JP2021069284A - Support systems for supporting brain infarction treatment - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a cerebral infarction treatment support method and a cerebral infarction treatment support system for facilitating the handling of support information useful for identifying the type of cerebral infarction. SOLUTION: This cerebral infarction treatment support method includes a step of measuring a biological sample collected from a patient 1 and generating gene-related information 240 related to a susceptibility gene related to cerebral infarction, and the gene-related information 240 of the patient 1. A step of setting the identification information 245a, a step of associating the set identification information 245a of the patient 1 with the identification information 245a of the patient 1 stored in the management unit 250, and a step of associating the patient 1 stored in the management unit 250. It is provided with a step of associating and managing at least one of the patient information 245 of the patient 1 according to the identification information 245a of the patient or the identification information 245a of the patient 1 and the gene-related information 240. [Selection diagram] FIG. 10

Description

The present invention relates to a cerebral infarction treatment support method and a cerebral infarction treatment support system, and more particularly to a cerebral infarction treatment support method and a cerebral infarction treatment support system that support the treatment of a cerebral infarction patient in the acute phase.

In recent years, research has been conducted to identify the type of cerebral infarction based on the presence or absence of a susceptibility gene in a patient's biological sample (see, for example, Non-Patent Document 1).

Daisuke Kawakami, "Development of a rapid genotype determination system for the moyamoya disease susceptibility gene RNF213", Medical Science Digest, 2019, Vol. 45, March (No. 590), p. 47-49

The detection device for identifying the presence or absence of a susceptibility gene in a patient's biological sample is usually installed in a room separate from the treatment room in which the device for treating cerebral infarction is installed. In this case, the technician performing the detection operation by the detection device cannot know to which treatment room the patient from whom the biological sample was collected was brought to, and therefore, in order to identify the type of cerebral infarction obtained by the detection operation. It is not possible to determine which treatment room to bring useful support information to. Such a situation is fatal in the acute treatment of cerebral infarction, which requires immediate treatment.

The present invention has been made to solve the above-mentioned problems, and one object of the present invention is cerebral infarction treatment support that facilitates the handling of support information useful for identifying the type of cerebral infarction. It is to provide a method and a cerebral infarction treatment support system.

As a result of diligent studies by the inventor of the present application in order to achieve the above object, it was found that the presence or absence of a specific human gene significantly correlates as a susceptibility gene for specifying the type of cerebral infarction. I came to do it. That is, the cerebral infarction treatment support method in the first aspect of the present invention includes a step of measuring a biological sample collected from a patient and generating gene-related information related to a susceptibility gene related to cerebral infarction, and a patient in the gene-related information. The step of setting the identification information of the patient, the step of associating the set patient identification information with the patient identification information stored in the management department, and the patient identification information or patient identification stored in the management department. It includes at least one of the patient information of the patient related to the information and a step of associating and managing the gene-related information.

The cerebral infarction treatment support system in the second aspect of the present invention stores a detection device that measures a biological sample collected from a patient and generates gene-related information related to a susceptibility gene related to cerebral infarction, and patient identification information. At the same time, it is communicably connected to the detection device, and the set patient identification information is associated with the stored patient identification information, and the stored patient identification information or the patient related to the patient identification information. It is provided with at least one of the patient information of the patient and a management unit that manages the gene-related information in association with each other.

In the cerebral infarction treatment support method in the first phase and the cerebral infarction treatment support system in the second phase, gene-related information related to the susceptibility gene related to cerebral infarction is provided in the treatment of patients with cerebral infarction in the acute phase by the above configuration. , It can be managed in association with at least one of the patient identification information stored in the management unit or the patient information related to the patient identification information. This allows the physician to easily call up information related to the susceptibility gene for cerebral infarction for a patient who is being treated for cerebral infarction from the management department. From the above, it is possible to facilitate the handling of support information useful for identifying the type of cerebral infarction.

It is a schematic diagram which shows the whole structure of the cerebral infarction treatment support system. It is a schematic diagram which shows the structural example of the detection device. It is a figure (A)-(F) for demonstrating the detection result of the detection apparatus. It is a figure for demonstrating the 2nd information. It is a schematic diagram which shows the kind of a treatment device. It is a figure which showed the example of the 1st information and the 2nd information. It is a figure which shows the configuration example of the cerebral infarction treatment support system. It is a flow chart for explaining the flow of treatment of a cerebral infarction patient in an acute phase. It is a flow chart which showed the cerebral infarction treatment support method. It is a schematic diagram for demonstrating the cooperation of information between each server and modality in a cerebral infarction treatment support system. It is a schematic diagram for demonstrating the process of transmitting the 1st information and / or the 2nd information to an X-ray photographing apparatus. It is a flow chart which showed the process of transmitting the 1st information and / or the 2nd information. It is a flow chart which showed the process of deleting the 1st information. It is a flow chart which showed the process of transmitting the 2nd information and CT image or MRI image. It is a block diagram which shows the structure of the angiography apparatus. It is a figure which shows an example of the angiography apparatus. It is a figure for demonstrating the generation of a superposed image. It is a figure for demonstrating the reconstruction of the blood vessel image data. It is a flowchart which shows the operation of the angiography apparatus. It is a flow chart which showed the process of transmitting the 2nd information by 1st modification. It is a flow chart which showed the process of deleting the 1st information by 2nd modification.

Hereinafter, embodiments embodying the present invention will be described with reference to the drawings.

The configuration of the cerebral infarction treatment support system 100 according to the embodiment will be described with reference to FIG.

The cerebral infarction treatment support system 100 is a system that supports the diagnosis and treatment of cerebral infarction patients in the acute stage. The cerebral infarction treatment support system 100 is provided in a medical facility such as a hospital, for example. The cerebral infarction treatment support system 100 is configured to provide doctors and the like with useful information for diagnosis and treatment when diagnosing and treating an acute cerebral infarction patient who has been transported to a facility. The cerebral infarction treatment support system 100 provides support information different from the medical image, such as a doctor, separately from the medical image (X-ray image, CT image, MRI image, etc.) used for diagnosis and treatment of the cerebral infarction patient in the acute stage. Can be provided to.

The cerebral infarction treatment support system 100 includes at least a gene detection device 10, an image control unit 20, and a display unit 30.

The detection device 10 is configured to measure the biological sample 2 collected from the patient 1 and generate the first information 41 as to whether or not the biological sample 2 has a susceptibility gene for cerebral infarction. The detection device 10 is installed in a laboratory of a medical facility such as a hospital, for example.

The biological sample 2 is a liquid collected from patient 1 and containing at least the genomic DNA of patient 1. The biological sample 2 includes, for example, a sample such as blood or saliva collected from the patient 1. In addition, blood includes either whole blood, plasma, or serum. The sample may be a tissue such as hair, nails, skin, mucous membrane, or cells. The biological sample 2 may contain a component used for measurement of the detection device 10 in addition to the sample. The biological sample 2 may contain, for example, a lysate for eluting a gene from the sample, a reaction solution for amplifying a gene, and the like. The reaction solution is designed to specifically react with the susceptibility gene for cerebral infarction to be detected. As used herein, a biological sample is a concept that includes not only the sample itself collected from patient 1, but also a prepared sample prepared by the sample and other components.

Sensitivity genes for stroke are significantly correlated with the likelihood of developing a particular type of stroke. That is, the presence of a susceptibility gene for cerebral infarction in biological sample 2 means that the likelihood of developing a type of cerebral infarction related to the susceptibility gene is significantly higher than that in the absence of the susceptibility gene. Indicates low. The susceptibility gene for cerebral infarction can be a mutation in a particular gene or a gene polymorphism. The first information 41 indicates whether such a gene mutation or gene polymorphism is present or absent in the DNA in the biological sample 2.

The first information 41 is at least information that can determine whether or not a susceptibility gene for cerebral infarction is present. The first information 41 may be binary information indicating either "with a susceptibility gene for cerebral infarction (positive)" or "without a susceptibility gene for cerebral infarction (negative)". In the first information 41, there are "two (mutant homo)", "one (mutant / wild-type hetero)", and "no (wild-type homo)" mutations or polymorphisms that are susceptibility genes. It can be information indicating any of the above.

In the cerebral infarction treatment support system 100, the second information 42 related to the diagnosis or treatment of cerebral infarction can be generated based on the first information 41 whether or not a susceptibility gene for cerebral infarction exists. The second information 42 may include, for example, information indicating the type of cerebral infarction that is significantly associated with the susceptibility gene for cerebral infarction. In addition to this, for example, a patient having a susceptibility gene may develop a characteristic (trait) that facilitates the development of cerebral infarction. The characteristics that make cerebral infarction more likely to occur are, for example, that the blood vessels in the brain tend to be thin and the blood vessel walls tend to be weak. The second information 42 is secondary information generated by taking the first information 41 as to whether or not a susceptibility gene for cerebral infarction is present as the primary information and adding other medical scientific knowledge. The second information 42 does not need to be generated by the detection device 10. The second information 42 can be generated by, for example, a computer or server capable of acquiring the first information 41 from the detection device 10 via a network.

