阅读说明：本技术 血压关联信息显示装置、血压关联信息显示方法、以及程序 (Blood pressure related information display device, blood pressure related information display method, and program ) 是由 小久保绫子 桑原光巨 山下新吾 刈尾七臣 于 2020-03-03 设计创作，主要内容包括：在本发明中,根据与被检者的脉动连动地变化的血压的时间序列数据,基于预先设定的判定基准来检测血压激增。针对检测出的各血压激增,求出连结形成该血压激增的多个拍对应峰值的包络线作为个别波形(C11、C12、C13、…)。对得到的多个个别波形(C11、C12、C13、…)进行统计处理,求出时间序列数据内的血压激增的代表性波形和波形偏差。进行在显示画面上使表示代表性波形的曲线(Cav)重叠地显示在表示血压激增的波形偏差的区域(Sd)的处理。(In the present invention, a rapid increase in blood pressure is detected based on a preset criterion from time-series data of blood pressure that changes in conjunction with pulsation of a subject. For each detected blood pressure surge, an envelope connecting a plurality of beat-to-beat peaks forming the blood pressure surge is obtained as an individual waveform (C11, C12, C13, …). The obtained individual waveforms (C11, C12, C13, and …) are statistically processed to obtain a representative waveform and a waveform deviation of a rapid increase in blood pressure in the time-series data. A curve (Cav) representing a representative waveform is superimposed on a display screen and displayed in a region (Sd) of waveform deviation representing a rapid increase in blood pressure.)

1. A blood pressure related information display device for visually displaying information related to a sudden increase in blood pressure,

comprising:

a blood pressure surge detection unit that detects a surge in blood pressure based on a preset determination criterion from time-series data of blood pressure that changes in conjunction with pulsation of a subject;

an individual waveform acquisition unit that obtains, as an individual waveform, an envelope of peaks corresponding to a plurality of beats forming the blood pressure surge, for each detected blood pressure surge;

a statistical processing unit that performs statistical processing on the plurality of individual waveforms to obtain a representative waveform and a waveform deviation of a sudden increase in blood pressure in the time-series data; and

and a display processing unit that performs processing for displaying a curve representing the representative waveform on a display screen so as to be superimposed on a region of the waveform deviation representing the rapid increase in blood pressure.

2. The blood pressure-related information display device according to claim 1,

the statistical processing unit creates, in a storage area, a state equivalent to a state in which the plurality of individual waveforms are slid relative to each other in the lateral direction on a coordinate plane including lateral coordinates indicating a lapse of time and vertical coordinates indicating an amount of blood pressure fluctuation accompanying a rapid increase in blood pressure, and positions of peaks of the plurality of individual waveforms are aligned, and statistically processes blood pressure fluctuation amount data of the plurality of individual waveforms for each lateral coordinate to obtain the representative waveform and the waveform deviation.

3. The blood pressure-related information display device according to claim 2,

the blood pressure fluctuation amount data of each of the plurality of individual waveforms is a fluctuation amount based on a blood pressure value at a start point of the individual waveform.

4. The blood pressure-related information display device according to claim 3,

the blood pressure variation data of a plurality of the individual waveforms is normalized in such a manner as to align the heights of the peaks of the plurality of the individual waveforms.

5. The blood pressure-related information display device according to any one of claims 2 to 4,

the lateral coordinate representing the lapse of time is determined by a beat number that determines a peak corresponding to the beat,

the statistical processing unit performs statistical processing on the blood pressure fluctuation amount data of the plurality of individual waveforms for each beat number.

6. The blood pressure-related information display device according to any one of claims 2 to 5,

the statistical processing unit sets, as zero, a contribution of a portion that is insufficient compared with the longest individual waveform to the statistical processing of the blood pressure fluctuation amount data, for an individual waveform shorter than the individual waveform having the longest lateral dimension, among the plurality of individual waveforms.

7. The blood pressure-related information display device according to any one of claims 2 to 6,

the waveform deviation obtained by the statistical processing unit is defined as ± k times a standard deviation of a distribution formed by the blood pressure fluctuation amount data of the plurality of individual waveforms when k is a natural number,

the display processing unit displays, on the display screen, a region having a width in a longitudinal direction that is ± k times the standard deviation as a region indicating the waveform deviation.

8. The blood pressure-related information display device according to any one of claims 2 to 6,

the waveform deviation obtained by the statistical processing unit is defined as a quartile range of a distribution formed by the blood pressure fluctuation amount data of the plurality of individual waveforms,

the display processing unit displays a region having a width corresponding to the quartile range in a longitudinal direction on the display screen as a region indicating the waveform deviation.

9. The blood pressure-related information display device according to any one of claims 2 to 6,

the display processing unit performs processing for displaying a curve representing a plurality of the individual waveforms so as to form a region representing the waveform deviation on the display screen, in a form distinguishable from a curve representing the representative waveform.

10. The blood pressure-related information display device according to any one of claims 1 to 9,

comprising: an input unit which inputs information indicating a body state specifying period in which a body state of the subject can be specified, along with time-series data of blood pressure that changes in conjunction with pulsation of the subject,

the statistical processing unit obtains a representative waveform and a waveform deviation of a rapid increase in blood pressure in the time-series data for each of the body state specifying periods,

the display processing unit performs processing for displaying a curve representing the representative waveform in a region of the waveform deviation representing the rapid increase in blood pressure so as to be superimposed for each of the physical state specifying periods on the display screen.

11. A method for displaying information relating to blood pressure, which visually displays information relating to a surge in blood pressure,

detecting a sudden increase in blood pressure based on a preset criterion from time-series data of blood pressure that changes in conjunction with pulsation of a subject;

for each detected blood pressure surge, obtaining an envelope connecting a plurality of beat-to-beat peak values forming the blood pressure surge as an individual waveform;

performing statistical processing on the obtained plurality of individual waveforms to obtain a representative waveform and a waveform deviation of a blood pressure surge in the time-series data;

and performing a process of displaying a curve representing the representative waveform on a display screen so as to be superimposed on a region of the waveform deviation representing the rapid increase in blood pressure.

12. A program for causing a computer to execute the blood pressure-related information display method according to claim 11.

Technical Field

The present invention relates to a blood pressure related information display device and a blood pressure related information display method, and more particularly, to a device and a method for visually displaying information related to a sudden increase in blood pressure of a subject. The present invention also relates to a program for causing a computer to execute such a blood pressure-related information display method.

Background

It is known that, in a patient with Sleep Apnea Syndrome (SAS), the blood pressure rises sharply when breathing starts again after absence of breathing, and then falls. In the present specification, such an abrupt blood pressure change is referred to as "sudden increase in blood pressure" (or simply "sudden increase"). It is considered that the visual display of information (for example, a waveform of a blood pressure surge) related to the blood pressure surge occurring in a patient contributes to the diagnosis and treatment of SAS.

Conventionally, for example, in fig. 3 of patent document 1(WO2017/082107a1), a waveform of a fluctuation state (blood pressure surge) of a Sleep Apnea Syndrome (SAS) patient is displayed as a graph.

Documents of the prior art

Patent document

Patent document 1: WO2017/082107A1

Disclosure of Invention

Problems to be solved by the invention

However, in patent document 1, the waveform of the rapid increase in blood pressure is merely displayed in a form in which the time axis is enlarged for the time-series data of the systolic blood pressure value (SBP) and the peak of each pulse is known, and is not displayed as a curve (shape) showing the tendency of the increase or decrease of blood pressure.

In this situation, the present applicant previously filed an invention of classifying and visually displaying patterns (shapes) of waveforms of a rapid increase in blood pressure of SAS patients (japanese patent application No. 2017 050066). This enables the doctor to grasp the pattern of the waveform in which the blood pressure of each SAS patient increases rapidly in a relatively short period of time. Furthermore, it is convenient if the doctor can observe a representative waveform of a rapid increase in blood pressure and a waveform deviation of each SAS patient in a superimposed manner. In addition, not limited to SAS patients, it is also considered that a representative waveform and waveform deviation obtained by observing a rapid increase in blood pressure of a subject in a superimposed manner are used as a material for evaluating a risk of cardiovascular diseases and a material for evaluating a risk of diseases in a specific organ.

Therefore, an object of the present invention is to provide a blood pressure related information display device and a blood pressure related information display method capable of displaying a representative waveform of a rapid increase in blood pressure and a waveform deviation in a superimposed manner. Another object of the present invention is to provide a program for causing a computer to execute such a blood pressure related information display method.

