Specific embodiment
In order to make the object, technical scheme and advantages of the embodiment of the invention clearer, below in conjunction with the embodiment of the present invention
In attached drawing, technical scheme in the embodiment of the invention is clearly and completely described, it is clear that described embodiment is
A part of the embodiment of the present invention, instead of all the embodiments.Based on the embodiments of the present invention, those of ordinary skill in the art
Every other embodiment obtained without creative efforts, shall fall within the protection scope of the present invention.
Fig. 1 is the processing method flow diagram that the embodiment of the present invention predicts the death rate, as shown in Figure 1, the present invention is implemented
A kind of processing method for prediction death rate that example provides, comprising the following steps:
S101: age and the Testing index parameter of patient to be predicted are obtained;The Testing index parameter includes alkaline phosphatase
Enzyme, glutamyl transpeptidase, hepatitis B E antigen, hepatic encephalopathy, serum sodium, Prothrombin activity and total gallbladder whether occur red
Element.
Specifically, device obtains age and the Testing index parameter of patient to be predicted;The Testing index parameter includes alkali
Acid phosphatase, glutamyl transpeptidase, hepatitis B E antigen, whether occur hepatic encephalopathy, serum sodium, Prothrombin activity and
Total bilirubin.Device can be the equipment etc. for executing this method.Age corresponding A ge, alkaline phosphatase corresponding A LP, glutamy turn
Peptase, which corresponds to GGT, hepatitis B E antigen corresponds to HBeAg, hepatic encephalopathy whether occurs corresponds to HE, when can be admitted to hospital according to patient
Testing result determine whether hepatic encephalopathy;Serum sodium corresponds to NA, Prothrombin activity corresponds to PTA, total bilirubin pair
Answer TBIL.
S102: the age and the Testing index parameter are inputted to preset model, by the output knot of the preset model
Anticipated mortality result of the fruit as the patient to be predicted in preset number of days;The preset model is constructed based on ANN;
Wherein, the anticipated mortality is the result is that as caused by virus B hepatitis correlation acute-on-chronic liver failure.
Specifically, device inputs the age and the Testing index parameter to preset model, by the preset model
Export anticipated mortality result of the result as the patient to be predicted in preset number of days;The preset model is based on ANN
Building;Wherein, the anticipated mortality is the result is that as caused by virus B hepatitis correlation acute-on-chronic liver failure.It is default
Number of days may be set according to actual conditions, and be chosen as 28 days (i.e. from 28 days for predicting to count on the day of the death rate, later) or 90
It.Artificial neural network (ANN) is made of one group of processing unit (neuron) that is highly complex and connecting each other, these processing are single
Member is related to weighting connection, it includes input, output and one or more hidden layers.The 28 days and 90 days death rates include to import
The neuron of data available, including various clinical datas, demography and laboratory data and output layer include exporting not
With the neuron of prediction result.Hidden layer is used to allow to output and input interaction complicated between neuron.
Construct the prediction model and need first to acquire data, specifically may is that the demography of patient, Laboratory Variables,
(HBV reactivation, bacterium infection, alcoholism, hemorrhage of digestive tract, hepatotoxic medication, operation), and complication (hyponatremia, it is spontaneous
Property bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome), the Organ Failures such as liver, kidney, brain, blood coagulation, circulation, breathing be
It is obtained from patient medical record or hospital database when HBV-ACLF is diagnosed and during being hospitalized.4 relevant to clinical prognosis are commented
Subsystem, including CLIF-ACLF, MELD, MELD-Na and CTP scoring, calculate in baseline.28 days and 90 days after registration
The death rate is obtained by the case history of patient or with directly contacting for household.
It should be understood that being needed pre- to being constructed based on ANN in advance before using the preset model prediction death rate
If model is trained.It is possible to further be trained using back-propagation algorithm to based on the preset model that ANN is constructed.
The advantages of artificial neural network includes self study, adaptive and reasoning process.ANN can learn from example, by changing mind
The weight connected in member connects each input with corresponding output.When applicable, input will be from first layer neuron
Each layer of neuron is traveled to, until generating output.Then adaptive process is carried out.The value of output and the value of desired output carry out
Compare.If had differences between the two values, an error signal will be generated, therefore, it is possible to use backpropagation (BP)
Algorithm changes the weight connected between neuron, to reduce the global error of network.In the training process, ANN and desired output
Error between value reduces, until reaching minimum value (i.e. network convergence).ANN can according to the knowledge accumulated in training process,
Output is generated from new input data, as reasoning process.It therefore, being capable of Accurate Prediction data by training ANN.It can lead to
The error calculated between generated and desired output valve is crossed, is calculated by learning process of the BP to ANN.Adjustment nerve
The weight connected between member, to reduce the global error of network.If the sum of square error reaches compared with cross-validation data set
Minimum then terminates training.Finally, each patient is provided 28 days and 90 days anticipated mortality results.