The image control unit 20 acquires at least one of the first information 41 generated by the detection device 10 and the second information 42 related to the susceptibility gene generated based on the first information 41. The image control unit 20 controls the display unit 30 so as to display at least one of the acquired first information 41 and second information 42. The image control unit 20 includes, for example, a computer configured to be able to communicate with the detection device 10 and the display unit 30.

Specifically, the image control unit 20 includes a reception unit 21 and a video output unit 22. The receiving unit 21 receives at least one of the first information 41 generated by the detection device 10 and the second information 42 related to the susceptibility gene generated based on the first information 41. The receiving unit 21 can directly communicate with the detection device 10 by wire or wirelessly, for example. The receiving unit 21 can communicate with the detection device 10 via a network, for example. The receiving unit 21 does not need to receive information from the detection device 10, and is connected to a device that stores the first information 41 generated by the detection device 10 and the second information 42 generated based on the first information 41 via a network. It suffices if it is accessible.

The video output unit 22 outputs at least one of the received first information 41 and second information 42 to the display unit 30. The video output unit 22 is electrically connected to the display unit 30 by wire or wirelessly. FIG. 1 shows an example in which the image control unit 20 is installed outside the image interpretation chamber 901 and the catheter chamber 902. In the example of FIG. 1, the image control unit 20 delivers at least one of the first information 41 and the second information 42 to the display unit 30 installed in the image interpretation chamber 901 and the catheter chamber 902.

The display unit 30 is a monitor that displays information. The display unit 30 is arranged in at least one of the catheter chamber 902 in which the blood vessel X-ray imaging apparatus is arranged and the interpretation chamber 901 in which the image viewing terminal of the radiodiagnosis image or the MRI image is arranged. .. The image control unit 20 outputs the received information (first information 41 and / or second information 42) to the display unit 30. The display unit 30 displays the information (first information 41 and / or second information 42) output from the image control unit 20.

In the cerebral infarction treatment support system 100, the information output from the image control unit 20 (at least one of the first information 41 and the second information 42) is displayed on the display unit 30 at least during the treatment or diagnosis of the patient 1. ..

For patients with cerebral infarction in the acute stage, CT images or MRI images for diagnosis are taken by a CT device or MRI device in the hospital, and diagnosis is performed in the interpretation room 901 in the hospital. In the cerebral infarction treatment support system 100, for example, when the patient 1 is diagnosed, the information received by the image control unit 20 is output to the display unit 30 installed in the interpretation room 901. The image interpretation room 901 is a room in which a radiological diagnostic device (X-ray imaging device, CT device, etc.) or an image viewing terminal (PC) for diagnostic images such as MRI is arranged.

After diagnosis, in the stage of treatment of a cerebral infarction patient, for example, catheter treatment is performed on the infarcted site in the cerebrovascular. In the cerebral infarction treatment support system 100, for example, at the time of catheter treatment of patient 1, the information received by the image control unit 20 is output to the display unit 30 installed in the catheter room 902. The catheter room 902 is a room in which a blood vessel X-ray imaging device used at the time of catheter treatment is installed.

As described above, the display unit 30 is arranged in at least one of the catheter room 902 and the interpretation room 901 in the hospital. The cerebral infarction treatment support system 100 may include another display unit in addition to the display unit 30 of the catheter room 902 and the interpretation room 901. Such a display unit 30 can be a display unit of a portable information terminal such as a tablet terminal carried by a doctor or the like.

(Detector)
The detection device 10 detects a susceptibility gene (gene to be detected) related to cerebral infarction from the biological sample 2. To detect a susceptibility gene is to detect a specific base sequence in the genomic DNA contained in the biological sample 2. As a detection result, the detection device 10 generates first information 41 as to whether or not the biological sample 2 has a susceptibility gene for cerebral infarction.

The susceptibility gene detected by the detection device 10 is not limited to one (one type). If the presence or absence of susceptibility genes for a plurality of types of cerebral infarction significantly correlates with the likelihood of developing any type of cerebral infarction, the first information 41 may represent the presence or absence of each of the plurality of types of susceptibility genes. ..

The detection device 10 amplifies, for example, the gene to be detected in the biological sample 2. The detection device 10 binds the gene to be detected to the labeling substance, for example. The detection device 10 detects a susceptibility gene related to cerebral infarction, for example, by detecting a labeling substance bound to a gene to be detected. The labeling substance is not particularly limited as long as it is a substance that generates a signal that can be detected by the detection device 10, and includes, for example, a fluorescent substance (fluorescent label). In this case, the detection device 10 irradiates the biological sample 2 with excitation light and detects the fluorescence generated from the labeling substance.

In the configuration example of FIG. 2, the detection device 10 is a gene amplification detection device that amplifies and detects a gene to be detected by using a PCR (Polymerase Chain Reaction) method. The detection device 10 includes a container mounting unit 11, a detection unit 12, a temperature adjusting unit 13, and a data processing unit 14.

The container mounting portion 11 is configured so that the sample container 3 containing the biological sample 2 can be installed. The sample container 3 is a translucent reaction container, and may be a so-called PCR tube, a well plate, or the like.

The temperature adjusting unit 13 is configured to heat and / or cool the sample container 3 installed in the container mounting unit 11 to adjust the temperature of the biological sample 2. The temperature adjusting unit 13 performs a thermal cycle process for periodically raising and lowering the temperature of the biological sample 2. By the thermal cycle treatment, the gene to be detected (susceptibility gene for cerebral infarction) in the biological sample 2 is amplified.

The detection unit 12 includes a light source 12a and a photodetector 12b. The light source 12a includes, for example, an LED (light emitting diode) element, and generates excitation light of a fluorescent probe contained in the biological sample 2. The light source 12a irradiates the biological sample 2 in the sample container 3 installed in the container mounting portion 11 with excitation light. The fluorescent probe contained in the biological sample 2 is excited by irradiation with excitation light to generate fluorescence. The photodetector 12b is configured to detect the fluorescence generated from the fluorescent probe contained in the biological sample 2. The photodetector 12b outputs a detection signal according to the fluorescence intensity generated from the biological sample 2. The photodetector 12b includes, for example, a photomultiplier tube (PMT) or a photodiode.

Here, in the configuration example of FIG. 2, the detection device 10 contains a sample 2a containing blood or saliva collected from patient 1 and a reaction solution 2c containing a component that suppresses the influence of an inhibitor in the sample 2a. It is configured to perform gene amplification processing on the biological sample 2 obtained. That is, the detection device 10 is a direct PCR device that performs PCR processing on a biological sample 2 prepared without performing purification treatment for purifying DNA from sample 2a. "Direct PCR" means performing the PCR process without going through the DNA purification process. The reaction solution 2c containing a component that suppresses the influence of the inhibitor, the reaction solution 2c contains a PCR enzyme, a fluorescent probe, a primer, and a component that suppresses the influence of the inhibitor in the sample 2a. As a component that suppresses the influence of the inhibitor, for example, it is preferable to use Ampdirect (registered trademark) buffer manufactured by Shimadzu Corporation.

Further, the detection device 10 is configured to perform a real-time PCR method in which labeling treatment with a labeling substance is performed in the process of gene amplification. That is, the detection device 10 specifically binds the fluorescent probe to the gene to be detected (susceptibility gene for cerebral infarction) in the gene amplification process by PCR treatment, instead of performing labeling treatment on the amplification product after gene amplification by PCR treatment. Let me.

In the configuration example of FIG. 2, first, the sample 2a collected from the patient 1 is mixed with the cytolytic solution 2b. The mixed solution of the sample 2a and the cytolytic solution 2b is mixed with the reaction solution 2c in the sample container 3. The reaction solution 2c contains a PCR enzyme, a fluorescent probe, a primer, and a component that suppresses the influence of the inhibitor in the sample 2a. As a result, the biological sample 2 is prepared. With a component that suppresses the effects of inhibitors, PCR treatment can be performed without DNA (deoxyribonucleic acid) purification treatment. The detection unit 12 detects fluorescence indicating the presence of the gene to be detected in the process of gene amplification by real-time PCR processing, and outputs a detection signal according to the fluorescence intensity to the data processing unit 14.

The data processing unit 14 is composed of a computer including a processor 14a such as a CPU (Central Processing Unit), a storage unit 14b that stores a program 15 for gene analysis, and a communication unit 14c. The storage unit 14b includes a volatile and / or non-volatile storage device. The communication unit 14c includes a communication interface that can be connected to a network of a medical facility such as a hospital.

The processor 14a acquires the detection signal output from the detection unit 12. The processor 14a analyzes the detection signal by executing the program 15 stored in the storage unit 14b. The processor 14a generates the first information 41 as to whether or not the biological sample 2 has a susceptibility gene for cerebral infarction by analysis. The processor 14a causes the server 50 to transmit the first information 41 via the network by the communication unit 14c. The first information 41 may be directly transmitted to the image control unit 20.

Patient information 45 is added to the biological sample 2 collected from the patient 1. The patient information 45 includes unique identification information that identifies the patient 1. For example, the detection device 10 adds the patient information 45 of the patient 1 from which the biological sample 2 was collected to the first information 41.