Means for solving the problems

In order to solve the above-mentioned problems, a blood pressure related information display device of the present disclosure visually displays information related to a sudden increase in blood pressure,

comprising:

a blood pressure surge detection unit that detects a surge in blood pressure based on a preset determination criterion from time-series data of blood pressure that changes in conjunction with pulsation of a subject;

an individual waveform acquisition unit that obtains, as an individual waveform, an envelope of peaks corresponding to a plurality of beats forming the blood pressure surge, for each detected blood pressure surge;

a statistical processing unit that performs statistical processing on the plurality of individual waveforms to obtain a representative waveform and a waveform deviation of a sudden increase in blood pressure in the time-series data; and

and a display processing unit that performs processing for displaying a curve representing the representative waveform on a display screen so as to be superimposed on a region of the waveform deviation representing the rapid increase in blood pressure.

In the present specification, the "predetermined criterion" is a criterion for detecting a sudden increase in blood pressure typically in a Sleep Apnea Syndrome (SAS) patient. For example, as disclosed in japanese patent application No. 2017 and 048946 and japanese patent application No. 2017 and 050066, the difference (blood pressure fluctuation amount) between the systolic blood pressure value at the time of the surge start point and the systolic blood pressure value at the time of the peak point is 20mmHg (or 15mmHg) or more and the period between the time of the surge start point and the time of the peak point is greater than 5 beats and the period between the time of the peak point and the time of the surge end point is greater than 7 beats in a peak detection section (for example, a period of 15 beats).

The plurality of "beat-to-peak values" forming the blood pressure surge for creating the envelope refer to peak values corresponding to the systolic blood pressure in the continuous instantaneous blood pressure waveform. However, the peak value may be a peak value corresponding to the diastolic blood pressure value (DBP).

The "statistical process" refers to a process of averaging individual waveforms, a process of obtaining an intermediate value, and the like. The "representative waveform" of a rapid increase in blood pressure refers to, for example, an average waveform obtained by averaging a plurality of individual waveforms, a waveform corresponding to an intermediate value between a plurality of individual waveforms, or the like. The "waveform deviation" in which the blood pressure is abruptly increased means, for example, the width of the distribution of a plurality of individual waveforms.

The "display screen" is typically a screen of a display, but may be a paper surface output by a printer, for example.

In addition, the "display" of a curve representing a representative waveform on the display screen is typically performed such that horizontal coordinates indicate the passage of time (e.g., the progression of beats) and vertical coordinates indicate the amount of blood pressure fluctuation associated with a rapid increase in blood pressure.

In the blood pressure related information display device disclosed in the publication, the rapid blood pressure increase detection unit detects a rapid blood pressure increase based on a preset determination criterion from time-series data of blood pressure that changes in conjunction with pulsation of the subject. The individual waveform acquisition unit obtains, as an individual waveform, an envelope connecting a plurality of beat-to-beat peak values forming the blood pressure surge, for each detected blood pressure surge. A statistical processing unit performs statistical processing on the plurality of individual waveforms obtained, and obtains a representative waveform and a waveform deviation of a rapid increase in blood pressure in the time-series data. The display processing unit performs processing for displaying a curve representing the representative waveform on a display screen so as to be superimposed on a region of the waveform deviation representing the rapid increase in blood pressure. Thus, the user (typically, a doctor, a nurse, or other medical staff, and may be the subject, the same applies hereinafter) can intuitively grasp the curve of the representative waveform indicating the rapid increase in blood pressure of the subject and the region indicating the waveform deviation by observing the display screen. This is considered to be useful as a material for evaluating the risk of cardiovascular diseases and a material for evaluating the risk of diseases in a specific organ, in addition to the diagnosis and treatment of SAS.

In one embodiment, the statistical processing unit creates a state equivalent to a state in which the plurality of individual waveforms are slid relative to each other in the lateral direction and aligned with the positions of the peaks of the plurality of individual waveforms in a coordinate plane including lateral coordinates indicating a lapse of time and vertical coordinates indicating an amount of blood pressure fluctuation associated with a rapid increase in blood pressure in a storage region, and statistically processes blood pressure fluctuation amount data of the plurality of individual waveforms for each lateral coordinate to obtain the representative waveform and the waveform deviation.

In the present specification, the "peak value of the individual waveform" refers to a peak value of each blood pressure surge, and corresponds to the largest beat-to-beat peak value among a plurality of beat-to-beat peak values forming each blood pressure surge.

The "equivalent state" is a state that does not require a process of actually drawing and aligning the positions of the peaks of the plurality of individual waveforms on the coordinate plane, and is sufficient if the data in the storage area is equivalent to the state defined on the coordinate plane.

In the blood pressure related information display device according to the one embodiment, the statistical processing unit creates a state equivalent to a state in which the plurality of individual waveforms are slid relative to each other in the lateral direction and the positions of the peaks of the plurality of individual waveforms are aligned in a storage area, and in this state, statistical processing is performed on the blood pressure fluctuation amount data of the plurality of individual waveforms, so that the representative waveform and the waveform deviation can be grasped.

In the blood pressure related information display device according to one embodiment, the blood pressure fluctuation amount data of the plurality of individual waveforms is a fluctuation amount based on a blood pressure value at a start point of the individual waveform.

In the blood pressure related information display device according to the embodiment, the representative waveform and the waveform deviation can be easily grasped.

In one embodiment, the blood pressure related information display device is characterized in that the blood pressure variation data of the plurality of individual waveforms is normalized so as to align the heights of the peaks of the plurality of individual waveforms.

In the blood pressure related information display device according to the embodiment, the representative waveform and the waveform deviation can be grasped more easily.

In one embodiment, the blood pressure related information display device is characterized in that,

the lateral coordinate representing the lapse of time is determined by a beat number that determines a peak corresponding to the beat,

the statistical processing unit performs statistical processing on the blood pressure fluctuation amount data of the plurality of individual waveforms for each beat number.

Here, since the beat interval is not constant due to the beat of the heart, the period of 1 beat when a sudden increase in blood pressure forming one individual waveform occurs may be different from the period of 1 beat when a sudden increase in blood pressure forming another individual waveform occurs. "the lateral coordinate … indicating the passage of time is determined by a beat number" means that the passage of time is indicated by the progress of beats, regardless of this difference.

In the blood pressure related information display device according to one embodiment, the horizontal coordinate indicating the elapse of time is specified by a beat number specifying the beat corresponding peak. Therefore, even if the period of 1 heartbeat when a sudden increase in blood pressure occurs that forms a certain individual waveform is different from the period of 1 heartbeat when a sudden increase in blood pressure occurs that forms another individual waveform, it is easy to grasp the representative waveform and the waveform deviation. In addition, when the statistical processing is performed on the blood pressure fluctuation amount data of the plurality of individual waveforms, the statistical processing unit may perform the statistical processing on the blood pressure fluctuation amount data for each beat number. Therefore, the amount of calculation by the statistical processing unit is reduced compared to the case where the statistical processing of the blood pressure fluctuation amount data is continuously performed in the lateral direction.

In one embodiment, the statistical processing unit is configured to set, as zero, a contribution of a portion insufficient compared with the longest individual waveform to the statistical processing of the blood pressure fluctuation amount data, for an individual waveform shorter than the individual waveform having the longest lateral dimension, among the plurality of individual waveforms.

In the blood pressure related information display device according to the one embodiment, even when the plurality of individual waveforms are different from each other in lateral dimension on the coordinate plane, the statistical processing of the blood pressure fluctuation amount data can be performed without hindrance.

In one embodiment, the blood pressure related information display device is characterized in that,

the waveform deviation obtained by the statistical processing unit is defined as ± k times a standard deviation of a distribution formed by the blood pressure fluctuation amount data of the plurality of individual waveforms when k is a natural number,

the display processing unit displays, on the display screen, a region having a width in a longitudinal direction that is ± k times the standard deviation as a region indicating the waveform deviation.

In the blood pressure related information display device according to this embodiment, a region having a width in the longitudinal direction that is ± k times the standard deviation (however, k is a natural number, and typically k is 1, 2, or 3) is displayed on the display screen as a region indicating the waveform deviation. Therefore, the user can intuitively grasp the curve representing the representative waveform in which the blood pressure of the subject increases and the region representing the waveform deviation. The display of the region indicating the waveform deviation is particularly advantageous, for example, when the variation of the individual waveform is sufficiently handled as a normal distribution (for example, when the number of the individual waveforms is several tens or more).

In one embodiment, the blood pressure related information display device is characterized in that,

the waveform deviation obtained by the statistical processing unit is defined as a quartile range of a distribution formed by the blood pressure fluctuation amount data of the plurality of individual waveforms,

the display processing unit displays a region having a width corresponding to the quartile range in a longitudinal direction on the display screen as a region indicating the waveform deviation.

