JP4685490B2 - Blood pressure measurement system - Google Patents

Description

  The present invention relates to a sphygmomanometer, and more particularly to a blood pressure measurement system that measures and stores blood pressure continuously (intermittently) in association with an outside air temperature near the auricle.

A portable continuous blood pressure device has been proposed in which a cuff is wrapped around an upper arm, etc., and a main body portion including an electronic circuit, an operation unit, and a display unit is held by a pocket, a belt, or the like and measured at predetermined time (hour / minute) intervals. In such a portable continuous blood pressure device, blood pressure is displayed and stored in association with temperature (atmospheric temperature) (Patent Document 1: Japanese Patent Laid-Open No. 2001-8907). However, blood pressure is usually measured at 30-minute intervals so as not to disturb nighttime sleep. For this reason, when there is early morning hypertension or nighttime persistent hypertension, there is a problem that it is difficult to judge from which time point the blood pressure tends to increase and from which time point the hypertension region is 150 mmHg or more.
Japanese Patent Laid-Open No. 2001-8907

  The present invention has been made to solve the problems of the prior art as described above, and its purpose is not to give a sense of burden to the subject, without disturbing sleep at night, To provide a blood pressure measurement system capable of obtaining finer blood pressure information even in the case of nighttime persistent hypertension.

In order to achieve the above object, a blood pressure measurement system according to the present invention includes a blood pressure measurement unit including a cuff attached to a tragus, a temperature measurement unit that measures an external auditory canal temperature near the cuff or an outside air temperature near the auricle, An ear hook that holds the blood pressure measuring means so that the blood pressure measuring means is not detached from the tragus, a clock means for continuously driving the temperature measuring means and the blood pressure measuring means at predetermined time intervals, and the blood pressure measuring means A blood pressure value measured by the temperature measuring means in association with the ear canal temperature near the cuff or the outside air temperature near the auricle, and storing the blood pressure value measured at night or early morning When the value exceeds a predetermined value, the measurement interval is shortened by a predetermined value. The display of the blood pressure value is at least one of list display, dot display, and trend display, or any combination thereof.

  According to the blood pressure measurement device of the present invention, even when the outside temperature changes, the blood pressure (maximum blood pressure value, minimum value) is correlated with the temperature measured by the temperature measurement means attached to the ear pinna even when the outside air temperature changes. Blood pressure value) can be measured and stored. In addition, according to the blood pressure management device used in the blood pressure measurement device of the present invention, blood pressure (maximum blood pressure value, minimum blood pressure value) can be measured and stored in association with the room temperature from midnight to early morning or the temperature in the toilet. This makes it easier to determine nighttime persistent hypertension and early morning hypertension.

  A blood pressure measurement device according to a preferred embodiment of the present invention will be described with reference to the drawings. In the description of the present embodiment, the outside air temperature reflects the environmental temperature for the measurer, for example, indoor temperature, room temperature, toilet temperature, bathroom temperature, and the like. In addition, outside temperature is outside.

<Example>
Hereinafter, first, features of the blood pressure measurement device according to the present embodiment will be briefly described. The probe part including the cuff of the blood pressure measurement device according to the present embodiment is attached to the outer ear and its surroundings (peripheral part), but particularly to the superficial temporal artery and / or tragus and its peripheral part.

