用有创血压验证示波法测量血压的准确性

本文用山羊有创血压作对比研究了示波法无创测量血压的准确性.示波法一般通过袖带放气过程中脉搏波包络线顶点来估计平均压,而用幅度系数算法来估计收缩压和舒张压.虽然示波法能提供较为准确的平均压,但是估计收缩压和舒张压却存在较大误差.用5只山羊进行了试验,以研究幅度系数在不同个体之间的变异性.在用示波法测量山羊血压的同时记录山羊的有创血压.根据放气过程中的袖带内脉搏波包络线和用有创法得到的收缩压和舒张压,计算出每只羊的幅度系数.结果显示5只羊的幅度系数呈现出较大的离散性.究其根源在于,幅度系数法采用的系数是用统计方法得到的,它针对群体而不是个体,是一种经验算法.采用幅度系数算法的示波法血压测量技术不够准确,必须寻找一种新的血压测量方法.     

手机血压测量模块的研制

本文介绍手机血压测量模块的研制,通过将人体血压参数测量的重要工具电子血压计与当前普遍流行的手机结合起来,充分利用手机功能,并将极大降低现行血压计的价格.市场调查表明,手机血压计具有极大的市场需求.     

Cuff Pressure Oscillations in the Measurement of Relative Blood Pressure

The continuous relative blood pressure measure obtained with a partially-inflated arm blood-pressure cuff operates under the same principle as the oscillometric method of blood pressure determination. In psychophysiological studies the rise in blood pressure seen, for example, in response to an emotion-evoking question, produces a rise in cuff pressure, along with any of three pulse-amplitude changes: a decrease, no change, or an increase. These seemingly paradoxical responses which accompany an increase in blood pressure may be explained by considering the relationship of cuff pressure to the cuff pressure for maximum oscillations. Experiments were conducted in which cuff pressure and its oscillations were recorded. Indications of an increase in blood pressure, and the pulse-amplitude changes resulting there from, were obtained at different cuff pressures in the same subject. The results confirm the hypothesis that with cuff pressure below the point of maximum oscillation, an increase in blood pressure results in a decrease in pulse amplitude. With a cuff pressure just above the point of maximum oscillations, an increase in blood pressure results in an increase in pulse amplitude.     

振动法血压测量中血压的判定方法

讨论了振动法血压测量中血压的判定方法，并提出了一种基于宽松规一化准则用幽会法判定收缩压和舒张压的新方法，初步实验表明，该方法是可行的。     

利用脉搏波特征参数连续测量血压的方法研究

通过研究血压与脉搏波特征参数的关系，提出了一个选择多个与血压相关的脉搏波特征参数,通过回归分析建立适合不同人的特征方程，进行血压的连续测量的新方法，为了验证测量结果的准确性；研制了张力计。实验结果表明：该方法具有较高的测量精度，可以应用于临床危重病人的血压监护和一般医学研究中，经过进一步地改进和完善后可应用于载人航天和日常动态环境。     

一种袖带测量过程的物理模型及基于这种模型的新型收缩压测量方法的研究

传统的波动法血压无创测量技术由于利用了统计学原理，因此必然造成测量的个体误差。本文对袖带测量的物理过程进行了研究，在首先发明了袖带波动信号无失真提取技术的基础上，提出了一种袖带测量过程的物理模型，并对这一模型进行了证实。另外，根据这一模型提出了一种人体血压的无创测量方法，该方法不像传统方法那样采用统计学原理［１］，从而避免了所有个体采用统一的血压判据而导致的个体测量误差，实际实验表明，该技术的测量准确性要优于传统的波动法测量技术，这对改善医学临床血压无创自动测量技术的现状是有很大意义的     

R波相关振动法血压测量

为了提高振地血压测量的准确性，提出了一咱基于心电Ｒ波与血压振动波之间相关性，识别振动信号的一种抗干扰方法＝－Ｒ波相关法，结合振动波形特征识别，该方法可有效地提取信号，消除干扰影响，该算法已在１６位８０９８单片机上实现，本文同时给出了程序的详细流程图。     

Measurement of Neonatal Blood Pressure: A New Method

Psychophysiological research on the neonatal cardiac system has focused almost exclusively on heart rate. Other cardiovascular parameters such as blood pressure (BP) have been difficult, if not impossible, to examine in the newborn due to the difficulty involved in measurement. This study tested a new, non-invasive device that simultaneously measured systolic, diastolic, and mean arterial BP and heart rate in the newborn. Eighty healthy babies’ BP and heart rate were measured for the first 3 days of life and the findings were compared with previous reports in the literature. BP was found to increase on each of the first 3 days of life while mean heart rate did not change during this period. State of alertness significantly affected BP and heart rate, with sucking leading to the greatest rise in BP, while crying elicited the highest heart rates. The results indicated that this new non-invasive technology provides an important advance that has considerable bearing on future studies of neonatal psychophysiology.     