Further, this method can also include: that sample data is respectively divided into training data and verify data;Complete
The pairs of training data after training, the training data for completing training is verified using the verify data.With 684 patients
Data as sample data for, can be using the data of 423 patients (accounting 61.8%) therein as training data;It can
Using by the data of 261 patients (accounting 38.2%) therein as verify data.
Can also be for statistical analysis to sample data, all statistical analysis can use SPSS software (19.0 editions
This, IBM, Armonk, NY) it carries out.Assess whether sample data is normal distribution using Kolmogorov-Smirnov inspection.
28 days of follow-up and 90 days, patient was divided into Survivor and died.Continuous variable, with average value ± standard deviation or middle position
Several and quartile range.For classified variable, data are indicated with frequency or percentage.Determine that (input becomes clinical or biochemical parameter
Amount) there is the variable of statistical difference or important clinical feature as input layer with choosing after the relationship of prognosis (output variable),
Artificial neural network is constructed, to predict the ACLF patient 28-90 days death rates.Ratio calculated ratio (OR) and corresponding 95% confidence
Section (95%CI).It is analyzed using ROC curve, the estimated performance of artificial neural network in training and verifying queue is commented
Estimate, respectively using area (AUR) under ROC curve, compares the pre- of ANN and meld points-scoring system sequence using Masmaticl method
Survey performance.Think that difference is statistically significant in P < 0.05.
As a result
The baseline characteristic of patient
During this investigation it turned out, review and summarization analyzes 684 patients for being diagnosed as ACLF, average age is 43.9 ±
11.7 years old, masculinity proportion 85.1%.175 patients dead (25.6%) in follow-up in 28 days;In follow-up in 90 days,
251 deaths (36.7%).Wherein the score of CTP, CLIF-ACLF and MELD-Na are 11 (10,12) respectively in research,
38.6 ± 8.1,22.9 (20.0,26.5), and 20.0 (18.1,28.0).
ANN structure
According to 28 days and follow-up in 90 days as a result, patient is divided into existence group and died.PTA (OR=0.908,95%CI:
0.891-0.926, P < 0.001), TBil (OR=1.003,95%CI:1.002-1.004, P < 0.001), age (OR=
1.037,95%CI:01.022-1.053, P < 0.001), Na (OR=0.923,95%CI:0.892-0.955, P < 0.001),
ALP (OR=0.995,95%CI:0.991-0.999, P=0.009), GGT) (OR=0.984,95%CI:0.975-0.993,
P < 0.001), HE (OR=5.623,95%CI:2.358-10.891, P < 0.001), HBeAg positive rate (OR=0.616,95%
CI:0.429-0.884, P=0.009) with 28 days death rates there is significant correlation.All these variables are included in building ANN
In.
In addition, PTA (OR=0.922,95%CI:0.907-0.937, P < 0.001), TBil (OR=1.003,95%CI:
1.003-1.004, P < 0.001), age (OR=1.040,95%CI:1.026-1.054, P < 0.001), NA (OR=1.379,
95%CI:1.113-1.708, P=0.003), ALP (OR=0.997,95%CI:0.993-1.000, P=0.034), GGT
(OR=0.997,0.984,95%CI:0.994-0.999, P=0.005), HE (OR=2.235,95%CI:1.883-
4.837, P < 0.001) and HBeAg positive rate (OR=1.005,95%CI:1.003-1.006, P < 0.001) all with death in 90 days
The significant correlation of rate.Equally, these variables are also contained in building ANN.
Evaluation of the ANN to 28 days/90 days anticipated mortality accuracys of ACLF
For 28 days death rates in training queue, the precision of prediction of ANN (AUR 0.948,95%CI 0.925-0.970)
It is significantly higher than meld points-scoring system, including MELD (AUR0.777,95%CI:0.735-0.820, P < 0.001), MELD-na
(AUR 0.758,95%CI:0.711-0.805, P < 0.001), in verifying queue, the AUR of 28 days death rates of ANN is
0.748 (95%CI:0.673-0.822), still better than MELD (AUR 0.619,95%CI:0.536-0.701, P=0.0099),
MELD-Na (AUR 0.720,95%CI:0.642-0.799, P=0.424), CTP (AUR 0.713,95%CI:0.634-
0.792, P=0.303), CLIF-ACLF (AUR 0.696,95%CI:0.615-0.777, P=0.2004).
