Blood pressure related information display device, blood pressure related information display method, and storage medium

Abstract

In the present invention, a blood pressure surge is detected based on a pre-set judgment criterion according to time series data of blood pressure that changes in conjunction with the pulse of the subject. For each detected blood pressure surge, an envelope connecting multiple beat corresponding peaks forming the blood pressure surge is obtained as an individual waveform (C11, C12, C13, ...). The obtained multiple individual waveforms (C11, C12, C13, ...) are statistically processed to obtain a representative waveform and waveform deviation of the blood pressure surge in the time series data. A process is performed to display a curve (Cav) representing a representative waveform on a display screen in an overlapping manner on an area (Sd) representing the waveform deviation of the blood pressure surge.

Description

Technical Field

[0001] The present invention relates to a blood pressure-related information display device and a blood pressure-related information display method, and more specifically, to a device and a method for visually displaying information related to a blood pressure surge of a subject. In addition, the present invention relates to a computer-readable storage medium storing a program for causing a computer to execute such a blood pressure-related information display method. Background Art

[0002] It is known that for patients with sleep apnea syndrome (SAS), blood pressure rises sharply when they start breathing again after not breathing, and then drops. In this specification, such a sharp change in blood pressure is referred to as "blood pressure surge" (or simply "surge"). It is believed that by visually displaying the relevant information of the blood pressure surge occurring in the patient (for example, the waveform of the blood pressure surge), it is helpful for the diagnosis and treatment of SAS.

[0003] In the past, for example, in Patent Document 1 (WO2017 / 082107A1) Figure 3 In FIG. 1 , a waveform of a fluctuating state (blood pressure surge) of a patient with sleep apnea syndrome (SAS) is shown as a graph.

[0004] Prior art literature

[0005] Patent Literature

[0006] Patent Document 1: WO2017 / 082107A1 Summary of the invention

[0007] Problems to be solved by the invention

[0008] However, in Patent Document 1, the waveform of the blood pressure surge is simply displayed by magnifying the time axis of the time series data of the systolic blood pressure value (SBP) to show the peak value of each pulse, and is not displayed as a curve (shape) indicating the tendency of the blood pressure to rise or fall.

[0009] Under such circumstances, the applicant has previously applied for an invention for classifying and visually displaying the patterns (shapes) of the waveforms of the blood pressure surges of SAS patients (Japanese Patent Application No. 2017-050066). As a result, doctors can grasp the patterns of the waveforms of the blood pressure surges of each SAS patient in a relatively short period of time. Furthermore, it is convenient if doctors can observe the representative waveforms and waveform deviations of the blood pressure surges of each SAS patient in an overlapping manner. In addition, it is also believed that the representative waveforms and waveform deviations of the blood pressure surges of the subjects observed in an overlapping manner, not limited to SAS patients, can be used as materials for evaluating cardiovascular disease risks and materials for evaluating disease risks of specific organs.

[0010] Therefore, the present invention aims to provide a blood pressure-related information display device and a blood pressure-related information display method that can overlap and display a representative waveform of a blood pressure surge and a waveform deviation. In addition, the present invention aims to provide a computer-readable storage medium storing a program for causing a computer to execute such a blood pressure-related information display method.

[0011] Technical means of solving problems

[0012] In order to solve the above-mentioned problem, the blood pressure-related information display device of the present disclosure visually displays information related to a phenomenon in which blood pressure rises to a peak value in multiple heartbeats and then the peak value drops in multiple heartbeats, i.e., a blood pressure surge, and is characterized in that:

[0013] have:

[0014] a blood pressure surge detecting unit that detects a blood pressure surge based on a predetermined determination criterion from time series data of blood pressure that changes in conjunction with the subject's pulse;

[0015] The individual waveform acquisition unit obtains, for each detected blood pressure surge, an envelope connecting a plurality of beat-corresponding peaks forming the blood pressure surge as the individual waveform;

[0016] a statistical processing unit that performs statistical processing on the obtained plurality of individual waveforms to obtain a representative waveform and waveform deviation of a blood pressure surge in the time series data; and

[0017] The display processing unit performs processing for displaying, on a display screen, a curve representing the representative waveform in an overlapping manner in a region of the waveform deviation representing the blood pressure surge,

[0018] The statistical processing unit creates in the storage area a state equivalent to sliding the plurality of individual waveforms relatively in the horizontal direction and aligning the positions of the peaks of the plurality of individual waveforms on a coordinate plane including a horizontal coordinate indicating the passage of time and a vertical coordinate indicating the blood pressure variation accompanying a blood pressure surge, and in this state, statistical processing is performed on the blood pressure variation data of the plurality of individual waveforms for each of the horizontal coordinates to obtain the representative waveform and the waveform deviation.

[0019] The statistical processing unit sets to zero a contribution to the statistical processing of the blood pressure variation data of an individual waveform shorter than an individual waveform having the longest lateral dimension among the plurality of individual waveforms, corresponding to a number of beats less than that of the longest individual waveform.

[0020] In this specification, "predetermined judgment criteria" refers to, typically, a criterion for detecting a blood pressure surge in patients with sleep apnea syndrome (SAS). For example, the peak detection interval (e.g., a period of 15 heart beats) disclosed in Japanese Patent Application No. 2017-048946 and Japanese Patent Application No. 2017-050066 includes the period from the moment of the surge start point to the moment of the surge peak point, and the difference (blood pressure change) between the systolic blood pressure value at the moment of the surge start point and the systolic blood pressure value at the moment of the peak point is more than 20 mmHg (or 15 mmHg), the period between the moment of the surge start point and the moment of the peak point is greater than 5 heart beats, and the period between the moment of the peak point and the moment of the surge end point is greater than 7 heart beats.

[0021] The plurality of "beat-corresponding peaks" used to create the blood pressure surge for creating the envelope refers to the peaks corresponding to the systolic blood pressure in the continuous instantaneous blood pressure waveform, but may also be the peaks corresponding to the diastolic blood pressure value (DBP).

[0022] In addition, "statistical processing" refers to processing such as averaging individual waveforms or finding median values. The "representative waveform" of a blood pressure surge refers to, for example, an average waveform obtained by averaging multiple individual waveforms, or a waveform equivalent to the median value of multiple individual waveforms. In addition, the "waveform deviation" of a blood pressure surge refers to, for example, the width of the distribution of multiple individual waveforms.

[0023] In addition, the “display screen” typically refers to a screen of a display, but may also refer to, for example, a paper surface output by a printer.

[0024] Furthermore, “display” of, for example, a graph showing a representative waveform on a display screen is typically performed in a manner such that the horizontal coordinate represents the passage of time (eg, the progression of beats) and the vertical coordinate represents the amount of blood pressure fluctuation associated with a blood pressure surge.

[0025] In this specification, "peak value of individual waveform" refers to the peak value of each blood pressure surge, which is equivalent to the peak value of each blood pressure surge. The largest beat corresponding peak value among the increased multiple beat corresponding peak values.

[0026] In addition, "equivalent state" means that there is no need to actually draw and align multiple of the individual As long as the data in the storage area is in the state specified on the coordinate plane, States that are equivalent in state are sufficient.

[0027] In the disclosed blood pressure-related information display device, a blood pressure surge detection unit detects a blood pressure surge based on a pre-set judgment standard based on the time series data of the blood pressure that changes in conjunction with the pulse of the subject. The individual waveform acquisition unit obtains an envelope connecting multiple beat corresponding peaks that form the blood pressure surge as an individual waveform for each detected blood pressure surge. The statistical processing unit performs statistical processing on the obtained multiple individual waveforms to obtain a representative waveform and waveform deviation of the blood pressure surge in the time series data. The display processing unit performs processing to overlap the curve representing the representative waveform on the display screen to display the area of ​​the waveform deviation representing the blood pressure surge. As a result, the user (typically a medical-related person such as a doctor or nurse. It can also be a subject. The same applies hereinafter) can intuitively grasp the curve representing the representative waveform of the blood pressure surge of the subject and the area representing the waveform deviation by observing the display screen. In addition to the diagnosis and treatment of SAS, this is considered to be useful as a material for evaluating cardiovascular disease risks and a material for evaluating disease risks of specific organs.

[0028] In the blood pressure-related information display device, the statistical processing unit creates a state in the storage area equivalent to sliding the plurality of individual waveforms relatively in the horizontal direction and aligning the positions of the peaks of the plurality of individual waveforms. In this state, the blood pressure variation data of the plurality of individual waveforms are statistically processed to grasp the representative waveform and the waveform deviation. In addition, even if the horizontal dimensions of the plurality of individual waveforms on the coordinate plane differ from each other by a certain number of beats, the statistical processing of the blood pressure variation data can be performed without any hindrance.

