摘要
进入21世纪后,人类从工业时代迈向了信息时代,生活水平稳步提高,工作节奏也日趋加快,心血管疾病的发病数也与日俱增。心脏病已成为严重威胁人类健康和生命的三大疾病之一。而心脏病具有病情隐蔽、发作突然、病发危险性高等特点,对先天性心脏病患者、尤其是中老年患者的危害性极大。据世界卫生组织估计,到2020年左右,我国和其他发展中国家,将会迎来心脏病的发病顶峰。为了有效的预防与治疗心脏病,一系列的手段孕育而生,心电图就是其中之一。心电图异常的出现频率和复杂形式是猝死或急性心脏事件独立的预测指示。实时监测心电图,能够发现常规心电图不易发现的心率失常和心肌缺血等病症,是临床分析病情、确诊和判断疗效的重要依据,而且它还可以为心血管疾病的诊断提供重要依据。及时发现心电变化异常,赢得早期救治时间和挽救生命的机会,对心血管疾病患者来说具有重要意义。
本文研究的基于智能手机的远程心电显示系统主要应用于人体实时心电检测和动态心电分析,适用于心血管疾病的临床检查、监护和平时心脏功能保健,可广泛用于医院诊断治疗、院前急救、家庭监护、健康保健等众多领域,在心脏疾病的预防、诊断、治疗中将发挥重要作用。该系统主要由三部分组成:美国BIOPAC公司MP150型16通道生理信号记录分析系统、GPRS移动通信网络和医生监护手机。生理信号记录分析系统完成心电数据的采集与预处理,然后进行初步判决,检测到异常心电信号后,分析系统自动将异常信号数据通过GPRS移动通信网络传输给医生,监护医生的智能手机使用Java技术的“Java 2 Platform Micro Edition (J2ME)”构建心电显示平台,在此平台上运行心电显示程序来查看异常心电图,并根据病人的情况做出初步的诊断与指导。
试验结果表明,基于智能手机的远程心电显示系统可以及时、有效地显示异常心电。该系统的实现将为医院经营模式的改变、医生监护手段的提升以及病人诊疗的方便性等方面提供有力的技术支持与服务。该系统解除了监护病人及主治医生活动区域的限制,给患者的远程诊断与救治提供了帮助,实现了远程监护。
In the 21st century, human vary from the industrial age to the information age, the standard of living has improved steadily, the pace of work are becoming increasingly faster, but the incidence of cardiovascular diseases is increasing too. Heart disease has become a serious threat to human health and life. It has the characteristics of hidden, sudden, and high risk of congenital, especially has great dangers to elderly patients. According to the World Health Organization’s estimation, China and other developing countries will meet the peak incidence of heart disease around 2020. In order to efficiently prevent and treat the heart disease, a serious of measures were born. The abnormal frequency and complexity form of the ECG are the independent predictor instructions of sudden death or acute cardiac events. Real-time monitoring ECG, which can detect arrhythmia and myocardial ischemia and other diseases easier than routine electrocardiogram, is an important basis for clinical analysising, diagnosising and judging. It is also an important basis for cardiovascular disease. The timely detection of abnormal ECG has great significance for patients such as gaining time for early treatment and life-saving opportunities.
This paper proposed a remote ECG real-time display system which based on smart phone. It mainly used in human testing and Holter ECG analysis for clinical examination of cardiovascular disease, normal heart function custody and health care, diagnosis or treatment which can be widely used in hospitals, pre-hospital first aid, home care, health care and many other fields, the system will play an important role in the heart disease prevention, diagnosis, and treatment. The system is used in human real-time ECG detection and Holter ECG analysis. It mainly consists of three parts: the BIOPAC's MP150-type 16-channel recording physiological signal analysis system, GPRS mobile phone networks and medical care. Physiological signal analysis system using for the recording of ECG data acquisition and preprocessing, and make a preliminary judgement. When comes to abnormal ECG, the analysis system transmits abnormal signal data automatically to a doctor via GPRS mobile communications network. The doctor uses a smart phone whose display platform is using Java technology--- "Java 2 Platform Micro Edition (J2ME)" to construct ECG, to check the abnormal electrocardiogram on this platform ECG display program, and then to make a preliminary diagnosis and guidance according to the patient's condition .
The results show that the long-distance ECG display system which based on smart phones, can show the abnormal ECG in time and efficiently. Achievement of the system will provide strong technical support and services for the change of the business model for the hospital, the doctor and the patient care means to enhance ease of treatment and so. It releases the patient and the attending doctor from the regional restriction, and gives assistance to the remote diagnosis and treatment and realizes remote monitoring.