In the blood pressure-related information display device according to the one embodiment, a region having a width corresponding to the quartile range in the longitudinal direction is displayed on the display screen as a region indicating the waveform deviation. Therefore, the user can intuitively grasp the curve representing the representative waveform in which the blood pressure of the subject increases and the region representing the waveform deviation. In addition, the calculation is completed easily without excessive calculation, as compared with the case where the region representing the waveform deviation is defined by the standard deviation. Therefore, it is possible to contribute to an increase in processing speed and a saving in memory.

In one embodiment, the display processing unit performs processing of displaying a curve indicating a plurality of the individual waveforms on the display screen so as to form a region indicating the waveform deviation, in a form distinguishable from a curve indicating the representative waveform.

In the blood pressure-related information display device according to the one embodiment, a curve indicating the representative waveform and curves indicating a plurality of the individual waveforms are displayed so as to form an area indicating the waveform deviation on the display screen. Therefore, the user can intuitively grasp the curve representing the representative waveform in which the blood pressure of the subject increases and the region representing the waveform deviation. The display of the curve representing the plurality of individual waveforms is advantageous, for example, in a case where the number of individual waveforms is several or less, for a user to grasp a change in the individual waveform.

In one embodiment, the blood pressure related information display device is characterized in that,

comprising: an input unit which inputs information indicating a body state specifying period in which a body state of the subject can be specified, along with time-series data of blood pressure that changes in conjunction with pulsation of the subject,

the statistical processing unit obtains a representative waveform and a waveform deviation of a rapid increase in blood pressure in the time-series data for each of the body state specifying periods,

the display processing unit performs processing for displaying a curve representing the representative waveform in a region of the waveform deviation representing the rapid increase in blood pressure so as to be superimposed for each of the physical state specifying periods on the display screen.

In the present specification, the "body state-specific period" refers to a non-breathing period, a rapid eye movement sleep period, a non-rapid eye movement sleep period, a waking period, and/or a transcutaneous arterial oxygen saturation (SpO)₂) A period of physical condition such as a low period in which the subject is likely to cause a rapid increase in blood pressure.

In the blood pressure related information display device according to the one embodiment, the input unit inputs information indicating a period during which the physical condition of the subject is specified, along with time-series data of the blood pressure that changes in conjunction with pulsation of the subject. The statistical processing unit obtains a representative waveform and a waveform deviation of a rapid increase in blood pressure in the time-series data for each of the body state specifying periods. The display processing unit performs processing for displaying a curve representing the representative waveform in a region of the waveform deviation representing the rapid increase in blood pressure so as to be superimposed for each of the physical state specifying periods on the display screen. Thus, the user can grasp the curve of the representative waveform indicating the rapid increase in blood pressure of the subject and the region indicating the waveform deviation for each period of the physical state specified by the physical state, in other words, for each period of the physical state in which the subject is likely to become a factor of the rapid increase in blood pressure. Therefore, the user can grasp, for example, the factor (physical condition) causing the most severe blood pressure surge.

In another aspect, a blood pressure related information display method of the present disclosure, which visually displays information related to a sudden increase in blood pressure,

detecting a sudden increase in blood pressure based on a preset criterion from time-series data of blood pressure that changes in conjunction with pulsation of a subject;

for each detected blood pressure surge, obtaining an envelope connecting a plurality of beat-to-beat peak values forming the blood pressure surge as an individual waveform;

performing statistical processing on the obtained plurality of individual waveforms to obtain a representative waveform and a waveform deviation of a blood pressure surge in the time-series data;

and performing a process of displaying a curve representing the representative waveform on a display screen so as to be superimposed on a region of the waveform deviation representing the rapid increase in blood pressure.

According to the blood pressure-related information display method of the present disclosure, the user can intuitively grasp the curve of the representative waveform indicating the rapid increase in blood pressure of the subject and the region indicating the waveform deviation. This is considered to be useful as a material for evaluating the risk of cardiovascular diseases and a material for evaluating the risk of diseases in a specific organ, in addition to the diagnosis and treatment of SAS.

In another aspect, a program of the present disclosure is a program for causing a computer to execute the blood pressure-related information display method.

The blood pressure-related information display method can be implemented by causing a computer to execute the program of the present disclosure.

Effects of the invention

As described above, according to the blood pressure related information display device and the blood pressure related information display method of the present disclosure, the representative waveform of a rapid increase in blood pressure and the waveform deviation can be displayed in a superimposed manner. In addition, the blood pressure-related information display method can be implemented by causing a computer to execute the program of the present disclosure.

Drawings

Fig. 1 is a block diagram showing an embodiment of a system in which a blood pressure related information display device according to the present invention is configured on a network.

Fig. 2 is a block diagram showing the configuration of a hospital terminal included in the system.

Fig. 3 is a block diagram showing the structure of a server included in the system.

Fig. 4 is a diagram showing an embodiment in which time-series data of the blood pressure at night of the subject and a physical state that can be a factor of a rapid increase in blood pressure are measured together by the system.

Fig. 5A is a diagram showing an operation flow of the server when the basic blood pressure related information display method is executed.

Fig. 5B is a diagram showing an operation flow of the server when the applicable blood pressure-related information display method is executed.

In fig. 6, (a) in fig. 6 is a graph showing time-series data of the blood pressure at the time-bottom of the subject. Fig. 6 (B) is a diagram enlarging a part of fig. 6 (a) and then showing a blood pressure surge detected on the time-series data and a non-respiratory/low-respiratory event measured by the PSG device.

Fig. 7 is a diagram illustrating a waveform (individual waveform) of a blood pressure surge and explaining a criterion for detecting the blood pressure surge.

Fig. 8 is a diagram conceptually illustrating a process of averaging individual waveforms of a rapid increase in blood pressure.

Fig. 9 (a) is a diagram illustrating a plurality of individual waveforms. Fig. 9 (B) is a diagram illustrating image data in a form in which a curve representing an average waveform is superimposed on a region representing a waveform deviation.

Fig. 10 is a detailed flowchart showing statistical processing of individual waveforms for a blood pressure surge.

Fig. 11 is a diagram illustrating a table in which the time at which the detected blood pressure surge is specified is recorded.

Fig. 12 is a diagram illustrating a table in which time series data of beat-to-beat peaks of individual waveforms are recorded for a certain blood pressure surge.

Fig. 13 is a diagram illustrating a table for statistically processing blood pressure fluctuation amount data.

Fig. 14 is a diagram showing a flow of display processing at the hospital terminal when the applicable blood pressure-related information display method is executed.

Fig. 15A is a diagram showing image data in a form in which curves representing average waveforms created for a non-breathing period, a rapid eye movement sleep period, a non-rapid eye movement sleep period, and a waking period are arranged and thumbnail-displayed on a display screen so as to overlap in a region representing a waveform deviation.

Fig. 15B is a diagram showing a form in which image data created for the apnea period is displayed on the display screen in an enlarged manner.

In fig. 16, (a) of fig. 16 is a diagram illustrating a plurality of individual waveforms obtained for a non-breathing period, as in (a) of fig. 9. Fig. 16 (B) is a diagram showing a modification of the form of displaying the waveform deviation.

Detailed Description

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

(Structure of System)

Fig. 1 shows an example of a system (denoted as a whole by reference numeral 100) in which a blood pressure related information display device according to an embodiment of the present invention is configured as a network. The system 100 includes: hospital terminals 200A, 200B having a display 240 as a display screen; a server 300; a tension measuring type sphygmomanometer 400; and a PSG (polysomnography) device 500. These hospital terminals 200A and 200B, server 300, sphygmomanometer 400, and PSG apparatus 500 can communicate with each other via a Local Area Network (LAN) Network 900. The communication via the network 900 may be either wireless or wired. In the present embodiment, the network 900 is an in-hospital lan (local Area network), but is not limited to this, and may be another type of network such as the internet, or may be 1-to-1 communication using a USB cable or the like. In the present example, only two hospital terminals 200A and 200B are shown, but three or more hospital terminals may be provided.

As shown in fig. 2, the hospital terminal 200A includes: a main body 200M, a control unit 210 mounted on the main body 200M, a storage unit 220, an operation unit 230, a display 240 as a display screen, and a communication unit 290. The hospital terminal 200A is a commercially available notebook personal computer, and is provided with application software (computer program) for performing processing described later, and can access the server 300.