[0029] In one embodiment of the blood pressure-related information display device, each of the plurality of blood pressure variation data of the individual waveforms is a variation based on a blood pressure value at a starting point of the individual waveform.

[0030] In the blood pressure-related information display device of this embodiment, it is easy to grasp the representative waveform and the waveform deviation.

[0031] In one embodiment of the blood pressure-related information display device, the blood pressure variation amount data of the plurality of individual waveforms are normalized so that the heights of the peaks of the plurality of individual waveforms are aligned.

[0032] In the blood pressure-related information display device of this embodiment, it is easier to grasp the representative waveform and the waveform deviation.

[0033] In one embodiment, the blood pressure related information display device is characterized in that:

[0034] The horizontal coordinate representing the time lapse is determined by the beat number that determines the peak value corresponding to the beat,

[0035] The statistical processing unit performs statistical processing on the blood pressure variation data of the plurality of individual waveforms for each of the beat numbers.

[0036] Here, the heartbeat interval is not constant due to the pulsation of the heart, so the period of one heartbeat when a blood pressure surge occurs to form a certain individual waveform may be different from the period of one heartbeat when a blood pressure surge occurs to form another individual waveform. "The horizontal coordinate indicating the passage of time ... is determined by the beat number" means that the passage of time is expressed by the progression of beats, regardless of this difference.

[0037] In a blood pressure-related information display device according to one embodiment, the horizontal coordinate indicating the passage of time is determined by the beat number that determines the peak value corresponding to the beat. Therefore, even if the period of one heart beat when a blood pressure surge occurs that forms a certain individual waveform is different from the period of one heart beat when a blood pressure surge occurs that forms another individual waveform, it is easy to grasp the representative waveform and the waveform deviation. In addition, when the statistical processing unit performs statistical processing on the blood pressure variation data of a plurality of the individual waveforms, it only needs to perform statistical processing on the blood pressure variation data according to each of the beat numbers. Therefore, compared with the case where the statistical processing of the blood pressure variation data is continuously performed in the horizontal direction, the amount of calculation of the statistical processing unit is reduced.

[0038] In one embodiment, the blood pressure related information display device is characterized in that:

[0039] The waveform deviation obtained by the statistical processing unit is defined as ±k times the standard deviation of the distribution formed by the blood pressure variation data of the plurality of individual waveforms, when k is a natural number.

[0040] The display processing unit displays, on the display screen, a region having a width corresponding to ±k times the standard deviation in the vertical direction as a region indicating the waveform deviation.

[0041] In the blood pressure-related information display device of this embodiment, an area having a width in the vertical direction equivalent to ±k times (however, k is a natural number. Typically, k is set to 1, 2 or 3) of the standard deviation is displayed on the display screen as an area representing the waveform deviation. Therefore, the user can intuitively grasp the curve of the representative waveform representing the blood pressure surge of the subject and the area representing the waveform deviation. The display of the area representing the waveform deviation is particularly useful when, for example, the changes in individual waveforms are fully handled as a normal distribution (for example, when the number of individual waveforms is more than dozens).

[0042] In one embodiment, the blood pressure related information display device is characterized in that:

[0043] The waveform deviation obtained by the statistical processing unit is defined as the interquartile range of the distribution formed by the blood pressure variation data of the plurality of individual waveforms.

[0044] The display processing unit displays, on the display screen, a region having a width corresponding to the interquartile range in the vertical direction as a region indicating the waveform deviation.

[0045] In the blood pressure-related information display device of this embodiment, an area having a width equivalent to the interquartile range in the vertical direction is displayed on the display screen as an area representing the waveform deviation. Therefore, the user can intuitively grasp the curve of the representative waveform representing the blood pressure surge of the subject and the area representing the waveform deviation. In addition, compared with the case where the area representing the waveform deviation is defined by the standard deviation, there is no need for excessive calculations, and the calculation is simply completed. Therefore, it can help to improve processing speed and save storage.

[0046] In one embodiment of a blood pressure-related information display device, it is characterized in that the display processing unit processes the curves representing the plurality of individual waveforms on the display screen in a form distinguishable from the curve representing the representative waveform to form an area representing the waveform deviation.

[0047] In the blood pressure-related information display device of this embodiment, a curve representing the representative waveform and a curve representing a plurality of the individual waveforms are displayed to form an area representing the waveform deviation on the display screen. Therefore, the user can intuitively grasp the curve representing the representative waveform of the blood pressure surge of the subject and the area representing the waveform deviation. The display of the curve representing the plurality of individual waveforms is useful for enabling the user to grasp the changes in the individual waveforms, for example, when the number of individual waveforms is less than a few.

[0048] In one embodiment, the blood pressure related information display device is characterized in that:

[0049] The apparatus comprises: an input unit for inputting information indicating a specific period of a physical state capable of determining the physical state of the subject, along with time series data of blood pressure that changes in conjunction with the pulse of the subject;

[0050] The statistical processing unit obtains a representative waveform and waveform deviation of a blood pressure surge in the time series data for each specific period of the physical condition,

[0051] The display processing unit performs processing for displaying, on the display screen, a curve representing the representative waveform in a superimposed manner on a region of the waveform deviation representing a sudden increase in the blood pressure for each of the physical condition specific periods.

[0052] In this specification, "specific period of physical condition" refers to a period when the subject is in a physical condition that may be a factor in a surge in blood pressure, such as a period of apnea, a period of rapid eye movement sleep, a period of non-rapid eye movement sleep, a period of wakefulness, and / or a period when the transcutaneous arterial oxygen saturation (SpO2) is low.

[0053] In the blood pressure-related information display device of one embodiment, the input unit inputs information representing a specific period of the subject's physical state along with time series data of blood pressure that changes in conjunction with the subject's pulsation. The statistical processing unit obtains a representative waveform and waveform deviation of a blood pressure surge in the time series data according to each specific period of the physical state. The display processing unit performs processing on the display screen to display a curve representing the representative waveform in an overlapping manner on an area of ​​the waveform deviation representing the blood pressure surge according to each specific period of the physical state. Thus, the user can grasp the curve representing the representative waveform of the subject's blood pressure surge and the area representing the waveform deviation according to each specific period of the physical state, in other words, according to each period when the subject becomes a physical state that may be a factor of a blood pressure surge. Therefore, the user can grasp, for example, the factor (physical state) that causes the most severe blood pressure surge.

[0054] On the other hand, the blood pressure-related information display method disclosed in the present invention visually displays information related to a phenomenon in which blood pressure rises to a peak value in a plurality of heartbeats and then the peak value decreases in blood pressure in a plurality of heartbeats, i.e., a blood pressure surge, and is characterized in that:

[0055] have:

[0056] A step of detecting a blood pressure surge based on a predetermined criterion based on time series data of blood pressure that changes in conjunction with the subject's pulse;

[0057] For each detected blood pressure surge, an envelope connecting a plurality of beat-corresponding peaks forming the blood pressure surge is obtained as an individual waveform; and

[0058] A step of performing statistical processing on the obtained plurality of individual waveforms to obtain a representative waveform and waveform deviation of a blood pressure surge in the time series data;

[0059] In this step, the statistical processing unit creates in the storage area a state equivalent to sliding the plurality of individual waveforms relatively in the horizontal direction and aligning the positions of the peaks of the plurality of individual waveforms on a coordinate plane including a horizontal coordinate representing the passage of time and a vertical coordinate representing the blood pressure variation accompanying a blood pressure surge, and in this state, statistical processing is performed on the blood pressure variation data of the plurality of individual waveforms for each of the horizontal coordinates to obtain the representative waveform and the waveform deviation.

[0060] In this step, the statistical processing unit sets the contribution of the individual waveform shorter than the individual waveform with the longest lateral dimension among the plurality of individual waveforms to the statistical processing of the blood pressure variation data to zero, which is equal to the number of beats that is less than that of the longest individual waveform.

[0061] The blood pressure-related information display method further includes the step of performing a process of causing a curve representing the representative waveform to be displayed on a display screen in an overlapping manner in a region of the waveform deviation representing a sudden increase in the blood pressure.

[0062] According to the blood pressure-related information display method disclosed in the present invention, the user can intuitively grasp the curve of the representative waveform representing the blood pressure surge of the subject and the area representing the waveform deviation. In addition to the diagnosis and treatment of SAS, this is considered to be useful as a material for evaluating cardiovascular disease risks and a material for evaluating disease risks of specific organs. In addition, a state equivalent to sliding a plurality of the individual waveforms relatively in the horizontal direction and aligning the positions of the peaks of a plurality of the individual waveforms is created in the storage area. In this state, the representative waveform and the waveform deviation can be grasped by statistically processing the blood pressure variation data of the plurality of the individual waveforms. In addition, even if the lateral dimensions of the plurality of the individual waveforms on the coordinate plane differ from each other by a considerable number of beats, statistical processing of the blood pressure variation data can be performed without hindrance.

