四线涡轮式慢阻肺健康监护系统研究
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摘要
针对传统涡轮式肺活量计存在检测精度不高、可靠性差的问题,该文提出一种新颖的四线涡轮式检测方法,研制了一款高精度、高可靠性的慢阻肺监护系统。在硬件上,根据四线涡轮式检测方法设计了四线式呼气采集电路,提高了光路接收分辨率,并通过合理的元器件布置,减少了发光-光敏二极管相互间串扰,提高了系统的可靠性;在软件上,采用线性回归算法对其脉冲计数与分析得到用力肺活量、峰值流速等早期筛查与诊断指标。该系统利用标准Fluke气流分析仪的进行了数据标定,与传统医用涡轮式肺功能仪测试对比:用力肺活量平均相对误差由1.98%降低至1.47%;峰值流速平均相对误差由2.04%降低至1.02%。实验表明,四线涡轮式慢阻肺监护系统的呼气指标比传统慢阻肺系统检测精度更高,可靠性更好,适用于慢阻肺疾病的早期筛查与精准诊断,结合血氧饱和度、呼气末二氧化碳等指标,能实现对慢阻肺患者的医疗监护,特别对于中度和重度慢阻肺患者能起到预警和控制病情的作用。
To improve accuracy and reliability of the traditional turbine-vital capacity meter, a novel four-line turbine-detection method is presented for the high precision and high reliability Chronic Obstructive Pulmonary Disease(COPD) monitoring system. On the hardware, a four-line breath signal acquisition circuit is designed following the four-line turbine-type detection method, which improves the resolution of the optical path through reasonable components arrangement. On the software, a linear regression algorithm is used to obtain early screening and diagnostic indicators such as Forced Vital Capacity(FVC), Peak Expiratory Flow(PEF) and so on. The standard Fluke air flow analyzer is used for data calibration, compared with the traditional medical turbine-type lung function meter: FVC average relative error is reduced from 1.98% to1.47% and PEF average relative error is reduced from 2.04% to 1.02%. It is showed that the expiratory parameters of the four-line turbine-type COPD monitoring system is more accurate and reliable than that of the traditional COPD system which is suitable for early screening and accurate diagnosis of COPD. Combined with pulse oxygen saturation, End-tidal CO2, it can be used to achieve the medical care for COPD and play an important role to early detect and control of disease for moderate or severe COPD patients.
To improve accuracy and reliability of the traditional turbine-vital capacity meter, a novel four-line turbine-detection method is presented for the high precision and high reliability Chronic Obstructive Pulmonary Disease(COPD) monitoring system. On the hardware, a four-line breath signal acquisition circuit is designed following the four-line turbine-type detection method, which improves the resolution of the optical path through reasonable components arrangement. On the software, a linear regression algorithm is used to obtain early screening and diagnostic indicators such as Forced Vital Capacity(FVC), Peak Expiratory Flow(PEF) and so on. The standard Fluke air flow analyzer is used for data calibration, compared with the traditional medical turbine-type lung function meter: FVC average relative error is reduced from 1.98% to1.47% and PEF average relative error is reduced from 2.04% to 1.02%. It is showed that the expiratory parameters of the four-line turbine-type COPD monitoring system is more accurate and reliable than that of the traditional COPD system which is suitable for early screening and accurate diagnosis of COPD. Combined with pulse oxygen saturation, End-tidal CO2, it can be used to achieve the medical care for COPD and play an important role to early detect and control of disease for moderate or severe COPD patients.
引文
[1]ALLINSON J P,HARDY R,DONALDSON G C,et al.Combined impact of smoking and early-life exposures on adult lung function trajectories[J].American Journal ofRespiratory and Critical Care Medicine,2017,196(8):1021-1030.doi:10.1164/rccm.201703-0506OC.
[2]VOGELMEIER C F,CRINER G J,MARTINEZ F J,et al.Global strategy for the diagnosis,management,and prevention of chronic obstructive lung disease 2017 report:GOLD executive summary[J].American Journal of Respiratory&Critical Care Medicine,2017,195(5):557-582.doi:10.1183/13993003.00214-2017.
[3]ROBERTS S D,FARBER M O,KNOX K S,et al.FEV1/FVC ratio of 70%misclassifies patients with obstruction at the extremes of age[J].Chest,2006,130(1):200-206.doi:10.1378/chest.130.1.200.
[4]BAKER E and FATOYE F.Clinical and cost effectiveness of nurse-led self-management interventions for patients with COPD in primary care:A systematic review[J].International Journal of Nursing Studies,2017,71:125-138.doi:10.1016/j.ijnurstu.2017.03.010.
