JP2009000388A - Vascular endothelial function measuring device - Google Patents

Abstract

The conventional vascular endothelial function measurement not only poses a heavy burden and pain on the subject, regardless of whether the vascular endothelial function measurement method is invasive or non-invasive, A large measurement environment was required.
Blood pressure ischemia and ischemia time are controlled by the pulse wave velocity calculated from blood pressure measurement and bioimpedance measurement, and the amount and rate of change of bioimpedance value before and after ischemia and the pulse wave velocity Evaluate vascular endothelial function and display, print and record. Further, a simple configuration is adopted in which the bioelectrical impedance measurement unit, the blood pressure measurement unit, and the ischemic unit are attached to the measurement site.
[Selection] Figure 1

Description

  The present invention relates to a vascular function measuring apparatus capable of easily evaluating the degree of arteriosclerosis by measuring a pulse wave velocity and a vasodilator response before and after ischemia.

  Conventionally, pulse wave velocity or pulse wave velocity is generally used as an index of vascular diseases such as arteriosclerosis. The pulse wave propagation speed is the speed at which the wave generated when the blood vessel wall pressure derived when pumping blood from the heart moves through the artery is transmitted through the blood vessel wall, and the higher the speed, the harder the blood vessel. means. The pulse wave propagation speed is obtained by measuring the pulse wave at two points on the blood vessel and the propagation time thereof and dividing the distance between the two points by the propagation time.

  Up to now, as the pulse wave velocity measuring device, 1) the time difference between the second heart sound acquired using the heart sound microphone and the pulse wave of the hip artery and carotid artery acquired using the pulse wave sensor, and the pulse wave sensor 2) Measuring from a pulse wave of an artery measured by slightly compressing two points of a subject's limb using a cuff 3) A blood vessel at two points using an ultrasonic sensor Measurement of diameter fluctuation and obtaining pulse wave velocity by cross-correlating fluctuation waveforms 4) A pair of constant current supply electrodes are attached to the heart side and the distal side with respect to the blood vessel running of the subject, and 2 between them It is known that two or more measurement electrodes are attached at regular intervals, and the propagation time between the electrode pairs of the waveform is obtained from the bioimpedance waveform obtained from these measurement electrodes and the interval between the electrodes.

  Among the above, as an example of a method for obtaining the pulse wave velocity from the bioimpedance waveform of 4), a method shown in Patent Document 1 below has been proposed. This suggests that the pulse wave velocity can be measured with a simple configuration with a small load on the subject.

  Also, in recent years, an index representing the function of a single-layer cell called an endothelial cell covering the inner surface of a blood vessel called the vascular endothelial function (the ease of blood vessel expansion) has been recognized as an index of vascular diseases such as arteriosclerosis. I came. Endothelial cells produce various substances such as nitric oxide (NO). If the production of these substances is reduced or decomposition is promoted, the blood vessels become difficult to expand, and the blood flow of each organ is reduced. descend. It has been reported that the vasodilator response by endothelial cells is impaired by risk factors such as hypertension, aging and diabetes. It has also been reported that when vascular endothelial function is impaired, arteriosclerosis is promoted by the disorder. That is, the recognition that vascular endothelial dysfunction itself is a risk factor for arteriosclerosis is increasing.

  From this, it is considered that by measuring the vasodilatory reaction by endothelial cells, functional abnormalities of vascular endothelial cells can be detected and early lesions of arteriosclerosis can be easily found.

  As a conventional method for measuring a vasodilator response by endothelial cells, a method has been adopted in which acetylcholine or the like is administered into a coronary artery by an invasive method using a catheter or the like to examine the coronary artery vasodilator response.

  However, such an invasive method requires a great deal of labor for measurement and imposes a heavy burden on the subject. For this reason, a non-invasive method using an ultrasonic diagnostic apparatus called FMD (Flow-Mediated Dilation) method has been proposed, and blood flow dependence of the brachial artery as a vasodilation reaction by endothelial cells. Methods for examining vasodilatory responses have also been performed.