The precision of prediction of training 90 days death rate ANN of queue is AUR 0.913 (95%CI 0.887-0.938), significantly high
In MELD (AUR 0.765,95%CI:0.726-0.805, P < 0.001), MELD-Na (AUR0.775,95%CI:0.733-
0.817, P < 0.001), (AUR 0.712,95%CI:0.669-0.755, P < 0.001) CTP, CLIF-ACLF (AUR0.818,
95%CI:0.782-0.854, P < 0.001), respectively in the verification, the AUR of ANN be 0.754 (95%CI:
0.697-0.812), still better than MELD (AUR 0.626,95%CI:0.560-0.691, P=0.0193), MELD-Na (AUR
0.669,95%CI:0.604-0.733, P=0.1330), CTP (AUR 0.656,95%CI:0.591-0.720, P=
, and CLIF-ACLF (AUR 0.632,95%CI:0.565-0.698, P=0.264) 0.0763)
It discusses
MELD and other points-scoring systems based on MELD are mainly used for Decompensational cirrhosis patient.However, due to ACLF
It is had differences (such as death rate) with cirrhosis in many aspects, MELD etc. is not enough to predict ACLF's based on the points-scoring system of MELD
The death rate.In addition, compared with single factor test, with it is multifactor combine can more effectively predict the prognosis of ACLF.
Artificial neural network can be used to simulate complicated non-linear biosystem.The risk factors of ACLF have first been determined.
In this research, discovery is between 28~90 days dead groups and existence group, PTA, age, TBil, Na, ALP, GGT, HE, HBeAg sun
There are significant differences for property rate.Studies have shown that PTA is related to the death rate of HBV-ACLF.Age, TBil and serum sodium are also HBV-
The predictive factors of ACLF prognosis.In addition, low hemoglobin concentration is according to independent related to the development of ACLF.In addition, HBeAg positive quilt
It confirms related to more serious hepatopathy.
Then, we establish the model based on ANN, to predict HBV-ACLF 28-90 days in individual patient
The death rate.The model is trained and constructs in large quantities of HBV-ACLF patients (n=423), then in another independent team
(n=261) is verified in column.ROC analysis shows, compared with the points-scoring system based on meld, ANN model to 28,90 death
The precision of prediction of rate is higher, including MELD, MELD-na, CTP, CLIF-ACLF.This may be due to complicated, neural network
Multidimensional and nonlinear characteristic.
This research establishes prediction model, and the cross validation in different queues.It may from not concentric data
It will form an independent prognostic model.However, artificial neural network is related to a reasoning process, drawn with reducing by new data set
The mistake risen.As a result, final table provides accurate 28 days and 90 days mortality risks, higher Score on Prediction HBV-
The higher mortality risk of ACLF.
28 days HBV-ACLF and 90 days are predicted based on the model of ANN in conclusion the embodiment of the present invention constructs one
The death rate, it show compared to traditional points-scoring system based on meld superiority.
The processing method of the prediction death rate provided in an embodiment of the present invention, passes through the preset model that will be constructed based on ANN
Result is exported as anticipated mortality of the patient to be predicted in preset number of days as a result, it is possible to improve by virus B hepatitis phase
Close the precision of prediction of the death rate of the patient in preset number of days caused by acute-on-chronic liver failure.
On the basis of the above embodiments, the method also includes:
It is trained in advance to based on the preset model that ANN is constructed.
Specifically, device is trained to based on the preset model that ANN is constructed in advance.It can refer to above-described embodiment, no longer
It repeats.
The processing method of the prediction death rate provided in an embodiment of the present invention, is further able to improve by virus B hepatitis
The precision of prediction of the death rate of the patient caused by related acute-on-chronic liver failure in preset number of days.
It is on the basis of the above embodiments, described to be trained in advance to based on the preset model that ANN is constructed, comprising:
It is trained using back-propagation algorithm to based on the preset model that ANN is constructed.
Specifically, device is trained using back-propagation algorithm to based on the preset model that ANN is constructed.It can refer to above-mentioned
Embodiment repeats no more.
