JPS625618B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION (Field of Industrial Application) The present invention relates to an analysis device for diagnosing hemodynamics that analyzes the properties and hemodynamics of blood vessels in the circulatory system and provides clinical diagnosis of the circulatory system.

Living organisms are composed of a huge number of cells. Various organs, the brain, muscles, nerves, etc. are constructed from these individual cells, forming the body. In order for these cells to live, they must supply oxygen and metabolic substances, and at the same time excrete metabolic wastes.The blood plays this role, and its route is the systemic circulation made up of blood vessels. . Therefore, it is no exaggeration to say that the main part that maintains the life of cells is the circulatory system centered on the essential organs.

The above-mentioned roles for individual cells are actually played by capillaries, but blood is supplied to the capillaries by the heart, the aorta, and the arterial system of small and medium arteries, and returns to the heart via the venous system. . Of these routes, it goes without saying that the heart's blood storage and pumping actions are important, but it is the arterial route that acts as the afterload of the heart that directly influences these actions.

This arterial route not only functions as a pipe for blood to pass through, but also stores energy during the systolic phase of the heart and uses the elasticity of the blood vessel walls to bounce the blood back to the peripheral capillaries during the diastolic phase of the heart. It is trying to maintain blood flow in the extruded capillaries. Therefore, if the arterial route hardens and loses its elasticity, this will place a heavy burden on the heart, making it difficult for blood to reach the peripheral capillaries, thereby reducing the supply of oxygen and metabolic substances to cells, and reducing metabolic waste. This appears as an increase in blood pressure as well as a decrease in the excretion of
This increase in blood pressure can easily lead to damage to blood vessels due to external factors such as rapid exercise or sudden changes in temperature, and damage to arteries and capillaries in the head can be particularly life-threatening.

Therefore, as mentioned above, understanding the properties and hemodynamics of blood vessel walls in the circulatory system is not only important for diagnosis in clinical medicine, but also essential for preventive medicine.

Conventionally, when understanding the properties of blood vessel walls and hemodynamics in the circulatory system, pressure information was obtained by puncturing a skin blood vessel or inserting a catheter directly into the blood vessel to measure blood pressure, and by measuring the flow rate. Information is obtained invasively by making an incision in the skin and exposing the blood vessels using an electromagnetic flowmeter or similar measuring device. It is true that this method is a direct method, but it not only causes pain to the subject, but also makes it extremely difficult to grasp the normal state of the living body due to excessive tension during measurement. Furthermore, since this method is an invasive measurement, there is a risk of bacterial infection, and it is not easy to use it clinically.

Recently, with the development of electronics, a variety of highly accurate small-sized detectors have begun to be used that can non-invasively detect pulsation fluctuations in the arteries of the living body's circulatory system and blood fluctuations from the body surface of the living body. However, the signal obtained from this detector simply detects changes in pulsation in the arteries of the circulatory system as changes in pulse pressure, and also simply detects changes in blood in the arteries of the circulatory system. This method only detects volumetric changes, and it is not possible to comprehensively grasp the function and movement state of the arterial route in the body's circulatory system.

(Objective of the present invention) The present invention was created as a result of research to overcome the above-mentioned conventional drawbacks. The objective is to provide a highly practical device that can detect and output.

When considering the function of the arterial route of a living body's circulatory system as physical information, pressure and volume information can be considered. When detecting information about the arterial route to be measured, pressure can be detected at a point, but volume information cannot be obtained unless the volume is detected in one section.

Therefore, the part of the circulatory system to be measured is conceptually considered as one compartment, and the pressure fluctuation ΔP applied to this compartment and the volume fluctuation ΔV of the compartment in response to the pressure change ΔP are detected respectively. However, if ΔP and ΔV are expressed as compliance C=ΔV/ΔP, dynamic changes in the blood vessel wall in the arterial route, such as expansion and contraction, occur through pressure and volume changes due to the pressure, that is, the expansion and contraction of the blood vessel wall. It can aim to assess elasticity. The properties (hardness, elasticity) of blood vessels at the measurement target site of the biological circulatory system can be functionally expressed from the magnitude of the obtained value.

In addition, if the relationship between ΔP and ΔV is expressed graphically, that is, as a pressure-volume diagram (PV diagram), it can be expressed as a volume change that changes from moment to moment corresponding to the pressure change of the measurement target, in other words, the measurement area The displacement movement of the blood vessel wall can be displayed. Among the information obtained from the PV diagram, the area surrounded by pressure and volume changes represents the amount of work on the blood vessel wall that is the object of measurement, and the rotation direction represents the elasticity of the blood vessel wall that is the object of measurement. This is based on the knowledge that the slope can represent a dynamic change state of compliance, and that this information can represent the dynamics of the circulatory system arterial route to be measured.

(Means for Solving the Problem) A hemodynamic diagnostic analyzer according to a first aspect of the present invention includes a pulse pressure detection section that non-invasively detects pulsation in the circulatory system of a living body as a pulse pressure change signal; a first processing circuit that stores an output signal of the detection section as a pulse pressure fluctuation signal; a volume detection section that non-invasively detects a fluctuation amount of blood in the circulatory system of a living body as a volume change signal; and the volume detection section. a second processing circuit that stores the output signal of the first processing circuit as a volume variation signal; and a trigger circuit that outputs a signal when the time phases of the output signal of the first processing circuit and the output signal of the second processing circuit match. and,
Due to the output signal of the trigger circuit, the first
and a display circuit that divides the output signal of the second processing circuit by the output signal of the second processing circuit to display it as a compliance or PV diagram.

