Hemodialysis dynamic regulation and control method, regulation and control device, electronic equipment and medium

Abstract

The invention discloses a dynamic regulation and control method and device for hemodialysis, electronic equipment and a medium, and relates to the technical field of intelligent adjusting.The dynamic regulation and control method for hemodialysis comprises the steps that first vital sign data of a patient when the patient uses a sugar-free dialyzate for dialysis are monitored, and time sequence data of the first vital signs of the patient are obtained; judging whether the patient has a hypotension event or not according to the time sequence data of the first vital signs; if the patient has the hypotension event, judging whether the hypotension event is caused by a hypoglycemia event or not; if the hypotension event is caused by the hypoglycemia event, the dialysate of the patient is switched from a sugar-free dialysate to a first sugar concentration dialysate, and the first sugar concentration dialysate is a sugar-containing dialysate. According to the embodiment of the invention, serious harm to a patient caused by a hypotension event is avoided.

Description

Technical Field

[0001] The present invention relates to the technical field of intelligent regulation, and in particular to a hemodialysis dynamic regulation method, a regulation device, an electronic device and a medium. Background Art

[0002] The incidence of late-stage renal failure and uremia in my country continues to rise. According to incomplete statistics, there are nearly 1 million patients with late-stage renal failure and uremia in my country, and the number is still increasing at a rate of about 10% per year. The mortality rate of patients is as high as 67.6%, accounting for 10% of the total number of deaths. At present, the only way for patients with late-stage renal failure and uremia to prolong their lives is still hemodialysis.

[0003] Uremic patients are prone to hypotension during hemodialysis (more than 30% probability). Hypotension in hemodialysis patients can cause brain hypoxia, affect the therapeutic effect of hemodialysis, and may be life-threatening in severe cases.

[0004] Therefore, how to reduce the harm of hypotension events to patients during hemodialysis has become a technical problem that needs to be solved urgently. Summary of the invention

[0005] In view of the above problems, the embodiments of the present application provide a hemodialysis dynamic control method, a control device, an electronic device and a computer-readable storage medium, which are used to solve the problem in the prior art that hypotension events during hemodialysis are more harmful to patients.

[0006] According to one aspect of an embodiment of the present application, a dynamic control method for hemodialysis is provided, and the dynamic control method for hemodialysis includes: monitoring the first vital sign data of a patient when hemodialysis is performed using a sugar-free dialysate, and obtaining time series data of the patient's first vital sign; judging whether a hypotensive event occurs in the patient according to the time series data of the first vital sign; if a hypotensive event occurs in the patient, judging whether the hypotensive event is caused by a hypoglycemic event; if the hypotensive event is caused by a hypoglycemic event, switching the patient's dialysate from a sugar-free dialysate to a dialysate with a first sugar concentration, where the first sugar concentration dialysate is a sugar-containing dialysate.

[0007] Preferably, if the hypotension event is caused by a hypoglycemia event, after the patient's dialysate is switched from a sugar-free dialysate to a dialysate with a first sugar concentration, the dynamic control method of hemodialysis also includes: continuously monitoring the patient's second vital sign data, and judging whether the patient's hypotension event has improved based on the second vital sign data; if the patient's hypotension event has not improved, switching the patient's dialysate from the first sugar concentration dialysate to the second sugar concentration dialysate, the second sugar concentration dialysate being a sugar-containing dialysate, and the glucose concentration of the second sugar concentration dialysate is higher than that of the first sugar concentration dialysate.

[0008] Preferably, if the hypotension event is caused by a hypoglycemia event, after the patient's dialysate is switched from a sugar-free dialysate to a dialysate with a first sugar concentration, the dynamic control method of hemodialysis also includes: continuously monitoring the patient's third vital sign data, the third vital sign including: blood glucose concentration, blood pressure, blood volume and osmotic pressure difference; judging whether the patient's blood glucose and blood pressure conditions are stable based on the third vital sign data; if the patient's blood glucose and blood pressure conditions are stable, switching the patient's dialysate from the first sugar concentration dialysate or the second sugar concentration dialysate to a sugar-free dialysate.