The processing method of the prediction death rate provided in an embodiment of the present invention, is further able to improve by virus B hepatitis
The precision of prediction of the death rate of the patient caused by related acute-on-chronic liver failure in preset number of days.
On the basis of the above embodiments, the method also includes:
Sample data is respectively divided into training data and verify data.
Specifically, sample data is respectively divided into training data and verify data by device.It can refer to above-described embodiment, no
It repeats again.
It completes to the training data to verify the training number for completing training using the verify data after training
According to.
Specifically, device is completed to the training data to verify using the verify data after training and complete instruction
Experienced training data.It can refer to above-described embodiment, repeat no more.
The processing method of the prediction death rate provided in an embodiment of the present invention, is further able to improve by virus B hepatitis
The precision of prediction of the death rate of the patient caused by related acute-on-chronic liver failure in preset number of days.
Fig. 2 is the processing device structure diagram that the embodiment of the present invention predicts the death rate, as shown in Fig. 2, the present invention is implemented
Example provides a kind of processing unit for predicting the death rate, including acquiring unit 201 and predicting unit 202, in which:
Acquiring unit 201 is used to obtain age and the Testing index parameter of patient to be predicted;The Testing index parameter packet
It includes alkaline phosphatase, glutamyl transpeptidase, hepatitis B E antigen, hepatic encephalopathy, serum sodium, factor activity whether occur
Degree and total bilirubin;Predicting unit 202 is used to input the age and the Testing index parameter to preset model, will be described pre-
If anticipated mortality result of the output result of model as the patient to be predicted in preset number of days;The preset model is
Based on ANN building;Wherein, the anticipated mortality by virus B hepatitis correlation acute-on-chronic liver failure the result is that caused
's.
Specifically, acquiring unit 201 is used to obtain age and the Testing index parameter of patient to be predicted;The Testing index
Parameter includes alkaline phosphatase, glutamyl transpeptidase, hepatitis B E antigen, hepatic encephalopathy, serum sodium, fibrin ferment whether occurs
Former mobility and total bilirubin;Predicting unit 202 is incited somebody to action for inputting the age and the Testing index parameter to preset model
Anticipated mortality result of the output result of the preset model as the patient to be predicted in preset number of days;It is described default
Model is constructed based on ANN;Wherein, the anticipated mortality is the result is that by the related slow extra urgaent dispatch liver failure of virus B hepatitis
Caused by exhausting.
The processing unit of the prediction death rate provided in an embodiment of the present invention, passes through the preset model that will be constructed based on ANN
Result is exported as anticipated mortality of the patient to be predicted in preset number of days as a result, it is possible to improve by virus B hepatitis phase
Close the precision of prediction of the death rate of the patient in preset number of days caused by acute-on-chronic liver failure.
On the basis of the above embodiments, described device is specifically used for: carrying out in advance to the preset model constructed based on ANN
Training.
Specifically, described device is specifically used for: being trained in advance to based on the preset model that ANN is constructed.
The processing unit of the prediction death rate provided in an embodiment of the present invention, is further able to improve by virus B hepatitis
The precision of prediction of the death rate of the patient caused by related acute-on-chronic liver failure in preset number of days.
On the basis of the above embodiments, described device is specifically used for: using back-propagation algorithm to being constructed based on ANN
Preset model is trained.
Specifically, described device is specifically used for: being instructed using back-propagation algorithm to based on the preset model that ANN is constructed
Practice.
The processing unit of the prediction death rate provided in an embodiment of the present invention, is further able to improve by virus B hepatitis
The precision of prediction of the death rate of the patient caused by related acute-on-chronic liver failure in preset number of days.
On the basis of the above embodiments, described device is specifically used for: by sample data be respectively divided into training data and
Verify data;It completes to the training data to verify the training number for completing training using the verify data after training
According to.
Specifically, described device is specifically used for: sample data is respectively divided into training data and verify data;It completes
After training to the training data, the training data for completing training is verified using the verify data.
The processing unit of the prediction death rate provided in an embodiment of the present invention, is further able to improve by virus B hepatitis
The precision of prediction of the death rate of the patient caused by related acute-on-chronic liver failure in preset number of days.
The processing unit of the prediction death rate provided in an embodiment of the present invention specifically can be used for executing above-mentioned each method and implement
The process flow of example, details are not described herein for function, is referred to the detailed description of above method embodiment.
