基于脉搏波特征参数的无创连续血压测量研究进展

脉搏波与血压变化息息相关，可以通过脉搏波特征参数进行无创连续血压测量。本研究首先介绍脉搏波特征参数以及通过脉搏波特征参数进行无创连续血压测量的原理；总结了当前利用脉搏波特征参数计算血压的测量模型，主要有一元线性回归模型、多元线性回归模型和神经网络模型，并主要分析了这些模型的测量原理和研究进展，以及各种模型的优缺点；最后对基于脉搏波特征参数进行血压测量，研究方向进行了展望。     

基于神经网络的脉搏波信号血压检测算法

脉搏波信号蕴含大量的人体生理与病理信息,与血压的变化息息相关,利用其特征参数可以无创连续检测血压。神经网络因其极强的学习能力、泛化能力以及可以充分逼近任意复杂的非线性关系而被应用于脉搏波血压提取算法中。本研究介绍了脉搏波特征参数,并简述了基于脉搏波特征参数进行血压测量的研究进展,详细叙述了基于神经网络的脉搏波特征参数血压检测算法,最后对不同神经网络模型的优缺点进行分析,并对基于神经网络的脉搏波特征参数血压监测算法的研究方向进行展望。     

基于脉搏波信号的无创血压测量的研究进展与展望

脉搏波蕴含着许多人体生理与病理的重要信息,大量研究通过光电容积描记法(photoplethysmography, PPG)来利用脉搏波特征参数进行无创血压监测。为此,我们总结了脉搏波的特征参数及利用其进行血压测量的基本原理。然后,我们对利用脉搏波特征参数进行血压测量的有线性回归(linear regression, LR)模型、随机森林(random forest, RF)模型、支持向量机(support vector machines, SVM)模型和神经网络模型及不同模型的优缺点和研究进展进行综述。最后,对基于脉搏波信号的无创血压测量的研究进行展望。     

利用脉搏波连续检测家兔血压的实验研究

目的:研究利用脉搏波连续检测血压方法的准确性和可行性.方法:采用动脉插入法连续测量10只健康成年家兔的血压,并同步记录脉搏波信号.提取某一时段的每搏血压值及相应的脉搏波特征参数进行逐步回归分析,并形成回归方程.利用该回归方程和另一时段的脉搏波特征参数计算该时段的每搏血压值.结果:计算血压值与真实血压值的偏差很小.平均偏差在1 mmHg以内.结论:该方法具有良好的准确性,今后有望应用于实际.     

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。     

基于脉搏波特征参数的无创血压测量改进算法

解决目前利用脉搏波特征参数无法准确计算出病理及生理血压(高血压、低血压和正常血压)的问题。利用主成分分析得到脉搏波主成分参数,利用脉搏波主成分参数和血压进行线性回归得到初步血压计算模型,借助较大的数据库和逐步逼近法建立多级模型,提高模型计算值的精度。改进后的算法能够使用脉搏波特征参数建立普适的血压计算模型,计算出的血压值精度较高。本研究提出的基于脉搏波特征参数的无创血压测量改进算法能够有效扩大血压计算范围,实现包括高血压、低血压和正常血压在内的无创血压测量。     

血压变异性和容积脉搏波特征参数变异性的关联分析

目的 分析血压变异性和容积脉搏波特征参数变异性的相关性,确定相关性较好的参数,为利用容积脉搏波特征参数的变异性来估计血压变异性提供理论依据.方法 同步连续采集运动前后19个样本的容积脉搏波信号和血压信号,根据容积脉搏波信号的波形特征,提取8个特征参数,利用皮尔森相关系数分析血压变异性和容积脉搏波特征参数变异性在时域的相...     