[0009] Preferably, the first vital sign includes: albumin concentration and blood glucose concentration; if the patient has a hypotensive event, determining whether the hypotensive event is caused by a hypoglycemic event includes: determining whether condition one or condition two and condition three are simultaneously met; if condition one or condition two and condition three are simultaneously met, determining that the hypotensive event is caused by a hypoglycemic event; wherein, condition one includes that the blood glucose concentration is lower than the first hypoglycemia concentration, condition two includes that the blood glucose concentration is not lower than the first hypoglycemia concentration and not higher than the second hypoglycemia concentration, and the rate of decrease of the blood glucose concentration is higher than a preset rate of decrease threshold, and condition three includes that the albumin concentration is not lower than a preset low protein concentration threshold, and the first hypoglycemia concentration is lower than the second hypoglycemia concentration.

[0010] Preferably, if the patient's blood sugar and blood pressure conditions are stable, after the patient's dialysate is switched from the first sugar concentration dialysate or the second sugar concentration dialysate to the sugar-free dialysate, the dynamic control method of hemodialysis also includes: monitoring the patient's insulin secretion parameters, the first insulin secretion parameter is used to characterize the patient's insulin secretion; determining the patient's insulin secretion rate according to the insulin secretion parameter; evaluating the probability of the patient experiencing a rebound hypoglycemia event according to the insulin secretion rate; if the probability of the patient experiencing a rebound hypoglycemia event is higher than a preset safety threshold, determining the required insulin enzyme dose according to the patient's real-time blood sugar concentration and insulin secretion rate; and switching the sugar-free dialysate to a dialysate containing insulin enzyme according to the required insulin enzyme dose.

[0011] Preferably, the insulin secretion parameters include: the patient's glucose fluctuation curve G(t), glycosylated hemoglobin GA, glycosylated albumin HbA1c and dialysis ultrafiltration rate UFR.

[0012] Preferably, determining the insulin secretion rate of the patient according to the insulin secretion parameter includes: inputting G(t) and UFR into Formula 1 to determine the insulin secretion rate S(t) of the patient, where Formula 1 is: α is the basal secretion coefficient, β is the fluctuation response coefficient, and γ is the dialysis ultrafiltration inhibition factor.

[0013] According to another aspect of an embodiment of the present application, a dynamic control device for hemodialysis is provided, which includes: a processing module, used to monitor the first vital sign data of a patient when hemodialysis is performed using a sugar-free dialysate, and obtain the time series data of the patient's first vital sign; a first judgment module, used to judge whether a hypotensive event occurs in the patient based on the time series data of the first vital sign; a second judgment module, used to judge whether the hypotensive event is caused by a hypoglycemic event if a hypotensive event occurs in the patient; and a switching module, used to switch the patient's dialysate from a sugar-free dialysate to a dialysate with a first sugar concentration if the hypotensive event is caused by a hypoglycemic event, the first sugar concentration dialysate being a sugar-containing dialysate.

[0014] According to another aspect of an embodiment of the present application, an electronic device is provided, comprising a storage device, a processor, and a computer program stored in the storage device and executable on the processor, wherein when the processor executes the computer program, the steps of the method for dynamic control of hemodialysis as described in any one of the above items are implemented.

[0015] According to another aspect of the embodiments of the present application, a computer-readable storage medium is provided. Preferably, a computer program is stored on the computer-readable storage medium, and when the computer program is executed by a processor, the steps of any of the above methods for dynamic regulation of hemodialysis are implemented.

[0016] The embodiment of the present application further determines whether the patient's hypotension event is caused by a hypoglycemia event when it is determined that the patient has a hypotensive event based on the time series data of the first vital sign, and when the hypoglycemia event causes the hypotensive event, switches the patient's dialysate from the sugar-free dialysate to a dialysate with a first sugar concentration to supplement the patient's blood sugar through the dialysate, thereby improving the patient's hypotension in time by improving the patient's blood sugar level, thereby preventing the hypotensive event from causing serious harm to the patient. BRIEF DESCRIPTION OF THE DRAWINGS

[0017] Figure 1 A schematic diagram of the process of the dynamic regulation method of hemodialysis provided in an embodiment of the present application is shown;

[0018] Figure 2 A schematic flow chart of a method for dynamic regulation of hemodialysis provided in another embodiment of the present application is shown. DETAILED DESCRIPTION

[0019] In order to make the above-mentioned objects, features and advantages of the present invention more obvious and easy to understand, the specific implementation methods of the present invention are described in detail below in conjunction with the drawings. It is obvious that the described embodiments are only part of the embodiments of the present invention, but not all of the embodiments.

