Method and device for examining patients aimed at identification of particular physiological state. RU patent 2508044.

FIELD: medicine.

SUBSTANCE: group of inventions relates to medicine. Versions of method and work of device for examination of patient intended for identification of a particular physiological state with application of methods which use sounds, produced by patient's body and measured at specified distance from patient's body area, which produces sounds, are based on placement of first acoustic sensor, for instance, device which measures sound level, on particular section of patient's body to form outlet signal, which corresponds to sound level; modification of outlet signal of first acoustic sensor by means of preliminarily calculated transfer function, bringing outlet signal of first acoustic sensor to outlet signal of second acoustic sensor, installed at specified distance from patient's body area, which produces sounds; and application of modified outlet signal of first acoustic sensor in order to determine presence of a particular physiological state in patient's organism.

EFFECT: group of inventions makes it possible to increase self-descriptiveness of obtained data in course of patient's examination.

25 cl, 10 dwg

AREA OF TECHNOLOGY AND PRECONDITIONS OF CREATION OF THE INVENTION

The present invention relates to methods and devices for examination of patients with the purpose of revealing of certain physiological conditions in the body with the use of acoustic information. Invention is especially useful for use in the well-known methods that use sounds from the patient's body, measured at a certain distance from the patient's body, emitting sounds, for example, one measuring device, and therefore the invention described in respect of such techniques.

Measurement of acoustic parameters of some functions of the body, especially related to the respiratory system, or to stop breathing or partial stop breathing, provides valuable medical information. In particular, the invention can be applied, for example, measuring the intensity of snoring, which is an important medical argument, especially in the field of sleep medicine. Other examples related to the respiratory system of the body include the measurement of the intensity of wheezing and whistles when breathing (higher notes), cough, breathing rate, etc. that are clinically important for diagnostics of various diseases of the respiratory system. In addition, have the meaning of the sounds concerning the cardiovascular system, such as the well known heart sounds, the sounds, related to the musculoskeletal system, sounds related to the gastrointestinal system and the sounds associated with certain methods of measurements, such as, for example, measurement of blood pressure.

Measurement of the intensity of snoring is important to identify the respiratory activity of the patient and its state of the airway during sleep. The intensity of snoring is influenced, among other physiological factors: the degree of openness of the respiratory tract, muscle tone of the upper respiratory tract mucous membranes of the tumor and the degree of activity of the respiratory centre, especially during sleep. Measurement of the frequency spectrum of sounds snore can also provide useful clinical data, for example, to determine the location of the source of snoring in the respiratory system of the patient.

Quantitative characteristics of the acoustic activity are essential because they allow clinicians assess the clinical relevance of, for example, the nature and intensity of snoring to carry out diagnostics. Traditionally, the intensity of sounds of snoring was determined in decibels at a distance, usually one meter from the sound source. Established clinical criteria for quantitative estimation of the intensity of snoring are defined as follows.

In medicine, associated with laboratory measurements, and in particular in sleep medicine, recording acoustic patient activities traditionally performed by setting the level sensor sound, such as a microphone, at a certain distance (for example, one meter) of the patient. Providing an environment of acoustic measurements requires good technical knowledge and experience, and, accordingly, this method is not suitable for measurements outside of specialized laboratories. The above measurement is very sensitive to external acoustic activity, such as, for example, snoring other sleeping patients, that can significantly affect the accuracy of the measurements of respiratory activity of the patient.

As practice shows, measurement outside of specialized laboratories are becoming more common. In particular, such measures include the use of systems ambulatory measurements, which are playing an increasingly important role in clinical medicine and are particularly important in sleep medicine. Outpatient examination are a lot of well-known advantages, among which the increase of facilities for patients, accessibility, as well as significant cost savings.

You can highlight the main advantage of (among many)that is recording an acoustic activity of the respiratory system directly from the surface of the patient's body, which significantly reduces the problem of the influence of external noise that is inherent measurements at a fixed distance from the patient.

The quality of the acoustic measurement relating to the different systems of the body, can also affect the motion of a body of the patient, as well as the position, posture or orientation of a patient's body at the place of examination relative to vertical direction. In addition, during the diagnosis of many pathological States is not only used the acoustic information, but also information about this position and/or movement.

The definition of different physiological signals, including the position of the body, move it and acoustic measurement relating to the different body systems, described in the publications of US patents 4784162, US 5275159, US 6171258 and bids US 2005/0113646 A1. In these patent application describes the measurement of the position of the body and its movements and/or acoustic activity, which is performed using the individual sensors on the surface of the patient's body. These sensors were not intended for measurement of a single common location, and they are not fit to place them so as to ensure the measurements from one place.

