基于DSP技术研制的心血管功能无创检测仪

目的:研制一种心血管功能无创检测仪,通过采集人体指端容积脉搏信号对人体心血管功能进行实时监测,借助DSP强大的运算能力,快速分辨脉搏波的起始点,提取脉搏波波形特征参数并计算血流动力学参数,从而可间接地对人体心血管功能进行评价。方法:采用TI公司DSP2812高性能数字信号处理器,DSP心血管功能检测仪在硬件电路上设计了波幅增益自动调节、电源管理、基线抑制等模块,软件中设计了自动判波、基线拟合功能,可获得高信噪比的脉搏波信号。结果:该仪器可实现增益自动调节、多模式数据存储和远程数据通信等功能,它还具有处理速度快、功能齐全、工作稳定可靠等特点。结论:DSP心血管功能检测仪不仅可应用于医院和科研院所,同时在社区医疗和家庭保健中具有广阔的应用前景。     

指端脉搏波检测与频域分析实验设计

目的 本文介绍了一种人体脉搏信号检测并进行频域分析的实验技术、频域分析的应用。方法 设计了一种无创伤脉搏信号检测器，提取理想的脉搏信号，再利用生理机能实验系统进行频域分析。结果 获得了指端脉搏波的功率谱图。结论 指端脉搏频域分析结果对健康普查、心血管系统疾病的检测有重要的实用参考价值，为科学的诊断提供很好的信息来源。     

基于ZigBee的无线传输脉搏检测系统设计

目的：设计了一种基于ZigBee技术的无线传输脉搏检测系统。方法：由CC2430控制单元将脉搏传感器采集到的人体浅表动脉处的搏动信号通过模拟电路的预处理,经数模转换后得到数字信号,再将转换后的数字信号传给控制和显示单元中的信息处理单元．进行处理和显示,同时将数据通过ZigBee无线通讯单元发送到上位机,由上位机存储数据,供医护人员检索和回放。结果：实验表明,此系统能够对人体的脉搏信号进行实时采集,同时可通过ZigBee无线网络进行实时、安全、可靠的通信。结论：该检测系统通过运用ZigBee无线通信技术,可以通过人体随身携带的无线终端采集到脉搏数据．使采集系统具有移动性,因此能广泛适用于健康运动监测、医院移动监测等领域。     

腕部气囊式脉搏波自动采集装置的研制

目的:研制一种可以在测量血压的同时采集脉搏波信号并得到心血管评价参数的医疗电子仪器,对实现心血管功能日常监测具有重要意义。方法:将气压式传感器采集腕部气囊内压力信号转换为电信号,通过信号处理电路将其分为接近直流的气囊压力信号和脉搏波信号,经过并行模拟数字(A/D)转换后,利用单片机控制气泵和气阀的充气、放气通断,以实时判断气囊压力值和脉搏波波幅,从而计算出平均动脉压,采集桡动脉压力信号。结果:基于示波法血压自动测量方式可根据脉搏波波幅与袖套压力的对应关系确定平均动脉压,并计算得到收缩压和舒张压,在平均动脉压对应的袖套压力状态下采集到人体桡动脉压力脉搏波波形。结论:该装置可提供一种在测得人体腕部血压的同时自动无创的采集脉搏波的方法。     

无创心血管功能参数检测仪的研制

该研究基于光电容积脉搏波描记术(PPG)和nRF52832微控制器,设计了一种无创心血管功能参数检测仪,其具有使用方便、实时无创检测、低功耗等特点,实现了PPG信号采集、心血管功能参数计算等功能,不仅可应用于临床,更适用于社区及家庭。现主要介绍该检测仪的整体框架方案、硬件设计、算法软件设计。     

心血管血流参数无损伤检测系统的研究

根据血流动力学原理,本文作者介绍一种微机化的心血管血流参数无损伤自动实时检测系统。该系统采用由脉搏波计算心输出量的独特技术,经过对正常健康人和心血管病人的大量临床试验,证实该系统有良好的性能和临床诊断效果。在临床医学、基础医学、航空医学和健康检查等许多方面都具有广阔的应用前景。     