[0063] In another aspect, a computer-readable storage medium of the present disclosure stores a program for causing a computer to execute the blood pressure-related information display method.

[0064] The blood pressure related information display method can be implemented by causing a computer to execute the computer readable storage medium of the present disclosure.

[0065] Effects of the Invention

[0066] As described above, according to the blood pressure-related information display device and blood pressure-related information display method of the present disclosure, a representative waveform of a blood pressure surge and a waveform deviation can be displayed in an overlapping manner. In addition, the blood pressure-related information display method can be implemented by causing a computer to execute a program stored in a computer-readable storage medium of the present disclosure. BRIEF DESCRIPTION OF THE DRAWINGS

[0067] Figure 1 This is a block diagram showing an embodiment in which the blood pressure-related information display device of the present invention is configured as a system on a network.

[0068] Figure 2 This is a block diagram showing the structure of a hospital terminal included in the system.

[0069] Figure 3 It is a block diagram showing the structure of a server included in the system.

[0070] Figure 4 This is a diagram showing an embodiment in which the system measures time series data of a subject's blood pressure for one night and a physical condition that may be a factor causing a blood pressure surge.

[0071] Figure 5A This is a diagram showing the operation flow of the server when executing the basic blood pressure-related information display method.

[0072] Figure 5B It is a diagram showing the operation flow of the server when executing the applied blood pressure related information display method.

[0073] Figure 6 middle, Figure 6 (A) is a graph showing time series data of the subject's blood pressure for one night. Figure 6 (B) is the enlarged Figure 6 A portion of (A) is then shown, showing a graph of blood pressure surges detected on the time series data and apnea / hypopnea events measured by the PSG device.

[0074] Figure 7 This is a diagram illustrating waveforms (individual waveforms) of a blood pressure surge and explaining a criterion for detecting a blood pressure surge.

[0075] Figure 8 This is a diagram conceptually illustrating a process of averaging individual waveforms of a blood pressure surge.

[0076] 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.

[0077] Fig.10 This is a detailed flowchart showing the statistical processing of individual waveforms of blood pressure surges.

[0078] Fig.11 The figure is an example of a table recording the time when the detected blood pressure surge was specified.

[0079] Fig.12 This is a diagram showing an example of a table in which time series data of the peak values ​​corresponding to the beats of individual waveforms are recorded for a certain blood pressure surge.

[0080] Fig.13 This is a diagram showing an example of a table for statistical processing of blood pressure variation data.

[0081] Fig.14 This is a diagram showing the flow of display processing at the hospital terminal when the practical blood pressure-related information display method is executed.

[0082] Fig.15A The diagram shows image data in a format in which curves representing average waveforms created for each of the apnea period, REM sleep period, non-REM sleep period, and wakefulness period are arranged and thumbnailed on a display screen so as to overlap within a region representing a waveform deviation.

[0083] Fig. 15B FIG. 1 is a diagram showing a mode in which image data created for the apnea period is displayed in an enlarged manner on the display screen.

[0084] Fig.16 middle, Fig.16 (A) and Fig. 9 (A) is a diagram similarly illustrating a plurality of individual waveforms obtained for an apnea period. Fig.16 (B) is a diagram showing a modified example of the form of displaying waveform deviation. DETAILED DESCRIPTION

[0085] Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

[0086] (System Structure)

[0087] Figure 1An example of a system (the whole is indicated by reference numeral 100) in which the blood pressure-related information display device of the present invention is configured as an embodiment on a network is shown. The system 100 includes: hospital terminals 200A and 200B having a display 240 as a display screen; a server 300; a sphygmomanometer 400 of a tension measurement method; and a PSG (polysomnography) device 500. These hospital terminals 200A and 200B, the server 300, the sphygmomanometer 400, and the PSG device 500 can communicate with each other via a network 900, which is a LAN (Local Area Network) in the hospital. The communication via the network 900 can be either wireless or wired. In this embodiment, the network 900 is a LAN (Local Area Network) in the hospital, but it is not limited to this. It can be other types of networks such as the Internet, or it can be a one-to-one communication using a USB cable or the like. It should be noted that only two hospital terminals 200A and 200B are shown in this example, but three or more can also be set.

[0088] like Figure 2 As shown, 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 composed of a commercially available notebook personal computer, in which application software (computer program) is installed to perform the processing described later, and can access the server 300.

[0089] The control unit 210 includes a CPU (Central Processing Unit) and its auxiliary circuits, controls each unit of the hospital terminal 200A, and executes the processing described below according to the program and data stored in the storage unit 220. In other words, the control unit 210 processes the data input from the operation unit 230 and the communication unit 290, and stores the processed data in the storage unit 220, displays it on the display 240, or outputs it from the communication unit 290.

[0090] The storage unit 220 includes a RAM (Random Access Memory) used as a work area required for the control unit 210 to execute a program, and a ROM (Read Only Memory) for storing basic programs executed by the control unit 210. In addition, as a storage medium of an auxiliary storage device used to assist the storage area of ​​the storage unit 220, a semiconductor memory (memory card, SSD (Solid State Drive)) or the like can be used.

[0091] In this example, the operation unit 230 is composed of a keyboard and a mouse, and usually inputs an operation signal indicating an operation of the doctor as a user to the control unit 210. In addition, the operation unit 230 may be composed of other operation devices such as a touch panel, and may replace the keyboard and the mouse, or be added to the keyboard and the mouse.

[0092] The display 240 includes a display screen (for example, an LCD (Liquid Crystal Display) or an EL (Electroluminescence) display, etc.) The display 240 is controlled by the control unit 210 to display a predetermined image on the display screen.

[0093] Communication unit 290 transmits information from control unit 210 to server 300 via network 900 .

[0094] Although not shown in the figure for the sake of simplicity, the other hospital terminals 200B, ... also have the same configuration as the hospital terminal 200A.

[0095] like Figure 3 As shown, 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 in which a program (software) is installed to perform the processing described later.

[0096] The control unit 310 includes a CPU and its auxiliary circuits, controls various parts of the server 300, and performs prescribed processing according to the 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, or displays it on the display 340, or outputs it from the communication unit 390.

[0097] The storage unit 320 includes a RAM used as a work area required for the control unit 310 to execute a program, and a ROM for storing a basic program executed by the control unit 310. The storage unit 320 is provided with a database 321 including blood pressure measurement data sent from a large number of subjects. In addition, as a storage medium of an auxiliary storage device used for the storage area of ​​the auxiliary storage unit 320, a magnetic disk (HD (Hard Disk), FD (Flexible Disk)), an optical disk (CD (Compact Disc), DVD (Digital Versatile Disk), BD (Blu-ray Disc)), a magneto-optical disk (MO (Magneto-Optical disk)), or a semiconductor storage unit (memory card, SSD) etc. can be used.

[0098] In this example, the operation unit 330 is composed of a keyboard and a mouse, and inputs an operation signal indicating an operation by a user to the control unit 310. In addition, the operation unit 330 may be composed of other operation devices such as a touch panel, which may replace the keyboard and the mouse, or be in addition to the keyboard and the mouse.

[0099] The display 340 includes a display screen (eg, an LCD or an EL display, etc.) The display 340 is controlled by the control unit 310 to display a predetermined picture on the display screen.

[0100] The communication unit 390 transmits information from the control unit 310 to other devices (the hospital terminal 200A in this example) via the network 900 , and receives information transmitted from other devices via the network 900 and transfers the information to the control unit 310 .

[0101] In this example, Figure 1 The sphygmomanometer 400 shown in the figure is composed of a sphygmomanometer of the tension measurement method disclosed in Japanese Patent Application No. 2017-050066. Figure 4 As shown, the sphygmomanometer 400 includes: a pressure sensor unit 402 that continuously detects the pressure pulse wave of the radial artery passing through the measured part (e.g., the left wrist) of the subject 90 in each beat by using a tonometry 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 unit 402 and the main unit 401 are connected by a signal cable 403. The tonometry method is a method of measuring the pressure pulse wave and determining the blood pressure by flattening the blood vessel by the pressure sensor unit 402 (e.g., a pressure pulse wave sensor). If the blood vessel is regarded as a circular tube with uniform thickness, the blood vessel wall can be considered regardless of the flow of blood in the blood vessel and the presence or absence of pulsation, thereby deriving a relationship between the internal pressure of the blood vessel (blood pressure) and the external pressure of the blood vessel (pressure of the pressure pulse wave) based on Laplace's law. Using this relationship, under the condition that the blood vessel is flattened on the pressing surface, by approximating the radius of the outer wall and the inner wall of the blood vessel, it is possible to approximate that the pressure of the pressure pulse wave is equal to the blood pressure. Therefore, thereafter, the pressure of the pressure pulse wave becomes the same value as the blood pressure. As a result, the sphygmomanometer 400 measures the blood pressure value of the measured part (e.g., the left wrist) with each heartbeat, for example, Figure 6 The time series data 801 of blood pressure that establishes a correspondence between the measurement time (time) and the blood pressure is output as shown in (A). The time series data 801 for one night includes the peak values ​​corresponding to about 30,000 heart beats (equivalent to the peak values ​​of systolic blood pressure (SBP) or diastolic blood pressure (DBP)).