You can also set other publications related to this issue: for example, patents US 6468234, US 7077810 international application WO 2005/120167. However, the technical solutions described in these publications are not used acoustic sensors, but only vibration sensors for measuring vibration of the patient's body.

There are several reasons why obtaining information related to body position and movements, as well as information acoustic measurements from one place, when all the means of obtaining this information is available in one General case, it is preferable for the evaluation of different physiological and pathological conditions, and these reasons are illustrated by the examples below.

Application for the respiratory system

The emergence of the deterioration in the passage of the upper respiratory tract or even complete failure to carry out is a sign of a well-known obstructive sleep apnea syndrome. The emergence of obstructive sleep apnea patient is usually preceded by serious acoustic activity or snoring, but it stops when the airflow is reduced sufficiently due to the progressive respiratory tract.

On the other hand, the termination of snore may be due to the termination of the partial failure of the respiratory tract, causing the snoring. The distinction between these two extremes can be facilitated by measuring the motion of the surface in the place of measurement. In case of deterioration of failure increased movements of the surface, which by their nature have a frequency below acoustic arise as a result of vibration tissues caused by large changes in pressure in the place of failure as a result of unsuccessful attempts to breath. These movements can be measured by a suitable motion sensor.

Although on the surface of the body there are enough places suitable for measurement of acoustic and/or vibratory activity associated with and conditions of SDB, the inventors have found that the best place for these measurements is the area of the chest from the chin to the grudinnoj a bone and breast area surrounding hole. These seats are best suited for measurements of acoustic signals and signals of movement due to their proximity to the source of the disturbances and due to the fact that in these areas between the body surface and ground clearance of the respiratory tract are mainly soft tissue.

For the effective measurement of these parameters in this area is badly needed to receive a full set of measurements of position of a body, body movements and acoustic characteristics from one place. The present invention specifically directed towards the solution of this problem.

Application for measurement of blood pressure

There are several well-known methods of noninvasive measurement of blood pressure. The two most widely used methods is (listening) and oscillatory.

In way perceived the acoustic information, which is obtained with a stethoscope and which is connected with varying degrees of opening of the artery, with a progressive outlet air from the cuff blood pressure, and changing the sound determine appropriate systolic and diastolic arterial pressure. It is the most widely used method in clinical practice, and the so-called "tones of Korotkov" are used for measurements of blood pressure. There are also automatic devices that analyze the acoustic information.

The second most commonly used method of measuring blood pressure is called "the oscillometric" method, which is based on the measurement of fluctuations in the volume of the measured segment limbs associated with changes in the degree of opening of the artery in the process of the gradual exit of air from cuff blood pressure. Depending on the amplitude of the resulting changes in the volume, you can define the systolic, mean, and estimated the diastolic pressure. Measurement of changes in the volume is usually done on changes in pressure in the cuff blood pressure or on the amplitude of the movements of the skin near the measured artery.

Proposed in the present invention device has significant advantages compared with each of the above methods, because it can provide information needed to determine the blood pressure under both ways.

Furthermore, the addition of the meter body position, for example, the traditional measurement of blood pressure in the brachial artery, provides important information regarding the orientation of the measurement loop, which can be used, for example, to determine the hydrostatic pressure increase at the sitting of the patient by the hand corner relative to the longitudinal axis of the body.

Finally, in the application of precise positioning sensor significantly affect the accuracy of the measurement, since the zone pulsation is very small. Only instrument containing all sensors located exactly in the right place, and enough reliable data.

Cardiology

Realization of acoustic measurements and measurements of the motion of the surface, as well as determination of position of a body from a single common location where the means of obtaining this information is posted in the General case, can provide useful information about the work of the heart, as illustrated in the example below.

Listen to the tones of the heart is widely used in clinical practice, which is especially useful, among other things, to define the States of the heart defect.

On the interpretation of the doctor tones heart can influence the noises generated by the patient's breathing. For example, in the so-called second tone of the heart (called inside the blood and surrounding tissues associated with a sudden overlapping reverse blood flow from the closure of the aortic and pulmonary valves at the end of ventricular systole) recognition of the patient's breath can help in establishing the diagnosis, when it is necessary to determine what caused the "splitting" of the tone of the heart: a pathological condition or normal physiological causes.

Essentially, this refers to the influence of intrathoracic pressure on the reverse blood flow in the right side of the heart. Inhalation occurs increased negative pressure inside the chest, increasing the volume of blood in the right ventricle. This continues for as long as pulmonary artery valve remains open regarding the aortic valve.

This situation creates physiological "splitting of the second heart sound.

