CN1394546A - Blood pressure measuring device and method - Google Patents
Blood pressure measuring device and method Download PDFInfo
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- CN1394546A CN1394546A CN 02125445 CN02125445A CN1394546A CN 1394546 A CN1394546 A CN 1394546A CN 02125445 CN02125445 CN 02125445 CN 02125445 A CN02125445 A CN 02125445A CN 1394546 A CN1394546 A CN 1394546A
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Abstract
The blood pressure measuring equipment is characterized by that its keyboard is connected with CPU, air pump, cuff, pressure sensor, amplifier, voltage comparator and comparative voltage generator in turn; the CPU also is respectively connected with comparative voltage generator, voltage comparator, PWM generator and display; the described PWM generator is connected with air-discharge valve and cuff in turn. Its measuring method includes the following steps: 1. readying blood pressure measuring equipment; 2. regualting air-charged pressure value, and controlling air-discharging rate; 3. making detection process and further controlling air-discahrging rate; 4. data acquisition and recalculating systolic pressure and diastolic pressure; and 5. storing and delivering information.
Description
Technical field
The present invention relates to a kind of device and method of measuring blood pressure and heart rate.
Background technology
At present, the blood pressure measurement technology can be divided into two kinds of direct method and indirect methods.The direct method of measurement is called the intrusion method again, is the pressure sensing probe directly is inserted in the arteries of human body, but the situation of change of continuous measurement human blood-pressure.The direct method of measurement has advantages such as measurement result is accurate, continuity, but the measurement device costliness, desired measurement skill is higher, has the risk of viral infection simultaneously, general at present is adopted in the process important operating carrying out, is difficult to apply on a large scale.Therefore the indirect method measurement method is called the non-invasive measurement method again, and it does not need the insertion of probe in blood vessel, measures easyly, is widely used clinically.The indirect method measurement method can be divided into continuous mode method and discontinuous measurement method again.The method of noinvasive continuous blood pressure measuring has incomparable superiority, but because its technical difficulty is bigger, at present can't practical application.
Being interrupted the non-invasive blood pressure measurement method, is the measuring method of using always, mainly contains two kinds, auscultation and oscillographic method.
Auscultation proposed still extensive use in clinical so far by the husband of doctor Ke's rood section of Russia in 1905.Its method is to utilize inflation cuff interruption artery blood flow, slowly venting then, when pressure drops to systolic pressure, can hear the sound (Ke Shi sound) of representing heartbeat by means of stethoscope, when the pressure in the cuff descends gradually, the intensity of this sound and tone have certain variation, and when the pressure in the cuff drops to diastolic pressure when following, this sound disappears.Utilize threshold variations that the Ke Shi sound is reflected when systolic pressure and diastolic pressure just can determine the pressure value of measurand.There is its inherent shortcoming in auscultation: the one, and still be to have arguement on the 5th phase problem at diastolic pressure mutually corresponding to the 4th always; The 2nd, differentiate systolic pressure, diastolic pressure by listening Ke Shi sound, reading is influenced by user audition, easily introduces subjective error.The electric sphygmomanometer made from the auscultation principle though realized automatic detection, exists that error is big, repeatability is low, be subject to noise jamming.
Most Blood pressure monitors and autoelectrinic sphygomanometer adopt oscillographic method to measure blood pressure.Oscillographic method is measured blood pressure need utilize inflation cuff interruption artery blood flow equally, and slowly venting then detects blood vessel wall and beats and cause the gas pressure wave of oscillation in the cuff in deflation course.When cuff internal pressure during greater than systolic pressure, tremulous pulse is closed, the impact of cuff endogenous cause of ill near-end pulse and the tiny wave of oscillation occurs; When cuff internal pressure during less than mean arterial pressure, wave of oscillation amplitude increases, and when the cuff internal pressure equaled mean arterial pressure, ductus arteriosus wall was in load condition, and it is maximum that wave of oscillation amplitude reaches; The cuff internal pressure during less than mean arterial pressure wave of oscillation amplitude reduce gradually; The cuff internal pressure less than diastolic pressure after, ductus arteriosus wall is fully expanded at relaxing period, the tube wall rigidity increases, and wave of oscillation amplitude is kept less level.Measure blood pressure by the dependency of setting up systolic pressure, diastolic pressure, mean arterial pressure and the fluctuation of cuff internal pressure.No pickup device in the cuff during oscillographic method measuring blood pressure, simple to operate, anti-outside noise interference performance is strong, also can record mean pressure by pressure oscillation wave amplitude maximum simultaneously.
In the electric sphygmomanometer that adopts oscillographic method, determine that the computational methods of systolic pressure and diastolic pressure mainly contain amplitude proportional coefficient calculations method and wave character point method.For blood pressure measurement, tens seconds the time of process need of once inflating and exitting, in this process, can obtain the pressure oscillation ripple of a series of different amplitudes, the frequency that these waves of oscillation occur is identical with pulse.Carry out match for the pressure oscillation wave train and obtain an envelope, the pairing force value of envelope maximum is the mean pressure of human body.
In amplitude proportional coefficient calculations method, at first determine the maximum amplitude of pressure oscillation ripple, it is the wave of oscillation amplitude of mean pressure correspondence, then this amplitude is multiplied each other with the proportionality coefficient of systolic pressure and diastolic pressure respectively, obtain two new wave of oscillation amplitudes in the both sides of mean pressure, their pairing force value are respectively systolic pressure and diastolic pressure.According to the difference of human body at aspects such as age, body weight, height, Measuring Time, the corresponding proportionality coefficient of systolic pressure and diastolic pressure fluctuates within the specific limits, the proportionality coefficient fluctuation range of general systolic pressure is 0.46～0.64, and the proportionality coefficient fluctuation range of diastolic pressure is 0.43～0.73.
