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Abstract
III
Abstract
With the continuous development of the social economy, great changes have taken
place in people's lives, and unhealthy lifestyles have led to the cardiovascular disease
becoming the primary disease threatening human health. Cardiac diseases have short-
term and sudden characteristics, the traditional short-term ECG monitoring is easy to
miss abnormal ECG, while clinical long-term dynamic ECG monitoring has high cost
and imbalance between supply and demand, its popularity and application are low.
Traditional disposable Ag/AgCl wet electrodes will reduce the signal-to-noise ratio of
ECG signals in long-term ECG monitoring due to the reduction of gel moisture, and
some patients are allergic to wet gels.
The application of traditional dry electrodes to
wearable devices has serious problems of baseline drift and motion artifacts. There are
insufficient research on impedance modeling of wet and dry electrodes and pressure
testing at low frequency. In view of the above problems, the paper establishes the skin-
electrode interface impedance circuit model and electrode pressure test and designs an
ECG monitoring system based on the flexible dry electrode to realize long-term
dynamic monitoring of human ECG.
The main research content and work of the paper:
(1) The skin-electrode impedance comparison experiments and electrode drying
experiments were carried out for flexible dry electrodes and disposable Ag/AgCl wet
electrodes of 1~1000 Hz, the experimental results show that the skin-electrode
impedance of the flexible dry electrode is close to that of the disposable Ag/AgCl wet
electrode, and the overall impedance change of the flexible dry electrode after drying
is small, demonstrates the superior performance of flexible dry electrodes.
(2) The skin-electrode impedance circuit model of wet and dry electrodes is
established, and the important determinants of the impedance of wet and dry electrodes
are analyzed in the parallel equivalent capacitance and equivalent resistance formed by
the epidermis layer and the electrode interface layer. The variation trend of absolute
value, imaginary part value and the equivalent capacitance value of the skin-electrode
impedance of four types of electrodes at different frequencies and different pressures
are studied. The experimental results show that the indicators of dry electrodes are more
sensitive to pressure changes than wet electrodes. The pressure test experiment verifies
the wet and dry electrode impedance circuit models established in this paper.
(3) Aiming at the defect that the reduction of the moisture of the disposable
东南大学硕士学位论文
IV
Ag/AgCl wet electrode gel leads to a significant increase in the skin-electrode
impedance and introduces noise and interference, an ECG patch based on the flexible
dry electrode is designed, and completed the software and hardware design of ECG
patch. The low-noise single-lead input front end is designed, and the embedded
software programming provides a solution for long-term ECG monitoring. The ECG
patch is a patch configuration as a whole, which has the advantages of small size and
low power consumption. The system only uses the 2-electrode mode to collect ECG
signals, which improves the portability and comfort of the device.
(4) A comparison experiment of various indicators was carried out between the
ECG patch based on the flexible dry electrode and the Shimmer device. The comparison
of ECG waveform shape and PSD shows that the ECG patch could collect high-quality
ECG signals; the RR interval comparison results showed a high correlation (r=0.999);
in order to evaluate the quality of ECG signals collected by the ECG patch, signal
quality indices comparison experiment was conducted, the seven SQI parameters
indicate that the quality of the ECG signals collected by the two devices is generally
close; a long-term ECG monitoring experiment was carried out for the ECG patch, and
the results showed that the ECG signal collected under the long-term working state of
the ECG patch was clear, stable and reliable.
The results of the paper enrich the research on wet and dry electrode impedance
circuit modeling and electrode pressure testing; the ECG patch based on flexible dry
electrodes is helpful for the early detection of cardiac diseases and has good application
prospects.
KeyWords: Flexible dry electrode; skin-electrode impedance; ECG patch; signal
quality indices; long-term ECG monitoring
目 录
第一章 绪论............................................................................................... 1
1.1 研究背景和意义 ............................................................................... 1
1.2 国内外研究现状 ............................................................................... 2
1.2.1 干电极和皮肤-电极界面研究现状 ........................................... 2
1.2.2 穿戴式心电监护设备研究现状 ................................................. 4
1.3 本文的研究内容和章节安排 .......................................................... 7
第二章 皮肤-电极阻抗建模与电极压力实验 ......................................... 9
2.1 心电信号特征与噪声分类 .............................................................. 9
2.1.1 心电信号特征与测量原理 ......................................................... 9
2.1.2 心电信号噪声来源与分类 ....................................................... 10
2.2 柔性干电极 ..................................................................................... 11
2.2.1 电极阻抗测试 ........................................................................... 11
