Hong Sung Jun, Lee Jong Shill, Oh Jae Hoon, Chee Young Joon, Jang Dong Pyo, Kim In Young
aDepartment of Biomedical Engineering bDepartment of Emergency Medicine, College of Medicine, Hanyang University, Seoul cDepartment of Biomedical Engineering, College of Engineering, University of Ulsan, Ulsan, Korea.
Blood Press Monit. 2017 Dec;22(6):364-370. doi: 10.1097/MBP.0000000000000284.
In this study, to measure blood pressure (BP) on the basis of human hearing threshold, we proposed a method that detects the audible or inaudible Korotkoff sounds (K-sounds) using the equal loudness contour and automatically assesses the BP.
In this study, we detected the systolic period of K-sounds using cuff pressure oscillation and then converted the K-sounds corresponding to the systolic interval into sound pressure levels (SPLs). Next, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) were assessed by mapping the K-sounds, which were converted into SPLs on an equal loudness contour.
To validate the accuracy of our proposed method, we compared it with the auscultatory method. The mean differences (mean±SD) in the SBP and DBP were 0.31±1.95 and 1.20±2.17 mmHg, respectively. For the SBP, the linear regression equation was y=0.98x+1.56 mmHg (where x and y represent the auscultatory and the proposed method, respectively), with a SE of estimate of 1.93 mmHg and a correlation coefficient of 0.99. For the DBP, the linear regression equation was y=1.01x-1.94 mmHg, with an SE of estimate of 2.18 mmHg and a correlation coefficient of 0.98. All P values were less than 0.0001 for both regressions.
The auscultatory method of BP monitoring is sensitive to the observer's condition or environmental noise. To overcome these disadvantages, we used the human hearing threshold for objective SBP and DBP automatic assessment, and this method can be applicable to an automatic auscultatory method.
在本研究中,为了基于人类听力阈值测量血压(BP),我们提出了一种利用等响曲线检测可听或不可听的柯氏音(K音)并自动评估血压的方法。
在本研究中,我们利用袖带压力振荡检测K音的收缩期,然后将与收缩期对应的K音转换为声压级(SPL)。接下来,通过在等响曲线上绘制转换为SPL的K音来评估收缩压(SBP)和舒张压(DBP)。
为了验证我们提出的方法的准确性,我们将其与听诊法进行了比较。SBP和DBP的平均差异(均值±标准差)分别为0.31±1.95和1.20±2.17 mmHg。对于SBP,线性回归方程为y = 0.98x + 1.56 mmHg(其中x和y分别代表听诊法和所提出的方法),估计标准误为1.93 mmHg,相关系数为0.99。对于DBP,线性回归方程为y = 1.01x - 1.94 mmHg,估计标准误为2.18 mmHg,相关系数为0.98。两种回归的所有P值均小于0.0001。
血压监测的听诊法对观察者的状态或环境噪声敏感。为了克服这些缺点,我们利用人类听力阈值进行客观的SBP和DBP自动评估,并且该方法可应用于自动听诊法。