CN114366044B - Skin microvascular reactivity test system and method based on local pressure induction - Google Patents
Skin microvascular reactivity test system and method based on local pressure induction Download PDFInfo
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
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Abstract
The application discloses a skin microvascular reactivity test system and a skin microvascular reactivity test method based on local pressure induction, and provides a skin microvascular reactivity test system based on local pressure induction. The application can test and obtain the blood flow characteristic signal by a local pressure-induced reactive hyperemia mode under the condition of avoiding discomfort of a tester, can evaluate the blood flow regulating capability of skin microvasculature, and can be widely applied to the technical field of biomedical engineering.
Description
Technical Field
The application relates to the technical field of biomedical engineering, in particular to a skin microvascular reactivity test system and method based on local pressure induction.
Background
The human blood vessel has the function of actively adjusting the size of the lumen, thereby adjusting the blood flow, wall shearing force, blood pressure and other hemodynamic characteristics. Studies have shown that in the development of cardiovascular diseases such as atherosclerosis, vascular regulation dysfunction occurs earlier than vascular structure lesions and plaque formation, the earliest stage of cardiovascular disease that can be detected. The cardiovascular disease risk of the patient can be more accurately estimated by adding the vascular regulating function evaluation based on the traditional risk factors. The skin microcirculation is rich and is in a shallow surface layer, and is the part which is easiest to carry out vascular regulation function test.
Reactive hyperemia testing is a commonly used class of vascular function testing methods that induce changes in the angiogenic hyperemic response by introducing external stimuli. The toe arm ischemia induced reactive hyperemia (PORH) test is currently the most widely used reactive hyperemia test protocol in the clinic by placing an inflatable cuff on the upper arm and then recording the change in blood flow to the forearm or finger (or its surrogate indicator) after rest, cuff inflation and cuff deflation. During the POSH test, cuff inflation causes brachial artery occlusion and downstream tissue ischemia, and once the cuff is deflated, the compensatory increased blood flow tends to exceed normal blood flow levels, typically with a more healthy blood vessel, a more hyperemic response. Some of the instruments currently used in the clinic and laboratory are based on POSH schemes such as EndoPAT, available from Iamar Medical, inc. of Israel, VENDYS, available from Endothesix, U.S.A.
The POSH test causes the brachial artery to be blocked by the inflation of the oversleeves, the blocking time generally needs to last about 5 minutes, the pressurization value is generally higher than the contraction pressure of a tester by tens of mmHg, the test condition has higher requirements on the ischemia tolerance of the tester, and the tester can generate uncomfortable feeling such as swelling, tingling, pain and the like; moreover, certain populations may have potential health risks for use, such as hypertension or patients with unstable plaque in the blood vessels.
In addition, the PORH scheme uses the cuff to pressurize the brachial artery of the upper arm, and the blood flow change is detected in the forearm or fingertip, the pressure stimulation part is inconsistent with the blood flow detection part, and the detection result contains both brachial artery regulation effect and peripheral microcirculation regulation effect, so the interpretation of the test result is poor.
Disclosure of Invention
Therefore, the embodiment of the application provides a skin microvascular reactivity test system and a skin microvascular reactivity test method based on local pressure induction, which avoid great stimulation and uncomfortable feeling to a tester in a local pressure induction mode, and can accurately position a detection position at the same time, thereby improving the accuracy of a test result.
The first aspect of the embodiment of the application provides a skin microvascular reactivity test system based on local pressure induction, which comprises a data acquisition module, an image preprocessing module and a signal analysis module, wherein the data acquisition device is used for acquiring blood flow image data, the image preprocessing module is used for processing and obtaining blood flow signals according to the blood flow image data, the signal analysis module is used for extracting characteristics of the blood flow signals, the data acquisition module comprises a pressure stimulation device and a skin blood flow detector, the pressure stimulation device comprises a support ring, a support head and a pressure control device, the support head is connected to the top of the support ring, the pressure control device is connected to the bottom of the support ring, the pressure stimulation device is used for controlling the support head to implement local pressure stimulation on a target position through the pressure control device, and the blood flow detector is used for acquiring the blood flow image data of the target position.
