CN102058429B - Hyperglycemia control system - Google Patents
Hyperglycemia control system Download PDFInfo
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- CN102058429B CN102058429B CN2009102018102A CN200910201810A CN102058429B CN 102058429 B CN102058429 B CN 102058429B CN 2009102018102 A CN2009102018102 A CN 2009102018102A CN 200910201810 A CN200910201810 A CN 200910201810A CN 102058429 B CN102058429 B CN 102058429B
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Abstract
The invention relates to the field of medical treatment, and discloses a hyperglycemia control system. In the invention, a first mapping relationship of height, body weight, and body surface area and a second mapping relationship of the body surface area, a blood sugar value and an insulin dosage value are prestored through a storage module. The required insulin dosage value is obtained through inquiry of the first mapping relationship and the second mapping relationship after the height, the body weight and the current measured blood sugar value are acquired, so that the required insulin dosage value for controlling the hyperglycemia of a patient can be obtained completely by means of software automation, the requirement on medical personnel is reduced, and simultaneously the accuracy and rapidity of the adopted medical treatment measures are ensured effectively.
Description
Technical field
The present invention relates to medical field, particularly the hyperglycemia control technology in the medical field.
Background technology
Hyperglycemia causes that owing to defect of insulin secretion or biological agent obstacle or both exist simultaneously significantly the symptom of hyperglycemia includes polyuria, excessive thirst, polyphagia, weight loss etc.Hyperglycemia causes that life-threatening emergency has ketoacidosis or non-ketosis hyperosmolar coma (or hypertonicity syndrome).And hyperglycemia also can cause various acute or chronic complication.
At present, the heavy disease of ICU has concurrent stress hyperglycemia more than 30% approximately.Studies confirm that stress hyperglycemia (particularly acute stage) is one of key factor that influences prognosis, and closely related with patient's dead residual rate.According to large research statistics, when blood glucose was 4.4-8.3mmol/L, mortality rate was 12.5%; When continuing to be higher than 11.1mmol/L, mortality rate is up to 35.5%.
This shows that the control of patient's hyperglycemia is had extremely important meaning.But existing blood glucose control methods lack quantizating index more, time and effort consuming, and effect is also not satisfactory.
Specifically, domesticly generally recommend the premix subcutaneous injection of insulin, or insulin pump carries out the insulin strengthening treatment.Yet this mode all needs to begin medication from low dosage by rule of thumb, often needs just can reach target blood glucose more than 3-5 days, has missed the gold opportunity of acute stage correction hyperglycemia.
And blood glucose management mode control hyperglycemia is strengthened in the use of some experts' propositions abroad, though obtained effect preferably, it makes Blood glucose control reach quantification and continuous, has obviously reduced the ICU mortality rate, has shortened patient ICU and has lived between the Time of institute.But this method operates very complicated, and the blood glucose reaching standard time is still longer.
Summary of the invention
The object of the present invention is to provide a kind of hyperglycemia control system, make the required insulin dosage value that is used for control patient hyperglycemia can be obtained by software automation fully, greatly reduce the requirement to the medical worker who is responsible for the blood glucose regulation and control, reduce the probability of human error simultaneously, effectively guaranteed the accuracy of the medical measure taked and property rapidly.
For solving the problems of the technologies described above, embodiments of the present invention provide a kind of hyperglycemia control system, comprise:
First memory module, first mapping relations that are used for storing height, body weight and body surface area, wherein, a kind of height and the unique corresponding body surface area of the combination of body weight;
Second memory module, for second mapping relations of memory bank surface area, blood glucose value and insulin dosage value, wherein, a kind of body surface area and the unique corresponding insulin dosage value of the combination of blood glucose value;
Acquisition module is for the blood glucose value that obtains patient's height, body weight and current measurement according to user's input;
Enquiry module, be used for inquiring about first mapping relations according to height, body weight that acquisition module obtains, obtain the body surface area of unique correspondence, the blood glucose value of the current measurement of obtaining according to the body surface area that obtains and acquisition module, inquire about second mapping relations, obtain the insulin dosage value of unique correspondence;
Output module is used for exporting the insulin dosage value that enquiry module inquires to the user; Enquiry module is after obtaining the insulin dosage value of unique correspondence, and the indication output module is exported the insulin dosage value that inquires.
