TWI268773B

TWI268773B - Method for detecting continuous blood pressure waveform

Info

Publication number: TWI268773B
Application number: TW94103201A
Authority: TW
Inventors: Tsair Kao; Di-He Wang; Wei-Jr Hu; Jia-Jung Wang; Jiun-Peng Liou
Original assignee: Tsair Kao
Priority date: 2005-02-02
Filing date: 2005-02-02
Publication date: 2006-12-21
Also published as: TW200628125A

Abstract

A method for detecting continuous blood pressure waveform is disclosed, which comprises capturing cardiograph signal of a user and pulse signal of the user's finger by optical manner, taking a plurality of characteristic values from the cardiograph signal and the pulse signal, establishing a transferring function by the characteristic values, correcting the pulse signal by referring to the transferring function, and outputting the continuous blood pressure waveform. Because the pulse signal is detected by noninvasive optical plethysmography, the user does not feel uncomfortable as using traditional pressure exertion method.

Description

1268773 九、發明說明：【發明所屬之技術領域】本發明是關於-種血麼量測方法及量測系統，特別是指一種以非侵入方式連續量測血壓波形之方法及量測系統【先前技術】傳統血壓的測量方法，是備置一組水銀柱血磨計及聽診器，讓受測者採平躺或坐姿，將其手臂置於有支托的位置 ’並露出上臂，接著將血壓計的零點與受測者的心、臟在同一料線上，並㈣脈帶纏於其上臂距肘關節上i忖處，由另人以艮扣、中指觸診受測者肱動脈（一般為肘關節内面之内⑷的脈動’並把聽診器置於㈣脈處，接著關緊血麼計之充氣囊加以擠壓把空氣打人氣囊’此時血壓計之水銀柱會缓慢上升，約打到180mmHg左右時，再以每秒約下: 2mmHg之速度慢慢放氣。判讀血壓數值時，在放氣的這段期間需注視血壓計上的讀數及由聽診器傾聽動脈血流聲音，第一聲柯氏音 (Korotkoff sound)為收縮壓，最後一聲則為舒張壓。其原理即在於量取收縮壓時，完全被壓扁的血管逐漸因減壓而開始有？充通過而出現聲音。此聲音可由聽診器在肘寓處聽到： Π π 7在手如處重新摸到脈搏的跳動。第一個聲音出現時在水銀血壓計上顯示的讀數即是收縮壓；而在量取舒張壓時，此時的聲音因繼續放氣減壓終致血流完全暢通而消失，故聽 #為聽到取後一聲時水銀血壓計上顯示的讀數即是舒張壓。 5 1268773 值得注意的是有些人聲音消失前會減弱，此時仍以最後一聲為舒張壓。 ^ 至於電子式血壓計的測量方法，主要是以受測者採平躺或坐姿’將其手臂置於有支托的位置，不需要捲袖子，血壓計與心臟在同-水平線上，按鍵後等待螢幕顯示即可。一般電子式血壓計依其充氣方式分類，可分為全自動充氣式( 只需按-個按鍵，綁袋就會自動充氣）及半自動充氣式（需要用手來壓縮橡皮囊充氣）;若依其測量部份分類，又可分為手臂型、手腕型及手指型等測量方式。至於電子式血壓計之原理’有用仙柯氏音的方式，或另用震i法原理，不需使用聽診器，就可以電子電路來量取其收縮壓及舒張壓。震盪法原理之電子血壓計，儀器會先把壓脈帶充氣擠壓動脈完全阻止血液的流動，再慢慢的洩壓。當壓脈袋壓力接近收縮壓前，即可感應到壓脈袋上方動脈的脈動，^壓脈帶内壓力Μ，故壓脈帶振動幅度小，繼續慢慢玫放慶脈袋内壓力，則脈動漸強。經實驗証明當壓脈袋内壓力等於平均動脈壓時，壓脈袋内壓力振幅最大。這是基於彈性的血管壁，當内外壓差相同時，血管壁有相對較大的彈性，故可產生最大的震盪。之後，因壓脈帶内壓力降低，使血流障礙減小，使壓脈帶振幅漸小，直到壓脈袋内壓力小於舒張壓而無法產生脈動為止。震盪法電子血壓計是獲得平均動脈壓，再由平均動脈壓振幅比例，求取收縮壓及舒張壓。然而，目前無論是以水銀柱血壓計或是電子式血壓計來進行量測血壓時均有下述缺點： 1268773 血壓叶均屬於非連續的量測方式，不單次收縮壓及舒張壓，因此無法父測者的血壓之情況。 1)以水銀柱或電子式亦即，一次充放氣只能顯適用於一般需長時間監控 :每次W堅時仍然需要在受測者之手臂、手腕或曰二疋的屋力’當長時間監控血壓時，若仍然採用 =施加Μ力的量測方式，將使得受測者在量取㈣時容易感到不舒適。1268773 IX. Description of the Invention: [Technical Field] The present invention relates to a blood measurement method and a measurement system, and more particularly to a method and a measurement system for continuously measuring a blood pressure waveform in a non-invasive manner. Technology] The traditional blood pressure measurement method is to prepare a set of mercury column blood stone meter and stethoscope, so that the subject can lie flat or sitting, put his arm in the position with support and expose the upper arm, then the zero point of the sphygmomanometer The heart and the dirt of the subject are on the same line, and (4) the pulse band is wrapped around the elbow joint of the upper arm. The other person uses the button and the middle finger to palpate the radial artery of the subject (generally the inner surface of the elbow joint). Within the (4) pulsation 'and put the stethoscope at the (four) pulse, then close the blood sac of the sac to squeeze the air into the airbag'. At this time, the mercury column of the sphygmomanometer will rise slowly, about 180mmHg, then Slowly deflate at a rate of about 2 mmHg per second. When reading the blood pressure value, watch the sphygmomanometer reading during the deflation period and listen to the arterial blood flow sound by the stethoscope, the first Korotkoff sound (Korotkoff Sound) is the systolic pressure, and the last sound is the diastolic pressure. The principle is that when the systolic blood pressure is measured, the completely flattened blood vessel gradually begins to decompress and begins to have a sound. The sound can be seen by the stethoscope in the elbow. I heard at the apartment: Π π 7 Re-sensing the beat of the pulse in the hand. The first reading on the mercury sphygmomanometer is the systolic blood pressure; when measuring the diastolic pressure, the sound is continued. After the deflation and decompression, the blood flow is completely unblocked and disappears, so the reading displayed on the mercury sphygmomanometer when listening to the sound is the diastolic pressure. 5 1268773 It is worth noting that some people will weaken before the sound disappears. Still taking the last breath as diastolic pressure. ^ As for the measurement method of the electronic sphygmomanometer, the subject is mainly placed in a position where the subject is placed in a support position, without the need to roll the sleeves, the sphygmomanometer and The heart is on the same-horizontal line, waiting for the screen to display after pressing the button. Generally, the electronic sphygmomanometer is classified according to its inflation method, and can be divided into fully automatic inflatable type (just press a button, the bag will automatically inflate) and half from Dynamic inflatable type (need to compress the rubber bladder by hand); if it is classified according to its measurement, it can be divided into arm type, wrist type and finger type. As for the principle of electronic sphygmomanometer In the way of sound, or by using the principle of shock i, you can measure the systolic pressure and diastolic pressure by electronic circuit without using a stethoscope. The electronic sphygmomanometer of the principle of oscillating method, the instrument will first compress the vein with the vein Completely stop the flow of blood, and then slowly release the pressure. When the pressure of the pressure vessel is close to the systolic pressure, the pulsation of the artery above the pressure vessel can be sensed, and the pressure inside the pressure band is Μ, so the vibration amplitude of the pressure pulse band is small. Continue to slowly increase the pressure inside the Qingmai bag, then the pulse is getting stronger. It is proved by experiments that when the pressure in the pressure pulse bag is equal to the average arterial pressure, the pressure amplitude in the pressure pulse pocket is the largest. This is based on the elastic blood vessel wall, inside and outside. When the pressure difference is the same, the vessel wall has a relatively large elasticity, so that the maximum oscillation can be generated. Thereafter, as the pressure in the cuff is lowered, the blood flow disorder is reduced, and the amplitude of the cuff is gradually reduced until the pressure in the cuff is less than the diastolic pressure and the pulsation is not generated. The oscillating electronic sphygmomanometer obtains the mean arterial pressure, and then the ratio of the mean arterial pressure amplitude to obtain the systolic blood pressure and diastolic blood pressure. However, at present, whether the blood pressure is measured by a mercury column sphygmomanometer or an electronic sphygmomanometer has the following disadvantages: 1268773 Blood pressure leaves are non-continuous measurement methods, not single systolic pressure and diastolic blood pressure, so it is impossible The condition of the blood pressure of the father. 1) With mercury column or electronic type, one charge and discharge gas can only be applied to the general long-term monitoring: every time W is still needed, the arm of the subject's arm, wrist or squatting is needed. When monitoring blood pressure for time, if the measurement method of applying force is still used, the subject will feel uncomfortable when measuring (4).