The control Unit 210 includes a CPU (Central Processing Unit) and its auxiliary circuits, controls each Unit of the hospital terminal 200A, and executes processes to be described later in accordance with programs and data stored in the storage Unit 220. That is, data input from the operation unit 230 and the communication unit 290 are processed, and the processed data are stored in the storage unit 220, displayed on the display 240, or output from the communication unit 290.

The storage unit 220 includes a RAM (Random Access Memory) used as a work area necessary for the control unit 210 to execute a program, and a ROM (Read Only Memory) for storing a basic program executed by the control unit 210. As a storage medium of the auxiliary storage device for assisting the storage area of the storage unit 220, a semiconductor memory (memory card, SSD (Solid State Drive)) or the like can be used.

In this example, the operation unit 230 is composed of a keyboard and a mouse, and normally inputs an operation signal instructing a doctor as a user to operate to the control unit 210. The operation unit 230 may be configured by another operation device such as a touch panel, and may be added in place of or in addition to the keyboard and the mouse.

The Display 240 includes a Display screen (for example, an LCD (Liquid Crystal Display) or EL (Electroluminescence) Display, etc.). The display 240 is controlled by the control unit 210 to display a predetermined picture on the display screen.

Communication unit 290 transmits information from control unit 210 to server 300 via network 900.

Although not shown for simplicity, the other hospital terminals 200B and … have the same configuration as the hospital terminal 200A.

As shown in fig. 3, the server 300 includes a control unit 310, a storage unit 320, an operation unit 330, a display 340, and a communication unit 390. The server 300 is a general-purpose computer device on which a program (software) is installed to perform processing described later.

The control unit 310 includes a CPU and its auxiliary circuits, controls each unit of the server 300, executes predetermined processing in accordance with programs and data stored in the storage unit 320, processes data input from the operation unit 330 and the communication unit 390, and stores the processed data in the storage unit 320, displays the processed data on the display 340, or outputs the processed data from the communication unit 390.

The storage section 320 includes a RAM used as a work area necessary for the control section 310 to execute programs, and a ROM for storing basic programs executed by the control section 310. The storage unit 320 is provided with a database 321 including blood pressure measurement data sent from a large number of subjects. As a storage medium of the auxiliary storage device for assisting the storage area of the storage unit 320, a magnetic Disk (HD (Hard Disk), FD (Flexible Disk)), an Optical Disk (CD (Compact Disk), DVD (Digital Versatile Disk), BD (Blu-ray Disk)), an Optical Disk (MO (Magneto-Optical Disk)), a semiconductor storage unit (memory card, SSD), or the like can be used.

In this example, the operation unit 330 is composed of a keyboard and a mouse, and inputs an operation signal instructing an operation by a user to the control unit 310. The operation unit 330 may be configured by another operation device such as a touch panel, and may be added in place of or in addition to the keyboard and the mouse.

The display 340 includes a display screen (e.g., an LCD or EL display, etc.). The display 340 is controlled by the control unit 310 to display a predetermined picture on the display screen.

The communication unit 390 transmits information from the control unit 310 to another device (in this example, the hospital terminal 200A) via the network 900, and receives information transmitted from another device via the network 900 and transmits the information to the control unit 310.

In this example, the sphygmomanometer 400 shown in FIG. 1 is constituted by a sphygmomanometer of a tension measuring system disclosed in Japanese patent application No. 2017-050066. As shown in fig. 4, the sphygmomanometer 400 includes: a pressure sensor unit 402 that continuously detects pressure pulse waves passing through the radial artery of a measurement site (e.g., the left wrist) of the subject 90 for each beat by a tension measurement method; and a main unit 401 that outputs the change in pressure detected by the pressure sensor unit 402 as time-series data of the blood pressure. The pressure sensor portion 402 and the main body unit 401 are connected by a signal cable 403. The tonometry is a method of measuring a pressure pulse wave by flattening a blood vessel by the pressure sensor unit 402 (for example, a pressure pulse wave sensor) and determining a blood pressure. When a blood vessel is regarded as a circular tube having a uniform thickness, the relationship between the internal pressure (blood pressure) of the blood vessel and the external pressure (pressure of a pressure pulse wave) of the blood vessel can be derived from laplace's law by considering the blood vessel wall regardless of the flow or the presence or absence of pulsation of blood in the blood vessel. By using this relational expression, under the condition that the blood vessel on the pressing surface is compressed, the pressure of the pressure pulse wave can be approximated to be equal to the blood pressure by approximating the radii of the outer wall and the inner wall of the blood vessel. Therefore, the pressure of the pressure pulse wave thereafter becomes the same value as the blood pressure. As a result, the sphygmomanometer 400 measures the blood pressure value of the measurement site (for example, the left wrist) for each heartbeat, and outputs the time-series data 801 of the blood pressure in which the measurement time (time) and the blood pressure are associated with each other, for example, as shown in fig. 6 a. The time-series data 801 of one-evening includes beat-to-beat peaks (corresponding to peaks of Systolic Blood Pressure (SBP) or Diastolic Blood Pressure (DBP)) of about 3 ten thousand heart beats.

In this example, the PSG device 500 shown in fig. 1 is a commercially available PSG device (for example, neurosax (registered trademark) EEG-9200 manufactured by japan photoelectric industry co., ltd.) and is executed only when the PSG device is usedMethod for displaying applicable blood pressure-related information described later]It is used when in use. As shown in fig. 4, the PSG device 500 includes a sensor group 502, and a main unit 501 that processes signals from the sensor group 502 and outputs information for determining the physical state of the subject 90. In this example, sensor group 502 includes: brain wave detection electrode 502A for detecting brain waves, eye movement detection electrode 502B for detecting eye movement, airflow sensor 502C for detecting airflow accompanying respiration, electrocardiogram electrode 502D for obtaining an electrocardiogram, and percutaneous arterial blood oxygen saturation (SpO) detection₂) And an electromyogram electrode 502F for obtaining an electromyogram. The sensor group 502 and the main body unit 501 are connected by a signal cable not shown via a cable box not shown. In this example, PSG device 500 may be capable of outputting a signal indicative of a no-breath period (or a low-breath period), a rapid eye movement sleep period, a non-rapid eye movement sleep period, a wake period, and/or an SpO period₂The information of the low period is information indicating a period during which the physical state of the subject 90 is determined (this is referred to as a "physical state specifying period"). Here, "no breathing" during sleep means "a state in which breathing is stopped for 10 seconds or more". In addition, "low breathing" means that ventilation by breathing is reduced to 10 seconds or more and 50% or less. Further, "rapid eye movement sleep" refers to sleep accompanied by rapid eye movement, "non-rapid eye movement sleep" refers to sleep not accompanied by rapid eye movement, and "awake" refers to a state of being awake. SpO₂It is a value obtained by measuring a few% of hemoglobin contained in red blood cells flowing in arterial blood and having oxygen bonded thereto through the skin (percutaneously). SpO₂The period of "low" means SpO in this example₂Less than 90% of the time period.

For example, in fig. 6 (B) shown by enlarging a part of fig. 6 (a), "no breathing" periods are indicated by hatched bars 805, …. In addition, the "low breath" period is indicated by the white bars 804, …. In such an approach, the PSG device 500 can output information indicating the period specified for the physical state of the subject 90 in a variety of ways.

(blood pressure-related information display method)

The system 100 is roughly divided into creation of image data included in the server 300 and display of image data on a hospital terminal (for example, 200A), and can implement the following "a. basic blood pressure-related information display method" and "b. applicable blood pressure-related information display method".

[ A. basic blood pressure-related information display method ]

In this basic blood pressure related information display method, image data is created and displayed as described below, using only time-series data 801 of blood pressure in which a measurement time (time) output from a sphygmomanometer 400 corresponds to the blood pressure, as illustrated in fig. 6 a, without using a PSG device 500.