Fig. 3 is electronic equipment entity structure schematic diagram provided in an embodiment of the present invention, as shown in figure 3, the electronic equipment
It include: processor (processor) 301, memory (memory) 302 and bus 303;
Wherein, the processor 301, memory 302 complete mutual communication by bus 303;
The processor 301 is used to call the program instruction in the memory 302, to execute above-mentioned each method embodiment
Provided method, for example, obtain age and the Testing index parameter of patient to be predicted;The Testing index parameter includes
Whether alkaline phosphatase glutamyl transpeptidase, hepatitis B E antigen, there is hepatic encephalopathy, serum sodium, Prothrombin activity
And total bilirubin;The age and the Testing index parameter are inputted to preset model, by the output result of the preset model
As anticipated mortality result of the patient to be predicted in preset number of days;The preset model is constructed based on ANN;Its
In, the anticipated mortality is the result is that as caused by virus B hepatitis correlation acute-on-chronic liver failure.
The present embodiment discloses a kind of computer program product, and the computer program product includes being stored in non-transient calculating
Computer program on machine readable storage medium storing program for executing, the computer program include program instruction, when described program instruction is calculated
When machine executes, computer is able to carry out method provided by above-mentioned each method embodiment, for example, obtains patient's to be predicted
Age and Testing index parameter;The Testing index parameter include alkaline phosphatase, glutamyl transpeptidase, hepatitis B E antigen,
Whether hepatic encephalopathy, serum sodium, Prothrombin activity and total bilirubin are occurred;Input the age and Testing index ginseng
Number is pre- as the death rate of the patient to be predicted in preset number of days using the output result of the preset model to preset model
Survey result;The preset model is constructed based on ANN;Wherein, the anticipated mortality is the result is that by virus B hepatitis
Caused by related acute-on-chronic liver failure.
The present embodiment provides a kind of non-transient computer readable storage medium, the non-transient computer readable storage medium
Computer instruction is stored, the computer instruction makes the computer execute method provided by above-mentioned each method embodiment, example
It such as include: age and the Testing index parameter for obtaining patient to be predicted;The Testing index parameter includes alkaline phosphatase, paddy ammonia
Whether acyl transpeptidase hepatitis B E antigen, there is hepatic encephalopathy, serum sodium, Prothrombin activity and total bilirubin;Input
The age and the Testing index parameter are to preset model, using the output result of the preset model as the trouble to be predicted
Anticipated mortality result of the person in preset number of days;The preset model is constructed based on ANN;Wherein, the death rate is pre-
It surveys the result is that as caused by virus B hepatitis correlation acute-on-chronic liver failure.
Those of ordinary skill in the art will appreciate that: realize that all or part of the steps of above method embodiment can pass through
The relevant hardware of program instruction is completed, and program above-mentioned can be stored in a computer readable storage medium, the program
When being executed, step including the steps of the foregoing method embodiments is executed;And storage medium above-mentioned includes: ROM, RAM, magnetic disk or light
The various media that can store program code such as disk.
The embodiments such as electronic equipment described above are only schematical, wherein it is described as illustrated by the separation member
Unit may or may not be physically separated, and component shown as a unit may or may not be object
Manage unit, it can it is in one place, or may be distributed over multiple network units.It can select according to the actual needs
Some or all of the modules therein is selected to achieve the purpose of the solution of this embodiment.Those of ordinary skill in the art are not paying wound
In the case where the labour for the property made, it can understand and implement.
Through the above description of the embodiments, those skilled in the art can be understood that each embodiment can
It realizes by means of software and necessary general hardware platform, naturally it is also possible to pass through hardware.Based on this understanding, on
Stating technical solution, substantially the part that contributes to existing technology can be embodied in the form of software products in other words, should
Computer software product may be stored in a computer readable storage medium, such as ROM/RAM, magnetic disk, CD, including several fingers
It enables and using so that a computer equipment (can be personal computer, server or the network equipment etc.) executes each implementation
Method described in certain parts of example or embodiment.
Finally, it should be noted that the above various embodiments is only to illustrate the technical solution of the embodiment of the present invention, rather than it is right
It is limited;Although the embodiment of the present invention is described in detail referring to foregoing embodiments, the ordinary skill of this field
Personnel are it is understood that it is still possible to modify the technical solutions described in the foregoing embodiments, or to part
Or all technical features are equivalently replaced;And these are modified or replaceed, it does not separate the essence of the corresponding technical solution
The range of various embodiments of the present invention technical solution.