3)僅以單次量測無法即時獲知㈣波形隱含血管硬化程度及其他心血管變化的生理資訊，因&，如能獲得連續血歷波形將更有利於瞭解受測者心血管健康狀況。【發明内容】有鑑於現有的量測血壓方乃具有上迷缺點，本發明之首要目地，在於提供一種非样井彳又入式里取連績血壓波形之量測方法及其量測系統。本I月之Α目的，在於提供一種連續血壓波形量測方法及其㈣系統’無須受醫事專業輯q也可操作，可應用於居家照護用途。本1月之再目白◊，在於提供一種連續血壓波形量測方法及其量測系統，可自行設定警示高血壓，當量測連續十跳收縮壓均高於使用者所設定的高血壓值，本發明會發出警不聲，提供使用者注意血壓值超過高血壓設定值。本4明之又一目的，在於提供一種連續血壓波形量測方法及其量測系統，可自行設定警示低血壓，當量測連續十跳舒張壓均低於使用者所設定的低血壓值，本發明會發 1268773 • 出g μ ’提供使用者注意血㈣低於低血屢設定值。本毛明之另-目的，在於提供一種連續血壓波形量測方法及其量測系統，利用移動中值法以除去手動干擾雜訊，因此降低逐跳血屡推估誤差。 " 、本發^另-目的，在於提供—種連續血壓波形量測方法及其量測系統，利則旨部光學電信號（ppG)之逐跳脈波振幅大小，若遇有所量測波形異常的情況，本發明可自重新設定新的收縮壓、#張壓及本系統其他參考值。本發明之另一目的，在於提供一種連續血壓波形量測方法及其量測系統，利用不同的心率及光學脈波信號舒張期波形特徵所建立之轉換函數庫，可將光學脈波信號之波形轉換為連續血壓波形。因此，本發明之連續血壓波形量測方法，係掏取一受測者之心電信號及以光學方式擷取該受測者指部之脈波信號，接著抽取該心電信號及該脈波信號之複數特徵值，並利用该等特徵值建立一轉換函數，再以該轉換函數校準該脈波信號而輸出連續血壓信號之波形。本發明之連續血壓波形量測系統，係以非侵入方式取传受測者之連續血壓波形。該連續血壓波形量測系統包 S —用以置取該受測者之心電圖信號之第一量測裝置、一以光學方式量取該受測者之指部脈波信號之第二量:測裝置 ’ 一習用電子血壓計之第三量測裝置，及一糕接該第一量測裝置、第二量測裝置及第三量測裝置之連續血壓監測儀。該血壓監測儀用以抽取該心電圖信號之特徵值，及第二 8 1268773 、第三量測裝置所獲得之脈波到達時間、光 :皮:上升時間、收㈣、舒耐考值及已建立之= 丈、/乂㈣特徵值調整該光學脈波信號為連續血塵信號之波形。〇本發明的主要原理，即利用心電圖信號逐跳的心率變化結合光學量測方式，配合量取受測者手指部血管内的血3) It is not possible to know immediately (4) the physiological information of the waveform implied vascular sclerosis and other cardiovascular changes in a single measurement. Because of the continuous blood flow waveform, it will be more conducive to understanding the cardiovascular health of the subject. . SUMMARY OF THE INVENTION In view of the above-mentioned disadvantages of measuring blood pressure, the primary object of the present invention is to provide a measurement method and a measurement system for taking a continuous blood pressure waveform in a non-sample well. The purpose of this I month is to provide a continuous blood pressure waveform measurement method and (4) system that can be operated without medical treatment, and can be applied to home care applications. This January's re-emphasis is to provide a continuous blood pressure waveform measurement method and its measurement system, which can set the warning hypertension automatically, and the equivalent 10-minute systolic blood pressure is higher than the user-set hypertension value. The present invention will alert you to provide the user with a blood pressure value that exceeds the high blood pressure setting. Another object of the present invention is to provide a continuous blood pressure waveform measuring method and a measuring system thereof, which can set the warning low blood pressure by itself, and the continuous ten-jump diastolic pressure of the equivalent test is lower than the low blood pressure value set by the user. The invention will issue 1268773 • The g μ ' is provided to the user to pay attention to the blood (4) below the low blood set value. The other purpose of the present invention is to provide a continuous blood pressure waveform measurement method and a measurement system thereof, which utilizes a moving median method to remove manual interference noise, thereby reducing the hop-by-hop blood estimation error. ", this hair ^ another - purpose, is to provide a continuous blood pressure waveform measurement method and its measurement system, the purpose of the optical electrical signal (ppG) hop-by-hop pulse amplitude, if there is a measured waveform In case of abnormality, the present invention can self-reset new systolic pressure, #tension and other reference values of the system. Another object of the present invention is to provide a continuous blood pressure waveform measuring method and a measuring system thereof, which can convert the waveform of the optical pulse wave signal by using a conversion function library established by different heart rate and diastolic waveform characteristics of the optical pulse wave signal. Convert to a continuous blood pressure waveform. Therefore, the continuous blood pressure waveform measuring method of the present invention extracts an electrocardiographic signal of a subject and optically captures a pulse wave signal of the finger of the subject, and then extracts the ECG signal and the pulse wave. A complex eigenvalue of the signal, and a conversion function is established by using the eigenvalues, and the pulse wave signal is calibrated by the conversion function to output a waveform of the continuous blood pressure signal. The continuous blood pressure waveform measuring system of the present invention transmits the continuous blood pressure waveform of the subject in a non-invasive manner. The continuous blood pressure waveform measuring system package S is a first measuring device for taking the electrocardiogram signal of the subject, and a second quantity for optically measuring the pulse signal of the finger of the subject: The device is a third measuring device of a conventional electronic sphygmomanometer, and a continuous blood pressure monitor that is connected to the first measuring device, the second measuring device and the third measuring device. The blood pressure monitor is configured to extract the characteristic value of the electrocardiogram signal, and the arrival time of the pulse wave obtained by the second 8 1268773 and the third measuring device, light: skin: rise time, receive (four), Shu Nakau value and established = zhang, / 乂 (4) eigenvalue adjustment The optical pulse signal is the waveform of the continuous blood dust signal.主要 The main principle of the present invention is to use the electrocardiogram signal hop-by-hop heart rate change combined with the optical measurement method to match the amount of blood in the blood of the subject's finger