Further, FIG. 2 shows an example in which a prepared sample in which the sample 2a, the cell lysate 2b, and the reaction solution 2c are mixed is supplied to the detection device 10 as the biological sample 2, but instead of this, for example, a sample. A biological sample 2 containing only 2a may be supplied to the detection device 10. In this case, the detection device 10 is provided with a mechanism for dispensing the cytolytic solution 2b and the reaction solution 2c into the sample container 3 containing the biological sample 2, and is configured to prepare a sample for measurement in the detection device 10. It may have been done.

The susceptibility gene for cerebral infarction may be a single nucleotide polymorphism (SNP) in the base sequence of a specific gene. Examples of SNP detection methods include RFLP (restricted enzyme fragment length polymorphism) method, PCR-SCSP (single-strand DNA higher-order structure polymorphism analysis) method, ASO (Allele Specific Oligonucleotide) hybridization method, and sequencing method. ARMS (Amplification Refracting Mutation System) method, Denaturing Gradient Gel Electrophoresis method, RNAseA cleavage method, DOL (Dye-labeled Oligonucleotide Ligation) method, TaqMan PCR method, primer extension method, invader method, etc. it can. The detection device 10 may be a device capable of implementing any of the above detection methods in addition to the configuration example shown in FIG.

(Sensitivity gene for cerebral infarction)
The susceptibility gene for cerebral infarction is, for example, RNF213p. Contains a genetic polymorphism of R4810K.

RNF213 (Ring finger protein 213) (GenBank accession number NM_001256071.1) is located in the human chromosomal region 17q25.3.

RNF213 p. The R4810K gene polymorphism is a single nucleotide polymorphism (SNP; Single Nucleotide Polymorphism) of 73097 G> A in the nucleotide sequence represented by SEQ ID NO: 2. The detection device 10 detects the SNP of 73097 G> A in the biological sample 2.

SEQ ID NO: 2 is a partial nucleotide sequence of human chromosome 17 DNA containing the mysterin gene and genes in the peripheral region [FLJ3520, NPTX1, CARD14, and Raptor (KIAA1303)], and is registered in NCBI with Contig # NT010783. Corresponds to nucleotides 43560001 to 43795000 of .15.

In the nucleotide sequence represented by SEQ ID NO: 2, in addition to the SNP at position 73097 (73097 G> A) which is G or A, the SNP at position 4766 (4766 T> C) which is T or C, The SNP at position 120764 (120764 G> A), which is G or A, the SNP at position 152917 (152917 G> A), which is G or A, and the SNP at position 232102, which is G or A (232102 G> A). ) Can also exist.

In the present specification, the position of the SNP is described with reference to the position of the nucleotide in the nucleotide sequence represented by SEQ ID NO: 2. For example, "SNP at position 73097" means the SNP at the nucleotide at position 73097 in the nucleotide sequence represented by SEQ ID NO: 2. When describing "73097 G> A" or the like, the base of the major allele (G in this case) is described before the symbol of ">", and the base of the minor allele (A in this case) is described after.

Further, in the present specification, the nucleotide sequence is described as a DNA sequence unless otherwise specified, but when the polynucleotide is RNA (ribonucleic acid), thymine (T) should be appropriately read as uracil (U). To do. The polynucleotide may contain any additional sequence in addition to the contiguous subsequence of the nucleotide sequence represented by SEQ ID NO: 2 or its complementary sequence.

According to the research by the present inventors, RNF213 p. The R4810K polymorphism was found to increase the risk of ischemic stroke (ie, atherothrombotic stroke) due to aortic atherosclerosis. The inventors of the present application have filed a patent application based on this finding. The application numbers of the patent applications filed by the inventors of the present application are Japanese Patent Application No. 2018-233549, PCT / JP2018 / 045915, and the present specification incorporates the entire disclosure contents of these applications by reference.

3 (A) to 3 (F) show the RNF 213 p. This is an example of the detection result of the R4810K gene polymorphism. In each of the graphs of FIGS. 3A to 3F, the vertical axis indicates the signal intensity (fluorescence intensity) of the detection signal of the detection device 10, and the horizontal axis indicates the number of PCR processing cycles in the detection device 10. ..

FIG. 3 (A) shows the detection results of the wild-type positive control of the RNF213 gene. FIG. 3B shows the detection result of the mutant positive control of the RNF213 gene. The wild type is p. It means a base sequence in which the R4810K gene polymorphism does not exist, and the mutant type means p. It means the base sequence in which the R4810K gene polymorphism is present. The positive control is a synthesis of DNA having wild-type and mutant sequences, respectively. FIG. 3C shows the detection results of positive control of heterozygotes, one of which is wild-type and the other of which is a mutant in the RNF213 allele. FIG. 3 (D) shows the detection result using blood collected from the subject. FIG. 3 (E) shows the detection results using saliva collected from the subject. FIG. 3F shows the detection result of the negative control for verifying the determination result of the detection device 10. Negative controls are samples that do not contain either wild-type or mutant forms of the RNF213 gene.

In FIG. 3 (A), the intensity of the fluorescent signal (referred to as wild-type signal 16) generated from the fluorescent probe that specifically binds to the wild-type of the RNF213 gene is increased, and the fluorescent probe that specifically binds to the mutation of the RNF213 gene is increased. The intensity of the fluorescent signal (referred to as mutant signal 17) generated from the above has not changed. In FIG. 3B, the intensity of the wild-type signal 16 does not change, and the intensity of the mutant signal 17 increases. In FIG. 3C, the intensities of both the wild-type signal 16 and the mutant signal 17 are increased. Therefore, from the detection result of the detection device 10, based on the intensity change of the mutant signal 17, RNF213 p. It is possible to determine the presence or absence of the R4810K gene polymorphism.

From FIGS. 3 (D) and 3 (E), it was confirmed that changes in signal intensity similar to those for positive control can be obtained from blood and saliva samples actually collected from the subjects. From FIG. 3 (F), it was confirmed that there was no non-specific amplification and that specific amplification and labeling for the gene to be detected were realized.

From the above, the data processing unit 14 shown in FIG. 2 determines the presence or absence of the susceptibility gene (RNF213 p.R4810K gene polymorphism) related to cerebral infarction based on the intensity change of the mutant signal 17. The data processing unit 14 creates the first information 41 according to the determination result. That is, the first data processing unit 14 shows that the data processing unit 14 has the susceptibility gene for cerebral infarction when the intensity of the signal (mutant signal 17) derived from the labeling substance for the susceptibility gene for cerebral infarction increases. Generate information 41. The first information indicating that the data processing unit 14 does not have the susceptibility gene for cerebral infarction when the intensity of the signal (mutant signal 17) derived from the labeling substance for the susceptibility gene for cerebral infarction does not increase in the detection result. 41 is generated.

As a criterion for determining the presence or absence of a susceptibility gene in the detection result, for example, a threshold value is set for the signal strength. The data processing unit 14 acquires, for example, a difference value between the signal strength at the start of the PCR process and the signal strength at the end of the PCR process, and determines that there is a susceptibility gene when the acquired difference value exceeds the threshold value. .. Simply, when the signal strength of the mutant signal 17 exceeds the threshold value, it may be determined that there is a susceptibility gene.

The susceptibility gene for cerebral infarction is described in RNF213 p. It may be other than the R4810K gene polymorphism. Recent genetic studies have suggested a correlation between cardiogenic cerebral infarction and related genes PITX2 (human chromosomal region 4q25) and ZFHX3 (human chromosomal region 16q22). A correlation between lacunar infarction and ALDH2 (human chromosomal region 12q24) as a related gene has been suggested. Sensitivity genes for cerebral infarction can include one or more of these genes. The susceptibility gene for cerebral infarction may be any gene that shows a significant correlation with a specific cerebral infarction, and is not limited to the above-mentioned genes.

(Second information)
Next, the second information 42 will be described. In the example shown in FIG. 4, the second information 42 includes information 42a regarding the type of cerebral infarction, information 42b regarding the cerebrovascular of patient 1, and a therapeutic device recommended or deprecated for use in the treatment of cerebral infarction catheter of patient 1. It includes at least one of the indicated information 42c (hereinafter referred to as “device information 42c”). The second information 42 is generated, for example, in the form of a message (sentence) to the user.

The information 42a regarding the type of cerebral infarction is information indicating the type of cerebral infarction that significantly correlates with the susceptibility gene whose presence or absence was detected by the first information 41. The types of cerebral infarction are classified into three types: cardiogenic cerebral embolism, lacunar infarction, and atherothrombotic cerebral infarction. The presence of a susceptibility gene indicates, for example, that the likelihood of developing any type of stroke is significantly higher or lower. Information 42a regarding the type of stroke can be a message indicating the type of stroke that is significantly or less likely to develop.

