压力反射敏感性检测系统的设计与实现

中国组织工程研究与临床康复 第14卷 第52期 2010–12–24出版

Journal of Clinical Rehabilitative Tissue Engineering Research December 24, 2010 Vol.14 No.52

P .O. Box 1200, Shen yan g 110004

9790

School of Biomedical Engineering, Capital Medical University, Beijing 100069, China

Zhang Yun, Associate professor, School of Biomedical

Engineering, Capital Medical University, Beijing 100069, China

mail_zhangyun@

Supported by: the Basic Clinical

Program of Capital Medical University, No. 2004JK31*

Received: 2010-07-28 Accepted: 2010-11-23

首都医科大学生物医学工程学院，北京市 100069

张韫，女，汉族，1983年首都医科大学毕业，副教授，主要从事生物医学信息学研究。mail_zhangyun @

中图分类号:R318 文献标识码:B

文章编号:1673-8225 (2010)52-09790-04

收稿日期：2010-07-28

修回日期：2010-11-23 (20100728001/G ·A)

压力反射敏感性检测系统的设计与实现*

张 韫，王 锐，贾三庆

Design and implementation of baroreflex sensitivity monitor system

Zhang Yun, Wang Rui, Jia San-qing

Abstract

BACKGROUND: In various dangerous layering techniques, baroreflex sensitivity (BRS) is a reliable, accurate, independent predictor for arrhythmia and sudden cardiac death following acute myocardial infarction. Studies commonly utilize pressure and electrocardiogram measurements apparatus to calculate data for BRS.

OBJECTIVE: To design and develop BRS monitor system to predict sudden cardiac death reliably and accurately after acute myocardial infarction.

METHODS: The developed BRS monitor system was used to acquire all patients’ original pulse wave data using electronic blood pressure monitor which also was self-designed. The electronic blood pressure monitor was accomplished by oscillometric method. Pulse wave signals underwent processes of filtering of hardware and software and magnifying for calculating systolic pressure and diastolic pressure. Subsequently, the heart rate was conversed according to the blood pressure value and finally BRS value was calculated by both average values of blood pressure and heart rate. The blood pressure of the subjects was forcibly changed by intravenous injection of vasoactive substances.

RESULTS AND CONCLUSION: Self-designed BRS monitor system consists of the circuit of the electronic blood pressure monitor, pulse wave processing procedures and BRS calculation program. First, electronic blood pressure monitor was used to get pulse wave data. Then, we wrote computer program that was used to process pulse wave to acquire two groups of data of the blood pressure and heart rate. Afterwards, BRS value was calculated with changing average values of the heart rate and blood pressure. In conclusion, depending on BRS value, we can predict possibility of occurring sudden cardiac death who suffered from acute myocardial infarction. Because the device acquires original data which is used to calculate BRS value only from electronic blood pressure monitor, it is convenient to take. Therefore it is possible to visit patients of acute myocardial infarction at any moment. The development of this monitoring system may provide a better idea to effectively control occurrence of sudden cardiac death after acute myocardial infarction in clinic.

Zhang Y, Wang R, Jia SQ. Design and implementation of baroreflex sensitivity monitor system.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2010;14(52): 9790-9793. [ ]

摘要

背景：在诸多危险分层技术中，压力反射敏感性是比较可靠和准确的急性心肌梗死后心律失常和心脏性猝死的独立预报因子。至今的报道显示，有关压力反射敏感性的研究都是分别利用血压测量设备和心电测量设备采集计算压力反射敏感性所需的数据。

目的：为准确地预测急性心肌梗死后心脏性猝死的发生，设计并开发了压力反射敏感性检测系统。

方法：研发的压力反射敏感性检测系统是使用自行设计的电子血压计采样患者的脉搏波，电子血压计是采用示波法实现的。脉搏波信号经软硬件滤波、放大和定标后，用于计算收缩压和舒张压。而后，根据2次收缩压的差值得到心率值，再由血压和心率的变化均值计算出压力反射敏感性值。采用静脉注射血管活性物质强制造成患者血压的变化。

结果与结论：自行设计的压力反射敏感性检测系统由电子血压计电路、脉搏波处理程序和压力反射敏感性计算程序3部分组成。首先，使用电子血压计获得脉搏波。然后，编程对脉搏波数据进行处理，以便从脉搏波中获得心率和血压的变化均值。最后，利用心率和血压的变化值计算压力反射敏感性，并根据该值对患者急性心肌梗死后心脏性猝死发生的可能性进行判断。由于该系统只用电子血压计获取计算压力反射敏感性所需的全部原始数据，故具有体积小和方便携带等优点，不仅可以作为急性心肌梗死患者随访的医疗设备，而且为临床有效控制急性心肌梗死后发生心脏性猝死提供了很好的思路。 关键词：压力反射敏感性；急性心肌梗死；数字血压计；示波法；设计 doi:10.3969/j.issn.1673-8225.2010. 52.025

张韫，王锐，贾三庆. 压力反射敏感性检测系统的设计与实现[J].中国组织工程研究与临床康复，2010，14(52):9790-9793. [ ]

0 引言

近20多年来，随着生活水平的提高和生活

节奏的加快，心血管疾病的发病率逐渐增高。大量实验室及临床研究表明，压力反射敏感性(baroreflex sensitivity, BRS)能确切反映自主神经尤其是迷走神经对心血管的调节作用，是评

估心脏自主神经功能状态的有效方法之一[1]

。心力衰竭、急性心肌梗死和高血压等多种心血管疾病的发生发展均与BRS 的改变有关

[2-4]

。其

中患急性心肌梗死后的一两年内，患者继发心律不齐和心脏性猝死的危险大幅度提高。因此，如何对心脏性猝死进行危险分层，达到早发现、早治疗的研究受到医学界的广泛关注。经大量临床研究发现，在诸多危险分层技术中，BRS