(creation of image data on Server 300)

i) In the system shown in fig. 4, continuous blood pressure measurement using the sphygmomanometer 400 is performed for the subject 90 after evening (including the sleep period) (in this example, measurement of the physical state using the PSG device 500 is not performed). In this example, time-series data of blood pressure from the blood pressure meter 400 is received by the hospital terminal 200A and temporarily stored in the storage unit 220. Next, for example, a doctor as a user operates the operation unit 230 of the hospital terminal 200A, and transmits time-series data of blood pressure measured with respect to the subject 90 and information indicating a physical state specifying period to the server 300 via the network 900.

ii) the server 300 is always in an operating state in this example (except for a maintenance period, etc.), and waits for data from the hospital terminal 200A as shown in step S101 of fig. 5A (showing an operation flow of the server 300 when the basic blood pressure-related information display method is executed). When the control unit 310 of the server 300 receives the time-series data of the blood pressure from the hospital terminal 200A from the network 900 via the communication unit 390 as the input unit (yes in step S101), the received time-series data of the blood pressure is stored in the database 321 of the storage unit 320. Then, the processing of steps S102 to S107 described below is executed.

iii) first, as shown in step S102, the control unit 310 functions as a preprocessing unit that performs preprocessing such as smoothing using a known moving average method or the like, noise removal, and high-frequency component removal using a low-pass filter on the time-series data of the blood pressure.

iv) next, as shown in step S103, the control unit 310 functions as a blood pressure surge detection unit that detects a surge in blood pressure based on a predetermined criterion from the time-series data of the blood pressure of the subject 90, as disclosed in japanese patent application No. 2017 and 048946, and japanese patent application No. 2017 and 050066, for example. Thus, for example, in fig. 6 (B), a plurality of blood pressure surges are detected as indicated by the dashed rectangular boxes 803, and …. It is said that blood pressure spikes may occur hundreds of times. In this example, a black circle ● is marked on the peak corresponding to the Systolic Blood Pressure (SBP), and these are connected by an envelope. In addition, the peaks corresponding to Diastolic Blood Pressure (DBP) are marked with white circles and connected by an envelope.

Here, the "predetermined determination criterion" for detecting a sudden increase in blood pressure means that, for example, as shown in fig. 7 (an example of an individual waveform of a sudden increase in blood pressure is shown by a curve C), a peak detection interval (for example, a period of 15 heartbeats) includes a period from the time of a sudden increase start point P1 to the time of a sudden increase peak point P2, a difference (blood pressure fluctuation amount) L1 between a systolic blood pressure value (SBP) at the time of a sudden increase start point P1 and a systolic blood pressure value (SBP) at the time of a peak point P2 is 20mmHg (or 15mmHg) or more, a period T1 between the time of a sudden increase start point P1 and the time of a peak point P2 is greater than 5 heartbeats, and a period T3 between the time of a peak point P2 and the time of a sudden increase end P4 is greater than 7 heartbeats. In this example, the surge start point P1 is defined as a point at which the systolic blood pressure value (SBP) is given a minimum before the peak point P2. The rapid increase end point P4 is defined as a point at which the blood pressure decreases by L1 × 0.75(═ L3) from the peak point P2 after the peak point P2.

v) next, as shown in step S104 of fig. 5A, the control unit 310 functions as an individual waveform acquisition unit, and obtains, as an individual waveform, an envelope connecting a plurality of beat-to-beat peaks (peaks corresponding to Systolic Blood Pressure (SBP) in this example) forming the blood pressure spike 803 for each of the detected blood pressure spikes 803, …. As shown in fig. 7, the individual waveforms of the blood pressure surge appear as a curve C having a mountain-like shape.

vi) next, as shown in step S105 of fig. 5A, the control unit 310 functions as a statistical processing unit, and in this example, performs statistical processing on all the obtained individual waveforms to obtain a representative waveform and a waveform deviation of a rapid increase in blood pressure in the time-series data 801. Here, the "statistical processing" refers to processing for averaging individual waveforms. In this example, the "representative waveform" in which the blood pressure is rapidly increased means an average waveform obtained by averaging a plurality of individual waveforms. In this example, the "waveform deviation" in which the blood pressure increases rapidly means the width of the distribution of the plurality of individual waveforms.

Conceptually, the process of averaging individual waveforms of rapid blood pressure increase refers to the following process. As illustrated in fig. 8, as the blood pressure surge, there is an individual waveform C1 of "surge No. 1" and an individual waveform C2 of "surge No. 2". In this case, the process of averaging the individual waveforms of which the blood pressure increases abruptly corresponds to the following process: on a coordinate plane Q including a horizontal coordinate X indicating the passage of time and a vertical coordinate Y indicating the amount of blood pressure fluctuation accompanying a rapid increase in blood pressure, the blood pressure fluctuation amount data of the plurality of individual waveforms C1, C2 are averaged for each horizontal coordinate X in a state where the plurality of individual waveforms C1, C2 are slid relative to each other in the horizontal direction X and the positions of the peaks of the plurality of individual waveforms C1, C2 are aligned, and a curve Cav indicating the averaged waveform is obtained as a representative waveform. Here, in fig. 8, the horizontal coordinate X indicating the passage of time is specified by a beat number for specifying a beat-to-beat peak. The vertical coordinate Y is determined by the amount of blood pressure fluctuation of the systolic blood pressure value (SBP) accompanying a sudden increase in blood pressure. The specific data processing (statistical processing of individual waveforms of blood pressure surge) will be described in detail later.

In this example, the range of the "waveform deviation" in which the blood pressure abruptly increases is the standard deviation σ of the distribution (distribution per lateral coordinate X) formed using the blood pressure fluctuation amount data of the plurality of individual waveforms, and is defined as a range of ± k times the standard deviation σ (however, k is a natural number) for each lateral coordinate X. Typically, k is set to 1, 2 or 3. Hereinafter, unless otherwise specified, the range of the "waveform deviation" in which the blood pressure increases abruptly is the range of ± σ. The display of the region (for example, the region Sd shown in fig. 9B described later) indicating the waveform deviation ± σ becomes a particularly useful display in the case where the deviation of the individual waveform is enough to be handled as a normal distribution (for example, in the case of several tens or more).

Thereby, a curve Cav representing a waveform which is an average of representative waveforms, and a waveform deviation ± σ for each lateral coordinate X are obtained.

vii) next, as shown in step S106 of fig. 5A, the control unit 310 functions as a part of the display processing unit, and creates image data in a form in which a curve Cav representing an average waveform is superimposed on a region (denoted by reference numeral Sd) of waveform deviation representing a rapid increase in blood pressure.

For example, as shown in (a) of fig. 9, in step S104 of fig. 5A, individual waveforms C11, C12, C13, … are obtained. In this case, in step S106 of fig. 5A, for example, as shown in fig. 9 (B), image data Im in the form of a curve Cav representing an average waveform is superimposed on a region Sd representing a waveform deviation is obtained. In this example, a curve Cav indicating an average waveform is shown by a solid line having a certain concentration. The region Sd indicating the waveform deviation is represented as a region having an intermediate density between the curve Cav and the background region (white region in this example) Bg.

viii), the control unit 310 of the server 300 transmits the created image data Im to the hospital terminal 200A, which is the supply source of the time-series data of the blood pressure in this example, via the network 900, as shown in step S107 of fig. 5A.

The control unit 310 of the server 300 may transmit the image data Im to a hospital terminal 200B other than the hospital terminal 200A, for example, according to a designation of a user who operates the hospital terminal 200A.

(statistical processing of Individual waveforms of sudden increase in blood pressure)

Fig. 10 shows a detailed flow of the statistical processing for the individual waveforms of the blood pressure spike by the control unit 310 of the server 300 described in step S105 of fig. 5A.

As shown in step S111 in fig. 10, the control unit 310 acquires time-series data of beat-to-peak values of the individual waveforms from the database 321 for all detected blood pressure spikes. In this example, the number of acquired blood pressure spikes is N.

For example, as shown in the table MT1 of fig. 11, the detected blood pressure surge No.1 is determined as the start time (time of the start point) 22: 20: 15. peak time (time of peak) 22: 20: 21. end time (end point time) 22: 20: 26. further, the blood pressure surge No.2 is determined as the start time 22: 25: 35. peak time 22: 25: 44. end time 22: 25: 52. in addition, the method of time expression is "time: dividing into: seconds "(the same applies hereinafter).

In this case, for example, with respect to the blood pressure surge No.1, the time-series data of the beat-to-peak value of the individual waveform is, for example, as shown in table MT2 of fig. 12, and at the start time 22: 20: 15, 130[ mmHg ] peak corresponding to SBP, 78[ mmHg ] peak corresponding to DBP, and 61[ beats/min ] pulse rate PR are recorded as beat-corresponding peaks. At time 22 corresponding to the next heartbeat: 20: 16, a peak value corresponding to SBP was 134[ mmHg ], a peak value corresponding to DBP was 80[ mmHg ], and a pulse rate PR was 60[ beats/min ]. Thus, the time-series data of the beat-to-peak values are sequentially recorded, and at the end time 22: 20: a peak value corresponding to SBP of 133 mmHg, a peak value corresponding to DBP of 82 mmHg, and a pulse rate PR of 61 beats/min were recorded at 26. Although not shown for simplicity, time series data of beat-to-peak values of individual waveforms is similarly recorded for the blood pressure surge No. 2.