Information 42b regarding the cerebrovascular of patient 1 is information on the morphology or nature of the cerebrovascular of patient 1 that is inferred based on the presence or absence of a susceptibility gene. Information 42b about the cerebral blood vessels of patient 1 can be a message indicating that the cerebral blood vessels tend to be thick or thin, for example, when they have a susceptibility gene. Information 42b about the cerebral blood vessels of patient 1 can be a message indicating that the cerebral blood vessels tend to be strong (hard to be damaged) or weak (vulnerable), for example, when they have a susceptibility gene.

The device information 42c is information indicating the type or shape of a therapeutic device that is an option in catheter treatment.

Treatment devices for catheter treatment of cerebral infarction include a thrombus recovery device 5a, a thrombus suction device 5b, and a percutaneous angioplasty device 5c shown in FIG. The thrombus recovery device 5a has a coiled wire for entwining and collecting the thrombus. The thrombus suction device 5b has a hollow tubular shape and is configured so that the thrombus can be removed by sucking the thrombus inside. The percutaneous angioplasty device 5c comprises a balloon catheter and a stent.

The device information 42c can be, for example, a message indicating a therapeutic device whose use is recommended or deprecated among the thrombus recovery device 5a, the thrombus suction device 5b, and the percutaneous angioplasty device 5c.

For example, RNF213 p. The presence of the R4810K gene polymorphism significantly increases the likelihood of developing atherosclerotic cerebral infarction. In addition, when having this gene polymorphism, the relatively thick blood vessels in the brain, which is the infarct site due to atherothrombotic cerebral infarction, tend to be thinner than the same site in the group not having this gene polymorphism. In addition, relatively large blood vessels in the brain tend to be thinner than normal, so the use of thrombus recovery devices that are prone to contact with blood vessels can lead to reocclusion due to endothelial damage to the occluded blood vessels.

Therefore, as an example, as shown in FIG. 6, the first information 41 is RNF213 p. When R4810K gene polymorphism is indicated, the information 42a regarding the type of cerebral infarction indicates that the type of cerebral infarction developed by the patient 1 from which the biological sample 2 was collected is "highly likely to be atherothrombotic cerebral infarction". Includes a message. The information 42b regarding the cerebral blood vessels of the patient 1 includes a message to the effect that "the cerebral blood vessels tend to be thin" of the patient 1 from which the biological sample 2 was collected. The device information 42c is a message stating that "the use of the thrombus recovery device 5a is deprecated" and / or "the use of the thrombus aspiration device 5b or the percutaneous angioplasty device 5c is recommended". Includes a message. The device information 42c may include a message stating that "use of a smaller diameter therapeutic device than usual is recommended".

In the configuration example of FIG. 2, the cerebral infarction treatment support system 100 includes a server 50 that is communicably connected to the detection device 10 and the image control unit 20 and stores the first information 41. As shown in FIG. 4, the server 50 is configured to generate the second information 42 based on the first information 41.

As described above, the server 50 has a second information generation table 51 for generating the second information 42 according to the content of the first information 41 (with / without the susceptibility gene). The second information generation table 51 is a data table in which the presence / absence of a specific susceptibility gene and the content of the second information 42 to be generated corresponding to the presence / absence of the susceptibility gene are recorded in association with each other. When the server 50 acquires the first information 41 from the detection device 10, the server 50 generates the second information 42 by referring to the second information 42 corresponding to the contents of the first information 41 from the second information generation table 51. The second information 42 is associated with the first information 41 or the patient information 45 assigned to the first information 41. The patient information 45 given to the first information 41 may also be given to the second information 42.

The second information 42 may be generated by the server 50 in the hospital, or may be generated by a cloud server or the like via the Internet. The detection device 10 may generate the second information 42 together with the first information 41. The server 50 includes, for example, at least one of a radiological information system server and a medical image management system server connected to a network in a hospital. Here, the radiological information system server is called a RIS (Radiology Information Systems) server 52 (see FIG. 7), and is a server that mainly executes inspection by a radiological device and processing of a system that manages inspection results. The medical image management system server is a server that collects and records medical image data, and is also called a DICOM server 53 (see FIG. 7) because it handles medical image data conforming to the DICOM standard, which is a standard.

The image control unit 20 (see FIG. 1) is configured to receive at least the second information 42 from, for example, the server 50. The image control unit 20 outputs at least the received second information 42 to the display unit 30 and displays it. The image control unit 20 may receive both the first information 41 and the second information 42 and display them on the display unit 30. The image control unit 20 may display only the first information 41 on the display unit 30, and in this case, the cerebral infarction treatment support system 100 does not have to generate the second information 42.

(Structure example of cerebral infarction treatment support system)
FIG. 7 shows a more specific configuration example of the cerebral infarction treatment support system 100. The cerebral infarction treatment support system 100 may be configured as part or all of the in-hospital network.

Radiation devices such as CT device 101 and MRI device 102 and detection device 10 are connected to the hospital network. Various portable terminals 103 such as tablet-type information terminals and various servers such as RIS server 52 and DICOM server 53 are connected to the hospital network. Further, the blood vessel X-ray imaging device 70 installed in the catheter room 902 and the image viewing terminal 80 installed in the image interpretation room 901 are connected to the in-hospital network.

A blood vessel X-ray apparatus 70, a catheter apparatus 104, and the like are installed in the catheter chamber 902. At the time of treatment, the treatment device 5 to be used is prepared. The blood vessel X-ray imaging device 70 is an angiography apparatus that performs fluoroscopic imaging of blood vessels. The blood vessel X-ray imaging apparatus 70 detects and images the X-rays emitted from the X-ray source by the X-ray detector. The blood vessel X-ray imaging device 70 includes a first control device 71 that performs control processing of the device, and a first display unit 72 that displays an captured X-ray image. The blood vessel X-ray imaging apparatus 70 performs fluoroscopic imaging of the catheter and the treatment device 5 introduced into the blood vessel at the time of catheter treatment in a moving image format, and displays them on the first display unit 72. The details of the blood vessel X-ray imaging apparatus 70 will be described later.

The image viewing terminal 80 installed in the image reading room 901 is, for example, a PC (personal computer), and includes a second control device 81 constituting the PC main body and a second display unit 82. In the interpretation room 901, a doctor or the like browses a medical image of the patient 1 using an image viewing terminal 80, identifies a thrombus site of the cerebral infarction patient 1, diagnoses, and determines a treatment policy. The medical image includes a CT image taken by the CT device 101 and an MRI image taken by the MRI device.

In the configuration example of FIG. 7, the image control unit 20 includes a first control device 71 included in the blood vessel X-ray imaging device 70 installed in the catheter chamber 902. The first control device 71 includes a receiving unit 21 and a video output unit 22. The display unit 30 includes a first display unit 72 that is installed in the catheter chamber 902 and displays an X-ray image 73 of the blood vessel X-ray imaging apparatus 70.

Specifically, the first control device 71 includes at least one of the first information 41 and the second information 42 received during the catheter treatment of the patient 1 in the catheter room 902, and the patient 1 photographed by the blood vessel X-ray imaging device 70. X-ray image 73 is output to the first display unit 72. As a result, the information received by the image control unit 20 (at least one of the first information 41 and the second information 42) is displayed when the patient 1 is treated in the catheter room 902.

Further, in the configuration example of FIG. 7, the image control unit 20 includes a second control device 81 included in the image viewing terminal 80 installed in the image reading room 901. The second control device 81 includes a receiving unit 21 and a video output unit 22. The display unit 30 includes a second display unit 82 installed in the image interpretation room 901 and displaying the screen of the image viewing terminal 80.

Specifically, the second control device 81 receives at least one of the first information 41 and the second information 42 and the CT image 6 or the MRI image 7 of the patient 1 at the time of diagnosing the patient 1 in the interpretation room 901. Therefore, it is configured to output to the second display unit 82. As a result, the information received by the image control unit 20 (at least one of the first information 41 and the second information 42) is displayed at the time of diagnosing the patient 1 in the interpretation room 901.

As described above, the first information 41 and the second information 42 are provided with the patient information 45, or are recorded in the server 50 (RIS server 52 or DICOM server 53) in association with the patient information 45. Further, patient information 45 is added to the X-ray image 73, the CT image 6 and the MRI image 7 by the blood vessel X-ray imaging apparatus 70 at the time of imaging. It can be identified that these images and the first information 41 and the second information 42 were obtained from the same patient 1 based on the patient information 45.

Therefore, in the above configuration example, the image control unit 20 receives the image of the patient 1 to which the patient information 45 is given, and includes the image having the same patient information 45 and at least one of the first information 41 and the second information 42. Is output to the display unit 30. The image of the patient 1 includes any one of the X-ray image 73, the CT image 6 and the MRI image 7 taken by the angiography apparatus 70, and may include a medical image other than these.

The cerebral infarction treatment support system 100 is configured to provide at least one of the first information 41 and the second information 42 to a doctor or the like at the time of postoperative evaluation or confirmation of the progress of treatment after the treatment of the cerebral infarction patient 1. May be done.

(Patient treatment flow)
Next, with reference to FIG. 8, the flow of treatment of the acute cerebral infarction patient 1 will be briefly described.

First, the patient 1 who is presumed to have developed a cerebral infarction is brought to the hospital as an emergency case.