[0102] In addition, in this example, Figure 1The PSG device 500 shown in the figure is composed of a commercially available PSG device (for example, Neurofax (registered trademark) EEG-9200 manufactured by Nihon Kohden Co., Ltd.), and is used only when executing [B. Applied blood pressure related information display method] described later. Figure 4 As shown in FIG. 5 , 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, the sensor group 502 includes an electroencephalogram detection electrode 502A for detecting electroencephalograms, an eye movement detection electrode 502B for detecting eye movement, an airflow sensor 502C for detecting airflow accompanying breathing, an electrocardiogram electrode 502D for obtaining an electrocardiogram, a pulse oximeter 502E for detecting transcutaneous arterial oxygen saturation (SpO2), and an electromyogram electrode 502F for obtaining an electromyogram. The sensor group 502 and the main unit 501 are connected by a signal cable (not shown) via a cable box (not shown). In this example, the PSG device 500 is capable of outputting information indicating an apnea period (or a hypopnea period), a REM sleep period, a non-REM sleep period, a wakefulness period, and / or a period of low SpO2 as information indicating a period during which the physical state of the subject 90 is determined (which will be referred to as a "physical state specific period"). Here, "apnea" during sleep refers to a "state in which breathing stops for more than 10 seconds." In addition, "hypopnea" refers to a state in which the ventilation generated by breathing decreases to more than 10 seconds and less than 50%. In addition, "REM sleep" refers to sleep accompanied by rapid eye movements, "non-REM sleep" refers to sleep not accompanied by rapid eye movements, and "wakefulness" refers to a state of wakefulness. SpO2 refers to a value of how many percent of hemoglobin contained in red blood cells flowing in arterial blood is bound to oxygen, measured through the skin (transcutaneously). A period in which SpO2 is "low" refers to a period in which SpO2 is less than 90% in this example.

[0103] For example, when zooming in Figure 6 A partial view of (A) Figure 6 In (B), the "apnea" period is indicated by shaded bars 805, 805, .... In addition, the "hypopnea" period is indicated by white bars 804, 804, .... In this manner, the PSG device 500 can output information indicating a specific period of the physical condition of the subject 90 in a variety of ways.

[0104] (Blood pressure related information display method)

[0105] The system 100 is roughly divided into creation of image data on the server 300 and display of the image data on the hospital terminal (e.g. 200A), and can implement the following "A. Basic blood pressure related information display method" and "B. Applied blood pressure related information display method".

[0106] [A. Basic blood pressure related information display method]

[0107] In this basic blood pressure related information display method, the PSG device 500 is not used, and only the Figure 6 The time series data 801 of blood pressure in which the measurement time (time) output by the sphygmomanometer 400 and the blood pressure are associated with each other as exemplified in (A) is used to create and display image data as follows.

[0108] (Creation of Image Data on Server 300)

[0109] i) in Figure 4 In the illustrated method, blood pressure measurement is continuously performed using the sphygmomanometer 400 for the subject 90 over a night (including during sleep) (in this example, measurement of the physical condition using the PSG device 500 is not performed). In this example, the time series data of the blood pressure from the sphygmomanometer 400 is received by the hospital terminal 200A and temporarily stored in the storage unit 220. Then, for example, a doctor who is a user operates the operation unit 230 of the hospital terminal 200A, and the time series data of the blood pressure measured for the subject 90 and the information indicating the physical condition during a specific period are transmitted to the server 300 via the network 900.

[0110] ii) The server 300 is always in operation in this example (except during maintenance, etc.), as shown in FIG. Figure 5A As shown in step S101 of the (operation flow of the server 300 when executing the basic blood pressure-related information display method), the server 300 waits for data from the hospital terminal 200A. When the control unit 310 of the server 300 receives the above-mentioned blood pressure time series data from the hospital terminal 200A via the communication unit 390 as an input unit from the network 900 (step S101 is "Yes"), the received blood pressure time series data is stored in the database 321 of the storage unit 320. Then, the processing of steps S102 to S107 described below is performed.

[0111] iii) First, as shown in step S102, the control unit 310 functions as a preprocessing unit and performs preprocessing such as smoothing using a known moving average method, noise removal, and high-frequency component removal using a low-pass filter on the time series data of blood pressure.

[0112] iv) Next, as shown in step S103, the control unit 310 functions as a blood pressure surge detection unit, and detects a blood pressure surge based on a predetermined judgment criterion, such as disclosed in Japanese Patent Application No. 2017-048946 and Japanese Patent Application No. 2017-050066, based on the time series data of the blood pressure of the subject 90. Figure 6 In (B), as shown by the dotted rectangular boxes 803, 803, ..., multiple blood pressure surges are detected. It is said that blood pressure surges can occur hundreds of times a night. In this example, the peaks corresponding to the systolic blood pressure (SBP) are marked with black circles ●, and they are connected by an envelope. In addition, the peaks corresponding to the diastolic blood pressure (DBP) are marked with white circles ○, and they are connected by an envelope.

[0113] Here, the "predetermined criterion" for detecting a blood pressure surge refers to, for example, Figure 7 As shown in (an example of an individual waveform of a blood pressure surge represented by a curve C), within the peak detection interval (e.g., a period of 15 heartbeats), the period from the surge start point P1 to the surge peak point P2 is included, and the difference (blood pressure fluctuation) L1 between the systolic blood pressure value (SBP) at the surge start point P1 and the systolic blood pressure value (SBP) at the peak point P2 is greater than 20 mmHg (or 15 mmHg), the period T1 between the surge start point P1 and the peak point P2 is greater than 5 heartbeats, and the period T3 between the peak point P2 and the surge end point P4 is greater than 7 heartbeats. In this example, the surge start point P1 is earlier than the peak point P2 and is defined as a point where the systolic blood pressure value (SBP) is minimal. In addition, the surge end point P4 is later than the peak point P2 and is defined as a point where the blood pressure drops by L1×0.75 (=L3) from the peak point P2.

[0114] v) Then, if Figure 5A As shown in step S104, the control unit 310 functions as an individual waveform acquisition unit, and for each of the detected blood pressure surges 803, 803, ..., an envelope connecting the multiple beat-corresponding peaks (in this example, equivalent to the peak of the systolic blood pressure (SBP)) that form the blood pressure surge 803 is obtained as an individual waveform. Figure 7 As shown, the individual waveform of the blood pressure surge is expressed as a curve C in a mountain-like shape.

[0115] vi) Then, if Figure 5A As shown in step S105, the control unit 310 functions as a statistical processing unit. In this example, statistical processing is performed on all the individual waveforms obtained to obtain a representative waveform and waveform deviation of the blood pressure surge in the time series data 801. Here, "statistical processing" refers to the processing of averaging individual waveforms. In this example, the "representative waveform" of the blood pressure surge refers to the average waveform obtained by averaging multiple individual waveforms. In addition, in this example, the "waveform deviation" of the blood pressure surge refers to the width of the distribution of multiple individual waveforms.

[0116] Conceptually speaking, the process of averaging individual waveforms of blood pressure surges refers to the following process. Figure 8 As illustrated in , as a blood pressure surge, there are individual waveforms C1 of "Surge No. 1" and individual waveform C2 of "Surge No. 2". In this case, the processing of averaging the individual waveforms of the blood pressure surge is equivalent to the following processing: on a coordinate plane Q including a horizontal coordinate X representing the passage of time and a vertical coordinate Y representing the blood pressure change amount accompanying the blood pressure surge, the blood pressure change amount data of the multiple individual waveforms C1 and C2 are averaged on each horizontal coordinate X while the positions of the peaks of the multiple individual waveforms C1 and C2 are aligned while sliding the multiple individual waveforms C1 and C2 relatively on the horizontal coordinate X, and the curve Cav representing the average waveform is obtained as a representative waveform. Here, Figure 8 In the above, the horizontal coordinate X indicating the passage of time is determined by the beat number for specifying the peak value corresponding to the beat. The vertical coordinate Y is determined by the blood pressure change of the systolic blood pressure value (SBP) accompanying the blood pressure surge. It should be noted that the specific data processing (statistical processing of individual waveforms of blood pressure surge) will be described in detail later.