Next, as shown in step S112 in fig. 10, the control unit 310 shifts the start point P1 of each individual waveform as a reference (0 mmHg) for the N individual waveforms. That is, the blood pressure value (SBP value in this example) at the start point P1 of each of the N individual waveforms is subtracted from the blood pressure value (SBP value in this example) at each time. Thus, blood pressure fluctuation data at each time is obtained. By shifting in this manner, it is easy to grasp the curve Cav representing the average waveform as a representative waveform and the waveform deviation ± σ for each lateral coordinate X.

Next, as shown in step S113 of fig. 10, the control unit 310 specifies the individual waveform having the longest X-direction (lateral direction) size among the N individual waveforms. The longest dimension in the X direction is obtained as the number of beats M.

Next, as shown in step S114 of fig. 10, the control unit 310 secures a storage area of N rows and M columns in the storage unit 320 as a work area for performing the calculation.

For simplicity, as shown in the example in fig. 8, the number N of acquired blood pressure spikes is 2, the X-direction size of the individual waveform C1 of "spike No. 1" is 12 beats, and the X-direction size of the individual waveform C2 of "spike No. 2" is 17 beats. At this time, the control unit 310 specifies the individual waveform having the longest X-direction dimension as C2, and obtains the longest X-direction dimension as the beat number M of 17. Then, as shown in the second to third rows of the table MT3 of fig. 13, the control unit 310 secures a storage area of 2 rows and 17 columns in the storage unit 320 as a work area for performing the calculation for "surge No. 1" and "surge No. 2". In fact, when the number N of acquired blood pressure spikes is greater than 2, a memory area with more rows than 2 is secured. In the uppermost stage (first row) of the table MT3, a beat number indicating the X-direction coordinate is shown.

Next, as shown in step S115 of fig. 10, the control unit 310 relatively slides the N individual waveforms in the storage area of the N rows and M columns in the lateral direction X to align the positions (beat numbers) of the peaks of the N individual waveforms. For example, in the example of fig. 13, the positions of the peaks of the two individual waveforms C1, C2 "surge No. 1" and "surge No. 2" are aligned in the lateral direction X to be at beat number 10 (indicated by a circle surrounded by a broken line). As a result, in the second row of table MT3, the blood pressure fluctuation amount data of "surge No. 1" are represented by beat numbers "0", "4", "10", "13", … "," 11 ", and" 3 ", in that order, in beat numbers 4 to 15 (the same applies to the unit mmhg. hereinafter). In addition, in the third row of table MT3, the blood pressure fluctuation amount data of "surge No. 2" is represented by beat numbers "0", "2", "3", "5", … "," 4 ", and" 2 ", in that order, by beat number 1 to 17. In this way, the state of aligning the positions (beat numbers) of the peaks of the N individual waveforms is equivalent to the state of relatively sliding the plurality of individual waveforms C1, C2 in the lateral direction X on the coordinate plane Q shown in fig. 8 and aligning the positions of the peaks of the plurality of individual waveforms C1, C2. This makes it easier to grasp the curve Cav representing the average waveform as a representative waveform and the waveform deviation ± σ at each lateral coordinate X. Note that the value of the starting point (beat number 4) of the individual waveform C1 of "surge No. 1" and the values of the starting points (beat number 1) of the individual waveforms C2 of "surge No. 2" are both "0", which is the result of the above-described offset (step S112 in fig. 10).

Next, as shown in step S116 of fig. 10, the control unit 310 performs statistical processing (averaging in this example) on the blood pressure fluctuation amount data of the N individual waveforms for each beat number (row) to obtain an average value. For example, in the example of fig. 13, the average value of the blood pressure fluctuation amount data for the individual waveforms of "surge No. 1" and "surge No. 2" is shown in the bottom row (fourth row) of the table MT 3. From the average value of the beat number, a curve Cav indicating a waveform as an average of representative waveforms is determined.

At this time, the control unit 310 sets the contribution of the portion lacking the longest individual waveform (in the above example, "surge No. 2") to the statistical processing of the blood pressure fluctuation amount data to zero for the individual waveform (in the above example, "surge No. 1") shorter than the individual waveform (in the above example, "surge No. 2") having the longest dimension in the X direction among the N individual waveforms. For example, in the example of fig. 13, regarding the individual waveform of "surge No. 1", the contribution to the statistical processing of the blood pressure fluctuation amount data is set to zero for the portions of the individual waveform of "surge No. 2" whose X-direction dimension is smaller than the "surge No. 2", that is, for the portions of beat numbers 1 to 3 and the portions of beat numbers 16 to 17. Thus, even when the X-direction sizes of the N individual waveforms on the coordinate plane Q are different from each other, the statistical processing of the blood pressure fluctuation amount data can be performed without hindrance.

Further, as shown in step S117 of fig. 10, the control unit 310 obtains the standard deviation σ of the distribution of the blood pressure fluctuation amount data of the N individual waveforms for each beat number (column). The region of each beat number ± σ is determined as the already described region Sd representing the waveform deviation.

In this way, in this flow, when statistical processing is performed on the blood pressure fluctuation amount data of the N individual waveforms, the statistical processing of the blood pressure fluctuation amount data may be performed for each beat number (column). Therefore, the amount of calculation by the control unit 310 is reduced compared to the case where the statistical processing of the blood pressure fluctuation amount data is continuously performed in the lateral direction X.

In step S112 of fig. 10, the N individual waveforms may be normalized so as to align the heights of the peaks of the N individual waveforms, in addition to shifting the starting point P1 of each individual waveform as a reference (0 mmHg). This makes it easier to grasp the curve Cav representing the average waveform as a representative waveform and the waveform deviation ± σ for each lateral coordinate X.

(display of image data on Hospital terminal)

The hospital terminal 200A receives the image data Im as shown in (B) of fig. 9 from the server 300 via the network 900.

Next, when a display instruction is given by the user via the operation unit 230 of the hospital terminal 200A, the control unit 210 of the hospital terminal 200A functions as a part of the display processing unit, and the image data Im is displayed on the display screen of the display 240. At this time, on the display screen of the display 240, an average value of the blood pressure fluctuation amount (difference L1 between the systolic blood pressure value (SBP) at the time of the surge start point P1 and the systolic blood pressure value (SBP) at the time of the peak point P2 shown in fig. 7), values of the standard deviations σ (or ± σ, ± 2 σ, ± 3 σ) of the distribution, and the like may be displayed together.

The user can grasp the curve Cav of the representative waveform indicating a rapid increase in blood pressure and the region Sd indicating the waveform deviation of the subject 90 by observing the display screen of the display 240. In addition to diagnosis and treatment of SAS, it is considered that this is useful as a material contributing to evaluation of cardiovascular disease risk and a material contributing to evaluation of disease risk of a specific organ.

The user may input a transfer instruction via the operation unit 230 of the hospital terminal 200A and may transmit the image data Im to another hospital terminal 200B or the like other than the hospital terminal 200A.

[ B. method for displaying applicable blood pressure-related information ]

In this applicable blood pressure-related information display method, the following image data is created and displayed using time-series data of blood pressure in which the measurement time (time) output from the sphygmomanometer 400 is associated with the blood pressure and information indicating a physical condition specifying period output from the PSG device 500.

(creation of image data in Server 300)

i) In the embodiment shown in fig. 4, continuous blood pressure measurement using the sphygmomanometer 400 and physical state measurement using the PSG apparatus 500 are performed for the subject 90 after the lapse of time (including the sleep period). In this example, time-series data of blood pressure from the blood pressure meter 400 and information indicating a physical condition specifying period from the PSG device 500 are received by the hospital terminal 200A and temporarily stored in the storage unit 220. Next, for example, a doctor as a user operates the operation unit 230 of the hospital terminal 200A to transmit time-series data of blood pressure measured with respect to the subject 90 and information indicating a physical state specifying period to the server 300 via the network 900.

ii) the server 300 is always in an operating state (except for the maintenance period) in this example, and waits for data from the hospital terminal 200A as shown in step S151 of fig. 5B (which shows an operation flow of the server 300 when the applicable blood pressure-related information display method is executed). When the control unit 310 of the server 300 receives the above-described data (time-series data of blood pressure and information indicating a physical state specifying period) from the hospital terminal 200A from the network 900 via the communication unit 390 as an input unit (yes in step S151), the received time-series data of blood pressure and information indicating a physical state specifying period are stored in the database 321 of the storage unit 320. Then, the processing of steps S152 to S157 described below is executed.

iii) first, as shown in step S152, the control unit 310 functions as a preprocessing unit that performs preprocessing such as smoothing using a well-known motion average, noise removal, and high-frequency component removal using a low-pass filter on the time-series data of the blood pressure.