However, if such a splitting is not changed in the process of inhalation, then this may indicate a pathological condition, perhaps due to the discharge of blood from left to right within the heart. In this scenario, you may encounter a suspected defect atrial or ventricular septal.

Some actions invasiveness can be taken to increase the venous return to the right side of the heart, including the adoption of patient position lying on a back, may result in improved accuracy of the above diagnosis.

In the above example would be beneficial to the combined device which provides a measurement of the position of the body and its movements, and acoustic measurements, because it will help to more accurately record heart sounds with acoustic sensor, model breathing on the basis of the signals the position of the body and its movements and posture of the patient, measured respective sensor, when such a device is in the appropriate place of the chest wall.

In addition, this instrument can be obtained vibration character connected with mechanical disturbances caused by the closure of the heart valve and its pathological conditions. These vibrations can be measured by a suitable motion sensor.

As already indicated in the above examples, and this is also true for the case considered, exact positioning of the sensor is a critical factor for a successful measure, as the site on which you listen to the tones of the heart, and especially the splitting of the second heart sound, has a very small size. Only instrument containing all sensors located exactly in the right place, and enough reliable data.

Rheumatology

Combined unit, which guarantees the determination of the position of the body, the measurement of its movements and acoustic signals can also be useful for the quantitative measurement and analysis of joints pathologies by measuring the movements of the joints, which correspond to the certain acoustic model.

Because the device can be used to provide information about the position of the limb in three-dimensional space, depending on the time and can also be used to get the dynamic characteristics of the movements of the limbs, then the corresponding acoustic information can provide a quantitative assessment of the extent of damage to the joint. As already indicated in the above examples, and this is also true for the case considered, exact positioning of the sensor is the critical factor for the successful measurement. It is clear that, subject to limited space for installation of the device of the joint, the only instrument with all the sensors located in exactly the right spot allows to measure properly to ensure a sufficiently reliable data.

Gastroenterology

One of the purposes of the present invention is to provide a method and device for examination of the patient to identify a specific physiological state by means of a technique that uses acoustic activity, the patient is manifested in a specific area of the patient's body, and therefore has certain advantages and benefits. Another aim of the present invention is to provide a method and device for measurement of a large number of physiological state of the patient through the use of not only the measurement of acoustic activity, but also measurements of position and/or movement of the patient on-site inspection.

The present invention provides a method of examination of the patient to identify a specific physiological state of the body by using a technique that uses the sounds coming from the patient and measured at a given distance from the patient's body, from which emanate sounds, including: placement of the first acoustic sensor on a certain section of the patient's body to generate an output signal to the sounds measured in this first acoustic sensor; modification of the output signal of the first acoustic sensor using precomputed transfer function (TF)leading the output signal to the output signal of the second acoustic sensor installed on the specified distance from the patient's body, from which emanate sounds; and use the modified output signal of the first acoustic sensor for determining the existence of certain physiological state of the organism of the patient.

In the preferred options for implementing the invention preliminary calculation of the transfer function includes: placement of the first acoustic sensor on a certain section of the patient's body; the placement of the second acoustic sensor at a given distance from the patient's body, from which emanate sounds; simultaneous measurement of the sounds first and second acoustic sensors to create corresponding output signals and processing the output signal of the first and second acoustic sensors to calculate transfer function which gives the output signal of the first acoustic sensor to the output signal of the second acoustic sensor.

The first acoustic sensor located on the particular section of the body of the patient, can be pre-calibrated to compensate for outside noise at certain times when used for the examination of the patient to identify a specific physiological state of the body, for which perform: the installation of a generator of reference of sound frequencies in the location of the first acoustic sensor; the inclusion of a reference generator sound frequencies simultaneously with the inclusion of the first and second acoustic sensors; processing the output signal of the first and second acoustic sensors to determine the difference between them, which is an indicator of the external noise; and the modification of the calculated transfer function using the metric of external noise.

In the present invention is offered another variant of the method of examination of the patient to identify a specific physiological state of the body by using a technique that uses the sounds coming from the patient and measured at a given distance from the field the patient's body, from which emanate sounds, including: floatation of the first acoustic sensor on a certain section of the patient's body to generate an output signal to the sounds measured in this first acoustic sensor; modification of the output signal of the first acoustic sensor with a pre-calculated indicator of external noise, resulting in the output signal to the output signal of the second acoustic sensor installed on the specified distance from the patient's body, from which emanate sounds; and use the modified output signal of the first acoustic sensor for determining the presence of a particular physiological state of the organism of the patient.