[0020] According to one aspect of an embodiment of the present application, a method for dynamic regulation of hemodialysis is provided, comprising: Figure 1 The flowchart of the hemodialysis dynamic control method provided by the embodiment of the present application is shown, and the method is executed by the hemodialysis dynamic control device. The hemodialysis dynamic control device can be a hemodialysis device, or an electronic device that communicates with the hemodialysis dynamic control device. Figure 1 As shown, the method includes the following steps S110 to S140:

[0021] S110, monitoring the first vital sign data of the patient when he / she is undergoing hemodialysis with a sugar-free dialysate, and obtaining time series data of the first vital sign of the patient.

[0022] Among them, the first vital sign may include conventional parameters: albumin concentration, ultrafiltration rate, pre-dialysis systolic blood pressure, dialysis time and blood glucose concentration, and may also include hypotension monitoring parameters, for example, blood volume monitoring (BVM) data (such as relative blood volume change rate), heart rate variability (HRV) index (reflecting autonomic nervous function), bioimpedance analysis (evaluating extracellular fluid dynamics), and hemodynamic parameters.

[0023] S120, judging whether the patient has a hypotensive event based on the time series data of the first vital sign.

[0024] Use LSTM or Transformer to process the time series data of the first vital sign and the dynamically changing time series data during dialysis (such as hemodynamic parameters every 15 minutes) to determine whether the patient has a hypotensive event. Furthermore, the causal forest can be introduced to distinguish the direct / indirect effects of risk factors in the first vital sign, and the doubly robust estimation can be used to eliminate the influence of confounding variables.

[0025] The time series data of the first vital sign can be used to directly determine whether the patient has a hypotensive event, and can also predict the probability distribution of whether the patient will have a hypotensive event in the future.

[0026] S130: If the patient has a hypotensive event, determine whether the hypotensive event is caused by a hypoglycemic event.

[0027] Among them, the possible causes of hypotension in hemodialysis patients are: 1. The patient's blood glucose concentration is low, and the hemodialysis patient is also a diabetic patient; 2. Hypoproteinemia / malnutrition / insufficient protein intake. Hypoproteinemia will increase the permeability of the vascular wall, making it easier for fluid and protein in the blood to seep out of the blood vessels, resulting in insufficient circulating blood volume, which in turn leads to a decrease in blood volume and hypotension; 3. An increased ultrafiltration rate causes a decrease in circulating blood volume and a drop in blood pressure; 4. The pre-dialysis systolic pressure is too low, the blood vessels are elastic, and the blood pressure drops sharply; 5. The longer the dialysis time, the greater the possibility of malnutrition anemia in uremic patients. Uremic patients with severe anemia have worse tolerance to hemodialysis. At the same time, anemia will cause vasodilation, especially in patients with severe anemia. The vasodilation is more serious, and hypotension is very likely to occur.

[0028] The embodiments of the present application provide solutions for the hypotension caused by hypoglycemia.

[0029] In the case where the first vital sign includes albumin concentration and blood glucose concentration, S130 further includes sub-steps S131 to S132:

[0030] S131, determine whether condition one or condition two and condition three are met at the same time.

[0031] S132, if condition one or condition two and condition three are met at the same time, it is determined that the hypotension event is caused by a hypoglycemia event.

[0032] Among them, condition one includes that the blood glucose concentration is lower than the first low blood glucose concentration, condition two includes that the blood glucose concentration is not lower than the first low blood glucose concentration and not higher than the second low blood glucose concentration, and the rate of decrease of the blood glucose concentration is higher than the preset rate of decrease threshold, and condition three includes that the albumin concentration is not lower than the preset low protein concentration threshold.

[0033] When it is determined that the risk of hypotension has reached the threshold, blood glucose status and albumin concentration are judged.

