Nichols B, Shrestha R P, Horowitz J, Hollot C V, Germain M J, Gaweda A E, Chait Y
Departments, UMass, Amherst, MA 01003, USA.
Annu Int Conf IEEE Eng Med Biol Soc. 2011;2011:83-6. doi: 10.1109/IEMBS.2011.6089902.
Many end stage renal disease (ESRD) patients suffer from anemia due to insufficient endogenous production of erythropoietin (EPO). The discovery of recombinant human EPO (rHuEPO) over 30 years ago has shifted the treatment of anemia for patients on dialysis from blood transfusions to rHuEPO therapy. Many anemia management protocols (AMPs) used by clinicians comprise a set of experience-based rules for weekly-to-monthly titration of rHuEPO doses based on hemoglobin (Hgb) measurements. In order to facilitate the design of an AMP based on formal control design methods, we present a physiologically-relevant erythropoiesis model, and show that its nonlinear dynamics can be approximated using a static nonlinearity, a step that greatly simplifies AMP design. We demonstrate applicability of our results using clinical data.
许多终末期肾病（ESRD）患者因内源性促红细胞生成素（EPO）产生不足而患有贫血。30多年前重组人促红细胞生成素（rHuEPO）的发现，使透析患者贫血的治疗从输血转变为rHuEPO治疗。临床医生使用的许多贫血管理方案（AMP）包括一组基于经验的规则，用于根据血红蛋白（Hgb）测量值对rHuEPO剂量进行每周至每月的滴定。为了便于基于形式控制设计方法设计AMP，我们提出了一个生理相关的红细胞生成模型，并表明其非线性动力学可以用静态非线性近似，这一步大大简化了AMP设计。我们使用临床数据证明了我们结果的适用性。
