CN111653372A - Blood coagulation factor calculation platform and method for treating hemophilia - Google Patents
Blood coagulation factor calculation platform and method for treating hemophilia Download PDFInfo
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/02042—Determining blood loss or bleeding, e.g. during a surgical procedure
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/70—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for mining of medical data, e.g. analysing previous cases of other patients
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H70/00—ICT specially adapted for the handling or processing of medical references
- G16H70/40—ICT specially adapted for the handling or processing of medical references relating to drugs, e.g. their side effects or intended usage
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H80/00—ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
Abstract
The invention discloses a blood coagulation factor calculation platform and a blood coagulation factor calculation method for treating hemophilia, wherein a bleeding information acquisition unit is used for recording and acquiring bleeding information of a patient; the bleeding information evaluation unit is combined with the expert consensus database unit to evaluate the bleeding information input and collected by the patient and determine whether the patient needs to perform an operation; the blood coagulation factor calculation unit is used for calculating the administration dosage and the treatment course according to different conditions of operation or non-operation after the fact that whether the operation is needed or not is obtained; and the expert consensus database unit is used for storing and managing the patient condition evaluation standard and the blood coagulation factor supplement standard. The individual administration dosage can be calculated according to different types, different parts and different degrees of bleeding, operation, non-operation and other conditions by combining the body weight of the patient and the activity basic level of the blood coagulation factor, and the corresponding administration treatment course is recommended so as to achieve the individual treatment of the hemophilia patient.
Description
Technical Field
The invention relates to the technical field of medical treatment, in particular to a blood coagulation factor calculation platform and a blood coagulation factor calculation method for treating hemophilia.
Background
Hemophilia is a recessive inherited bleeding disorder in which the X chromosome gene is mutated to cause deficiency of the associated coagulation factor, which can be classified into hemophilia a (coagulation factor viii (fviii) deficiency) and hemophilia B (coagulation factor ix (fix) deficiency) depending on the type of coagulation factor that is deficient. Epidemiological investigation in China shows that hemophilia patients are 2.73/10 ten thousand. The incidence rate of hemophilia is far greater for men than women, the incidence rate of hemophilia A is 80.0-85.0%, and the incidence rate of hemophilia B is 15.0-20.0%. FVIII is mainly synthesized in the liver, vascular endothelium, etc., whereas FIX is a vitamin K dependent coagulation factor, mainly synthesized in the middle. Depending on the level of FVIII/FIX activity, haemophila a and B can be further classified into 3 classes: light (> 5% -40%; major surgery or trauma can cause severe bleeding, rare spontaneous bleeding); intermediate type (1% -5%; severe bleeding after minor surgery/trauma, occasional spontaneous bleeding); heavy (< 1%; spontaneous bleeding in muscles or joints).
Hemophilia is characterized by spontaneous bleeding that occurs to varying degrees from childhood, often with life-long, with repeated minor trauma or delayed after minor surgery, and which, if left untreated, can lead to joint deformity and pseudotumor formation, with low incidence but high disability rates, and serious ones that can endanger the life of the patient. Clinically, hemophilia is characterized by bleeding from deep tissues such as skin mucosa, joints, muscles, internal organs, and central nervous system. Bleeding sites occur in the motor system in 90% of hemophiliacs and become a major factor affecting the activity of hemophiliacs. In all bleeding sites, joint bleeding accounted for 80%. For patients who are ineffectual in conservative treatment, surgical treatment is required, and blood coagulation factor replacement therapy in the surgical period is an important factor influencing the success rate and the effect after the surgery.
The most effective way to prevent and treat bleeding in hemophilia today is replacement therapy with the corresponding coagulation factor, i.e. to supplement the missing coagulation factor. However, in the prior art, the supplementing amount of the blood coagulation factor is generally determined according to the clinical experience of a doctor, or the doctor can give a treatment scheme by consultation after consulting data, and the supplementing amount of the blood coagulation factor is difficult to control scientifically and accurately, so that the patient is not favorable for rehabilitation.
