阅读说明：本技术 一种咽喉部阻抗基线值确定方法及基线提取方法 (Throat impedance baseline value determining method and baseline extracting method ) 是由 胡人友 陈婷 廖训 侯晨婕 郭凌 于 2021-07-15 设计创作，主要内容包括：本发明公开了一种咽喉部阻抗基线值确定方法及基线提取方法,其中,咽喉部阻抗基线值确定方法包括以下步骤：1)屏蔽整个阻抗监测期间吞咽、反流事件、进食、咳嗽等症状发生的时间段,记录所有时间段的起始、结束时刻；2)选取阻抗基线计算通道；3)提取阻抗基线计算时刻点；4)基线值计算。本发明提供了一种咽喉部阻抗基线值确定方法及基线提取方法,其中,按照前述方法确定的基线计算时刻点符合稳定性的特征,提取的咽喉部阻抗基线具有较高的灵敏度与特异性,通过基线的自动提取与显示,有助于本领域技术人员更加客观、快速地研究分析咽喉部病症。(The invention discloses a pharyngeal impedance baseline value determining method and a pharyngeal impedance baseline extraction method, wherein the pharyngeal impedance baseline value determining method comprises the following steps of: 1) shielding the time periods of swallowing, reflux events, eating, coughing and other symptoms during the whole impedance monitoring period, and recording the starting time and the ending time of all the time periods; 2) selecting an impedance baseline calculation channel; 3) extracting an impedance baseline calculation time point; 4) and calculating a baseline value. The invention provides a pharyngeal impedance baseline value determining method and a baseline extracting method, wherein a baseline calculation time point determined according to the method accords with the characteristic of stability, the extracted pharyngeal impedance baseline has higher sensitivity and specificity, and the pharyngeal impedance baseline value is automatically extracted and displayed to be helpful for technicians in the field to objectively and quickly research and analyze the pharyngeal symptoms.)

1. A method for determining a throat impedance baseline value is characterized by comprising the following steps:

1) shielding the time periods of swallowing, reflux events, eating, coughing and other symptoms during the whole impedance monitoring period, and recording the starting time and the ending time of all the time periods;

2) selecting an impedance baseline calculation channel;

3) extracting an impedance baseline calculation time point;

4) and calculating a baseline value.

2. A method of determining a laryngeal impedance baseline value in accordance with claim 1, wherein said step 3) includes the steps of:

31) determining an analysis time period (i), i is 1,2, … … n, i is a non-0 natural number;

32) searching a stable time period length Tneed during each determined analysis time period (i) as a baseline calculation time point or directly intercepting a previous stable time period length Tneed during each determined analysis time period (i) as a time position of the baseline calculation time point;

3min<Tneed<20min。

3. a method of determining a laryngeal impedance baseline value in accordance with claim 2, wherein the method of determining the period (i) of analysis in step 31) is any one of the following:

during lying down

a. Shielding the standing time period during lying, and respectively selecting a plurality of time points with the interval of X1 hours and a time period before and after the time point, wherein the impedance standard deviation of not more than half an hour is less than m times of the impedance mean value, namely determining the analysis time period (i);

wherein 0< X1< 2;

b. shielding the standing time period during lying down, wherein the time period when the standard deviation of the impedance is less than m times of the mean value of the impedance every X2 hours is the period (i) for determining the analysis time period;

wherein 1< X2< 2;

c. selecting a time period with the standard deviation of impedance being less than m times of the mean value of impedance as a period (i) for determining analysis during the longest continuous lying period;

d. selecting a time period with the standard deviation of the impedance being less than m times of the mean value of the impedance during all lying periods as a period (i) for determining analysis;

a1. shielding a horizontal time period during the vertical position, and respectively selecting a plurality of time points with the interval of X1 hours and a time period before and after which the impedance standard deviation is less than m times of the impedance mean value of half an hour, namely determining an analysis time period (i);

b1. during the standing position, shielding a horizontal position time period, wherein a time period when the standard deviation of the impedance is less than m times of the mean value of the impedance every X2 hours is determined as an analysis time period (i);

c1. selecting a time period with the impedance standard deviation being less than m times of the impedance mean value as the longest continuous standing time, namely determining the analysis time period (i);

d1. selecting a time period with the impedance standard deviation less than m times of the impedance mean value as a period (i) for determining analysis during all the standing periods;

