陳茜茹 鐘清華 張涵 黃偉新
關鍵詞: 臨床聽診; DSP; 心音; 肺音; 分離系統; 小波變換
中圖分類號: TN945+.5?34; TP391.4 ? ? ? ? ? ? 文獻標識碼: A ? ? ? ? ? ? ? ? ? 文章編號: 1004?373X(2019)06?0092?04
Abstract: In allusion to the problem that the heart sounds and lung sounds are mixed and also overlapped in the spectrum during the clinical auscultation process, a heart and lung sound separation system based on DSP is designed. The heart and lung sound sensor collects physiological sound signals from the chest wall, which are sent to the signal acquisition and playback circuit for amplification, filtering and digitalization. In the DSP processor, the iterative multi?resolution decomposition and multi?resolution reconstruction (MRD?MRR) separation algorithm based on the wavelet transform is used to separate the heart and lung signals. The separated heart and lung sounds are output by means of audios, and transmitted to the computer via the serial port for backuping or further processing. On the basis of the platform, a heart and lung sound separation experiment was carried out by using the physiological sound signals collected from the chest walls of 30 healthy adults. The results show that the separation algorithm has the best processing effect when using the db8 wavelet function and hard threshold, and the system has a good real?time performance, stable and reliable data transmission, and a high application value.
Keywords: clinical auscultation; DSP; heart sound; lung sound; separation system; wavelet transform
胸部聽診是現代醫學中診斷心臟系統疾病和呼吸系統疾病的一種重要手段。傳統的聽診器由共振片、聲音共振腔和傳導聲音的導管組成,是廣大醫師最常用的診斷工具。然而它有一些不可彌補的缺點[1]:難以捕捉到人體內臟發出的一些微弱卻非常重要的生理聲音,準確性差;聽診結果容易受人耳聽力敏感局限和聽診者主觀經驗的影響;胸壁聽診時通常為心肺音混合聲音,需要聽診者根據主觀經驗區分心音和肺音。這些缺點最終導致診斷過程極度依賴醫生主觀經驗,易造成誤診,錯過患者的最佳治療時機。隨著電子技術和信號處理技術的不斷發展,結合了現代電子技術與生物醫學技術的電子聽診器研發成功。電子聽診器可以將采集后的信號進行放大等一系列模擬或數字信號處理,在一定程度上改良了傳統聽診器,但從胸壁檢測到的生理聲信號混合了頻譜上相互重疊的心音信號和肺音信號,如何將心肺音混合信號分離出心音信號和肺音信號是電子聽診器需要解決的重要問題[2]。本文介紹了基于DSP的心肺音分離系統和迭代多分辨率分解?多分辨率重構(Multi?resolution Decomposition and Multi?resolution Reconstruction,MRD?MRR)分離算法,并通過實際測試,效果很好。
基于DSP的心肺音分離系統結構如圖1所示,信號采集部分由心肺音傳感器采集數據,并對心肺音信號進行前期處理,將采集到的模擬信號轉化為數字信號;DSP 處理器對心音肺音信號進行分離等處理以及對相關外部設備的控制;存儲部分主要是擴展的程序存儲和數據存儲,由FPGA,FLASH 和SDRAM 組成。另外,DSP 還可通過USB 接口和PC進行通信,也可直接和SDCARD 進行通信。心肺音分離算法由DSP軟件實現,分離后的心音和肺音一方面通過音頻輸出,另一方面通過串口傳輸到計算機中備份或進行進一步處理。