In wave character point method, mainly contain two kinds of determination methods, the one, the critical point determining method, promptly in deflation course, the pairing pressure of first unexpected saltus step in the pressure oscillation ripple is judged as systolic pressure, and that the pairing pressure that fluctuates before the pressure oscillation wave amplitude does not continue to reduce is judged as diastolic pressure; The 2nd, pressure wave envelope flex point diagnostic method, promptly in deflation course, the pairing force value of the flex point that occurs on the envelope when pressure oscillation ripple increases gradually is a systolic pressure, and the pairing force value of the flex point that occurs on the envelope when pressure oscillation ripple reduces gradually is a diastolic pressure.Wave character point method is bigger to interferential sensitivity, and the error that causes characteristic point to be judged is easy to generate great measurement error.Therefore, most of electric sphygmomanometers adopt amplitude proportional coefficient calculations method.
By above-mentioned elaboration as can be known, the pressure value that amplitude proportional coefficient calculations method is calculated is mainly according to the setting of systolic pressure and diastolic pressure proportionality coefficient, and this proportionality coefficient not only varies with each individual, and same people also has certain fluctuation at different time sections systolic pressure and the pairing proportionality coefficient of diastolic pressure.If adopt unified systolic pressure and diastolic pressure proportionality coefficient, the error of blood pressure measurement will increase so.
The distribution of human blood-pressure is very big, and systolic pressure can reach more than the 250mmHg, minimum can be below 70mmHg.According to the oscillographic method measuring principle, the prerequisite of correct measurement is that the pressure of having inflated in the cuff of back must be higher than systolic pressure, with passing through of blood flow in the interruption artery blood vessel.The deficiency of the blowing pressure will make that systolic pressure can not be correctly measured.In addition, when adopting oscillographic method to measure blood pressure, need a slowly process of venting.Because the difference of the blowing pressure height, under a basicly stable outgassing rate, the time of venting also has nothing in common with each other.In this case, hyperpietic's Measuring Time is with long, and long-time compressing to blood vessel will cause the discomfort on the health.Because in deflation course, cuff internal pressure volume descends gradually, under fixed vent valve aperture, outgassing rate will be more and more lower, and the pressure decline curve is non-linear, and this will cause the lengthening of Measuring Time, influence correctly detecting of pressure oscillation ripple simultaneously, produce bigger blood pressure measurement error.
Summary of the invention
In order to overcome above-mentioned deficiency of the prior art, a kind of blood pressure measurement apparatus and side of the present invention with adaptive characteristic, method, it has the function of automatic adjustment outgassing rate and gain amplifier, improved certainty of measurement effectively, under guaranteeing certainty of measurement ground prerequisite, Measuring Time has been reduced in the small range, and can stores repeatedly historical measurement data automatically, eliminate some singular points in the current measurement data, improved the repeatability of measuring effectively.
In order to solve the problems of the technologies described above, the keyboard in the blood pressure measurement apparatus of the present invention connects CPU, inflator pump, cuff, pressure transducer, amplifier, voltage comparator and comparison voltage generator successively; Described CPU also connects comparison voltage generator, voltage comparator, PWM generator and display respectively; Described PWM generator also connects vent valve and cuff successively.
In blood pressure measurement apparatus of the present invention, by LM324, resistance R 22, R23, R24, R25, R26, R29 and adjustable resistance VR1, the described amplifier that capacitor C 9 and C10 are constituted receives the signal that comes from described pressure transducer, by the wave filter that is made of resistance R 28 and capacitor C 12 signal is transported to described voltage comparator then.The described comparison voltage generator that is constituted by LM124, audion TR9, resistance R 27 and R36, capacitor C 11; By resistance R 27 the 50Hz square wave is input to the base stage of described audion TR9, the cycle that is used to control comparative voltage produces; The comparative voltage signal that comparison voltage generator produces is transported to voltage comparator.The described voltage comparator that is made of LM324, audion TR10, resistance R 31 and R32 receives the signal that comes from described amplifier output by first port of described LM324, and described voltage comparator receives the signal that comes from described comparison voltage generator output by second port of described LM324; And V by linking to each other with described audion TR10 colelctor electrode
OUTThe signal that voltage comparator is received is input to the input capture port of CPU.
Blood pressure measuring method of the present invention comprises the following steps:
First step: be ready to used blood pressure measurement apparatus, described blood pressure measurement apparatus comprises CPU, charge valve, cuff, pressure transducer, program control vent valve, comparison voltage generator, amplifier, voltage comparator, PWM generator and display;
Second step: after utilizing the charge valve inflation, the blowing pressure value is discerned and adjusted to CPU automatically, and according to the size of inflation final pressure and the amplitude control outgassing rate of pressure oscillation waveform;
Third step: enter testing process, CPU is according to the amplitude of pressure oscillation waveform, count frequency by change CPU timer internal, determine the pressure signal gain amplifier, and preserve detected pressure oscillation wave sequence, according to pressure oscillation amplitude and heart rate, further control outgassing rate then;
The 4th step: enter data acquisition flow, CPU is according to the sequence of above-mentioned pressure oscillation maximum amplitude, calculate the theoretical value of systolic pressure and diastolic pressure, change and come the corrected Calculation coefficient according to the parameter of the amplitude of described theoretical value, pressure oscillation waveform, single pressure oscillation waveform with the dependency of historical measurement data, after selecting, determining penalty coefficient, recomputate systolic pressure and diastolic pressure;
The 5th step: the memorizer in the CPU is preserved above-mentioned systolic pressure and diastolic pressure, the information of heart rate, systolic pressure and diastolic pressure that display output is above-mentioned.
Memorizer in CPU described in the described data acquisition flow is stored the historical repeatedly pressure oscillation wave sequence of measuring and the pressure oscillation wave sequence of current measurement automatically; Computer in CPU described in the described data acquisition flow automatically identifies the measurement data of same tested human body by judging the variation characteristic of whole pressure oscillation wave sequence; The parameter of described single pressure oscillation waveform comprises climbing speed, fall off rate and waveform width; Described gain amplifier is set at third gear, and gain amplifier is respectively 0.7,1.0 and 1.5; Described penalty coefficient comprises systolic pressure penalty coefficient and diastolic pressure penalty coefficient; The span of described systolic pressure penalty coefficient is 0.44～0.59, and the span of described diastolic pressure penalty coefficient is 0.55～0.70, and determines concrete numerical value according to the situation that detects of pressure oscillation waveform.