The hemodynamic diagnostic analysis device of the second invention includes a pulse pressure detection section that non-invasively detects the pulsation of the circulatory system of a living body as a pulse pressure change signal, and an output signal of the pulse pressure detection section that detects pulse pressure fluctuations. a first processing circuit that stores the signal as a signal; a volume detection section that non-invasively detects the amount of variation in blood in the circulatory system of the living body as a volume change signal; and a volume detection section that stores the output signal of the volume detection section as a volume variation signal. a second processing circuit for correcting the stored signal of the first processing circuit and the stored signal of the second processing circuit with a reference signal of pulse pressure fluctuation and a reference signal of volume fluctuation of the circulatory system of the living body; a trigger circuit that outputs a signal when the time phases of the output signal of the first processing circuit and the output signal of the second processing circuit match; and a trigger circuit that outputs a signal when the output signal of the first processing circuit and the output signal of the second processing circuit match; The present invention is characterized by comprising a display circuit that divides the output signal of the second processing circuit by the output signal of the processing circuit and displays it as a compliance or PV diagram.

(Actions and Effects of the Present Invention) The present invention utilizes pulse pressure change signals and volume change signals to non-invasively obtain compliance and P. -This is a device for creating V-diagrams.

Among the information obtained from the device of the present invention, compliance is shown in Figures 6 and 7 in the first embodiment.
As shown in the figure, it is useful for expressing the characteristics of the aortic blood vessels of the subject's circulatory system and for clarifying the functional classification of diseases. For example, the age status can be determined by the compliance shown in FIG. 6, and the condition of a healthy person or a diseased person can be determined by the compliance shown in FIG.

In addition, as shown in FIG. 9 of the second embodiment, the PV diagram shows the area encompassed by the loop of the PV diagram, which represents the amount of work accompanying the contraction and diffusion of the blood vessel walls of the circulatory system. The shape of the diagram provides useful visual information to assist in diagnosing the circulatory system. For example, in the same figure, A indicating a large PV area indicates a healthy person, and B and C indicating a small PV area indicate a diseased person.

The configuration of the present invention is relatively simple and inexpensive, and
Moreover, it does not cause any pain to the subject. Also,
Since it can be drawn quantitatively in real time and in functional and graphical representations, it is possible to quickly obtain diagnostic analysis results based on accurate information. Therefore, it is a novel and extremely significant device that is expected to become widespread in the medical field, especially in the field of preventive medicine.

(Example) Hereinafter, the analysis device for diagnosing hemodynamics of the present invention will be explained as follows.
1 to 5 and 1 based on the embodiment of
This will be explained using Figure 2.

The hemodynamic diagnostic analysis device of the first embodiment functionally displays the properties of blood vessels in the circulatory system of a living body, and as shown in FIG. It consists of a cardeograph 30, a second processing circuit 40, a trigger circuit 50, a compliance calculation circuit 60, and a typewriter 70.

The pulse wave meter 10 has a sensing part 11 containing a semiconductor strain-electricity conversion element, a band 12 that can be easily attached to and taken off from the subject, and an air band that presses the sensing part 11 with a predetermined pressing force when worn. It has a pressing body 13 equipped with a pump, and by non-invasively pressing the sensing part 11 against the arterial part of the subject's circulatory system from the body surface, pulsation changes propagating from the subject's arterial part can be detected. Sensing part 11
It is a highly reliable detector that can convert and output an analog pulse pressure change signal using a semiconductor strain-electric conversion element, and the output of the pulse wave meter 10 is transmitted to the first processing circuit 2.
Output to 0. That is, the sensing section 11 of the pulse wave meter 10 is composed of a strain-to-electrical conversion element in which four strain gauges are formed insulatively on a silicon single crystal diaphragm by the diffusion method, and these gauges are incorporated into a full bridge circuit. When it is pressed onto the cortical layer of the subject's artery, pulsating fluctuations in the artery are transmitted through the skin to the strain-to-electrical conversion element of the sensing section 11, generating strain in the diaphragm that is proportional to the pressure fluctuation. The strain is converted by a strain gauge into an analog electrical signal proportional to the applied pressure, and this analog pulse pressure change signal is output to the first processing circuit 20, where it detects the pulsation fluctuations transmitted to the skin surface of the subject. is converted by the pulse wave meter 10 into an analog pulse pressure change signal proportional to this.

The first processing circuit is a circuit that stores and holds a predetermined electrical signal among the input electrical signals, calibrates it to a predetermined signal, and outputs it. It has a memory circuit 23 and a potential correction circuit 24.

That is, the rise detection circuit 21 that converts an input electrical signal into a predetermined signal waveform includes a high-pass filter that removes the DC component of the input signal, a differentiator that converts it into a differential wave signal, and a pulse signal that is sliced. The input end 21a of the rise detection circuit is connected to the output end 10a of the pulse wave meter 10 in the preceding stage.
The DC component of the signal input to the rise detection circuit 21 is removed by a high-pass filter, the differentiator converts it into a differential waveform, the slice circuit forms a pulse signal, and the signal is output to the storage circuit 23. It's supposed to be done.

The A-D converter circuit 22 includes a high-pass filter and an A-D converter to remove DC components from the input signal and convert it into a digital signal. 22a is connected to the output end 10a of the pulse wave meter in the previous stage, and the signal input to the A-D converter circuit 22 has its DC component removed by a high-pass filter, and converted into a digital signal by the A-D converter. It is intended to be converted and output to the storage circuit 23.