液，積變化參數’加上其脈㈣達時間與波形特徵，獲得非侵入式連續動脈壓波形。又 I始耘序、枝正程序期間所獲得的脈波到達時間泉考值、光學血液容積脈波上升時时考值、即時心率參考值及手^ °卩晨盪法電子血壓計獲得收縮壓、舒張壓、平均 /号值汁异出逐跳連績之收縮壓、舒張壓，最後經由 p -ζφ- _3y 、、’ 〇漫立之血液容積波形與血壓波形轉換函數，將光 4*谷積彳田。十法所取得的脈波信號轉換為連續血壓波形。 [實施方式】有關本發明前述及其他技術内容、特點與功效，以下配百 > 考圖式之較佳實施例的詳細說明，將可清楚的呈現如圖1所示，為本發明之連續血壓波形量測系統1，其係以非长入方式量取一受測者3之連續血壓波形，該量測系統1包含一第一量測裝置11、一第二量測裝置12、一第星則衣置13及一連續血壓監測儀14，該連續血壓監測儀 14並电連接有一儲存單元15、一顯示單元16及一警示單元17 〇 9 1268773The liquid, product variation parameter 'plus its pulse (four) time and waveform characteristics, to obtain a non-invasive continuous arterial pressure waveform. The initial value of the pulse wave arrival time, the time value of the optical blood volume pulse wave rise, the immediate heart rate reference value, and the hand ^ 卩卩法电子电子获得获得获得获得Diastolic blood pressure, diastolic blood pressure, systolic blood pressure, diastolic blood pressure, diastolic blood pressure waveform, blood pressure waveform conversion function, light 4* valley Accumulate in the field. The pulse wave signal obtained by the ten method is converted into a continuous blood pressure waveform. [Embodiment] The foregoing and other technical contents, features, and advantages of the present invention will be described in detail in the following detailed description of the preferred embodiments of the present invention. The blood pressure waveform measuring system 1 is configured to measure a continuous blood pressure waveform of a subject 3 by a non-long-incidence method. The measuring system 1 includes a first measuring device 11 , a second measuring device 12 , and a first measuring device The star is placed on the 13 and a continuous blood pressure monitor 14. The continuous blood pressure monitor 14 is electrically connected to a storage unit 15, a display unit 16, and a warning unit 17 〇9 1268773