In accordance with the other features of the invention position and/or movement of the patient's body, which is the first acoustic sensor, measured position sensor and/or movement which is placed on a certain section of the patient's body and create an output signal is also used to determine whether a certain physiological state of the organism of the patient. Using the optional position transmitter and/or movement placed on the patient's body in the same place, which is located acoustic transducers, does proposed in the present invention is particularly useful for determining breathing disorders, pathological conditions of the cardiovascular system, such as blood pressure, disorders of the joints, including the movement of the joints associated with certain acoustic models, or pathological conditions of the gastrointestinal tract of the patient, as explained above.

The present invention also proposed device for examination of the patient to identify a specific physiological state of the body by using a technique that uses sounds from the patient and measured at a given distance from the patient's body, from which emanate sounds, containing: first acoustic sensor, made with the possibility of placing on certain section of the patient's body to generate an output signal to the sounds measured in this first acoustic sensor; second acoustic sensor made with possibility of installation on a given distance from the patient's body, from which emanate sounds, and generate an output signal corresponding to the sounds measured in this second acoustic sensor and processor that provides simultaneous output signals of the first and second acoustic sensors calculation according to the adopted signals transfer function (TF), resulting output signal of the first acoustic sensor to the output signal of the second acoustic sensor to the use of computed transfer function for the modification of the output signal of the first acoustic sensor and use the modified output signal of the first sound sensor to obtain information useful for determining the presence of a particular physiological state of the organism of the patient.

Other features, benefits and advantages of the invention will become apparent from the following description.

BRIEF DESCRIPTION OF DRAWINGS

The invention is considered in the present description on the example and with reference to the drawings below:

figure 1 - schematic view, which illustrates the basic components of one of the options proposed in the present invention of the device;

figure 2 - block diagram of the algorithm provides basic stage of preliminary calibration of the device for determination of the transfer function, resulting output signal acoustic sensor placed on the patient's body to the signal acoustic sensor installed on the specified distance from the patient's body, from which comes the sound;

figure 3 is a block diagram that includes the main components of the proposed in the present invention of a device to use the transfer function for the conversion of the output signal sensor placed on the patient's body to use adopted time methodology for determining the presence of a particular physiological state of the acoustic activity;

figure 4 - a graph of the output signal system made in compliance with the scheme presented in figure 3, which uses a transducer, placed on the patient's body, in comparison with the schedule of the output signal acoustic sensor, located at the specified distance from the patient's body, from which comes the sound;

figure 5 is a block diagram of the algorithm, illustrating the method of determining the external noise in accordance with the present invention to compensate for the output signal acoustic sensor placed on the patient's body, which provides registration of conditions of external noise present during the survey;

figure 6 - schematic view of the device, made in accordance with the present invention, which contains an acoustic sensor microphone type of position transmitter or posture of the patient and a motion sensor that is placed on one of the surveyed part of the body of the patient, all of the above elements are placed in a common housing;

figure 7 - block diagram illustrating the use of the device, shown in figure 6, to determine whether certain physiological state of the patient;

figure 8 - schematic view of the device in accordance with the scheme of figure 8, but modified so that it can be used also for calculation of external noise used to compensate for noise present during the survey;

figure 9 - block diagram illustrating the application of the device, shown in figure 8;

figure 10 is a block diagram illustrating the device in accordance with figures 8 and 9, in which the acoustic activities provided by means of the calibration of the sensor movements body.

You must understand that the above-mentioned drawings and the description below is primarily intended to facilitate the understanding of an essence of the invention and possible options for its implementation, including the preferred option for practicing the invention. For clarity and brevity in the description is not given more detail than is necessary for the person skilled in the art that uses standard techniques and design skills to understand and implement the described invention.

You should also understand, that the described variants of realization of the invention are given as an example only and invention can be implemented in other forms and in other applications, different from those considered in the present description.

DETAILED DESCRIPTION OF THE INVENTION

So, on the figure 1 shows the examined patient 2, lying on the bed 4, for example, during sleep. As shown in figure 1, acoustic sensor SS 1 is located on a particular part of the body of the patient, in this case on the chest, for generating output signals corresponding to the sounds of the measured sensor SS 1 . Output signals from the sensor SS 1 comes in a 6-core processor for processing, which will be described below.

Figure 1 shows also the second sensor SS 2 , located at the specified distance from the patient's body, from which emanate sounds (as shown by the dashed arc), for example at a distance of 1 metre, in accordance with the existing methodology "Gold Standard" analysis of acoustic information.