[0117] In this example, the range of the "waveform deviation" of the blood pressure surge is the standard deviation σ of the distribution (distribution of each horizontal coordinate X) formed by using the blood pressure variation data of multiple individual waveforms, and is defined as the range of ±k times (however, k is a natural number) the standard deviation σ for each horizontal coordinate X. Typically, k is set to 1, 2, or 3. Hereinafter, unless otherwise specified, the range of the "waveform deviation" of the blood pressure surge is the range of ±σ. The region representing the waveform deviation ±σ (for example, the region described later) Fig. 9 The display of the area Sd) shown in (B) becomes a particularly useful display when the deviation of the individual waveforms is sufficient to be handled as a normal distribution (for example, when there are dozens or more).

[0118] Thus, a curve Cav representing a waveform that is an average of representative waveforms and waveform deviations ±σ for each horizontal coordinate X are obtained.

[0119] vii) Then, if Figure 5A As shown in step S106, the control unit 310 functions as a part of the display processing unit to create image data in a format in which the curve Cav representing the average waveform is superimposed on the region (indicated by reference symbol Sd) representing the waveform deviation of the blood pressure surge.

[0120] For example, Fig. 9 As shown in (A), Figure 5A In step S104, individual waveforms C11, C12, C13, ... are obtained. In this case, by Figure 5A Step S106, for example, Fig. 9As shown in (B), image data Im in the form of a curve Cav representing an average waveform superimposed on an area Sd representing a waveform deviation is obtained. In this example, the curve Cav representing an average waveform is represented by a solid line having a certain density. The area Sd representing the waveform deviation is represented as an area having an intermediate density between the curve Cav and the background area (white area in this example) Bg.

[0121] viii) Afterwards, if Figure 5A As shown in step S107 , the control unit 310 of the server 300 transmits the created image data Im via the network 900 to the hospital terminal 200A, which is a source of providing the time series data of the blood pressure in this example.

[0122] Furthermore, the control unit 310 of the server 300 may transmit the image data Im to another hospital terminal 200B or the like other than the hospital terminal 200A, for example, according to a designation by a user operating the hospital terminal 200A.

[0123] (Statistical processing of individual waveforms of blood pressure surges)

[0124] Fig.10 Shown for Figure 5A The detailed flow of the statistical processing of the individual waveforms of the blood pressure surge by the control unit 310 of the server 300 is described in step S105.

[0125] like Fig.10 As shown in step S111, the control unit 310 acquires time series data of beat-corresponding peak values ​​of individual waveforms for all detected blood pressure surges from the database 321. In this example, the number of acquired blood pressure surges is N.

[0126] For example, Fig.11 As shown in Table MT1, the detected blood pressure surge No. 1 is determined as the start time (start point time) 22:20:15, the peak time (peak time) 22:20:21, and the end time (end point time) 22:20:26. In addition, the blood pressure surge No. 2 is determined as the start time 22:25:35, the peak time 22:25:44, and the end time 22:25:52. In addition, the method of expressing time is "hour: minute: second" (the same below).

[0127] In this case, for example, regarding blood pressure surge No. 1, the time series data of the peak values ​​of the individual waveforms are as follows: Fig.12As shown in Table MT2, at the start time 22:20:15, the peak value of SBP corresponding to 130 [mmHg], the peak value of DBP corresponding to 78 [mmHg], and the pulse rate PR of 61 [beats / minute] are recorded. At the time 22:20:16 corresponding to the next heartbeat, the peak value of SBP corresponding to 134 [mmHg], the peak value of DBP corresponding to 80 [mmHg], and the pulse rate PR of 60 [beats / minute] are recorded. In this way, the time series data of the beat-corresponding peak values ​​are recorded in sequence, and at the end time 22:20:26, the peak value of SBP corresponding to 133 [mmHg], the peak value of DBP corresponding to 82 [mmHg], and the pulse rate PR of 61 [beats / minute] are recorded. Although the illustration is omitted for simplicity, the time series data of the beat-corresponding peak values ​​of the individual waveforms are also recorded in the same way for blood pressure surge No. 2.

[0128] Then, if Fig.10 As shown in step S112, the control unit 310 offsets the N individual waveforms by using the starting point P1 of each individual waveform as a reference (=0 [mmHg]). That is, for each of the N individual waveforms, the blood pressure value (in this example, the SBP value) at the starting point P1 of the individual waveform is subtracted from the blood pressure value (in this example, the SBP value) at each moment. Thus, the blood pressure variation data at each moment is obtained. By performing such an offset, it is easy to grasp the curve Cav representing the average waveform as a representative waveform and the waveform deviation ±σ for each horizontal coordinate X.

[0129] Then, if Fig.10 As shown in step S113, the control unit 310 determines the individual waveform having the longest X-direction (lateral) dimension among the N individual waveforms. In addition, the longest X-direction dimension is obtained as the number of beats M.

[0130] Then, if Fig.10 As shown in step S114 , the control unit 310 reserves a storage area of ​​N rows and M columns in the storage unit 320 as a work area for executing the calculation.

[0131] For simplicity, Figure 8 As shown in the example, the number of blood pressure surges N = 2, the X-direction size of the individual waveform C1 of "Surge No. 1" is 12 beats, and the X-direction size of the individual waveform C2 of "Surge No. 2" is 17 beats. At this time, the control unit 310 specifies the individual waveform with the longest X-direction size as C2, and calculates the longest X-direction size as the number of beats M = 17. Then, as Fig.13As shown in the second to third rows of Table MT3, the control unit 310 ensures a storage area of ​​2 rows and 17 columns in the storage unit 320 as an operation area for performing operations for "surge No. 1" and "surge No. 2". It should be noted that, in fact, when the number N of blood pressure surges obtained is greater than 2, a storage area with more rows than 2 is ensured. The beat number representing the X-direction coordinate is shown in the top section (first row) of Table MT3.

[0132] Then, if Fig.10 As shown in step S115, the control unit 310 slides N individual waveforms relatively in the horizontal direction X in the storage area of ​​N rows and M columns and aligns the positions (beat numbers) of the peaks of the N individual waveforms. Fig.13 In the example, the positions of the peaks of the two individual waveforms C1 and C2, “Surge No. 1” and “Surge No. 2”, on the horizontal direction X are aligned to be at beat number 10 (indicated by a dotted circle). As a result, in the second row of Table MT3, the blood pressure variation data of “Surge No. 1” are represented in sequence by beat numbers 4 to 15 as “0”, “4”, “10”, “13”, ..., “11”, “3” (unit is mmHg. The same applies below). In addition, in the third row of Table MT3, the blood pressure variation data of “Surge No. 2” are represented in sequence by beat numbers 1 to 17 as “0”, “2”, “3”, “5”, ..., “4”, “2”. In this way, the state of aligning the positions (beat numbers) of the peaks of N individual waveforms is equivalent to Figure 8 The state where the positions of the peaks of the plurality of individual waveforms C1 and C2 are relatively slid in the horizontal direction X on the coordinate plane Q shown in the figure is aligned. As a result, it is easier to grasp the curve Cav representing the average waveform as a representative waveform and the waveform deviation ±σ at each horizontal coordinate X. In addition, the value of the starting point (beat number 4) of the individual waveform C1 of "surge No. 1" and the value of the starting point (beat number 1) of the individual waveform C2 of "surge No. 2" are both "0", which is the offset ( Fig.10 The result of step S112).

[0133] Then, if Fig.10 As shown in step S116, the control unit 310 performs statistical processing (averaging in this example) on the blood pressure variation data of N individual waveforms for each beat number (column) to obtain an average value. Fig.13 In the example, the bottom row (fourth row) of Table MT3 shows the average values ​​of the blood pressure variation data for each beat number for the individual waveforms of "Surge No. 1" and "Surge No. 2". The curve Cav representing the average waveform as a representative waveform is determined by the average value of the beat number.

[0134] At this time, the control unit 310 sets the contribution of the portion of the beat count of the individual waveform ("surge No. 1" in the above example) shorter than the individual waveform with the longest X-direction dimension among the N individual waveforms ("surge No. 2" in the above example) to the statistical processing of the blood pressure variation data to zero. Fig.13 In the example of FIG. 1 , for the individual waveform of “surge No. 1”, the portion whose X-direction size is smaller than that of the individual waveform of “surge No. 2”, i.e., the portion for beat numbers 1 to 3 and the portion for beat numbers 16 to 17, is set to contribute zero to the statistical processing of the blood pressure variation data. Thus, even when the X-direction sizes of N individual waveforms on the coordinate plane Q are different from each other, the statistical processing of the blood pressure variation data can be performed without any hindrance.

[0135] Furthermore, if Fig.10 As shown in step S117, the control unit 310 obtains the standard deviation σ of the distribution of the blood pressure variation data of N individual waveforms for each beat number (column). The region of each beat number ±σ is determined as the region Sd indicating the waveform deviation described above.