其中，第一量測裝置11用以量取該受測者3之心電圖信號（ECG)301 ;第二量測裝置12用以光學容積描計法 (Photoplethysmograph，簡稱PPG)的原理量取受測者3的指部3 1所感應到的光學脈波信號302 ;第三量測裳置13用以量取受測者3的血壓（Blood pressure)信號303以產生參考用收縮壓與舒張壓；連續血壓監測儀丨4是耦接第一量測裝置 11、第二量測裝置12及第三量測裝置13，該連續血壓監測儀14是用以抽取心電圖信號3〇1之特徵值，並以其定量及調整光學脈波信號3G2(作用容後再述），輸出連續血壓信號 3〇4之波形儲存在儲存單元15中，或可在顯示單元μ上顯示。、本較佳實施例中’第三量測裝置13係以習用量取血壓的，式電子血料取得參考收縮麼與舒張I值，’然而亦可以，其它量取準確血M值之方式取得，不財較佳實施例所提之手腕式為限。弟二量測褒置12中的指套12。，其置於手指”上， 3】\12Q㈣具有之—光發射器⑵發射光信號至手指 :號之光：:哭：由:?偵測器122接收其穿透或散射光谓測器！22之^出發射器同方向或對角方向，至於光而不同，苴旦、、，其皮下組織内的動脈血液容積的變化、出之連績光學脈波信號3 02如圖3所示。配合圖1、4 % - 具有的各步驟：π ’說明本發明連續血麼波形量測方法 10 1268773 步驟S1G.將連續血壓债測儀14開機以開始進行量測功能。 β步驟S20 :設定警示高血壓、低血壓值。本實施例中，是在連續血㈣測儀14中設定警示用血壓值，當連續量測受測者3的連續血壓信號304中有十跳收縮壓高於高血麼值或低血壓低於低血壓值，警示單元17會產生警示聲來提醒受測者注意。步驟S30:建立量測參考值，包括收縮壓、舒張壓、脈波到達時間、心率、光學脈;皮上升時間、脈波大小值。本實施例是在連續血壓偵測儀14中建立測量參考值，連續血壓監測儀14是由第一量測褒置u所量取的心電圖信唬二1 '第二量測裳置i 2所量取的光學脈波信號3 〇 2及第二I測襄置13所獲得的血壓信號3〇3中的參考用血慶值（收縮壓' 舒張壓及平均動脈壓）’為往後連續血壓波形量測建立參考值。率、光學脈步驟S40 :取得連續逐跳脈波到達時間、波上升時間、脈波大小值等生理參數。本實施例是在受測者3身上設置好第一量測裝置H、苐二量測裝置12及第三量測梦詈里、j忒且U，以即時量測受測者3 =括心電，信號3G1、連續逐跳光學脈波信號搬及血壓信號303取得所需的生理參數。步驟S50:利用數學模型求得逐跳收縮壓、舒張壓之值，用以將其逐跳參數及步, η “ ^ ,^ 30取传的翏考值以數學模型求侍逐跳收縮壓與舒張壓之值。 11 ,1268773 步驟S60 :利用參考值心率及光學脈波信號之波形在舒張期的特徵，由已預先建立的轉換函數庫尹提取最佳血塵波形轉換函數。步驟S70 :將光學脈波信號之波形轉換為血壓波形，此轉換後波形與實際血壓波形相近。步驟S80 ··連續血壓波形之收縮壓、舒張壓校正，主要是將轉換後血壓波形高點設為推估收縮壓，低點為推估舒張壓。The first measuring device 11 is configured to measure the electrocardiogram signal (ECG) 301 of the subject 3; the second measuring device 12 is used for measuring the principle of the optical plethysmograph (PPG). The optical pulse signal 302 sensed by the finger 3 1 of the person 3; the third measuring skirt 13 is used to measure the blood pressure (Blood pressure) signal 303 of the subject 3 to generate a reference systolic pressure and a diastolic pressure; The continuous blood pressure monitor 丨4 is coupled to the first measuring device 11, the second measuring device 12 and the third measuring device 13, and the continuous blood pressure monitor 14 is configured to extract the characteristic value of the electrocardiogram signal 3〇1, and The waveform for outputting the continuous blood pressure signal 3〇4 is stored in the storage unit 15 or can be displayed on the display unit μ by quantifying and adjusting the optical pulse wave signal 3G2 (described later). In the preferred embodiment, the third measuring device 13 takes the blood pressure by the amount of blood, and the electronic blood material obtains the reference contraction and the diastolic I value, 'however, other methods can obtain the accurate blood M value. It is not limited to the wrist type mentioned in the preferred embodiment. The second measurement of the finger cuff 12 in the tweezers 12. , it is placed on the finger, 3] \12Q (four) has - the light emitter (2) emits the light signal to the finger: the light of the number:: cry: by: the detector 122 receives its penetration or scattered light detector! The emitters of the 22 are in the same direction or in the diagonal direction. As for the light, the change of the arterial blood volume in the subcutaneous tissue, and the continuous optical pulse signal 03 are shown in Fig. 3. With the steps of Fig. 1, 4% - having π ' illustrating the continuous blood waveform measurement method of the present invention 10 1268773 Step S1G. Turn on the continuous blood pressure debt detector 14 to start the measurement function. β Step S20: Setting the warning In the present embodiment, the warning blood pressure value is set in the continuous blood (four) measuring instrument 14, and when the continuous blood pressure signal 304 of the subject 3 is continuously measured, there is a ten-hop systolic blood pressure higher than the high blood. If the value or hypotension is lower than the hypotensive value, the warning unit 17 will generate a warning sound to alert the subject. Step S30: Establish the measurement reference value, including systolic blood pressure, diastolic blood pressure, pulse wave arrival time, heart rate, optical pulse ; skin rise time, pulse wave size value. This embodiment is The measurement reference value is established in the continuous blood pressure monitor 14, and the continuous blood pressure monitor 14 is the optical pulse measured by the first measurement device u, which is measured by the electrocardiogram signal 2' The reference blood value (systolic pressure 'diastolic blood pressure and mean arterial pressure) in the blood pressure signal 3〇3 obtained by the wave signal 3 〇 2 and the second I measuring device 13 is used as a reference for measuring the continuous blood pressure waveform in the future. Value, optical pulse step S40: obtaining physiological parameters such as continuous hop-by-hop pulse arrival time, wave rise time, pulse wave size value, etc. In this embodiment, the first measurement device H, 苐 is set on the subject 3 The second measuring device 12 and the third measuring nightmare, j忒 and U, to measure the subject 3 = include ECG, signal 3G1, continuous hop-by-hop optical pulse signal and blood pressure signal 303 Step S50: Using the mathematical model to obtain the value of hop-by-hop systolic pressure and diastolic pressure for hop-by-hop parameters and steps, η " ^ , ^ 30 to pass the reference value to the mathematical model The value of systolic and diastolic blood pressure. 11 , 1268773 Step S60 : Using the characteristics of the reference heart rate and the waveform of the optical pulse signal in the diastolic phase, the optimal blood dust waveform conversion function is extracted by the pre-established conversion function library Yin. Step S70: Converting the waveform of the optical pulse wave signal into a blood pressure waveform, and the converted waveform is similar to the actual blood pressure waveform. Step S80 · The systolic blood pressure and diastolic blood pressure correction of the continuous blood pressure waveform are mainly to set the high point of the blood pressure waveform after the conversion to the estimated systolic pressure, and the low point to estimate the systolic pressure.