Optionally, the stent head is movably connected to the stent ring.
Optionally, the bracket head is of a hollow structure, and the specification of the bottom section of the bracket head comprises 0.5 square centimeters to 5 square centimeters.
Optionally, the bottom contact surface of the bracket head is made of transparent materials.
Optionally, a connecting ring is arranged at the bottom of the support ring, and the connecting ring is used for connecting the support ring with the pressure control device.
Optionally, the pressure control device is a weight or a chest expander.
Optionally, the blood flow detector is a laser speckle contrast imager, a laser doppler imaging device, or an imaging photoplethysmograph.
A second aspect of the embodiment of the present application provides a testing method for a skin microvascular reactivity testing system based on local pressure induction according to the first aspect of the embodiment of the present application, including:
fixing a bracket head connected to the top of a bracket ring in a pressure stimulation device in a data acquisition module at a target position;
controlling the stent head to apply local pressure stimulation to the target position according to a pressure control device connected to the bottom of the stent ring;
collecting blood flow image data of the target position according to a blood flow detector in the data collecting module;
processing the blood flow image data according to an image preprocessing module to obtain a blood flow signal;
and carrying out feature extraction on the blood flow signal according to the signal analysis module to obtain test information.
Optionally, the processing the blood flow image data according to the image preprocessing module to obtain a blood flow signal includes:
determining a region of interest in the blood flow image data according to an image preprocessing module;
performing spatial averaging processing on the image values in the region of interest to obtain a first blood flow signal;
and carrying out noise elimination processing according to the first blood flow signal to obtain a second blood flow signal.
Optionally, the feature extraction is performed on the blood flow signal according to a signal analysis module to obtain test information, including:
extracting to obtain a blood flow baseline mean value and a blood flow rebound peak value according to the time history change of the blood flow signal;
calculating to obtain a measurement index according to the blood flow baseline average value and the blood flow rebound peak value;
and according to the blood flow baseline mean value, the blood flow rebound peak value and the measurement index, combining priori knowledge data to obtain test information.
The embodiment of the application provides a skin microvascular reactivity test system based on local pressure induction, which comprises a data acquisition module, an image preprocessing module and a signal analysis module, wherein the data acquisition device is used for acquiring blood flow image data, the image preprocessing module is used for processing the blood flow image data to obtain blood flow signals, the signal analysis module is used for carrying out characteristic extraction on the blood flow signals, the data acquisition module comprises a pressure stimulation device and a skin blood flow detector, the blood flow regulation capacity of skin microvascular can be accurately reflected by keeping a pressure stimulation part and a blood flow detection part in the test process consistent, the influence of regulation is naturally shielded by large blood vessels or other factors, the pressure stimulation device comprises a support ring, a support head and a pressure control device, the support head is connected to the top of the support ring, the pressure control device is connected to the bottom of the support ring, the pressure stimulation device is used for controlling the support head to carry out local pressure stimulation on a target position through the pressure control device, the local pressure stimulation on the target position is realized through the pressure stimulation device, large stimulation and discomfort caused to a tester, such as swelling, pain, blood vessel pain and the like can be prevented, and the blood flow regulation capacity of the skin microvascular can be prevented, and the blood flow regulation system can be used for acquiring the blood flow data of a patient, such as the blood flow position of the patient is not suitable for the blood flow image and the patient. According to the embodiment of the application, the blood flow characteristic signal can be obtained through testing in a mode of inducing reactive hyperemia by local pressure under the condition that a tester is ensured not to generate uncomfortable feeling of testing, and then the blood flow regulating capability of the skin microvasculature is evaluated.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings required for the description of the embodiments will be briefly described below, and it is apparent that the drawings in the following description are only some embodiments of the present application, and other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
FIG. 1 is a schematic diagram of an overall and partial enlarged structure of a skin microvascular responsiveness test system based on local pressure induction according to an embodiment of the present application;
FIG. 2 is a schematic functional flow chart of a skin microvascular reactivity test system based on local pressure induction according to an embodiment of the present application;
FIG. 3 is a schematic diagram of a blood flow calendar and its characteristic values collected by a skin microvascular reactivity test system based on local pressure induction according to an embodiment of the present application;
fig. 4 is a flow chart of a test method using a skin microvascular reactivity test system based on local pressure induction according to an embodiment of the present application.
