资料来源:哈姆娜·库雷希和克雷格·戈尔根,珀杜大学韦尔登生物医学工程学院,西拉斐特,印第安纳州
在这里,我们将强调人类和啮齿动物之间非侵入性血压测量技术的主要相似性和差异,并研究控制血压的工程原理。还将讨论控制当前袖口技术以获得收缩和舒张压力的原理。
与移动设备连接的商用袖口通常结构紧凑且便携,因此几乎可以在任何地方进行测量。非侵入性便携式血压袖口对于高血压和其他心血管问题患者特别有用,需要仔细监测和及早发现血压的任何变化。
同样,非侵入性血压测量系统也可用于啮齿动物。该技术用于实验室设置,并可用于在整个研究中监测动物健康。虽然放射性遥测是啮齿动物血压测量的黄金标准,但这种技术具有侵入性,如果操作不当,可能导致动物死亡。因此,非侵入性方法便于在动物身上进行测量,因为它们可以提供有价值的数据,而无需植入设备。一个商用系统将被用来演示如何在临床环境以外的人身上测量血压。这种技术允许患者定期监测自己的血压,而不必每次需要进行这些测量时访问诊所。
此处描述的方法利用压力传感器和遮挡袖口利用流经啮齿动物尾部的血流。无论是人类移动血压袖口还是啮齿动物非侵入性尾袖口方法,都利用类似的血液动力学原理获取血压测量,为包括临床医生、研究人员和患者。
血压测量由收缩和舒张组分组成,这两种指标都是心血管健康的重要指标。收缩压定义为由于心脏收缩而对动脉壁施加的最大宫内压力,而舒张压定义为主动脉瓣关闭时的最低宫内压力。
使用市售袖口进行的血压测量使用示波方法进行测量。在临床环境中,临床方法常用于测量血压。临床医生通常会在手臂的胸动脉周围充气血压袖口,直到血管完全闭塞。一旦他们放气,临床医生会听他们第一次通过听诊器听到心脏跳动的点。这一点表示收缩压,因为动脉内的压力足够大,足以打开血管。然后,袖口继续放气,直到听不到重复的声音。这一点表示舒张压,因为血管保持开放。除自动技术外,测波技术与奥西托技术类似。袖口算法不是听声音,而是在血压袖口开始泄气时检测血流中的振荡。当血液再次开始流经动脉时,这些振荡开始,表明收缩压。当血流变得稳定时,振荡水平,表示舒张压。
在啮齿动物中测量血压的非侵入性方法也使用自动化技术。此处描述的系统包括一个遮挡袖口,该袖口在尾动脉周围膨胀和放气,类似于临床血压袖口在胸动脉周围如何膨胀和放气。体积压力记录 (VPR) 传感器也放置在尾部周围。该传感器可以使用压力传感器确定血压,该传感器可以指示收缩压和舒张压何时发生在动物的尾部,这是真实系统血压的密切替代物。
1. 无线血压袖口
2. 啮齿动物的非侵入性血压测量
血压测量通常用于监测心血管健康。血压是血管壁上循环血液产生的横向压力。密切监测对发现和治疗低血压、低血压和高血压、高血压非常重要,两者都会损害心脏、肾脏和大脑等重要器官的功能。
血压通过听诊手动测量,临床医生使用充气袖口遮挡动脉,然后在气减时聆听血流通过胸动脉的声音。血压也可以通过示波仪自动测量,使患者可以在家里测量血压。充气袖口包含一个压力传感器,该传感器根据血液动力学原理将动脉振动转换为收缩压力和舒张压。
本视频将说明血压原理,演示目前测量人类和小动物收缩压和舒张压的方法,并讨论一些应用。
血压测量由收缩和舒张组分组成,这两种成分都是心血管健康的重要指标。
收缩压是心脏跳动时心脏收缩期间对动脉施加的最大宫内压力的量度,舒张压是最小宫内压力或节拍之间压力的量度当心脏放松,主动脉瓣关闭时。为了测量血压,在病人的上臂上放置一个袖口,然后膨胀到血流完全被阻塞的地方。当袖口放气时,临床医生在观察压力计读数时进行麻醉。