步驟S90 :將連續血壓信號304之波形儲存在儲存單元 15中及在顯示單元1 6上作顯示。步驟S 100 ·偵測連續血壓值是否連續十跳高於高血壓設定值或低於低血壓設定值？若是，則由sn〇產生警示於警示單元17。本實施例中，是設定若有連續十次均小於參考值20毫秒，或有連續十次均大於參考值2〇毫秒，本系統會回步驟S30重新設定新的收縮壓、舒張壓及本系統其他參考值。Step S90: The waveform of the continuous blood pressure signal 304 is stored in the storage unit 15 and displayed on the display unit 16. Step S100 · Is the continuous blood pressure value detected for ten consecutive hops higher than the high blood pressure set value or lower than the low blood pressure set value? If so, an alert is generated by the warning unit 17 by sn〇. In this embodiment, if the setting is less than the reference value of 20 milliseconds for ten consecutive times, or that the continuous ten times are greater than the reference value of 2 milliseconds, the system will return to step S30 to reset the new systolic pressure, diastolic pressure and the system. Other reference values.

凋胍波到達時間亢字脈汲波形特徵，是否需再次校正參考值？這是因為遇有量測波形為異常的情況需加以校正。本實施例中，是❹^光學脈波信號逐跳脈波振幅大小，若有連續人次均小於參考值Q 8 #，或有連、’只人均大於芩考值1 ·2倍時，本系統會回步驟S30重新設定新的收縮壓、舒張壓及本系統其他參考值。认步驟S120 :詢問是否終止連續血壓波形量測，若是，則到ν驟S 140結束s測；若不是，則到步驟㈣繼續連續 12 1268773 血壓波形量測。必須說明的是，在正式量取連續血壓波形之前，步驟 S30是建立量測參考值，連續血壓監測儀14由第一量測裝置11量取的心電圖信號301及第二量測裝置12量取的光學脈波h號3 02，取得連續十次逐跳脈波到達時間、心率波波形上升時間平均值，之後以第三量測I 13㈣收縮^ 、舒張壓及平均罐。等待一小段時間手指動脈血管充Withering wave arrival time 亢 word pulse waveform characteristics, do you need to correct the reference value again? This is because the situation where the measured waveform is abnormal needs to be corrected. In this embodiment, the amplitude of the pulse wave amplitude of the optical pulse wave signal is ,^, and if the continuous person is less than the reference value Q 8 #, or there is a connection, 'only the average person is greater than the reference value of 1 · 2 times, the system Go back to step S30 to reset the new systolic pressure, diastolic pressure and other reference values of the system. Step S120: Query whether to terminate the continuous blood pressure waveform measurement, and if so, then end the s measurement by step S140; if not, proceed to step (4) to continue the blood pressure waveform measurement for 12 1268773. It should be noted that, before the continuous blood pressure waveform is formally measured, step S30 is to establish a measurement reference value, and the continuous blood pressure monitor 14 measures the electrocardiogram signal 301 and the second measurement device 12 measured by the first measuring device 11. The optical pulse wave h No. 3 02 obtains the arrival time of the hop-by-hop pulse wave and the average value of the rise time of the heart rate wave waveform, and then measures the I 13 (four) contraction ^, the diastolic pressure and the average can. Waiting for a short period of time, finger artery vascular filling

盈之時再重複t測連續三次，並以此三次平均值為下述連續血壓量測之參考值，建立測量參考值後電子血壓計a只在再作校正時使用。配合圖1、5〜8所示’將本發明之連續血麼波形量測方法的原理作一說明，其中，目5說明所取得的心電圖作號 3〇卜光學脈波（PPG)信號3〇2，可計算出脈波到達時間^ ’圖6說明光學脈波信號的上升時間tb，圖7說明心電圖信號3〇1的逐跳心跳間期⑽），以及圖8言兒明光學脈波信號302之振幅。兹將逐跳收縮壓與舒張壓求得之數學模型說明如下：育先，必須進行逐跳收縮壓匕及舒張壓^之推估。因為光子脈波m形與血壓信號波形相近，而血壓信號的波動又與血液容積之變動相關，因此由Bramwdi _腿的血壓模型可知： 2 ΔΡ-F 、 c hp [式 l] 八中C疋脈波傳導速度（Pulse Wave Velocity，簡稱 PWV)，△ p是脈壓佶值’ P疋血液密度，ΔΚ是動脈血液容 13 1268773 積，即舒張壓末期動脈積的k動值，厂為沒有脈動的動脈容容積。 —般而言’脈波傳導速度，之定義和脈波傳，改得v距離ζ 夂得V%間：τ之比值如[式2]所示·· [式2]Repeat the t test three times in succession, and use the three averages as the reference value of the following continuous blood pressure measurement. After establishing the measurement reference value, the electronic sphygmomanometer a is used only for correction. The principle of the continuous blood wave measurement method of the present invention will be described with reference to Figs. 1, 5 to 8, wherein the objective 5 indicates that the obtained electrocardiogram is 3 光学 optical pulse wave (PPG) signal 3〇 2, can calculate the pulse arrival time ^ 'Figure 6 illustrates the rise time tb of the optical pulse signal, Figure 7 illustrates the hop-by-hop heartbeat interval (10) of the ECG signal 3〇1, and Figure 8 shows the optical pulse signal The amplitude of 302. The mathematical model obtained by hopping systolic pressure and diastolic blood pressure is described as follows: In the first stage, it is necessary to carry out the estimation of systolic systolic pressure and diastolic pressure. Because the m-shaped photon pulse waveform is similar to the blood pressure signal waveform, and the fluctuation of the blood pressure signal is related to the change of the blood volume, the blood pressure model of the Bramwdi _ leg can be known: 2 ΔΡ-F, c hp [Formula l] Eight C 疋Pulse Wave Velocity (PWV), △ p is the pulse pressure 佶 value ' P 疋 blood density, Δ Κ is the arterial blood volume 13 1268773 product, that is, the k-movement value of arterial product at the end of diastolic blood pressure, the factory has no pulsation Arterial volume. - Generally speaking, the definition of pulse wave velocity, and the pulse wave transmission, the v distance is changed, and the V% is obtained: the ratio of τ is as shown in [Formula 2].