0<m<0.5。

4. a laryngeal impedance baseline value determination method according to claim 2, characterised in that in step 32) the method of finding the length of the settling period Tneed as the baseline calculation time point during each determined analysis period (i) is such that for each determined analysis period (i) the following steps are performed:

321a, calculating an impedance Mean value or a impedance median value during the current determined analysis time period (i), and taking the impedance Mean value or the impedance median value as a first comparison value Mean;

322A.

uniformly dividing a currently determined analysis time period (i) into K time periods, respectively judging whether the maximum interruption in the K time periods is greater than an interruption time threshold value break second, if so, deleting the time periods, otherwise, not processing;

judging whether the sum of the remaining time periods is shorter than the length Tneed of the stable time period, if so, continuing to lengthen the time period forwards and backwards and returning to the step I until the sum K1 of the remaining time periods is larger than or equal to the length Tneed of the stable time period;

wherein k is more than or equal to 10, break is more than or equal to 1;

323A, respectively calculating impedance Mean values of all the remaining time periods, selecting K2 time periods with the Mean value closest to the first contrast value Mean, calculating impedance standard deviations of K2 time periods, and selecting P time periods K (i) with the minimum standard deviation from the K2 time periods, wherein i is 1,2, … … n, and i is a non-0 natural number, so that the length of the P time periods is just greater than or equal to the length Tneed of the stable time period;

wherein p is less than or equal to K2, and p is more than or equal to 10.

5. A laryngeal impedance baseline value determination method according to claim 2, characterised in that in step 32) the method of finding the length of the settling period Tneed as the baseline calculation time point during each determined analysis period (i) is such that for each determined analysis period (i) the following steps are performed:

321B, judging and recording the time position of the interruption greater than the interruption time threshold break second during the period of the current analysis time period (i);

intercepting a time segment seg (i) which is equal to the length Tneedr of a stable time segment within interval and interval seconds in sequence during the current determined analysis time segment period (i), wherein i is 1,2, … … n, i is a non-0 natural number, and removing the time segment seg (i) containing the time position of the interruption which is greater than the interruption time threshold break seconds;

wherein interval is more than 10, break is more than or equal to 1;

323B, respectively solving the variances of the time sections seg (i) which are removed and contain the time when the interruption time is more than the interruption time threshold break second, and selecting the time section with the minimum variance as the time position of the base line calculation time point.

6. A laryngeal impedance baseline value determination method according to claim 2, characterised in that in step 32) the method of finding the length of the settling period Tneed as the baseline calculation time point during each determined analysis period (i) is such that for each determined analysis period (i) the following steps are performed:

321C, in the period of determining the period of analysis (i), adopting a window function with the length of M, sequentially spacing M/2, moving the window function, carrying out fast Fourier transform on the impedance value in the window function, filtering out an amplitude with overlarge frequency, namely removing curve burrs, and then carrying out inverse Fourier transform;

wherein, the length M refers to the length of the intercepted time window, namely the length of the window function, and M is more than 3 seconds;

and 322C, performing linear fitting on the impedance data after the inverse Fourier transform in the window functions to obtain impedance slopes in the window functions, sequencing the impedance slopes in all the window functions, intercepting p sections of window functions with smaller slopes to ensure that the time sum Tsum is just greater than or equal to the length Tneed of the stable time period, and randomly selecting the time period equal to the length Tneed of the stable time period between the p sections of window functions as the position of the baseline calculation time point.

7. A laryngeal impedance baseline method as in claim 1 wherein the baseline calculation in step 4) may be any one of the following:

calculating the impedance mean value or the median value of the time point by using a baseline as a baseline value;

and II, filtering out the impedance mean value after the too high and too low of the baseline calculation time point to be a baseline value, wherein the too high is a value which exceeds 20% of the impedance mean value of all the baseline calculation time points, and the too low is a value which is lower than 20% of the impedance mean value of all the baseline calculation time points.

8. A laryngeal impedance baseline extraction method, comprising the laryngeal impedance baseline value determination method of any one of claims 1 to 7, and further comprising the step of 5) drawing a line based on the baseline value and displaying the line.