6-core processor handles the output signals simultaneously received from two sensors SS 1 and SS 2 , and produces output that represents a transfer function that is to be used to bring the output acoustic sensor SS 1 , placed on the body the patient, the output of information that pass the second acoustic sensor SS 2 , located at the specified distance from the patient's body, emitting sounds, as it is used in the accepted way of analysis of the acoustic information received from the patient to identify a specific physiological state.

Figure 2 shows the block diagram of the algorithm provides basic stage of receipt of the transfer function. As shown in figure 2, the first probe SS 1 have on the patient's body, while the second sensor SS 2 features at a given distance (for example, at a distance of 1 m) from the area of the patient's body, from which emanate sounds, as shown in blocks 10 and 11. The outputs of the two acoustic sensors SS 1 and SS 2 simultaneously accepted (block 12) and served in a 6-core processor, which handles the output signals from the sensors to determine the transfer function, resulting output acoustic sensor SS 1 to output information acoustic sensor SS 2 (block 13).

Preferably two stages, these blocks 12 and 13, repeat repeatedly (block 14), and the 6-core processor calculates the average of the transfer function, which is used to produce the output information acoustic sensor SS 1 , placed on the patient's body, output acoustic sensor SS 2 , if this sensor was installed at a given distance from the patient's body for measurement of the sounds emanating from the patient's body.

At subsequent examinations of the patient can use only the first acoustic sensors placed on the patient's body, because its output signals can be converted using the previously obtained the transfer function for the output signals, which have been obtained from a sensor located at the specified distance (1 m) from the area of the patient's body, the sounds of which are measured.

In most case, the first SS 1 and the second SS 2 acoustic sensors are sound level meters that measure the sound level in dB. However, in some applications, it may also be necessary analysis of output signals of both acoustic sensors using other measured parameters, such as measured their frequency spectra.

It should be added that the first acoustic sensor SS 1 , when it is first used to determine the transfer function and the subsequent use for holding valid surveys of patients, attached to the body of the patient in a certain place. In the example shown in figure 1, this place is the patient's chest. However, for measurements can be used in different places, for example fossa, chin area, upper lip and neck. Output of both sensors SS 1 and SS 2 the preliminary calibration or the output of a sensor SS 1 when conducting valid surveys may be transferred, in it's 6-core processor via a wired or wireless link.

Acoustic sensors can be Omni-directional or targeted microphones. Preferably, they are attached to the patient's body from the surveyed area, for example, with the use of gluing structure between the sensor and the surface of the body, with the help of adhesive tape or with a belt.

Figure 3 shows a block diagram of a device that uses one sensor SS 1 , attached to the patient's body, after the pre-calibration to determine the transfer function to measure acoustic signals from the patient to provide information that will be useful to identify certain physiological state. In figure 3 as an acoustic sensor specified microphone 20, which is placed on the patient's body to produce output signals transmitted in a 6-core processor (see figure 1). 6-core processor performs hardware filtering and processing of signals received (block 21), and the conversion of analog-digit (block 22). 6-core processor converts the information coming from the Converter 22 using the transfer function obtained previously in accordance with the algorithm diagram of which is shown in the figure 2, to get the output of the microphone 20 output that would have been received by acoustic sensor (for example, a microphone SS 2 , figure 1), located within the specified distance from the patient's body, from which emanate sounds, in accordance with the current methods of analysis of acoustic activity. Output microphone 20 modified using the transfer function and is then converted by the inverter digit-analog in analog information (block 24), which is displayed in the audio level in decibels (block 25).

The figure shows the graphs of changes in the amplitude of acoustic signals measured simultaneously at the patient's body (upper graph)and at some distance from the patient's body (lower graph). The similarity of forms of graphs is quite evident.

The above way of converting the acoustic signals received on the surface of the patient's body, the equivalent sound levels in decibels, using the previously obtained the transfer function has been confirmed by a comparison of the calculated values in decibels with measured values in the group of 19 patients. The comparison showed that the average of the mean difference in each trial amounted to 0.7 dB RMS deviation of 2 dB of the standard deviations of the trials.

As already mentioned, the main advantage in outpatient conditions is to put the acoustic measuring device on the surface of the patient's body, and not at some distance from him, because otherwise the measurement results will influence the noise environment that is missing when the measurements are conducted in laboratories of sleep medicine. Thus, room acoustic sensor on the patient's body helps to improve the capability of distinguishing between the sounds emanating from the patient, and obstructing the sounds of the environment, because at some distance from the patient's body, emitting sounds, the remote sensor is subjected to all sources of sound. The acoustic sensor, located on the body of the patient, can still act the noise environment, either directly or after the body of the patient, and the noise level can vary significantly for different environments in which measurements are made. This is especially important when required precise quantitative measures for the implementation of standardized assessments, as, for example, in the case of measuring the characteristics of snore.