[0034] It is determined whether condition one or condition two is met to confirm that the patient has a hypoglycemic event, and condition three is met to exclude the patient from having hypoalbuminemia.

[0035] Condition 1: Blood glucose concentration <70 mg / dL, where 70 mg / dL is the commonly used clinical diagnostic standard for hypoglycemia.

[0036] Condition 2: A blood glucose concentration <90 mg / dL and a rapid decrease (the rate of decrease in blood glucose concentration <-20 mg / dL / h) may also cause hypotension, even if the hypoglycemia criteria are not met.

[0037] Condition three: Albumin concentration > 3.5 g / dL, hypotension is not caused by hypoproteinemia.

[0038] S140: If the hypotension event is caused by a hypoglycemia event, the patient's dialysate is switched from a sugar-free dialysate to a dialysate with a first sugar concentration, where the first sugar concentration dialysate is a sugar-containing dialysate.

[0039] The first sugar concentration dialysate is set to contain 1.5% glucose concentration. 1.5% glucose concentration is a commonly used initial intervention concentration in clinical practice, which can quickly increase blood sugar levels while avoiding drastic changes in osmotic pressure caused by excessive sugar concentration. This concentration is safe for most patients and is not likely to cause reverse ultrafiltration or electrolyte disturbances.

[0040] The embodiment of the present application further determines whether the patient's hypotension event is caused by a hypoglycemia event when it is determined that the patient has a hypotensive event based on the time series data of the first vital sign, and when the hypoglycemia event causes the hypotensive event, switches the patient's dialysate from the sugar-free dialysate to a dialysate with a first sugar concentration to supplement the patient's blood sugar through the dialysate, thereby improving the patient's hypotension in time by improving the patient's blood sugar level, thereby preventing the hypotensive event from causing serious harm to the patient.

[0041] Figure 2 A schematic diagram showing a flow chart of a method for dynamic regulation of hemodialysis provided by another embodiment of the present application is shown. Figure 2 The hemodialysis dynamic control method includes the following steps S210 to S290:

[0042] S210, monitoring the first vital sign data of the patient when he / she is undergoing hemodialysis with a sugar-free dialysate, and obtaining time series data of the first vital sign of the patient.

[0043] S220, determining whether a hypotensive event occurs in the patient based on the time series data of the first vital sign.

[0044] S230: If the patient has a hypotensive event, determine whether the hypotensive event is caused by a hypoglycemic event.

[0045] S240: If the hypotension event is caused by a hypoglycemia event, the patient's dialysate is switched from a sugar-free dialysate to a dialysate with a first sugar concentration, where the first sugar concentration dialysate is a sugar-containing dialysate.

[0046] S250, continuously monitor the patient's second vital sign data, and determine whether the patient's hypotension event has improved based on the second vital sign data; if the patient's hypotension event has improved, jump to S260; if the patient's hypotension event has not improved, jump to S251.

[0047] The patient's secondary vital signs data can be monitored in real time, for example, blood pressure and heart rate can be measured every 5 minutes and trends can be recorded. The blood pressure improvement criteria can be set as follows:

[0048] Systolic blood pressure (SBP), rising by ≥10 mmHg or stabilizing at >90 mmHg, the increase of systolic blood pressure or stabilization within the safe range indicates that the intervention is effective; diastolic blood pressure (DBP), rising by ≥5 mmHg or stabilizing at >60 mmHg, the increase of diastolic blood pressure or stabilization within the safe range indicates that the intervention is effective; blood pressure trend, three consecutive measurements show an upward or stable trend to avoid single measurement errors and ensure the sustainability of blood pressure improvement; heart rate (HR), falling by ≥5 beats / minute or stabilizing at 60-100 beats / minute, a decrease or stability in heart rate indicates that autonomic nervous function has recovered and the risk of hypotension has been reduced.

[0049] S251, switching the patient's dialysate from a dialysate with a first sugar concentration to a dialysate with a second sugar concentration, wherein the dialysate with the second sugar concentration is a sugar-containing dialysate, and the glucose concentration of the second sugar concentration dialysate is higher than that of the first sugar concentration dialysate.