Patent application No. CN201780085211.1 provides a method of treating reversible hemophiliac arthropathy in a human joint suffering from hemophilia comprising administering to said human an effective amount of a chimeric protein or composition comprising a coagulation factor and an Fc region, but which is administered in an amount that is not obtainable by a scientific, accurate calculation.
Disclosure of Invention
Technical problem to be solved
The invention aims to provide a blood coagulation factor calculation platform and a blood coagulation factor calculation method for treating hemophilia, and aims to solve the problems that in the prior art, the blood coagulation factor supplement dosage is generally determined according to the clinical experience of doctors, or the doctor consults data and then gives a treatment scheme through consultation, and the blood coagulation factor supplement dosage is difficult to control scientifically and accurately.
(II) technical scheme
In order to realize the blood coagulation factor calculation platform and the method for treating hemophilia, the invention provides the following technical scheme for solving the problems that the supplementing amount of the blood coagulation factor in the prior art is generally determined according to the clinical experience of doctors, or the doctor consults the data and then gives a treatment scheme, and the supplementing amount of the blood coagulation factor is difficult to control scientifically and accurately:
a blood coagulation factor calculation platform for treating hemophilia comprises a plurality of mobile terminals and a blood coagulation factor database server in wireless connection with the mobile terminals, wherein the mobile terminals are connected with the blood coagulation factor database server through an intranet or the Internet; the blood coagulation factor database server comprises an expert consensus database unit, a bleeding information acquisition unit, a bleeding information evaluation unit and a blood coagulation factor calculation unit, wherein the expert consensus database unit is connected with the bleeding information evaluation unit, and the bleeding information acquisition unit, the bleeding information evaluation unit and the blood coagulation factor calculation unit are sequentially connected, wherein:
the bleeding information acquisition unit is used for inputting and acquiring bleeding information of a patient, wherein the bleeding information comprises but is not limited to hemophilia types, bleeding time, imaging, blood coagulation factor basic activity values, weight information, von willebrand factor, antigen measurement, inhibitor detection and gene detection;
the bleeding information evaluation unit is used for evaluating the bleeding information input and collected by the patient by combining with the expert consensus database unit and determining whether the patient needs to perform an operation;
the blood coagulation factor calculation unit is used for calculating the administration dosage and the treatment course according to different conditions of operation or non-operation after the fact that whether the operation is needed or not is obtained;
and the expert consensus database unit is used for storing and managing the patient condition evaluation standard and the blood coagulation factor supplement standard.
Preferably, the mobile terminal is a mobile phone or a PDA.
Preferably, the plurality of mobile terminals are connected with the blood coagulation factor database server through a WIFI network, a 4G/5G network and a Bluetooth network.
A coagulation factor calculation method for treating hemophilia, comprising the steps of:
s1, recording and collecting bleeding information of the patient, wherein the bleeding information comprises but is not limited to hemophilia types, bleeding time, imaging, blood coagulation factor basic activity values, weight information, von Willebrand factor, antigen measurement, inhibitor detection and gene detection;
s2, recording and collecting bleeding information of the patient, and evaluating by combining with an expert consensus database to determine whether the patient needs to perform an operation;
s3, calculating the administration dosage and the treatment course according to different conditions of operation or non-operation after the operation is needed.
Preferably, the bleeding type includes bleeding site, large/small operation.
Preferably, the formula for calculating the administration dose is:
FVIII supplementation amount ═ (coagulation factor target activity level-coagulation factor basal activity level) × body weight (kg) × 0.5;
FIX supplementation amount ═ (coagulation factor target activity level-coagulation factor basal activity level) × body weight (kg) × F, where concentrated coagulation factor IX formulations were used, F ═ 1; using recombinant factor IX formulation, F ═ 1.2;
among these, FVIII supplementation corresponds to hemophilia a, i.e. coagulation Factor Viii (FVIII) deficiency), FIX supplementation corresponds to hemophilia B, i.e. coagulation Factor Ix (FIX) deficiency.