Therefore, other features of the present invention is the inclusion of the device means of internal calibration, providing a standardized acoustic signal between the sensor and the surface of the patient's body. In this case, the precise determination of the share of external noise in measured acoustical signal and precise measurement of the acoustic activity inside the body of the patient. Providing for a possibility to use different types of microphones in the device required for the accomplishment of specific requirements of the task of carrying out measurements. Level of external noise can be determined by measurement of acoustic activity with internal calibration signal to obtain the transfer function and without such a signal to conduct actual inspection of the patient, while the device is attached to the patient. Determining the difference between the level of acoustic signals with signal internal calibration to obtain the transfer function and without such a signal, you can determine the level of external noise and make an adjustment of the received information.

Figure 5 shows a block diagram of the algorithm implementation of the internal calibration of acoustic sensor (SS 1 )must be placed on the patient's body to determine the function of external noise for the respective sensor at a certain time when the patient must undergo a screening for interested physiological state.

As indicated in the block diagram, shown in figure 5, first, determine the transfer function in accordance with the algorithm block diagram of which is shown in the figure 2 (block 30). The output signals of the SS sensor 1 located on the patient's body, accepted (block 31), then are modified using the transfer function (block 32) and are recorded in the processor 6 (unit 33).

Inducted into the device generator sound frequencies used for internal calibration of acoustic sensor SS 1 to determine the indicators of external noise can be a separate element of the device, such as a properly designed piezoelectric film, generating sound (for example, film Mylar), or ready loudspeaker with suitable small size.

As already indicated, a particularly important feature of the present invention is that it provides information about body position or posture, as well as on the movements of the body, which are measured in time and at the place of performance of acoustic measurements. This additional information is very useful for defining the various above-mentioned physiological States.

We know many of sensors that can measure the position of the body or posture and body movement. For example, sensors of position of a body are typically a device, sensitive to the slope that contain conductive ball, a number of mercury, a bubble of air, etc. that are in certain positions depending on the angle of the device. Motion sensors are typically a device type accelerometer, which generate output signals depending on the changes of speed.

Alternatively, you may want a device with three-dimensional accelerometer to measure the angle of the sensor relative to the direction of gravity provided that an acceleration of the patient vertical measurement can be neglected. Also can be used two accelerometer, when there is a shared coordinate is measured twice to determine the position of the sensors relative to the direction of gravity, or three mutually orthogonal to one-coordinate of the accelerometer. Preferably use of accelerometers, since they essentially are not limited to the measurement of only a small set of directions and can provide smooth measuring direction in the whole range in all three coordinates, and, accordingly, provide the dynamics of the continuous changes of direction during the whole process of examination.

The use of multidimensional accelerometers simultaneously as sensors of body position and movement sensors patient is well known in engineering and described, for example, in the US patents 5593431, US 6477421 and US 7054687.

Division of the information on the position and movement is carried out by corresponding filtering the high and low frequency components of the signal. So, low-frequency component of the signal used to determine the position of the body, and high-frequency component is used to determine the motion of the body (helps, for example, to identify the type of respiratory model). Sensor can be used for measuring the motion of the patient and to the measurement of the position of his body,

In figure 6 schematically illustrates one of the options proposed in the present invention of the device, which uses a sensor 40 of the position and movement placed on the microphone 41 used as an acoustic sensor on the patient's body (sensor SS 1 , figure 1). The relative location of the microphone 41 and sensor 40 of the position and movement can be reversed, or these elements may be located in a row, next to each other. As shown in figure 6, the output of the microphone 41 is transmitted through the cable 42 in processor 43, the appropriate processor 6 in figure 1, which processes the information, as already described, and transfers the processed information by cable 44 45 output connector.

Figure 7 shows a block diagram of the entire device, which are illustrated first of all functions performed by the processor 43 (see figure 6). As shown in figure 7, processor 43 performs the following functions: carries out a filtration of received signals (block 46); converts the processed signal in digital form (block 47); calculates the transfer function (block 48); converts the signal back to analog form (block 49); and provides different kinds of output, including output information about the position (49A), about the movement (49b) and about the level of measured sounds in decibels (49).

An important feature of the present invention is the ability to play acoustic information, information about body position and his movement for later viewing and analysis after an examination.

In the case of acoustic data recorded during examination of the patient can be played in audio form via any means known in the technique, or may be presented on the graphical display that shows the intensity of sound and its frequency. As already indicated, this information, among other things, may be useful for recognition of the status of the respiratory tract, the respiratory system of the patient and determine the types and extent of problems associated with failing respiratory tract.