Embodiment of the present invention compared with prior art, the main distinction and effect thereof are:
Store second mapping relations of first mapping relations, body surface area, blood glucose value and the insulin dosage value of height, body weight and body surface area in advance by memory module.Behind the blood glucose value that gets access to patient's height, body weight and current measurement, enquiry module is by the inquiry of first mapping relations, obtain the body surface area of unique correspondence, pass through the inquiry of second mapping relations again, obtain the insulin dosage value of unique correspondence, the insulin dosage value that output module output inquires.Make the required insulin dosage value that is used for control patient hyperglycemia can be obtained by software automation fully, greatly reduce the requirement to the medical worker, provide feasibility for the task of regulating and controlling blood sugar being given the relative medical worker more shallow, that Professional knowledge is more weak relatively of experience, as long as veteran doctor opens corresponding doctor's advice, need not spend more time for regulating and controlling blood sugar, thereby effectively improve healthcare givers's resource utilization.And the medical worker only need provide the blood glucose value of patient's height, body weight and current measurement, and required insulin dosage value is obtained by software automation, has reduced the probability of human error, has effectively guaranteed the accuracy of the medical measure taked and property rapidly.
Further, acquisition module periodically obtains the blood glucose value of the current measurement of described patient, and behind the blood glucose value that gets access to the current measurement of described patient each time, the indication enquiry module carries out the inquiry of described second mapping relations.Enquiry module indicates described output module to export the insulin dosage value that inquires after inquiring the insulin dosage value of unique correspondence each time.By periodically detecting, regulating and control, can make the blood glucose regulation and control not stay the blind area, make the patient reach target blood glucose as soon as possible, effectively reduce hyperglycemia to the critically ill patient's of ICU harmful effect.
Further, first mapping relations are
Second mapping relations are insulin dosage value=[body surface area * 30 * 0.6 * 1000 * [(blood glucose value of current measurement-0.1)/100] ÷ 2]/3;
Wherein, the unit of described insulin dosage value is U, and the unit of body surface area is m
2, the unit of height is cm, and the unit of body weight is kg, and the unit of the blood glucose value of current measurement is g/dl.Prove by a large amount of clinical practices, can control hyperglycemia in time, effectively, steadily, easily by the required insulin dosage value of above-mentioned formula gained, reduced ICU critical patient's incidence of nosocomial infection and case fatality rate.
Further, the hyperglycemia control system also comprises the 3rd memory module, is used for storage blood glucose value, the insulin value of empty stomach state and the 3rd mapping relations of insulin resistance index IRI of state on an empty stomach; Acquisition module also is used for obtaining the blood glucose value of state on an empty stomach and the insulin value of state on an empty stomach; Enquiry module is also inquired about described the 3rd mapping relations for the blood glucose value of the empty stomach state that obtains according to described acquisition module and the insulin value of empty stomach state, obtain the IRI of unique correspondence, and indicate described output module to export the IRI that described enquiry module inquires to described user.Because insulin resistance index IRI is one of performance parameter that effectively embodies patient's islet function, therefore by software automation draw IRI, can further make the medical worker can understand patient's islet function rapidly, exactly.
Further, the hyperglycemia control system also comprises the 4th memory module, be used for the storage blood glucose value of state on an empty stomach, the insulin value of empty stomach state and the 4th mapping relations of β cell function index BCFI, acquisition module also is used for obtaining the blood glucose value of state on an empty stomach and the insulin value of state on an empty stomach, enquiry module is also inquired about described the 4th mapping relations for the blood glucose value of the empty stomach state that obtains according to described acquisition module and the insulin value of empty stomach state, obtain the BCFI of unique correspondence, and indicate described output module to export the BCFI that described enquiry module inquires to described user.Because β cell function index BCFI is one of performance parameter that effectively embodies patient's islet function, therefore by software automation draw BCFI, can further make the medical worker can understand patient's islet function rapidly, exactly.