iv) next, as shown in step S153, the control unit 310 functions as a blood pressure surge detection unit that detects a surge in blood pressure based on a predetermined criterion from the time-series data of the blood pressure of the subject 90, as disclosed in japanese patent application No. 2017 and 048946, and japanese patent application No. 2017 and 050066, for example. Thus, for example, in fig. 6 (B), a plurality of blood pressure surges are detected as indicated by the dashed rectangular boxes 803, and …. Here, the "preset criterion" for detecting a sudden increase in blood pressure is the same as the criterion described with reference to step S103 in fig. 5A with reference to fig. 7.

v) next, as shown in step S154 of fig. 5B, the control unit 310 functions as an individual waveform acquisition unit, and obtains, as an individual waveform, an envelope of a plurality of beat-to-beat peaks (in this example, peaks of Systolic Blood Pressure (SBP) forming the blood pressure spike 803 for each of the detected blood pressure spikes 803, and …. As shown in fig. 7, the individual waveforms of the blood pressure surge are shown as a curve C having a mountain-like shape.

vi) next, as shown in step S155 in fig. 5B, the control unit 310 functions as a statistical processing unit, and in this example, performs statistical processing on a plurality of individual waveforms obtained for each of the above-described body state specifying periods to obtain a representative waveform and a waveform deviation of a rapid increase in blood pressure in the time-series data 801. In this example, if a certain physical state specifying period (e.g., a no-breathing period) partially overlaps with a period from a start point P1 to an end point P4 of a sudden increase in blood pressure, the sudden increase in blood pressure is treated as a sudden increase in blood pressure occurring in the physical state specifying period. Here, the "statistical process" refers to a process of averaging individual waveforms as described in step S105 of fig. 5A using fig. 8 (and fig. 10 to 13). That is, the process of averaging the individual waveforms of rapid blood pressure increase corresponds to a process of averaging the blood pressure fluctuation amount data of the plurality of individual waveforms C1 and C2 for each lateral coordinate X and obtaining a curve Cav representing a waveform that is an average of representative waveforms, in a state where the plurality of individual waveforms C1 and C2 are relatively slid in the lateral direction X and the positions of the peaks of the plurality of individual waveforms C1 and C2 are aligned on a coordinate plane Q including the lateral coordinate X representing the lapse of time and the vertical coordinate Y representing the blood pressure fluctuation amount according to the rapid blood pressure increase. In this example, as described in step S105 of fig. 5A, the range of the "waveform deviation" in which the blood pressure increases rapidly is defined as a range of ± σ for each lateral coordinate X, which is the standard deviation σ of the distribution (distribution for each lateral coordinate X) formed using the blood pressure fluctuation amount data of the plurality of individual waveforms.

Thus, the waveform deviation ± σ for each lateral coordinate X and the curve Cav representing the average waveform as the representative waveform are obtained for each body state specific period. For example, when the body state specific period specified in the time-series data at first-half is four periods of no-breathing period (including low-breathing period), rapid eye movement sleep period, non-rapid eye movement sleep period, and waking period, the curve Cav representing the waveform as the average of the representative waveforms and the waveform deviation ± σ for each lateral coordinate X are obtained for the no-breathing period. Similarly, a curve Cav representing a waveform as an average of representative waveforms and a waveform deviation ± σ for each lateral coordinate X are obtained for a rapid eye movement sleep period, a non-rapid eye movement sleep period, and a waking period, respectively.

vii) next, as shown in step S156 of fig. 5B, the control unit 310 functions as a part of the display processing unit, and creates image data Im in the form of a curve Cav representing an average waveform superimposed on the region Sd representing the waveform deviation of the rapid increase in blood pressure as shown in fig. 9 (B) for each of the above-described body state specific periods.

For example, as shown in fig. 15A described later, image data Im1, Im2, Im3, and Im4 in the form of curves Cav1, Cav2, Cav3, and Cav4 each representing an average waveform are superimposed on regions Sd1, Sd2, Sd3, and Sd4 each representing a waveform deviation for a non-breathing period (including a low-breathing period), a rapid eye movement sleep period (REM), a non-rapid eye movement sleep period (NREM), and an awake period, respectively.

viii), the control unit 310 of the server 300 transmits the image data Im1, Im2, Im3, Im4 created for each body state specifying period to the hospital terminal 200A, which is the supply source of the time-series data of blood pressure in this example, via the network 900, as shown in step S157 of fig. 5B.

The controller 310 of the server 300 may transmit the image data Im1, Im2, Im3, Im4 to the hospital terminal 200B and the like other than the hospital terminal 200A, for example, according to a designation by the user who operates the hospital terminal 200A.

(display of image data in Hospital terminal)

Fig. 14 shows a flow of display processing in the hospital terminal 200A in the case of receiving image data created for each body state specific period from the server 300. In this example, although the hospital terminal 200A is described, the same display processing can be performed by another hospital terminal 200B or the like.

First, as shown in step S201 of fig. 14, the hospital terminal 200A receives image data created for each physical state specifying period from the server 300 via the network 900. In this example, the physical state specific period is four periods of a no-breathing period (including a low-breathing period), a rapid eye movement sleep period, a non-rapid eye movement sleep period, and a waking period.

Next, the controller 210 of the hospital terminal 200A functions as a part of the display processing unit, and as shown in fig. 15A, the image data Im1, Im2, Im3, and Im4 created for each body state specific period are arranged and displayed in a thumbnail manner on the display screen of the display 240 (step S202 in fig. 14). As shown in fig. 15A, in this example, a body state specifying field 241 for specifying a body state specifying period and an image data field 242 disposed correspondingly thereunder are displayed on the display screen of the display 240. In this example, the body state specification column 241 includes, from left to right: a "no breath" column 241a indicating a no breath period, a "REM" column 241b indicating a rapid eye movement sleep period, an "NREM" column 241c indicating a non-rapid eye movement sleep period, and an "awake response" column 241d indicating an awake period. The image data field 242 includes: a column 242a displaying image data Im1 created for a non-breathing period, a column 242b displaying image data Im2 created for a rapid eye movement sleep period, a column 242c displaying image data Im3 created for a non-rapid eye movement sleep period, and a column 242d displaying image data Im4 created for a waking period.

In this example, the image data Im1 created for the non-breathing period has a form in which a curve Cav1 representing an average waveform is superimposed on a region Sd1 representing a waveform deviation. The image data Im2 created for the rapid eye movement sleep period is in a form in which a curve Cav2 representing an average waveform is superimposed on a region Sd2 representing a waveform deviation. The image data Im3 created for the non-rapid eye movement sleep period is in a form in which a curve Cav3 representing an average waveform is superimposed on a region Sd3 representing a waveform deviation. The image data Im4 created for the awake period is in a form in which a curve Cav4 representing an average waveform is superimposed on an area Sd4 representing a waveform deviation.

By observing the thumbnail display of the image data Im1, Im2, Im3, Im4, the user can grasp the curve Cav representing the representative waveform of the rapid increase in blood pressure of the subject 90 and the area Sd representing the waveform deviation for each period specified by the body state, in other words, for each period of the body state in which the subject 90 may become a factor of the rapid increase in blood pressure. Therefore, the user can easily grasp, for example, the factor (physical condition) causing the most severe blood pressure surge. For example, among the image data Im1, Im2, Im3, and Im4, the amount of blood pressure fluctuation of the image data Im1 created for the non-breathing period is the largest, and therefore it can be determined that "non-breathing" causes the most severe blood pressure surge.

Next, as shown in step S203 of fig. 14, the control unit 210 of the hospital terminal 200A determines whether or not the displayed image data Im1, Im2, Im3, Im4 is selected. When the user selects any one of the image data Im1, Im2, Im3, and Im4 by operating the operation unit 230 (yes in step S203 of fig. 14), the control unit 210 displays the image data for the selected body state specific period (in this example, the image data Im1 created for the non-breathing period) on the display screen of the display 240 in an enlarged manner as shown in fig. 15B (step S204 of fig. 14). In this case, the average value of the blood pressure fluctuation amount (the difference L1 between the systolic blood pressure value (SBP) at the time of the surge start point P1 and the systolic blood pressure value (SBP) at the time of the peak point P2 shown in fig. 7) and the values of the standard deviations σ (or ± σ, ± 2 σ, ± 3 σ) of the distribution may be displayed together on the display screen of the display 240 for the selected body state specified period.

