本文選題：閉環(huán)血糖控制　切入點：強化胰島素治療　出處：《北京化工大學》2013年碩士論文　論文類型：學位論文

【摘要】：重癥監(jiān)護患者經常遭受應激性高血糖，，應激性高血糖會導致嚴重的負面效果甚至死亡。通過降低血糖水平，可以減少負面效果甚至死亡率。此外，閉環(huán)血糖控制被認為是處理這類問題最理想的方式。模型預測控制作為一種閉環(huán)控制方法，由于其處理約束和時滯的優(yōu)越性，在血糖控制領域表現(xiàn)出了良好的控制效果。實際上，人體的“胰島素—血糖動態(tài)”帶有明顯的物理約束條件和時滯，因此，模型預測控制被認為是血糖領域中最有希望的選擇之一。然而，對于新來的重癥監(jiān)護病人，由于缺少其個體化模型，傳統(tǒng)的模型預測控制遇到了極大的挑戰(zhàn)。因此，本文提出了數(shù)據(jù)驅動模型預測控制，旨在實現(xiàn)ICU強化血糖管理。為了驗證數(shù)據(jù)驅動模型預測控制策略的有效性，將其在兩組不同的虛擬病人身上做仿真測試，其中一組基于Cobelli等提出的糖尿病代謝模型，另一組基于Hovorka等提出的ICU血糖管理模型。仿真結果表明數(shù)據(jù)驅動模型控制策略不僅實現(xiàn)了高效地血糖控制，而且對病人個體化差異以及測量噪聲有很好的魯棒性。同時，本文選取了經典的胰島素輸注協(xié)議—Yale協(xié)議作為對比方法。本文選取了以下一些評價指標：血糖濃度在三個區(qū)間（180mg/dL、70mg/dL以及在70-180mg/dL之間）的百分比、血糖危險指數(shù)、控制變化性網格分析、血糖和胰島素的平均值和方差。每項指標都表明數(shù)據(jù)驅動模型預測控制方法的控制性能優(yōu)于Yale協(xié)議。
[Abstract]:Intensive care patients often suffer from stress hyperglycemia, hyperglycemia will cause serious adverse effect or even death. By lowering the blood glucose level, can reduce the negative effect and even mortality. In addition, the closed-loop control of blood glucose is considered to deal with this problem. The best way to model predictive control as a closed-loop control method, because of its the superiority of dealing with constraints and delays, showing good control effect in blood glucose control field. In fact, the body's insulin glucose dynamics "with obvious physical constraints and delays, therefore, the model predictive control is considered to be one of the most promising fields in the selection of blood glucose. However, patients in intensive care for the new here, due to the lack of the individual model, traditional model predictive control has encountered great challenges. Therefore, this paper proposes a data driven model predictive control, purpose In the implementation of intensive glucose management. In order to verify the ICU data driven model to predict the effectiveness of the control strategy, the simulation test in two groups of patients with different virtual body, one group based on the metabolic model proposed by Cobelli, another group of ICU blood sugar management model proposed by Hovorka based on the simulation results show that the data. Model driven control strategy not only realizes the efficient control of blood glucose, but also has good robustness for individual patients and the differences of measurement noise. At the same time, this paper selects the classic insulin infusion protocol Yale protocol as the example of law. This paper chooses the following index: blood glucose concentration in the interval (180mg/dL, three 70mg/dL and 70-180mg/dL in between) the percentage of blood glucose variability control risk index, grid analysis, mean and variance of blood glucose and insulin. Each index showed that according to the number of flooding The control performance of the dynamic model predictive control method is superior to the Yale protocol.

【學位授予單位】：北京化工大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R459.7;TP273

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