基于脉搏波传导时间的血压测量方法

目的:设计一种连续血压测量方法,在无创的条件下能够实时监测受试者的血压。方法:对耳后动脉和趾背动脉的脉搏波进行特征识别,计算两个脉搏波之间的传播时间,并根据受试者的血液密度、血管内径、血管壁厚度等参数计算脉搏波传导速度,然后在传统脉搏波传导时间算法的基础上,增加受试者身高和体重,计算出人体的血压。结果:该算法得到的血压结果与真实值较为接近,并且实时性较好。结论:改进后的基于脉搏波传导时间的血压测量方法可用于血压的实时测量,为临床诊断提供帮助。     

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。     

基于光电容积脉搏波的无袖带血压测量技术研究进展

无袖带血压监测技术由于低生理/心理负荷等特点,在健康监测领域具有广阔的应用前景。其中,基于光电容积脉搏波的无袖带血压测量技术能够获取连续动态的血压参数,有效弥补传统袖带血压测量不便、间断测量等不足。本文对基于光电容积脉搏波的无袖带血压测量技术的研究进展进行综述。首先从传感测量和数据处理方面介绍了光电容积脉搏波信号的获取与分析方法。然后简述了传统的基于脉搏波速度理论进行血压测量的研究,重点分析了该领域的主要研究方向：基于形态学参数的机器学习方法研究以及基于序列学习的深度网络研究。最后对基于光电容积脉搏波的无袖带血压测量技术所面临的挑战及其应对策略进行了深入分析和详细讨论,以期为该领域的相关研究提供参考。     

基于脉搏波传导时间和脉搏波特征参数的连续血压无创检测

本研究为克服在基于脉搏波传导时间(pulse transit time,PTT)方法无创血压检测中个体差异对测量准确性的影响,分析了个体脉搏波特征参数与血压值的相关性,并将个体脉搏波特征参数中与血压值相关度高的参数作为优化脉搏波特征参数加入PTT与血压的校正模型中,以提高模型普适性。基于偏最小二乘法(partial least squares,PLS)对50名志愿者200组PTT和脉搏波特征参数数据进行训练建模,得到舒张压、收缩压的预测模型。再选取5名新志愿者的PPT和脉搏波特征参数进行预测,最大预测误差小于5 mm Hg,满足AAMI国际电子血压计标准。将优化的脉搏波特征参数和PTT引入到连续血压预测模型当中,有助于提高血压预测模型的准确度和普适性,有助于无创连续血压检测的临床应用。     

一种基于射血前期的连续血压估计方法

常规基于脉搏波到达时间的连续血压监测系统需要同时佩戴心电极和指套式脉搏波传感器,对用户的依从性要求较高。为解决此问题,本研究基于射血前期与血压具有较高相关性的机理,提出了一种基于射血前期的连续血压估计方法。本研究招募了13名男性受试者,通过与美国顺泰公司的SunTech Oscar2动态血压监测仪进行对比测试,验证了所提血压估计方法的可行性。通过小样本的实验观测发现,本研究方法在一定程度上满足美国医疗仪器促进协会(AAMI)对于血压测量准确性的要求。该方法的准确性与基于脉搏波到达时间的血压估计方法相当,且能够明显降低用户的依从性要求,在便携式连续血压测量方面具有潜力。     

基于脉搏-心电的便携式血压仪的研制

设计一种体积小巧,测量过程无任何束缚的基于脉搏波传导时间(pulse wave transit time,PWTT)的血压仪。从反射式容积脉搏波(photoplethysmography,PPG)和心电波形(electrocardiogram,ECG)中提取脉搏波传导时间,再综合心率、每搏输出量和外周阻力对血压的影响,通过回归分析建立血压模型,最终实现血压测量。应用样机对20名志愿者进行血压测量,同时以传统水银血压计的测量结果作为标准,结果显示收缩压和舒张压的95%一致性界限分别为(-8.3,11.6),(-9.9,12.7),说明两种方法所测的血压值有较好的一致性。血压仪样机实体小巧,使用方便,使用过程没有任何束缚,同时在理论上对基于脉搏波传导时间的血压测量方法进行优化,实现了收缩压和舒张压的测量。     