Technical Field

The invention relates to the technical field of medical treatment, in particular to a throat impedance baseline extraction method.

Background

Laryngopharyngeal reflux (LPR) refers to the phenomenon of reflux of gastric contents, including solids, liquids, gases and mixtures, to a location above the upper esophageal sphincter. Laryngopharyngeal reflux disease (LPRD), which refers to damage to the mucous membranes of the larynx due to the reflux of gastric contents, causes a series of symptoms of discomfort and inflammatory signs of the larynx, even malignant changes, and is considered to be an extraesophageal manifestation of gastro-esophageal reflux disease (GERD).

The current 24-hour PH test of the laryngo oesophagus is considered the "gold standard" for the diagnosis of laryngo reflux. However, it has been found in practical clinical work that there is considerable confusion in using the diagnostic criteria of this approach, leading to low clinical diagnosis and cure rates for LPRD, or to the other extreme of PPI abuse.

With the great improvement of the detection technology and the development of multi-channel MII-pH monitoring, the novel cognition is provided for the properties and characteristics of the reflux and the regurgitation. In recent years, based on the MII-PH detection technology, a new detection index, namely a Baseline Impedance Level (BIL), becomes a brand-new valuable index with high sensitivity and specificity for diagnosing non-erosive esophagitis (NERD). However, at present, only a method suitable for selecting an impedance Baseline (BI) calculation point in a esophagus cavity is introduced, a method for selecting an impedance Baseline (BI) calculation point in a throat cavity is not introduced, and analysis software only provides a method for manually selecting the impedance Baseline (BI) calculation point, so that certain subjectivity exists.

Therefore, those skilled in the art are devoted to develop a method for determining a baseline value of laryngeal impedance and a method for extracting a baseline, which improve an objective diagnosis standard of the laryngopharyngeal reflux disease and improve a diagnosis rate of the laryngopharyngeal reflux disease.

Disclosure of Invention

In view of the above-mentioned defects of the prior art, the technical problem to be solved by the present invention is to provide a method for determining a baseline value of laryngeal impedance and a method for extracting the baseline, which improve an objective diagnosis standard of the laryngopharyngeal reflux disease and improve the diagnosis rate of the laryngopharyngeal reflux disease.

In order to achieve the above object, the present invention provides a method for determining a baseline value of laryngeal impedance, comprising the steps of:

1) shielding the time periods of swallowing, reflux events, eating, coughing and other symptoms during the whole impedance monitoring period, and recording the starting time and the ending time of all the time periods;

2) selecting an impedance baseline calculation channel;

3) extracting an impedance baseline calculation time point;

4) and calculating a baseline value.

Preferably, the step 3) comprises the following steps:

31) determining an analysis time period (i), i is 1,2, … … n, i is a non-0 natural number;

32) searching a stable time period length Tneed during each determined analysis time period (i) as a baseline calculation time point or directly intercepting a previous stable time period length Tneed during each determined analysis time period (i) as a time position of the baseline calculation time point;

3min<Tneed<20min。

preferably, the method for determining the period (i) of the analysis in step 31) may be any one of the following methods:

during lying down

a. Shielding the standing time period during lying, and respectively selecting a plurality of time points with the interval of X1 hours and a time period before and after the time point, wherein the impedance standard deviation of not more than half an hour is less than m times of the impedance mean value, namely determining the analysis time period (i);

wherein 0< X1< 2;

b. shielding the standing time period during lying down, wherein the time period when the standard deviation of the impedance is less than m times of the mean value of the impedance every X2 hours is the period (i) for determining the analysis time period;

wherein 1< X2< 2;

c. selecting a time period with the standard deviation of impedance being less than m times of the mean value of impedance as a period (i) for determining analysis during the longest continuous lying period;

d. selecting a time period with the standard deviation of the impedance being less than m times of the mean value of the impedance during all lying periods as a period (i) for determining analysis;

a1. shielding a horizontal time period during the vertical position, and respectively selecting a plurality of time points with the interval of X1 hours and a time period before and after which the impedance standard deviation is less than m times of the impedance mean value of half an hour, namely determining an analysis time period (i);

b1. during the standing position, shielding a horizontal position time period, wherein a time period when the standard deviation of the impedance is less than m times of the mean value of the impedance every X2 hours is determined as an analysis time period (i);

c1. selecting a time period with the impedance standard deviation being less than m times of the impedance mean value as the longest continuous standing time, namely determining the analysis time period (i);

d1. selecting a time period with the impedance standard deviation less than m times of the impedance mean value as a period (i) for determining analysis during all the standing periods;