[Features of blood pressure monitor]
Here, the difference in pain between the case where it is used in this embodiment as a blood pressure measurement site and the case where an upper arm or a finger is used as in the past will be described. Since the upper arm, wrist, and finger perform complex tasks as important parts of the body, many nerves are stretched around these blood vessels so that these tasks can be performed. On the other hand, the tragus which is a part of the pinna is fixed to the head and used for collecting sound. For this reason, since it is not used for complicated work like the upper arm and the finger, the amount of nerves around the arm is smaller than the amount of nerve in the upper arm and fingers. Therefore, when measuring blood pressure using the outer ear and its surroundings (preferably the tragus and / or the superficial temporal artery), the amount of nerves that are compressed during blood pressure measurement is small, so the upper arm, wrist, and finger are the measurement sites. Compared to blood pressure measurement, it has the advantage that pain during blood pressure measurement can be reduced. However, since the tragus is a small part of the pinna, if the small blood pressure measurement unit cannot be fixed securely and stably around the outer ear and its surroundings, the probe unit (blood pressure detection unit) moves during measurement. The blood pressure cannot be measured accurately. Therefore, in the blood pressure measurement device according to the present embodiment, a structure including a probe part (blood pressure detection part), an ear hook part, and a main body as shown in FIG. (Or its surroundings) can be fixed stably. As a result, the blood pressure in the outer ear and its surroundings (preferably the tragus and / or its surroundings) can be measured easily and stably over a long period of time while reducing the pain given to the subject. Moreover, it can memorize | store with the environmental temperature measured together with the measured blood pressure value, and measurement time (date and time).

  FIG. 1 is an external view showing an example of a blood pressure measurement device according to a preferred embodiment of the present invention. The blood pressure measurement device 1 includes a probe unit (blood pressure detection unit) 30, an ear hook unit 40, and a main body unit 100. The probe unit 30 is attached to the superficial temporal artery 28 and / or tragus 21 via the cuffs 31 and 32, and the main body unit 100 is accommodated in the breast pocket of the subject, for example. Information including blood pressure values (maximum blood pressure, minimum blood pressure, blood pressure measurement date / time, environmental temperature, posture (activity status), medication information, etc.) from the external communication unit 74 of the main body 100 of the blood pressure measurement device 1 wirelessly or by wire ) Is stored in the memory 208 via the external communication unit 207 of the blood pressure management apparatus (personal computer or host computer) 200. A control unit (CPU) 201 controls the entire system of the blood pressure management apparatus (personal computer or host computer) 200.

A part of the ear hook 40 is formed of a hollow pipe having a predetermined rigidity, and connects the probe part 30 and the main body part 100 by a connecting part 41 and an end part 42a. Inside the ear hook 40, there are an air pipe 43 for pressurized air supplied from the main body 100 to the probe section 30, and a detection signal and a temperature measuring section (sensation including a thermistor) from the power and probe section 30 to the main body 100. The pipe that accommodates the signal line 44 that transmits a signal from the warm portion is fixed so as not to move, and the probe portion 30 even if the air pipe 43 or the signal line 44 moves when the subject operates the main body portion 100. The air pipe 43 is held so as not to shift the mounting.

  The ear hook 40 is, for example, a hollow pipe made of metal such as aluminum, a shape memory alloy, or various resins, and is processed into a shape similar to the pinna so as to be easily attached to the pinna. It has a structure that goes around from the base to the back side of the earring and is fixed. In this way, the ear hook 41 is made of metal or hard resin, and by making the shape similar to the auricle, flexibility can be given to a portion to be hooked on the ear, so the ear hook 40 is hung on the ear. Can be firmly fixed to the ear when

  When the probe unit 30 is fixed to the tragus, the arm 38, the cuffs 31 and 32 that change the pressure applied to the tragus 21, the air pipe 43 that supplies pressurized air to the cuffs 31 and 32, and the cuffs 31 and 32 are provided. It is composed of a cuff fixing member such as an O-ring to be fixed. In the case of detecting and calculating blood pressure using a photoelectric pulse wave, a light emitting element 35 that irradiates light to the tragus 21 and a light receiving element 36 that receives light reflected by the capillaries are further provided near the cuff. . In these arrangements, the light receiving element 36 may be opposed to receive transmitted light. Further, when the probe unit 30 is fixed to the superficial temporal artery, there is only one cuff, and the arm unit and the holding frame are not required. In this case, in order to more securely fix the probe unit 30 to the superficial temporal artery, it is preferable to provide a member that is inserted into the concha cavity and pressed.