  In the non-invasive method by the FMD method, for example, an ultrasonic measurement terminal is positioned and arranged at a predetermined part of a subject's arm. Next, the blood vessel state in the resting state is detected, and the blood vessel diameter is detected. Thereafter, the blood vessel at the predetermined site is blocked for a predetermined time, for example, 5 minutes. After the ischemia is released, the measurement terminal is again arranged at the same position as the resting blood vessel diameter measurement site, and then at a measurement terminal arrangement position at a predetermined time interval after the ischemia is released, for example, 1 minute after the release of the ischemia. The blood vessel diameter is detected. From these blood vessel diameter measurement results, the blood vessel expansion rate is measured.

  However, in the above method, it is necessary to obtain the expansion ratio of the diameter of the blood vessel which is not so thick, and the measurement accuracy cannot be secured unless the ultrasonic measurement terminals are arranged at exactly the same position before and after ischemia. For this reason, a skillful technique is required for highly accurate detection.

  Moreover, it takes heat to obtain a long-axis B-mode image of a blood vessel using an expensive supersonic diagnosis apparatus, and if an image analysis apparatus or the like is not used separately, objectivity or reproducibility is obtained in blood vessel measurement. There were problems with the reliability and dissemination of measurement values.

  As a method for solving the above problems, a method is proposed in which the vascular endothelial function is used as an evaluation index from the amount of change in bioimpedance before and after ischemia shown in Patent Document 2 below.

JP 2006-326334 A JP 2000-201930 A

  However, it is considered that there is room for improvement in each of the aforementioned methods.

First, in the method according to the above-mentioned Patent Document 1, although only the pulse wave velocity can be easily measured, it cannot be said that this index alone is sufficient to determine a vascular disease such as arteriosclerosis. Judgment is based on the combined use of inspection and measurement results. As a result, the total inspection time becomes longer, the work becomes complicated, and the load on the subject is increased.

  Further, in the method according to Patent Document 2 described above, there are many electrodes and measurement units to be mounted, and it is complicated only by preparation for actual measurement. In addition, the test subject during the examination period was required not only to use the nerve restrained by the fixation of the ultrasonic measurement terminal but also to withstand the ischemic pressure and the ischemic time. In the FMD method, ischemia is generally performed at a pressure of 250 mmHg for 5 minutes, but ischemia due to a pressure of 250 mmHg is accompanied by considerable pain even in about 3 minutes unless a hypertensive person.

  The present invention has been made in view of the above problems, and can suppress a load on a subject, and can provide a stable measurement environment with a simple configuration and a little skill in measurement techniques, such as a blood vessel such as arteriosclerosis. An object of the present invention is to provide a blood vessel function measuring apparatus capable of evaluating a disease index. For example, the following configuration is provided as a means for achieving the object.

That is, constant current supply means for supplying a predetermined constant current between the first biological electrodes mounted on a predetermined portion of the subject's limb spaced apart by a predetermined distance;
Impedance measuring means for measuring a bioimpedance from a voltage value between a plurality of second bioelectrodes mounted at a predetermined distance apart at a predetermined site between the first bioelectrodes;
A pulse wave measuring means for obtaining a pulse wave from the impedance measuring means between the plurality of mounted second biological electrodes,
A pulse wave velocity calculating means for calculating a pulse wave velocity from the pulse wave measuring means;
Cuff control means for pressurizing an internal pressure of a cuff wound around the limb of the subject to which the second bioelectrode is attached;
Blood pressure value measuring means for controlling the cuff control means to measure a blood pressure value;
Ischemic control means for controlling the cuff control means for a certain period of time, and ischemic for a certain period of time by applying a pressure obtained by adding a predetermined pressure to the blood pressure value;
From the bioelectrical impedance and the amount of change before and after releasing the ischemic for a predetermined time, the amount of change and rate of change corresponding to the blood vessel diameter between the second bioelectrodes before and after ischemia And calculating the change amount and change rate of the pulse wave velocity before and after releasing the ischemia for a predetermined time, and calculating the change amount and change rate as an evaluation index for vascular endothelial function. The vascular endothelial function measuring device is provided with an evaluation index output means.