[0050] The second sugar concentration dialysate is set to contain 2.5% glucose concentration. 1.5% glucose concentration is a commonly used initial intervention concentration in clinical practice, which can quickly increase blood sugar levels while avoiding drastic changes in osmotic pressure caused by excessively high sugar concentrations. In the case of poor intervention with 1.5% glucose concentration dialysate, the sugar concentration of the dialysate can be increased. A higher concentration of glucose can further increase plasma osmotic pressure, promote the transfer of interstitial fluid into blood vessels, and increase blood volume.

[0051] Furthermore, lowering the dialysate temperature (e.g., 35.5°C) can stimulate vasoconstriction, increase peripheral vascular resistance, and help improve blood pressure. The effect can be enhanced by synergizing temperature regulation with glucose intervention.

[0052] S260, continuously monitor the patient's third vital sign data, the third vital sign includes: blood glucose concentration, blood pressure, blood volume and osmotic pressure difference.

[0053] S280, judging whether the patient's blood sugar and blood pressure are stable according to the third vital sign data; if the patient's blood sugar and blood pressure are stable, jumping to S290; if the patient's blood sugar and blood pressure are unstable, jumping to S260; if the patient's blood sugar and blood pressure are unstable, jumping back to S260

[0054] The third vital sign data can be monitored in real time, for example, blood sugar, blood pressure, blood volume and osmotic pressure are measured every 5 minutes. The criteria for switching from sugar-containing dialysate to sugar-free dialysate are:

[0055] Blood glucose concentration, ≥100mg / dL and stable for ≥15 minutes, blood glucose returns to the safe range and remains stable, indicating that there is no need to continue to supplement glucose; blood pressure, systolic pressure ≥100mmHg and stable for ≥15 minutes, blood pressure returns to the safe range and remains stable, indicating that the risk of hypotension has been eliminated; blood volume ≥95% and stable for ≥15 minutes, blood volume returns to the normal range and remains stable, indicating that osmotic pressure regulation is effective; osmotic pressure difference, Δπ≤5mOsm / kg and stable for ≥15 minutes, the osmotic pressure difference returns to the normal range and remains stable, indicating that water transfer is balanced.

[0056] S290, switching the patient's dialysate from the first sugar concentration dialysate or the second sugar concentration dialysate to a sugar-free dialysate.

[0057] When the patient's blood sugar and blood pressure conditions are stable, switching the patient's dialysate from the first sugar concentration dialysate or the second sugar concentration dialysate to a sugar-free dialysate can prevent hyperglycemia and avoid high blood sugar caused by long-term use of sugar-containing dialysate. It can also restore baseline treatment and resume regular sugar-free dialysate treatment after blood sugar and blood pressure stabilize.

[0058] Furthermore, the infusion of sugar-containing dialysate can be stopped immediately when blood sugar is too high, for example, blood sugar concentration>250mg / dL.

[0059] Among them, S210 to S240 are similar to the execution of S110 to S140 in the first embodiment, and are not described again here.

[0060] The embodiment of the present application determines through S250~S251 whether the intervention of the dialysate with the first sugar concentration on the hypotensive patient is an effective intervention. If it is an ineffective intervention, the sugar concentration of the dialysate is increased through S251; and the judgment conditions for switching back to the sugar-free dialysate are established through S280 and S290 to avoid the patient from experiencing hyperglycemia.

[0061] When using sugar-containing dialysate, the glucose concentration in the blood will increase, stimulating insulin secretion. After switching from sugar-containing dialysate to sugar-free dialysate, if the glucose supply is suddenly interrupted and the insulin level is still high, it will cause a sharp drop in blood sugar and rebound hypoglycemia. Therefore, how to smoothly transition the glucose concentration is the key.

[0062] In one approach, the regulation of insulin release may be combined, such as adding an insulin inhibitor to the dialysate. Specifically, after S290, the hemodialysis dynamic regulation method further includes:

[0063] S310, monitoring the patient's insulin secretion parameter, where a first insulin secretion parameter is used to characterize the patient's insulin secretion status.