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。     

利用脉搏波传播时间计算动脉血压的研究

本研究的目的是研究动脉血压和脉搏波传播时间的关系,探讨通过脉搏波传播时间计算动脉血压的可靠性。采用麻省理工学院MIMIC数据库,通过心电和光电容积脉搏波计算得到脉搏波传播时间,通过有创动脉血压获得平均动脉压,使用线性回归方法分段求得脉搏波传播时间和平均动脉压之间的线性方程,应用该方程结合脉搏波传播时间计算动脉血压,并与实际血压比较评价算法的效果。结果表明,脉搏波传播时间和动脉血压存在负相关关系,在一定时间范围内,可通过脉搏波传播时间计算平均动脉压,均方根误差小于5 mmHg。对临床采集数据的分析同样说明,通过脉搏波传播时间计算动脉血压是可行的。     

应用阻抗心动图测量脉搏波传导时间

为了研究射血前时间对用脉搏波传导时间进行连续血压测量的影响,本文设计并实现一种用阻抗心动图确定脉搏波起始点计算脉搏波传导时间的方法,在深呼使血压产生波动的过程中,采用此方法与心电R波峰值作起始点的方法进行对比实验.实验结果表明,用这种方法测量脉搏波传导时间随呼吸的变化曲线与血压变化的规律相一致.与用心电R波法相比,阻抗心电图法可以有效避免射血前时间变化对PWTT测量结果的影响,是一种准确测量脉搏波传导时间的方法.     

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。     

Pulse Transit Time as an Indicator of Arterial Blood Pressure

The relationship between pulse-arrival times and diastolic blood pressure was measured in 10 anesthetized dogs. The pulse-arrival time was measured using the R-wave of the electrocardiogram (ECG) as a time reference. Pulse-transit time was also measured between the carotid and femoral pulses. Blood pressure was raised with epinephrine injected intravenously and lowered with vagal stimulation. In all cases, pulse arrival and transit times decreased with an increase in diastolic pressure for diastolic pressures ranging from 15 to 250 mmHg. The correlation between pulse-arrival time and pressure was poorest when the ECG was used as a timing reference. The best correlation was found with true pulse-transit time and diastolic pressure. When pulse-transit time was used to compute pulse-wave velocity, it was found to increase nearly linearly with blood pressure. From 90–100 mmHg, the pulse-wave velocity increased typically by slightly less than six percent.     

Pulse Transit Time and Blood Pressure: An Intensive Analysis

Relationships between pulse transit time (PTT) and intra-arterial systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP) were examined in 4 subjects under three conditions: rest, paced respiration, and mental arithmetic. PTT was measured from the EKG R-wave to two peripheral pulses (brachial and radial) and from one pulse to the other. Three points on each pulse wave were used (peak, foot, slope) in the measurements, yielding nine different measures of PTT. The nine PTT measures were not consistently intercorrelated. PTTs initiated by the R-wave were moderately correlated with SBP, but not with DBP or MAP. Brachial to radial PTTs were not correlated with any measures of BP. Relationships between PTT and BP also varied from subject to subject. The limited magnitude of the correlations and their inconsistency suggest caution in the simple substitution of PTT for beat-to-beat measures of BP.     

The Covariation of Blood Pressure and Pulse Transit Time in Hypertensive Patients

To examine the relationship between blood pressure (BP) and pulse transit time (PTT) as measured by the time between the ECG R-wave and an associated peripheral pulse, BP was recorded via a radial artery catheter in 3 hvpertensive subjects who underwent a variety of conditions to alter BP. Overall. 70% of the data was usable. Absolute levels of systolic blood pressure (SBP) but not diastolic blood pressure (DBP) were found to correlate appreciably with PTT. There were significant associations between PTT and both SBP and mean BP but not DBP for direction of BP change. With large SBP changes (> 4 mmHg) an increase in the strength of association occurred in 14 of the 21 conditions across subjects. Overall, PTT did not accurately predict actual BP. PTT and SBP covaried more appreciably in these hypertensives than has been reported for normotensives.     