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。     

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。     

基于脉搏波信号和血管弹性腔模型的动脉血压连续测量方法

目的为满足健康监护中的连续测量血压的要求,研究并实现一种基于脉搏波信号和血管弹性腔模型的动脉血压拟合计算方法。方法利用自制的穿戴式人体生理参数监测系统收集测试对象的脉搏波信号、心电信号以及血压数据。根据心电信号与脉搏波信号的时间关系,推导出收缩压和脉搏波传导时间的回归分析方程,而舒张压的测量,则是通过脉搏波的波形系数分析以及血管单弹性腔模型的参数计算完成。结果试验结果表明,该方法血压测量结果的平均偏差和标准偏差为(0.51±0.74)kPa([384±5.54)mmHg],达到了美国医疗仪器促进协会建议的(0.665±1.064)kPa([5±8)mmHg]标准。结论结合脉搏波信号和弹性腔模型可以估算人体血压值,为连续血压测量提供了新的实现方法。     

Continuous blood pressure measurement using pulse transit time

Measurement of blood pressure (BP) during sleep is gaining in importance for clinical and scientific reasons. Diagnosis and follow-up of arterial hypertension requires BP measurement during sleep. Further, continuous BP measurements are necessary to elucidate the pathogenesis of sleep disturbances (e.g., sleep apnea), which are related to arterial hypertension. This review gives a short overview about cuff-based methods and methods for continuous and non-invasive BP measurement with a focus on sleep. The emphasis of this review is on the indirect measurement of BP using the pulse transit time (PTT). This method is based on the functional relation between arterial wall stiffness, pulse wave velocity, and BP. It can be used for absolute BP measurement when combined with calibration. Recent validation and application studies of the BP measurement using the PTT suggest that this method can in principle be used for BP monitoring during sleep. It opens the possibility to study the control of BP during sleep.     

Ambulatory instrument for monitoring indirect beat-to-beat blood pressure in superficial temporal artery using volume-compensation method

A portable instrument, based on a volume-compensation technique, is designed for ambulatory monitoring of indirect beat-to-beat blood pressure (BP) in the superficial temporal artery. The instrument consists of a small disc-type cuff and a portable unit carried by the subject. Several components are integrated in the cuff for applying counter-pressure to the artery, i.e. a reflectance-type photo-plethysmographic sensor for arterial volume detection, a pressure sensor for cuff pressure P_c measurement and a nozzle flapper-type electro-pneumatic convertor for controlling P_c. The portable unit includes volume servo control circuitry and a microprocessor-based signal-processing and recording unit. This automatically performs all the necessary measurement procedures and stores into a memory IC element the processed systolic, mean and diastolic blood pressure data, together with pulse intervals on a beat-to-beat basis from the servo-controlled P_c (indirectly measured BP waveform). With this instrument, momentary changes in BP during ambulatory situations such as bicycle ergometer exercise and daily activities including motorway driving are successfully recorded. From the results of simultaneous measurement of the subject's posture changes, the effect of posture change on blood pressure, e.g. baroreceptor-cardiac reflex, is also clearly demonstrated.     

Noninvasive measurement of arterial blood pressure and elastic properties using photoelectric plethysmography technique

The objective of this paper is to review our developed method for measuring noninvasively the arterial blood pressure as well as the mechanical properties of the vascular system in a thin portion of the biological segment such as human fingers or small animal extremities like rat tails and rabbit forelegs. This measurement is based on a principle called the 'volume-oscillometric method'. During the gradual change in cuff pressure, the amplitude of consecutive arterial volume pulsations associated with pulse pressure shows change characteristically due to the nonlinearity of arterial pressure-volume(P-V) relation. Arterial pressure can be accurately determined by detecting this characteristic change in the amplitude, while the arterial elastic properties such as P-V relationship and volume elastic modulus can be noninvasively obtained as a function of arterial transmural pressure, provided that the arterial volume changes are quantitatively determined during this pressure measurement. The validity and accuracy of this pressure and elasticity measurement with photoelectric plethysmography technique for detecting arterial volume changes are clearly demonstrated on the in vitro and in vivo experiments. Considering the simplicity and practicability of this measurement using the photoelectric plethysmography, we present a new portable instrument for the long-term ambulatory monitoring of indirect arterial pressure and a handy fully-automatic instrument for the noninvasive measurement of arterial elastic properties, and a few examples obtained by each instrument are also described.     