Blood pressure measurement apparatus of the present invention and method compared with prior art have following beneficial effect:
1, reduces of the influence of the diversity of human body to blood pressure measurement;
2, reduce of the influence of the undulatory property of external interference to blood pressure measurement;
3, dynamically adjust outgassing rate, improve precision and the stability measured, and reduce the omnidistance time of measuring;
4, adopt the recognition technology of pressure oscillation waveform to eliminate extraneous interference, improve repeatedly the stability of measurement result.
Description of drawings
Fig. 1-the 1st, the structured flowchart of blood pressure measurement apparatus of the present invention;
Fig. 1-2 is the circuit diagram of amplifier, comparison voltage generator and voltage comparator in the blood pressure measurement apparatus of the present invention;
Fig. 2 adopts blood pressure measurement apparatus of the present invention to carry out once the figure that detects of pressure oscillation ripple in the complete blood pressure measurement;
Fig. 3 is the envelope to pressure oscillation wave train amplitude shown in Figure 2;
Fig. 4 is the waveform parameter figure of the single pressure oscillation ripple of definition blood pressure measurement apparatus of the present invention;
Fig. 5 is the flow chart that adopts blood pressure measurement apparatus control the blowing pressure of the present invention;
Fig. 6 is the flow chart that adopts blood pressure measurement apparatus control outgassing rate of the present invention;
Fig. 7 is the flow chart that adopts blood pressure measurement apparatus control gain amplifier of the present invention;
Fig. 8 is when waveform number=5, the flow chart of blood pressure measurement apparatus control outgassing rate of the present invention;
Fig. 9-1 and Fig. 9 the-the 2nd, the flow chart of blood pressure determination in the embodiment of the invention;
The specific embodiment
Below in conjunction with the drawings and specific embodiments blood pressure measurement apparatus of the present invention and method are described in further details.
Fig. 1-1 shows blood pressure measurement apparatus of the present invention and comprises CPU 102, keyboard 101, inflator pump 103, cuff 104, pressure transducer 105, amplifier 106, voltage comparator 107, comparison voltage generator 112, PWM generator 109, vent valve 110 and display 111.Include storage device and accountant in the described central processing unit 102.Wherein said keyboard 101 connects CPU 102, inflator pump 103, cuff 104, pressure transducer 105, amplifier 106, voltage comparator 107 and comparison voltage generator 112 successively; Described CPU 102 also connects comparison voltage generator 112, voltage comparator 107, PWM generator 109 and display 111 respectively; Described PWM generator 111 also connects vent valve 110 and cuff 104 successively.
Pressure transducer 105 among the present invention adopts silicon pressure sensor, for example Motorola MPXV53G; Inflator pump 103 can adopt NSK P23B or the border KPM27C of Xiamen section; Program control vent valve 110 adopts the Xiamen border KSV15A of section; CPU 102 can adopt Ti MSP430F413,16 single-chip microcomputers, 8k memory capacity; PWM generator 109 can be comprised by CPU 102, also can be an independent chip, as, TL598.
Described CPU 102 is according to the blowing pressure height, by adjusting the output of PWM generator 109, the outgassing rate of control vent valve 110, described CPU 102 storage current pressure waveform sequences; Described amplifier 106 receives the pressure oscillation waveform that pressure transducer 105 passes over, and described CPU 102 is according to the amplitude adjustment of pressure oscillation waveform, definite and storage pressure signal gain amplifier.
Shown in Fig. 1-2, the amplifier among the present invention in the blood pressure measurement apparatus is by LM324, resistance R 22, R23, R24, R25, R26, R29 and adjustable resistance VR1, and capacitor C 9 and C10 constitute; The single-ended power supply of described LM324 employing+3.8V, adjustable resistance VR1 is used to adjust the zero-bit of amplifying output signal; The signal of pressure transducer 105 output is input to amplifier 106 by port Vout+ and Vout-, and is connected respectively to the port 3 and port 2 of LM324 by resistance R 23 and R24, and the signal after the amplification is exported by port one; By the wave filter that constitutes by resistance R 28 and capacitor C 12 signal is transported to the port one 0 of described voltage comparator then.
The described comparison voltage generator that described comparison voltage generator 112 is made of LM124, audion TR9, resistance R 27 and R36, capacitor C 11; By resistance R 27 the 50Hz square wave is input to the base stage of described audion TR9, the cycle of control comparative voltage produces; Comparison voltage generator 112 produces the comparative voltage signal of fixed cycle, fixed slope variation, outputs to the port 9 of voltage comparator 107.
Described voltage comparator 107. is made of LM324, audion TR10, resistance R 31 and R32.Described voltage comparator is by first port of described LM324, be that port one 0 receives the signal that comes from described amplifier output, described voltage comparator is by second port of described LM324, and promptly port 9 receives the signal that comes from described comparison voltage generator output; And V by linking to each other with described audion TR10 colelctor electrode
OUTThe signal that voltage comparator is received is input to the input capture port of CPU.
The annexation of each components and parts illustrates at Fig. 1-2 in above-mentioned amplifier 106, comparison voltage generator 112 and voltage comparator 107 circuit.
The work process of brief description blood pressure measurement apparatus of the present invention is as follows:
At first, cuff 104 is twined upper arm in human body, then by keyboard 101 operation start blood pressure measurement processes, 103 pairs of cufves 104 of CPU 102 control inflator pumps are inflated, the pressure transducer 1 05 that links to each other with cuff 104 is simultaneously experienced the pressure oscillation fluctuation of human body, pressure signal is sent to CPU 102 through voltage comparator 107 after amplifying through an amplifier 106.Described CPU 102 judges according to the situation of change of the pressure oscillation ripple that receives whether the pressure in the cuff 104 is higher than the systolic pressure of tested human body.If pressure is lower than systolic pressure, inflator pump 110 continues cuff 104 inflations; If pressure is higher than systolic pressure, CPU 102 one of output control signal to PWM generator 109, produce the square wave sequence of an EDM Generator of Adjustable Duty Ratio, open vent valve 110 and slowly exit.