一种简化的袖带测量模型及在收缩压测量中的应用研究

传统的波动法血压无创测量技术由于利用了统计学原理，因此必须造成测量时的个体误差。作者对袖带测量的物理进行了研究，根据已有的结论，提出了一种袖带测量过程的物理模型，根据这一模型提出了一种人体血压的无创测量方法，该方法不象传统方法那样采用统计学原理，从而避免了所有个体采用统一的血压判据而导致的个体测量误差，实际实验表明，该技术的测量准确性要优于传统的波动法测量技术，这对改善医学临床血压无创自动测量技术     

无创伤测量手指动脉血压初探

本文提出用手指套光电传感器无创伤测量人体手手指动脉收缩压和平均压的方法，设计了仪器的线路，指出了误差产生的原因，在修正了动脉收缩压，平均压和舒张压三者之间关系后，可得到与水银血计比较接近的测量值。这是一种安全，简单，易行，能自动间歇测量的血压计。     

基于脉搏波传导时间的连续血压测量系统

针对现有连续无创血压测量系统采样频率和计算精度较低的问题,我们设计了一套基于STM32F103T4和DSP TMS320C5535芯片的双核血压测量系统。利用STM32和DSP芯片在信号高速采样及高精度运算上的优势,实现了对脉搏波信号的高速采样和计算,改善了连续无创血压测量方法的精度。实验测量30名随机受试者,其医用水银血压计和本系统测量结果的差值均符合美国医疗仪器促进协会(AAMI)标准要求,通过Bland-Altman差值法对两种方法进行一致性检验分析,结果表明两者具有很好的一致性。本研究设计的连续无创血压测量系统可初步在家庭和临床医疗方面进行人体血压的动态跟踪测量。     

基于脉搏波传导时间的连续血压监测系统

为了实现无创连续血压测量,提出了一种基于脉搏波传导时间(pulse transit time,PTT)的连续血压测量方案。通过同步采集心电(electrocardiogram,ECG)信号与光电脉搏波(photoplethysmograph,PPG)信号,以ECG的R波峰值点作为PTT的开始点,PPG信号的最大值点作为PTT的结束点,得到PTT,与水银血压计测得舒张压(diastolic blood pressure,DBP)与收缩压(systolic blood pressure,SBP)进行回归分析,得到了DBP和SBP的数学模型。利用该方法对41名身体健康的青年人进行实验,利用本方案得到的SBP与水银血压计的相关系数为0.82,其差值的平均数与标准偏差为0.15±2.05 mm Hg;得到的DBP与水银血压计的相关系数为0.73,其差值的平均数与标准偏差为0.12±2.16 mm Hg。利用Bland-Altman差值法对本系统血压测量方法与水银血压计测血压方法进行一致性检验,结果显示两种血压测量方法具有很好的一致性。     

一种血压反馈控制系统的状态分析方法

通常在判断血压状态时,先划一个界限,然后将实际血压与这个界限作比较,以此来判断血压状态。这样的判断强调了血压的现值,而没有将血压变化率的信息展现出来。提出血压状态分析法,包括血压状态图和血压稳定性。以家兔为对象、去甲肾上腺素为扰动剂,采集动物在给药前血压平稳期、药物起效期、快速上升期、剧烈振荡期、血压恢复期和给药后血压平稳期的血压数据,建立血压反馈控制系统数学模型结构和血压状态图。根据采集的血压数据,分析血压状态图中血压的稳定态和稳定域、血压变化率的稳定域。通过动物实验,对这种血压状态分析法进行检验,为进一步研究血压控制技术提供新理论和新方法。     

脉搏波波速法无创血压测量中多模量血压计算模型研究

针对脉搏波波速法无创血压测量中血压计算模型建模困难和模型计算精度较低的问题,结合T_PTT、ln(T_PTT)及(1/T_PTT)²等模量建立多模量血压计算模型。首先,利用99名随机测试者的实验数据确定多模量模型参数,并基于实验数据计算各模型性能评价指标,其中多模量血压计算模型拟合相关系数最大,为0.891,误差方差最小,仅为6.1,实验表明,多模量血压计算模型具有更好的拟合效果和更低的计算误差。然后,利用医用水银血压计和自主设计的多模量血压测量系统两种方法采集另外36名随机测试者的收缩压和舒张压数据,并计算两种方法采集数据间的相关参数,其中收缩压差值的绝对值d<6 mmHg,差值均值E_d=0.55 mmHg,差值的标准差δ_d=2.98 mmHg;舒张压差值的绝对值d<6 mmHg,差值均值E_d=0.57 mmHg,差值的标准差δ_d=3.42 mmHg,完全符合美国医疗仪器促进协会SP10-199中对电子血压计测量差值＜8 mmHg的要求。最后,采用Bland-Altman差值法,对两种方法测量数据一致性进行检验,发现舒张压与收缩压的95 %一致性界限分别为(-5.3,6.4)和(7.2,-6.2),完全在临床血压测量可接受范围之内,较好地证明多模量血压计算模型用于无创血压测量的有效性。研究结果表明,多模量血压计算模型可以应用于脉搏波波速法无创血压测量。     

