基于外周动脉压力波形的脉搏传导时间获取方法研究及应用
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摘要
通过外周动脉压力波形获取脉搏传导时间PTT,进而能够计算出脉搏波传播速度PWV,用来正确评估人体的心脑血管现状或生理及病理等相关信息,具有无创、廉价、安全和操作简单等特点,医生和病人较容易接受,具有广泛的医学临床应用价值和重要的社会意义。
外周动脉压力波形受到血液动力学参数、血液成分、血细胞生理状况、年龄和生理病理等诸多个体差异因素的影响,其波形的获取也容易受到测量传感器、测量部位和环境温度状况等测量条件因素的影响,因此获取的波形是多样变异性的,通过波形计算出的PTT数值精度难以提高,由此导致结果的重复性也较差,严重阻碍了脉搏波传导时间PTT在临床上的应用。本文以不同年龄段人群的桡动脉压力波形数据为研究对象,在总结前人研究工作的基础上,分别提出了在时域、频域和时-频域计算PTT的相关理论和方法,并对三种方法获取的结果进行了相关性分析和Bland-Altman分析,为无创法计算PTT在临床医学上的广泛应用做了一些深入性的理论工作。
本论文首先对国内外近年内发展起来的计算PTT的各种方法进行了分类与总结,并且针对不同方法的特点进行了比较,探讨了各种方法存在的问题。从而引入本课题研究的科学问题和技术难点。
第二,分析了桡动脉压力波形信号的时域特征以及相关研究应用的现状,概括说明了对外周动脉压力波形测试获取的自助式脉搏测量仪器的特点。重点介绍了波形分析体系的软件系统,包括嵌入式软件工作的过程和PC机软件的总体框架等操作窗口。最后给出了严格按照测量步骤获取的桡动脉、颈动脉、股动脉和足部动脉压力波形的输出结果以及各个波形的特征差异,为下一步研究外周动脉压力波形奠定了基础。
第三,依据用于雷达和通信信号处理数据重叠的方法能够复合噪声的特点,在时域中提出一种对桡动脉压力波形进行单周期重叠的方法确定关键点e的位置,介绍了其操作理论与方法,并且用该方法计算出289位研究对象的脉搏波传导时间PTT的数值,接着对计算结果跟年龄等参数的相关性和PTT的应用展开了讨论。结果表明用该方法在馒头波形中准确识别出e点的位置存在缺陷,为此考虑了从频域入手做进一步的研究和探索。
第四,以傅里叶变换理论为基础,介绍了改进频域分析算法的基本原理,在此基础上提出了评估动脉硬化新的评估指标,即第一峰值F1、第二峰值F2及两者的相位迁移时间τ,重点考察了138位研究对象的频域特征值(F1、F2和τ)跟年龄的相关性,结论证明提出的新参数可以作为一种简易的无创评估指标。为了更深入的研究外周动脉的频域特征,同时还研究分析了典型外周动脉的功率谱特征,如桡动脉、颈动脉、股动脉和足背动脉的生理布局特征和功率谱线特点等。
第五,在上述对外周动脉压力波形信号频域特征研究的基础上,提出了一种利用桡动脉波形数据的频谱特性,经过巴特沃兹带通滤波去除不需要的频谱成分后,重构波形数据的方法定位关键点c和e的位置来计算脉搏波传导时间PTT。同时对频域重构法和波形重叠法计算出的PTT数据做对比分析,采用SPSS软件进行组内相关性和Bland-Altman分析,结果证明两种方法获取的PTT数值基本趋于一致,可以作为一种获取PTT的计算方法,但是频域重构法计算得出的PTT数值普遍偏大。
第六,借鉴多分辨率小波分解和系数重构的方法,已成功应用于ECG信号的QRS波检测等方面的研究经验,引入该方法对桡动脉波形信号进行多分辨率分解获取多层细节信息,优选提取出关键层的小波系数,然后重建这些小波系数对波形c点和e点的位置识别,计算出脉搏波传导时间PTT的数值。
最后选择时间域桡动脉波形重叠的方法作为参考标准,分别用频域重构法和多分辨率小波系数重构法计算出24位年轻人研究对象的PTT数值做比较分析,结果证明多分辨率小波系数重构算法计算出的PTT数值跟波形重叠的方法的相关性较好(R=0.910,P<0.001),优于频域带通滤波重构算法(R=0.689,P<0.001)。
Pulse transmit time (PTT) is an important physiological parameter for assessment of cardio-cerebral vascular status and reflection of some disease information; it is calculated by peripheral arterial pressure signal, and fartherly gaining pulse wave velocity (PWV). The two parameters are independent predictor of cardiovascular disease partially reflected the vascular damage, with non-invasive, inexpensive, safe and simple operation, etc. So they has a wide range of application and social significance for evaluating body healthy in clinic, and are accepted easily by doctors and patients.