After delivery, patient information 45 and triage information are input to the in-hospital network system. The triage information is information indicating the priority of the treatment sequence determined based on the severity of the patient 1. In addition, sample 2a is obtained from patient 1.

For patient 1, the CT image 6 or the MRI image 7 is taken by the CT device 101 or the MRI device 102 in the imaging room. A biological sample 2 is prepared from the sample 2a and supplied to the detection device 10 in parallel with the imaging of the patient 1. The cerebral infarction treatment support system 100 detects the susceptibility gene by the detection device 10 in parallel with the imaging of the patient 1.

Next, in the interpretation room 901, the patient 1 is diagnosed based on the captured CT image 6 or MRI image 7. The image control unit 20 displays at least one of the first information 41 and the second information 42 together with the image of the patient 1 based on the patient information 45 (see FIG. 6). Based on the provided information, doctors and the like diagnose that patient 1 has cerebral infarction, identify the thrombus site, and determine the treatment policy.

For example, the first treatment is performed according to the treatment policy. The first treatment is administration of a thrombolytic agent to patient 1. If the administration of the thrombolytic agent does not sufficiently improve the blood flow in the cerebrovascular disease, a second treatment is performed as necessary. The second treatment is catheter treatment.

At the time of catheter treatment, the image control unit 20 displays at least one of the first information 41 and the second information 42 together with the X-ray image 73 (see FIG. 7) of the patient 1 based on the patient information 45. The doctor in charge of treatment selects the treatment device 5 with reference to the provided information, and performs catheter treatment with reference to the intravascular X-ray image 73.

(Operation of cerebral infarction treatment support system)
Next, the operation of the cerebral infarction treatment support system 100 will be described with reference to FIG. The cerebral infarction treatment support system 100 implements the cerebral infarction treatment support method of the present embodiment. The detection device 10 shall be referred to FIG. 2, and the first information 41, the second information 42, and the patient information 45 shall be referred to FIGS. 4 and 6.

In step 91, the detection device 10 measures the biological sample 2 collected from the patient 1 and generates the first information 41 as to whether or not the biological sample 2 has a susceptibility gene for cerebral infarction.

In step 92, the detection device 10 adds the patient information 45 of the patient 1 to the first information 41 generated by the biological sample 2 collected from the patient 1 brought in as an emergency case.

In step 93, the second information 42 may be generated based on the first information 41. If the second information 42 is not displayed, step 93 is unnecessary.

In step 94, the receiving unit 21 (see FIGS. 1 and 7) of the image control unit 20 receives at least one of the first information 41 and the second information 42.

In step 95, the video output unit 22 (see FIGS. 1 and 7) of the image control unit 20 outputs at least one of the first information 41 and the second information 42 received by the image control unit 20 to the display unit 30. To display. The image control unit 20 receives the first information 41 of the patient 1 from which the biological sample 2 has been collected based on the patient information 45, and outputs the first information 41 to the display unit 30 (see FIGS. 1 and 7).

The display of the first information 41 and / or the second information 42 may be performed only at the time of treatment and the time of diagnosis of patient 1. In particular, the treatment of cerebral infarction patient 1 in the acute phase needs to be carried out in a short period of time. Therefore, if it takes time to detect the susceptibility gene, it is possible that the generation of the first information 41 has not been completed at the time of diagnosis of patient 1. Even in that case, in the present embodiment, the received information is displayed on the display unit 30 together with the patient information 45 by at least the time of treatment of the patient 1. The treating doctor can select the treatment device 5 with reference to the first information 41 and / or the second information 42.

(Other configuration examples of cerebral infarction support system)
Next, the cerebral infarction treatment support system 200 according to another configuration example will be described with reference to FIGS. 10 and 11. The cerebral infarction treatment support system 200 implements the cerebral infarction treatment support method in the form of this real child.

In the configuration example shown in FIG. 10, the cerebral infarction treatment support system 200 includes a detection device 210, a server 250, and a modality 105. The server 250 is an example of a "management unit" in the claims.

The server 250 includes a RIS server 252, a DICOM server 253, and a hospital information system server connected to a network in the hospital. Here, the hospital information system server is called a HIS (Hospital Information Systems) server 254, and includes, for example, an automatic reception system, an electronic medical record management system, a medical accounting system, a medical appointment system, a pharmacy management system, and the like. The HIS server 254 is configured to store patient information 245. Since the RIS server 252 and the DICOM server 253 have the same configurations as the RIS server 52 (see FIG. 7) and the DICOM server 53 (see FIG. 7, respectively), detailed description thereof will be omitted.

Modality 105 includes a blood vessel X-ray imaging apparatus 270 (see FIG. 11), an image viewing terminal 80 (see FIG. 11), a CT apparatus 101 (see FIG. 7), an MRI apparatus 102 (see FIG. 7), and the like. As used herein, "modality" means a generic term for these medical imaging devices. Since the blood vessel X-ray imaging apparatus 270 has the same configuration as the blood vessel X-ray imaging apparatus 70, detailed description thereof will be omitted. Further, the blood vessel X-ray imaging apparatus 270 is an example of a "device used for treating a patient" within the scope of claims.

(Gene-related information)
The detection device 210 measures the biological sample 2 collected from the patient 1 and generates gene-related information 240 related to the susceptibility gene for cerebral infarction. In addition, the gene-related information 240 includes first information 241 whether or not the biological sample 2 has a susceptibility gene for cerebral infarction, and second information 242 related to the susceptibility gene generated based on the first information 241. Including.

(1st information and 2nd information)
The server 250 is configured to generate the second information 242 related to the susceptibility gene based on the first information 241 included in the gene-related information 240 generated by the detection device 210. The first information 241 is the same information as the first information 41 (see FIG. 4). That is, the first information 241 includes patient information 245 and information with / without gene polymorphism. Further, the patient information 245 is the same information as the patient information 45 (see FIG. 4), and includes the identification information 245a. The identification information 245a is unique information that can identify the patient 1. The identification information 245a includes, for example, a patient identification number. Further, the second information 242 is the same information as the second information 42 (see FIG. 4). That is, the second information 242 is at least information 42a regarding the type of cerebral infarction, information 42b regarding the cerebrovascular of patient 1, and information 42c indicating a therapeutic device recommended or deprecated for use in the treatment of the cerebral infarction catheter of patient 1. Including either.

In the example shown in FIG. 10, the HIS server 254 transmits an inspection request 201 to the detection device 210. When transmitting the examination request 201, the HIS server 254 also transmits the identification information 245a of the patient 1 to be examined.

Upon receiving the inspection request 201, the detection device 210 performs the inspection and generates the first information 241. Further, the detection device 210 associates the generated first information 241 with the identification information 245a transmitted together with the inspection request 201. The detection device 210 transmits the first information 241 associated with the identification information 245a to the HIS server 254.

The HIS server 254 manages the first information 241 transmitted from the detection device 210. Note that managing the first information 241 includes storing the first information 241 in the HIS server 254. Further, the management of the first information 241 includes transmitting the first information 241 to the blood vessel X-ray imaging apparatus 270 and the like.

The server 250 is configured to generate the second information 242 related to the susceptibility gene based on the first information 241 included in the gene-related information 240 generated by the detection device 210.

In the present embodiment, the server 250 is configured to store the identification information 245a of the patient 1. Further, the server 250 is communicably connected to the detection device 210. Further, the server 250 associates the set identification information 245a of the patient 1 with the stored identification information 245a of the patient 1, and also associates the set identification information 245a of the patient 1 with the stored identification information 245a of the patient 1 or the identification information 245a of the patient 1. It is configured to manage at least one of the patient information 245 of the patient 1 in association with the gene-related information 240. In the present embodiment, the process of setting the identification information 245a of the patient 1 in the gene-related information 240 is executed by the detection device 210 that generates the gene-related information 240.

In the present embodiment, the server 250 associates at least one of the first information 241 and the second information 242 with the identification information 245a that identifies the patient 1 (see FIG. 1), thereby causing the first information 241 and the second information. It is configured to manage at least one of 242 in association with patient information 245 of patient 1. In the present embodiment, the HIS server 254 is configured to associate the second information 242 with the patient information 245. Further, the HIS server 254 is configured to store the second information 242 in a state associated with the patient information 245.

Further, the HIS server 254 transmits the imaging request 202 of the patient 1 to the RIS server 252. The RIS server 252 transmits the shooting request 202 to the modality 105 based on the received shooting request 202. Specifically, when the request for acquiring the CT image 6 of the patient 1 is transmitted, the RIS server 252 transmits the imaging request 202 to the CT device 101. Further, when the request for acquiring the MRI image 7 of the patient 1 is transmitted, the RIS server 252 transmits the imaging request 202 to the MRI apparatus 102. Here, the imaging request 202 may include patient information 245.

The modality 105 (here, the CT device 101 or the MRI device 102) that has received the imaging request 202 photographs the patient 1. After the imaging is completed, the modality 105 transmits the acquired image (CT image 6 or MRI image 7) to the DICOM server 253.