内直ΐ此1是血f的彈性係數，a是管壁厚度4是血管媒」合上峨1]及[式2] ’且假設建立參考值期間，又侍麥考脈波到達時間厂’參考脈壓積的轡翻祐λτ, ^ r于扣動脈血液容、：編,.，及手指動脈舒張…血液容貝1J如[式3]所示：沮，· P &vr/vr [式3]The inner diameter is 1 is the elastic coefficient of blood f, a is the wall thickness 4 is the vascular medium "closes 峨 1] and [form 2] ' and assumes that during the establishment of the reference value, the maimai pulse arrival time factory' Reference pulse pressure product 辔佑 λτ, ^ r in the buckle artery blood volume,: edit,., and finger artery relaxation... Blood Rongbei 1J as shown in [Formula 3]: Ju, P & vr/vr [ Equation 3]

840 ^ 302 達間為A ’逐跳M值λρ2，逐職波容積變純心及逐跳手指動脈舒張壓末期血液容積值G，則840 ^ 302 is the A 逐 hop-by-hop M value λρ2, the volume of the voluntarily wave volume and the blood volume value G of the systolic finger artery at the end of the diastolic pressure.

p av2/v2 T2^Tr+ ATp av2/v2 T2^Tr+ AT

[式4] 取[式3]與[式4]比值， AP = ΑΡ (^Ϋ Γ T2 AVr/Vr [式 5] 由於心電圖R波到光學脈波信號之波形開始上升點盘收縮壓有線性關係’且光學脈波信號之波形開始上升點到光學脈波信號之波形頂點所代表的時間與有關，則： 14 1268773 [式6] L為參考用光學脈波信號之波形上升時間，A為逐跳光學脈波信號之波形上升時間。因此，推估逐跳收縮壓&可表示如下: 广 [式 7][Formula 4] Take the ratio of [Formula 3] and [Formula 4], AP = ΑΡ (^Ϋ Γ T2 AVr/Vr [Formula 5] Since the waveform of the R wave to the optical pulse wave of the electrocardiogram starts to rise, the disk systolic pressure is linear. The relationship 'and the waveform of the optical pulse signal begins to rise to the time represented by the waveform apex of the optical pulse signal. Then: 14 1268773 [Equation 6] L is the waveform rise time of the reference optical pulse signal, A is The waveform rise time of the hop-by-hop optical pulse signal. Therefore, the estimated hop-by-hop systolic pressure & can be expressed as follows: 广[式7]

表示逐跳的收縮壓可用建立參考血壓程序S30得到之收縮壓ABPr、脈壓#、脈波到達時間7；及PPG脈波上升時間來表示。在影響舒張壓波動的最主要的因素是心率及收縮壓推估逐跳舒張壓/^可表示如下： [式8]The systolic pressure indicating hop-by-hop can be expressed by establishing the systolic pressure ABPr, pulse pressure #, pulse wave arrival time 7 obtained by the reference blood pressure program S30, and the PPG pulse wave rise time. The most important factors influencing the fluctuation of diastolic blood pressure are heart rate and systolic blood pressure. The gradual diastolic blood pressure/^ can be expressed as follows: [Equation 8]

Pd，DBP，. + PP乂爷· K'— PPr · & Γ,+2ΔΓ TA RRr 此前項式子可視為舒張壓受收縮壓波動的影響，而後項式子則是舒張壓受心率波動而改變的分量。&，尤2為常數，灿是參考用心跳間期，由步驟S30獲得，肋(1)是逐跳心跳間期。Pd, DBP,. + PP Grandpa · K'-PPr · & Γ, +2ΔΓ TA RRr The previous formula can be regarded as the effect of systolic blood pressure fluctuation, while the latter formula is the diastolic pressure due to heart rate fluctuation. The component of change. &, especially 2 is a constant, can be used as a reference heartbeat interval, obtained by step S30, and rib (1) is a hop-by-hop heartbeat interval.