[0136] Thus, in this process, when statistical processing is performed on the blood pressure variation data of N individual waveforms, the statistical processing of the blood pressure variation data can be performed according to the beat number (column). Therefore, compared with the case where the statistical processing of the blood pressure variation data is performed continuously in the horizontal direction X, the amount of calculation of the control unit 310 is reduced.

[0137] In addition, in the Fig.10 In step S112, in addition to shifting the starting point P1 of each individual waveform as a reference (=0 [mmHg]), the N individual waveforms can also be normalized by aligning the heights of the peaks of the N individual waveforms. This makes it easier to grasp the curve Cav representing the average waveform as a representative waveform and the waveform deviation ±σ for each horizontal coordinate X.

[0138] (Display of image data on hospital terminal)

[0139] The hospital terminal 200A receives the following information from the server 300 via the network 900: Fig. 9 The image data Im shown in (B).

[0140] 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 displays the image data Im on the display screen of the display 240. At this time, the blood pressure variation amount ( Figure 7 The average value of the difference L1 between the systolic blood pressure value (SBP) at the surge start point P1 and the systolic blood pressure value (SBP) at the peak point P2 shown in the figure, the standard deviation σ (or ±σ, ±2σ, ±3σ) of the distribution, etc.

[0141] The user can understand the curve Cav, a representative waveform indicating a blood pressure surge, and the region Sd indicating a waveform deviation of the subject 90 by observing the display screen of the display 240. In addition to the diagnosis and treatment of SAS, this is considered to be useful as material for evaluating cardiovascular disease risks and for evaluating disease risks of specific organs.

[0142] Furthermore, the user may input a transfer instruction via the operation unit 230 of the hospital terminal 200A to transmit the image data Im to another hospital terminal 200B or the like other than the hospital terminal 200A.

[0143] [B. Applied blood pressure related information display method]

[0144] In this applied blood pressure-related information display method, the following image data is created and displayed using the time series data of blood pressure that establishes a correspondence between the measurement moment (time) output by the sphygmomanometer 400 and the blood pressure, and the information representing a specific period of the physical condition output by the PSG device 500.

[0145] (Creation of Image Data in Server 300)

[0146] i) in Figure 4 In the manner shown, blood pressure measurement is continuously performed for a night (including during sleep) using the sphygmomanometer 400, and physical condition measurement is performed using the PSG device 500 for the subject 90. In this example, the time series data of blood pressure from the sphygmomanometer 400 and the information indicating the specific period of physical condition from the PSG device 500 are received by the hospital terminal 200A and temporarily stored in the storage unit 220. Then, for example, a doctor who is a user operates the operation unit 230 of the hospital terminal 200A, and the time series data of blood pressure measured for the subject 90 and the information indicating the specific period of physical condition are transmitted to the server 300 via the network 900.

[0147] ii) The server 300 is always in operation in this example (except during maintenance, etc.). Figure 5BAs shown in step S151 of the (operation flow of the server 300 when executing the method for displaying applied blood pressure-related information), the server 300 waits for data from the hospital terminal 200A. When the control unit 310 of the server 300 receives the above-mentioned data (time series data of blood pressure and information indicating a specific period of physical condition) from the hospital terminal 200A via the communication unit 390 as an input unit from the network 900 ("Yes" in step S151), the received time series data of blood pressure and information indicating a specific period of physical condition are stored in the database 321 of the storage unit 320. Then, the processing of steps S152 to S157 described below is performed.

[0148] iii) First, as shown in step S152, the control unit 310 functions as a preprocessing unit and performs preprocessing such as smoothing using a known moving average, noise removal, and high-frequency component removal using a low-pass filter on the time series data of blood pressure.

[0149] iv) Next, as shown in step S153, the control unit 310 functions as a blood pressure surge detection unit, and detects a blood pressure surge based on a predetermined judgment criterion based on the time series data of the blood pressure of the subject 90, such as disclosed in Japanese Patent Application No. 2017-048946 and Japanese Patent Application No. 2017-050066. Figure 6 In (B), as shown in the dotted rectangular boxes 803, 803, ..., multiple blood pressure surges are detected. Here, the "predetermined judgment criteria" for detecting blood pressure surges are different from the reference Figure 7 about Figure 5A The determination criteria described in step S103 are the same.

[0150] v) Then, if Figure 5B As shown in step S154, the control unit 310 functions as an individual waveform acquisition unit, and for each of the detected blood pressure surges 803, 803, ..., an envelope of a plurality of beat-corresponding peaks (in this example, the peaks of the systolic blood pressure (SBP)) forming the blood pressure surge 803 is obtained as an individual waveform. Figure 7 As shown, the individual waveform of the blood pressure surge is represented by a curve C in a mountain-like shape.

[0151] vi) Then, if Figure 5BAs shown in step S155, the control unit 310 functions as a statistical processing unit. In this example, statistical processing is performed on the multiple individual waveforms obtained for each specific period of the body state described above to obtain a representative waveform and waveform deviation of the blood pressure surge in the time series data 801. In this example, if a specific period of a body state (for example, an apnea period) partially overlaps with the period from the start point P1 to the end point P4 of the blood pressure surge, the blood pressure surge is processed as a blood pressure surge occurring during the specific period of the body state. Here, "statistical processing" refers to the process of performing statistical processing on the blood pressure surge during the specific period of the body state. Figure 5A Use of step S105 Figure 8 (as well as Figure 10 to Figure 13 ) is performed in the same manner as described in the above description. That is, the processing of averaging individual waveforms of a blood pressure surge is equivalent to averaging the blood pressure fluctuation data of a plurality of individual waveforms C1 and C2 for each horizontal coordinate X on a coordinate plane Q including a horizontal coordinate X representing the passage of time and a vertical coordinate Y representing the blood pressure fluctuation amount accompanying the blood pressure surge, while aligning the positions of the peaks of a plurality of individual waveforms C1 and C2 by sliding the plurality of individual waveforms C1 and C2 relatively in the horizontal direction X, and obtaining a curve Cav representing the waveform of the average as a representative waveform. In addition, in this example, Figure 5A Similarly to step S105, the range of the "waveform deviation" of the blood pressure surge is defined as the range of ±σ for each horizontal coordinate X using the standard deviation σ of the distribution (distribution for each horizontal coordinate X) formed by the blood pressure variation data of multiple individual waveforms.

[0152] Thus, for each specific period of the body state, a curve Cav representing an average waveform of a representative waveform and a waveform deviation ±σ for each horizontal coordinate X are obtained. For example, when the specific periods of the body state determined in the time series data of one night are four types, namely, an apnea period (including a hypopnea period), a REM sleep period, a non-REM sleep period, and a wake period, a curve Cav representing an average waveform of a representative waveform and a waveform deviation ±σ for each horizontal coordinate X are obtained for the apnea period. Similarly, a curve Cav representing an average waveform of a representative waveform and a waveform deviation ±σ for each horizontal coordinate X are obtained for the REM sleep period, the non-REM sleep period, and the wake period, respectively.

[0153] vii) Then, if Figure 5B As shown in step S156 of FIG. 15 , the control unit 310 functions as a part of the display processing unit to create a display as shown in FIG. 15 , according to the specific period of each physical state as described above. Fig. 9 (B) shows an example of image data Im in a format in which a curve Cav representing an average waveform is superimposed on a region Sd representing a waveform deviation of a blood pressure surge.

[0154] For example, as described below Fig.15A As shown in, for the apnea period (including hypopnea period), rapid eye movement sleep (REM), non-rapid eye movement sleep (NREM), and wakefulness period, image data Im1, Im2, Im3, Im4 are obtained in the form of curves Cav1, Cav2, Cav3, Cav4 representing the average waveform overlapping the areas Sd1, Sd2, Sd3, Sd4 representing the waveform deviation, respectively.

[0155] viii) Afterwards, if Figure 5B As shown in step S157 , the control unit 310 of the server 300 transmits the image data Im1 , Im2 , Im3 , and Im4 created for each physical condition specific period to the hospital terminal 200A which is the source of the blood pressure time series data in this example via the network 900 .

[0156] Furthermore, the control unit 310 of the server 300 may transmit the image data Im1, Im2, Im3, and Im4 to other hospital terminals 200B and the like other than the hospital terminal 200A, for example, based on a designation by a user operating the hospital terminal 200A.

[0157] (Display of image data in hospital terminal)

[0158] Fig.14 The flow of display processing in the hospital terminal 200A is shown when image data created for each physical condition specific period is received from the server 300. In addition, in this example, although the hospital terminal 200A is described, other hospital terminals 200B and the like can also perform the same display processing.

[0159] First, Fig.14 As shown in step S201, the hospital terminal 200A receives image data created for each specific period of the body state from the server 300 via the network 900. In this example, the specific period of the body state is four types: an apnea period (including a hypopnea period), a rapid eye movement sleep period, a non-rapid eye movement sleep period, and a wakefulness period.