The DICOM server 253 stores the transmitted image (CT image 6 or MRI image 7). Here, by associating the patient information 245 included in the imaging request 202 with the patient information 245 stored in the HIS server 254, at least one of the first information 241 and the second information 242 stored in the HIS server 254 is used. , Patient information 245 can be stored in the header of the transmitted image. Further, the DICOM server 253 transmits the imaging completion information 203 indicating that the imaging of the image (CT image 6 or MRI image 7) has been completed to the HIS server 254.

The HIS server 254 that has received the shooting completion information 203 stores that the shooting in the transmitted shooting request 202 has been completed.

Further, the modality 105 acquires the first information 241 and the second information 242 and the image (CT image 6 or MRI image 7) by transmitting the request (request 204, 206, and 207) to the server 250. To do.

Specifically, when diagnosing a cerebral infarction, the image viewing terminal 80 is configured to acquire an image (CT image 6 or MRI image 7) from the DICOM server 253 by being operated by a doctor or the like. ing. The image viewing terminal 80 transmits an image transmission request 204 to the DICOM server 253 by being operated by a doctor or the like. Upon receiving the image transmission request 204, the DICOM server 253 transmits an image (CT image 6 or MRI image 7) to the image viewing terminal 80. For example, a doctor or the like creates a diagnostic report 205 regarding a stenosis site or the like based on an image (CT image 6 or MRI image 7) transmitted to the image viewing terminal 80. The created diagnostic report 205 is transmitted to, for example, the DICOM server 253. The DICOM server 253 stores the transmitted diagnostic report 205.

Further, the blood vessel X-ray imaging apparatus 270 acquires at least one of the first information 241 and the second information 242 and an image (CT image 6 or MRI image 7) when performing treatment for cerebral infarction. Therefore, request 206 and request 207 are transmitted to the server 250. The angiography apparatus 270 acquires information and images transmitted from the server 250 in response to requests 206 and 207.

Here, referring to FIG. 11, the server 250 refers to at least one of the first information 241 and the second information 242 and an image (CT image 6 or MRI image 7) with respect to the angiography apparatus 270. The configuration for transmitting the image will be described.

As shown in FIG. 11, the blood vessel X-ray imaging apparatus 270 requests the RIS server 252 to acquire at least one of the first information 241 and the second information 242 by being operated by a doctor or the like. It is configured to transmit 206. The blood vessel X-ray imaging apparatus 270 also transmits the identification information 245a when transmitting the transmission request 206.

Upon receiving the request 206, the RIS server 252 transmits the request 206 and the identification information 245a to the HIS server 254.

The HIS server 254 that has received the request 206 transmits at least one of the first information 241 and the second information 242 associated with the identification information 245a to the RIS server 252 based on the received identification information 245a. ..

The RIS server 252 transmits at least one of the received first information 241 and second information 242 to the blood vessel X-ray imaging apparatus 270.

Further, the blood vessel X-ray imaging apparatus 270 transmits a transmission request 207 of an image (CT image 6 or MRI image 7) to the DICOM server 253 based on an operation by a doctor or the like. The blood vessel X-ray imaging apparatus 270 also transmits the identification information 245a when transmitting the transmission request 207.

Upon receiving the transmission request 207, the DICOM server 253 uses the image of the patient 1 (CT image 6 or MRI image 7) from among the plurality of stored images (CT image 6 or MRI image 7) based on the identification information 245a. ) Is specified. The DICOM server 253 transmits the specified image (CT image 6 or MRI image 7) to the blood vessel X-ray imaging apparatus 270 via the RIS server 252.

That is, the server 250 is configured to associate the second information 242 with the CT image 6 or the MRI image 7 of the patient 1 using the identification information 245a. Further, the server 250 is configured to transmit at least one of the first information 241 and the second information 242 to the blood vessel X-ray imaging apparatus 270. In the present embodiment, the server 250 obtains the CT image 6 or MRI image 7 of the patient 1 and the second information 242 based on the request 206 and the request 207 from the blood vessel X-ray imaging device 270. It is configured to send to 270.

In the present embodiment, the RIS server 252 adopts a configuration in which at least one of the first information 241 and the second information 242 is transmitted to the vascular X-ray imaging apparatus 270, but is stored in the DICOM server 253. If at least one of the first information 241 and the second information 242 is stored in the CT image 6 or the MRI image 7 of the patient 1, at least one of the first information 241 and the second information 242 by the RIS server 252. No need to send. In this case, at least one of the first information 241 and the second information 242 can be stored in the header of the CT image 6 or the MRI image 7 of the patient 1.

(Transmission processing of first information and / or second information)
Next, a process in which the server 250 generates the first information 241 and the second information 242 will be described with reference to FIG.

In step 301, the detection device 210 measures the biological sample 2 collected from the patient 1 and generates gene-related information 240 related to the susceptibility gene for cerebral infarction. The detection device 210 transmits the generated gene-related information 240 to the server 250.

In step 302, the detection device 210 sets the identification information 245a of the patient 1 in the gene-related information 240.

In step 303, the server 250 associates the set patient 1 identification information 245a with the patient identification information 245a stored in the server 250.

In step 304, the server 250 manages the gene-related information 240 in association with at least one of the patient 1 identification information 245a or the patient 1 patient information 245 related to the patient 1 identification information 245a stored in the server 250. To do. The gene-related information 240 includes first information 241 whether or not the biological sample 2 has a susceptibility gene for cerebral infarction, and second information 242 related to the susceptibility gene generated based on the first information 241. Including. In the present embodiment, the server 250 has at least one of the patient 1 identification information 245a or the patient 1 patient information 245 related to the patient 1 identification information 245a stored in the server 250, and the first information 241 and the second information. It is managed in association with at least one of 242. Specifically, the server 250 manages the second information 242 in association with the patient information 245.

In step 305, the server 250 determines whether there is a request 206 for transmitting the first information 241 and / or the second information 242 from the blood vessel X-ray apparatus 270. If there is a request 206, the process proceeds to step 306. If there is no request 206, the process ends.

In step 306, the server 250 transmits at least one of the first information 241 and the second information 242 to the blood vessel X-ray imaging apparatus 270. After that, the process ends.

(Delete the first information)
In the present embodiment, the HIS server 254 associates the second information 242 with the patient information 245 and immediately or after a preset period of time has elapsed, or the treatment from the angiography device 270 ends. The first information 241 is deleted and the second information 242 in a state associated with the patient information 245 is stored based on the information 208 (see FIG. 10). In the present embodiment, the HIS server 254 associates the second information 242 with the patient information 245, and then deletes the first information 241 based on the information 208 indicating the end of treatment from the blood vessel X-ray apparatus 270. It is configured in.

Next, with reference to FIG. 13, the deletion process of the first information 241 when the first information 241 is deleted based on the information 208 (see FIG. 10) indicating the end of treatment will be described.

In step 401, the server 250 determines whether or not the information 208 indicating the end of treatment has been transmitted from the blood vessel X-ray imaging apparatus 270. When the server 250 receives the information 208 indicating the end of treatment from the blood vessel X-ray apparatus 270, the process proceeds to step 402. If the server 250 does not receive the information 208 indicating the end of treatment from the blood vessel X-ray apparatus 270, the server 250 repeats the process of step 401.

In step 402, the server 250 deletes the first information 241. After that, the process ends.

(Transmission of second information and CT image or MRI image)
Next, with reference to FIG. 14, a process in which the server 250 transmits the second information 242 and the CT image 6 or the MRI image 7 of the patient 1 to the blood vessel X-ray imaging apparatus 270 will be described.

In step 410, the DICOM server 253 determines whether or not there is a transmission request 207 for an image (CT image 6 or MRI image 7) from the blood vessel X-ray imaging apparatus 270. If there is an image transmission request, the process proceeds to step 411. If there is no image transmission request, the process of step 410 is repeated. When the transmission request 207 is transmitted from the blood vessel X-ray imaging apparatus 270, the identification information 245a is also transmitted.

Next, in step 411, the DICOM server 253 (server 250) associates the second information 242 with the CT image 6 or the MRI image 7 of the patient 1 using the identification information 245a. Specifically, the DICOM server 253 that has received the transmission request 207 has an image (CT image) of the patient 1 from among a plurality of stored images (CT image 6 or MRI image 7) based on the identification information 245a. By specifying 6 or the MRI image 7), the second information 242 is associated with the image (CT image 6 or MRI image 7).

Next, in step 412, the DICOM server 253 (server 250) transmits the specified image (CT image 6 or MRI image 7) to the angiography apparatus 270 via the RIS server 252. That is, the DICOM server 253 (server 250) transmits the CT image 6 or MRI image 7 of the patient 1 and the second information 242 to the blood vessel X-ray based on the request 206 and the request 207 from the blood vessel X-ray apparatus 270. It is transmitted to the photographing apparatus 270. After that, the process ends.

(Angiography device)
The angiography apparatus 270 (see FIG. 11) installed in the catheter chamber 902 is, for example, the angiography apparatus 500 shown in FIG. Hereinafter, a configuration example of the angiography apparatus 500 will be described in detail.