If any of the image data Im1, Im2, Im3, and Im4 is not selected (no in step S203 of fig. 14), the control unit 210 closes the image (step S205 of fig. 14), and the display process is ended.

The user may input a transfer instruction via the operation unit 230 of the hospital terminal 200A to transmit the image data Im1, Im2, Im3, Im4 to another hospital terminal 200B or the like other than the hospital terminal 200A.

As described above, the image data Im1, Im2, Im3, Im4 in the form of a curve showing an average waveform superimposed on a region showing a waveform deviation showing a rapid increase in blood pressure is displayed for each specific period of the body state, and this is considered to be useful as a material for evaluating the risk of cardiovascular diseases and a material for evaluating the risk of diseases of specific organs in addition to the diagnosis and treatment of SAS.

(modification 1)

In the illustrated embodiment, the server 300 creates the image data Im (or the image data Im1, Im2, Im3, Im4, and the like for each body state-specific period), and the images are displayed on the displays 240 of the hospital terminals 200A, 200B, …, but the invention is not limited thereto. Instead of transmitting the image data Im to the hospital terminals 200A, 200B, and …, the controller 310 of the server 300 may transmit only data for image creation, and the controller 210 of the hospital terminals 200A, 200B, and … may create the image data Im by itself.

(modification 2)

In the above-described embodiment, the blood pressure related information display device of the present invention is configured as the system 100 on the network including the hospital terminals 200A, 200B, … and the server 300, but is not limited to this.

For example, the blood pressure-related information display device of the present invention may be configured by only one of the hospital terminals 200A, 200B, …. That is, the hospital terminal (e.g., 200A) may execute all of the blood pressure related information display methods described above (including displaying the image data Im on the display screen of the display 240 from receiving the time-series data of the blood pressure from the sphygmomanometer 400 and the information indicating the physical condition specific period from the PSG device 500).

In this case, a program for causing the control unit 210 to execute the blood pressure related information display method is installed in the storage unit 220 of the hospital terminal 200A. Thus, the blood pressure related information display device of the present invention can be configured to be small and compact.

The blood pressure-related information display method may be recorded as software (computer program) on a recording medium capable of non-transitory (non-transient) data storage, such as a CD (compact disc), a DVD (digital versatile disc), or a flash memory. By installing software recorded in such a recording medium in a substantial computer device such as a personal computer, a PDA (personal digital assistant), a smartphone, or the like, it is possible to cause the computer device to execute the blood pressure-related information display method described above.

(modification 3)

In the above-described embodiment, the region Sd indicating the waveform deviation constituting the image data Im is defined as a range of ± k times (typically ± σ, ± 2 σ, or ± 3 σ) the standard deviation σ of the distribution formed by the blood pressure fluctuation amount data for each lateral coordinate X. However, the range of the region Sd representing the waveform deviation is not limited to being defined using the standard deviation σ.

For example, the region Sd indicating the waveform deviation may be defined as a quartile range of a distribution formed by the blood pressure fluctuation amount data for each horizontal coordinate X. That is, as the processing, the blood pressure fluctuation amount data is arranged in ascending order for each horizontal coordinate X. Then, the first quartile is set as the lower limit of the region Sd, and the third quartile is set as the upper limit of the region Sd. This makes it possible to obtain a region Sd indicating waveform variation.

In this way, when the region Sd indicating the waveform deviation is set to the quartile range of the distribution formed by the blood pressure fluctuation amount data for each horizontal coordinate X, the calculation is completed easily without requiring a large amount of calculation as compared with the case of defining using the standard deviation σ. Therefore, it is possible to contribute to an increase in processing speed and a saving in memory.

The "representative waveform" in which the blood pressure is rapidly increased is an average waveform obtained by averaging a plurality of individual waveforms, but is not limited thereto. The "representative waveform" of the blood pressure surge may be the second quartile (intermediate value) of the distribution formed by the blood pressure fluctuation amount data for each lateral coordinate X. In this case, as processing, the blood pressure fluctuation amount data is arranged in ascending order for each horizontal coordinate X, and the intermediate values are connected in the horizontal direction, so that a representative waveform can be obtained.

(modification 4)

In the embodiment described above, on the display screen of the display 240, the region Sd indicating the waveform deviation constituting the image data Im is displayed as a region having an intermediate density between the curve Cav indicating the representative waveform and the background region Bg, for example, as shown in fig. 9 (B). However, the display form of the region Sd indicating the waveform deviation is not limited to the region having the intermediate density.

For example, fig. 16 (a) shows a plurality of individual waveforms C11, C12, C13, …, as in fig. 9 (a). In this case, as shown in fig. 16 (B), the curves Ci representing the plurality of individual waveforms C11, C12, C13, and … may be displayed so as to form a region Sd 'representing the waveform deviation and so as to be distinguishable from the curve Cav' representing the representative waveform. In this example, the curve Cav' is shown by a solid line, while the curves Ci showing the plurality of individual waveforms C11, C12, C13, and … are shown by broken lines, respectively. In this example, image data in the form of a curve Cav ' representing a representative waveform superimposed on a region Sd ' (including a plurality of curves Ci) representing the waveform deviation is denoted by reference numeral Im '.

Thus, the user can intuitively grasp the curve Cav 'representing the representative waveform in which the blood pressure of the subject 90 increases and the region Sd' representing the waveform deviation. For example, in the case where the number of individual waveforms is several or less, the display of the curve Ci representing the plurality of individual waveforms helps the user to grasp the deviations of the individual waveforms C11, C12, C13, ….

Note that the curve Cav' representing the representative waveform and the curve Ci representing the plurality of individual waveforms C11, C12, C13, and … may be distinguished from each other. For example, a curve Cav' indicating a representative waveform is shown by a red solid line, and a curve Ci indicating a plurality of individual waveforms C11, C12, C13, and … may be shown by a blue solid line.

Further, a threshold value N α (for example, N α is 10) is set for the number N of blood pressure surges acquired for each body state specifying period, and if the number N of acquired blood pressure surges is equal to or greater than the threshold value N α, first image data Im including a region Sd representing waveform deviations (a region having an intermediate density of a width of ± σ in the longitudinal direction) as shown in fig. 9B is created and displayed, whereas if the number N of acquired blood pressure surges is smaller than the threshold value N α, second image data Im 'including a region Sd' (a curve Ci representing a plurality of individual waveforms C11, C12, C13, …) representing waveform deviations as shown in fig. 16B may be created and displayed. For the determination as to whether or not the number N of blood pressure surges is larger than the threshold value na, the control unit 310 of the server 300 can function as a blood pressure surge number determination unit, for example.

Alternatively, for example, the control unit 310 of the server 300 may create both the first image data Im including the area Sd representing the waveform deviation as shown in fig. 9 (B) and the second image data Im 'including the area Sd' representing the waveform deviation as shown in fig. 16 (B). In this case, for example, both the first image data Im and the second image data Im 'may be transmitted from the server 300 to the hospital terminal (e.g., 200A), and the first image data Im and the second image data Im' may be displayed on the display screen of the display 240 in a switching manner in accordance with an input by the user via the operation unit 230 of the hospital terminal (e.g., 200A).

(modification 5)

In the above-described embodiment, the sphygmomanometer 400 is a tension measurement type sphygmomanometer, but is not limited thereto. The sphygmomanometer 400 may include a light emitting element that emits light toward the artery passing through the corresponding portion of the measurement site and a light receiving element that receives reflected light (or transmitted light) of the light, and continuously detect the blood pressure based on the volume change of the pulse wave of the artery (electro-optical method). The sphygmomanometer 400 may also include a piezoelectric sensor that is in contact with the measurement site, detect deformation due to pressure of the artery passing through the corresponding portion of the measurement site as a change in electrical resistance, and continuously detect the blood pressure based on the change in electrical resistance (piezoelectric method). The sphygmomanometer 400 further includes a transmitting element for transmitting a radio wave (transmission wave) toward the artery passing through the corresponding portion of the measurement site, a receiving element for receiving a reflected wave of the radio wave, and a blood pressure sensor for detecting a change in distance between the artery and the sensor due to a pulse wave of the artery as a phase shift between the transmission wave and the reflected wave and continuously detecting the blood pressure based on the phase shift (radio wave irradiation method). Further, other methods may be applied as long as physical quantities that can calculate blood pressure can be observed.

The above embodiments are merely examples, and various modifications can be made without departing from the scope of the present invention. The above-described plurality of embodiments may be established individually or in combination. In addition, the respective features in the different embodiments may be individually established, or may be combined.

Description of the reference numerals

100 system

200A, 200B, … Hospital terminal

240 display

300 server

400 sphygmomanometer

500 PSG device