All the received information, in any combination, can be displayed sequentially in time, and this can provide invaluable assistance in the clinical assessments and conclusions on the results of the survey. All of the received signals can also be presented as output together with any other information obtained during the examination.

Figure 8 schematically illustrates one of the options proposed in the present invention of a device which provides the possibility of internal calibration to provide an indication of external noise, as discussed above, in particular with reference to the block diagram of figure 5. The device shown in figure 8, in General similar device, shown in figure 6, except that in the latter case the device in addition to the sensors 40 and 41 introduced generator SG sound frequencies, and therefore for a designation of the same parts use the same reference numbers. As already indicated, in particular, with links to the block diagram of figure 5, generator SG sound frequencies is used to perform an internal calibration of sensors 40, 41 by the definition of the parameter external noise for specific sensors used and specific environmental conditions during the survey.

Figure 9 shows a block diagram of the algorithm, the corresponding block diagram in figure 7, is characterized by the introduction of the generator SG sound frequencies. In all other respects the block diagram figure 9 is similar to the block diagram of figure 7, and therefore to specify the same parts use the same reference numbers (excluding the generator SG sound frequencies).

Figure 10 illustrates the alternative proposed in the present invention device (instead of a device figure 9), in which the acoustic signals provided by the calibration of accelerometers, used to determine the position and movements of the body.

Thus, in the device block diagram of which is shown in figure 10, generator SG sound frequencies is absent, and instead uses a line 50 feedback from the Converter 49 digit-analog for the filing of the analogue output signal processor on the sensor 40 of the position and movement of the body.

The present invention can be used in conjunction with any known medical device in which the additional use of some or all of the measured signal can be useful. Proposed in the invention of the device can be used as an independent measuring system by connecting it to the corresponding system of data collection, using all the available information. At the same time can be used by multiple devices performing measurements in different places in the body of the patient, to further improve and get useful information. Examples of such useful combinations of dimensions in different places may include comparing the same joints to identify problems on the basis of the comparative analysis, acoustic information related to the respiratory system, in different areas to improve the ability to identify a region, which is the source of sounds, the measurement of tones hearts in different areas to improve the ability to identify the nature of abnormal tones etc.

Thus, while the invention has been described in relation to the preferred implementation options, you must understand that these options were considered only as examples, and that can be implemented many other changes, modification and application of the invention.

1. Method of examination of the patient to identify a specific physiological state by using at least one specific parameter of sound transmitted area of the patient's body, from which emanate sounds, for a specified distance from the specified area, including: floatation of the first acoustic sensor on a certain section of the patient's body to generate an output signal to the sounds measured in this first acoustic sensor; modification of the output signal of the first acoustic sensor using precomputed transfer function to obtain at least one output acoustic parameter corresponding to the value of the corresponding parameter of the output signal of the second acoustic sensor, which first calibrated sensor passed the second acoustic sensor located on a specified distance from the area of the body the patient, from which emanate sounds; specified at least one output acoustic parameter includes at least one parameter sound, specific for a given distance from the area of the patient's body, from which emanate sounds; and use the modified output signal of the first acoustic sensor to determine the presence of the certain physiological state.

2. The method according to claim 1, wherein a preliminary calculation of the transfer function includes: placement of the first acoustic sensor on the specified certain section of the patient's body; the placement of the second acoustic sensor at a given distance from the patient's body, from which emanate sounds; simultaneous measurement of the sounds first and second acoustic sensors to create corresponding output signals and processing the output signal of the first and second acoustic sensors for calculating precomputed transfer function for the modification of the output the signal of the first acoustic sensor to obtain at least one output acoustic parameter corresponding to the value of the corresponding parameter of the output signal of the second acoustic sensor passed the second acoustic sensor, located at the specified distance from the patient's body, from which emanate sounds.

3. The method according to claim 1, wherein the first and second acoustic sensors are sound level meters, and the first acoustic sensor is attached to the specified certain section of the patient's body.

4. The method according to claim 1, wherein carry out a preliminary calibration of the first acoustic sensor for compensation of external noise in the time, when the examination of the patient to identify a specific physiological state, in this pre-calibration includes: placement of the generator of reference of sound frequencies in the location of the first acoustic sensor; the inclusion of a reference generator audio frequencies simultaneously with the inclusion of the first and second acoustic sensors; processing the output signal of the first and second acoustic sensors to determine the difference between them, which is an indicator of the external noise; and the modification of the calculated transfer function using the metric of external noise.

5. The method according to claim 1, wherein the specified certain physiological condition is a snoring or respiratory failure.