0<m<0.5。

preferably, in the step 32), the method for finding the stable time period length Tneed as the baseline calculation time point during each determined analysis time period (i) is to perform the following steps for each determined analysis time period (i):

321a, calculating an impedance Mean value or a impedance median value during the current determined analysis time period (i), and taking the impedance Mean value or the impedance median value as a first comparison value Mean;

322A.

uniformly dividing a currently determined analysis time period (i) into K time periods, respectively judging whether the maximum interruption in the K time periods is greater than an interruption time threshold value break second, if so, deleting the time periods, otherwise, not processing;

judging whether the sum of the remaining time periods is shorter than the length Tneed of the stable time period, if so, continuing to lengthen the time period forwards and backwards and returning to the step I until the sum K1 of the remaining time periods is larger than or equal to the length Tneed of the stable time period;

wherein k is more than or equal to 10, break is more than or equal to 1;

323A, respectively calculating impedance Mean values of all the remaining time periods, selecting K2 time periods with the Mean value closest to the first contrast value Mean, calculating impedance standard deviations of K2 time periods, and selecting P time periods K (i) with the minimum standard deviation from the K2 time periods, wherein i is 1,2, … … n, and i is a non-0 natural number, so that the length of the P time periods is just greater than or equal to the length Tneed of the stable time period;

wherein p is less than or equal to K2, and p is more than or equal to 10.

Preferably, in the step 32), the method for finding the stable time period length Tneed as the baseline calculation time point during each determined analysis time period (i) is to perform the following steps for each determined analysis time period (i):

321B, judging and recording the time position of the interruption greater than the interruption time threshold break second during the period of the current analysis time period (i);

intercepting a time segment seg (i) which is equal to the length Tneedr of a stable time segment within interval and interval seconds in sequence during the current determined analysis time segment period (i), wherein i is 1,2, … … n, i is a non-0 natural number, and removing the time segment seg (i) containing the time position of the interruption which is greater than the interruption time threshold break seconds;

wherein interval is more than 10, break is more than or equal to 1;

323B, respectively solving the variances of the time sections seg (i) which are removed and contain the time when the interruption time is more than the interruption time threshold break second, and selecting the time section with the minimum variance as the time position of the base line calculation time point.

Preferably, in the step 32), the method for finding the stable time period length Tneed as the baseline calculation time point during each determined analysis time period (i) is to perform the following steps for each determined analysis time period (i):

321C, in the period of determining the period of analysis (i), adopting a window function with the length of M, sequentially spacing M/2, moving the window function, carrying out fast Fourier transform on the impedance value in the window function, filtering out an amplitude with overlarge frequency, namely removing curve burrs, and then carrying out inverse Fourier transform;

wherein, the length M refers to the length of the intercepted time window, namely the length of the window function, and M is more than 3 seconds;

and 322C, performing linear fitting on the impedance data after the inverse Fourier transform in the window functions to obtain impedance slopes in the window functions, sequencing the impedance slopes in all the window functions, intercepting p sections of window functions with smaller slopes to ensure that the time sum Tsum is just greater than or equal to the length Tneed of the stable time period, and randomly selecting the time period equal to the length Tneed of the stable time period between the p sections of window functions as the position of the baseline calculation time point.

Preferably, the method for calculating the baseline value in step 4) may be any one of the following methods:

calculating the impedance mean value or the median value of the time point by using a baseline as a baseline value;

and II, filtering out the impedance mean value after the too high and too low of the baseline calculation time point to be a baseline value, wherein the too high is a value which exceeds 20% of the impedance mean value of all the baseline calculation time points, and the too low is a value which is lower than 20% of the impedance mean value of all the baseline calculation time points.