  And, for example, the first bioelectrode separated by a predetermined distance and the bioelectrodes of the plurality of second bioelectrodes separated by a predetermined distance between the first bioelectrodes are mounted inside the cuff. A device for measuring vascular endothelial function is provided.

  Further, for example, the present invention provides an apparatus for measuring vascular endothelial function in which the ischemic control means controls the cuff internal pressure or pressurization time according to the pulse rate obtained by the pulse rate detecting means.

  Further, for example, the present invention provides a blood vessel endothelial function measuring device in which the ischemic control means controls the pressurization time of the cuff internal pressure in accordance with the pulse wave propagation speed obtained by the pulse wave propagation speed calculating means.

  In addition, for example, the calculation control unit measures the change amount and change rate of the bioelectrical impedance and the change amount and change rate of the pulse wave propagation velocity a plurality of times every predetermined time after releasing the ischemia, and the plurality of times The present invention provides a vascular endothelial function measuring apparatus that displays a plurality of vascular endothelial function evaluation indexes calculated based on measurement results, and displays changes in the ratio over time.

  As described above, the vascular endothelial function measuring device of the present invention is intended to solve the problems of conventional vascular endothelial function measurement, and the amount and rate of change of the bioimpedance value before and after ischemia and the pulse rate. Evaluate vascular endothelial function at wave propagation speed and control blood pressure measurement and pulse wave propagation speed to control ischemic pressure and ischemic time, so that the state of blood vessels before and after ischemia can be measured without much technical skill. Measurements and indicators can be evaluated.

  Hereinafter, preferred embodiments of a vascular endothelial function measuring device according to the present invention will be described in detail with reference to the drawings.

  FIG. 1 is a diagram for explaining a basic configuration of a blood vessel function measuring device according to Example 1a and Example 1b, which is an example of the invention according to the present invention, and FIG. 2 is a diagram for explaining a mounting state of a detection unit on a subject in Example 1a. FIG. 3 is a diagram for explaining a mounting state of the detection unit with respect to the subject in Example 1b.

  In FIG. 1, reference numeral 10 denotes an arithmetic control unit that controls the entire apparatus of Example 1a and Example 1b, and incorporates a pre- and post-ischemia comparison unit 12 and a pulse wave velocity calculation unit 13 that will be described in detail later. The arithmetic control unit 10 can be controlled by an operation from the operation unit 15. The arithmetic control unit 10 can control the display unit 16, the recording unit 17, the storage unit 18, the communication unit 19, and others.

  The built-in pre- and post-ischemic comparison unit 12 compares various measured values and measurement results before and after ischemia and calculates a diagnostic index. For example, the impedance change rate before and after ischemia can be compared. Then, an evaluation index of vascular function is derived from these indices, and the result is displayed on the display unit 16, recorded and output to the recording unit 17, stored in the storage unit 18, and connected to an external device via the communication unit 19. It is possible to communicate the results.

  The built-in pulse wave velocity calculation unit 13 obtains the pulse wave velocity from the bioimpedance value measured by the voltage electrodes 41, 42, and 43 and the distance between the voltage electrodes. The calculated pulse wave velocity result is passed to the pre- and post-ischemic comparison unit 12, displayed on the display unit 16, recorded and output to the recording unit 17, stored in the storage unit 18, and via the communication unit 19. It is possible to communicate the result with an external device.

  Reference numeral 20 denotes a blood pressure measurement and ischemia control unit, which measures and measures the blood pressure and pulse rate before ischemia of the subject and forearm ischemia by subjecting the blood pressure measurement / pressurization cuff 22 to pressurization and measurement control.