The variation wave of peripheral arteries pressure signal is acquired because of the serious influence of several factors to measurement process. These factors include experimental conditions, such as selective sensors, measurement position and environment temperature as well as the individual variations such as hemodynamic parameters, blood component and cells, age, physiological and pathological status. The high accuracy of PTT is rather difficult to calculate by the various waves, which leads to poor reducibility and limit of its application in clinical medicine.
In this paper, analysis on radial arterial pressure wave signal was in different ages of the asymptomatic subjects, the methods of calculating PTT were presented in time domain, frequency domain and time-frequency domain based on previous studies, their computed results were assessed validity by correlations and Bland-Altman analysis. And dissertation focused on further research on the fundamental algorithm in calculating PTT non-invasively to improve it widely used in clinical.
Firstly, the definition of PTT and PWV were given, and the importance of non-invasive detection of these parameters. Then in recent years methods and their classification of calculating PTT at home and abroad were summarized and discussed in depth. We analyzed the problems in different existed methods and proposed the scientific issues and technical difficulties of our research project.
Secondly, we analysed in-depth characteristics and application of the radial artery pressure wave signal. In order to acquire and display peripheral artery pressure signal, an overview of the measuring pulse instrument and its hardware structure were presented in our laboratory independent research. On the other hand, the paper mainly focused on analysis system software implementation, first we described the MCU software design in detail, second introduced the system block diagram of the PC software, include of the main interface of software, the test window of cardiovascular function and results window of measurement. At last, the radial, carotid, femoral and dorsalis pedis artery pressure waveform were measured in strict accordance with the measurement procedures, and superimposed display all periods wave. So these will be the foundation for further study of peripheral artery pressure wave signal.
Thirdly, according to processing method of the radar and communications signal, the superimposed wave can be recombination noise characteristics in the time domain, and we boldly proposed a method of detection key point e by superimposed wave in the radial artery pressure signal, its operating theory and method were given in detail. The PTT values of289asymptomatic subjects were computed by this method, its correlations with age and AI were discussed. Thus the results show some defects of this method for calculating the strange bread wave, and the location of the point e in wave is still no way to identify accurately, so we study them in the frequency domain for further research and exploration.
Fourthly, we improved algorithm of the frequency domain analysis based on Fourier transform theory, the first peak frequency F1, the second peak F2and the phase shift time τ between two peaks were proposed to assessing atherosclerosis with ages. And the characteristic parameters(F1, F2and τ) of138subjects in the frequency domain were calculated, their correlations with age were discussed, the results indicate that the new parameters can be as simply non-invasive evaluation for atherosclerosis. On the other hand, the radial, carotid, femoral and dorsalis pedis artery physical layout in body and their power spectrum characteristics were analyzed and discussed, and we intensified to learn frequency domain features of peripheral arterial pressure signal.
Fifthly, on the basis of study frequency domain features of peripheral artery pressure wave signal, we presented a new method based on the spectrum characteristic of the radial arterial waveform, the method which was the Butterworth band-pass filtering unwanted frequency components and reconstructing after filtering data for detection the key points c and e in the wave to calculating the pulse transit time PTT. The previous two methods were examined using SPSS software by correlation and the Bland-Altman analysis; the results show that the calculating PTT values of two ways are the basic consistent. However, comparison to the superimposed radial wave method, the PTT value of the frequency domain reconstruction method is large, and it can be as a method for computing the PTT.
Sixthly, because the multi-resolution wavelet transform has been successfully applied to detection and evaluation of QRS characteristic points in the ECG signal, we learned from the previous studies, and presented this approach for detection of c and e key points in the radial arterial wave signal. We Selected some good multiresolution wavelet coefficients of the critical layers to reconstruct a new wave, and detected the key characteristic points of c and e in it for calculating the PTT value.
Finally, we selected the superimposed radial wave method as a reference standard, respectively compared with the frequency domain reconstruction method and multi-resolution wavelet coefficients reconstruction method in calculating PTT value of the24young subjects. The test results show that the multi-resolution wavelet coefficients reconstruction algorithm is independently correlated with the superimposed radial wave method(R=0.910, P<0.001), and superior to the frequency domain band-pass filtering reconstruction method(R=0.689, P<0.001).
