WO2020080601A1 - Moniteur de pression sanguine et procédé de mesure de la pression sanguine en utilisant celui-ci - Google Patents
Moniteur de pression sanguine et procédé de mesure de la pression sanguine en utilisant celui-ci Download PDFInfo
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- WO2020080601A1 WO2020080601A1 PCT/KR2018/015596 KR2018015596W WO2020080601A1 WO 2020080601 A1 WO2020080601 A1 WO 2020080601A1 KR 2018015596 W KR2018015596 W KR 2018015596W WO 2020080601 A1 WO2020080601 A1 WO 2020080601A1
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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
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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
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
Definitions
- the present invention relates to a blood pressure monitor and a blood pressure measuring method, and more specifically, a blood pressure monitor for calculating blood pressure using a blood pressure difference (a change in blood pressure) and a change in pulse wave parameters according to an altitude difference (height difference) of a pulse wave measurement location and blood pressure using the same It relates to a measuring method.
- blood pressure In general, measuring the pressure that blood has on the walls of blood vessels is called blood pressure, and the heart repeats contraction and relaxation about 60 to 80 times per minute.
- the pressure on the blood vessels is called 'constriction blood pressure' and is called 'highest blood pressure' because it is the highest.
- the blood vessel pressure is called 'relaxed blood pressure' and is called 'lowest blood pressure' because it is the lowest.
- the blood pressure of normal people is 120 mmHg of systolic blood pressure and 80 mmHg of diastolic pressure. More than 1 out of 4 adults in Korea are hypertensive, and since the age of 40, this rate has been increasing rapidly, and there are also patients classified as hypotension.
- the high blood pressure is a problem, because it can cause other complications that can threaten life, such as eye disease, kidney disease, arterial disease, brain disease, heart disease, if left without proper management of high blood pressure, complications Patients with or at risk of complications should continuously measure and manage blood pressure.
- Blood pressure measurement methods include a stethoscope (Korotkoff sounds) method, an oscillometric method, and a tonometric method.
- the auscultation method is a typical pressure measurement method. In the process of depressurizing after blocking the flow of blood by applying sufficient pressure to a part of the body where arterial blood passes, the pressure at the moment of the first pulse sound is measured as systolic pressure. It is a method to measure the pressure at the moment when the pulse sound disappears by diastolic pressure.
- the oscillometric method and the tonometric method are applied to a digitized blood pressure measuring device.
- the oscillometric method like the auscultation method, sufficiently pressurizes the body part passing through the arterial blood so that the blood flow of the artery is blocked, and then depressurizes the body part at a constant rate, or the pulse wave generated during the process to pressurize the body part at a constant rate. Detect and measure systolic and diastolic blood pressure.
- the pressure at a certain level may be measured as systolic blood pressure or diastolic blood pressure compared to the moment when the amplitude of the pulse wave is the maximum, and the pressure when the rate of change of the pulse wave amplitude is rapidly changed is measured as systolic blood pressure or diastolic blood pressure. You may.
- systolic blood pressure is measured ahead of the moment when the amplitude of the pulse wave is maximum, and diastolic blood pressure is measured later than the moment when the amplitude of the pulse wave is maximum.
- systolic blood pressure is measured later than the moment when the amplitude of the pulse wave is maximum, and diastolic blood pressure is measured before the moment when the amplitude of the pulse wave is maximum.
- the tonometric method is a method capable of continuously measuring blood pressure by applying a certain pressure of a size that does not completely block the blood flow of the artery to the body part, and using the size and shape of the pulse wave generated at this time.
- a device for measuring blood pressure in various ways that is, a sphygmomanometer, is the most basic medical device for measuring blood pressure, which is the basis of a health index, and is not only provided in general hospitals, but also in homes and sports centers. It is widely used to measure blood pressure.
- a blood pressure monitor that measures blood pressure using pulse waves
- a blood pressure monitor that calculates blood pressure based on optical arterial wave (PPG) or other pulse wave propagation speed (PTT)
- PPG optical arterial wave
- PTT pulse wave propagation speed
- the present inventor has developed a blood pressure monitor and a blood pressure acquisition method capable of reflecting, for example, a rapid change in a blood vessel state having a large effect on blood pressure along with blood flow, for example, a change in blood vessel cross-section.