  The blood pressure measurement and ischemia control unit 20 is also configured by a normal blood pressure measurement device, such as a pressure sensor for detecting the cuff internal pressure, a pressure pump for pressurizing the rubber sac 23 of the cuff 22, and reducing the cuff internal pressure at a constant speed. Thus, for example, a constant speed exhaust valve for performing blood pressure measurement, a quick exhaust valve for rapidly reducing the cuff internal pressure such as in the case of releasing ischemia, a blood pressure determining unit for determining a maximum blood pressure value, a pulse rate, and the like are included. Since these configurations are known, detailed description thereof will be omitted.

  Reference numeral 30 denotes a constant current supply unit capable of supplying a constant current of a predetermined frequency between the constant current electrodes 31 and 32, and includes, for example, an oscillation circuit that oscillates a signal of about 60 kHz and a constant current source. Reference numeral 40 denotes an impedance converter that detects impedance values (bioimpedance) of the voltage electrodes 41, 42, 43 mounted between the constant current electrodes 31, 32 supplied by the constant current supply unit 30. For the voltage electrodes 41, 42, 43, it is desirable to use materials that have stable materials, electrical resistance, and contact with the skin.

  When a minute high-frequency current is passed from the constant current electrodes 31 and 32 between the voltage electrodes 41, 42 and 43, a voltage proportional to the impedance of the tissue existing between the electrodes is detected. In a portion where there is no other organ such as the upper arm or the lower limb, the impedance detected between the voltage electrodes 41, 42, 43 is mainly affected by blood pumped from the heart. The change of the bioelectrical impedance in the time series direction is the impedance volume pulse wave.

  Reference numeral 15 denotes an operation unit that controls various settings of the apparatus and measurement start, end, and stop, 16 denotes a display unit that can display measurement results and diagnostic indicators, explanations of measurement operations, and 17 denotes measurement results and diagnostic indicators. Reference numeral 18 denotes a storage unit for storing measurement results and diagnostic indicators. Reference numeral 19 denotes a communication unit that outputs a measurement result and a diagnostic index to a device such as an external computer by communication, and can record the measurement result and the diagnostic index on a storage medium having a larger capacity than the storage unit 18 via the communication unit 19.

  In Example 1a and Example 1b having the above-described configuration, a method for attaching electrodes and cuffs to a subject will be described with reference to FIGS. 2 and 3.

  The part where the constant current electrodes 31 and 32 are attached to the subject, that is, the measurement part of the subject, is separated by a predetermined distance from the part where the blood vessel can be blocked in the subject's body and where the blood vessel is most simply arranged, for example, the lower limbs or the upper arm It is desirable to install it. Here, a case where the upper arm part is a measurement site will be described as an example.

  In the embodiment 1a shown in FIG. 2, the constant current electrode 31 is attached to the upper arm near the shoulder of the upper arm, and the constant current electrode 32 is attached near the forearm. A blood pressure measurement / ischemic cuff 22 is attached to the upper arm, a voltage electrode 41 is provided between the constant current electrode 31 and the blood pressure measurement / ischemic cuff 22, and a blood pressure measurement / ischemic cuff 22 is provided between the constant current electrode 32. This is an example in which the voltage electrode 42 and the voltage electrode 43 are mounted.

  In addition, about a measurement site | part, you may utilize not only the arm part shown in the said example but another site | part including a leg. Further, for example, a blood pressure measurement / ischemic cuff 22 is attached to the upper arm, a constant current electrode 31 near the upper arm of the forearm, a constant current electrode 32 near the wrist, and a voltage electrode 41, between the constant current electrodes 31, 32. The same measurement is possible even if 42 and 43 are mounted.

  In the present embodiment shown in FIG. 2, a constant current having a predetermined frequency is applied to the constant current electrodes 31 and 32 during impedance measurement.