The storage circuit 23 is composed of an IC memory, and the input terminal 23a is the output terminal 22 of the previous stage AD conversion circuit.
b, the input terminal 23b is connected to the rising edge detection circuit 2 in the previous stage.
1, the terminal 23c is connected to a potential correction circuit 24, which will be described later, and the terminal 23d is connected to a trigger circuit 50, which will be described later. The output signal of the A-D conversion circuit 22 at the previous stage is stored and held until the application of the signal, and the signal is output to a potential correction circuit 24 (to be described later), where the potential is corrected and the signal is stored and held in the memory circuit 23 again. do. Then, at the same time that the memory retention in the memory circuit 23 ends, a memory completion signal is output to the trigger circuit 50, which will be described later.

The potential correction circuit 24 is a circuit that shifts the input signal to the correct zero potential position, and is composed of a readout circuit, a zero potential reference power supply, and a comparison calculation circuit.The terminal 24a of the potential correction circuit 24 is connected to the memory circuit. 23 is connected to the terminal 23c of the memory circuit 23, the signal of the memory circuit 23 is read out, the signal is read out by the reading circuit, and this signal is compared with the potential of the reference power supply of zero potential by the arithmetic circuit. If it is shifted, it is shifted to the correct zero potential position, and a comparison operation is performed to see if the final potential of the signal is the correct zero potential. If the zero potential is shifted, the entire signal is shifted, and the input signal is The data is read out so that the final potential becomes zero potential and is output to the memory circuit 23 by the read circuit.

In this way, based on the output signal of the pulse wave meter 10 in the previous stage based on the output signal of the rise detection circuit 21, the AD conversion circuit 22 removes the DC component, and the signal converted to a digital signal is stored in the storage circuit 23. The signal is held and then output to the potential correction circuit 24, where the zero potential of the signal is corrected, and the signal is stored again in the memory circuit 23, and a termination signal is output to the trigger circuit 50 at the same time as the memory retention is completed. .

On the other hand, the impedance cardiograph 30 has a pair of AC applying electrodes 30a, a pair of detecting electrodes 30b, an AC power source 31, and a processing circuit 32, and sends an electrical signal to the subject via the pair of AC applying electrodes. This is a reliable detector that can non-invasively detect and output the amount of blood fluctuation due to the inflow and outflow of blood in the blood vessels of the circulatory system of the subject as an analog impedance change. The output of the graph 30 is to be output to a second processing circuit 40. In other words, the impedance cardiograph 30 includes a pair of alternating current applying electrodes 30 each placed at a predetermined length apart along one artery of the subject.
a and the detection electrode 30b are fixed in contact with the subject's skin, and when the arterial part is placed in a high-frequency alternating current electric field by applying a high-frequency current to the subject through the alternating current applying electrode 30a, the arterial part is placed in a high-frequency alternating current electric field. An impedance change proportional to the blood volume in the flowing blood vessel is detected from the detection electrode 30b, and an analog electrical signal in which this impedance change is proportional to the blood volume change in the blood vessel is sent from the impedance cardiograph 30 to the second processing circuit 40. The blood flow rate variation of the subject observed from the upper surface of the subject's skin is converted into an analog volume change signal proportional to this output.

The second processing circuit 40 is a circuit that stores and holds a predetermined electrical signal among the input electrical signals, and calibrates it to a predetermined signal and outputs it, and its configuration and operation and effect are the same as the first processing circuit 20 described above. The input end of the second processing circuit is connected to the output end 33 of the impedance cardeograph 30, and the input end of the second processing circuit is connected to the output end 33 of the impedance cardeograph 30.
Based on the output signal of the rising edge detection circuit 41, the DC component is removed by the AD conversion circuit 42, and the signal converted to a digital signal is sent to the storage circuit 43.
The memory is held in the memory circuit 43, and the signal is subsequently output to the potential correction circuit 44, where the zero potential of the signal is corrected, and the memory is held again in the memory circuit 43. At the same time as the memory retention is completed, a termination signal is sent to the trigger circuit 50. It is designed to output a signal.

The trigger circuit 50 is a circuit consisting of an AND circuit 51 and a trigger pulse generation circuit 52, which match the time phases of two input signals and output them.The trigger circuit 50 outputs when two input signals are input.
One terminal 51a of the AND circuit is connected to the memory circuit 23 of the first processing circuit 20, and the other terminal 51b is connected to the second
are connected to the memory circuit 43 of the processing circuit 40, and the terminal 51c is connected to the trigger pulse circuit 52. The trigger pulse circuit 52 is a circuit that outputs a predetermined signal when a signal is input, and a terminal 52a of the trigger pulse circuit 52 is connected to each storage circuit 23, 43 of the first and second processing circuits, When both storage end signals of each storage circuit 23, 43 are input, the AND circuit 51 outputs one signal, and the temporal phase shift is made to match, and due to the output signal of the AND circuit 51, the trigger pulse generation circuit 52
Therefore, trigger pulses are to be output to each of the memory circuits 23 and 43 at the same time.

The compliance calculation circuit 60 is a circuit consisting of a division calculation circuit that divides two input signals, and one terminal 60a of the compliance calculation circuit 60 is connected to the output terminal 2 of the first processing circuit 20 in the previous stage.
5, and the other terminal 60b is connected to the output terminal 45 of the second processing circuit 40, and the other terminal 60b is connected to the output terminal 45 of the second processing circuit 40.
The output signal of the second processing circuit 40 is divided by the output signal of the second processing circuit 40, and the divided signal is output to the typewriter 70.