Description of drawings
Fig. 1 is the structural representation according to the hyperglycemia control system of first embodiment of the invention;
Fig. 2 is according to the storage of first mapping relations in first embodiment of the invention sketch map;
Fig. 3 is according to the storage of second mapping relations in first embodiment of the invention sketch map.
The specific embodiment
In the following description, in order to make the reader understand the application better many ins and outs have been proposed.But, persons of ordinary skill in the art may appreciate that even without these ins and outs with based on many variations and the modification of following each embodiment, also can realize each claim of the application technical scheme required for protection.
For making the purpose, technical solutions and advantages of the present invention clearer, below in conjunction with accompanying drawing embodiments of the present invention are described in further detail.
First embodiment of the invention relates to a kind of hyperglycemia control system.As shown in Figure 1, this hyperglycemia control system comprises:
First memory module, first mapping relations that are used for storing height, body weight and body surface area, wherein, a kind of height and the unique corresponding body surface area of the combination of body weight.
Second memory module, for second mapping relations of memory bank surface area, blood glucose value and insulin dosage value, wherein, a kind of body surface area and the unique corresponding insulin dosage value of the combination of blood glucose value.
Acquisition module is for the blood glucose value that obtains patient's height, body weight and current measurement according to user's input.
Enquiry module, be used for inquiring about first mapping relations according to height, body weight that acquisition module obtains, obtain the body surface area of unique correspondence, the blood glucose value of the current measurement of obtaining according to the body surface area that obtains and acquisition module, inquire about second mapping relations, obtain the insulin dosage value of unique correspondence.
Output module is used for exporting the insulin dosage value that enquiry module inquires to the user.Enquiry module is after obtaining the insulin dosage value of unique correspondence, and the indication output module is exported the insulin dosage value that inquires.
In the present embodiment, first mapping relations of first memory module storage are as follows:
Wherein, the unit of body surface area is m
2, the unit of height is cm, the unit of body weight is kg.Specifically can be by the form storage of table, as shown in Figure 2, abscissa is represented body weight, and vertical coordinate is represented height, can uniquely determine a numerical value (representing this numerical value with asterisk among Fig. 2) according to each concrete body weight value and height values, this numerical value is the body surface area that obtains according to above-mentioned formula (1).
Second mapping relations of second memory module storage are as follows:
Insulin dosage value=[body surface area * 30 * 0.6 * 1000 * [(blood glucose value of current measurement-0.1)/100] ÷ 2]/3 (2)
Wherein, the unit of insulin dosage value is U, and the unit of body surface area is m
2, the unit of the blood glucose value of current measurement is g/dl.Specifically can be by the form storage of table, as shown in Figure 3, abscissa is represented body surface area, vertical coordinate is represented the blood glucose value of current measurement, blood glucose value according to each concrete body surface area and current measurement, can uniquely determine a numerical value (representing this numerical value with asterisk among Fig. 3), this numerical value is the insulin dosage value that obtains according to above-mentioned formula (2).Prove by a large amount of clinical practices, can control hyperglycemia in time, effectively, steadily, easily by the required insulin dosage value of above-mentioned formula gained, reduced ICU critical patient's incidence of nosocomial infection and case fatality rate.
Specifically, the medical worker obtains patient's the finger tip blood glucose of height, body weight, current detection in detection after, can be input in the hyperglycemia control system by the finger tip blood glucose of human-computer interaction interface with the height surveyed, body weight, current detection.Obtained the occurrence (be 60kg as body weight, height is 170cm, and finger tip blood glucose is 12.5mmol/L) of the finger tip blood glucose of this height, body weight, current detection by the acquisition module in the hyperglycemia control system.Enquiry module is by the inquiry to first mapping relations, and the body surface area that obtains this patient (is 1.68m
2), obtain this patient's insulin dosage value (being 12U) again by the inquiry to second mapping relations, and the indication output module demonstrates the insulin dosage value that inquires by man machine interface, make the medical worker behind the finger tip blood glucose of height, body weight that input is surveyed, current detection, can know the insulin dosage value that this patient is required rapidly.After learning the required insulin dosage value of this patient, the medical worker can be with Micropump intravenous methods commonly used, " neutralization " hyperglycemia.As be the normal saline of insulin (as Novolin R) the adding 1ml of per unit, with Micropump persistent intravenous injection (quiet notes in 1 hour).