Amplification in the blood pressure measurement apparatus of the present invention and A/D translation function, its flow process is as follows: the signal of pressure transducer 105 outputs at first carries out the amplitude conversion through an amplifier 106, and its transformation range is 0-1V; Central processing unit 102.The continuous square wave of a 50Hz of output, its dutycycle is 1: 9, starts the charge and discharge process of primary voltage at the rising edge of each square wave, produces the comparative voltage waveform of a fixed slope; Comparative voltage and signal voltage are input to a voltage comparator 107, produce a potential pulse, and the persistent period of pulse, promptly width is directly proportional with signal voltage value; The burst length sequence is input to the input capture port of CPU 102, CPU 102, by CPU 102 timer internals the rising edge of pulse and the moment of trailing edge are carried out record, the size of the count value reflection sensor output voltage of intervalometer output promptly realizes the A/D conversion.The realization of pressure signal gain amplifier is to realize by the count frequency of change CPU timer internal.The count value of intervalometer output is with 2 bytes store, and the amplitude of pressure oscillation waveform is with 1 bytes store.Therefore, the dynamic range of the amplitude of pressure oscillation waveform is limited, when count frequency one timing, may transfinite when amplitude is big.The pulse width of identical sensor output voltage correspondence is consistent, and count frequency is high more, and the dynamic range of data is big more, and precision is also high more; Count frequency is low more, and the dynamic range of data is more little, and precision is also low more.Therefore, change the adjustment of the big I realization pressure signal gain amplifier of count frequency.
We know, the characteristic of tissue and diversity can cause the inhomogeneous of venting speed, influence detecting of pressure oscillation waveform, blood pressure measurement apparatus of the present invention dynamically keeps uniform venting speed by program control vent valve 110, accelerates or slow down venting speed according to the power of the actual pressure oscillation waveform that detects simultaneously.So, can under the prerequisite that keeps measurement accuracy, Measuring Time be shortened in the less time period.
In order to achieve the above object, described CPU 102 is adjusted the dutycycle that PWM generator 109 produces square wave according to the maximum pressure value of inflation and the situation that detects of the preceding ripple of pressure oscillation several times, the control outgassing rate, thus reduce Measuring Time.In deflation course, the pressure oscillation fluctuation is received by CPU 102 through pressure transducer 105, amplifier 106 and voltage comparator 107.
In the process that pressure signal is gathered, CPU 102 is judged the gain amplifier of the amplitude adjustment pressure signal of the wave of oscillation.For the more weak situation of pressure oscillation waveform, increase gain amplifier, the recall rate of the pressurize wave of oscillation; For the strong situation of pressure oscillation waveform, reduce gain amplifier, it is saturated to avoid the pressure signal gathered to occur, and exceeds 1 bytes of memory scope.Therefore, blood pressure measuring device of the present invention has the bigger range of dynamic measurement and the higher suitability.
In addition, in deflation course, central processing unit 102 detects the variation that causes outgassing rate because of cuff 104 volume-variation, adjusts the output of PWM generator 109, the rate stabilization that cuff 104 internal pressures are descended guarantees the correctness that the pressure oscillation ripple detects in a more constant scope.
After venting finished, the storage device in the CPU 102 was preserved a pressure oscillation wave train.The pressure oscillation wave train that accountant in the CPU 102 is preserved described storage device is compared with the historical pressures wave of oscillation sequence of preservation, the variation characteristic of the envelope that obtains by the match of more whole pressure oscillation wave train institute can automatically identify the historical data that whether has same tested human body.
The rate of rise and the descending slope of 102 pairs of all pressure oscillation waveforms of described CPU carry out statistical analysis, the size and the slope variation situation of high amplitude are selected suitable computational methods automatically according to the pressure oscillation waveform then, finally obtain blood pressure measurement, and on display 111, show.In addition,, obtain the heart rate of tested human body, on display 111, show output equally according to the distribution in time of pressure oscillation ripple.
Described CPU 102 is being carried out current pressure value when calculating, take all factors into consideration the current pressure wave of oscillation and historical record, eliminate in the measuring process moving or some data singular points that the factors such as interference of external environment cause by the level and smooth method of waveform because of tested personnel's arm, limit simultaneously in the repeatedly measurement within a certain period of time of same human body because of the range of choice of interferential intervention different calculation methods, reduce the diversity that the various computing coefficient is produced under some critical condition, improved the repeatability and the accuracy of this blood pressure measuring device.
When adopting blood pressure measurement apparatus of the present invention to carry out blood pressure determination, its method is as follows:
First step: be ready to used blood pressure measurement apparatus, described blood pressure measurement apparatus comprises CPU 102, inflator pump 103, pressure transducer 105, program control vent valve 110, amplifier 106, PWM generator 109 and display 111;
Second step: after utilizing charge valve 103 inflations, CPU 102 is identification and adjustment the blowing pressure value automatically, and according to the size of inflation final pressure and the amplitude control outgassing rate of pressure oscillation waveform;
Third step: enter testing process, CPU 102 is according to the amplitude of pressure oscillation waveform, by adjustment to count frequency in the timer internal, determine the gain amplifier of pressure signal, and preserve detected pressure oscillation wave sequence, according to pressure oscillation amplitude and heart rate, further control outgassing rate then;
The 4th step: enter data acquisition flow, CPU 102 is according to the sequence of above-mentioned pressure oscillation maximum amplitude, calculate the theoretical value of systolic pressure and diastolic pressure, change according to the amplitude of described theoretical value, pressure oscillation waveform and the parameter of single pressure oscillation waveform, and come the corrected Calculation coefficient with the dependency of historical measurement data, after selecting, determining penalty coefficient, recomputate systolic pressure and diastolic pressure; The parameter of described single pressure oscillation waveform comprises climbing speed, fall off rate and waveform width;
The 5th step: the memorizer in the CPU 102 is preserved above-mentioned systolic pressure and diastolic pressure, the information of heart rate, systolic pressure and diastolic pressure that display 111 outputs are above-mentioned.