外周动脉压力波形受到血液动力学参数、血液成分、血细胞生理状况、年龄和生理病理等诸多个体差异因素的影响,其波形的获取也容易受到测量传感器、测量部位和环境温度状况等测量条件因素的影响,因此获取的波形是多样变异性的,通过波形计算出的PTT数值精度难以提高,由此导致结果的重复性也较差,严重阻碍了脉搏波传导时间PTT在临床上的应用。本文以不同年龄段人群的桡动脉压力波形数据为研究对象,在总结前人研究工作的基础上,分别提出了在时域、频域和时-频域计算PTT的相关理论和方法,并对三种方法获取的结果进行了相关性分析和Bland-Altman分析,为无创法计算PTT在临床医学上的广泛应用做了一些深入性的理论工作。
本论文首先对国内外近年内发展起来的计算PTT的各种方法进行了分类与总结,并且针对不同方法的特点进行了比较,探讨了各种方法存在的问题。从而引入本课题研究的科学问题和技术难点。
第二,分析了桡动脉压力波形信号的时域特征以及相关研究应用的现状,概括说明了对外周动脉压力波形测试获取的自助式脉搏测量仪器的特点。重点介绍了波形分析体系的软件系统,包括嵌入式软件工作的过程和PC机软件的总体框架等操作窗口。最后给出了严格按照测量步骤获取的桡动脉、颈动脉、股动脉和足部动脉压力波形的输出结果以及各个波形的特征差异,为下一步研究外周动脉压力波形奠定了基础。
第三,依据用于雷达和通信信号处理数据重叠的方法能够复合噪声的特点,在时域中提出一种对桡动脉压力波形进行单周期重叠的方法确定关键点e的位置,介绍了其操作理论与方法,并且用该方法计算出289位研究对象的脉搏波传导时间PTT的数值,接着对计算结果跟年龄等参数的相关性和PTT的应用展开了讨论。结果表明用该方法在馒头波形中准确识别出e点的位置存在缺陷,为此考虑了从频域入手做进一步的研究和探索。
第四,以傅里叶变换理论为基础,介绍了改进频域分析算法的基本原理,在此基础上提出了评估动脉硬化新的评估指标,即第一峰值F1、第二峰值F2及两者的相位迁移时间τ,重点考察了138位研究对象的频域特征值(F1、F2和τ)跟年龄的相关性,结论证明提出的新参数可以作为一种简易的无创评估指标。为了更深入的研究外周动脉的频域特征,同时还研究分析了典型外周动脉的功率谱特征,如桡动脉、颈动脉、股动脉和足背动脉的生理布局特征和功率谱线特点等。
第五,在上述对外周动脉压力波形信号频域特征研究的基础上,提出了一种利用桡动脉波形数据的频谱特性,经过巴特沃兹带通滤波去除不需要的频谱成分后,重构波形数据的方法定位关键点c和e的位置来计算脉搏波传导时间PTT。同时对频域重构法和波形重叠法计算出的PTT数据做对比分析,采用SPSS软件进行组内相关性和Bland-Altman分析,结果证明两种方法获取的PTT数值基本趋于一致,可以作为一种获取PTT的计算方法,但是频域重构法计算得出的PTT数值普遍偏大。
第六,借鉴多分辨率小波分解和系数重构的方法,已成功应用于ECG信号的QRS波检测等方面的研究经验,引入该方法对桡动脉波形信号进行多分辨率分解获取多层细节信息,优选提取出关键层的小波系数,然后重建这些小波系数对波形c点和e点的位置识别,计算出脉搏波传导时间PTT的数值。
最后选择时间域桡动脉波形重叠的方法作为参考标准,分别用频域重构法和多分辨率小波系数重构法计算出24位年轻人研究对象的PTT数值做比较分析,结果证明多分辨率小波系数重构算法计算出的PTT数值跟波形重叠的方法的相关性较好(R=0.910,P<0.001),优于频域带通滤波重构算法(R=0.689,P<0.001)。
Pulse transmit time (PTT) is an important physiological parameter for assessment of cardio-cerebral vascular status and reflection of some disease information; it is calculated by peripheral arterial pressure signal, and fartherly gaining pulse wave velocity (PWV). The two parameters are independent predictor of cardiovascular disease partially reflected the vascular damage, with non-invasive, inexpensive, safe and simple operation, etc. So they has a wide range of application and social significance for evaluating body healthy in clinic, and are accepted easily by doctors and patients.