Detailed Description
The present application will be described in further detail with reference to the drawings and examples, in order to make the objects, technical solutions and advantages of the present application more apparent. It should be understood that the specific embodiments described herein are for purposes of illustration only and are not intended to limit the scope of the application.
In order to make the present disclosure and technical solutions more clear, the related terms and meanings are described:
vascular regulating function: the human blood vessel has a series of automatic adjusting capability, and the blood flow dynamics parameters such as local pressure, shearing force, blood flow and the like in the blood vessel can be controlled and adjusted through the change of the vessel diameter.
Reactive hyperemia test: one common test for detecting vascular regulation is by introducing external stimuli such as mechanical stimuli, temperature stimuli, etc. to cause a rapid hyperemic response to angiogenesis.
The structural function of the device of the application is described in detail below with reference to the attached drawings of the specification:
referring to fig. 1, an embodiment of the application provides a skin microvascular reactivity test system based on local pressure induction, which comprises a data acquisition module, an image preprocessing module and a signal analysis module, wherein the data acquisition module is used for acquiring blood flow image data, the image preprocessing module is used for processing blood flow signals according to the blood flow image data to obtain blood flow signals, and the signal analysis module is used for extracting characteristics of the blood flow signals.
Specifically, the pressure stimulation device of the data acquisition device builds the environmental conditions of data testing by applying local pressure stimulation to the target test part of the forearm of the tester, then acquires blood flow image data of the target test position through the blood flow detector of the data acquisition device, then transmits the acquired blood flow image data to the image preprocessing module, processes the blood flow image data through the image preprocessing module to obtain blood flow signals, further transmits the processed blood flow signals to the signal analysis module, and performs feature extraction on the blood flow signals through the signal analysis module. Finally, according to the extracted characteristic data and combined with related priori knowledge, whether the blood flow regulating function of the skin microvasculature is normal or not can be comprehensively judged.
In some embodiments, the support head is movably connected to the top of the support ring, that is, the support head is a replaceable component, and can be replaced by a support head with a corresponding specification according to different testing requirements.
In some embodiments, the stent head is a hollow structure, and the area specification of the cross section of the bottom of the stent head, which is contacted with the test site for applying the local pressure stimulation, comprises 0.5 square centimeter to 5 square centimeters, and the contact surface of the stent head can be in a round shape, a square shape or other special-shaped shapes, and the stent head can be correspondingly replaced with the stent head with the corresponding specification according to different test requirements.
In some embodiments, the bottom contact surface of the support head and the test part for implementing the local pressure stimulation is made of transparent materials, including PVC, glass and the like, and the collecting lens of the blood flow detector directly collects blood flow data of the test part for implementing the local pressure stimulation through the hollow structure of the support head, and the distance that the collecting lens of the blood flow detector is positioned 30cm right above the test part is better, correspondingly, the bottom contact surface of the support head is made of transparent lenses, so that the collecting device of the blood flow detector can conveniently collect blood flow image data with clear imaging.
In some embodiments, the bottom of the support ring is provided with a connecting ring, the pressure control device is connected to the support ring through the connecting ring, and the support head is further controlled to apply local pressure stimulation to the tested target position through the support ring, correspondingly, the pressure control device is provided with a connecting buckle or a connecting hook for being matched with the connecting ring to connect the pressure device to the support ring, and specifically, the support ring can be polygonal such as trilateral, quadrilateral, or circular such as perfect circle, ellipse, and the like.
In some embodiments, the pressure control device may be a weight or a chest expander, and the accurate pressure control is achieved by increasing or decreasing the number or the weight of the weight or setting the force value of the chest expander, so as to achieve accurate local pressure stimulation.
In some embodiments, the blood flow detector is a laser speckle contrast imager, a laser doppler imaging device, or an imaging photoplethysmograph.
In some specific embodiments, referring to fig. 2, the local pressure induction-based skin microvascular responsiveness test system of the present application is specifically composed and functions as follows:
the system is composed of a data acquisition module, an image preprocessing module and a signal analysis module.