Pulse Transit Time: Relationship to Blood Pressure and Myocardial Performance

The purpose of this research was to evaluate, in human subjects, the degree to which pulse transit time (PTT) covaries with systolic (SBP) and diastolic (DBP) blood pressure, and the degree to which PTT is sensitive to sympathetic influences on myocardial performance. Six studies were performed involving 118 young adult males. In all subjects, cardiovascular activity was assessed in both the resting state and during three stressors: the cold pressor, a pornographic movie and unsignaled shock avoidance reaction time task. The studies differed with respect to where on the arterial tree the pulse wave was transduced, whether blood pressure was measured invasively or noninvasively, and whether the myocardial sympathetic innervations were intact or not. It was observed that PTT covaried quite consistently with SBP but very inconsistently with DBP. The degree of covariation was influenced by the individual's reactivity and, with DBP, by the type of stress. PTT was appreciably influenced by myocardial sympathetic excitation and to a lesser degree by vascular processes. The use of PTT as an index of blood pressure and myocardial performance is discussed.     

Pulse Transit Time Feedback and Bidirectional Blood Pressure Change

The current study examined the effects of pulse transit time feedback on systolic and diastolic blood pressure. Three subjects were given feedback designed to increase or decrease transit times. Eleven-twelve one-hour training sessions were provided over a two-week period. The results showed that during increase training, significant increases in systolic pressure and heart rate were observed, while pulse transit time showed a significant decrease. Diastolic blood pressure increases were moderate and only inconsistently observed. During decrease training, diastolic pressure and heart rate declined significantly below baseline. Pulse transit time increases were consistent but lower in magnitude than observed for the opposite training condition. Moderate systolic blood pressure decreases were inconsistently observed.     

Aortic-Radial Pulse Transit Time and ECG Q-Wave to Radial Pulse Wave Interval as Indices of Beat-By-Beat Blood Pressure Change

This study examined beat-by-beat relationships between blood pressure, the time interval from the ECG Q-wave to the radial pulse wave (QRPI), and its two components, the cardiac pre-ejection period (PEP) and aortic-radial arterial pulse transit time (AR-PTT). In 8 subjects, intra-arterial systolic (SBP) and diastolic (DBP) blood pressure, QRPI, PEP, and AR-PTT were measured during rest, mental arithmetic, cold pressor, and inhalation of amyl nitrite. Both PEP and AR-PTT varied widely during each experimental condition indicating that QRPI change reflected both PEP and AR-PTT change. AR-PTT varied inversely with SBP and DBP; PEP sometimes varied directly and sometimes inversely with both SBP and DBP. QRPI varied inversely with both SBP and DBP with the magnitude of the correlation in a particular instance depending on the relationships for that instance between blood pressure and both PEP and AR-PTT. Implications of the results for the use of either QRPI or AR-PTT as indices of blood pressure change are discussed.     

Vascular Unloading Method for Noninvasive Measurement of Instantaneous Arterial Pressure: Applicability in Psychophysiological Research

A new method proposed previously by us (1980) was described to evaluate its applicability in psychophysiological research. In this method, beat-to-beat systolic and diastolic pressure as well as the pressure waveform can be measured noninvasively in the human finger. By use of a hydraulicservosystem, the photoplethysmographically detected vascular volume changes associated with intraarterial pressure in the finger are compensated by an applied counterpressure (cuff pressure) to maintain a proper value corresponding to the unloaded vascular volume. At this state the controlled cuff pressure follows instantaneously the intraarterial pressure. Comparison data were obtained by direct measurement of blood pressure in the brachial artery in 3 normotensive and 3 hypertensive subjects. High correlations between the two measures were obtained in each subject under various conditions. By maintaining circulation in the finger, this method enables the noninvasive and continuous measurement of instantaneous arterial pressure for more than one hour without much discomfort. This indirect method should be useful in many areas of psychophysiological research.