[5]LI Yi,FENG Jing,LI Yuechuan,et al.A new pulmonary rehabilitation maintenance strategy through home-visiting and phone contact in COPD[J].Dove Press journal,2018,12:97-104.doi:10.2147/PPA.S150679.
[6]顾宇,叶寒生,冯超,等.一种恒功率热式气体流量计温度补偿实现[J].仪表技术与传感器,2015(10):38-39.doi:10.3969/j.issn.1002-1841.2015.10.012.GU Yu,YE Hansheng,FENG Chao,et al.Temperature compensation for constant power thermal gas flowmeter[J].Instrument Technique and Sensor,2015(10):38-39.doi:10.3969/j.issn.1002-1841.2015.10.012.
[7]FANG Lide,WANG Xiaojie,et al.Wet gas over-reading characteristic research of inside and outside tube differential pressure flowmeter[J].Applied Mechanics&Materials,2013(241-244):168-171.doi:10.4028/www.scientific.net/AMM.241-244.168.
[8]PILLOW J J,LJUNGBERG H,HüLSKAMP G,et al.Functional residual capacity measurements in healthy infants:Ultrasonic flow meter versus a mass spectrometer[J].European Respiratory Journal,2004,23(5):763-771.doi:10.1183/09031936.04.00091504.
[9]贾天震,杨汀,魏建磊,等.新型涡轮便携式肺功能仪的研制与开发[J].电子技术应用,2017,43(11):62-65.doi:10.16157/j.issn.0258-7998.171411.JIA Tianzhen,YANG Ting,WEI Jianlei,et al.The research and development of a novel portable turbine pulmonary function meter[J].Application of Electronic Technique,2017,43(11):62-65.doi:10.16157/j.issn.0258-7998.171411.
[10]何子军.呼气信号分析方法及其在肺功能检查中的应用研究[D].[博士论文],中国科学技术大学,2014:17-22.HE Zijun.The method for analyzing expiratory signals and its application in pulmonary function testing[D].[Ph.D.dissertation],University of Science and Technology of China,2014:17-22.
[11]CLARKE M,GOKALP H,FURSSE J,et al.Dynamic threshold analysis of daily oxygen saturation for improvedmanagement of COPD patients[J].IEEE Journal of Biomedical&Health Informatics,2015,20(5):1352-1360.doi:10.1109/JBHI.2015.2464275.
[12]韩庆阳,王晓东,李丙玉,等.EEMD在同时消除脉搏血氧检测中脉搏波信号高频噪声和基线漂移中的应用[J].电子与信息学报,2015,37(6):1384-1388.doi:10.11999/JEIT141390.HAN Qingyang,WANG Xiaodong,LI Bingyu,et al.Using EEMD to eliminate high frequency noise and baseline drift in pulse blood-oximetry measurement simultaneously[J].Journal of Electronics&Information Technology,2015,37(6):1384-1388.doi:10.11999/JEIT141390.
[13]VERONEZ L,PEREIRA M C,da SILVA S,et al.Volumetric capnography for the evaluation of chronic airways diseases[J].International Journal of Chronic Obstructive Pulmonary Disease,2014,9:983-989.doi:10.2147/COPD.S62886.
[14]BRIDGEMAN D,ZHAO D,TSOW F,et al.A non-invasive and inexpensive capnography device for the monitoring of COPD and other pulmonary diseases[C].2014 IEEEHealthcare Innovation Conference,Seattle,USA.2014:1-4.doi:10.1109/HIC.2014.7145572.
[15]ZHONG Xingfu,WU Yingxiang,TIAN Shuxiang,et al.Flow rate measurement in multiphase flow using turbine flow-meter[J].Chinese Journal of Scientific Instrument,2002,23(Suppl):858-859.
[16]文红燕.涡轮流量计在线监测系统的研究[D].[硕士论文],中国计量大学,2016:8-14.WEN Hongyan.Research on the online monitoring system of turbine flow meter[D].[Master dissertation],China Ji Liang University,2016:8-14.
[17]周旺,方震,陈贤祥,等.获取呼气指标的装置及方法[P].中国专利,CN107569233A.2018-01-12.ZHOU Wang,FANG Zhen,CHEN Xianxiang,et al.Obtaining expiration indicator device and method[P].China Patent,CN107569233A.2018-01-12.
[2]VOGELMEIER C F,CRINER G J,MARTINEZ F J,et al.Global strategy for the diagnosis,management,and prevention of chronic obstructive lung disease 2017 report:GOLD executive summary[J].American Journal of Respiratory&Critical Care Medicine,2017,195(5):557-582.doi:10.1183/13993003.00214-2017.