Fig. 4 shows when adopting blood pressure measurement apparatus of the present invention, to the definition of single pressure oscillation wave-wave shape parameter.
Fluctuation width 405 is the interval of pressure oscillation ripple appearance point 401 when cuff 104 internal pressures drop to described appearance point 401 corresponding pressure values.The computational methods of the amplitude of fluctuation are to obtain the average decrease speed of this time period internal pressure according to the interval of the force value of twice adjacent pressure oscillation ripple starting point and appearance, promptly make a straight line 403 by twice adjacent pressure oscillation ripple starting point 401 and 407, each point is made the vertical line of described straight line 403 on the excess pressure wave of oscillation then, the point that the greatest length vertical line passes through on waveform is an oscillation amplitude peak 402, cross oscillation amplitude peak 402 then and make plumb line, the length corresponding with straight line 403 intersection points is oscillation amplitude 409.Because the pressure in the process that the wave of oscillation occurs in the cuff 104 is continuing decline, adopt the aforementioned calculation method can compensate the oscillation amplitude error of calculation that causes because of the venting velocity variations substantially.
The pressure oscillation ripple rate of rise is the line 406 of pressure oscillation ripple starting point 401 and oscillation amplitude peak 402 and the angle α of twice pressure oscillation ripple starting point line 403; Rise slope under the pressure oscillation ripple and be oscillation amplitude peak 402 and the line 408 of pressure oscillation ripple starting point 407 and the angle β of twice pressure oscillation ripple starting point line 403 next time.
Embodiment 1:
As shown in Figure 5, in 501 incipient stages of blood pressure measurement, default initial pressure value, the initial pressure value that present embodiment is set is after the 160mmHg 502, next step 503 will be closed vent valve 110, and next 504 CPU 102 start inflator pump 103, and inflate the cuff 104 that is wound in arm this moment, control the signal that PWM generator 109 produces a high duty ratio simultaneously, make vent valve 110 be in closed condition substantially; Pressure in the CPU 102 continuous detecting cufves 104, when force value reaches first force value of program setting, stop inflator pump 110, suspend inflation 2 seconds 506, in this interval, carry out step 507, shape to detected waveform, the amplitude and the waveform descending slope that are the wave of oscillation are judged, if the amplitude of the wave of oscillation sets value less than amplitude, and the waveform descending slope is less than the slope drop-out value, show that then current force value has been higher than the systolic pressure of measurand, CPU 102 is opened vent valve 110, enters blood pressure testing process 509; If do not satisfy above-mentioned 507 conditions, CPU 102 increases 40mmHg with pressure set points on original basis, shown in step 508, and restart inflator pump 103, force value in cuff 104 reaches new pressure set points height, repeats above-mentioned judgement flow process 505, until the systolic pressure of cuff 104 internal pressures greater than measurand, so far finish the process that the blowing pressure is judged automatically, entered blood pressure measurement flow process 509 subsequently.
Fig. 6 shows after having finished above-mentioned the blowing pressure and judging flow process automatically, beginning outgassing rate controlled selection flow process 601, CPU 102 is written into final the blowing pressure height 602, according to being written into different final the blowing pressure height values, different initial outgassing rates is selected by system, shown in 603 among Fig. 6 and 604.
That is, if: during pressure altitude＜=160mmHg, then controlling outgassing rate is 4mmHg/s;
If: during 200mmHg＞=pressure altitude＞160mmHg, then controlling outgassing rate is 5mmHg/s;
If: during 240mmHg＞=pressure altitude＞200mmHg, then controlling outgassing rate is 5.5mmHg/s;
If: during pressure altitude＞240mmHg, then controlling outgassing rate is 6mmHg/s.
In a word, the blowing pressure final relief speed more is also big more, controls the signal of the corresponding dutycycle of PWM generator 109 outputs at last, realizes the control of different outgassing rates.
As shown in Figure 7, in deflation course, be in the detection of pressure oscillation waveform, because pressure in the cuff 104 and gas volume continue to descend, inhomogeneous variation behind the tissue characteristics pressurized of arm makes the driving signal that is applied to fixed duty cycle on the vent valve 110 can not guarantee that outgassing rate remains on the steady state value of setting.In order to realize the venting of constant rate of speed, CPU 102 detects the variation of cuff internal pressure with the sample frequency of 50Hz, calculates venting speed, and the exit control of speed of the dutycycle of adjusting the driving signal of program control vent valve 110.
Through after the above-mentioned feedback control flow process, the outgassing rate of system fluctuates in a smaller scope, has avoided the vibration of system deflation speed appearance, has improved the precision that detects of waveform, has improved the precision of blood pressure measurement.
When as shown in Figure 7 pressure signal gain amplifier begins 701, at first setting initial gain amplifier is 1.0, see step 702, behind the different signal gain amplifier 703 that obtains to occur in the reality, concern 704 according to current waveforms amplitude and full scale, determine the gain values 705 that is adopted, carry out data acquisition 706 then.
That is, in above-mentioned 703,704 and 705, system determines the final gain values that adopts according to following different situations:
When signal gain amplifier=1.0,
If: 40% of full scale＜=current waveforms amplitude＜=85% o'clock, then gain=1.0;
If: 40% o'clock of current waveforms amplitude＜full scale, then gain=1.5;
If: 85% o'clock of current waveforms amplitude＞full scale, then gain=1.7;
When signal gain amplifier=0.7,
If: 65% of current waveforms amplitude＞=full scale, then gain=1.0;
If: 65% of current waveforms amplitude＜full scale, then gain=0.7;
When signal gain amplifier=1.5,
If: 55% of current waveforms amplitude＜=full scale, then gain=1.0;
If: 55% of current waveforms amplitude＞full scale, then gain=1.5.