  The voltage electrodes 41, 42, 43 are mounted between the constant current electrodes 31, 32. The voltage electrodes 41 and 42 are mounted via a voltage electrode fixing jig 45 that positions and fixes the distance between the voltage electrodes 41 and 42 at a predetermined distance L1 and the distance between the voltage electrodes 42 and 43 at a predetermined distance L2. In addition, as long as the method of attaching this electrode is a method in which the voltage electrode fixing jig 45 and the electrodes 41, 42, 43 are not detached, any method can be adopted.

The voltage electrodes 42 and 43 are positioned and fixed at a predetermined distance L2 [cm] by using the voltage electrode fixing jig 35 to fix the bioimpedance at the voltage electrodes 42 and 43 with the voltage electrode 41 as a reference. This is to obtain the pulse wave velocity from the measurement data. For example, the pulse wave propagation velocity Vpwv1 when the peak of the waveform appears in the measurement data of the bioimpedance obtained at the voltage electrode 43 after s1 [sec] from the peak of the waveform of the measurement data of the bioimpedance obtained at the voltage electrode 42. [cm / sec] is Vpwv1 = L2 / s1 [cm / sec]
It becomes.

  Another reason for fixing the voltage electrodes 41 and 42 by using the voltage electrode fixing jig 35 is that the distance between the voltage electrodes 41 and 42 is fixed at a predetermined distance L1 and the distance between the voltage electrodes 42 and 43 is fixed at a predetermined distance L2. This is for facilitating relative comparison of the measurement results before and after and accurately detecting minute fluctuations. Thereby, even if the subject changes or the measurement date changes, the separation distance is constant, so that a quantitative measurement result can be obtained.

  Moreover, you may use the form of Example 1b shown in FIG. FIG. 4 is a structural diagram of the inside of the blood pressure measurement / ischemic cuff 22 used in Example 1b shown in FIG. The constant current electrodes 31 and 32 are disposed near both edges of the cuff winding circumferential direction of the blood pressure measurement / ischemic cuff 22, and the voltage electrode 41 and the voltage electrode 43 are disposed at positions spaced apart from each other by a predetermined distance. . Further, the distance between the voltage electrodes 41 and 42 is set to be a predetermined distance L1, and the distance between the voltage electrodes 42 and 43 is set to be a predetermined distance L2. It is desirable to use bendable materials for the constant current electrodes 31 and 32 and the voltage electrodes 41, 42 and 43. With this structure, as shown in FIG. 3, not only the preparation for measurement is completed simply by attaching the blood pressure measurement / ischemic cuff 22 to the measurement site (here, the upper arm), but also the interval between the voltage electrodes 41 and 42. Since L1 and the distance between the voltage electrodes 42 and 43 are always constant at L2, a quantitative measurement result can be obtained.

  The vascular endothelial function measuring method of the present embodiment as described above will be described below with reference to the flowchart of FIG.

  In the present embodiment, first, in process S1 of FIG. 5, as shown in FIG. 2 or FIG. 3, an electrode and a cuff are attached to a predetermined part of the subject. When the wearing ends, the process proceeds to step S2, and the arithmetic control unit 10 activates the blood pressure measurement and ischemia control unit 20 to measure the blood pressure of the subject, particularly the maximum blood pressure value and the pulse rate.

  The measurement result is stored in the storage unit 18 and displayed on the display unit 16. Moreover, it outputs to the communication part 19 as needed.

  In the case where blood pressure is manually measured by a doctor or the like, the electrodes and cuffs in process S1 may be attached after the blood pressure measurement in process S2.

  Then, it progresses to process S3 and a bioimpedance is measured for predetermined time as a measurement process of the vascular state before ischemia. Here, the measurement data of the bioimpedance between the voltage electrodes 41 and 42 is acquired by the impedance converter 40.

  The data acquisition result is stored in the storage unit 18 and the pulse wave impedance graph drawn on the time axis is displayed on the display unit 16, and the pulse wave propagation velocity obtained by the pulse wave propagation velocity calculation unit 13 is also stored in the storage unit 18. To do. Moreover, it outputs to the communication part 19 as needed.