6. The method according to claim 1, wherein the specified certain physiological status of a blood pressure, a condition of closing of the valve of the heart or other cardiovascular status of the patient.

7. The method according to claim 1, wherein a certain physiological condition constitutes a violation of the work of the joint patient detected by measuring the motion of the joint associated with certain acoustic models.

8. The method according to claim 1, wherein a certain physiological condition refers to the gastrointestinal system of the patient.

9. The method according to claim 1, wherein the specified sound represents the equivalent sound level in dB.

10. Method of examination of the patient to identify a specific physiological state by using at least one specific parameter sound transferred to the area of the patient's body, from which emanate sounds, and defined for a specified distance from the specified area, including: floatation of the first acoustic sensor on a certain section of the patient's body to generate an output signal to the sounds measured in this first acoustic sensor; modification of the output signal of the first acoustic sensor using precomputed function of the external noise to obtain at least one output acoustic parameter corresponding to the value of the corresponding parameter of the output signal of the second acoustic sensor, which first calibrated sensor passed the second acoustic sensor, located at the specified distance from the patient's body, from which emanate sounds, adjusted for ambient noise; specified at least one output acoustic parameter includes at least one parameter sound, specific for a given distance from the area of the patient's body, from which emanate sounds; and use the modified output signal of the first acoustic sensor for determining the presence of a particular physiological state.

12. The method according to claim 11, in addition to measure the position of the patient's body that hosts the first acoustic sensor by positioning sensor position on the specified certain section of the patient's body and generate an output signal, which is also used to detect the presence of certain physiological movements.

13. The method according to section 12, in addition to measure the movement of the patient's body by placing the motion sensor in the specified certain section of the patient's body and generate an output signal, which is also used to detect the presence of certain physiological movements.

14. The method according to item 13, which includes play acoustic information, information about body position and his movement for later viewing and analysis after an examination.

15. The method according to item 13, in which the motion sensor is a generator of sound frequencies.

16. Device for examination of the patient with to identify a specific physiological state by using at least one specific parameter of sound transmitted area of the patient's body, from which emanate sounds, and defined for a specified distance from the specified area, containing a: first acoustic sensor, made with the possibility of placing on certain section of the patient's body to generate an output signal to the sounds measured in this first acoustic sensor; second acoustic sensor, made with the possibility of installation on a given distance from the patient's body, from which originate sounds, and generate an output signal to the sounds measured in this second acoustic sensor and processor, made with the possibility of simultaneous reception of output signals of the first and second acoustic sensors calculations on these accepted signals transfer function for the modification of the output signal of the first acoustic sensor to obtain at least one output acoustic parameter corresponding to the value of the corresponding parameter of the output signal of the second acoustic sensor passed the second acoustic sensor, located at the specified distance from the patient's body, from which emanate sounds, to use the calculated transfer function for the modification of the output signal of the first acoustic sensor and the use of the modified output signal of the first acoustic sensor to obtain information useful for definition of presence of the certain physiological state of the organism of the patient.

17. The device according to article 16, which additionally contains at least one of the following: sensor status, made with the possibility of attaching to the specified certain section of the patient's body; and the processor shall ensure the use of the output signal of the sensor position to provide information, useful to identify certain specified physiological state; and motion sensor, made with the possibility of attaching to the specified particular part of the body of the patient; and the processor shall ensure the use of the sensor input of the movement for the formation of information useful for the specific physiological state.

18. The device according to article 16, which additionally contains a generator of the reference frequency, made with the possibility of attaching to the specified particular part of the body of the patient, to form the reference audio signals with the purpose of using them for the definition of the parameter external noise, which is carried out for pre-calibration device, to take account of external noise present during the reception of the output signal of the first acoustic sensor used to generate information useful for definition of presence of the certain physiological state.

19. Device see item 18, in which the motion sensor is a generator of sound frequencies.

20. Device see item 18, in which the position transmitter is a generator of sound frequencies.

21. The device according to paragraph 17, where all or some of the following components: first acoustic sensor, proximity sensor, motion sensor and reference generator frequency audio - placed in a common enclosure.

22. The device according to paragraph 17, containing additional funds to play acoustic information, information about the position of the body and its movements for later viewing and analysis after an examination.

23. The device according to paragraph 17, in which the indicated certain physiological condition is at least one of the following States: snoring or breathing problems; blood pressure; condition closing heart valve or other cardiovascular status of the patient; or disruption of the work of the joint patient detected by measuring the motion of the joint associated with certain acoustic models; the state related to the gastrointestinal system of the patient.

24. The device according to article 16, in which the value of the specified output acoustic parameter represents the equivalent sound level in dB.