- Korean Patent Application Publication No. 10-2010-0118331 which is a prior document, discloses a blood pressure measuring device and method for correcting an error in blood pressure
- Korean Patent Registration No. 10-1844897 discloses a blood pressure monitor equipped with a function for measuring measurement conditions. It starts.
- An object of the present invention is to provide a sphygmomanometer for calculating blood pressure using a difference in blood pressure (a change in blood pressure) and a change in pulse wave parameters according to an altitude difference (height difference) of a pulse wave measurement position and a blood pressure measurement method using the same.
- An aspect of the present invention includes: a parameter change amount calculation unit for calculating a change amount of a pulse wave parameter (Parameter: PM) caused by an altitude difference between two arbitrary points where pulse wave measurement is performed; And it provides a blood pressure monitor including a blood pressure change unit for calculating the blood pressure from the change in blood pressure caused by the altitude difference between the two points where the measurement of the pulse wave is made, and the change in the pulse wave parameter and the pulse wave parameter.
- a parameter change amount calculation unit for calculating a change amount of a pulse wave parameter (Parameter: PM) caused by an altitude difference between two arbitrary points where pulse wave measurement is performed
- a blood pressure monitor including a blood pressure change unit for calculating the blood pressure from the change in blood pressure caused by the altitude difference between the two points where the measurement of the pulse wave is made, and the change in the pulse wave parameter and the pulse wave parameter.
- the blood pressure calculating unit may calculate a blood pressure change rate from the blood pressure change amount according to the change amount of the parameter of the pulse wave, and calculate the blood pressure using the blood pressure change rate and the pulse wave parameter.
- the pulse wave parameter (PM) is not limited to any one of an optical arterial wave (PPG), arterial pressure, arterial electrical resistance pulse wave, pulse transit time (PTT), and blood flow velocity.
- the blood pressure monitor may further include a pulse transit time (PTT) detection unit for detecting the pulse transmission time.
- PTT pulse transit time
- the PTT detection unit may include an electrocardiogram measurement unit for measuring an electrocardiogram (ECG) and a pulse wave measurement unit for measuring the pulse wave.
- ECG electrocardiogram
- the electrocardiogram measurement unit and the pulse wave measurement unit may be provided in a cuff that can be worn on a predetermined part of the body.
- the sphygmomanometer may further include a blood flow velocity measurement unit for detecting the blood flow velocity, which is a kind of the pulse wave parameter.
- the blood pressure monitor may further include an optical arterial wave measurement unit for detecting the optical arterial wave or an arterial pressure measurement unit for detecting the arterial pressure.
- the blood pressure monitor may further include an arterial electrical resistance pulse wave measurement unit for detecting the arterial electrical resistance pulse wave.
- the rate of blood pressure change may be calculated by the following [Equation 1].
- ⁇ P is the amount of blood pressure change caused by altitude difference between any two points where pulse wave is measured (blood pressure difference caused by altitude difference)
- ⁇ PM is the amount of change in pulse wave parameter between any two points
- the amount of change in the pulse wave parameter may be a difference in pulse wave transmission time measured at the arbitrary two points.
- the sphygmomanometer may further include a blood pressure difference calculator for calculating the amount of change in blood pressure, which is a blood pressure difference caused by an altitude difference between two arbitrary points, using Equation 2 below.
- the gravity acceleration is changed to a gravity acceleration for each region and input to the blood pressure difference calculator.
- the density of the blood is preferably changed for each race and input to the blood pressure difference calculating unit. That is, it is preferable that the density of blood is set for each race and the density of blood corresponding to the user's race is applied for calculating the blood pressure difference.
- Another aspect of the present invention calculates the amount of change in the pulse wave parameter (PM) caused by the altitude difference between any two points where pulse wave measurement is made, and is generated by the altitude difference between the two points where pulse wave measurement is made.