(III) advantageous effects
Compared with the prior art, the invention provides a blood coagulation factor calculation platform and a blood coagulation factor calculation method for treating hemophilia, and the platform and the method have the following beneficial effects:
the platform realizes the combination of the self weight of the patient and the activity basic level of the blood coagulation factor, can calculate the individualized administration dosage for the conditions of different types, different parts and different degrees of bleeding, operation, non-operation and the like, and recommends the corresponding administration course so as to achieve the individualized treatment of the hemophilia patient. Meanwhile, the doctor can be helped to quickly and accurately make a treatment scheme, the data reference and calculation load is reduced, and the scientificity and effectiveness of treatment are improved; the system can help clinical pharmacists to take medicine monitoring on hemophilia hospitalized patients and provide help for long-term medicine monitoring on the hemophilia patients in later period; provides support for researchers to develop clinical research related to the blood coagulation factor supplementation treatment of hemophiliacs.
Drawings
FIG. 1 is a topology diagram of a platform connection relationship of the present invention;
FIG. 2 is a functional block diagram of the platform of the present invention;
FIG. 3 is a flow chart of hemophilia assessment according to the present invention;
FIG. 4 is a flow chart of the calculation of the amount of hemophilia coagulation factor supplementation according to the present invention;
FIG. 5 is a screenshot of an example platform application APP in accordance with the present invention.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
As shown in fig. 1 to 5, a blood coagulation factor calculation platform for treating hemophilia comprises a plurality of mobile terminals and a blood coagulation factor database server wirelessly connected with the mobile terminals, wherein the mobile terminals are connected with the blood coagulation factor database server through an intranet or the internet; the blood coagulation factor database server comprises an expert consensus database unit, a bleeding information acquisition unit, a bleeding information evaluation unit and a blood coagulation factor calculation unit, the expert consensus database unit is connected with the bleeding information evaluation unit, the bleeding information acquisition unit, the bleeding information evaluation unit and the blood coagulation factor calculation unit are sequentially connected, and the mobile terminal is a mobile phone or a PDA. Wherein:
a bleeding information collecting unit for entering and collecting bleeding information of a patient, the bleeding information including but not limited to hemophilia type, bleeding type (bleeding part, major/minor operation), bleeding time, imaging, blood coagulation factor basal activity value, weight information, von willebrand factor, antigen measurement, inhibitor measurement, gene measurement;
the bleeding information evaluation unit is used for evaluating the bleeding information input and collected by the patient by combining with the expert consensus database unit and determining whether the patient needs to perform an operation;
the blood coagulation factor calculation unit is used for calculating the administration dosage and the treatment course according to different conditions of operation or non-operation after the fact that whether the operation is needed or not is obtained;
and the expert consensus database unit is used for storing and managing the patient condition evaluation standard and the blood coagulation factor supplement standard.
The blood coagulation factor database server is connected with the plurality of mobile terminals through a WIFI network, a 4G/5G network and a Bluetooth network.
The invention also provides a blood coagulation factor calculation method for treating hemophilia, which comprises the following steps:
s1, recording and collecting bleeding information of the patient, wherein the bleeding information includes but is not limited to hemophilia type, bleeding type (bleeding part, large/small operation), bleeding time, imaging, blood coagulation factor basic activity value, weight information, von willebrand factor, antigen detection, inhibitor detection and gene detection;
s2, recording and collecting bleeding information of the patient, and evaluating by combining with an expert consensus database to determine whether the patient needs to perform an operation;
s3, calculating the administration dosage and the treatment course according to different conditions of operation or non-operation after the operation is needed.