〜g a & 一％腦可讀取之儲存單it 15，其中儲存有供—血壓監測儀14執行將受測者3之脈波轉換為連續血壓信號之執行程式，該執行程式預先以-血壓信號之參數輸人以料參考，當該程式讀取該脈波之參數代入上述血壓預測式’可得出對應之血二言號且將該血壓加以轉換’藉此將該受測者之脈波參數轉換為連續血壓信號，該執行程式伤於一丁柱式係於期内判斷該脈波之大二及極小值’並將其設定為一第一準位及—第位，接著將第一準位及第二準位分別由 LA /j之推估收縮壓及[ 15 1268773 式8]之推估舒張壓取代，便可將所擷取之脈波轉換為連續血壓波形。、一轉換函數庫的建立，是利用自回歸（ARX)模型，針對不同“率，遠用具代表性的光學脈波信號之波形及已知特定口^位血愿波形（如橈動脈或㈣脈），選用適當階數及模型參數建立其轉換函數。爾後，轉換函數庫選用，以心率及 :學脈波信號之波形舒張期特徵判別。由於本步驟為事先兀成’已建立轉換函數庫，故本系統及裝置無須獲知實際魘波形而利用此轉換函數庫可重建血壓波形。在量測過程中，為了移動中值法加以消除達時間6及脈波上升時間值來代表。降低手動產生干擾雜訊影響，採用，本實施例中，是將所量測脈波到 ’均採用三個連續量測值為中間 /知納上述’本發明之連續血壓波形量測方法及其量測系、，先’可適用於-般需長時間監控受測者的血壓波形，而使用光學式量取指部脈波’是屬於非侵人式量測，可使受測者車父為舒適’以及分析所獲得連續血壓波形將有利於瞭解受測者心血管健康狀況。处、惟以上所述者，僅為本發明之較佳實施例而已，當不施以此限定本發明督姑；夕^岡 — 乃貝軛之乾圍’即大凡依本發明申請專利範圍及發明說明書内容所作飼 1谷所作之間早的等效變化與修飾，皆應仍屬本發明專利涵蓋之範圍用。【圖式簡單說明】圖1疋-不意圖，說明本發明之連續血壓波形量測系 16 1268773 統；圖2是一示意圖，說明以光學容積描計法原理製成之第二量測裝置及其指套；圖3是一光學容積描計波形圖，說明連續光學脈波信號近似於血壓信號之波形；圖4是一流程圖，說明本發明連續血壓波形量測系統之量測步驟；圖5是一波形圖，說明心電圖信號R波到光學脈波信號之跟部的時間差為脈波脈波到達時間；圖6是一波形圖，說明光學脈波信號於心室收縮期上升時間；及圖7是一波形圖，說明心電圖信號的逐跳心跳間期； J、〇圖8是一波形圖，說明光學脈波信號的振幅大, 17 1268773 【主要元件符號說明】 1 量測系統 16 顯示單元 11 第一量測裝置 17 警示單元 12 第二量測裝置 3 受測者 120 指套 31 指部 121 光發射器 301 心電圖信號 122 光偵測器 302 光學脈波信號 13 第三量測裝置 303 血壓信號 14 血壓監測儀 304 連續血壓信號 15 儲存單元 S10- -S140步驟 18~ ga & a % brain readable storage list it 15, wherein the stored blood pressure monitor 14 performs an execution program for converting the pulse of the subject 3 into a continuous blood pressure signal, and the execution program is preceded by - blood pressure The parameter of the signal is input for reference. When the program reads the parameter of the pulse wave and substitutes the blood pressure prediction formula to obtain the corresponding blood two-word number and converts the blood pressure, thereby taking the pulse of the subject The wave parameter is converted into a continuous blood pressure signal, and the execution program is injured in a single column type to determine the sophomore and minimum values of the pulse wave during the period and set it as a first level and a - position, and then The level and the second level are replaced by the estimated systolic pressure of LA /j and the estimated diastolic pressure of [ 15 1268773 8], respectively, and the pulsed wave can be converted into a continuous blood pressure waveform. The establishment of a conversion function library is to use the autoregressive (ARX) model for different "rates, the waveforms of the representative optical pulse signals and the known specific blood waveforms (such as the radial artery or (four) pulse). ), select the appropriate order and model parameters to establish its conversion function. Then, the conversion function library is selected, and the heart rate and the waveform diastolic characteristics of the pulse signal are discriminated. Since this step is to form the conversion function library in advance, Therefore, the system and the device can reconstruct the blood pressure waveform by using the conversion function library without knowing the actual 魇 waveform. In the measurement process, the moving median method is used to eliminate the time 6 and the pulse rise time value to represent. The influence of the noise, in the present embodiment, is to measure the pulse wave to the 'continuous blood pressure waveform measurement method and the measurement system thereof using the three continuous measurement values. First, it can be applied to - generally need to monitor the blood pressure waveform of the subject for a long time, and the use of optical measurement of the finger pulse wave is a non-invasive measurement, which can make the subject's father Optimum and analysis of the obtained continuous blood pressure waveform will be beneficial to understand the cardiovascular health of the subject. The above, but only the preferred embodiment of the present invention, is not limited to the present invention.夕^冈—The dry yoke of the yoke yoke, that is, the early equivalent change and modification between the yue and the grain of the invention according to the scope of the invention and the contents of the invention should still be covered by the patent of the present invention. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1A is a schematic view showing a continuous blood pressure waveform measuring system of the present invention; FIG. 2 is a schematic view showing a second measuring device manufactured by the principle of optical volumetric method. Figure 3 is an optical plethysmogram waveform illustrating the continuous optical pulse wave signal approximating the waveform of the blood pressure signal; Figure 4 is a flow chart illustrating the measurement steps of the continuous blood pressure waveform measurement system of the present invention; Figure 5 is a waveform diagram showing the time difference between the R wave of the electrocardiogram signal and the heel of the optical pulse signal as the pulse wave arrival time; Figure 6 is a waveform diagram illustrating the optical pulse signal at the ventricular systole Rise time; and Figure 7 is a waveform diagram illustrating the hop-by-hop heartbeat interval of the electrocardiogram signal; J, 〇 Figure 8 is a waveform diagram illustrating the large amplitude of the optical pulse signal, 17 1268773 [Description of main component symbols] 1 Measuring system 16 Display unit 11 First measuring device 17 Warning unit 12 Second measuring device 3 Subject 120 Finger sleeve 31 Finger 121 Light emitter 301 ECG signal 122 Light detector 302 Optical pulse signal 13 Third Measuring device 303 blood pressure signal 14 blood pressure monitor 304 continuous blood pressure signal 15 storage unit S10--S140 step 18