- a blood pressure measurement method for calculating blood pressure from a change in blood pressure that is a blood pressure difference, a change in the pulse wave parameters, and a pulse wave parameter.
- the blood pressure measuring method includes: (a) calculating a change amount of the pulse wave parameter; And it may include the step (b) of calculating the blood pressure from the change in blood pressure and the change in the pulse wave parameters and pulse wave parameters.
- the blood pressure measuring method may further include the step of calculating the change in blood pressure from the altitude difference between the arbitrary two points before, after, or simultaneously with step (a) of calculating the change in the pulse wave parameter.
- the step (b) includes calculating a blood pressure change rate from the blood pressure change amount according to the change amount of the pulse wave parameter and calculating the blood pressure using the blood pressure change rate and the pulse wave parameter;
- the rate of blood pressure change may be calculated by the following [Equation 1].
- ⁇ P is the amount of blood pressure change caused by altitude difference between any two points where pulse wave is measured (blood pressure difference caused by altitude difference)
- ⁇ PM is the amount of change in pulse wave parameter between any two points
- the blood pressure may be calculated using the following [Equation 3] from the blood pressure change rate and the pulse wave parameter.
- PM1 is the blood pressure for a high position (H1) among 2 arbitrary points, PM1 is the value of pulse wave parameter measured at the height of H1)
- the present invention is a sphygmomanometer that measures blood pressure using a difference in blood pressure caused by an altitude difference (height difference) of a measurement position and a change in pulse wave parameters according to a change in measurement position, and more specifically, blood vessels having a large influence on blood pressure measurement along with blood flow in the sphygmomanometer Since it is a blood pressure monitor capable of reflecting a rapid change of state in blood pressure calculation, blood pressure at a measurement position can be more accurately measured from a change in pulse wave parameter every time blood pressure is measured, and accuracy of blood pressure, that is, reliability of a blood pressure monitor can be greatly improved.
- FIG. 1 is a block diagram showing the configuration of a blood pressure monitor according to an embodiment of the present invention
- Figure 2 is a schematic view showing a blood pressure monitor according to an embodiment of the present invention.
- FIG. 3 is a view showing an example of a blood pressure measurement method according to an embodiment of the present invention.
- PTT pulse transit time
- Figure 5 is a flow chart schematically showing a blood pressure measurement method according to an embodiment of the present invention.
- FIG. 6 is a developed view showing a blood pressure monitor according to another embodiment of the present invention.
- FIG. 7 is a view showing a state in which the blood pressure monitor shown in FIG. 6 is worn on the body (upper arm);
- FIG. 9 is a diagram illustrating a method of measuring blood velocity, which is another example of pulse wave parameters.
- the blood pressure monitor is a device for measuring blood pressure, and may be implemented as a portable blood pressure monitor, more specifically, a wearable measuring device of blood pressure.
- an embodiment of the present invention may be provided as a portable sphygmomanometer worn on the human body to measure the pulse wave of the measurement target region (target region) and obtain a blood pressure value from the pulse wave parameter.
- an embodiment of a blood pressure monitor uses a parameter change amount calculating unit 10 for calculating a change amount of a pulse wave parameter (PM), and blood pressure using data such as pulse wave parameters It includes a blood pressure calculation unit 20 for calculating.
- a parameter change amount calculating unit 10 for calculating a change amount of a pulse wave parameter (PM), and blood pressure using data such as pulse wave parameters It includes a blood pressure calculation unit 20 for calculating.
- the sphygmomanometer may be provided as a wearable sphygmomanometer, that is, a portable type, such as a wrist sphygmomanometer or a finger sphygmomanometer that can be worn on a predetermined part of the human body, for example, a wrist or a finger.
- the present invention may be applied to a smart phone, for example, a blood pressure monitor that measures blood pressure by contacting a finger with a light measuring sensor of the smart phone.
- the parameter change amount calculating unit 10 is configured to calculate a change amount of the pulse wave parameter PM generated by the altitude difference ⁇ H between any two points where pulse wave measurement is performed.
- the blood pressure calculating unit 20 calculates blood pressure from a change in blood pressure generated by an altitude difference between two points at which pulse waves are measured, a change in the pulse wave parameters, and a pulse wave parameter.
