Medical diagnostic computer complex "polyreactive"
(57) Abstract:The invention relates to medicine, namely to devices for functional diagnostics. The technical result consists in increasing the accuracy of measurement of hemodynamic parameters, the increase in the number of these indicators, expanding diagnostic capabilities and automation of the data. The complex consists of a high-frequency generator with electrodes modified tetrapolar rheography two channels, each of which includes a differential amplifier, a linear detector srednetemperaturnogo values, the amplifier peoplesmart, three lowpass filter and two analog differentiating device. Between the channels is enabled by four devices summation and subtraction, in addition, the device includes a channel phonocardiogram and two channels of ECG, the outputs of which are connected to the inputs of the multi-channel analog-to-digital Converter included in the slot of the computer. 2 Il. The invention relates to medicine, namely to devices for functional diagnostics, and can be used to determine indices of Central hemodynamics as at rest and when performing functional tests, nab is the faculty" to determine the status and reserves of the cardiovascular system of man and diagnosis of heart and coronary insufficiency, and to establish the type of hypertensive reaction to the load. This allows for the adequate selection of therapy, assessment of its effectiveness in patients with cardiac profile, the optimal selection of technology when conducting and permanent pacing and selection of the optimal frequency of stimulation on hemodynamic criteria; the assessment of disability due to disease of the cardiovascular system; screening large populations for early detection of diseases of the cardiovascular system.The closest analogue is the dual rheography type RPG-02, which is intended to determine the hemodynamic performance by tetrapolar impedance measurement method (1).The device comprises a generator of sinusoidal current with frequency of 40 kHz, the current from which is fed to the sensed area of the body via the current electrodes, common to both channels.Changing impedances are two identical channels, each of which contains two potentiometric electrode, a differential amplifier of high frequency, the measuring unit, the output of which is connected to the input of medical novocane the economic output of which is connected to the input of the differential amplifier peoplesmart (low-frequency amplifier, and switch device for starting a basic impedance.With the amplifier output signal is fed to an active low pass filter with a cutoff frequency of 30 Hz, and then at the divider output "REO". With the release of "REO" signal is sent to an analog differentiating device, and after filtering and amplification is fed to the divider "WPPT".With a linear detector signal is also fed to a DC amplifier, and then on exit "PLET".To set scale recording on the recording device (for example, ALCAR, N-338 and others) the instrument is equipped with a built-in calibrator, simulating variations of the resistance of the sinusoidal frequency of 1.59 Hz, an amplitude of 0.1 and 0.5 Ohms relative to the base value of 20 Ohms.Thus, the device for determining hemodynamic contains high-frequency generator, the output of which is connected to the pair of current electrodes, and two channels, each of which has two input terminals connected to respective pairs of potentiometric electrodes and series-connected differential amplifier, a linear detector srednetemperaturnogo values, the amplifier peoplesmart, the first lowpass filter, the first analog differentiating device and the second the values in the determination of the indices of Central hemodynamics and respectively in the diagnosis of diseases of the cardiovascular system: the registration of the base impedance, volume and differentiated reogram, the device makes it possible to find drum volume and its derivatives: the minute blood volume and cardiac index, but there is no information on the contractility, diastolic function of the heart, in particular on the phase structure of diastole, very difficult to determine the period of the expulsion of blood from the left ventricle, which affects the accuracy of the calculation of the stroke volume and the lack of units for simultaneous registration of phonocardiogram (tones the heart and the electrocardiogram to verify the obtained curves and finding the necessary markers.The technical result of the invention is to improve the accuracy of the measurement of hemodynamic parameters, increasing the number of these indicators, a significant expansion of diagnostic capabilities and automation of processes decode the obtained curves, calculation of the necessary indicators and issue diagnostic conclusions.The technical result is achieved by the fact that at the diagnostic unit, comprising a generator of sinusoidal high frequency voltage, the output of which is connected to the pair of current electrodes, two channels, each of which has two input terminals, connect the capacity of the amplifier, linear detector srednetemperaturnogo values, the amplifier peoplesmart, the first lowpass filter, the first analog differentiating device and the second lowpass filter, and a computer in each channel have introduced sequentially connected to the output of the second lowpass filter, a second analog differentiating device and the third lowpass filter, and between the channels included four devices summation and subtraction, respectively connected in each of the channels to the outputs of the linear detectors srednetemperaturnogo values, the first low-pass filters, the second low-pass filters and third low-pass filters, the inputs and outputs of the devices summation and subtraction and outputs a third low-pass filters connected to the corresponding inputs of the multi-channel analog-to-digital Converter included in the slot machine have been added to the channel formation photocarcinogenic containing fantatsic and bandpass amplifier, and two channels of ECG, each containing electrodes for the removal of biopotentials, instrumental amplifier and low pass filter, the outputs of the additional channels podklyucheniya structural diagram of a medical diagnostic computer complex "Polyreactive", a in Fig. 2 - algorithm for generating diagnostic conclusions.The device comprises a generator 1 sinusoidal high frequency voltage, the output of which is connected to the pair of current electrodes 2. Two other pairs of potentiometric electrodes 3 are connected to the inputs of the differential amplifiers 4 left and right channels. Both channels contain sequentially connected to the outputs of the respective differential amplifiers, detectors 5, the amplifier 6 peoplesmart, the first filters 7 lower frequencies, the first analog differential device 8, the second filters 9 lower frequencies, the second analog differential device 10, and third filters 11 of the lower frequencies. The outputs of the detectors 5, the first filter 7, the second filter 9 and the third filter 11 is connected to the input multi-channel analog-to-digital Converter 12, which is connected with the slot (connector) of the computer 13. The same outputs are connected respectively to both channels with analog adders 14, 15, 16 and 17, as well as with analog vycitalem 18, 19, 20 and 21. The outputs of all adders and vychitala served on the analog-to-digital Converter 12. It also connected fantatsic 22 through a bandpass amplifier 23 and outputs two identical channels electrochemically amplifiers 25 and low-pass filters 26.Polyreactive works as follows.The patient superimposed electrodes 2, 3, 24, and sets fantatsic 22 to a previously published method of polyreactive (2).When applying the excitation current generated by the generator 1 volume conductor formed the chest of the patient, the potentiometric electrons 3 creates a potential difference proportional to the total electrical resistance (impedance) volume conduction. Baseline (mean) value of the impedance is modulated with a variable component determined pulse wave of the blood supply to the chest. Differential amplifiers 4 left and right channels amplify the voltage drop that occur respectively on the left and right halves of the chest and modulated flow due to pumping function of the heart. At the output of the detectors 5 are voltage proportional to the base impedances of the respective areas of the chest. Amplifiers 6 peoplesmart filter out the DC component of the impedance and increase the variable (modulated flow) component. The filters 7, limiting top bandwidth, the mind is l main (bulk) rogramme, proportional changes in blood volume in the respective halves of the chest. Differentiating device 8 and the filters 9 form a signal proportional to the flow velocity, and a differentiating device 10 and the filters 11 is proportional to the acceleration of blood flows. The outputs of the adders 14, 15, 16 and 17 are signals proportional to the average of the values respectively of the base impedance, three-dimensional, graded and re-differentiated of reogram, and outputs subtractive devices 18, 19, 20 and 21 - the difference of the base impedance, three-dimensional, differentiated and re-differentiated reogram left and right halves of the chest. Photosensors 22 and band-pass amplifier 23 form a curve tones the heart and the electrodes 24, instrumentation amplifiers 25 and filters 26 - two bipolar leads of the electrocardiogram. The presence in the device channel phonocardiogram allows verification eographically curves on the subject of finding them markers, we need to measure hemodynamic parameters with the dimension of time. For these purposes, the use of curves of the two leads of the electrocardiogram, and in addition they are required for the diagnosis of focal lesions m scrutinous level and being converted into a digital code processed by a computer using the software package "Polyreactive". Processing incoming computer input signals is carried out according to the algorithm shown in Fig. 2. The processed signals are displayed on the display screen in the form of curves or numerical values. Monitoring curves is carried out in real time. At the same time save them on your computer's hard drive. Processing curves is carried out in an interactive mode after shooting the original background or full survey, including a record of the original background, a few steps foot isometric load and multiple stages of recovery. Duration full shooting about 30 minutes diagnostic conclusion automatic. Device channels curves volumetric difference, velocity, and acceleration of blood flows between the left and right halves of the chest allows you to monitor diastolic heart function, namely the phase of the diastole of the left ventricle is the duration of isometric relaxation, rapid filling, which consists of two intervals of acceleration time and deceleration time, a period of relaxation, slow filling and systolic function of the left atrium, including the time of atrial swap. The presence of channel monitoring of rogramme the Oia, the hydraulic capacity of the heart, the maximum volume acceleration of exile and a number of other indicators of the pump and contractile function of the heart (3, 4, 5).During medical tests polyreactive surveyed 431 people (240 men and 91 women) aged 18 to 59 years. The incidence of "silent" myocardial ischemia compared to cycle ergometry above 2 times, with daily monitoring of ECG - 1.4 times, the incidence of coronary heart disease is higher by 2.1 times compared to cycle ergometry and 5.2 times compared with the daily ECG monitoring.Sources of information:
1. M. I. Gurevich and other Impedance realtystore, Kiev, Naukova Dumka, 1982, S. 103, Fig.59.2. Dumler A. A., Isometric stress-polyreactive in the evaluation of hypertensive reactions and diagnosis of heart and coronary insufficiency in patients with essential hypertension. Author's abstract on competition of a scientific degree of candidate of medical Sciences. Perm, 1995, S. 10, 11.3. Zubarev, M. A. and other Method of determining the phase structure of the diastole, the Patent of Russia No. 1600692, 1990, S. 3.4. Zubarev, M. A., and others, the Method of determining the period of the expulsion of blood. Patent of Russia No. 1671263, 1991, S. 2.">Medical diagnostic computer system comprising a generator of sinusoidal high frequency voltage, the output of which is connected to the pair of current electrodes, two channels, each of which has two input terminals connected to respective pairs of potentiometric electrodes and series-connected differential amplifier, a linear detector srednetemperaturnogo values, the amplifier peoplesmart, the first lowpass filter, the first analog differentiating device and the second lowpass filter, and a computer, characterized in that each channel have introduced sequentially connected to the output of the second lowpass filter, a second analog differentiating device and the third lowpass filter, and between the channels included four devices summation and subtraction, respectively connected in each of the channels to the outputs of the linear detectors srednetemperaturnogo values, the first low-pass filters, the second low-pass filters and third low-pass filters, the inputs and the outputs of the summation and subtraction and outputs a third low-pass filters connected to the corresponding inputs of m is found, the channel forming phonocardiogram, containing fantatsic and bandpass amplifier, and two channels of ECG, each containing electrodes for the removal of biopotentials, instrumental amplifier and low pass filter, the outputs of the additional channels connected to the corresponding inputs of the multi-channel analog-to-digital Converter.
SUBSTANCE: method involves recording rheogram from feet and legs lifted and fixed at an angle of 45є. Then, rheogram is recorded on inhaling from legs directed vertically downward. Functional blood circulation reserve index is calculated as product of results of dividing and subtracting rheographic indices recorded under conditions of lifted and lowered extremities that means under conditions of functional venous system relief and venous hypertension, respectively.
EFFECT: enhanced effectiveness in recognizing patient group suffering from severe lower extremities ischemia.