[0160] Next, the control unit 210 of the hospital terminal 200A functions as a part of the display processing unit, such as Fig.15A As shown, on the display screen of the display 240, the image data Im1, Im2, Im3, Im4 ( Fig.14 Step S202). Fig.15AAs shown in , in this example, a body state specific column 241 for determining a body state specific period and an image data column 242 correspondingly arranged below the body state specific column 241 are displayed on the display screen of the display 240. In this example, the body state specific column 241 includes, from left to right, an "apnea" column 241a indicating an apnea period, a "REM" column 241b indicating a rapid eye movement sleep period, a "NREM" column 241c indicating a non-rapid eye movement sleep period, and a "wake response" column 241d indicating a wake period. The image data column 242 includes a column 242a displaying image data Im1 created for the apnea period, a column 242b displaying image data Im2 created for the rapid eye movement sleep period, a column 242c displaying image data Im3 created for the non-rapid eye movement sleep period, and a column 242d displaying image data Im4 created for the wake period.

[0161] In this example, the image data Im1 created for the apnea period is in a form in which the curve Cav1 representing the average waveform is overlapped with the region Sd1 representing the waveform deviation. The image data Im2 created for the REM sleep period is in a form in which the curve Cav2 representing the average waveform is overlapped with the region Sd2 representing the waveform deviation. The image data Im3 created for the non-REM sleep period is in a form in which the curve Cav3 representing the average waveform is overlapped with the region Sd3 representing the waveform deviation. In addition, the image data Im4 created for the wake period is in a form in which the curve Cav4 representing the average waveform is overlapped with the region Sd4 representing the waveform deviation.

[0162] By observing the thumbnail display of these image data Im1, Im2, Im3, and Im4, the user can grasp the curve Cav representing the representative waveform of the blood pressure surge of the subject 90 and the area Sd representing the waveform deviation for each specific period of the physical state, in other words, for each period in which the subject 90 becomes a physical state that may be a factor of the blood pressure surge. Therefore, the user can easily grasp the factor (physical state) that causes the most serious blood pressure surge, for example. For example, among the image data Im1, Im2, Im3, and Im4, the blood pressure change amount of the image data Im1 created for the apnea period is the largest, so it can also be determined that "apnea" causes the most serious blood pressure surge.

[0163] Then, if Fig.14 As shown in step S203, the control unit 210 of the hospital terminal 200A determines whether the displayed image data Im1, Im2, Im3, Im4 is selected. If the user selects any one of the image data Im1, Im2, Im3, Im4 by operating the operation unit 230 ( Fig.14 Step S203 is "yes"), such as Fig. 15B As shown, the control unit 210 displays the image data for the selected specific period of the physical state (in this example, the image data Im1 created for the apnea period) in an enlarged manner on the display screen of the display 240 ( Fig.14 At this time, the blood pressure variation amount ( Figure 7 The average value of the difference L1 between the systolic blood pressure value (SBP) at the surge start point P1 and the systolic blood pressure value (SBP) at the peak point P2 shown in the figure, the standard deviation σ (or ±σ, ±2σ, ±3σ) of the distribution, etc.

[0164] In addition, when none of the image data Im1, Im2, Im3, and Im4 is selected ( Fig.14 Step S203 is "No"), the control unit 210 turns off the image ( Fig.14 Step S205) ends the display processing.

[0165] Furthermore, 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, and Im4 to another hospital terminal 200B or the like other than the hospital terminal 200A.

[0166] As shown above, the image data Im1, Im2, Im3, and Im4 are displayed in a form in which a curve representing an average waveform is overlapped with an area of ​​waveform deviation representing a blood pressure surge during each specific period of the physical state. In addition to the diagnosis and treatment of SAS, this is considered to be useful as a material for evaluating the risk of cardiovascular disease and the risk of disease in a specific organ.

[0167] (Variant 1)

[0168] In the above-described embodiment, the server 300 creates the image data Im (or the image data Im1, Im2, Im3, Im4 for each specific period of the physical state. The same applies hereinafter), and the image is displayed on the display 240 of the hospital terminal 200A, 200B, ..., but the present invention is not limited thereto. Instead of sending the image data Im to the hospital terminal 200A, 200B, ..., the control unit 310 of the server 300 may send only the data for image creation, and the control unit 210 of the hospital terminal 200A, 200B, ... may create the image data Im itself.

[0169] (Variant 2)

[0170] 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 the present invention is not limited to this.

[0171] For example, the blood pressure-related information display device of the present invention may be constituted by only any 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 method (including receiving the time series data of the blood pressure from the sphygmomanometer 400 and the information indicating the specific period of the physical condition from the PSG device 500 to displaying the image data Im on the display screen of the display 240, etc.).

[0172] In this case, a program for causing the control unit 210 to execute the above-mentioned 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.

[0173] In addition, the blood pressure related information display method can also be recorded as software (computer program) on a recording medium capable of storing data in a non-transitory manner, such as a CD (Compact Disc), a DVD (Digital Versatile Disc), or a flash memory. By installing the software recorded on such a recording medium in a substantial computer device such as a personal computer, a PDA (Personal Digital Assistant), or a smart phone, the blood pressure related information display method can be executed by the computer device.

[0174] (Variant 3)

[0175] In the above-described embodiment, the region Sd representing the waveform deviation constituting the image data Im is defined as a range of ±k times (typically ±σ, ±2σ, or ±3σ) the standard deviation σ of the distribution formed by the blood pressure variation data at each transverse coordinate X. However, the range of the region Sd representing the waveform deviation is not limited to being defined using the standard deviation σ.

[0176] For example, the region Sd representing the waveform deviation may also be defined as the quartile range of the distribution formed by the blood pressure variation data for each horizontal coordinate X. That is, as a process, the blood pressure variation 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. In this way, the region Sd representing the waveform deviation can be obtained.

[0177] In this way, when the region Sd representing the waveform deviation is made the quartile range of the distribution formed by the blood pressure variation data at each horizontal coordinate X, the calculation is simpler without requiring a large amount of calculation, compared to the case of defining using the standard deviation σ. Therefore, it can contribute to improving the processing speed and saving the storage unit.

[0178] In addition, the "representative waveform" of the blood pressure surge is set to be 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 (median value) of the distribution formed by the blood pressure variation data for each horizontal coordinate X. In this case, as a process, the blood pressure variation data is arranged in ascending order for each horizontal coordinate X, and the medians are connected horizontally to obtain a representative waveform.

[0179] (Variant 4)

[0180] In the above-described embodiment, on the display screen of the display 240, the area Sd indicating the waveform deviation constituting the image data Im is shown as follows. Fig. 9 As shown in (B) of FIG. 1 , the region Sd representing the waveform deviation is displayed as a region having an intermediate density between the curve Cav representing the representative waveform and the background region Bg. However, the display mode of the region Sd representing the waveform deviation is not limited to the region having an intermediate density.

[0181] For example, Fig.16 (A) and Fig. 9 (A) of FIG. 1 shows a plurality of individual waveforms C11, C12, C13, ... in the same manner. In this case, as Fig.16 As shown in (B), the curves Ci representing the plurality of individual waveforms C11, C12, C13, ... may be displayed in a manner that the curves Ci representing the plurality of individual waveforms C11, C12, C13, ... can be distinguished from the curve Cav' representing the representative waveform so as to form the region Sd' representing the waveform deviation. In this example, the curve Cav' is displayed with a solid line, whereas the curves Ci representing the plurality of individual waveforms C11, C12, C13, ... are displayed with dotted lines. In this example, image data in a form in which the curve Cav' representing the representative waveform is superimposed on the region Sd' (including the plurality of curves Ci) representing the waveform deviation is denoted by reference symbol Im'.

[0182] Thus, the user can intuitively understand the curve Cav′ representing the representative waveform of the blood pressure surge of the subject 90 and the area Sd′ representing the waveform deviation. For example, when the number of individual waveforms is less than a few, the display of the curve Ci representing the plurality of individual waveforms helps the user understand the deviations of the individual waveforms C11, C12, C13, ...

[0183] In addition, it is sufficient as long as the curve Cav′ representing the representative waveform and the curve Ci representing the plurality of individual waveforms C11, C12, C13, ... can be distinguished. For example, the curve Cav′ representing the representative waveform is displayed by a red solid line, while the curve Ci representing the plurality of individual waveforms C11, C12, C13, ... can also be displayed by a blue solid line.

[0184] In addition, a threshold Nα is set for the number N of blood pressure surges obtained during a specific period of each physical state (for example, Nα=10). If the number N of blood pressure surges obtained is greater than the threshold Nα, the following is performed: Fig. 9 The creation and display of the first image data Im including the region Sd (region with a middle density having a width of ±σ in the vertical direction) indicating the waveform deviation shown in (B) of FIG. 1 and FIG. 2 , on the other hand, if the number N of blood pressure surges obtained is less than the threshold value Nα, the following may also be performed: Fig.16 The creation and display of the second image data Im' including the region Sd' indicating the waveform deviation (curve Ci indicating a plurality of individual waveforms C11, C12, C13, ...) shown in (B) of FIG. For determining whether the number N of blood pressure surges is greater than the threshold value Nα, for example, the control unit 310 of the server 300 can function as a blood pressure surge number determination unit.