In above-mentioned testing process, CPU 102 is analyzed the oscillation amplitude and the heart rate that detect waveform simultaneously, Fig. 8 shows the number that waveform detects and equals at 5 o'clock, the control flow of its outgassing rate, concern 803 according to oscillation amplitude and heart rate, give outgassing rate an adjustment amount 804 respectively, finally control outgassing rate 805, describe the analysis situation in detail in conjunction with following table:
| Project | Big (height) | Generally | Less (low) |
| Oscillation amplitude | ?????＞70 | ????30～70 | ??????＜30 |
| Heart rate | ＞90 times/second | 55～90 times/second | ＜55 times/second |
| The outgassing rate adjustment amount | ????1mmHg/s | ??????0 | ????0.5mmHg/s |
When oscillation amplitude is bigger, promptly greater than 70 o'clock, and heart rate is lower, during promptly less than 55 times/second, keeps original outgassing rate;
When oscillation amplitude is bigger, promptly greater than 70 o'clock, and heart rate is general, promptly 55～90 times/second the time, outgassing rate is increased a less value, promptly increases 0.5mmHg/s;
When oscillation amplitude is bigger, promptly greater than 70 o'clock, and heart rate is higher, during promptly greater than 90 times/second, outgassing rate is increased a bigger value, promptly increases 1mmHg/s;
When oscillation amplitude is general, promptly when 30～70 scopes, and heart rate is lower, during promptly less than 55 times/second, outgassing rate is reduced a less value, promptly reduces 0.5mmHg/s;
When the value of oscillation amplitude and heart rate all is in mean level, promptly oscillation amplitude is in 30～70 scopes, and heart rate will keep original outgassing rate in the time of 55～90 times/second;
When oscillation amplitude is general, promptly when 30～70 scopes, and heart rate is higher, during promptly greater than 90 times/second, outgassing rate is increased a less value, promptly increases 0.5mmHg/s;
Less when oscillation amplitude, promptly less than 30 o'clock, and heart rate is lower, during promptly less than 55 times/second, outgassing rate is reduced a bigger value, promptly reduces 1mmHg/s;
Less when oscillation amplitude, promptly less than 30 o'clock, and heart rate is general, promptly 55～90 times/second the time, outgassing rate is reduced a less value, promptly reduces 0.5mmHg/s;
Less when oscillation amplitude, promptly less than 30 o'clock, and heart rate is higher, during promptly greater than 90 times/second, keeps original outgassing rate;
By the adjustment of above-mentioned outgassing rate, waveform can reflected waveform the situation that detects of sequence, also guaranteed the stability of system.
In above-mentioned outgassing rate control flow, relate to the comparison of the size of waveform amplitude.When the comparison of carrying out every value size, 102 pairs of data of CPU are carried out normalization, promptly eliminate the influence that the unlike signal gain amplifier is set in the pressure detecting process.The signal gain amplifier is made as 3 grades, is respectively 0.7,1.0 and 1.5.General for amplitude, promptly amplitude is in 30～70 situation, and selecting gain amplifier is 1.0; Bigger for amplitude, promptly amplitude is greater than 70 situation, and selecting gain amplifier is 0.5; Less for amplitude, promptly amplitude is less than 30 situation, and selecting gain amplifier is 1.5.
Detecting in the process of pressure oscillation waveform, in order to reduce memory capacity, CPU 102 is not preserved all Wave datas, just calculates vibration maximum amplitude, the rate of rise, descending slope and pulsation width when detecting each waveform.After deflation course finishes, the sequence build-up pressure waveform envelope of CPU 102 vibration maximum amplitudes, and calculate the meansigma methods and the mean square deviation of the rate of rise, descending slope and pulsation width sequence respectively.
Select the corresponding calculated coefficient to calculate systolic pressure and diastolic pressure according to the feature of pressure oscillation waveform envelope line and the meansigma methods and the mean square extent of the rate of rise, descending slope and pulsation width then.
Embodiment 2:
Describe the algorithm selection flow process of pressure oscillation waveform number in detail below in conjunction with Fig. 9-1 and Fig. 9-2 greater than above-mentioned each data of 3 o'clock, need explanation a bit, for Reference numeral A, the B and the C that occur respectively among Fig. 9-1 and Fig. 9-2, the corresponding annexation of presentation graphs 9-1 and Fig. 9-2 flow process.
Before this, slowly deflation course finishes, and obtained complete pressure oscillation wave sequence, the situation that detects of pressure oscillation ripple begins algorithm flow 901 then in the once complete blood pressure measurement as shown in Figure 2, when pressure oscillation waveform number is less than or equal to 3 902, this moment, systolic pressure and diastolic pressure were 0 903, system prompt error message 904 finishes this flow process, and promptly 905.When pressure oscillation waveform number greater than 3 the time 902, carry out systolic pressure with initial coefficients 0.5 and calculate 906, different according to the value 907 of the systolic pressure that obtains after calculating and oscillation amplitude 908 are selected corresponding systolic pressure penalty coefficient 909, the relation between each parameter is as follows:
When the value of calculating systolic pressure＞=220mmHg, shown in 907:
If amplitude＞100, then systolic pressure penalty coefficient=0.5;
If 100＞=amplitude＞70, then systolic pressure penalty coefficient=0.59;
If 70＞=amplitude＞40, then systolic pressure penalty coefficient=0.52;
If amplitude＜=40, then systolic pressure penalty coefficient=0.44.
When the value of 180mmHg＜=calculating systolic pressure＜220mmHg:
If amplitude＞90, then systolic pressure penalty coefficient=0.5;
If 90＞=amplitude＞30, then systolic pressure penalty coefficient=0.58;
If amplitude＜=30, then systolic pressure penalty coefficient=0.48.
When the value of 130mmHg＜=calculating systolic pressure＜180mmHg:
If amplitude＞50, then systolic pressure penalty coefficient=0.5;
If 50＞=amplitude＞40, then new coefficient=0.58;
If amplitude＜=40, then systolic pressure penalty coefficient=0.46.