The typewriter 70 is a device that digitally prints and emits input signals, and the input terminal 70a of the typewriter 70 is connected to the compliance calculation circuit 6 in the previous stage.
0 output terminal 60b to digitally print the output signal of the compliance calculation circuit 60.

By having the circulatory dynamics diagnostic analysis device of the first embodiment configured as described above, the following effects are achieved.

First, when detecting the properties of blood vessels in the circulatory system of a subject using this hemodynamic diagnostic analyzer, a pulse wave meter 10 and an impedance cardeograph 30 are used.
is attached to the subject's measurement site.

That is, the pulse wave meter 10 is attached to the brachial artery of the upper arm of the subject using a band 12, as shown in FIG. But press it. By doing this, the pulsation of the subject's brachial artery is detected by the pulse wave meter 10 through the body surface.
The transmitted pulsation is converted into an analog pulse pressure change signal by a semiconductor strain-electric conversion element (see Fig. 4 and Fig. 12 I).
The signal is output to the first processing circuit 20.

The pulse pressure change signal inputted from the pulse wave meter 10 to the first processing circuit 20 has its DC component removed by the A-D converter circuit 22, and is converted into an analog pulse pressure change signal corresponding only to the pulse pressure change. Digital signal ((12th
Figure b). (see) and input to the storage circuit 23, but the storage signal is input to the rising edge detection circuit 21.
This is performed based on the pulse signal (see Fig. 12) at the steepest rise period in one heartbeat among the pulsation fluctuations of the subject's circulatory system, and the memory circuit 23 stores the pulse signal of one heartbeat. It is stored as a signal ΔP (see FIG. 12c) that is proportional to pulse pressure fluctuations. Here, the rising edge detection circuit 21 uses a high-frequency three-wave generator that removes the DC component of the input signal to produce an X wave (see Figure 12a), and a differentiator that converts the input signal into a differential wave signal (see Figure 12a), which converts it into a Y wave (see Figure 12a). ), and a slicing circuit that slices and converts it into a pulse signal generates a Z wave (see Figure 12), and an A/D converted signal △P (see Figure 12 c) based on this pulse signal.
It is stored in the memory circuit 23 as . By the way, since the potential correction circuit 24 is added to the memory circuit 23, the signal stored in the memory circuit 23 is kept at zero potential in order to remove signals caused by other breathing and body movements superimposed on the pulse pressure change signal. After the correction is completed, a storage end signal (see FIG. 12) is output to the trigger circuit 50 at the same time as the correction is completed.

On the other hand, in the impedance cardiograph 30, one of the application electrodes 30a and one of the detection electrodes 30b is attached to the neck of the subject, and the other of the application electrodes 30a and the other of the detection electrodes 30b are attached to the chest of the subject. Then, 50K is applied to the pair of application electrodes 30a.
Transmits an AC electrical signal of Hz, 300uA. In this way, the amount of blood fluctuation in the arterial route of the circulatory system of the subject is extracted from the pair of detection electrodes 30b from the subject's body surface as an analog volume change signal (see Fig. 5 and Fig. 12'). ), the signal is output to the second processing circuit 40.

The volume change signal input from the impedance cardeograph 30 to the second processing circuit 40 is A-
After removing the DC component in the D conversion circuit 42 and creating an analog volume fluctuation signal corresponding only to the volume fluctuation,
It is converted into a digital signal (see Fig. 12b') and input to the memory circuit 43, and the memory signal is detected by the rising edge detection circuit 41 as the most rising edge in one heartbeat among blood fluctuations in the subject's circulatory system. This is performed based on a pulse signal at a steep period of . Here, the rise detection circuit 41 is a high-frequency three-wave device that removes the DC component of the input signal.
The X' wave (see Figure 12'a) is converted into a Y' wave (see Figure 12') by a differentiator that converts it into a differential wave signal, and the Z' wave (see Figure 12') is generated by a slicing circuit that slices and converts it into a pulse signal. 12')) and outputs an A/D-converted signal ΔV (see FIG. 12'c) based on the pulse signal to the memory circuit 4.
3 is stored. By the way, since a potential correction circuit 44 is added to the memory circuit 43, the signal stored in the memory circuit 43 is corrected to zero potential in order to remove other signals due to breathing or body movement that are superimposed on the volume change signal. At the same time as the correction is completed, the end signal (12th
(see figure ') is output to the trigger circuit 50.

The pulse pressure fluctuation signal ΔP stored and held in the memory circuit 23 of the first processing circuit 20 and the second processing circuit 4
The volume fluctuation signal △V stored in the storage circuit 43 of
Since there is a time phase caused by the difference between the measurement position of the impedance cardeograph 30 and the measurement position of the impedance cardeograph 30, the trigger circuit 50
3 (see FIG. 12) and the storage end signal from the storage circuit 43 of the second processing circuit 40 (see FIG. 12'), the AND circuit 51
51a and 51b.

The AND circuit 51 generates an output signal (see FIG. 12) when the signals whose time phases are shifted are input to each other, and the signal is sent to the storage circuit 2 via the trigger pulse circuit 52.
3 and 43 at the same time (see FIG. 12), and the pulse pressure fluctuation signal ΔP of one heartbeat is stored in the memory circuit 23.
(See Fig. 12) and the volume fluctuation signal ΔV of one heartbeat stored in the memory circuit 43 (Fig. 12')
is simultaneously output to the compliance calculation circuit 60. Therefore, one signal input to the compliance calculation circuit 60, that is, the pulse pressure fluctuation signal ΔP() of one heartbeat, and the signal inputted from the other side, that is, the volume fluctuation signal ΔV('), have the same phase shift. state.

