血压测量共振理论的实验验证(二):动脉脉音和血压听诊音的起源
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摘要
目的探究动脉脉音和血压听诊音的起源。方法将一只心音传感器绑缚于心前区心尖搏动最强处,将另一只心音传感器绑缚于右肱动脉血压听诊处或右颈动脉搏动最强处,分别记录未测量血压时和测量血压时心音与肱动脉脉音、心音与颈动脉脉音的同步图;将一只心音传感器绑缚于右颈动脉搏动最强处,将另一只心音传感器绑缚于右肱动脉血压听诊处,记录未测量血压时此两处动脉脉音的同步图。结果动脉主峰波形与第1心音波形群近乎同时发生;动脉后峰波形与第2心音波形群近乎同时发生;血压听诊音波形出现在主峰的位置上。结论动脉主峰脉音、血压听诊音和第1心音三者是同源的,均起源于房室瓣关闭所产生的振动;动脉后峰脉音与第2心音是同源的,均起源于主动脉瓣/肺动脉瓣关闭所产生的振动。
Objective To explore the origin of arterial sound and blood pressure auscultation sound by heart-sound sensor. Methods Firstly,the synchronization sound graph of heart and brachial artery(or carotid artery)at the time of blood pressure measuring or not was recorded respectively after one heart sound sensor was attached to the strongest beating place of the precordial region,and the other sensor was attached to the blood pressure auscultation place of right brachial artery(or the strongest impulse place of carotid artery). Secondly,the synchronization sound graph of right brachial artery and carotid artery was recorded after one heart sound sensor was attached to the strongest impulse place of the carotid artery,and the other sensor was attached to the blood pressure auscultation place of right brachial artery. Results The waveform of arterial main-peak and the waveform group of first heart sound occurred simultaneously. The waveform of arterial post-peak and the waveform group of second heart sound occurred simultaneously. The waveform of blood pressure auscultation sound appeared on the place of the mainpeak waveform. Conclusion The arterial main-peak sound,the blood pressure auscultation sound and the first heart sound were homologous,they all originated from the atrioventricular valves which generated vibration at the time of shutting. The arterial post-peak sound and the second heart sound were homologous,they both originated from the aortic/pulmonary valves which generating vibration at the time of shutting.
Objective To explore the origin of arterial sound and blood pressure auscultation sound by heart-sound sensor. Methods Firstly,the synchronization sound graph of heart and brachial artery(or carotid artery)at the time of blood pressure measuring or not was recorded respectively after one heart sound sensor was attached to the strongest beating place of the precordial region,and the other sensor was attached to the blood pressure auscultation place of right brachial artery(or the strongest impulse place of carotid artery). Secondly,the synchronization sound graph of right brachial artery and carotid artery was recorded after one heart sound sensor was attached to the strongest impulse place of the carotid artery,and the other sensor was attached to the blood pressure auscultation place of right brachial artery. Results The waveform of arterial main-peak and the waveform group of first heart sound occurred simultaneously. The waveform of arterial post-peak and the waveform group of second heart sound occurred simultaneously. The waveform of blood pressure auscultation sound appeared on the place of the mainpeak waveform. Conclusion The arterial main-peak sound,the blood pressure auscultation sound and the first heart sound were homologous,they all originated from the atrioventricular valves which generated vibration at the time of shutting. The arterial post-peak sound and the second heart sound were homologous,they both originated from the aortic/pulmonary valves which generating vibration at the time of shutting.
引文
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[15]Schmid M,Prettenthaler H,Weger C,et al.Evaluation of a novel automated non-invasive pulse pressure variation algorithm[J].Comput Biol Med,2013,43(10):1583-1589.
[16]李康,霍勇.新型每搏即时连续无创血压监测技术的临床应用[J].中国介入心脏病学杂志,2013,21(6):396-398.
[2]王滨涛,王柏岩.血压听诊音性质的理论探讨[J].中国卫生产业,2015,12(23):9-12.
[3]姚泰,赵志奇,朱大年,等.人体生理学[M].北京:人民卫生出版社,4版:1159,1473,1648,1078.
[4]陈健.心音信号的频谱及时频分析研究[D].西华大学,2010.
[5]刘毅,邵庆余,朱兴雷,等.正常人与冠心病患者的第三心音分析[J].山东生物医学工程,2002,121(2):11-13.
[6]武伟宁.基于心音时间序列分析的瓣膜病辅助诊断方法研究[D].兰州理工大学,2014.
[7]陈洁,张俊琦,孙树平,等.正常心音的第一、第二频率检测[J].生物医学工程研究,2008,27(2):114-117.
[8]章新友,白翠珍.物理学[M].北京:中国医药科技出版社,2016:174-175.
[9]李辛.基础物理学[M].北京:中国医药科技出版社,2015:93-96.
[10]陈剑.心音信号自动分析与识别算法的研究[D].重庆:重庆大学生物医学工程,2003.
[11]张丽然.中心动脉压的测量方法及临床应用研究进展[J].疾病监测与控制,2014,8(6):371-373.
[12]李章俊,王成,朱浩,等.基于光电容积脉搏波描记法的无创连续血压测量[J].中国生物医学工程学报,2012,31(4):608-614.
[13]Xiang HY,Liu YY,Li YH,et al.Noninvasive measurement of beat-to-beat arterial blood pressure by the Korotkoff sound delay time[J].Blood Press Monit,2012,17(1):35-41.
[14]沈新明.TL-200Tensymetry连续无创血压与直接桡动脉测量不稳定血压的对比[J].中国医学创新,2014,11(6):86-88.
[15]Schmid M,Prettenthaler H,Weger C,et al.Evaluation of a novel automated non-invasive pulse pressure variation algorithm[J].Comput Biol Med,2013,43(10):1583-1589.
[16]李康,霍勇.新型每搏即时连续无创血压监测技术的临床应用[J].中国介入心脏病学杂志,2013,21(6):396-398.