(1) The data acquisition module consists of a pressure stimulation device and a skin blood flow detector.
The pressure stimulation device mainly comprises a metal annular bracket and a load weight below the annular bracket, wherein a round hole is formed below the bracket for hooking the weight; the holder head is designed as a hollow cylinder, the bottom of which (i.e. the contact with the skin) covers a circular planar transparent lens, with a diameter of about 1cm to 2cm.
The skin blood flow detector can perform non-contact and continuous monitoring on skin blood flow in a certain visual field range, obtain a sequence blood flow graph or a blood flow video, and can be preferably selected as a laser speckle contrast imager (or laser Doppler imaging equipment, imaging photoplethysmograph and the like).
(2) The image preprocessing module is connected with the data acquisition module and is used for deriving a smooth one-dimensional blood flow signal from the original two-dimensional blood flow image sequence. Firstly, selecting a region of interest (ROI) from a two-dimensional blood flow image, and then performing spatial averaging on image values in the ROI to extract a one-dimensional blood flow signal; finally, a wavelet filtering method is adopted to further eliminate noise and high-frequency fluctuation in the extracted blood flow signals, so that smooth one-dimensional blood flow signals are derived.
(3) The signal analysis module is connected with the image preprocessing module and is used for carrying out feature extraction and skin microvascular regulation function evaluation on blood flow signals. As shown in FIG. 3, the signal analysis module will extract baseline mean values w of skin blood flow before local pressure application according to the time history of blood flow signals 0 Peak value w of blood flow rebound after release of local skin pressure 2 And calculate the area under the curve a AUC . Wherein a is AUC By utilizing the rebound change curve of the blood flow signal after the release of the local pressure and the baseline average value w of the skin blood flow 0 The area enclosed by the two parts. After the characteristic values are obtained, healthy people w with the same age group are treated 2 ，w 2 -w 0 ，w 2 /w 0 ，a AUC And (3) taking the statistical data of the skin microvasculature as a reference value range, comparing the reference value range with a test result, and evaluating whether the blood flow regulating function of the skin microvasculature is normal or not according to the comparison result.
The embodiment of the application provides a testing method applying the system embodiment, as shown in fig. 4, the method comprises the following steps:
fixing a bracket head connected to the top of a bracket ring in a pressure stimulation device in a data acquisition module at a target position;
controlling the stent head to apply local pressure stimulation to the target position according to a pressure control device connected to the bottom of the stent ring;
acquiring blood flow image data of a target position according to a blood flow detector in the data acquisition module;
processing blood flow image data according to the image preprocessing module to obtain a blood flow signal;
and carrying out feature extraction on the blood flow signals according to the signal analysis module to obtain test information.
In some embodiments, processing blood flow image data to obtain a blood flow signal according to an image preprocessing module includes:
determining a region of interest in the blood flow image data according to the image preprocessing module;
performing spatial averaging processing on the image values in the region of interest to obtain a first blood flow signal;
and performing noise elimination processing according to the first blood flow signal to obtain a second blood flow signal.
Specifically, the image preprocessing module firstly selects a region of interest (ROI) from blood flow image data (i.e. an original two-dimensional blood flow image), and then performs spatial averaging processing on image values in the ROI to extract a one-dimensional blood flow signal (i.e. a first blood flow signal); finally, a wavelet filtering method is adopted to further eliminate noise and high-frequency fluctuation in the extracted blood flow signals, so that smooth one-dimensional blood flow signals (namely second blood flow information) are derived.
In some embodiments, feature extraction is performed on the blood flow signal according to the signal analysis module to obtain test information, including:
extracting to obtain a blood flow baseline average value and a blood flow rebound peak value according to the time history change of the blood flow signal;
calculating to obtain a measurement index according to the blood flow baseline average value and the blood flow rebound peak value;
and according to the blood flow baseline mean value, the blood flow rebound peak value and the measurement index, combining the priori knowledge data to obtain the test information.