A portable instrument for non-invasive monitoring of beat-by-beat cardiovascular haemodynamic parameters based on the volume-compensation and electrical-admittance method

A new, portable instrument has been developed for simultaneous monitoring of blood pressure, cardiac output and other cardiovascular haemodynamic variables. The measurements are based on the volume-compensation method and the transthoracic electrical admittance method. The instrument is small and light and can be carried by the subject. The portable unit controls the measurement procedures, performs the blood pressure and cardiac output measurement, processes signals and stores almost 32 000 beats of time-series data in a fully automated manner. A conventional personal computer is used to initialise the measurement system, and to reproduce and evaluate the measurement data. The measurement system provides a means to evaluate in detail, without restriction, the subject's cardiovascular haemodynamic responses to daily physical activities as well as to various psycho-physiological stresses. The paper describes a new, portable, cardiovascular haemodynamic instrument and in-the-field test results. Twelve subjects are monitored for trials, 60–210 min, and fewer than 3% of the data in each trial are artifactuel. Artefacts are due mainly to body movements.     

Continuous Non-Invasive Arterial Pressure Technique Improves Patient Monitoring during Interventional Endoscopy

Introduction: Close monitoring of arterial blood pressure (BP) is a central part of cardiovascular surveillance of patients at risk for hypotension. Therefore, patients undergoing diagnostic and therapeutic procedures with the use of sedating agents are monitored by discontinuous non-invasive BP measurement (NIBP). Continuous non-invasive BP monitoring based on vascular unloading technique (CNAP®, CN Systems, Graz) may improve patient safety in those settings. We investigated if this new technique improved monitoring of patients undergoing interventional endoscopy.     

无创血压、脉搏装置的初步设计

介绍了一种新颖的无创血压、脉搏装置.该装置采用了示波法测量血压和脉搏,选用专用压力传感器BP300、AVR单片机等对信号进行处理.与传统的方法相比,有较大的创新性.     

Noninvasive automatic monitoring of instantaneous arterial blood pressure using the vascular unloading technique

For the noninvasive monitoring of the beat-to-beat systolic and diastolic pressure and pressure waveform in the human finger, a new automated instrument was designed. This measurement is based on a principle called the vascular unloading technique. Using a hydraulic servocontrol system, the vascular volume change caused by intra-arterial pressure change can be compensated by applying counter pressure to maintain a constant vascular volume in the unloaded state. In this state the controlled counterpressure instantaneously follows the intra-arterial pressure. In this instrument all the necessary procedures, such as the setting of the reference value for the servocontrol, control of the servogain, processing and displaying of the data on a recorder, were carried out automatically. The simultaneous comparison of data with direct measurements and a few examples of the indirect pressure recordings by this instrument are shown and the principles, operation and evaluation of this method are described. This instrument was shown to permit the nonivasive and accurate tracking of instantaneous arterial pressure and to perform acceptably over a wide range of arterial pressure.     

Impression technique for the assessment of oedema

A new instrument for the assessment of oedema based on the impression method is described. The measurement parameters are defined and the errors corresponding to the electrical and mechanical stability of the instrument are measured. The overall accuracy is calculated theoretically for the translocated volume. The accuracy and reproducibility are evaluated on plastic foam. The clinical procedure to measure oedema with this instrument is described. We show that the accuracy of the translocated volume parameter is very dependent on the overall stability of the instrument and that this instrument has an overall relative error of less than 7·3 per cent for a representative measurement. Experimental measurements on plastic foam show that the measurement parameters could be reproduced with standard deviations of less than 6 per cent and that the standard deviations for translocated volume are within the calculated overall relative error. Measurements on four patients with chronic oedema in an extremity show significantly different results on locations where pitting could be recognised compared to the contralateral nonoedematous extremity.     

Long-term ambulatory monitoring of indirect arterial blood pressure using a volume-oscillometric method

A new portable instrument equipped with a microprocessor was designed for the long-term ambulatory monitoring of indirect arterial pressure in the human finger at desired intervals using a volume-oscillometric technique. All the necessary procedures such as (1) programmed control of cuff pressure, (2) detection of the systolic end-point and the point of maximum amplitude of arterial volume pulsations, (3) reading of the cuff pressures corresponding to these two points, (4) its processing and (5) recording of the systolic and mean pressure together with heart rate on a digital memory integrated circuit were performed automatically. After the monitoring, the data were reproduced and analysed by a conventional personal computer. Simultaneous comparison of the data with direct measurement, operation and evaluation of this instrument, and ambulatory monitoring were carried out. With this instrument noninvasive and accurate monitoring of arterial pressure could be made in unrestricted subjects during daily activities.