[0064] Optionally, the first insulin secretion parameter includes the patient's glucose fluctuation curve G(t), glycated hemoglobin GA, glycated albumin HbA1c, and dialysis ultrafiltration rate UFR.

[0065] G(t) continuously reflects the characteristics of blood glucose fluctuations throughout the day, including postprandial peaks, nocturnal hypoglycemia and blood glucose variability. It records the interstitial fluid glucose concentration every 5 minutes through a subcutaneous glucose sensor (such as the abdomen or arm). It is continuously monitored for 3-14 days to generate a dynamic curve; HbA1c reflects the average blood glucose level in the past 2-3 months; GA reflects the average blood glucose level in the past 2-3 weeks and is suitable for short-term blood glucose monitoring (such as gestational diabetes, treatment adjustment period) or situations where HbA1c is unreliable (such as anemia); UFR evaluates the fluid clearance efficiency per unit time during hemodialysis (unit: mL / h / mmHg), which directly affects the patient's volume balance and cardiovascular stability. Too high UFR may cause hypotension or dialysis imbalance syndrome.

[0066] S320, determining the patient's insulin secretion rate according to the insulin secretion parameter.

[0067] Specifically, S320 includes S321:

[0068] S321, input G(t) and UFR into Formula 1 to determine the patient's dynamic insulin secretion rate S(t), Formula 1 is:

[0069]

[0070] α is the basal secretion coefficient, β is the fluctuation response coefficient, and γ is the dialysis ultrafiltration inhibition factor.

[0071] α = 0.05 × HbAlc, indicating the basal secretion coefficient, long-term blood sugar control level; represents the fluctuation response coefficient, short-term sensitivity of blood glucose changes; γ = 0.02, represents the dialysis ultrafiltration inhibition factor (empirical constant; UFR is the dialysis ultrafiltration rate (mL / h / kg).

[0072] The steps of calculating S(t) may include inputting the real-time blood glucose curve G(t) and the dialysis parameter UFR; calculating the blood glucose change rate dG(t) by differential method or Savitzky-Golay filter smoothing; and calculating S(t) point by point according to the time step (eg, 5 minutes).

[0073] S330, assess the probability of rebound hypoglycemia in the patient based on the insulin secretion rate; if the probability of rebound hypoglycemia in the patient is higher than the preset safety threshold, jump to S340; if the probability of rebound hypoglycemia in the patient is not higher than the preset safety threshold, end.

[0074] If the insulin secretion rate is higher than 100 μU / min / m 2 (normalized for body surface area), it indicates the symptoms of rebound hypoglycemia; further, it can be judged in combination with blood glucose concentration. If the blood glucose decrease rate is >2mg / dL / min (0.11mmol / L / min), even if the insulin secretion rate does not reach the threshold, rebound hypoglycemia may occur due to "insulin-glucose feedback delay".

[0075] S340, determining the required insulin enzyme dosage according to the patient's real-time blood glucose concentration and insulin secretion rate; switching the sugar-free dialysis fluid to the dialysis fluid containing insulin enzyme according to the required insulin enzyme dosage.

[0076] If blood sugar is stable (4.4-7.0mmol / L) and secretion rate is normal (<80μU / min / m 2 ), maintain sugar-free dialysate; if blood glucose fluctuates (<4.4 or >10.0mmol / L) with compensatory increase in secretion rate (80-120μU / min / m 2 ), the dialysate containing insulinase (concentration 0.5-1.0U / L) was switched, and the ultrafiltration rate was reduced by 10%; if severe hypoglycemia (<3.9mmol / L) or excessive secretion rate (≥120μU / min / m 2 ), if emergency intervention is required, switch to high-concentration insulin enzyme dialysis fluid (1.5-2.0U / L), reduce the ultrafiltration rate by 20%, and supplement glucose intravenously.

[0077] In the embodiment of the present application, the probability of rebound hypoglycemia in the patient is judged by determining the dynamic secretion rate of insulin. If the probability is high, insulin enzyme is injected in time to avoid repeated hypoglycemia in the patient.