2.2.2 电极干燥实验 ........................................................................... 13
2.2.3 生物相容性实验 ....................................................................... 15
2.3 皮肤-电极阻抗电路模型 ............................................................... 15
2.3.1 湿电极皮肤-电极阻抗电路模型 ............................................. 16
2.3.2 干电极皮肤-电极阻抗电路模型 ............................................. 18
2.4 压力对不同电极皮肤-电极阻抗的影响 ....................................... 19
2.4.1 不同压力下的阻抗测量方案设计 ........................................... 19
2.4.2 皮肤-电极阻抗绝对值随频率变化趋势 ................................. 21
2.4.3 皮肤-电极阻抗绝对值随压力变化趋势 ................................. 23
2.4.4 皮肤-电极界面等效电容随压力变化趋势 ............................. 24
2.4.5 皮肤-电极阻抗虚部随压力变化趋势 ..................................... 25
2.4.6 分析与总结 ............................................................................... 26
2.5 本章小结 ......................................................................................... 27
第三章 基于柔性干电极的心电贴系统硬件设计 ................................ 29
3.1 系统总体设计方案 ......................................................................... 29
3.2 低噪声单导联输入端设计 ............................................................ 30
3.3 心电信号采集模拟端设计 ............................................................ 33
3.3.1 双极点高通滤波器设计 ........................................................... 33
3.3.2 双极点低通滤波器与放大电路设计....................................... 34
3.4 电源控制模块设计 ......................................................................... 35
3.5 数据存储电路设计 ......................................................................... 36
3.6 主控器电路设计 ............................................................................. 37
3.7 心电贴系统 PCB 设计 ................................................................... 39
3.8 心电贴外壳设计与实物展示 ........................................................ 40
3.9 本章小结 ......................................................................................... 41
第四章 基于柔性干电极的心电贴系统软件设计 ................................ 43
4.1 系统软件总体设计方案................................................................. 43
4.2 心电贴采样率软件设计................................................................. 44
4.2.1 ADC 初始化与设置 .................................................................. 44
4.2.2 定时器初始化与设计 ............................................................... 45
4.2.3 采样率程序设计 ....................................................................... 46
4.3 系统存储模块软件设计................................................................. 47
4.3.1 SPI 初始化与设计 ..................................................................... 47
4.3.2 DMA 初始化与设计 ................................................................. 48
4.3.3 TF 卡初始化与写数据块设计 .................................................. 49
4.3.4 系统存储程序设计 ................................................................... 49
4.4 心电信号去噪 ................................................................................. 51
4.4.1 小波变换去噪 ........................................................................... 51
4.4.2 移动平均滤波算法去噪 ........................................................... 53
4.5 R 波检测与心率计算 ...................................................................... 53
4.6 本章小结 ......................................................................................... 54
第五章 系统测试与对比实验 ................................................................ 57
5.1 系统功耗对比实验 ......................................................................... 57
5.2 心电图形态对比实验 ..................................................................... 58
5.3 RR 间期对比实验 ........................................................................... 60
5.4 信号质量指标对比实验................................................................. 61
5.5 长时程心电采集与存储实验 ........................................................ 64
5.6 24 小时动态心电报告 .................................................................... 65
5.7 本章小结 ......................................................................................... 66
第六章 总结与展望 ................................................................................ 69
6.1 总结 ................................................................................................. 69
6.2 展望 ................................................................................................. 70
参考文献 ................................................................................................... 73
第一章 绪论
1
第一章 绪论
1.1
研究背景和意义
随着社会经济的不断发展,国民生活也发生着巨大改变,不健康的饮食以及
生活习惯导致心血管疾病成为威胁人类健康的首要疾病。《中国心血管健康与疾
病报告 2020》指出,心血管疾病仍是我国城乡居民死亡原因的首位因素,其中农
村占比 46.66%,城市占比为 43.81%,全国心血管患病人数高达 3.3 亿
[1]
。由于不
良的生活习惯等因素,我国心血管疾病发病率和患病人数将继续上升,心血管疾
病给居民和社会带来了严重的经济负担,已经成为重大公共卫生问题。随着我国
老龄化人口的不断增多,对老年人群的心脏监测和心血管疾病预防、筛查和治疗
更为重要
[2]
。随着年龄的增长,人体器官老化、衰竭更为严重,老龄人口心血管
疾病患病风险更为突出。已有研究显示,大部分人群心血管疾病是可以实现早期
预防的
[3]
。加强对广大人群的心血管疾病的早期预防、诊断需要大量的可移动心
电监测设备,因此研发长时程可穿戴心电设备具有重大意义。
长时程动态心电监测是实现对早期心血管疾病诊断的重要手段
[4]
。心脏类疾
病有着短时、突发性的特征,导致患者异常心电信号难以被及时发现和捕捉。传
统的短时心电监测,难以及时发现异常心电信号,非常容易导致病人漏诊或误诊
的状况发生并且临床医生无法对患者做出正确的诊断与治疗。大多数临床上的心
电图检查发现患者已有心脏不适感或者已经存在心血管疾病问题,不能实现早期
预防和治疗。临床上的长时程动态心电监测设备和技术供需不平衡,不能实现和
普及广泛人群的长时程心电监测。传统的 Holter 监测设备导联数多,影响患者日
常生活和工作,且患者需要前往医院才能进行检测、拿取心电报告。目前单导联
可穿戴式心电监测设备已经成为了研究的热门,具有体积小、携带方便以及不影
响患者日常活动。
在心电监测中,心电信号经常会因为各种原因引入噪声干扰,其中干电极引
入的噪声干扰更为严重
[5]
。随着干电极在穿戴式设备上的应用越来越广泛,干电
极在心电监测方面表现出的噪声干扰更为突出。心电噪声引入的重要原因是电极
附着在皮肤表面状态不稳定,引起电极层与人体皮肤表层形成的皮肤-电极阻抗
不断发生变化,导致心电信号电位不稳定,造成采集的心电信号畸形甚至噪声覆
盖了原有心电信号波形特征,给后续心电信号分析处理带来巨大困难。因此对湿、
干电极的皮肤-电极阻抗研究,建立相关电路模型以及针对不同类型的湿、干电
极施加外部压力进行阻抗指标测试实验具有重要意义。
传统的一次性医用电极(Ag/AgCl 湿性电极)不能实现长期心电监测
[6]
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