具备血流参数检测功能的电子血压计的设计研究

目的:设计一种具有血流参数检测功能的电子血压计,不但可以测量人体的收缩压与舒张压,还可计算出人体的各项心血管血流参数。方法:将连接在气体压力传感器上的袖套裹于手腕处,对袖套充气加压,当袖套内的压力比收缩压高30mmHg时匀速放气,并利用示波法计算平均动脉压、收缩压和舒张压;再次给袖套充气至袖套内的压力为平均动脉压,保持压力不变,记录30s的脉搏波信号,通过脉搏波信号和测量出的血压值,计算人体的各项血流参数。结果:具备血流参数检测功能的电子血压计可以较为准确地测量出血压值,并可计算出人体外周血管阻力、心脏指数及心输出量等各项血流参数值。结论:利用具备血流参数检测功能的电子血压计在测量血压的过程中,同时也测量出人体的血流参数值,为疾病诊断提供更为可靠的依据,增添了电子血压计的功能,扩大了电子血压计的应用范围。     

金膜电极微分阳极溶出伏安法测定人发中的铜

铜是人体独特的催化剂,人体中的铜含量与贫血、心血管功能及智能相关。美国密执安大学用头发普查检验智力,发现学习好的青年头发中铜锌含量高。患唐氏综合症(先天愚性)妇女的发铜含量低。孕妇发铜含量与新生婴儿的体重有关。可见人体内的铜含量与人体健康有密切关系。     

一种脉搏波处理系统

本文介绍一种用于心血管功能检测的脉搏波处理系统。该系统是以微型计算机为主,由脉搏传感器,程控放大器和多功能数据采集器组成。本文重点介绍脉搏传感器和脉搏波特征点的自动识别方法。     

具有无线传输功能的血流参数自动检测装置的设计

目的：设计一款基于指端容积脉搏波的血流参数自动检测装置。方法：利用反射式光电传感器获得人体指端容积脉搏波,采用C8051F020单片机对脉搏波进行自动分析、处理与计算,将得到的各项血流参数通过TC35i型GSM模块远程传输给医生。结果：设计的血流参数检测装置能够实现指端容积脉搏波的采集与计算,并可顺利地通过GSM网络接收与发送短消息。结论：该装置使得血流参数检测变得简单、方便,利用GSM网络的无线传输功能,使检测不受地理位置的限制,特别适用于家庭医疗保健。     

The joint impact of cardiovascular risk factors upon medical costs

OBJECTIVE: The joint impact of obesity, hypertension, and hyperglycemia upon medical costs is not well known. Our objective was to evaluate the joint impact of these cardiovascular risk factors upon medical costs in the rural Japanese population. METHODS: The data were derived from a 6-year prospective observation of National Health Insurance beneficiaries in rural Japan. Data on blood chemistry tests, blood pressure, weight, and height were obtained from an annual health check-up provided by the local municipalities in 1995. We prospectively collected data on medical costs over a 6-year period for 12,340 subjects (5306 men and 7034 women) without prior histories of cardiovascular disease or cancer. RESULTS: Mean medical costs for individuals being overweight/obese, hypertensive, and hyperglycemic were 91.0% higher than those for individuals without any of these three cardiovascular risk factors. In this cohort, 17.2% of total medical costs were attributable to these three risk factors. CONCLUSION: Overweight/obesity, hypertension, and hyperglycemia could have a large impact on health care resources in rural Japan.     

A community-oriented primary care project in a rural population: reducing cardiovascular risk

A controlled community-oriented primary care (COPC) program designed to reduce cardiovascular risk was conducted in two towns in a poor, rural area of New York State that have populations with high levels of cardiovascular mortality. In both towns, house-to-house visits were used to screen for blood pressure, gather information about cardiovascular risk knowledge and behavior, and provide a cardiovascular educational program. Persons with elevated blood pressure were advised to seek follow-up. Additional interventions, carried out in the study town only, included ongoing follow-up for those with elevated blood pressure and their providers, and sliding-fee medical services for those with financial barriers to care. At rescreening 2 years later, residents of the study population had an adjusted systolic blood pressure 3.1 mm Hg lower than those in the control population (95% confidence interval [CI] = 0.9, 5.3). Furthermore, those who were screened at both rounds had an adjusted systolic blood pressure 2.7 mm Hg lower than those who had not previously been screened (95% CI = 0.6, 4.8). Although knowledge of cardiovascular risk factors increased among those who were surveyed in both rounds, there was little demonstrable effect on cardiovascular risk behaviors. Difficulties were encountered in engaging the participation of all medical providers, and less use was made of the sliding-scale program than expected. While it appears feasible to implement the technical methodology of a COPC model in a rural setting, it is crucial to engage the support of the local and medical community.     

What is the most effective approach to the reduction of cardiovascular risk in type-2 diabetes mellitus?