Claims

1268773 • 十、申請專利範圍： 1 · 一種連續血壓波形量測方法，包含下述步驟： • (A)擷取一受測者之心電信號； (B )以光學方式掘取該雙測者指部之脈波信號； (C) 抽取該心電信號及該脈波信號之複數特徵值； (D) 利用该專特徵值建立一轉換函數； (E) 以該轉換函數校準該脈波信號；及 ' (F)輸出連續血壓信號之波形。 2.依據申請專利範圍帛"員所述之連續血塵波形量測方法八中在步驟A)鈾，更具有一預處理步驟1)，該預 •處理步驟係量取該受測者血壓信號之收縮壓與舒張壓作為該脈波信號之定量標準。 :3·依據中請專利範圍第}項所述之連續血麗波形量測方法 ' #中’纟冑B)中’力該脈波信號之擷取方式係以光學容積描計法（PPG)為之。 φ 依據申°月專利範圍帛1工員戶斤述之連續血壓波形量測方法中ν •驟C)中，於该心電圖信號所抽取之特徵值係其逐跳與該脈波信號相對之脈波到達時間。 5.依據中請專利範圍第1項所述之連續血壓波形量測方法 ’其中’步驟Ε)之校準方式係以預先建立之-轉換函數庫將每-周期之脈波信號轉換為對應之血麼信號。 6· —種連續血壓波形量測系統，包含·· 二：：量測裝置’用以量取該受測者之心電圖信號第里測#置，以光學方式量取該受測者之指部 19 1268773 °亥執行程式預先以一血壓信號之參數輸入以作為參考，田為執行程式讀取該脈波之參數代入一血壓預測式，可出對應之血壓信號且將該血壓加以轉換，藉此將該受測者之脈波參數轉換為連續血壓信號。 14·依據申請專利範圍第13項所述之儲存單元，該執行程式所預先建立之該血壓預測式係用以預測收縮壓，該血壓預測式可表示為：1268773 • X. Patent application scope: 1 · A continuous blood pressure waveform measurement method, including the following steps: • (A) extracting the ECG signal of a subject; (B) optically excavating the dual tester (C) extracting the ECG signal and the complex eigenvalue of the pulse signal; (D) using the special feature value to establish a transfer function; (E) calibrating the pulse signal with the transfer function ; and ' (F) output the waveform of the continuous blood pressure signal. 2. According to the scope of the patent application 帛 " continuous blood dust waveform measurement method described in the eighth step in the step A) uranium, there is a pretreatment step 1), the pre-treatment step is to measure the blood pressure of the subject The systolic and diastolic pressures of the signal are used as the quantitative criteria for the pulse signal. :3. According to the method of measuring the continuous bloody waveform described in the scope of the patent scope, '#中'纟胄B), the method of extracting the pulse signal is based on optical volumetric method (PPG). For it. φ According to the continuous blood pressure waveform measurement method of the employee's continuous blood pressure waveform measurement method, the characteristic value extracted from the electrocardiogram signal is the pulse wave which is hop-by-hop and the pulse wave signal. Time of arrival. 5. According to the method of measuring the continuous blood pressure waveform described in the first paragraph of the patent scope, the calibration method of the 'step Ε) is to convert the pulse signal of each cycle to the corresponding blood by using a pre-established-transfer function library. What signal. 6·—A continuous blood pressure waveform measurement system, including: · 2: The measurement device is used to measure the electrocardiogram signal of the subject, and the optical measurement is performed on the finger of the subject. 19 1268773 °H execution program is pre-inputted with a parameter of a blood pressure signal for reference. The field for reading the pulse wave of the program is substituted into a blood pressure prediction formula, and the corresponding blood pressure signal can be output and the blood pressure can be converted. The pulse wave parameter of the subject is converted into a continuous blood pressure signal. 14. According to the storage unit described in claim 13 of the patent application, the blood pressure prediction formula pre-established by the execution method is used for predicting systolic blood pressure, and the blood pressure prediction formula can be expressed as:

=SBPr + pp (_tjl——Zk Tf.^2AT TA=SBPr + pp (_tjl - Zk Tf.^2AT TA

中’ .係該參考用血壓信號之舒張壓，#係該多考用血壓“號之脈壓，係該脈波到達時間差，7；該 :考用光學脈波信號之到達時間，。為參考用光學脈波 ^唬之波形上升時間，心係逐跳光學脈波信號上升時間 15·依據巾請專利範圍第13項所述之儲存單元，該執行程式貝先建立之该血壓預測式係用以預測舒張壓，該血壓預測式可表示為： Tr^2^T YA' r ^ "中，"係該參考用血壓信號之舒張壓，係該 /考用血壓彳§號之脈壓，△『係該脈波到達時間差，Γ，哕 =考用光學脈波信號之到達時間’。為參考用光學脈波信號之波形上升時間，[係逐跳光學脈波信號上升時間，碼係參考用心、跳間期，糊係量測逐跳時之心 ’ Κ ’欠2為常數。 21 1268773 16.依據申請專利範圍第13項所述之儲存單元，其中，該執 ' 行程式於將該脈波信號轉換為對應之血壓波形，其係以 ‘ 自回歸模型參數運算建立該轉換函數。The '. is the reference to the blood pressure signal of the diastolic pressure, # is the multi-test blood pressure "number of pulse pressure, the pulse wave arrival time difference, 7; this: test the arrival time of the optical pulse signal, for reference The rise time of the waveform of the optical pulse wave is used, and the rise time of the optical pulse wave signal of the hop by hop is 15. According to the storage unit described in the thirteenth patent scope, the blood pressure prediction type established by the execution program is used first. In order to predict the diastolic blood pressure, the blood pressure prediction formula can be expressed as: Tr^2^T YA' r ^ "中," is the diastolic blood pressure of the reference blood pressure signal, which is the pulse pressure of the blood pressure 彳§ , △ "The arrival time difference of the pulse wave, Γ, 哕 = the arrival time of the optical pulse signal is used." is the rise time of the waveform of the reference optical pulse signal, [the hop-by-hop optical pulse signal rise time, the code system Reference heart, jump period, paste measurement hop-by-hop heart ' Κ 'Under 2 is a constant. 21 1268773 16. According to the storage unit described in claim 13 of the scope of the patent, where the The pulse wave signal is converted into a corresponding blood pressure waveform, In 'autoregressive model to establish the operational parameters of the conversion function.

22twenty two