The variation wave of peripheral arteries pressure signal is acquired because of the serious influence of several factors to measurement process. These factors include experimental conditions, such as selective sensors, measurement position and environment temperature as well as the individual variations such as hemodynamic parameters, blood component and cells, age, physiological and pathological status. The high accuracy of PTT is rather difficult to calculate by the various waves, which leads to poor reducibility and limit of its application in clinical medicine.
In this paper, analysis on radial arterial pressure wave signal was in different ages of the asymptomatic subjects, the methods of calculating PTT were presented in time domain, frequency domain and time-frequency domain based on previous studies, their computed results were assessed validity by correlations and Bland-Altman analysis. And dissertation focused on further research on the fundamental algorithm in calculating PTT non-invasively to improve it widely used in clinical.
Firstly, the definition of PTT and PWV were given, and the importance of non-invasive detection of these parameters. Then in recent years methods and their classification of calculating PTT at home and abroad were summarized and discussed in depth. We analyzed the problems in different existed methods and proposed the scientific issues and technical difficulties of our research project.
Secondly, we analysed in-depth characteristics and application of the radial artery pressure wave signal. In order to acquire and display peripheral artery pressure signal, an overview of the measuring pulse instrument and its hardware structure were presented in our laboratory independent research. On the other hand, the paper mainly focused on analysis system software implementation, first we described the MCU software design in detail, second introduced the system block diagram of the PC software, include of the main interface of software, the test window of cardiovascular function and results window of measurement. At last, the radial, carotid, femoral and dorsalis pedis artery pressure waveform were measured in strict accordance with the measurement procedures, and superimposed display all periods wave. So these will be the foundation for further study of peripheral artery pressure wave signal.
Thirdly, according to processing method of the radar and communications signal, the superimposed wave can be recombination noise characteristics in the time domain, and we boldly proposed a method of detection key point e by superimposed wave in the radial artery pressure signal, its operating theory and method were given in detail. The PTT values of289asymptomatic subjects were computed by this method, its correlations with age and AI were discussed. Thus the results show some defects of this method for calculating the strange bread wave, and the location of the point e in wave is still no way to identify accurately, so we study them in the frequency domain for further research and exploration.
Fourthly, we improved algorithm of the frequency domain analysis based on Fourier transform theory, the first peak frequency F1, the second peak F2and the phase shift time τ between two peaks were proposed to assessing atherosclerosis with ages. And the characteristic parameters(F1, F2and τ) of138subjects in the frequency domain were calculated, their correlations with age were discussed, the results indicate that the new parameters can be as simply non-invasive evaluation for atherosclerosis. On the other hand, the radial, carotid, femoral and dorsalis pedis artery physical layout in body and their power spectrum characteristics were analyzed and discussed, and we intensified to learn frequency domain features of peripheral arterial pressure signal.
Fifthly, on the basis of study frequency domain features of peripheral artery pressure wave signal, we presented a new method based on the spectrum characteristic of the radial arterial waveform, the method which was the Butterworth band-pass filtering unwanted frequency components and reconstructing after filtering data for detection the key points c and e in the wave to calculating the pulse transit time PTT. The previous two methods were examined using SPSS software by correlation and the Bland-Altman analysis; the results show that the calculating PTT values of two ways are the basic consistent. However, comparison to the superimposed radial wave method, the PTT value of the frequency domain reconstruction method is large, and it can be as a method for computing the PTT.
Sixthly, because the multi-resolution wavelet transform has been successfully applied to detection and evaluation of QRS characteristic points in the ECG signal, we learned from the previous studies, and presented this approach for detection of c and e key points in the radial arterial wave signal. We Selected some good multiresolution wavelet coefficients of the critical layers to reconstruct a new wave, and detected the key characteristic points of c and e in it for calculating the PTT value.
Finally, we selected the superimposed radial wave method as a reference standard, respectively compared with the frequency domain reconstruction method and multi-resolution wavelet coefficients reconstruction method in calculating PTT value of the24young subjects. The test results show that the multi-resolution wavelet coefficients reconstruction algorithm is independently correlated with the superimposed radial wave method(R=0.910, P<0.001), and superior to the frequency domain band-pass filtering reconstruction method(R=0.689, P<0.001).
引文
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