- the parameter change amount calculation unit 10 and the blood pressure calculation unit 20 calculates blood pressure using data input from a sensor, for example, a signal detection sensor such as an optical blood flow meter or altitude difference detection unit described later.
- a sensor for example, a signal detection sensor such as an optical blood flow meter or altitude difference detection unit described later.
- the components are included in the blood pressure monitor control module (C).
- the blood pressure calculating unit 20 calculates a blood pressure change rate from a blood pressure change amount according to the change amount of the pulse wave parameter, and calculates the blood pressure using the blood pressure change rate and the pulse wave parameter.
- the blood pressure monitor further includes a blood pressure difference calculator 30 for calculating a blood pressure difference caused by an altitude difference ( ⁇ H) between the arbitrary two points, that is, a change in blood pressure due to the altitude difference. You can.
- the blood pressure monitor further includes a parameter measurement unit 40 for acquiring the pulse wave parameters.
- pulse wave parameter PM examples include optical arterial wave (PPG), arterial pressure, pulse transit time (PTT), blood flow velocity, and arterial electrical resistance pulse wave, and the pulse wave parameter is limited to the above-described example It is not.
- the blood pressure monitor is provided with a pulse transit time (PTT) detector 41 for detecting the pulse wave propagation time as an example of the parameter measurement part 40.
- PTT pulse transit time
- the PTT detection unit 41 may include an electrocardiogram measurement unit (electrocardiogram) 41a for measuring an electrocardiogram (ECG) and a pulse wave measurement unit 41b for measuring a pulse wave.
- ECG electrocardiogram
- the electrocardiogram measurement unit 41a and the pulse wave measurement unit 41b are provided with a cuff 110 that can be worn on a predetermined part of the body, for example, a wrist or an arm (upper arm), as shown in FIG. 2. Can be. Both ends of the cuff 110 may be detached by Velcro 120 or other detachable means.
- electrodes 41a for ECG measurement may be provided on the inner and outer surfaces of the cuff 110, and although not shown, calculate blood pressure from pulse wave parameters, control the blood pressure monitor, and output the calculated blood pressure.
- the control module C is embedded in the display device, and the display device may be mounted on the cuff 110 so that the user can visually check blood pressure.
- a blood flow rate measurement unit for detecting the blood flow rate described above may be applied.
- the blood pressure monitor may be provided with an optical arterial wave measuring unit for detecting optical arterial waves or an arterial pressure measuring unit for detecting the arterial pressure.
- the blood pressure monitor is provided with an arterial electrical resistance pulse wave measurement unit.
- the above-described arterial electrical resistance pulse wave may be measured based on a body fat measurement technique using electrical resistance, more specifically, a body fat measurement device. When measuring body fat, the body fat is measured based on the electrical resistance of the skin.
- the pulse wave of the artery that is, the pulse wave of the artery, can be measured by the electrical resistance of the artery.
- An example of the pulse wave measuring unit 41b is a photoplethysmography, but is not limited thereto, and a sensor capable of measuring pulse wave, for example, a pressure sensor is also possible.
- a general photo blood flow meter includes a light emitting part and a light receiving part.
- the altitude difference detection of the pulse wave measurement position may be performed by the altitude difference detection unit 50, and the altitude difference detection unit 50 includes at least one of an acceleration sensor, an altitude sensor, a pressure sensor, a differential amplifier, and a gyro sensor. can do.
- the altitude difference detecting unit 50 may be any device that can measure a height difference (altitude difference) between arbitrary positions where pulse waves are measured, and the altitude difference measured by the altitude difference detecting unit 50 is described above. It is input to a blood pressure difference calculator 30.
- the altitude difference ( ⁇ H) of the difference between the two points may be measured by hand using a ruler, such as a measuring tape, for example, and when the manually measured altitude difference is input to the blood pressure monitor, , A blood pressure difference (a change in blood pressure) generated by the altitude difference from the input altitude difference ⁇ H may be calculated by the blood pressure difference calculator 30.