[3]ROBERTS S D,FARBER M O,KNOX K S,et al.FEV1/FVC ratio of 70%misclassifies patients with obstruction at the extremes of age[J].Chest,2006,130(1):200-206.doi:10.1378/chest.130.1.200.
[4]BAKER E and FATOYE F.Clinical and cost effectiveness of nurse-led self-management interventions for patients with COPD in primary care:A systematic review[J].International Journal of Nursing Studies,2017,71:125-138.doi:10.1016/j.ijnurstu.2017.03.010.
[5]LI Yi,FENG Jing,LI Yuechuan,et al.A new pulmonary rehabilitation maintenance strategy through home-visiting and phone contact in COPD[J].Dove Press journal,2018,12:97-104.doi:10.2147/PPA.S150679.
[6]顾宇,叶寒生,冯超,等.一种恒功率热式气体流量计温度补偿实现[J].仪表技术与传感器,2015(10):38-39.doi:10.3969/j.issn.1002-1841.2015.10.012.GU Yu,YE Hansheng,FENG Chao,et al.Temperature compensation for constant power thermal gas flowmeter[J].Instrument Technique and Sensor,2015(10):38-39.doi:10.3969/j.issn.1002-1841.2015.10.012.
[7]FANG Lide,WANG Xiaojie,et al.Wet gas over-reading characteristic research of inside and outside tube differential pressure flowmeter[J].Applied Mechanics&Materials,2013(241-244):168-171.doi:10.4028/www.scientific.net/AMM.241-244.168.
[8]PILLOW J J,LJUNGBERG H,HüLSKAMP G,et al.Functional residual capacity measurements in healthy infants:Ultrasonic flow meter versus a mass spectrometer[J].European Respiratory Journal,2004,23(5):763-771.doi:10.1183/09031936.04.00091504.
[9]贾天震,杨汀,魏建磊,等.新型涡轮便携式肺功能仪的研制与开发[J].电子技术应用,2017,43(11):62-65.doi:10.16157/j.issn.0258-7998.171411.JIA Tianzhen,YANG Ting,WEI Jianlei,et al.The research and development of a novel portable turbine pulmonary function meter[J].Application of Electronic Technique,2017,43(11):62-65.doi:10.16157/j.issn.0258-7998.171411.
[10]何子军.呼气信号分析方法及其在肺功能检查中的应用研究[D].[博士论文],中国科学技术大学,2014:17-22.HE Zijun.The method for analyzing expiratory signals and its application in pulmonary function testing[D].[Ph.D.dissertation],University of Science and Technology of China,2014:17-22.
[11]CLARKE M,GOKALP H,FURSSE J,et al.Dynamic threshold analysis of daily oxygen saturation for improvedmanagement of COPD patients[J].IEEE Journal of Biomedical&Health Informatics,2015,20(5):1352-1360.doi:10.1109/JBHI.2015.2464275.
[12]韩庆阳,王晓东,李丙玉,等.EEMD在同时消除脉搏血氧检测中脉搏波信号高频噪声和基线漂移中的应用[J].电子与信息学报,2015,37(6):1384-1388.doi:10.11999/JEIT141390.HAN Qingyang,WANG Xiaodong,LI Bingyu,et al.Using EEMD to eliminate high frequency noise and baseline drift in pulse blood-oximetry measurement simultaneously[J].Journal of Electronics&Information Technology,2015,37(6):1384-1388.doi:10.11999/JEIT141390.
[13]VERONEZ L,PEREIRA M C,da SILVA S,et al.Volumetric capnography for the evaluation of chronic airways diseases[J].International Journal of Chronic Obstructive Pulmonary Disease,2014,9:983-989.doi:10.2147/COPD.S62886.
[14]BRIDGEMAN D,ZHAO D,TSOW F,et al.A non-invasive and inexpensive capnography device for the monitoring of COPD and other pulmonary diseases[C].2014 IEEEHealthcare Innovation Conference,Seattle,USA.2014:1-4.doi:10.1109/HIC.2014.7145572.
[15]ZHONG Xingfu,WU Yingxiang,TIAN Shuxiang,et al.Flow rate measurement in multiphase flow using turbine flow-meter[J].Chinese Journal of Scientific Instrument,2002,23(Suppl):858-859.
[16]文红燕.涡轮流量计在线监测系统的研究[D].[硕士论文],中国计量大学,2016:8-14.WEN Hongyan.Research on the online monitoring system of turbine flow meter[D].[Master dissertation],China Ji Liang University,2016:8-14.
[17]周旺,方震,陈贤祥,等.获取呼气指标的装置及方法[P].中国专利,CN107569233A.2018-01-12.ZHOU Wang,FANG Zhen,CHEN Xianxiang,et al.Obtaining expiration indicator device and method[P].China Patent,CN107569233A.2018-01-12.