  Next, in process S4, the arithmetic control unit 10 activates the blood pressure measurement and ischemia control unit 20 to pressurize the blood pressure measurement / ischemic cuff 22 and is ischemic for a predetermined time with the upper arm of the subject. In this embodiment, the cuff internal pressure is maintained at a pressure that is higher by about 30 to 50 mmHg than the maximum blood pressure value measured in step S2 for about 3 minutes.

  In order to reduce the burden on the subject at the time of ischemia, the pressure used for ischemia and the ischemia time may be adjusted according to the maximum blood pressure value or the pulse rate measured in step S2, for example.

  If sufficient ischemia is possible, the ischemia time and the ischemic pressure may be constant. In this case, the process S2 can be omitted, and the time burden on the subject can be reduced.

  Subsequently, in process S5, after a predetermined time has elapsed (after about 3 minutes in the present embodiment), the arithmetic control unit 10 controls the blood pressure measurement and ischemia control unit 20 to activate a built-in quick open valve (not shown). Then, the internal pressure of the blood pressure measurement / ischemic cuff 22 is rapidly reduced to release the ischemic state. Then, the process proceeds to process S6.

  In the process S6, after the ischemia is released, the measurement of the bioelectrical impedance for a predetermined time is obtained as in the process S3, the measurement data is acquired, the data acquisition result is stored in the storage unit 18, and the pulse wave impedance graph is drawn on the display unit 16 on the time axis. Is displayed, and the pulse wave velocity calculated by the pulse wave velocity calculator 13 is also stored in the storage unit 18. Moreover, it outputs to the communication part 19 as needed.

  Then, after the measurement is completed or during the measurement, in the process S7, the measurement data in the process S3 and the measurement data in the process S6 are calculated by the pre-ischemia comparison unit 12 to measure the state of the vascular endothelial function one by one. When the amount of change is larger, it is judged that the vascular endothelial function state is better, and is displayed on the display unit 16 as an index for identifying the state of the vascular endothelial function, and recorded and output from the recording unit 17. Further, it is stored in the storage unit 18 or output to the communication unit 19 as necessary.

  Then, in process S8, it is determined whether or not the predetermined time, the number of times of measurement, or measurement data that is considered sufficient for evaluation of the vascular endothelial function has been collected. If none of the conditions is satisfied, the process returns to process S6. If these conditions are satisfied, the process proceeds to step S9.

  Finally, in process S9, evaluation of the vascular endothelial function based on the above measurement and analysis results is performed as necessary.

  Since the measurement of the present embodiment is performed based on the change in impedance between the voltage electrodes 41, 42, and 43, the change in blood flow can be easily measured.

  As described above, according to the present invention, it is possible to provide a stable measurement environment while suppressing the load on the subject and having a simple configuration without much skill in measurement techniques.

It is a figure for demonstrating the structure of the vascular endothelial function measuring apparatus of the embodiment of one invention concerning this invention. It is a figure for demonstrating the mounting state of the electrode and cuff of this Embodiment 1a. It is a figure for demonstrating the mounting state of the cuff (illustrated in FIG. 4) of this Embodiment 1b. It is a figure for demonstrating the structure figure of the cuff in this Embodiment 1b. It is a flowchart figure for demonstrating the vascular endothelial function measurement procedure of the example of this Embodiment.

Explanation of symbols

10 ··········· Calculation control unit 12 ································································・ ・ ・ Operation unit 16 ・ ・ ・ ・ ・ ・ ・ ・ ・ Display unit 17 ・ ・ ・ ・ ・ ・ ・ ・ Recording unit 18 ・ ・ ・ ・ ・ ・ ・ ・ Storage unit 19 ・ ・ ・ ・ ・ ・ ・ ・・ Communication unit 20 ・ ・ ・ ・ ・ ・ ・ ・ ・ Blood pressure measurement and ischemia control unit 22 ・ ・ ・ ・ ・ ・ ・ ・ ・ ・ ・ Blood pressure measurement / ischemic cuff 23 ・ ・ ・ ・ ・ ・ ・ ・ ・ Rubber bag 30 ・ ・.... Constant current supply unit 31, 32 ... Constant current electrode 40 ... Impedance converter 41, 42, 43 ... Voltage electrode