- the altitude difference detection unit 50 is a configuration for detecting altitude change, and detects altitude of a target region, that is, a body region where blood pressure measurement is performed, and detects an altitude difference (height difference) between any two points where blood pressure measurement is performed.
- the altitude difference detecting unit 50 detects the height difference between two positions.
- the blood pressure change rate can be obtained from the blood pressure difference (a change in blood pressure) and the pulse wave parameter change caused by the above-described altitude difference.
- the rate of blood pressure change may be calculated by the following [Equation 1].
- ⁇ P is the amount of blood pressure change caused by altitude difference between any two points where pulse wave is measured (blood pressure difference caused by altitude difference)
- ⁇ PM is the amount of change in pulse wave parameter between any two points
- the blood pressure difference calculating unit 30 may calculate the blood pressure difference ⁇ P, that is, a change in blood pressure using Equation 2 below, but is not limited thereto.
- the gravitational acceleration is changed to the gravitational acceleration for each region and input to the blood pressure difference calculator 30.
- the gravity acceleration can be automatically set (changed) according to the user's current position.
- the density ⁇ of the blood may be a measured value or a predetermined average value.
- the density of the blood is changed for each race and input to the blood pressure difference calculation unit 30. More specifically, the density of the blood is set for each race, and the density of blood corresponding to the user's race is input to the blood pressure difference calculating unit 30 to be applied to blood pressure measurement.
- the amount of change in the pulse wave parameter may be a difference between the pulse wave transmission time (PTT) measured at the arbitrary two points.
- the blood pressure calculator 20 may calculate blood pressure using the following Equation 3 from the blood pressure change rate and pulse wave parameters. That is, the blood pressure can be expressed as a product of the blood pressure change rate and the pulse wave parameter.
- PM1 is the blood pressure for a high position (H1) among 2 arbitrary points, PM1 is the value of pulse wave parameter measured at the height of H1)
- the above-described blood pressure value P1 becomes a blood pressure value at a high position (H1) among any two points where pulse wave parameters are measured.
- the blood pressure P in the blood vessel may be expressed as [Equation 4] below.
- blood pressure measured at any two points i.e., different heights (H1, H2), is related to the following [Equation 5].
- P1 and P2 are the blood pressure of height H1 and H2 respectively
- V1 and V2 are the blood flow velocity of height H1 and H2 respectively
- T1 and T2 are the pulse propagation time of height H1 and H2 respectively
- the pulse wave propagation time T1 is obtained at the H1 height
- T2 is obtained at the H2 height
- the difference in pulse wave propagation time (PTT) which is an example of the change in the pulse wave parameter ( ⁇ T, PTT change)
- Equation 1 when the difference ( ⁇ T) of the pulse wave transmission time (PTT) described above is applied to the change in the pulse wave parameter, the rate of change in blood pressure in Equation 1 may be expressed as follows.
- the maximum blood pressure (P1max) at H1 height can be obtained as in [Equation 6]. have.
- the blood pressure value obtained from the H1 height is corrected to the blood pressure of the heart height using a known blood pressure correction method, and then displayed through the blood pressure output unit 70, for example, a digital screen.
- a known blood pressure correction method for example, a digital screen.
- the setting of the reference value in the blood pressure monitor may be performed through initial setting using blood pressure measured in a separate blood pressure monitor, and the blood pressure monitor setting may be implemented by the blood pressure monitor setting unit 60.
- a blood pressure measurement method that is, a blood pressure calculation method according to an embodiment of the present invention, calculates a change amount of a pulse wave parameter (PM) caused by an altitude difference between two arbitrary points where pulse wave measurement is performed,
- the blood pressure difference which is a difference in blood pressure caused by the altitude difference between two points at which the pulse wave is measured, is calculated through the process of calculating blood pressure from the change in the pulse wave parameter and the pulse wave parameter.
- the blood pressure measuring method comprises: (a) (S110) for calculating a change amount of the pulse wave parameter and (b) calculating a blood pressure from the change in the blood pressure change amount and the pulse wave parameter and the pulse wave parameter ( S120).