引文
[1]刘克军.我国三类主要慢性疾病的直接经济负担[J].卫生经济学研究,2007.1,228:19
[2]钱淼.远程心电监护系统的研究与设计[D].上海:东华大学硕士学位论文.2008
[3]王闯瑞.基于GPRS的远程心电监护系统研究[D].武汉:武汉理工大学硕士学位论文.2006
[4]杨虎.远程心电监测技术进展[J].中国医疗器械信息.2005.11(6):11-12
[5]穆飞航,蒋勇.可用于远程实时监测的移动心电监护系统[J].中国医学装备.2006.11,3(11):21-23.
[6]邹波,柴继红.远程心电监护系统的研制[J],深圳职业技术学院学报,2003,03:4
[7]远大心胸网. http://www.yodak.net/article/2008-06-23/37112125649003301.html
[8]吴凯,吴效明.多生理参数远程虚拟检测仪的设计与实现(J).微计算机信息.2006,0l(1):145,146,179
[9]郭继鸿等.动态心电图学[M],北京:人民卫生出版社,2003.7:1-3
[10]胡大一.临床动态心电图[M].北京:中国中医药出版社,2005.6:10-12.
[11]何伟.心电信号的频谱分析及应用.山东生物医学工程,1996, 15(3): 4349
[12]邱庆军,蒋景英,虞启琏.QRS波检测方法的回顾与新进展.中国医疗器械杂志, 1999, 23 (6) : 344~347.
[13]李明党.智能型远程心电监护系统研究[D].山东:山东科技大学硕士学位论文.2007
[14]王博亮.心电信号中QRS波群的实时监测算法[J].航天医学与医学工程. 1995,18(1):23-25.
[15]费保蔚,庄天戈,程敬之,等.一种心电图QRS波检测方法.北京生物医学工程, 1997, 16 (1) : 11~17.
[16]Mark L. Ahlstrom, W illis. Tompk ins. Automated high speed analysis of holter tapes with microcomputers.IEEE Tans on BME, 1983, 30 (10) : 651~657.
[17]Jiapu Pan, Willis. Tompk ins. A real time QRS detection algorithm. IEEE Tanson BME, 1985, 32 (3) : 230~236.
[18]杨玉星,尹冬云,张德成.基于数字信号处理技术的新型心电图分析系统.航天医学与医学工程, 2002, 15 (1) :189~194.
[19]M. Bahoura, M. Hassani, M. Hubin. DSP implementation of wavelet transform for real time ECG waveforms detection and heart rate analysis. Compter Methods and Programs in Biomedicine, 1997, 52: 35~42.
[20]商卫波.心电信号自动分析与诊断处理方法研究[D].西安:西北工业大学,2005:9-10.
[21]朱新建,卓像,朱凌云,等.移动远程心电监护实时监测算法及其单片机实现(J).北京生物医学工程,2006.4, 25(2):156-157
[22]纪承寅,汪涛,吕军.临床心电图快速解读[M].北京:军事医学科学出版社,2001.7:30-36,256-270
[23]鲍淑娣,张元亭.远程医疗:穿戴式生物医疗器械.中国医疗器械信息.2004,10(5):1-3.
[24]岳蜀华,王美涵,郭飞,等.可穿戴式无线心电监测仪的研究现状[J].生物医学工程与临床.2006,10(4):262-266.
[25] Open Mobile Alliance”OMA-WAP-MMS-CTR-V1_1-20040715-A”, 2004-06-15
[26]杨子华,胡倩.基于智能手机平台的MMS系统研究与实现[J].微计算机信息. 2007(1):155-156
[27]张鹏,宁莹璋,王雪梅. Java手机游戏实例手册[M].北京:海洋出版社,2006.
[28]黄聪明.Java移动通信程序设计---J2ME MIDP[M].北京:清华大学出版社,2002.
[29]刘月华,刘佳,杨沛.《J2ME手机游戏开发平台的设计与实现》.计算机工程.33(5):261-263.
[30]荣钦科技.J2ME手机游戏设计技术与实战[M].北京:电子工业出版社,2007.
[31]刘斌,丁璇,庞晖等.J2ME手机开发入门[M].北京:人民邮电出版社,2006.
[32] F. Sufi, Q. Fang and I. Cosic. ECG R-R Peak Detection on Mobile Phones. Proceedings of the 29th Annual International Conference of the IEEE EMBS Cite Internationale, Lyon, France. August 23-26,2007.
[33] F. Sufi, Q. Fang, S. S. Mahmoud and I. Cosic, A Mobile Phone Based Intelligent Telemonitoring Platform, 3rd IEEE-EMBS International Summer School and Symposium on Medical Devices and Biosensors (ISSS-MDBS 2006), Boston, MA, USA, September, 2006
[34] C. Wen , et al., Real-time ECG telemonitoring system design with mobile phone platform,Measurement (2007),doi:10.1016/j.measurement.2006.12.006