  FIG. 2 is a block diagram showing the entire control configuration of the blood pressure measurement device 100 including the probe unit 30 and the main body 50. In FIG. 1, reference numeral 30 denotes a probe unit, and 43 denotes an air pipe, which forms a flow path of pressurized air into the cuffs 31 and 32. Reference numeral 53 denotes a pressurizing unit (pressurizing pump) that sends pressurized air into the cuffs 31 and 32. A pressure reducing valve (exhaust valve) 54a exhausts the pressure in the cuffs 31 and 32 at a predetermined speed (for example, 2 to 3 mmHg / sec). Moreover, you may provide the quick exhaust valve which reduces the pressure in the cuffs 31 and 32 rapidly. Reference numeral 56 denotes a pressure detection unit, which includes a pressure sensor, a pressure detection amplifier (AMP), an A / D converter (A / D), etc. that change electrical parameters according to the pressure in the cuffs 31 and 32, and is an analog type. A cuff pressure signal P is output.

  In the case of the photoelectric pulse wave type, the light emitting element 35 and the light receiving element 36 in the probe unit 30 are pulse wave sensors for detecting the photoelectric pulse wave installed in the cuff 32 and irradiate light to the pulsating arterial blood flow. A light emitting element (LED, laser, etc.) 35 and a light receiving element (phototransistor, etc.) 36 for detecting the reflected light from the arterial blood flow. In addition, it is good also as a structure which arrange | positions the light receiving element 36 in the cuff 31, and detects the transmitted light which the light irradiated by the light emitting element 35 permeate | transmits the inside of a tragus. Reference numeral 59 denotes a received light signal detector, which includes a pulse wave detection amplifier (AMP) that amplifies the output signal of the light receiving element 36 and outputs an analog pulse wave signal M (intravascular volume change signal).

Here, a light emission control unit 68 that automatically changes the amount of light is connected to the light emitting element 35, while the light reception signal detection unit 59 includes a gain control unit that automatically changes the gain, a pulse wave detection filter and an amplifier. A time constant control unit that changes the time constant of the filter amplifier to be configured, an A / D converter (A / D), and the like, convert the analog signals M and P into digital data D. When calculating the systolic blood pressure and the systolic blood pressure using the pressure pulse wave, the light emitting element (LED, laser, etc.) 35 and the light receiving element (phototransistor, etc.) 36 are not necessary.

  Reference numeral 61 denotes a control unit (CPU) that mainly controls the entire system of the blood pressure measurement device 100, and includes a ROM that stores a control program executed by the CPU 61, a RAM that includes a data memory, an image memory, and the like. Reference numeral 64 denotes a liquid crystal display (LCD) which displays blood pressure values (maximum blood pressure, minimum blood pressure, pulse, outside air temperature, contents of image memory, etc.). An operation panel (keyboard) 66 is provided with a power switch 62, a start / stop switch 63, an event switch 65, and the like. In the event switch 65, information such as medication (medication) such as a hypertension improving drug is input. It should be noted that a plurality of types of antihypertensive drugs may be selectively input so that they can be input.

[Operation when measuring blood pressure]
Next, the operation at the time of blood pressure measurement by the sphygmomanometer 100 having the above-described configuration will be described. When the power switch 62 of the main body 100 is turned on and the start / stop switch 63 is turned on, the control unit 61 drives the pressurization unit (pressurization pump) 53 a via the pressurization control unit 53 and cuffs 31 through the pipe 43. And / or instructing the cuff 32 to be pressurized. The pressure detection unit (pressure sensor) 56 measures the pressure of the cuff 31 and / or the cuff 32 and transmits the measurement result to the control unit 61 through the signal line 44.