第一声可听见的Korotkoff声音对应于收缩压力,即血液开始再次流过开放血管的压力。随着袖口继续泄气,血液流动更自由,因为血管保持开放。当临床医生不再听到跳动的声音或自监测设备检测到振荡的平整时,记录舒张压。
类似的方法可以用来监测啮齿动物的血压。袖口在尾动脉周围膨胀和放气,而压力传感器检测收缩和舒张压力。现在,您已经了解了收缩压和舒张压之间的区别,让我们演示如何使用人类无线袖口和啮齿动物非侵入性技术来测量血压。
打开无线袖口和移动设备,然后打开袖口应用程序。然后,通过蓝牙配对设备,然后打开移动设备上的袖口应用程序。然后,将袖口绑在上臂上。确保血压监测仪放置在你的内二头肌。表带应紧紧地固定在手臂上。坐在一个位置,使袖口与你的心处于同一水平。在开始之前,确保你冷静和放松。
现在,通过按开始开始血压测量。每次测量大约需要一到三分钟。重复测量几次,以获得结果中的平均值。结果将显示在移动设备的屏幕上。保存结果后,从手臂上解开袖口并关闭设备。
要测量啮齿动物的血压,请先打开台式电脑、血压系统和加热阶段。然后,将 VPR 袖口和遮挡袖口连接到血压系统。使用软件确认袖口已正确校准并按预期工作。选择用于数据采集的相应参数。参数包括通缩时间、每个周期的集数、遮挡压力和集之间的延迟。遮挡压力通常设置为 250 毫米汞,并且每个周期通常有 20 组汞。可以根据用户需要指定其他参数。
安抚动物,防止它经历不必要的压力。环境应该安静,噪音最小。然后,将动物放在一个适当大小的支架中。确保动物的爪子不会卡在支架的附件中,并且尾巴在约束器之外。现在,将支架放在加热的舞台上。将遮挡袖口滑动,然后将 VPR 袖口滑到尾部底部,相距约一至两毫米。一旦袖口到位,磁带到舞台上。这将限制尾部移动。
然后,将尾巴加热到32至34摄氏度,以促进血管扩张和血流通过尾部。当阶段变暖时,选择电脑上血压升高的动物类型,然后将其动物ID输入系统,以便以后可以访问其数据。一旦阶段充分加热,开始通过按下启动获取血压数据。尽量保持一个平静的环境。保持袖口的位置恒定,如果动物移动很大,请记下。如果袖口滑下尾巴,或者如果动物在约束器内移动,按下暂停按钮,然后在当前测量完成后进行调整,然后继续测试。
检查以确保血压数据按预期获取。收集 20 到 40 个测量值。收集所有数据后,将动物从支架中取出,放回笼子。然后关闭设备并清洁与动物接触的表面。
使用人类血压监测仪的结果将在屏幕上输出,如图所示。使用该技术,将显示收缩和舒张压测量值,并计算多个读数。
人类的健康血压通常低于收缩压的汞120毫米,舒张压的汞含量低于80毫米。高于这些值的血压可能表明患者开始发展高血压,这可能导致进一步的健康并发症。
这是服用啮齿动物血压时获得的典型图表。图上的两条曲线表示从 VPR 传感器、蓝线和遮挡袖口(红线)收集的数据。蓝色曲线的拐点用于计算收缩和舒张压力。测量值与 OK 状态一起列在图表底部,表明系统认为此测量是可以接受的。
小鼠的典型血压测量值约为 120,超过 70 毫米汞,而大鼠的血压略高于 130,超过 90 毫米汞。
现在,让我们来看看血压是如何在公众和科学界的非侵入性测量的。
便携式非侵入性血压袖口使高血压患者在就诊期间能够监测其健康状况。有患先兆子宫颈癌风险的孕妇可以在婴儿出生前的关键月份监测其患此病的风险。
研究开发新的治疗药物需要经常进行血压评估。虽然侵入性技术,如皮下遥测和小鼠胡萝卜动脉罐,提供长期血压数据,但非侵入性尾袖系统是监测心血管动物模型中血压的诱人方法疾病。
您刚刚观看了 JoVE 的血压测量技术介绍。现在,您应该了解如何将非侵入性测量方法用于人类和啮齿动物,以及如何应用该技术来改善社区的健康监测。感谢您的收看!