[0078] According to another aspect of an embodiment of the present application, a dynamic control device for hemodialysis is provided, which includes: a processing module, used to monitor the first vital sign data of a patient when hemodialysis is performed using a sugar-free dialysate, and obtain the time series data of the patient's first vital sign; a first judgment module, used to judge whether a hypotensive event occurs in the patient based on the time series data of the first vital sign; a second judgment module, used to judge whether the hypotensive event is caused by a hypoglycemic event if a hypotensive event occurs in the patient; and a switching module, used to switch the patient's dialysate from a sugar-free dialysate to a dialysate with a first sugar concentration if the hypotensive event is caused by a hypoglycemic event, the first sugar concentration dialysate being a sugar-containing dialysate.

[0079] According to another aspect of an embodiment of the present application, an electronic device is provided, comprising a storage device, a processor, and a computer program stored in the storage device and executable on the processor, wherein when the processor executes the computer program, the steps of the method for dynamic control of hemodialysis as described in any one of the above items are implemented.

[0080] According to another aspect of the embodiments of the present application, a computer-readable storage medium is provided. Preferably, a computer program is stored on the computer-readable storage medium, and when the computer program is executed by a processor, the steps of any of the above methods for dynamic regulation of hemodialysis are implemented.

[0081] It should be understood by those skilled in the art that the embodiments of the present invention can be provided as methods, systems or computer program products. Therefore, the present invention can take the form of a complete hardware embodiment, a complete software embodiment or an embodiment combining software and hardware. Moreover, the present invention can take the form of a computer program product implemented on one or more computer-usable storage media containing computer-usable program codes. Among them, the storage medium can be implemented by any type of volatile or non-volatile storage device or a combination thereof, such as static random access memory (Static Random Access Memory, referred to as SRAM), electrically erasable programmable read-only memory (Electrically Erasable Programmable Read-Only Memory, referred to as EEPROM), erasable programmable read-only memory (Erasable Programmable Read Only Memory, referred to as EPROM), programmable read-only memory (Programmable Red-Only Memory, referred to as PROM), read-only memory (Read-Only Memory, referred to as ROM), magnetic memory, flash memory, disk or optical disk. These computer program instructions may also be stored in a computer-readable memory capable of directing a computer or other programmable data processing device to operate in a specific manner, so that the instructions stored in the computer-readable memory produce an article of manufacture comprising an instruction device, which implements the process Figure 1 A process or multiple processes and / or boxes Figure 1 A function specified in one or more boxes.

[0082] It should be noted that the above embodiments are only used to illustrate the technical solutions of the present invention rather than to limit it. Although the present invention has been described in detail with reference to the preferred embodiments, those skilled in the art should understand that the technical solutions of the present invention may be modified or replaced by equivalents without departing from the spirit and scope of the technical solutions of the present invention, which should all be included in the scope of the claims of the present invention.

Claims

1. A method for dynamic regulation of hemodialysis, characterized in that: The hemodialysis dynamic regulation method comprises: Monitoring the first vital sign data of the patient when the patient is dialyzed using the sugar-free dialysate, and obtaining time series data of the first vital sign of the patient; Determining whether a hypotensive event occurs in the patient according to the time series data of the first vital sign; If the patient has a hypotensive event, determining whether the hypotensive event is caused by a hypoglycemic event; If the hypotension event is caused by the hypoglycemia event, the patient's dialysate is switched from the sugar-free dialysate to a dialysate with a first sugar concentration, where the first sugar concentration dialysate is a sugar-containing dialysate.

2. The method for dynamic regulation of hemodialysis according to claim 1, characterized in that: After the step of switching the patient's dialysate from the sugar-free dialysate to the dialysate with the first sugar concentration if the hypotension event is caused by the hypoglycemia event, the hemodialysis dynamic control method further includes: continuously monitoring the second vital sign data of the patient, and determining whether the hypotension event of the patient has been improved according to the second vital sign data; If the patient's hypotension event is not improved, the patient's dialysate is switched from the first sugar concentration dialysate to a second sugar concentration dialysate, wherein the second sugar concentration dialysate is a sugar-containing dialysate, and the glucose concentration of the second sugar concentration dialysate is higher than that of the first sugar concentration dialysate.