It is well known that the target blood glucose values are not fulfilled in treatment of patients with type 2 diabetes mellitus. (UKPDS) The high mortality rate in type 2 diabetes mellitus is associated with the augmented cardiovascular risk. It is well documented, that the beneficial influence of high blood pressure, dyslipidaemia, and hypercoagulation compared to hyperglycaemia, is a more powerful approach in reduction of cardiovascular risk in type 2 diabetes mellitus. The effect of medical interventions on alteration of cardiovascular risk and glucose homeostasis is not always concordant: beta-blockers automatically reduce cardiovascular risk, but may result in deterioration of blood glucose values, sulfanylurea drugs effectively reduce hyperglycaemia, but could paradoxically increase the cardiovascular risk. The acarbose, metformin, thiazolidindione, fibric acid treatment improves the profile of vascular risk factors, additionally could have a beneficial metabolic effect resulting in reducing cardiovascular risk in patients with type 2 diabetes mellitus. In conclusion: the cardiovascular risk in type 2 diabetes mellitus can be most effectively influenced by reduction of high blood pressure, dyslipidaemia, and dysfunction of haemostasis. The improvement of glucose homeostasis is, novel medical interventions seem to be important tools in reducing cardiovascular risk in patients with type 2 diabetes mellitus.     

医学期刊应用文献计量学方法辅助选题策划模式初探

【目的】 将知识图谱软件CiteSpace和质性研究的方法应用到医学期刊选题策划实践中,初步构建一种文献计量学分析辅助选题策划的模式。【方法】 采用CiteSpace软件对国内与国际心血管病专业影响因子排名前3的6种医学期刊进行关键词共现分析与聚类分析,挖掘国内期刊在重点、热点选题方面与国际期刊的差异,作为备用选题。挖掘出的备用选题经CiteSpace初步分析后,邀请专家进行质性研究验证。将基于CiteSpace的文献计量学选题方式与专家选题方式相结合,构建一种双线并行的选题策划模式。【结果】 以挖掘出的备用选题“心血管疾病预防”为例,CiteSpace初步分析显示,国内期刊中该选题发文较少,且多数为指南或指南解读,研究论文和综述偏少,可以采用约稿与公开征稿相结合的方式进行组稿。进一步的质性研究中,专家均对该选题的价值给予认可,并明确了具体的主题方向,包括心血管疾病预防的现状、流行趋势、风险评估以及血压、血糖控制等。【结论】 CiteSpace分析和质性研究可以作为辅助方式,构建专家选题与文献计量学分析选题相结合的选题策划模式,为大数据时代医学期刊的高质量发展提供多元化途径。     

Effect of cardiovascular risk factors on individual and population medical expenditures: a 10-year cohort study of 4,535 National Health Insurance beneficiaries in Shiga

A 10-year follow-up cohort study of 4,535 National Health Insurance beneficiaries aged 40 to 69 years in Shiga was performed as part of a research project conducted by the Health Promotion Research Committee of the Shiga National Health Insurance Organizations in 2002. The relationship between cardiovascular risk factors and medical expenditures during the 10-year study period has been examined in this cohort. For example, there was a positively graded correlation between blood pressure and individual total medical expenditures per month. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensives were also higher than those in normotensives. However, from the viewpoint of the entire population, the excess medical expenditures attributable to hypertension within the total medical expenditures were higher for mild-to-moderate hypertensives than for severe hypertensives. On the other hand, although individual medical expenditures per month were 1.7-fold higher for participants with 2 or 3 risk factors and obesity, which was broadly equivalent to metabolic syndrome, than for those without these factors, the excess medical expenditures determined by risk clustering within the total medical expenditures were higher in normal-weight people than in obese people because of the higher prevalence of normal weight. These findings suggest that high-risk individuals are a good target of a high-risk approach, such as intensive health guidance, from the viewpoint of medical expenditures. However, another approach for the majority with a low-to-moderate cardiovascular risk should be considered, because they account for a greater proportion of the excess medical expenditures. Another way to solve this problem may be a population approach with an effective method of providing information to citizens.     

心血管疾病危险因素和相关行为模式的社区医疗调查及干预的探讨

目的对老年人群的心血管疾病危险因素及心血管疾病相关行为模式进行社区医疗调查,为进行有效社区医疗干预提供科学基础。方法抽血检测112名52～80岁无心血管疾病史的社区医疗对象的血清中甘油三酯、总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇(HDL-C及LDL-C);测量其体重、身高、腰围、血压;并采用体脂测量仪测量其身体脂肪含量,从社区医疗记录获得糖尿病史,用调查问卷了解其饮食习惯和相关行为模式。用Excel整理资料,应用SPSS11.5软件统计分析。结果老年人对心血管疾病知识有待提高(对高血压相关知识知晓率为50%左右;对糖尿病和高血脂有关知识知晓率为17%和16.1%)普遍存在在不良生活习惯(超重口味偏咸多肉少蔬果的老人有50%左右;吸烟或被动吸烟占43.8%)。结论就医意识不足、体重超重、高血压、脉压增大和糖尿病等是老年人心血管发病的危险因素。有必要针对心血管发病危险因素及心血管疾病相关行为模式,进行健康教育,提倡良好膳食习惯,增加运动等综合社区医疗干预措施。     