The control unit 61 controls the pressurization unit 53 a so that the pressure of the cuff 31 and / or the cuff 32 measured by the pressure detection unit 56 matches the pressure indicated by the control unit 61. In the case of the photoelectric pulse wave type, the control unit 61 transmits a signal to the light emission control unit 58, and the light emission control unit 58 causes the light emitting element (LED, laser light, etc.) 35 to be measured with a predetermined intensity (one of the auricles). Part, for example, superficial temporal artery, tragus, etc.). This irradiation light is absorbed by the hemoglobin of the capillary in the superficial temporal artery or tragus, and when the light receiving element 36 receives the reflected light, the received light is converted into an electric signal and sent to the light receiving signal detection unit 59. Transmit through line 44. The light receiving element 36 may be provided at a position opposite to the light emitting element 35. In this case, light is absorbed and transmitted by the hemoglobin of the capillary in the superficial temporal artery or tragus. When the pressure pulse wave is used, the light emitting element 35, the light receiving element 36, the light emission control unit 58, and the light reception signal detecting unit 59 are not necessary.

[Principle of blood pressure measurement]
Next, an example of the principle of blood pressure measurement using the blood pressure monitor 100 will be briefly described. In blood pressure measurement, first, the cuff 31 and / or the cuff 32 is pressurized by the pressurizing unit 53a to stop the blood flow of the superficial temporal artery 28 (see FIG. 2) or the capillaries in the tragus, and then the pressure reducing valve 54a. To gradually reduce the pressure. This decompression process is indicated as the pressure P of the cuff 31 and / or the cuff 32, and the pressure P of the cuff 31 and / or the cuff 32 decreases with the passage of time.

  A systolic blood pressure (systolic blood pressure) and a diastolic blood pressure (diastolic blood pressure) are calculated based on the value of the pulsation waveform and the cuff pressure in the decompression process. Such blood pressure measurement is performed, for example, continuously (intermittently) for 24 hours or more at a predetermined time interval (for example, every 15 minutes). The calculated systolic blood pressure (systolic blood pressure) and diastolic blood pressure (diastolic blood pressure) are detected by the temperature measuring unit 72a, and the ear canal temperature or the outside air temperature in the vicinity of the auricle calculated by the temperature calculating unit 72, the measurement date and time, Stored in the memory unit 68. If a threshold value (for example, 150 mmHg) is set, especially when this threshold value is exceeded at midnight (0:00) -early morning (6:00), the blood pressure measurement time interval is changed from a predetermined time interval (for example, 15 minute interval), The CPU 61 controls the blood pressure to be measured at shorter time intervals (for example, at intervals of 2 to 3 minutes).

In addition, when taking a hypertensive drug or the like (medication), the information is input by the event switch 65. The stored systolic blood pressure (systolic blood pressure), diastolic blood pressure (diastolic blood pressure), ear canal temperature or outside air temperature in the vicinity of the auricle is transmitted each time via the external communication unit 74, or once stored in the memory 68. And is transmitted to the blood pressure management device (host computer, personal computer) 200 every predetermined time, and these data are downloaded to the memory 208. In this blood pressure management apparatus 200, in addition to blood pressure value trend information, blood pressure values can be displayed in dots under predetermined search conditions. It is possible to send these data together with personal ID data to the hospital site and the attending doctor's site via the Internet, etc., so that they can be managed, and in addition to blood pressure trend information, blood pressure values can be displayed in dots under predetermined search conditions. ing. The blood pressure management device also has almost the same function as the blood pressure management device 200 at the hospital site and the attending physician site.

FIG. 3 is an example in which the measurement date and time are input as search conditions and displayed on the display unit 204 in the blood pressure management apparatus 200. In FIG. 3 (b), in winter, the blood pressure can be increased in the early morning. The blood pressure value displayed in dots indicates that the prescribed antihypertensive agent or the like is being taken (administered) by color (for example, in the case of the antihypertensive agent or the first selected drug) May be displayed in yellow, or in the case of a second-line selection drug, in orange or the like.

As a search condition, you can enter any combination of these, including the measurement date (daily, weekly, monthly, desired selection period), measurement time, and outside temperature (environmental temperature). Extract and display dots (matrix). In addition, a blood pressure value (maximum blood pressure, minimum blood pressure) trend display is also possible as is normally done.