After each hour, the medical worker detects the current finger tip blood glucose of patient again, and be input in the hyperglycemia control system, that is to say, acquisition module periodically (cycle is 1 hour) obtains the blood glucose value of the current measurement of patient, acquisition module is behind the blood glucose value that gets access to the current measurement of patient each time, the indication enquiry module carries out the inquiry of second mapping relations, obtain current required insulin dosage value, be shown to the medical worker by output module, make the medical worker to carry out the regulation and control of blood glucose to the patient per hour according to the dosage of finger tip blood sugar regulating Novolin R.By periodically detecting, regulating and control, can make the blood glucose regulation and control not stay the blind area, make the patient reach target blood glucose as soon as possible, effectively reduce hyperglycemia to the critically ill patient's of ICU harmful effect.
In addition, be appreciated that present embodiment with the cycle be 1 hour be that example describes, according to actual needs, also can be set at 1.5 hours the cycle, 2 hours etc.
What deserves to be mentioned is, when detected blood glucose＜3.9mmol/L, by every reduction 1mmol/L, with 5 gram glucose intravenous injections, change and survey 1 time/30min of blood glucose, determine whether need intravenous injection glucose again by survey blood glucose, be higher than 4.4mmol/L until blood glucose, change every 1h monitoring finger tip blood glucose into.If blood glucose is higher than 8.3mmol/L, adopt " titration " pattern (being the control methods of above-mentioned hyperglycemia) regulating and controlling blood sugar in real time again.
Be not difficult to find, in the present embodiment, store second mapping relations of first mapping relations, body surface area, blood glucose value and the insulin dosage value of height, body weight and body surface area in advance by memory module.Behind the blood glucose value that gets access to patient's height, body weight and current measurement, enquiry module is by the inquiry of first mapping relations, obtain the body surface area of unique correspondence, pass through the inquiry of second mapping relations again, obtain the insulin dosage value of unique correspondence, the insulin dosage value that output module output inquires.Make the required insulin dosage value that is used for control patient hyperglycemia can be obtained by software automation fully, greatly reduce the requirement to the medical worker, provide feasibility for the task of regulating and controlling blood sugar being given the relative medical worker (as the nurse) more shallow, that Professional knowledge is more weak relatively of experience, as long as veteran doctor opens corresponding doctor's advice, need not spend more time for regulating and controlling blood sugar, thereby effectively improve healthcare givers's resource utilization.And the medical worker only need provide the blood glucose value of patient's height, body weight and current measurement, and required insulin dosage value is obtained by software automation, has reduced the probability of human error, has effectively guaranteed the accuracy of the medical measure taked and property rapidly.
And, because present embodiment can in time, effectively, steadily quantize the titration hyperglycemia, be expected to improve the prognosis of ICU Cavity in Critical Patients, can obviously reduce medical worker's workload simultaneously, therefore have the certain social meaning.And, owing to be applicable to each ICU of the whole nation, being widely used, economic benefit is obvious.In addition, by in time, effectively control critical patient's stress hyperglycemia, can reduce incidence of nosocomial infection and case fatality rate, also alleviate patient's medical expense, therefore also have certain economic benefits.
Need to prove that first mapping relations in the present embodiment, second mapping relations are to sum up out according to a large amount of clinical practice proofs.If the continuous development along with Medical Technology, extract other with the account form of effective insulin dosage value, then can change first mapping relations in the present embodiment and/or second mapping relations fully, in order to further control hyperglycemia in time, effectively, steadily, easily, to reduce ICU critical patient's incidence of nosocomial infection and case fatality rate.