Cardiovascular risk factors. II. Signs of vascular damage: practical implications

In recent years, an increasing amount of information has become available on new indicators of cardiovascular damage, their determinants and the value of these indicators in the prediction of the development of cardiovascular disease. These indicators include carotid intima-media thickness, ECG characteristics, endothelial function and the measurement of coronary calcium. These indicators are currently used predominantly in cardiovascular disease research. At present, only limited information is available as to whether these indicators are useful in clinical practice for estimating the absolute risk of cardiovascular disease in an individual. The relative value of these newer indicators compared to the routinely collected risk factor information such as medical history, lifestyle, anthropometric variables, blood pressure and lipids is also not yet well established. The recent Dutch guidelines for the initiation of treatment with blood pressure lowering and lipid lowering drugs as a function of the absolute risk of cardiovascular disease within 10 years for the individual patient point toward the urgent necessity for research in the area of new risk indicators of vascular damage.     

Progestogen-only pills and high blood pressure: is there an association? A literature review

The progestogen-only pill (POP) is a contraceptive option for women who have high blood pressure either induced by use of combined oral pills or due to other causes; as long as it is well controlled and monitored. Combined oral contraception (COC) and Depo-Provera have been implicated in increased cardiovascular risk following use. High blood pressure has been theorized to be the critical path that leads to this increased risk. POP is the recommended method for women who are at risk of coronary heart disease due to presence of risk factors like hypertension. In order to offer POP as a safe, alternative contraception to women who develop hypertension on COCs or those who are at increased cardiovascular risk, it is important to take into account evidence of no association of high blood pressure with POP use. A search of published medical literature (PUBMED and Cochrane database) was undertaken with this objective. A total of four articles were selected for final review after application of inclusion and exclusion criteria. Three of these were prospective control trials and one a cross-sectional survey. There was no randomized study to answer this question. The results of these studies consistently reported no significant association of high blood pressure with use of POPs for up to 2-3 years of follow-up.     

Personal variables and their effects on physiologic stress reactions

In 24 male medical students hormonal, cardiovascular and state of mood data were collected on the day of an oral examination as compared to a control day. Analyses included 24-hour-noradrenaline-, adrenaline- and cortisol-excretion, blood levels of free testosterone, heart rate and blood pressure readings and state of mood ratings (Nitsch). Furthermore subdimensions of the type A construct, as included in the need-for-control questionnaire (Siegrist), were determined. Four subgroups were established according to total amount and stress reactivity of noradrenaline (NA) excretion. Further analysis showed that this line of separation held for the remaining hormones as well, thus revealing rather homogenous group- inherent hormonal patterns. However, in both groups with low hormonal stress reactivity cardiovascular reactivity was higher than in the groups with a pronounced hormonal stress response. Blood pressure rose highest and recovered slowest in the group, who had the highest NA and cortisol excretion on control day and highest allover cortisol excretion. This group rated high in the Siegrist subdimension "task-involvement" (inability to withdraw), the difference to the remaining groups being statistically significant. Neither the amount of hormonal nor that of cardiovascular reactivity were related to the state of mood ratings.     

医务放射工作人员心血管健康异常的影响因素研究

目的 应用Logistic模型分析性别、年龄、工龄、工种以及单位级别等因素对医疗放射工作人员心血管健康状况的影响。了解长期低剂量辐射与放射工作人员心血管健康异常之间关系。方法 收集2013年山东省某市医务放射工作人员共437人的职业健康体检资料中关于心血管检查项目,录入EXCEL表格中,运用SPSS台22.0软件进行logistic回归统计分析。结果 对心血管系统健康影响因素分析结果如下:单因素分析的结果提示影响血压和心率异常的因素有性别、年龄和工龄(P < 0.001),统计回归分析揭示其中的性别、年龄是血压和心率异常的独立影响因素(P < 0.001);经单因素分析,在α=0.05水平上,性别、年龄、工龄、单位级别和工种皆不是心电图异常表现的影响因素。结论 性别和年龄是导致医务放射工作人员心血管健康异常的独立影响因素,而工龄、工种以及单位级别不是其影响因素。本结果提示长期低剂量辐射与放射工作人员心血管健康异常无显著关联性。