Specifically, referring to fig. 3, the signal analysis module extracts baseline mean values w of skin blood flow before local pressure application according to time-lapse changes of the blood flow signal 0 (i.e. baseline mean of blood flow), peak value of rebound of blood flow after release of local pressure of skin w 2 (i.e., peak in blood flow rebound) and calculate the area under the curve a AUC (i.e., a metric). Wherein a is AUC By utilizing the rebound change curve of the blood flow signal after the release of the local pressure and the baseline average value w of the skin blood flow 0 The area enclosed by the two parts. After the characteristic values are obtained, healthy people w with the same age group are treated 2 ，w 2 -w 0 ，w 2 /w 0 ，a AUC As a benchmark range, and in conjunction with testingAnd comparing, and evaluating whether the blood flow regulating function of the skin microvasculature is normal according to the comparison result.
In some embodiments, the above-described test methods using, for example, a skin microvascular responsiveness test system based on local pressure induction, may be implemented by the following procedure:
1. the subject needs to meet the test conditions. The subjects remained unappeted, taking medicine, smoking, drinking and other functional drinks 2 hours prior to testing, without extensive exercise; resting for 15 minutes after entering the collection room for testing.
2. Skin blood flow baseline collection. The subject places the forearm of one arm flat on the chair armrest with the palm facing down. An imaging target area is selected near the wrist of the forearm and marked by a pen, then a skin blood flow detection instrument is started, a lens is aligned to the skin of the target area, and blood flow images are continuously acquired for 5 to 10 minutes. The forearm remained motionless throughout the test.
3. Local pressure and blood flow collection are performed on the skin. The annular bracket of the pressure stimulation device is sleeved on the forearm, so that the bracket head is aligned to the skin of the marked imaging target area, the plane lens at the bottom of the bracket head is tightly attached to the skin under the action of gravity, and then a weight with a certain mass is hung below the bracket, so that the bracket is provided with the following components: (weight + scaffold weight)/scaffold head floor area = 180mmHg (i.e. 24 kpa); after the pressure stimulation device was placed, blood flow images were continuously acquired for 5 minutes for the same skin area.
4. Blood flow collection after pressure release. The pressure stimulation device (ring support and weight) was removed from the forearm and blood flow images were continuously acquired for 10 minutes for the same skin area.
5. And (3) leading the acquired blood flow sequence images or videos into an image preprocessing module, averaging the blood flow values of the target area to form one-dimensional blood flow signals, performing noise reduction processing, and outputting smooth blood flow signals w (t).
6. Introducing the smooth blood flow signal w (t) into a signal analysis module, and respectively extracting skin blood flow baseline average value w as shown in FIG. 3 0 Peak value w of blood flow rebound after release of local skin pressure 2 Calculating the area under the curve a AUC 。
7. Will be healthy people w of the same age group 2 ，w 2 -w 0 ，w 2 /w 0 ，a AUC And (3) taking the statistical data of the skin microvasculature as a reference value range, comparing the reference value range with a test result, and evaluating whether the blood flow regulating function of the skin microvasculature is normal or not according to the comparison result.
The content of the system embodiment of the application is suitable for the method embodiment, the functions realized by the method embodiment are the same as those of the system embodiment, and the beneficial effects obtained by the method embodiment are the same as those obtained by the device embodiment.
In summary, the application provides a system and a method for testing skin microvascular reactivity based on local pressure induction, aiming at the technical defects that the traditional POSH test scheme is easy to cause uncomfortable feeling to testers and has poor interpretability of test results. The data acquisition device comprises the pressure stimulation device and the blood flow detector, and firstly, the accurate local pressure stimulation can be implemented on the target test position through the pressure stimulation device, so that great stimulation and uncomfortable feeling such as swelling, tingling and pain can not be caused to a tester. There is no population unsuitable for patients with unstable vascular plaques, such as hypertension. In addition, the blood flow detector and the pressure stimulation device together form the data acquisition device, so that the pressure stimulation part is consistent with the blood flow detection part when the reactivity test is carried out, the blood flow regulation capacity of skin micro-blood vessels can be accurately reflected, and the influence of large blood vessels or other factors participating in regulation can be naturally shielded. The application can evaluate the blood flow regulating capacity of the skin microvasculature by a mode of inducing reactive hyperemia by local pressure under the condition of ensuring that a tester does not generate test discomfort.