The pulse pressure fluctuation signal △P and volume fluctuation signal △V of the memory circuits 20 and 40 input to the compliance calculation circuit 60 are divided by △V/△P by the division calculation circuit, and a signal corresponding to the divided value is typed. Output to writer 70.

Since the typewriter 70 digitally prints the input signal, the output of the compliance calculation circuit 60 in the previous stage is digitally printed here.

This digital printing conceptually considers the arterial route to be measured as one compartment, and calculates the ratio of the pressure change ΔP applied to this compartment and the volume variation ΔV to the pressure change ΔP. That is, compliance, which represents the elasticity of the blood vessel wall, is displayed.

From this value, the elasticity of the arterial route blood vessels of the subject's circulatory system can be grasped non-invasively. Information useful for diagnosing the degree of aging and symptoms of blood vessels to be measured can be provided.

Here, the patient's compliance (C=△V/
Some clinical examples in which ΔP) was detected are shown in Figures 6 and 7.

In other words, Figure 6 plots the maximum value of the obtained compliance values, with healthy subjects as the subjects to be measured, with compliance on the vertical axis and aging on the horizontal axis. There is a clear tendency for compliance to decline as age increases.

This is based on the fact that the elasticity of blood vessels in the circulatory system decreases with age.

In addition, Figure 7 shows measurements taken for patients with heart disease between the ages of 30 and 60, with cases (IHD: ischemic heart disease, INF: myocardial infarction, HT: hypertension) plotted against compliance on the vertical axis. This is a plot of the maximum value of the compliance values obtained. If the compliance value is in the range of 0.6 to 0.8, it is not possible to immediately distinguish between the three types from the compliance value. However, in a range other than the above range, for example, a compliance value of 1 or more is IHD, a compliance value of 0.6 to 0.8 is IHD/INF, and a compliance value of about 0.57 or less is IHD.
It is HT. Since discrimination can be made based on compliance values in this way, it is possible to provide information that can broadly classify disease conditions.

In this way, the hemodynamic diagnostic analysis device of this embodiment expresses the properties of the aortic blood vessels in the subject's circulatory system,
It provides extremely useful information for functionally clarifying the classification of diseases, and is a useful device for diagnosis.

By the way, the hemodynamic diagnostic analyzer of the first embodiment is very convenient for expressing the properties of blood vessels in the circulatory system of a subject in quantitative numerical values and for functionally clarifying the classification of diseases. However, this is just one element of the circulatory system.

In other words, the blood vessels of the circulatory system not only serve as pipes for blood to pass through, but also serve to transport blood pumped from the heart to capillaries throughout the body without interruption. Therefore, it has one major circulatory system dynamic function: storing energy during the systolic phase of the heart and pushing the blood out to the periphery during the diastolic phase by rebounding on the tube wall to maintain blood flow to the capillaries.

Therefore, if the hemodynamics of the arterial route of the circulatory system can be systematically and clearly understood, more reliable diagnosis can be made.

The second embodiment of the analyzer for diagnosing hemodynamics, which will be described below, meets this demand.

In the hemodynamic diagnosis analysis device of the second embodiment, the compliance calculation circuit 60 and the typewriter 70 of the hemodynamic diagnosis analysis device of the first embodiment are used.
Instead, an X-Y plotter is installed, and the pulse pressure fluctuation △P and volume fluctuation △V of the subject's circulatory system are measured as △P and △.
It was designed to be drawn as a PV relationship, that is, a PV diagram.

The circulatory dynamics diagnostic analyzer of the second embodiment will be described in detail below with reference to FIG. 8.

Note that the same parts as in the first embodiment of the hemodynamic analysis analyzer are given the same reference numerals and detailed explanations will be omitted.

The pulse wave meter 10, the first processing circuit 20, the impedance cardiograph 30, the second processing circuit 40, and the trigger circuit 50 are configured in the same manner as in the first embodiment, and the first and second processing circuits 20, X-Y to 40
Connect the PROTTER 80.

The X-Y plotter 80 draws an analog figure using the two electrical signals inputted to the X-axis and Y-axis terminals 80a and 80b, respectively.
The axis terminal 80a is connected to the output terminal 25 of the first processing circuit 20, and the Y-axis terminal 80b is connected to the output terminal 45 of the second processing circuit 40.

The signals from the pulse wave meter 10 and the impedance cardiograph 30 worn on the subject are input to the first and second processing circuits 20 and 40, respectively.
By the action of the trigger circuit 50, the time phase shifts of both signals are matched and outputted to the XY plotter 80.

Since the X-axis terminal 80 of the X-Y plotter 80 is connected to the output terminal 25 of the first processing circuit 20, and the Y-axis terminal 80b is connected to the output terminal 45 of the second processing circuit 40, The XY plotter 80 draws an analog drawing on the XY plane based on the pulse pressure fluctuation signal ΔP input to the X-axis terminal 80a and the volume fluctuation signal ΔV input to the Y-axis terminal 80b. This analog diagram, that is, the so-called PV diagram, which graphically represents the relationship between pulse pressure fluctuation △P and volume fluctuation ΔV, is an analysis of the dynamics of the subject's circulatory system. The slope represents the compliance of the circulatory system, the area encompassed by the loop in the PV diagram represents the amount of work associated with the contraction and expansion of the blood vessel wall in the circulatory system, and the rotation direction of the loop in the PV diagram represents the compliance of the circulatory system. It shows the precedence of pulsation waves and blood fluctuation waves, and the shape of the PV diagram indicates diseases of the circulatory system. By observing this PV diagram, it is possible to clearly understand the hemodynamics of the subject's circulatory system. It is possible.