- the blood pressure measurement method includes the amount of change in blood pressure (blood pressure difference) from the altitude difference ( ⁇ H) between any two points before, after, or simultaneously with step (a) of calculating the difference in the pulse wave parameter, for example, the difference in pulse transmission time. ⁇ P) may be further included.
- the step (b) (S120) includes calculating a blood pressure change rate from the blood pressure change amount according to the change amount of the pulse wave parameter (S121) and calculating the blood pressure using the blood pressure change rate and pulse wave parameter (S122).
- the blood pressure change rate can be calculated in the manner described in the above-described embodiment.
- the blood pressure calculation may be performed through [Equation 3] more specifically, [Equation 3] described above using the blood pressure change rate and the pulse wave parameter.
- pulse wave parameter measurement for example, electrocardiogram and pulse wave measurement
- S10 electrocardiogram and pulse wave measurement
- another embodiment of a blood pressure monitor according to the present invention is a cuff blood pressure monitor 100A worn on a forearm (arm), an example of a pulse wave measurement unit provided at a different height from the electrocardiogram measurement unit 41a.
- the electrocardiogram measurement unit (41a) and pulse wave measurement unit (41b) is provided with a cuff (110A) forearm, one electrode of the electrodes of the electrocardiogram measurement unit It is mounted on the cuff 110A and the other electrode is connected by a wire to be attached to other parts of the body.
- PTT change can be obtained as in the embodiments shown in FIGS. 1 to 4 and applied as a pulse wave parameter change amount.
- the height difference of the photo blood flow meter 41b becomes the altitude difference ( ⁇ H) of the pulse wave measurement position. Therefore, the user's blood pressure can be calculated in the manner described above.
- FIG. 8 illustrates a method of measuring blood flow velocity, and pulse waves are detected as shown in FIG. 8 (b) at two points on the blood vessel A with a distance (s; blood vessel length between two points) between the pulse wave measurement points.
- the pulse wave may be detected by a plurality of pulse wave measuring units 42a and 42b spaced apart from each other, for example, a photo blood flow meter or a pressure sensor.
- FIG. 9 illustrates another method of measuring the blood rate, and for example, a sensor 43 based on ultrasonic waves or electromagnetic waves (radar) may be applied.
- radar electromagnetic waves
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Abstract
La présente invention concerne un moniteur de pression sanguine et un procédé de mesure de la pression sanguine en utilisant celui-ci, le moniteur de pression sanguine comprenant : une unité de calcul de variation de paramètre (PM) destinée à calculer la variation d'une onde de pression PM, qui est générée par la différence de hauteur entre deux points arbitraires auxquels une onde pression est mesurée ; et une unité de calcul de pression sanguine destinée à calculer la pression sanguine à partir de la variation de la pression sanguine, la variation de l'onde de pression PM, et l'onde de pression PM, qui sont générées par la différence de hauteur entre les deux points auxquels est mesurée l'onde de pression. La présente invention concerne un moniteur de pression sanguine destiné mesurer la pression sanguine en utilisant une différence de pression sanguine générée par la différence de hauteur de positions de mesure et la variation d'une onde de pression PM en fonction d'un changement dans les positions de mesure et, plus particulièrement, un moniteur de pression sanguine capable de réfléchir, dans un calcul de pression sanguine, un changement rapide de l'état d'un vaisseau sanguin qui influence de manière significative une mesure de la pression sanguine, conjointement avec un débit sanguin dans le moniteur de pression sanguine, ce qui permet de mesurer plus précisément la pression sanguine à une position de mesure donnée sur la base de la variation d'une onde de pression PM pour chaque mesure de pression sanguine et permet d'améliorer considérablement la précision de la pression sanguine, c'est-à-dire la fiabilité du moniteur de pression sanguine.
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CN114403826A (zh) * | 2020-10-28 | 2022-04-29 | 深圳市科瑞康实业有限公司 | 一种血压测量方法和装置 |
CN114403826B (zh) * | 2020-10-28 | 2024-02-23 | 深圳市科瑞康实业有限公司 | 一种血压测量方法和装置 |
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