculated intermittent degree, the vascular resistance of the shunt formation site A calculation means for calculating an index;
A computer program that functions as a computer program.
A storage medium storing the computer program according to claim 6.