图1显示了使用非侵入性血压系统服用啮齿动物血压获得的典型图表。图上有两条曲线:一条用于 VPR 传感器,另一条用于遮挡袖口。VPR传感器曲线的拐点是确定收缩和舒张压的位置,如图1所示。图的底部指示状态,用于传达系统是否认为此测量值可以接受。为了获得可接受的读数,每次试验都多次接受血压。
图 1.通过非侵入性测量系统获得的收缩和舒张压。
图 2.收缩压和舒张压的屏幕截图。
对于一个为人类提供的商业袖口,血压测量的结果在屏幕上输出,如图2所示。用户可以使用此技术查看收缩和舒张压测量。血压可以多次服用,以便结果输出所收集的数据的平均值。
两种商业袖口都可用于家庭使用,非侵入性方法用于动物研究,均采用自动化技术。通过使用传感器跟踪血流的变化,算法检测收缩和舒张压力,然后将这些结果传达给用户。虽然技术相似,但两种测量技术之间存在一些关键差异,应加以注意。当在人类受试者中接受血压时,环境通常是放松的,因为受试者是无节制的,相当舒适。相反,动物必须被限制或麻醉。抑制会使动物焦虑不安,从而扭曲血压测量,而麻醉会导致体温过低和血管收缩,使可靠的测量更难获得。这就是为什么在平静、光线昏暗的环境中,在意识动物中获得啮齿动物的血压,这样它们才能保持温暖,没有惊人的噪音。当啮齿动物测量血压以促进血液流过尾巴时,也使用通过加热的血管化。在获取数据之前,将动物与支架和袖口进行协调有助于减少不适,并允许收集更准确的结果。此外,如果用户在多天内从同一动物收集测量值,如果每天大致相同的时间获取,结果将更有意义。
能够使用用户友好、紧凑的袖口进行血压测量,对于患者来说是一个非常有用的工具,因为它允许患者在方便的情况下监控血压。然而,市售的血压袖口并不是用来取代临床获得的测量;相反,这些袖口旨在帮助患者监测他们的全身血压在访问之间。商业袖口也会受到噪音的影响,并不总是收集准确的结果。同样,对啮齿动物血压的非侵入性测量也是嘈杂的,特别是当动物移动时。因此,在查看来自这些系统的数据时,必须明智。
便携式非侵入性血压测量方法可用于各种应用。商业袖口允许高血压患者在诊所就诊期间监测其健康状况。这种方法可以帮助患者更加注意他们的饮食和运动决定,因为他们可以看到他们的生活方式对他们的血压有直接影响。商业袖口还可以帮助孕妇在怀孕的最后几个月跟踪自己的血压。孕妇有患先兆子宫颈癌的风险。因此,这些妇女必须知道,在妊娠后半期,她们是否面临这种病的风险。使用便携式袖口可以帮助这些妇女在婴儿出生前的关键月份跟踪自己的血压。
对于动物使用,非侵入性血压测量对于研究目的,尤其是那些有关心血管健康的研究,是有价值的。在程序和研究后(如在啮齿动物中诱导高血压)对动物进行血压检查,可以显示这些行为对动物健康的影响。虽然其他侵入性技术可以提供更一致的数据,但尾袖系统的非侵入性使得它们成为使用心血管疾病动物模型的人的诱人方法。
Blood pressure measurements are often used to monitor cardiovascular health. Blood pressure is the lateral pressure produced by circulating blood on vessel walls. Close monitoring is important to detect and treat hypotension, low blood pressure, and hypertension, high blood pressure, both of which can impair the function of vital organs, such as the heart, kidneys, and brain.
Blood pressure is measured manually by auscultation, where the clinician occludes the artery using an inflatable cuff and then listens for the sound of blood flow through the brachial artery as it deflates. Blood pressure can also be measured automatically by oscillometry, which allows patients to measure their blood pressure at home. The inflatable cuff contains a pressure transducer that converts the arterial vibrations to systolic and diastolic pressures based on hemodynamic principles.
This video will illustrate the principles of blood pressure, demonstrate the current methods to measure the systolic and diastolic blood pressures of humans and small animals, and discuss some applications.
Blood pressure measurements consist of systolic and diastolic components, both of which are important indicators of cardiovascular health.
The systolic blood pressure is a measure of the maximum intraluminal pressure exerted against the artery during heart contraction when your heart beats, and the diastolic pressure is a measure of the minimum intraluminal pressure, or the pressure in between beats when the heart relaxes and the aortic valve is closed. To measure blood pressure, a cuff is placed on the patient’s upper arm and then inflated to the point where blood flow is completely occluded. As the cuff deflates, the clinician auscultates while observing the manometer readings.
The first audible Korotkoff sound corresponds to the systolic pressure, the pressure at which blood begins to flow again through the open vessel. As the cuff continues to deflate, blood flows more freely as the vessel remains open. Diastolic pressure is recorded at the point when the clinician no longer hears the beating sound or the self-monitoring device detects a leveling-off of oscillations.