The invention also provides a pharyngeal impedance baseline value determining method and a pharyngeal impedance baseline extracting method, the pharyngeal impedance baseline value determining method comprises the pharyngeal impedance baseline value determining method, and the pharyngeal impedance baseline value is drawn and displayed according to the baseline value in step 5), so that the pharyngeal impedance baseline is formed.

The invention has the beneficial effects that: the invention provides a pharyngeal impedance baseline value determining method and a baseline extracting method, wherein a baseline calculation time point determined according to the method accords with the characteristic of stability, the extracted pharyngeal impedance baseline has higher sensitivity and specificity, and the pharyngeal impedance baseline value is automatically extracted and displayed to be helpful for technicians in the field to objectively and quickly research and analyze the pharyngeal symptoms.

Drawings

FIG. 1 is a schematic flow chart of an embodiment of the present invention.

Detailed description of the preferred embodiments

The invention is further illustrated by the following figures and examples.

A method for determining a baseline value of laryngeal impedance, as shown in fig. 1, comprising the steps of:

1) shielding the time periods of swallowing, reflux events, eating, coughing and other symptoms during the whole impedance monitoring period, and recording the starting time and the ending time of all the time periods;

2) the impedance baseline calculation channel is selected, the Upper Esophageal Sphincter (UES) and the channels above can be automatically selected in the embodiment, and in other embodiments, the channel can be manually added or deleted according to needs.

3) Extracting an impedance baseline calculation time point;

4) and calculating a baseline value.

Wherein, the step 3) comprises the following steps:

31) determining an analysis time period (i), i is 1,2, … … n, i is a non-0 natural number;

32) searching a stable time period length Tneed during each determined analysis time period (i) as a baseline calculation time point or directly intercepting a previous stable time period length Tneed during each determined analysis time period (i) as a time position of the baseline calculation time point;

3min<Tneed<20min。

the stable time period length Tneed is a time period set by the present application, and is generally set within 3 to 20 minutes, for example, 5 minutes, 10 minutes, etc., and is set according to personal habits or needs. Searching a stable time period length Tneed as a baseline calculation time point during each determined analysis time period (i), namely searching a time period within 3 to 20 minutes meeting the requirement as a baseline calculation time point during each determined analysis time period (i) according to the following method; directly intercepting the length Tneed of the previous stable time period in each determined analysis time period (i) as the time position of the baseline calculation time point, namely directly intercepting one time period of the previous 3 to 20 minutes in each determined analysis time period (i) as the length Tneed of the stable time period, namely the time position of the baseline calculation time point.

Wherein, the method for determining the period (i) of the analysis period in step 31) may be any one of the following methods:

during lying down

a. Shielding the standing time period during lying, and respectively selecting a plurality of time points with the interval of X1 hours and a time period before and after the time point, wherein the impedance standard deviation of not more than half an hour is less than m times of the impedance mean value, namely determining the analysis time period (i);

wherein 0< X1<2, in this embodiment, X1 may be 1, that is, a plurality of time points every 1 hour and a time period before and after the time point, in which the standard deviation of impedance is less than m times of the mean value of impedance in half an hour, are selected as the determined analysis time period (i).

b. Shielding the standing time period during lying down, wherein the time period when the standard deviation of the impedance is less than m times of the mean value of the impedance every X2 hours is the period (i) for determining the analysis time period;

wherein 1< X2<2, in this embodiment, X2 may be 1.5.

c. Selecting a time period with the standard deviation of impedance being less than m times of the mean value of impedance as a period (i) for determining analysis during the longest continuous lying period;

d. selecting a time period with the standard deviation of the impedance being less than m times of the mean value of the impedance during all lying periods as a period (i) for determining analysis;

a1. shielding a horizontal time period during the vertical position, and respectively selecting a plurality of time points with the interval of X1 hours and a time period before and after which the impedance standard deviation is less than m times of the impedance mean value of half an hour, namely determining an analysis time period (i);

b1. during the standing position, shielding a horizontal position time period, wherein a time period when the standard deviation of the impedance is less than m times of the mean value of the impedance every X2 hours is determined as an analysis time period (i);

c1. selecting a time period with the impedance standard deviation being less than m times of the impedance mean value as the longest continuous standing time, namely determining the analysis time period (i);

d1. selecting a time period with the impedance standard deviation less than m times of the impedance mean value as a period (i) for determining analysis during all the standing periods;

0< m <0.5, m may be 0.2 in this embodiment, or 0.3 or 0.4 in other embodiments.