基于光电容积脉搏波描记法的无创连续血压测量

为了摆脱传统血压计充气袖带的束缚、实现长期连续的血压监测,很多学者开展了基于PPG实现无创、连续血压监测的研究。阐述基于光电容积脉搏波描记法(PPG)实现无创、连续血压测量的基本原理。将当前基于PPG无创血压监测的研究分为3类,分别为心电(ECG)与PPG结合的血压测量技术、两路PPG结合的血压测量技术、脉搏波特征参数血压测量技术,分析这3类技术的基本测量原理、测量精度及其优缺点。在此基础上,论述基于PPG实现无创、连续监测血压的发展方向。     

Tracking-Cuff System for Beat-to-Beat Recording of Blood Pressure

A system is described for the automatic beat-to-beat tracking of blood pressure (BP) based on the detection of Korotkoff sounds. Upon each detection, a discrete adjustment in cuff pressure is made prior to the next cardiac cycle. In comparison with other continuous tracking systems, digital control allows for estimation of systolic BP based on precise knowledge of cuff pressure at each heart beat. Simultaneous recordings of intra-arterial pressure (radial artery) and systolic pressure measured with the tracking system were made in 4 subjects during 1-min trials of resting, paced respiration, and mental arithmetic. Correlations of the paired measures of intra-arterial and cuff pressure for 27 trials varied from .46 to .90 (median = .72). The standard error of estimate of intra-arterial systolic BP varied from 1.8 to 6.3 mmHg (median = 3.6). The system can be used without discomfort to track systolic BP for 60 and 120 sec in experiments involving repeated cuff inflations. Critical features and advantages of the tracking-cuff system for blood pressure measurement and biofeedback are discussed.     

高血压病患者血脂、血糖与血压关系的研究

目的:探讨高血压病患者血脂、血糖与血压的相关性。方法:测定482例高血压病患者和100例健康人Cho-C、TG、LDL-C、HDL-C、apoA、apoB、血糖(BS)以及血压(SBP、DBP),并进行统计学分析。结果:高血压组Cho-C、TG、LDL-C、BS明显升高(P<0.05~0.01);Cho-C与BS呈明显正相关(P<0.05);TG与BS、SBP、DBP呈明显正相关(P<0.05~0.01);BS与SBP呈明显正相关(P<0.05)。结论:高血压病患者存在脂代谢及糖代谢异常。TG与血糖水平及血压均呈正相关。     

手臂组织的简化力传递模型及其应用

为了探索一种有理论依据的无创定量测量血压的方法,本文从力学原理出发,提出了一个理想化的手臂活组织力传递模型,以便识别动脉壁内外侧压力平衡的特征信息,用动脉壁外侧压力 测量 脉内压力。通过模型在无创测量动脉血压中的初步应用,从理论和实践两方面探讨了该模型的实用价值。     

Apparatus and Procedure for Training Subjects to Control Their Blood Pressure

The purpose of this study was to devise a set of apparatus and procedures for treating the blood pressure response as a free operant. The system described herein developed out of an effort to combine some features of the Harvard and Rockefeller methods into a compact and inexpensive unit that could be transported easily and eventually adapted for home use. Application of the device requires fitting the subject with a standard cuff on each arm and inflating first one and then the other for intervals of 100 sec. The systolic or diastolic blood pressure threshold is tracked by readjusting cuff pressure every 3–4 heartbeats in order to hold the intensity of the Korotkoff sounds constant. A record of blood pressure is obtained by transducing and tracing moment-to-moment changes in cuff pressure on a strip chart recorder. Scores provided by this method and those obtained with the classical Riva-Rocci procedure were found to be highly correlated.     

Control of Diastolic Blood Pressure in Man by Feedback and Reinforcement

When provided with external feedback of their diastolic blood pressure and incentives to respond appropriately, normal male Ss learned to raise or lower their diastolic pressure in a 35-min training session. The difference between increase and decrease groups at the end of conditioning was 7.0 mm Hg or 10% of baseline. This difference was augmented to 10.4 mm Hg or 15% of baseline during extinction when half the Ss were asked to maintain continuing “voluntary control” even though feedback and incentives were withdrawn. Heart rate was also influenced when diastolic blood pressure was reinforced, although less markedly. Further analysis indicated that when diastolic pressure is reinforced, heart rate is partially reinforced in the same direction, accounting for the coincidental conditioning of the related cardiovascular measure. No consistent changes in respiration or post-session verbal reports were obtained. These results lend support to the possibility of therapeutic application of the techniques in patients with essential hypertension.