A similar method can be used to monitor rodent blood pressure. A cuff is inflated and deflated around the tail artery, while a pressure transducer detects systolic and diastolic pressure. Now that you understand the difference between systolic and diastolic pressure, let’s demonstrate how to measure blood pressure using a wireless cuff for humans and a noninvasive technique for rodents.
Turn on the wireless cuff and the mobile device and open the cuff application. Then, pair the devices via Bluetooth and open the cuff application on the mobile device. Then, strap the cuff onto your upper arm. Make sure that the blood pressure monitor is placed against your inner bicep. The strap should be secured tightly on your arm. Sit in a position so that the cuff is at the same level as your heart. Make sure you are calm and relaxed before starting.
Now, begin the blood pressure measurement by pressing start. Each measurement takes about one to three minutes. Repeat the measurement several times to obtain an average value in the results. The result will be displayed on the screen of the mobile device. After saving the results, unstrap the cuff from your arm and shut off the device.
To measure the blood pressure of a rodent, first turn on the desktop computer, blood pressure system, and heated stage. Then, attach the VPR cuff and occlusion cuff to the blood pressure system. Use software to confirm that the cuffs are properly calibrated and working as expected. Choose the appropriate parameters for data acquisition. Parameters include deflation time, the number of sets per cycle, occlusion pressure, and the delay between sets. Occlusion pressure is typically set to 250 millimeters of mercury, and there are usually 20 sets per cycle. Other parameters can be specified based on user needs.
Calm the animal to prevent it from experiencing unnecessary stress. The environment should be quiet, with minimal noise. Then, place the animal in an appropriately sized holder. Make sure the animal’s paws do not get stuck in the attachments of the holder and that the tail is outside of the restrainer. Now, place the holder on the heated stage. Slide the occlusion cuff, followed by the VPR cuff onto the base of the tail, approximately one to two millimeters apart. Once the cuffs are in place, tape them to the stage. This will restrict tail movement.
Then, heat the tail to 32 to 34 degrees Celsius to promote vasodilation and blood flow through the tail. As the stage is warming, choose the type of animal on the computer whose blood pressure you will be acquiring and then enter its animal ID into the system so you can access its data later. Once the stage is sufficiently heated, start acquiring blood pressure data by pressing start. Try to maintain a calm environment. Keep the position of the cuff constant and make a note if the animal moves substantially. If the cuffs slide down the tail, or if the animal moves inside the restrainer, press the pause button, then make adjustments after the current measurement is completed, and resume testing.
Check to make sure the blood pressure data are being acquired as expected. Collect 20 to 40 measurements. Once all data has been collected, remove the animal from the holder and place it back into a cage. Then turn off the equipment and clean the surfaces that were in contact with the animal.
The results using the blood pressure monitor for humans are outputted on a screen as shown. Using this technology, systolic and diastolic blood pressure measurements are displayed and multiple readings are averaged.
Healthy blood pressures in humans are typically below 120 millimeters of mercury for the systolic pressure and below 80 millimeters of mercury for the diastolic pressure. Blood pressures above these values could indicate that a patient is starting to develop high blood pressure, which can lead to further health complications.
Here is a typical graph that is obtained when taking rodent blood pressure. The two curves on the graph represent data collected from the VPR sensor, the blue line, and the occlusion cuff, the red line. The inflection points of the blue curve are used to calculate the systolic and diastolic pressure. The measurements are listed at the bottom of the graph along with the OK status, which indicates that this measurement is deemed acceptable by the system.
Typical blood pressure measurements for mice are around 120 over 70 millimeters of mercury, whereas rats have slightly higher blood pressures at around 130 over 90 millimeters of mercury.
Now, let’s take a look at how blood pressure is noninvasively measured in the public and scientific community.
Portable noninvasive blood pressure cuffs allow hypertensive patients to monitor their health between visits to the clinic. Pregnant women at risk for developing pre-eclampsia can monitor their risk for this condition in the critical months before the baby is born.
Research on the development of new therapeutic agents requires frequent blood pressure assessment. While invasive techniques such as subcutaneous telemetry and carotid artery cannulation in mice provide long-term blood pressure data, noninvasive tail-cuff systems are an attractive method to monitor the blood pressure in animal models of cardiovascular disease.
You’ve just watched JoVE’s introduction to blood pressure measurement techniques. You should now understand how noninvasive measurement methods are used for both humans and rodents and how the technology is applied to improve health monitoring for the community. Thanks for watching!
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