Here, a part of a clinical example in which the dynamics of the circulatory system of a subject was analyzed using the analysis device for diagnosing hemodynamics of this embodiment is shown in FIG. 9.

That is, in FIG. 9, the PV diagrams of three subjects are plotted on the same plane, with volume fluctuation ΔV taken as the vertical axis and pulse pressure fluctuation ΔP taken as the horizontal axis.

In the figure, A has a round shape, a large area, and a large inclination when rotated counterclockwise, and B and C have a complicated shape, a small area, and a small inclination when rotated clockwise. By drawing various PV diagrams for healthy people, diseased people, etc. in this way, useful visual information useful for diagnosis can be provided.

As described above, the hemodynamic diagnostic analyzer of the second embodiment uses a P-V that can clearly express the elasticity of the aortic blood vessel in the compartment of the circulatory system that is the object of measurement of the subject.
It is possible to create line diagrams.

Specifically, a pressure change occurs in the blood vessel wall to be measured due to the pressure of the heart. Due to this pressure change, the blood vessel wall instantly begins to expand, causing a volume change due to the pressure change. Thereafter, when the pressure decreases, the blood vessel wall contracts due to its own elasticity, returning to its original state and regaining its volume. The above-mentioned PV diagram is a graphic representation of these pressure changes and the dynamic behavior of the blood vessel wall caused by the pressure changes.

Among the information obtained from the PV diagram, the size of the area surrounded by pressure and volume expresses the amount of work on the blood vessel wall to be measured. Indicates that the blood vessel wall is hard. That is, young people have a large area, and elderly people have a small area. Furthermore, the rotation direction drawn by the PV diagram is determined by the preceding order of peak values in each waveform of the pulse pressure wave and the volume wave. At A in the figure, since the peak value of the pulse pressure wave of a healthy person precedes the peak value of the volume wave, when both are calculated, the rotation is usually counterclockwise. However, as shown in B and C in the figure, in patients with heart disease and hypertension, the left ventricular function decreases, so the peak value of the pulse pressure wave is later than the peak value of the volume wave.
In this case, calculating both results in normal clockwise rotation. Further, the slope of the figure in the PV diagram is a graphic representation of the compliance value, and a large slope indicates a tendency to be soft, and a small slope indicates a tendency to be hard.

As described above, the area, rotation direction, and gradient information represented by the PV diagram expresses the elasticity of the blood vessel wall (in other words, the degree of aging of the blood vessel wall) within the compartment that is the object of measurement of the circulatory system. The results obtained by this device are an effective device that can graphically express temporal changes in pressure and volume fluctuations at the measurement target site and provide information on hemodynamics.

The hemodynamic diagnostic analysis device of the first embodiment described above functionally displays the properties of the blood vessels in the circulatory system of the subject;
The circulatory dynamics diagnostic analyzer of the second embodiment graphically displays the circulatory system dynamics of the subject's circulatory system, so it provides very effective information in diagnosing the subject's circulatory system. However, in order to more accurately understand the dynamics of the biological circulatory system, it is difficult to use the pulse detector used in the hemodynamic diagnostic analyzer of the first and second embodiments. Since the wave meter 10 and the impedance cardeograph 30 detect from the subject's body surface non-invasively, in the case of a pulse wave meter, the detector is attached to the arterial part of the circulatory system, which is the measurement site. The magnitude of the pulse pressure change signal obtained from the detector increases or decreases as the distance from the body surface changes, and in the case of an impedance cardeograph, the volume changes depending on the positional relationship of the electrodes attached to the living body. Since the magnitude of the change signal increases or decreases, the compliance and PV diagrams obtained based on this signal are accurate information for PV analysis of the subject during diagnostic analysis. , when measuring the same subject several times, if there is a difference in the mounting position of the detector, the output signal may increase or decrease due to the difference in the mounting position, or P- When attempting to compare V analysis, differences in the size of the output signal may occur due to differences in the physique, constitution, degree of obesity, etc. of the subjects, so further consideration should be taken when making these comparisons. It takes.

Therefore, in view of such measurement problems, in order to more accurately grasp the dynamics of the circulatory system of the living body, a correction circuit 90 is installed in the first and second processing circuits 20 and 40 of the above-mentioned circulatory dynamics diagnostic analyzer. By adding the By comparing and correcting, the above-mentioned measurement problem was improved.

The analysis device for diagnosing hemodynamics according to the third embodiment will be explained below with reference to FIG. 10. An embodiment in which a correction circuit 90 is added to the analyzer for diagnosing circulatory dynamics will be described, and the same parts as the analyzer for diagnosing circulatory dynamics of the second embodiment will be given the same reference numerals and detailed explanations will be omitted.

Pulse wave meter 10, first processing circuit 20, impedance cardiograph 30, second processing circuit 40,
The trigger circuit 50 and the XY plotter 80 have the same configuration as in the second embodiment, and the first and second processing circuits 20 and 40 are connected to a correction circuit 90.

The correction circuit 90 includes a magnetic tape device 91, a scanning circuit 92, and a wave height correction circuit 93.