In the step 32), the method of finding the stable time period length Tneed as the baseline calculation time point during each determined analysis time period (i) may be any one of the following methods:

A. for each determined analysis period (i), performing the following steps:

321a, calculating an impedance Mean value or a impedance median value during the current determined analysis time period (i), and taking the impedance Mean value or the impedance median value as a first comparison value Mean;

322A.

uniformly dividing a currently determined analysis time period (i) into K time periods, respectively judging whether the maximum interruption in the K time periods is greater than an interruption time threshold value break second, if so, deleting the time periods, otherwise, not processing;

judging whether the sum of the remaining time periods is shorter than the length Tneed of the stable time period, if so, continuing to lengthen the time period forwards and backwards and returning to the step I until the sum K1 of the remaining time periods is larger than or equal to the length Tneed of the stable time period;

wherein k is more than or equal to 10, break is more than or equal to 1;

323A, respectively calculating impedance Mean values of all the remaining time periods, selecting K2 time periods with the Mean value closest to the first contrast value Mean, calculating impedance standard deviations of K2 time periods, and selecting P time periods K (i) with the minimum standard deviation from the K2 time periods, wherein i is 1,2, … … n, and i is a non-0 natural number, so that the length of the P time periods is just greater than or equal to the length Tneed of the stable time period;

wherein p is less than or equal to K2, and p is more than or equal to 10.

B. For each determined analysis period (i), performing the following steps:

321B, judging and recording the time position of the interruption greater than the interruption time threshold break second during the period of the current analysis time period (i);

intercepting a time segment seg (i) which is equal to the length Tneedr of a stable time segment within interval and interval seconds in sequence during the current determined analysis time segment period (i), wherein i is 1,2, … … n, i is a non-0 natural number, and removing the time segment seg (i) containing the time position of the interruption which is greater than the interruption time threshold break seconds;

wherein interval is more than 10, break is more than or equal to 1;

323B, respectively solving the variances of the time sections seg (i) which are removed and contain the time when the interruption time is more than the interruption time threshold break second, and selecting the time section with the minimum variance as the time position of the base line calculation time point.

C. For each determined analysis period (i), performing the following steps:

321C, in the period of determining the period of analysis (i), adopting a window function with the length of M, sequentially spacing M/2, moving the window function, carrying out fast Fourier transform on the impedance value in the window function, filtering out an amplitude with overlarge frequency, namely removing curve burrs, and then carrying out inverse Fourier transform;

wherein, the length M refers to the length of the intercepted time window, namely the length of the window function, and M is more than 3 seconds;

and 322C, performing linear fitting on the impedance data after the inverse Fourier transform in the window functions to obtain impedance slopes in the window functions, sequencing the impedance slopes in all the window functions, intercepting p sections of window functions with smaller slopes to ensure that the time sum Tsum is just greater than or equal to the length Tneed of the stable time period, and randomly selecting the time period equal to the length Tneed of the stable time period between the p sections of window functions as the position of the baseline calculation time point.

Wherein the content of the first and second substances,

the method for calculating the baseline value in the step 4) may be any one of the following methods:

calculating the impedance mean value or the median value of the time point by using a baseline as a baseline value;

and II, filtering out the impedance mean value after the too high and too low of the baseline calculation time point to be a baseline value, wherein the too high is a value which exceeds 20% of the impedance mean value of all the baseline calculation time points, and the too low is a value which is lower than 20% of the impedance mean value of all the baseline calculation time points.

The invention also provides a pharyngeal impedance baseline extraction method, which comprises the pharyngeal impedance baseline value determination method and further comprises the step 5) of drawing lines and displaying according to the baseline value.

The foregoing detailed description of the preferred embodiments of the invention has been presented. It should be understood that numerous modifications and variations could be devised by those skilled in the art in light of the present teachings without departing from the inventive concepts. Therefore, the technical solutions available to those skilled in the art through logic analysis, reasoning and limited experiments based on the prior art according to the concept of the present invention should be within the scope of protection defined by the claims.