AI 中文总结
针对肾上腺皮质功能不全患者皮质醇水平调节问题，提出含内源性昼夜节律的HPA轴新数学模型，用固定剂量开环策略模拟发现非最优，进而提出MPC，可严格处理剂量限制，辅助医生制定最优皮质醇替代治疗方案。
AI 中文摘要
肾上腺皮质功能不全（AI），即低皮质醇血症，会影响个体调节应激、代谢和免疫反应的能力，维持皮质醇水平在健康范围至关重要。本文提出了一种包含内源性昼夜节律的下丘脑 - 垂体 - 肾上腺（HPA）轴新数学模型，模拟原发性和继发性AI两种低皮质醇血症情况。用固定剂量的开环皮质醇替代策略模拟，结果表明固定策略虽有效但非最优。为获最优策略，提出模型预测控制器（MPC），其能严格处理皮质醇替代剂量限制，可辅助医生进行日常皮质醇替代治疗。
英文摘要
A model predictive controller (MPC) is used to construct a virtual assistant to aid a physician in prescribing cortisol replacement therapy for patients with adrenal insufficiency (AI). AI, also known as hypocortisolism, is a condition that occurs due to a low concentration of cortisol. This hormonal imbalance significantly impacts the individual's ability to regulate stress, metabolism, and immune responses. Thus, it is essential to maintain cortisol levels within a healthy range. The production of cortisol is governed by the hypothalamus-pituitary-adrenal (HPA) axis, a part of the endocrine system. In this paper, a novel mathematical model of the HPA axis is proposed that incorporates the endogenous circadian rhythm. This model simulates two conditions of hypocortisolism: primary and secondary AI. Adrenal insufficiency cannot be cured, but it can be treated with cortisol replacement therapy. The standard practice is to prescribe a therapeutic dose of hydrocortisone (HC). To evaluate the accuracy of the proposed HPA axis model, an open-loop cortisol replacement strategy with a fixed dosage is used to simulate both primary and secondary AI. The simulation results show that, analytically, it is possible to arrive at a fixed working cortisol replacement strategy. However, this strategy, though effective, is not optimal. To obtain optimal cortisol replacement strategies, an MPC is proposed. An important feature of MPC is that constraints on allowable cortisol replacement dosages can be rigorously addressed. This controller can serve as a virtual assistant to physicians in prescribing daily cortisol replacement therapy.