In some alternative embodiments, the functions/acts noted in the block diagrams may occur out of the order noted in the operational illustrations. For example, two blocks shown in succession may in fact be executed substantially concurrently or the blocks may sometimes be executed in the reverse order, depending upon the functionality/acts involved. Furthermore, the embodiments presented and described in the flowcharts of the present application are provided by way of example in order to provide a more thorough understanding of the technology. The disclosed methods are not limited to the operations and logic flows presented herein. Alternative embodiments are contemplated in which the order of various operations is changed, and in which sub-operations described as part of a larger operation are performed independently.
In the description of the present specification, a description referring to terms "one embodiment," "some embodiments," "examples," "specific examples," or "some examples," etc., means that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the present application. In this specification, schematic representations of the above terms do not necessarily refer to the same embodiments or examples. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples.
While embodiments of the present application have been shown and described, it will be understood by those of ordinary skill in the art that: many changes, modifications, substitutions and variations may be made to the embodiments without departing from the spirit and principles of the application, the scope of which is defined by the claims and their equivalents.
While the preferred embodiment of the present application has been described in detail, the present application is not limited to the embodiments described above, and those skilled in the art can make various equivalent modifications or substitutions without departing from the spirit of the present application, and these equivalent modifications or substitutions are included in the scope of the present application as defined in the appended claims.
Claims (8)
1. The skin microvascular reactivity test system based on local pressure induction comprises a data acquisition module, an image preprocessing module and a signal analysis module, wherein the data acquisition device is used for acquiring blood flow image data, the image preprocessing module is used for processing according to the blood flow image data to obtain blood flow signals, and the signal analysis module is used for extracting characteristics of the blood flow signals; the support head is movably connected to the support ring, the support head is of a hollow structure, and the bottom contact surface of the support head is made of transparent materials;
the blood flow image data of the test part for implementing local pressure stimulation is directly collected by the collecting lens of the blood flow detector through the hollow structure of the bracket head.
2. The local pressure induction based skin microvascular responsiveness test system of claim 1, wherein the gauge of the bottom cross section of the stent head comprises 0.5 square centimeters to 5 square centimeters.
3. The skin microvascular responsiveness test system based on local pressure induction of claim 1, wherein a connecting ring is provided at the bottom of the stent ring, the connecting ring being used for connecting the stent ring to the pressure control device.
4. The skin microvascular responsiveness test system based on localized pressure induction of claim 1, wherein the pressure control device is a weight or a chest expander.
5. The local pressure-induced skin microvascular responsiveness-based test system of claim 1, wherein said blood flow detector is a laser speckle contrast imager, a laser doppler imaging device or an imaging photoplethysmograph.
6. A test method using the local pressure-induced skin microvascular responsiveness test system of claim 1, comprising:
fixing a bracket head connected to the top of a bracket ring in a pressure stimulation device in a data acquisition module at a target position;
controlling the stent head to apply local pressure stimulation to the target position according to a pressure control device connected to the bottom of the stent ring;
collecting blood flow image data of the target position according to a blood flow detector in the data collecting module;
processing the blood flow image data according to an image preprocessing module to obtain a blood flow signal;
and carrying out feature extraction on the blood flow signal according to the signal analysis module to obtain test information.
7. The method according to claim 6, wherein the processing the blood flow image data according to the image preprocessing module to obtain a blood flow signal comprises:
determining a region of interest in the blood flow image data according to an image preprocessing module;
performing spatial averaging processing on the image values in the region of interest to obtain a first blood flow signal;
and carrying out noise elimination processing according to the first blood flow signal to obtain a second blood flow signal.
8. The method according to claim 6, wherein the feature extraction of the blood flow signal according to the signal analysis module to obtain test information includes:
extracting to obtain a blood flow baseline mean value and a blood flow rebound peak value according to the time history change of the blood flow signal;
calculating to obtain a measurement index according to the blood flow baseline average value and the blood flow rebound peak value;
and according to the blood flow baseline mean value, the blood flow rebound peak value and the measurement index, combining priori knowledge data to obtain test information.
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