Claims (6)

A constant current supply means for supplying a predetermined constant current between first biological electrodes mounted on a predetermined portion of the subject's limb that is separated by a predetermined distance;
Impedance measuring means for measuring a bioimpedance from a voltage value between a plurality of second bioelectrodes mounted at a predetermined distance apart at a predetermined site between the first bioelectrodes;
Pulse wave measuring means for obtaining pulse waves from the impedance measuring means between the plurality of second biological electrodes mounted;
A pulse wave velocity calculating means for calculating a pulse wave velocity from the pulse wave measuring means;
Cuff control means for pressurizing an internal pressure of a cuff wound around the limb of the subject to which the second bioelectrode is attached;
Blood pressure value measuring means for controlling the cuff control means to measure a blood pressure value;
Ischemic control means for controlling the cuff control means for a certain period of time, and ischemic for a certain period of time by applying a pressure obtained by adding a predetermined pressure to the blood pressure value;
From the bioelectrical impedance and the amount of change before and after releasing the ischemic for a predetermined time, the amount of change and rate of change corresponding to the blood vessel diameter between the second bioelectrodes before and after ischemia And calculating the change amount and change rate of the pulse wave velocity before and after releasing the ischemia for a predetermined time, and calculating the change amount and change rate as an evaluation index for vascular endothelial function. An vascular endothelial function measuring apparatus comprising: an evaluation index output means. A constant current supply means for supplying a predetermined constant current between first biological electrodes mounted on a predetermined part separated by a predetermined distance in the subject's limb;
Impedance measuring means for measuring a bioimpedance from a voltage value between a plurality of second bioelectrodes mounted at a predetermined distance apart at a predetermined site between the first bioelectrodes;
Pulse wave measuring means for obtaining pulse waves from the impedance measuring means between the plurality of second biological electrodes mounted;
A pulse wave velocity calculating means for calculating a pulse wave velocity from the pulse wave measuring means;
Cuff control means for pressurizing an internal pressure of a cuff wound around the limb of the subject to which the second bioelectrode is attached;
Ischemic control means for controlling the cuff control means for a certain time and applying a constant pressure for ischemia for a certain time;
From the bioelectrical impedance and the amount of change before and after releasing the ischemic for a predetermined time, the amount of change and rate of change corresponding to the blood vessel diameter between the second bioelectrodes before and after ischemia And calculating the change amount and change rate of the pulse wave velocity before and after releasing the ischemia for a predetermined time, and calculating the change amount and change rate as an evaluation index for vascular endothelial function. An vascular endothelial function measuring apparatus comprising: an evaluation index output means.   The first bioelectrode spaced apart by a predetermined distance and the plurality of second biological electrodes spaced apart by a predetermined distance between the first biological electrodes are mounted inside the cuff. 2. The vascular endothelial function measuring device according to 2.   4. The vascular endothelial function measuring device according to claim 1, wherein the ischemic control means controls the pressurization time of the cuff internal pressure in accordance with the pulse rate obtained by the pulse rate detecting means.   4. The vascular endothelial function measuring device according to claim 1, wherein the ischemic control means controls the pressurization time of the cuff internal pressure in accordance with the pulse wave propagation speed obtained by the pulse wave propagation speed calculating means.   The calculation control means measures the change amount and change rate of the bioelectrical impedance and the change amount and change rate of the pulse wave propagation speed a plurality of times every predetermined time after the release of the ischemia, and results in the measurement results of the plurality of times. 6. The vascular endothelial function measuring device according to claim 1, wherein a time change of the ratio is displayed for a plurality of vascular endothelial function evaluation indexes calculated based on the index.

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