Wherein, the formula for calculating the administration dose is as follows:
FVIII supplementation amount ═ (coagulation factor target activity level-coagulation factor basal activity level) × body weight (kg) × 0.5;
FIX supplementation amount ═ (coagulation factor target activity level-coagulation factor basal activity level) × body weight (kg) × F, where concentrated coagulation factor IX formulations were used, F ═ 1; using recombinant factor IX formulation, F ═ 1.2;
FVIII supplementation corresponds to hemophilia a, i.e. coagulation Factor Viii (FVIII) deficiency), FIX supplementation corresponds to hemophilia B, i.e. coagulation Factor Ix (FIX) deficiency. The first infusion of recombinant FVIII and FIX preparations was performed for hemophilia a and hemophilia B patients instead of therapy. FVIII at 1IU/kg per infusion: c is increased by 2IU/dl, the half-life period of FVIII in a body is 8-12 h, and 1 infusion is needed for every 8-12 h to keep the FVIII in the body at a certain level; FIX at 1IU/kg per infusion: c is increased by 1IU/dl, the half-life of FIX in the body is 24h, and the FIX needs to be infused 1 time per day to keep the FIX in the body at a certain level.
The consensus of the experts in hemophilia diagnosis and treatment (2017) states that hemophiliacs should avoid various operations as much as possible, and that adequate replacement therapy should be performed if surgery is necessary. The target activity level of the coagulation factor in the above formula is listed in the expert consensus, as shown in table 1, the target activity level of the coagulation factor required by patients varies according to different bleeding degrees, and individual treatment regimens should be adopted for different patients.
TABLE 1 alternative treatment regimen without limiting the clotting factors
The specific using process of the platform is shown in fig. 3 and 4, a doctor should perform various examinations on a patient before using the application program, evaluate the bleeding type, bleeding time and imaging of the patient, determine whether the patient needs an operation, the type of the operation is a major operation or a minor operation, and then calculate the corresponding blood coagulation factor treatment dosage and scheme on the platform. The operation interface of the platform is shown in fig. 5, a user needs to input the hemophilia type (A or B), the basic activity value of the coagulation factor, the weight of a patient, and the selected bleeding type (the type comprises a bleeding part and major/minor operations), and the platform calculates an initial dose, a treatment course, a maintenance dose and a treatment course; if an operation is required, preoperative and postoperative administration doses and treatment courses of the patient can be selected and calculated by the platform respectively. In conclusion, the platform realizes the combination of the body weight of the patient and the activity basic level of the blood coagulation factor, can calculate the individualized administration dosage for the conditions of different types, different parts and different degrees of bleeding, operation, non-operation and the like, and recommends the corresponding administration course of treatment so as to achieve the individualized treatment of the hemophilia patient.
The following describes the use effect of the platform by combining specific application examples:
the APP was tried in my hospital beginning in 2019, 1 month, and then developed in orthopedic and gastrointestinal surgery for hemophilia patients who need surgery. A hemophilia A patient diagnosed as 'colon tumorous lesion, hematoma formation, retroperitoneal hematoma and abscess formation' in 2019 in month 2 needs to be subjected to surgery in gastrointestinal surgery of our hospital, before the app is not used, a gastrointestinal surgeon plans a coagulation factor VIII supplementation scheme to be 1200IU and q12h, then combines the self condition of the patient, adjusts the treatment scheme to be 1500IU and q12h after calculation of the app of a coagulation factor calculator, and performs surgery on the patient on the next day, wherein the coagulation factor supplementation scheme of the patient still maintains 1500IU and q12h 1-3 days after the surgery; 4-6 days, the schedule is adjusted to 1000IU, q12 h; the weight of the mixture is adjusted to 400IU and q12h within 7-10 days. The patient has smooth operation, the postoperative incision can be healed, and complications such as red swelling, pus discharge and liquid discharge do not occur, so that the coagulation factor supplement scheme recommended by the app has clinical practicability and safety, and can be clinically popularized.