Second embodiment of the invention relates to a kind of hyperglycemia control system.Second embodiment improves on the basis of first embodiment, main improvements are: the hyperglycemia control system also comprises the 3rd memory module, is used for storage blood glucose value, the insulin value of empty stomach state and the 3rd mapping relations of insulin resistance index IRI of state on an empty stomach; The 4th memory module is used for storage blood glucose value, the insulin value of empty stomach state and the 4th mapping relations of β cell function index BCFI of state on an empty stomach.Wherein, a kind of blood glucose value of empty stomach state and the unique corresponding insulin resistance index of combination of the insulin value of state on an empty stomach.A kind of blood glucose value of empty stomach state and the unique corresponding β cell function index of combination of the insulin value of state on an empty stomach.
Acquisition module also is used for obtaining the blood glucose value of state on an empty stomach and the insulin value of state on an empty stomach.
Enquiry module is also inquired about the 3rd mapping relations and/or the 4th mapping relations for the blood glucose value of the empty stomach state that obtains according to acquisition module and the insulin value of empty stomach state, obtain IRI and/or the BCFI of unique correspondence, and the indication output module is exported IRI and/or the BCFI that enquiry module inquires to the user.
Because insulin resistance index IRI and β cell function index BCFI are one of performance parameters that effectively embodies patient's islet function, therefore by software automation draw IRI and BCFI, can further make the medical worker can understand patient's islet function rapidly, exactly.
In the present embodiment, the 3rd mapping relations of the insulin value of the blood glucose value of state, empty stomach state and insulin resistance index IRI are as follows on an empty stomach:
IRI=(the insulin value of the blood glucose value * empty stomach state of state on an empty stomach)/22.5 (3)
Wherein, the unit of the blood glucose value of state is mmol/L on an empty stomach, and the unit of the insulin value of state is uU/ml on an empty stomach, can store the 3rd mapping relations by the form of table equally.
The 4th mapping relations of the insulin value of the blood glucose value of state, empty stomach state and β cell function index BCFI are as follows on an empty stomach:
BCFI＝F
INS/FPG (4)
Wherein, the unit of the blood glucose value (FPG) of state is mmol/L on an empty stomach, on an empty stomach the insulin value (F of state
INS) unit be uU/ml, equally can by the table form store the 4th mapping relations.
Though pass through with reference to some of the preferred embodiment of the invention, the present invention is illustrated and describes, but those of ordinary skill in the art should be understood that and can do various changes to it in the form and details, and without departing from the spirit and scope of the present invention.
Claims (9)
1. a computer based hyperglycemia control system is characterized in that, comprises:
First memory module, first mapping relations that are used for storing height, body weight and body surface area, wherein, a kind of height and the unique corresponding body surface area of the combination of body weight;
Second memory module, for second mapping relations of memory bank surface area, blood glucose value and insulin dosage value, wherein, a kind of body surface area and the unique corresponding insulin dosage value of the combination of blood glucose value;
Acquisition module is for the blood glucose value that obtains patient's height, body weight and current measurement according to user's input;
Enquiry module, be used for inquiring about described first mapping relations according to height, body weight that described acquisition module obtains, obtain the body surface area of unique correspondence, the blood glucose value of the described current measurement of obtaining according to the described body surface area that obtains and described acquisition module, inquire about described second mapping relations, obtain the insulin dosage value of unique correspondence;
Output module is used for exporting the described insulin dosage value that described enquiry module inquires to described user; Described enquiry module indicates described output module to export the described insulin dosage value that inquires after obtaining the insulin dosage value of described unique correspondence;
Second mapping relations of described body surface area, blood glucose value and insulin dosage value are as follows:
Insulin dosage value=[body surface area * 30 * 0.6 * 1000 * [(blood glucose value of current measurement-0.1)/100] ÷ 2]/3;
Wherein, the unit of described insulin dosage value is U, and the unit of body surface area is m
2, the unit of the blood glucose value of current measurement is g/dl.
2. computer based hyperglycemia control system according to claim 1 is characterized in that described acquisition module periodically obtains the blood glucose value of the current measurement of described patient;
Described acquisition module indicates described enquiry module to carry out the inquiry of described second mapping relations behind the blood glucose value that gets access to the current measurement of described patient each time;
Described enquiry module indicates described output module to export the insulin dosage value that inquires after inquiring the insulin dosage value of unique correspondence each time.
3. computer based hyperglycemia control system according to claim 2 is characterized in that, the cycle of obtaining is 1 hour.
