人体动脉血管的粘性流体力学模型与中心动脉血压估计  

Modeling human vascular networks and estimation of central aortic pressure

作　　者：蒋升[1] 冀连营[1] 汪芳[2] 孙应飞[1] 张志强[3] 季福绥[2] 刘兵[2] 张闻多[2] 吴健康[1] 

机构地区：[1]中国科学院大学,北京100190 [2]北京医院,北京100730 [3]帝国理工学院

出　　处：《中国科学：信息科学》2013年第8期964-981,共18页Scientia Sinica(Informationis)

摘　　要：中心动脉血压与心血管疾病有着密切关联,准确的中心动脉血压估计是心血管病,特别是高血压病管理的关键技术.现有中心动脉血压估计方法,如通用传递函数法和多点移动平均法,均基于临床实验和经验,缺少系统理论基础且为通用方法,不能排除心血管个体差异对估计结果的影响.我们从粘性流体力学控制方程出发,建立了人体动脉血管网络模型,由测量出的桡动脉起始端和末端血压波形计算出被测者的动脉血管网络模型个性化参数,并由此推导出升主动脉—桡动脉传递函数,从测出的桡动脉血压波形计算出中心动脉血压波形为区别于现有中心动脉压测算方法,我们的方法简称为"模型法(MCAP)".该方法不仅具有理论依据,也考虑了不同个体的心血管特性(如:血管顺应性、血流阻力、血液流动惯性),保证了估计结果的可靠性和准确性.我们在北京医院对50例被试进行中心动脉血压计算实验.实验结果表明,通过模型法(MCAP)得到的中心动脉血压波形优于通过通用传递函数法(GTF)和多点移动平均法(NPMA)得到的结果(与侵入式血压波形的相关系数:rMCAP=0.9667,rGTF=0.9025,rNPMA=0.8099).基于模型法计算获得的收缩压与舒张压结果(误差均值(SBP/DBP)=3.9mmHg/3.6mmHg,误差标准差(SBP/DBP)=7.7mmHg/2.9mmHg)符合AAMI标准(误差均值5mmHg;误差标准差8mmHg).It becomes a common understanding that central aortic systolic and/or pulse pressures (CAP) provide direct and accurate prediction for cardiovascular structural damage and cardiovascular outcomes. Existing methods for CAP measurement and estimation, namely, method based on general transfer function, and N-point moving averaging method, are rather empirical, and lack of theoretical foundation. Those methods also have inherent drawback that there are not personalized, and missing individual aortic characteristics. Here in this paper, we present a novel method of model-based central aortic pressure measurement and computing, referred to as MCAP. MCAP has solid theoretical foundation; a novel human aortic network model is proposed and developed based on viscous fluid mechanics theory. In MCAP, model parameters of individuals are computed from measured pulse wave of radial artery and brachial artery, the central aortic radial artery transfer function is derived from the model, and finally, the central aortic pressure and pulse wave are obtained. We conducted an experiment at Cardiovascular Department of Beijing Hospital. Experimental results on 50 test cases have shown better performance of MCAP with comparison to GTF and N-point average method (r MCAP = 0.9667, r GTF = 0.9025, r NPMA = 0.8099). The MCAP accuracy (Mean(SBP/DBP) = 3.9 mmHg/3.6 mmHg, Stdev (SBP/DBP) = 7.7 mmHg/2.9 mmHg) of central artery systolic pressure and diastolic pressure is up to the standard of AAMI(Mean 5 mmHg, Stdev 8 mmHg).

关 键 词：血压测量 人体动脉血管模型 中心动脉血压 粘性流体力学控制方程 

分 类 号：O35[理学—流体力学] R312[理学—力学]