It is noted that, herein, relational terms such as first and second, and the like may be used solely to distinguish one entity or action from another entity or action without necessarily requiring or implying any actual such relationship or order between such entities or actions. Also, the terms "comprises," "comprising," or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Without further limitation, an element defined by the phrase "comprising an … …" does not exclude the presence of other identical elements in a process, method, article, or apparatus that comprises the element.
Although embodiments of the present invention have been shown and described, it will be appreciated by those skilled in the art that changes, modifications, substitutions and alterations can be made in these embodiments without departing from the principles and spirit of the invention, the scope of which is defined in the appended claims and their equivalents.
Claims (6)
1. A coagulation factor computing platform for treating hemophilia, comprising: the system comprises a plurality of mobile terminals and a blood coagulation factor database server in wireless connection with the mobile terminals, wherein the mobile terminals are connected with the blood coagulation factor database server through an intranet or the internet; the blood coagulation factor database server comprises an expert consensus database unit, a bleeding information acquisition unit, a bleeding information evaluation unit and a blood coagulation factor calculation unit, wherein the expert consensus database unit is connected with the bleeding information evaluation unit, and the bleeding information acquisition unit, the bleeding information evaluation unit and the blood coagulation factor calculation unit are sequentially connected, wherein:
the bleeding information acquisition unit is used for inputting and acquiring bleeding information of a patient, wherein the bleeding information comprises but is not limited to hemophilia types, bleeding time, imaging, blood coagulation factor basic activity values, weight information, von willebrand factor, antigen measurement, inhibitor detection and gene detection;
the bleeding information evaluation unit is used for evaluating the bleeding information input and collected by the patient by combining with the expert consensus database unit and determining whether the patient needs to perform an operation;
the blood coagulation factor calculation unit is used for calculating the administration dosage and the treatment course according to different conditions of operation or non-operation after the fact that whether the operation is needed or not is obtained;
and the expert consensus database unit is used for storing and managing the patient condition evaluation standard and the blood coagulation factor supplement standard.
2. A clotting factor computing platform for treating hemophilia according to claim 1, wherein: the mobile terminal is a mobile phone or a PDA.
3. A clotting factor computing platform for treating hemophilia according to claim 1, wherein: the mobile terminals are connected with the blood coagulation factor database server through a WIFI network, a 4G/5G network and a Bluetooth network.
4. A method of calculating a clotting factor for treating hemophilia comprising the steps of:
s1, recording and collecting bleeding information of the patient, wherein the bleeding information comprises but is not limited to hemophilia types, bleeding time, imaging, blood coagulation factor basic activity values, weight information, von Willebrand factor, antigen measurement, inhibitor detection and gene detection;
s2, recording and collecting bleeding information of the patient, and evaluating by combining with an expert consensus database to determine whether the patient needs to perform an operation;
s3, calculating the administration dosage and the treatment course according to different conditions of operation or non-operation after the operation is needed.
5. The method of claim 4, wherein the factor calculation is performed by: the bleeding types include bleeding site, major/minor surgery.
6. The method of calculating a coagulation factor for treating hemophilia according to claim 4, wherein the calculated dose formula is:
FVIII supplementation amount ═ (coagulation factor target activity level-coagulation factor basal activity level) × body weight (kg) × 0.5;
FIX supplementation amount ═ (coagulation factor target activity level-coagulation factor basal activity level) × body weight (kg) × F, where concentrated coagulation factor IX formulations were used, F ═ 1; using recombinant factor IX formulation, F ═ 1.2;
among these, FVIII supplementation corresponds to hemophilia a, i.e. coagulation Factor Viii (FVIII) deficiency), FIX supplementation corresponds to hemophilia B, i.e. coagulation Factor Ix (FIX) deficiency.
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| US20100069888A1 (en) * | 2008-08-08 | 2010-03-18 | Neal Solomon | Intelligent medical device system for personalized medicine applications |
| CN107845411A (en) * | 2017-12-04 | 2018-03-27 | 青岛大学附属医院 | Clinical medication decision support system |
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Application publication date: 20200911 |