  In the present sphygmomanometer 100, a small blood pressure measuring unit is attached to an appropriate location (superficial temporal artery or tragus) of the auricle, and blood pressure in the outer ear and its surroundings (superficial temporal artery or tragus) is easily and accurately measured. can do. The blood pressure measuring device described above detects a pulse wave by a so-called photoelectric pulse wave method using a light emitting element and a light receiving element, but includes a cuff that presses pressure on the tragus, and detects pulsation caused by blood vessels on the surface of the living body. A pulse wave can also be detected by capturing it as a pressure change with a cuff. That is, a pulsation obtained from a living body is converted into a change in pressure in the cuff by a cuff to which pressure is applied, and a pressure change in the cuff is detected by a pressure detection device. Even with such a configuration, a pulse wave of a living body can be detected.

  Next, retrieval and display of blood pressure data in the blood pressure management apparatus (personal computer) 200 in a home, a hospital, a hospital site, an attending physician site, etc. will be described. A CPU (control unit) 201 includes a program for controlling the entire system of the sphygmomanometer management apparatus 200. In the display unit 204 of the sphygmomanometer management apparatus 200, a selection screen is selected to display a search screen as shown in FIG. Thereafter, a search item is selected (input), search conditions are input using the input unit 202, and a search method is selected (input).

In Fig. 3 (b), the search items are (1) measurement date, (2) measurement time, the measurement date is from December 1, 2004 to March 25, 2005, and the measurement time is midnight. 0:00 to early morning 6:00, and the search logical expression is 1 * 2 (that is, “the measurement date is from December 1, 2004 to March 25, 2005” and “the measurement time is midnight. From 00 to early morning 6:00 ”)).
In the display screen of FIG. 3A, the search is executed when the cursor is placed on the search execution and clicked. The blood pressure (maximum blood pressure value) extracted satisfying the condition as shown in FIG. 4B is a dot (matrix). Is displayed.

  As described above, according to the blood pressure measurement device of the present embodiment, when going outside, the blood pressure is correlated with the temperature measured by the temperature measuring means attached to the ear pinna even when the outside air temperature changes. (Maximum blood pressure value, minimum blood pressure value) can be measured and stored. In addition, according to the blood pressure management device used in the blood pressure measurement device of the present invention, blood pressure (maximum blood pressure value, minimum blood pressure value) can be measured and stored in association with the room temperature from midnight to early morning or the temperature in the toilet. This makes it easier to determine nighttime persistent hypertension and early morning hypertension. In addition, this invention is not restricted to an Example, A change and application are possible suitably.

It is a block diagram of the Example of this invention. It is the schematic of the Example of this invention. It is a figure which shows the example of a search and display of the Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Blood pressure measuring device 30 Blood pressure detection part 31 Cuff 32 Cuff 35 Light emitting element 36 Light receiving element 38 Arm 39 Arm 40 Ear hook part 100 Main body part 200 Blood pressure management apparatus

Claims (3)

Blood pressure measuring means including a cuff attached to the tragus, temperature measuring means for measuring the temperature of the external auditory canal near the cuff or the outside air temperature of the auricle, and holding the blood pressure measuring means so as not to be detached from the tragus And a clock means for continuously driving the temperature measuring means and the blood pressure measuring means at predetermined time intervals, and a blood pressure value measured by the blood pressure measuring means is measured by the temperature measuring means. A storage means that associates and stores the temperature of the external auditory canal near the cuff or the outside air temperature near the pinna, and when the maximum blood pressure measured at night or early morning exceeds a predetermined value, the measurement interval is shortened by a predetermined amount A blood pressure measurement system. Communicates with blood pressure measuring system and a wired or wireless according to claim 1, a blood pressure measurement system for the trend storing blood pressure values ear canal temperature or ambient temperature of the auricle near to association, the ear canal temperature or ear A blood pressure measurement system that displays an extracted blood pressure value based on a search condition that includes an outside air temperature in the vicinity of the intervention as one condition. The blood pressure measurement system according to claim 2, wherein the display of the blood pressure value is at least one of list display, dot display, and trend display, or any combination thereof.

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