When the value of 130mmHg＜=calculating systolic pressure＜90mmHg:
If amplitude＞30, then systolic pressure penalty coefficient=0.5;
If 30＞=amplitude, then systolic pressure penalty coefficient=0.57.
After determining above-mentioned penalty coefficient, carry out systolic pressure with the systolic pressure penalty coefficient and calculate 910, calculate the mean square deviation of the rate of rise, descending slope and pulsation width and the mean ratio 911 of meansigma methods ratio again according to the value of the systolic pressure that calculates then, difference 912 according to the value of calculating systolic pressure, determine the size 913 of mean ratio, present embodiment provides following several situation:
If calculate the value＞=180mmhg of systolic pressure, and mean ratio＜=0.15, or
Value＜the 180mmhg of 130mmhg＜=calculating systolic pressure, and mean ratio＜=0.15, or
Calculate the value＜130mmhg of systolic pressure, and mean ratio＜=0.2,
The value of systolic pressure=calculating systolic pressure then;
If calculate the value＞=180mmhg of systolic pressure, and mean ratio＞0.15, or
Value＜the 180mmhg of 130mmhg＜=calculating systolic pressure, and mean ratio＞0.15, or
Calculate the value＜130mmhg of systolic pressure, and mean ratio＞0.2,
Then obtain systolic pressure according to following formula;
Formula: systolic pressure=calculating systolic pressure * { 1.0+[Min (mean ratio, a)-b] * c};
The concrete numerical value of coefficient a, b and c is relevant with the value of calculating systolic pressure in above-mentioned 912 steps in the formula, and its relation is as follows:
When the value of calculating systolic pressure＞=180mmHg, the a=0.25 in the formula then, b=0.15, c=1;
When the value of 130mmHg＜=calculating systolic pressure＜180mmHg, the a=0.25 in the formula then, b=0.15, c=0.8;
When the value of calculating systolic pressure＜130mmHg, the a=0.3 in the formula then, b=0.2, c=1.
After obtaining systolic pressure as stated above, calculate diastolic pressure 915 with coefficient 0.6, different according to the value 916 of calculating diastolic pressure and amplitude 917 are determined diastolic pressure penalty coefficient 918, and the relation of calculating the value of diastolic pressure and amplitude and diastolic pressure penalty coefficient is as follows:
When the value of calculating diastolic pressure＞=110mmHg:
If amplitude＞100, then diastolic pressure coefficient=0.69;
If 100＞=amplitude＞70, then diastolic pressure penalty coefficient=0.55;
If amplitude＜=40, then diastolic pressure penalty coefficient=0.7.
When the value of 110mmHg＞=calculating diastolic pressure＞70mmHg:
If amplitude＞90, then diastolic pressure penalty coefficient=0.7;
If amplitude＜=90, then diastolic pressure penalty coefficient=0.56.
After determining the diastolic pressure penalty coefficient, carry out the calculating 919 of diastolic pressure with penalty coefficient.
Display 111 shows the diastolic pressure 920 that the systolic pressure of being tried to achieve by above-mentioned 914 steps and above-mentioned 919 steps are tried to achieve, and finishes this blood pressure determination process 921.Above-mentioned flow process has been eliminated the requirement of different human body to computational methods to a certain extent.
Diversity that it should be noted that human body is bigger, is reflected in the intensity and the persistent period of heart rate, heart beating, and arrhythmia, atrium heart disease such as be not closed completely causes that the spectral characteristic of pressure oscillation ripple has certain difference.In addition, in measuring process, the state of the arm of tested human body also can not be unalterable, as the contraction of muscle, and the moving of arm position, the bending of elbow joint and finger etc., this can make all that also the spectral characteristic of pressure oscillation ripple changes.Blood pressure measurement apparatus of the present invention carries out digital filtering to pressure signal in the pressure detecting process handles, and has reduced interference of noise effectively, has strengthened stability, has reduced the influence of individual difference, has improved the recall rate of pressure oscillation waveform.
In addition, mentioned amplitude all is the peak swing on the envelope when calculating each penalty coefficient in the present embodiment, as shown in Figure 3 301.
Embodiment 3:
Present embodiment mainly illustrates when blood pressure measuring method of the present invention enters data acquisition flow, and how CPU makes the parameter according to the amplitude of above-mentioned theoretical value, pressure oscillation waveform, single pressure oscillation waveform change and carry out the judgement of same anthropometric data and corrected Calculation coefficient with the dependency of historical measurement data.
Owing to include a memorizer at blood pressure measurement apparatus of the present invention, statistical values such as meansigma methods that the pressure oscillation waveform envelope line that several times were measured before described memorizer was preserved automatically and climbing speed, fall off rate and the pulsation width of pressure oscillation ripple are tried to achieve respectively and mean square deviation.
In current measuring process, blood pressure measurement apparatus of the present invention is tried to achieve envelope to the pressure oscillation wave sequence of current measurement, calculate the meansigma methods and the mean square deviation of climbing speed, fall off rate and pulsation width, and compare with the historical pressures waveform envelope of preserving, by judging the registration of two pressure oscillation waveform envelope lines, be the force value of waveform amplitude peak and present position thereof, the envelope rate of rise and descending slope, the deviation after the normalization;
By judging described registration=1-[(full swing amplitude difference/twice mean oscillatory amplitude)+(full swing amplitude corresponding pressure poor/twice average pressure)+(the envelope rate of rise poor/twice average packet winding thread rate of rise)+(envelope descending slope poor/twice average packet winding thread descending slope)]/whether 4 size identify the historical measurement data of same human body.
Travel through comparison by data, select the deviation minimum, i.e. the best historical Wave data of registration repeatedly storage.If the registration of pressure oscillation waveform is than higher, for example described registration was greater than 70% o'clock, and the deviation of statistical parameter within the specific limits, judged that then this twice measuring object is same human body, otherwise was the measurement result of different people; If institute's store historical data does not satisfy the Rule of judgment of same anthropometric data, this time blood pressure measurement is calculated with flow process shown in Figure 9, and the sequence the earliest of time in the historical Wave data is replaced.