The magnetic tape device 91 is a commercially available device that stores and holds input signals as digital signals.The magnetic tape device 91 stores and stores input signals as digital signals. Enter and set the blood pressure fluctuation value in advance, or
One reference signal selected based on the subject's normal blood pressure is selected and output from a plurality of reference signals input in advance. In addition, the constants of fluid specific resistance ρ, segment length L, and impedance change △Z are added to the volume fluctuation signal obtained from the impedance cardiograph as a reference signal for the volume fluctuation signal. Input and set the accurate volume variation value obtained by substituting V=ρ(L/Z ₀ ) ²・△Z) in advance.
Alternatively, multiple reference signals calculated by the cardiac output calculation formula may be input in advance based on numerical values obtained from statistics, and one of the reference signals may be selected based on the patient's constitution and the position of the detector. It is possible to select and output to the scanning circuit 92.

The scanning circuit 92 is a circuit that sequentially outputs input signals, and its input end 92a is connected to the preceding magnetic tape device 91, and the output of the magnetic tape device 91 is sequentially output to the pulse height correction circuit 93.

The pulse height correction circuit 93 is composed of a readout circuit and a comparison calculation circuit that compare and calculate a signal input from the other terminal with a signal input from one input terminal, and output the result, and the input terminal 93a of the pulse height correction circuit 93 is used to scan The other terminal 93b is connected to the circuit 92, and the other terminal 93b is connected to the first,
Memory circuits 23 and 43 of second processing circuits 20 and 40
are connected to the memory circuits 23 and 43 of the first and second processing circuits 20 and 40, which are connected to the memory circuits 23 and 43 of the first and second processing circuits 20 and 40 and which are inputted via the read-out circuit, using the signals inputted from the scanning circuit 92 as a reference, and are subjected to a comparison operation by the comparison operation circuit. After correcting the wave height of the signal, the signal is read again and sent to the first and second processing circuits 20 and 40 via the reading circuit.
It is designed to output to the memory circuits 23 and 43 of.

By doing so, the output signals of the pulse wave meter 10 and the impedance cardiograph 30 worn on the subject are transmitted to the first and second processing circuits 20 and 30, respectively.
Enter 40. The signals input to the first and second processing circuits 20 and 40 are stored in the memory circuits 23 and 43, respectively, and at the same time are corrected to zero potential by the potential correction circuits 24 and 44, and are stored and held again.

Since the correction circuit 90 is connected to the storage circuits 23 and 43, the reference signal of the pulse pressure fluctuation signal and the reference signal of the volume fluctuation signal held in the magnetic tape device 91 of the correction circuit 90 are transmitted to the scanning circuit 92. The signals are sequentially output to the wave height correction circuit 93. The wave height correction circuit 93 first reads out the pulse pressure fluctuation signal stored in the storage circuit 23 of the first processing circuit 20 which is input from the readout circuit, and combines the signal with the scanning circuit 92.
A comparison calculation circuit performs a comparison calculation on a pulse pressure fluctuation reference signal inputted from the input circuit, corrects it, and outputs it to the storage circuit 23 of the first processing circuit 20 via a reading circuit. Next, the volume fluctuation signal stored in the storage circuit 43 of the second processing circuit 40 inputted from the readout circuit is read out, and the volume fluctuation reference signal inputted from the scanning circuit 92 is compared with the volume fluctuation signal inputted from the scanning circuit 92 in the comparison calculation circuit. The second processing circuit 4 performs a comparison operation and corrects it, and also reads it out through a reading circuit.
0 memory circuit 43.

The signals stored in the first and second processing circuits 20 and 40 are matched in time phase by the trigger circuit 50 and sent to the XY plotter 80.
Here, an analog figure is drawn on the XY plane.

This analog figure is a P-V diagram depicting the relationship between the pulse pressure fluctuation ΔP corrected by the reference pulse pressure fluctuation and the volume fluctuation ΔV corrected by the reference volume fluctuation. The diagram hardly includes any differences in output due to changes in the distance between the arteries of the subject's circulatory system and the detector attached to the body surface, and therefore is not useful for diagnosing the subject's circulatory system. In,
The device was able to provide more accurate information.

The present invention has been explained above with reference to embodiments, but
The present invention is not limited to the above-mentioned embodiments, but can take several further embodiments.

For example, in the first, second, and third embodiments,
A pulse wave meter using a semiconductor strain-electric conversion element was used to detect pulsation changes in the arteries of the subject's circulatory system, but the present invention is not limited to this. Any device that can faithfully detect pulsation changes in the circulatory system as a pulse pressure signal in a non-invasive manner may be used, such as a pulse wave meter using a displacement meter, or an electrodynamic pulse wave meter.

Further, in the first, second, and third embodiments, an impedance cardiograph was used to detect blood fluctuations in the circulatory system of the subject, but the present invention is not limited to this. ,
Any device that can faithfully detect blood fluctuations in the circulatory system as changes in volume in a non-invasive manner, such as a photoplethysmometer or an ultrasonic blood flow meter, may be used.

Furthermore, in the first, second, and third examples, an oscilloscope was placed next to the pulse wave meter and impedance cardeograph to check whether the pulsation changes and blood fluctuations of the subject could be faithfully detected. It is also possible to provide monitoring means.

Furthermore, in the first, second, and third embodiments, a circuit consisting of an AND circuit and a trigger pulse generation circuit was used as the trigger circuit, but the circuit is not limited to this. Any circuit that eliminates the time phase shift of the output signal of the second processing circuit and outputs it may be used.

Further, in the second embodiment, an X-Y plotter was used, but the invention is not limited to this, and it may be combined with a D-A converter to include an analog X-Y plotter, memory scope, X-Y display, It is also possible to use an analog XY display circuit such as a -Y cathode ray tube oscilloscope.