4. computer based hyperglycemia control system according to claim 1 is characterized in that, first mapping relations of described height, body weight and body surface area are as follows:
Wherein, the unit of described body surface area is m
2, the unit of height is cm, the unit of body weight is kg.
5. computer based hyperglycemia control system according to claim 1 is characterized in that, the blood glucose value of described current measurement is the current blood glucose value that measures at patient's finger tip.
6. according to each described computer based hyperglycemia control system in the claim 1 to 5, it is characterized in that described hyperglycemia control system also comprises the 3rd memory module, be used for storage blood glucose value FPG, the insulin value F of empty stomach state of state on an empty stomach
INSWith the 3rd mapping relations of insulin resistance index IRI, wherein, the insulin value F of a kind of blood glucose value FPG of empty stomach state and empty stomach state
INSThe unique corresponding insulin resistance index IRI of combination;
Described acquisition module also is used for obtaining the blood glucose value FPG of empty stomach state and the insulin value F of empty stomach state
INS
Described enquiry module is also for the blood glucose value FPG of the empty stomach state that obtains according to described acquisition module and the insulin value F of empty stomach state
INSInquire about described the 3rd mapping relations, obtain the insulin resistance index IRI of unique correspondence, and indicate described output module to export the insulin resistance index IRI that described enquiry module inquires to described user.
7. computer based hyperglycemia control system according to claim 6 is characterized in that, the insulin value F of the blood glucose value FPG of described empty stomach state, empty stomach state
INSAs follows with the 3rd mapping relations of insulin resistance index IRI:
IRI=(the insulin value F of the blood glucose value FPG * empty stomach state of empty stomach state
INS)/22.5;
Wherein, the unit of the blood glucose value FPG of described empty stomach state is mmol/L, the insulin value F of described empty stomach state
INSUnit be uU/ml.
8. computer based hyperglycemia control system according to claim 6 is characterized in that, described hyperglycemia control system also comprises the 4th memory module, is used for storage blood glucose value FPG, the insulin value F of empty stomach state of state on an empty stomach
INSWith the 4th mapping relations of β cell function index BCFI, wherein, the insulin value F of a kind of blood glucose value FPG of empty stomach state and empty stomach state
INSThe unique corresponding β cell function index BCFI of combination;
Described acquisition module also is used for obtaining the blood glucose value FPG of empty stomach state and the insulin value F of empty stomach state
INS
Described enquiry module is also for the blood glucose value FPG of the empty stomach state that obtains according to described acquisition module and the insulin value F of empty stomach state
INSInquire about described the 4th mapping relations, obtain the β cell function index BCFI of unique correspondence, and indicate described output module to export the β cell function index BCFI that described enquiry module inquires to described user.
9. computer based hyperglycemia control system according to claim 8 is characterized in that, the insulin value F of the blood glucose value FPG of described empty stomach state, empty stomach state
INSAs follows with the 4th mapping relations of β cell function index BCFI:
BCFI＝F
INS/FPG；
Wherein, the unit of the blood glucose value FPG of described empty stomach state is mmol/L, the insulin value F of described empty stomach state
INSUnit be uU/ml.
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| CN85104764A (en) * | 1985-06-13 | 1986-12-10 | 王之嵘 | Portable and practical calculating device for clinic doctors |
| CN1516562A (en) * | 2002-04-25 | 2004-07-28 | 松下电器产业株式会社 | Dosage determination support device, syringe, and health-care support system |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN85104764A (en) * | 1985-06-13 | 1986-12-10 | 王之嵘 | Portable and practical calculating device for clinic doctors |
| CN1516562A (en) * | 2002-04-25 | 2004-07-28 | 松下电器产业株式会社 | Dosage determination support device, syringe, and health-care support system |
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| Title |
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| 抢救糖尿病酮症酸中毒患者常见的失误与对策;王龙玉;《中华现代中西医杂志》;20030630;第1卷(第3期);正文 * |
| 王龙玉.抢救糖尿病酮症酸中毒患者常见的失误与对策.《中华现代中西医杂志》.2003,第1卷(第3期),正文. |
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