[0185] Alternatively, for example, the control unit 310 of the server 300 may also create a Fig. 9 The first image data Im shown in (B) includes a region Sd indicating a waveform deviation, and Fig.16 In this case, for example, the first image data and the second image data Im' are sent from the server 300 to the hospital terminal (e.g., 200A), and the first image data Im and the second image data Im' can be switched and displayed on the display screen of the display 240 according to the input of the user via the operation unit 230 of the hospital terminal (e.g., 200A).

[0186] (Variant 5)

[0187] In addition, in the above-described embodiment, the sphygmomanometer 400 is a sphygmomanometer of a tension measurement method, but it is not limited to this. The sphygmomanometer 400 may also include a light emitting element that irradiates light toward an artery that passes through a corresponding portion of the measured part, and a light receiving element that receives reflected light (or transmitted light) of the light, and continuously detects blood pressure based on the volume change of the pulse wave of the artery (photoelectric method). In addition, the sphygmomanometer 400 may also include a piezoelectric sensor that contacts the measured part, detects deformation caused by the pressure of the artery that passes through a corresponding portion of the measured part as a change in resistance, and continuously detects blood pressure based on the change in resistance (piezoelectric method). Furthermore, the sphygmomanometer 400 includes a transmitting element that transmits an electric wave (transmitting wave) toward an artery that passes through a corresponding portion of the measured part, and a receiving element that receives reflected waves of the electric wave, detects a change in the distance between the artery and the sensor caused by the pulse wave of the artery as a phase deviation between the transmitted wave and the reflected wave, and continuously detects blood pressure based on the phase deviation (electric wave irradiation method). In addition, as long as a physical quantity that can calculate blood pressure can be observed, methods other than these may also be applied.

[0188] The above embodiments are merely examples, and various modifications can be made without departing from the scope of the present invention. The multiple embodiments described can be established separately, or each embodiment can be combined. In addition, each feature in different embodiments can be established separately, or each feature in different embodiments can be combined.

[0189] Description of Reference Numerals

[0190] 100 Systems

[0191] 200A, 200B, ... Hospital Terminal

[0192] 240 Display

[0193] 300 Servers

[0194] 400 Blood Pressure Monitor

[0195] 500 PSG units

Claims

1. A blood pressure related information display device that visually displays information related to a phenomenon in which blood pressure rises to a peak value over a plurality of heartbeats and then the peak value decreases over a plurality of heartbeats, i.e., a blood pressure surge, characterized in that: have: a blood pressure surge detecting unit that detects a blood pressure surge based on a predetermined determination criterion from time series data of blood pressure that changes in conjunction with the subject's pulse; The individual waveform acquisition unit obtains, for each detected blood pressure surge, an envelope connecting a plurality of beat-corresponding peaks forming the blood pressure surge as the individual waveform; A statistical processing unit that performs statistical processing on the obtained plurality of individual waveforms to obtain a representative waveform and waveform deviation of a blood pressure surge in the time series data; as well as The display processing unit performs processing for displaying, on a display screen, a curve representing the representative waveform in an overlapping manner in a region of the waveform deviation representing the blood pressure surge, The statistical processing unit performs the following processing: determining, among the plurality of individual waveforms each having a lateral size, the longest individual waveform having the longest lateral size in units of beats, A state is created in the storage area, which is equivalent to sliding the plurality of individual waveforms relatively in the horizontal direction and aligning the positions of the peaks of the plurality of individual waveforms on a coordinate plane including a horizontal coordinate indicating the passage of time and a vertical coordinate indicating the blood pressure variation accompanying a blood pressure surge, wherein the horizontal coordinate is determined by the beat number that determines the beat-corresponding peak value, and in this state, the blood pressure variation data of the plurality of individual waveforms are statistically processed for each beat number used to determine the horizontal coordinate to obtain the representative waveform and the waveform deviation, For an individual waveform whose lateral dimension is shorter than the longest individual waveform in terms of the number of beats, contribution to the statistical processing of the blood pressure variation data of a portion corresponding to the number of beats that is shorter than the longest individual waveform is set to zero.

2. The blood pressure related information display device according to claim 1, characterized in that: The blood pressure variation data of the plurality of individual waveforms are variations based on the blood pressure value at the start point of the individual waveform.

3. The blood pressure related information display device according to claim 1 or 2, characterized in that: The blood pressure variation data of the plurality of individual waveforms are normalized so that the heights of the peaks of the plurality of individual waveforms are aligned.

4. The blood pressure related information display device according to claim 1 or 2, characterized in that: The statistical processing unit performs the following processing: when the number of the individual waveforms is set to N and the horizontal size of the longest individual waveform is set to M in units of the number of beats, a storage area of ​​N rows and M columns is secured as the storage area, When creating a state equivalent to relatively sliding the plurality of individual waveforms and aligning the positions of the peaks of the plurality of individual waveforms, the N individual waveforms are relatively slid in a horizontal direction in units of beat numbers in the storage area of ​​the N rows and M columns, and the beat numbers for determining the peaks of the N individual waveforms are aligned.

5. The blood pressure related information display device according to claim 1 or 2, characterized in that: The waveform deviation obtained by the statistical processing unit is defined as ±k times the standard deviation of the distribution formed by the blood pressure variation 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 corresponding to ±k times the standard deviation in the vertical direction as a region indicating the waveform deviation.

6. The blood pressure related information display device according to claim 1 or 2, characterized in that: The waveform deviation obtained by the statistical processing unit is defined as the interquartile range of the distribution formed by the blood pressure variation data of the plurality of individual waveforms. The display processing unit displays, on the display screen, a region having a width corresponding to the interquartile range in the vertical direction as a region indicating the waveform deviation.

7. The blood pressure related information display device according to claim 1 or 2, characterized in that: The display processing unit performs processing for displaying the curves representing the plurality of individual waveforms in a form distinguishable from the curve representing the representative waveform, so as to form an area representing the waveform deviation on the display screen.

8. The blood pressure related information display device according to claim 1 or 2, characterized in that: The apparatus comprises: an input unit for inputting information indicating a specific period of a physical state capable of determining the physical state of the subject, along with time series data of blood pressure that changes in conjunction with the pulse of the subject; The statistical processing unit obtains a representative waveform and waveform deviation of a blood pressure surge in the time series data for each specific period of the physical condition, The display processing unit performs processing for displaying, on the display screen, a curve representing the representative waveform in a superimposed manner on a region of the waveform deviation representing a sudden increase in the blood pressure for each of the physical condition specific periods.

9. A method for displaying blood pressure-related information, visually displaying information related to a phenomenon in which blood pressure rises to a peak value in a plurality of heartbeats and then the peak value decreases in a plurality of heartbeats, i.e., a blood pressure surge, characterized in that: have: A step of detecting a blood pressure surge based on a predetermined criterion based on time series data of blood pressure that changes in conjunction with the subject's pulse; For each detected blood pressure surge, an envelope connecting a plurality of beat-corresponding peak values ​​forming the blood pressure surge is obtained as an individual waveform; as well as The step of performing statistical processing on the obtained plurality of individual waveforms to obtain a representative waveform and waveform deviation of a blood pressure surge in the time series data, The following processing is performed in this step: determining, among the plurality of individual waveforms each having a lateral size, the longest individual waveform having the longest lateral size in units of beats, A state is created in the storage area, which is equivalent to sliding the plurality of individual waveforms relatively in the horizontal direction and aligning the positions of the peaks of the plurality of individual waveforms on a coordinate plane including a horizontal coordinate indicating the passage of time and a vertical coordinate indicating the blood pressure variation accompanying a blood pressure surge, wherein the horizontal coordinate is determined by the beat number that determines the beat-corresponding peak value, and in this state, the blood pressure variation data of the plurality of individual waveforms are statistically processed for each beat number used to determine the horizontal coordinate to obtain the representative waveform and the waveform deviation, For an individual waveform whose lateral dimension is shorter than the longest individual waveform in terms of the number of beats, the contribution of the portion corresponding to the number of beats less than the longest individual waveform to the statistical processing of the blood pressure variation data is set to zero, The blood pressure-related information display method further includes the step of performing a process of causing a curve representing the representative waveform to be displayed on a display screen in an overlapping manner in a region of the waveform deviation representing a sudden increase in the blood pressure. 10 . A computer-readable storage medium storing a program for causing a computer to execute the blood pressure-related information display method according to claim 9 .

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