In addition, in the first, second, and third embodiments, the first processing circuit 20 is connected to the rise detection circuit 21 and the A-D
Conversion circuit 22, memory circuit 23, and potential correction circuit 24
I tried to memorize the input signal by configuring it more, but
As shown in FIG. 11, a shift register 26 is provided between the rise detection circuit 21 and the storage circuit 23, and an averaging circuit 27 is provided between the A-D conversion circuit 22 and the storage circuit 23. Then, the A-
The signal input from the D conversion circuit 22 is averaged by the averaging circuit and inputted to the storage circuit, and at the same time, the pulse signal from the rise detection circuit 21 is counted by the shift register, and when a certain count value is reached, the storage circuit It is also possible to cause the memory circuit 23 to hold a signal corresponding to the average value by stopping the memory holding function of the memory circuit 23. The above-described configuration can be applied to the second processing circuit 40 as well.

Further, in the third embodiment, the correction circuit 90 is configured of a magnetic tape device 91, a scanning circuit 92, and a wave height correction circuit 93, but the present invention is not limited to this. Any circuit that can electrically set the reference signal as a digital signal and make corrections using this signal may be used.

In summary, the present invention includes a pulse pressure detection section that non-invasively detects pulsation in the circulatory system of a living body as a pulse pressure change, and a first processing circuit that stores an output signal of the pulsation detection section as a pulse pressure fluctuation signal. a volume detection unit that non-invasively detects blood fluctuations in the circulatory system of the living body as a volume change signal; a second processing circuit that stores an output signal of the volume detection unit as a volume change signal;
a trigger circuit that matches the time phases of the output signal of the processing circuit and the output signal of the second processing circuit, and the output signal of the first processing circuit and the output signal of the second processing circuit for compliance or P--
It consists of a display circuit that displays a V-diagram, and when the pulse pressure detection section and the volume detection section are attached to a living body, the pulse pressure detection section non-invasively detects pulsation changes in the living body's circulatory system as pulse pressure change signals. At the same time as it is detected, it is output to the first processing circuit, where it is stored and output to the trigger circuit. On the other hand, the volume detection section non-invasively detects the amount of blood fluctuation in the circulatory system of the living body as a volume change signal, and simultaneously outputs it to the second processing circuit,
It is stored here and output to the trigger circuit. By the way, the trigger circuit triggers the output signal of the first processing circuit and the output signal of the second processing circuit when the time phases of the output signal of the first processing circuit and the output signal of the second processing circuit match. By outputting this to the display circuit connected to it, the display circuit can be used for compliance or P-V
It makes a great contribution to the field of clinical medicine because it allows accurate drawing of diagrams and therefore accurate understanding of the properties and hemodynamics of blood vessels in the body's circulatory system.

[Brief explanation of the drawing]

Fig. 1 is a circuit diagram showing the first embodiment of the present invention, Fig. 2 is a cross-sectional view when the pulse wave meter is attached to a living body, and Fig. 3 is an explanatory diagram when the impedance cardeograph is attached to a living body. , Figure 4 is a diagram showing pulse pressure changes, Figure 5 is a diagram showing volume changes, Figure 6 is a clinical example showing the relationship between compliance and the age of the subject, and Figure 7 is a diagram showing compliance and subject age. A clinical example showing the relationship with the examiner's case, FIG. 8 is a circuit diagram showing the second embodiment of the present invention, FIG. 9 is a clinical example showing the relationship between pulse pressure fluctuation ΔP and volume fluctuation ΔV, FIG. 10 is a circuit diagram showing a third embodiment of the present invention, and FIG. 11 is a modification of the processing circuit. FIG. 12 is a waveform diagram showing output waveforms of each circuit configuration of the first embodiment. In the figure, 10... pulse wave meter, 20... first processing circuit,
30... Impedance cardeograph, 40... Second processing circuit, 50... Trigger circuit, 60... Compliance calculation circuit, 70... Typewriter,
80...X-Y plotter, 90...correction circuit.

Claims (1)

[Scope of Claims] 1. A pulse pressure detection section that non-invasively detects the pulsation of the circulatory system of a living body as a pulse pressure change signal; and a first pulse pressure detection section that stores the output signal of the pulse pressure detection section as a pulse pressure variation signal. a volume detection unit that non-invasively detects the amount of change in blood in the circulatory system of a living body as a volume change signal; and a second processing circuit that stores an output signal of the volume detection unit as a volume change signal. and a trigger circuit that outputs a signal when the time phases of the output signal of the first processing circuit and the output signal of the second processing circuit match, and a display circuit that displays a compliance or PV diagram by dividing the output signal of the second processing circuit by the output signal of the processing circuit;
An analysis device for diagnosing hemodynamics characterized by the following. 2. A pulse pressure detection unit that non-invasively detects the pulsation of the circulatory system of the living body as a pulse pressure change signal; a first processing circuit that stores the output signal of the pulse pressure detection unit as a pulse pressure variation signal; a volume detection unit that non-invasively detects a variation in blood in the circulatory system of the patient as a volume change signal; a second processing circuit that stores an output signal of the volume detection unit as a volume variation signal; a correction circuit that corrects the memory signal of the processing circuit and the memory signal of the second processing circuit with a reference signal of pulse pressure variation and a reference signal of volume variation in the circulatory system of the living body; and an output signal of the first processing circuit; a trigger circuit that outputs a signal when the time phases of the output signals of the second processing circuit match; and a trigger circuit that performs the second processing on the output signal of the first processing circuit due to the output signal of the trigger circuit. a display circuit that displays a compliance or PV diagram by dividing the output signal of the circuit;
An analysis device for diagnosing hemodynamics characterized by the following.