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

【摘要】：重癥監(jiān)護(hù)患者經(jīng)常遭受應(yīng)激性高血糖，，應(yīng)激性高血糖會(huì)導(dǎo)致嚴(yán)重的負(fù)面效果甚至死亡。通過(guò)降低血糖水平，可以減少負(fù)面效果甚至死亡率。此外，閉環(huán)血糖控制被認(rèn)為是處理這類問(wèn)題最理想的方式。模型預(yù)測(cè)控制作為一種閉環(huán)控制方法，由于其處理約束和時(shí)滯的優(yōu)越性，在血糖控制領(lǐng)域表現(xiàn)出了良好的控制效果。實(shí)際上，人體的“胰島素—血糖動(dòng)態(tài)”帶有明顯的物理約束條件和時(shí)滯，因此，模型預(yù)測(cè)控制被認(rèn)為是血糖領(lǐng)域中最有希望的選擇之一。然而，對(duì)于新來(lái)的重癥監(jiān)護(hù)病人，由于缺少其個(gè)體化模型，傳統(tǒng)的模型預(yù)測(cè)控制遇到了極大的挑戰(zhàn)。因此，本文提出了數(shù)據(jù)驅(qū)動(dòng)模型預(yù)測(cè)控制，旨在實(shí)現(xiàn)ICU強(qiáng)化血糖管理。為了驗(yàn)證數(shù)據(jù)驅(qū)動(dòng)模型預(yù)測(cè)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(cè)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(jié)果表明數(shù)據(jù)驅(qū)動(dòng)模型控制策略不僅實(shí)現(xiàn)了高效地血糖控制，而且對(duì)病人個(gè)體化差異以及測(cè)量噪聲有很好的魯棒性。同時(shí)，本文選取了經(jīng)典的胰島素輸注協(xié)議—Yale協(xié)議作為對(duì)比方法。本文選取了以下一些評(píng)價(jià)指標(biāo)：血糖濃度在三個(gè)區(qū)間（180mg/dL、70mg/dL以及在70-180mg/dL之間）的百分比、血糖危險(xiǎn)指數(shù)、控制變化性網(wǎng)格分析、血糖和胰島素的平均值和方差。每項(xiàng)指標(biāo)都表明數(shù)據(jù)驅(qū)動(dòng)模型預(yù)測(cè)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(xué)位授予單位】：北京化工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R459.7;TP273

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 趙嘉晶;;動(dòng)態(tài)血糖監(jiān)測(cè)進(jìn)展[J];海南醫(yī)學(xué);2009年S4期

2 王戰(zhàn)建;蘇杰英;;動(dòng)態(tài)血糖監(jiān)測(cè)系統(tǒng)在糖尿病診治中的應(yīng)用進(jìn)展[J];中國(guó)實(shí)用內(nèi)科雜志;2007年04期

3 沈國(guó)文;徐紹蓮;;ICU危重患者應(yīng)激性高血糖研究進(jìn)展[J];齊魯護(hù)理雜志;2012年28期

4 ;《中國(guó)重癥加強(qiáng)治療病房(ICU)建設(shè)與管理指南》(2006)[J];中國(guó)危重病急救醫(yī)學(xué);2006年07期

本文編號(hào)：1646141