3. The method for dynamic regulation of hemodialysis according to claim 2, characterized in that: After the step of switching the patient's dialysate from the sugar-free dialysate to the dialysate with the first sugar concentration if the hypotension event is caused by the hypoglycemia event, the hemodialysis dynamic control method further includes: Continuously monitoring the third vital sign data of the patient, wherein the third vital sign includes: blood glucose concentration, blood pressure, blood volume and osmotic pressure difference; Determining whether the patient's blood sugar and blood pressure are stable according to the third vital sign data; If the patient's blood sugar and blood pressure conditions are stable, the patient's dialysate is switched from the first sugar concentration dialysate or the second sugar concentration dialysate to the sugar-free dialysate.

4. The method for dynamic regulation of hemodialysis according to claim 3, characterized in that: The first vital sign includes: albumin concentration and blood glucose concentration; if the patient has a hypotensive event, determining whether the hypotensive event is caused by a hypoglycemic event includes: Determine whether condition 1 or condition 2 is met at the same time as condition 3; If the condition 1 or the condition 2 and the condition 3 are met at the same time, it is determined that the hypotension event is caused by the hypoglycemia event; Among them, condition one includes that the blood glucose concentration is lower than a first low blood glucose concentration, condition two includes that the blood glucose concentration is not lower than the first low blood glucose concentration and not higher than the second low blood glucose concentration, and the rate of decrease of the blood glucose concentration is higher than a preset rate of decrease threshold, and condition three includes that the albumin concentration is not lower than a preset low protein concentration threshold, and the first low blood glucose concentration is lower than the second low blood glucose concentration.

5. The method for dynamic regulation of hemodialysis according to claim 4, characterized in that: After the patient's blood sugar and blood pressure conditions are stable, the patient's dialysate is switched from the first sugar concentration dialysate or the second sugar concentration dialysate to the sugar-free dialysate, the hemodialysis dynamic control method further includes: Monitoring the patient's insulin secretion parameter, wherein the first insulin secretion parameter is used to characterize the patient's insulin secretion condition; determining the insulin secretion rate of the patient according to the insulin secretion parameter; Assessing the probability of rebound hypoglycemia occurring in the patient according to the insulin secretion rate; If the probability of rebound hypoglycemia occurring in the patient is higher than a preset safety threshold, determining the required insulin enzyme dosage according to the patient's real-time blood glucose concentration and the insulin secretion rate; The sugar-free dialysis fluid is switched to a dialysis fluid containing insulin enzyme according to the required insulin enzyme dosage.

6. The method for dynamic regulation of hemodialysis according to claim 5, characterized in that: The insulin secretion parameters include: the patient's glucose fluctuation curve G(t), glycosylated hemoglobin GA, glycosylated albumin HbA1c and dialysis ultrafiltration rate UFR.

7. The method for dynamic regulation of hemodialysis according to claim 6, characterized in that: Determining the insulin secretion rate of the patient according to the insulin secretion parameter comprises: G(t) and UFR are input into Formula 1 to determine the patient's insulin secretion rate S(t), which is: α is the basal secretion coefficient, β is the fluctuation response coefficient, and γ is the dialysis ultrafiltration inhibition factor.

8. A hemodialysis dynamic control device, characterized in that: The hemodialysis dynamic control device comprises: A processing module, used for monitoring the first vital sign data of the patient when the patient is dialyzed using the sugar-free dialysate, and obtaining the time series data of the first vital sign of the patient; A first judgment module, used for judging whether the patient has a hypotensive event according to the time series data of the first vital sign; A second judgment module is used to judge whether the hypotension event is caused by a hypoglycemia event if the patient has a hypotension event; A switching module is used to switch the patient's dialysate from the sugar-free dialysate to a dialysate with a first sugar concentration if the hypotension event is caused by the hypoglycemia event. The first sugar concentration dialysate is a sugar-containing dialysate.

9. An electronic device comprising a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein: When the processor executes the computer program, the steps of the hemodialysis dynamic control method according to any one of claims 1 to 7 are implemented.

10. A computer-readable storage medium, characterized in that: The computer-readable storage medium stores a computer program, and when the computer program is executed by a processor, the steps of the hemodialysis dynamic control method according to any one of claims 1 to 7 are implemented.

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