(Configuration of angiography device)
As shown in FIGS. 15 and 16, the angiography apparatus 500 of the present embodiment includes a top plate 501 on which the patient 1 is placed, an imaging unit 502 including an X-ray source 521 and a detection unit 522, and image processing. A unit 503, a control unit 504, and a display unit 505 are provided.

The top plate 501 is formed in a rectangular flat plate shape in a plan view. The top plate 501 is placed on the top plate so that the head-foot direction of the patient 1 is along the long side of the rectangle and the left-right direction of the patient 1 is along the short side of the rectangle. In the present specification, the head and foot direction of the patient 1 is the X direction, the left-right direction of the patient 1 is the Z direction, and the X direction and the direction orthogonal to the Z direction are the Y direction.

The imaging unit 502 is configured to irradiate the patient 1 with X-rays from the X-ray source 521, and the detection unit 522 detects the X-rays transmitted through the patient 1.

As shown in FIG. 16B, the X-ray source 521 is attached to one end of the C-shaped holding portion 523. The X-ray source 521 can irradiate the patient 1 with X-rays by applying a voltage by an X-ray tube driving unit (not shown). The X-ray source 521 has a collimator capable of adjusting the X-ray irradiation field, which is the irradiation range of X-rays.

The detection unit 522 is attached to the other end of the holding unit 523. That is, the detection unit 522 is arranged on the opposite side of the top plate 501 from the X-ray source 521. Since the detection unit 522 is arranged so as to face the X-ray source 521, it is configured to be able to detect the X-rays that have passed through the patient 1. The detection unit 522 includes, for example, an FPD (flat panel detector).

As shown in FIG. 15, the image processing unit 503 is a computer configured to include a processor such as a GPU (Graphics Processing Unit) or an FPGA (Field-Programmable Gate Array) configured for image processing. The image processing unit functions as an image processing device by executing an image processing program.

The image processing unit 503 is configured to generate a fluoroscopic image 520 (see FIG. 17) of the patient 1 based on the detection signal output from the detection unit 522.

The control unit 504 is a computer configured to include a CPU (Central Processing Unit), a ROM (Read Only Memory), a RAM (Random Access Memory), and the like.

The control unit 504 is configured to acquire the CT image 6 or the MRI image 7 from the server 506. Since the server 506 has the same configuration as the server 250 (see FIGS. 10 and 11), detailed description thereof will be omitted.

As shown in FIG. 15, the control unit 504 acquires a CT image 6 or an MRI image 7 of the patient 1 undergoing fluoroscopic imaging from the server 506 based on the patient information 545 of the patient 1 undergoing fluoroscopic imaging. It is configured to do.

The control unit 504 selects the CT image 6 or the MRI image 7 having the same spatial coordinates as the fluoroscopic image 520 generated by the image processing unit 503 among the CT image 6 or the MRI image 7 of the patient 1 undergoing fluoroscopic imaging. It is configured as follows. FIG. 17 is a schematic view showing a process of generating a superposed image 530 of the head 550 of the patient 1. The control unit 504 is configured to control the fluoroscopic image 520 to be superimposed (stacked) on the CT image 6 or the MRI image 7 acquired by the display unit 505 and displayed.

As shown in FIG. 17, when the treatment position (thrombus site) 511 is associated with the CT image 6 or the MRI image 7, the control unit 504 controls the display unit 505 to display the treatment position 511 together with the superimposed image 530. Is configured to do. In FIG. 17, the treatment position 511 is marked with a mark 531. The mark 531 may be a figure surrounding the treatment position 511, and an arrow may be displayed.

The control unit 504 is configured to control the acquisition of the gene information 540 that matches the patient information 545 of the patient 1 on which fluoroscopy is performed from the server 506. The genetic information 540 includes at least one of the first information 541 and the second information 542. The first information 541 is the same information as the first information 41 (see FIG. 4). That is, the first information 541 includes patient information 545 and information with / without gene polymorphism. Further, the second information 542 is the same information as the second information 42 (see FIG. 4). That is, the second information 542 is at least information 42a regarding the type of cerebral infarction, information 42b regarding the cerebrovascular of patient 1, and information 42c indicating a therapeutic device recommended or deprecated for use in the treatment of the cerebral infarction catheter of patient 1. Including either.

The control unit 504 is configured to control the gene information 540 to be further displayed on the image in which the fluoroscopic image 520 displayed on the display unit 505 and the CT image 6 or the MRI image 7 are superimposed. The control unit 504 is configured to control the genetic information 540 to be displayed at a position that does not overlap the treatment position 511. As shown in FIG. 17, the position that does not overlap with the treatment position 511 is a position that does not overlap with the mark 531 when the mark 531 indicating the treatment position 511 is displayed.

The display unit 505 is a monitor provided in the angiography apparatus 500. As shown in FIG. 17, in the fluoroscopic image 520, the catheter 512 is clearly imaged, but the blood vessel 513 is not. Therefore, by superimposing the CT image 6 or the MRI image 7, a superposed image 530 in which the catheter 512 and the blood vessel 513 are superposed is generated. As shown in FIG. 17, in the superimposed image 530, the pixel value of the blood vessel 513 is inverted in order to clarify the catheter 512. In addition, in FIG. 18, it is whitened to show that the pixel value of the blood vessel 513 is inverted. The pixel value of the catheter 512 may be inverted. In addition, the superimposed image displays the mark 531 indicating the treatment position 511 and the gene information 540. In FIG. 17, the gene information 540 is represented by characters. By displaying the superimposed image 530, the treatment position 511, and the genetic information 540 on the display unit 505 provided in the angiography apparatus 500, a doctor or the like can confirm the treatment during the treatment. The displayed genetic information 540 is at least one of the first information 541 and the second information 542.

(Flow of diagnosis by doctors, etc.)
Doctors and the like take a CT image 6 or an MRI image 7 when the patient 1 who has a cerebral infarction is transported to a hospital.

In CT imaging, a patient is imaged from a plurality of directions while rotating and moving the imaging unit. As shown in FIG. 18A, a plurality of two-dimensional image data are generated in CT imaging. FIG. 18A shows an image taken while moving in the cephalopod direction (X direction). Then, three-dimensional image data can be generated by reconstructing a plurality of two-dimensional CT images 6 continuously captured as shown in FIG. 18B. A desired CT image 6 can be obtained by cutting the three-dimensional data in an arbitrary direction. For example, when the blood vessel 513 extends along the cephalopod direction, the three-dimensional image data reconstructed as shown in FIG. 18C may be cut in a direction parallel to the cephalopod direction (X direction).

In addition, three-dimensional image data can be generated by reconstructing the MRI image 7. An image of the blood vessel 513 can be generated by cutting the generated three-dimensional image data in the extending direction of the blood vessel.

The doctor or the like confirms the treatment position 511, which is the treatment position, from the CT image 6 or the MRI image 7 taken in the interpretation room 901. By selecting the treatment position 511 of the CT image 6 or the MRI image 7, the doctor or the like marks the treatment position 511 and associates the treatment position 511 with the CT image 6 or the MRI image 7.

In the case of the CT image 6, the doctor or the like can determine the treatment position 511 by the CT value which is the absorption value of X-rays. Here, in the case of cerebral infarction, a thrombus is formed in the blood vessel 513 at the treatment position 511. The thrombus has a higher CT value because it absorbs X-rays than the blood vessel to which the contrast medium is administered, and is displayed in black as compared with the blood vessel without the thrombus. The doctor or the like identifies the treatment position 511 from the difference in the CT value.

In the case of the MRI image 7, the doctor or the like can determine the treatment position 511 from the detection signal. Since the detection signal is strong in the place where the blood flow is fast and the detection signal is weak in the place where the blood flow is slow, the blood vessel with slow blood flow (cerebral infarction is occurring) is displayed darker than other blood vessels. Therefore, the doctor or the like specifies the treatment position 511.

After the imaging of the CT image 6 and the MRI image 7 of the patient 1 is completed, the doctor or the like starts the treatment to remove the thrombus. As shown in FIG. 17, when a doctor or the like starts fluoroscopic imaging for treatment, a superposed image 530 and genetic information 540 in which a fluoroscopic image 520, a CT image 6 or an MRI image 7 are superimposed are displayed on a display unit 505. Is displayed. As shown in FIG. 17, since the treatment position 511 of the CT image 6 or the MRI image 7 is marked with a mark 531, the treatment position 511 can be confirmed even if the doctor performing the treatment and the doctor diagnosing in the interpretation room 901 are different. can do. Since the superimposed image 530 and the genetic information 540 are displayed on the display unit 505, the doctor or the like can smoothly perform the operation.

Next, the operation of fluoroscopic imaging of the angiography apparatus 500 will be described with reference to FIG.

In step 601 the angiography apparatus 500 starts fluoroscopy by accepting the input of the user. When fluoroscopic imaging is started, the angiography apparatus 500 irradiates patient 1 with X-rays from the X-ray source 521. The detection unit 522 detects the X-rays that have passed through the patient 1 and outputs a detection signal.