Under the measuring condition of same human body, blood pressure measurement apparatus of the present invention at first extracts the bigger part of diversity on the two pressure oscillation waveform envelope lines, then by comparing the situation of change of peripheral point, judge what whether these differences in the current envelope caused because of the interference in the external world, various analysis situations are as follows:
If the singular point that external interference causes, with reference to the part corresponding on the historical pressures waveform envelope and the data of peripheral point these singular points are carried out smoothing processing, select corresponding design factor according to the amplitude of current pressure waveform envelope size then, and with historical pressures waveform envelope in compare according to the selected design factor of amplitude size;
If the design factor of twice measurement, promptly the systolic pressure coefficient is identical with the diastolic pressure coefficient, increases the correction of current measurement statistical parameter to the systolic pressure coefficient, calculates current pressure value, and corresponding historical pressure oscillation Wave data is upgraded;
If according to the selected design factor difference of amplitude size, the size of twice measurement data registration of foundation is carried out the linear interpolation correction to twice design factor, that is: in twice measurement
Revise back design factor=historical design factor+(current design factor-historical design factor) * (1-registration);
For example: the value with 0.5 systolic pressure coefficient calculations systolic pressure is 150, oscillation amplitude is 48, the coefficient of corresponding selection is 0.58, the oscillation amplitude of historical measurement data is 52, the coefficient of corresponding selection is 0.5, the registration of twice measurement data is 80%, and is judged as twice measurement of same human body, and revised systolic pressure design factor computing formula is as follows:
Revised systolic pressure design factor=0.5+ (0.58-0.5) * (1-0.8)=0.52
Increase of the correction of current measurement statistical parameter then, calculate current pressure value, and corresponding historical pressure oscillation Wave data is upgraded the systolic pressure coefficient.
Take all factors into consideration current measurement result and historical measurement result, can improve the measurement reproducibility and the accuracy of device effectively.
Claims (10)
1. blood pressure measurement apparatus, it is characterized in that: keyboard connects CPU, inflator pump, cuff, pressure transducer, amplifier, voltage comparator and comparison voltage generator successively; Described CPU also connects comparison voltage generator, voltage comparator, PWM generator and display respectively; Described PWM generator also connects vent valve and cuff successively.
2. blood pressure measurement apparatus according to claim 1, it is characterized in that, by LM324, resistance R 22, R23, R24, R25, R26, R29 and adjustable resistance VR1, the described amplifier that capacitor C 9 and C10 are constituted receives the signal that comes from described pressure transducer, by the wave filter that is made of resistance R 28 and capacitor C 12 signal is transported to described voltage comparator then.
3. blood pressure measurement apparatus according to claim 1 is characterized in that, the described comparison voltage generator that is made of LM124, audion TR9, resistance R 27 and R36, capacitor C 11; By resistance R 27 the 50Hz square wave is input to the base stage of described audion TR9, the cycle that is used to control comparative voltage produces; The comparative voltage signal that comparison voltage generator produces is transported to voltage comparator.
4. blood pressure measurement apparatus according to claim 1, it is characterized in that, the described voltage comparator that is made of LM324, audion TR10, resistance R 31 and R32 receives the signal that comes from described amplifier output by first port of described LM324, and described voltage comparator receives the signal that comes from described comparison voltage generator output by second port of described LM324; And V by linking to each other with described audion TR10 colelctor electrode
OUTThe signal that voltage comparator is received is input to the input capture port of CPU.
5. a blood pressure measuring method is characterized in that it comprises the following steps:
First step: be ready to used blood pressure measurement apparatus, described blood pressure measurement apparatus comprises CPU, inflator pump, cuff, pressure transducer, vent valve, amplifier, comparison voltage generator, voltage comparator, PWM generator and display;
Second step: after utilizing the inflator pump inflation, the blowing pressure value is discerned and adjusted to CPU automatically, and according to the size of inflation final pressure and the amplitude control outgassing rate of pressure oscillation waveform;
Third step: enter testing process, CPU is adjusted the gain amplifier of pressure signal, and is preserved detected pressure oscillation wave sequence according to the amplitude of pressure oscillation waveform, then according to pressure oscillation amplitude and heart rate, further controls outgassing rate;
The 4th step: enter data acquisition flow, CPU is according to the sequence of above-mentioned pressure oscillation maximum amplitude, calculate the theoretical value of systolic pressure and diastolic pressure, change and come the corrected Calculation coefficient according to the parameter of the amplitude of described theoretical value, pressure oscillation waveform, single pressure oscillation waveform with the dependency of historical measurement data, after selecting, determining penalty coefficient, recomputate systolic pressure and diastolic pressure;
The 5th step: the memorizer in the CPU is preserved above-mentioned systolic pressure and diastolic pressure, the information of heart rate, systolic pressure and diastolic pressure that display output is above-mentioned.
6. blood pressure measuring method according to claim 5, it is characterized in that the memorizer in CPU described in the described data acquisition flow is stored the historical repeatedly pressure oscillation wave sequence of measuring and the pressure oscillation wave sequence of current measurement automatically.
7. blood pressure measuring method according to claim 5, it is characterized in that, computer in CPU described in the described data acquisition flow automatically identifies the measurement data of same tested human body by judging the variation characteristic of whole pressure oscillation wave sequence.
8. blood pressure measuring method according to claim 5 is characterized in that, the parameter of described single pressure oscillation waveform comprises climbing speed, fall off rate and waveform width.
9. blood pressure measuring method according to claim 5 is characterized in that described gain amplifier is set at third gear, and gain amplifier is respectively 0.7,1.0 and 1.5.
10. blood pressure measuring method according to claim 5 is characterized in that, described penalty coefficient comprises systolic pressure penalty coefficient and diastolic pressure penalty coefficient; The span of described systolic pressure penalty coefficient is 0.44～0.59, and the span of described diastolic pressure penalty coefficient is 0.55～0.70, determines specified numerical value according to the situation that detects of pressure oscillation waveform.
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