In step 602, the image processing unit 503 generates a fluoroscopic image 520 based on the detection signal.

In step 603, the control unit 504 controls to acquire the CT image 6 or the MRI image 7 having the same spatial position coordinates as the fluoroscopic image 520 generated in step 602 from the server 506.

In step 604, the control unit 504 controls the display unit 505 to superimpose the fluoroscopic image 520 on the acquired CT image 6 or MRI image 7.

In step 605, the control unit 504 controls to acquire the gene information 540 in which the patient information 545 matches from the server.

In step 606, the control unit 504 controls the display unit 505 to display the acquired genetic information 540 and the superimposed image 530 on which the CT image 6 or the MRI image 7 and the fluoroscopic image 520 are superimposed.

(Effect of this embodiment)
In this embodiment, the following effects can be obtained.

The cerebral infarction treatment support method of the present embodiment includes step 301 of measuring the biological sample 2 collected from the patient 1 and generating gene-related information 240 related to the susceptibility gene related to cerebral infarction as described above, and gene-related. Step 302 for setting the patient 1 identification information 245a in the information 240, step 303 for associating the set patient 1 identification information 245a with the patient 1 identification information 245a stored in the server 250, and the server 250. It includes at least one of the stored identification information 245a of the patient 1 or the patient information 245 of the patient 1 according to the identification information 245a of the patient 1 and step 304 for managing the gene-related information 240 in association with each other.

Further, the cerebral infarction treatment support system 200 of the present embodiment measures the biological sample 2 collected from the patient 1 as described above, and generates the gene-related information 240 related to the susceptibility gene related to the cerebral infarction 210. And the patient 1 identification information 245a is stored, and the patient 1 identification information 245a, which is communicably connected to and communicated with the detection device 210, is associated with the stored patient 1 identification information 245a and is stored. It is provided with at least one of the patient 1 identification information 245a or the patient 1 patient information 245 related to the patient 1 identification information 245a, and a server 250 (management unit 250) that manages the gene-related information 240 in association with each other.

In the cerebral infarction treatment support method and the cerebral infarction treatment support system 100 of the present embodiment, according to the above configuration, when treating the cerebral infarction patient 1 in the acute phase, the patient 1 provides gene-related information 240 related to the susceptibility gene related to the cerebral infarction. , Patient 1 identification information 245a stored in the server 250 or patient 1 patient information 245 related to patient 1 patient information 245 can be managed in association with each other. As a result, the doctor can easily call the information related to the susceptibility gene related to the cerebral infarction for the patient 1 who treats the cerebral infarction from the server 250. As described above, it is possible to facilitate the handling of support information useful for identifying the type of cerebral infarction.

Further, in the above embodiment, a further effect can be obtained by configuring as follows.

That is, in the above embodiment, the step 302 of setting the identification information 245a of the patient 1 in the gene-related information 240 is executed by the detection device 210 that generates the gene-related information 240. With this configuration, when the gene-related information 240 is generated, the identification information 245a of the patient 1 can be set on the spot. As a result, it is possible to suppress the occurrence of a setting error as compared with the configuration in which the doctor or the like sets the identification information 245a of the patient 1 for the gene-related information 240.

Further, in the above embodiment, the gene-related information 240 is related to the first information 241 whether or not the biological sample 2 has a susceptibility gene for cerebral infarction and the susceptibility gene generated based on the first information 241. At least one of the patient 1 identification information 245a or the patient 1 patient information 245 related to the patient 1 identification information 245a stored in the server 250 (management unit 250) including the 2 information 242, and the gene-related information 240. In step 304 of associating and managing the patient 1, at least one of the patient 1 identification information 245a or the patient 1 identification information 245a stored in the server 250, and the first information 241 and the second information. It is managed in association with at least one of 242. With this configuration, in the treatment of the cerebral infarction patient 1 in the acute phase, the first information 241 of whether or not the patient 1 has a susceptibility gene for cerebral infarction, and the second information generated based on the first information 241 are generated. At least one of 242 can be associated with patient information 245. As a result, if the first information 241 or the second information 242 is transmitted to the blood vessel X-ray apparatus 270 at the time of treatment, the doctor who actually performs the treatment considers the information based on the presence or absence of the susceptibility gene and causes cerebral infarction. A treatment device for catheter treatment can be selected according to the type. As described above, it is possible to manage support information useful for the doctor to identify the type of cerebral infarction and to provide the support information to the doctor at the time of treatment of the cerebral infarction.

Further, in the above embodiment, the second information 242 includes information 42a regarding the type of cerebral infarction, information 42b regarding the cerebrovascular disease of patient 1, and a therapeutic device recommended or not recommended for use in the treatment of cerebral infarction catheter of patient 1. Includes at least one of the indicated information 42c. With this configuration, as the second information 242 derived based on the first information 241 whether or not the patient has a susceptibility gene for cerebral infarction, particularly useful support information is provided to doctors involved in the treatment of cerebral infarction. can do.

Further, the above embodiment further includes a step 306 of transmitting at least one of the first information 241 and the second information 242 to the blood vessel X-ray imaging apparatus 270 based on the request 206 from the blood vessel X-ray imaging apparatus 270. .. With this configuration, the first information 241 or the second information 242 is transmitted based on the request 206 from the blood vessel X-ray imaging apparatus 270. Therefore, a doctor or the like operates the blood vessel X-ray imaging apparatus 270 to operate the blood vessel X-ray imaging apparatus 270. The first information 241 or the second information 242 can be acquired at any timing. As a result, the convenience of the user (doctor, etc.) can be improved.

Further, in the above embodiment, after associating the second information 242 with the patient information 245 and associating the second information 242 with the patient information 245, the first information 241 is deleted and the patient information 245 is associated with the second information 242. A step 402 for storing the second information 242 of the above is further included. With this configuration, the second information 242 and the patient information 245 are associated with each other on the server 250. Therefore, when the patient 1 is treated, the second information 242 of the patient 1 is used as the angiography device 70 and / or The second information 242 can be easily transmitted to the image viewing terminal 80. Further, by deleting the first information 241 after associating the second information 242 and the patient information 245, it is possible to provide particularly useful support information to the doctor involved in the treatment of cerebral infarction. It is possible to prevent the first information 241 that requires careful handling ethically from remaining on the server 250. Therefore, even in an emergency such as the treatment of patient 1 of cerebral infarction in the acute phase, it is possible to reliably provide the second information 242 to the doctor without using uncertain communication means such as oral communication. At the same time, it is possible to prevent the first information 241 from leaking from the server 250 and spreading to the outside.

Further, in the above embodiment, in step 402, treatment is performed immediately after associating the second information 242 with the patient information 245, or after a preset period has elapsed, or from the blood vessel X-ray apparatus 270. Based on the information 208 indicating the end, the first information 241 is deleted, and the second information 242 in a state associated with the patient information 245 is stored. With this configuration, when the first information 241 is deleted immediately after associating the second information 242 with the patient information 245, it is possible to reliably suppress the spread of the first information 241. Further, when the first information 241 is deleted after the preset period has elapsed, when the doctor or the like directly confirms the first information 241 within the preset period, the doctor or the like first asks the doctor or the like. Information 241 can be presented. Further, when deleting the first information 241 based on the information 208 indicating the end of treatment from the blood vessel X-ray imaging apparatus 270, unlike the configuration in which the first information 241 is deleted by an operation by a doctor or the like, the first information 241 is deleted. 1 Information 241 can be reliably prevented from remaining on the server 250 without being deleted.

Further, the above embodiment further includes step 411 of associating the second information 242 with the CT image 6 or the MRI image 7 of the patient 1 using the identification information 245a. With this configuration, by associating the second information 242 with the CT image 6 or the MRI image 7, the second information 242 can be displayed together when the CT image 6 or the MRI image 7 is displayed. it can. As a result, when a doctor or the like displays the CT image 6 or the MRI image 7 at the time of treatment, the second information 242 can be easily displayed together with the CT image 6 or the MRI image 7.

Further, in the above embodiment, based on the request from the blood vessel X-ray imaging apparatus 270, the CT image 6 or MRI image 7 of the patient 1 and the second information 242 are transmitted to the blood vessel X-ray imaging apparatus 270 in step 412. Including further. With this configuration, for example, at the time of diagnosis of patient 1 who has developed cerebral infarction, even if the second information 242 is not directly associated with the CT image 6 or the MRI image 7, the server 250 can use the CT image. 6 or the MRI image 7 and the second information 242 can be transmitted to the angiography apparatus 270. Therefore, the CT image 6 or the MRI image 7 and the second information 242 can be reliably presented to the doctor who actually identifies the type of cerebral infarction.

Further, in the above embodiment, the susceptibility gene for cerebral infarction is RNF213p. Contains a genetic polymorphism of R4810K. With this configuration, RNF213p. The first information 241 as to whether or not the gene polymorphism of R4810K is possessed can be presented to the doctor. Based on this first information 241, doctors and the like tend to have a significantly higher possibility that the type of cerebral infarction developed by patient 1 is atherothrombotic cerebral infarction, and that the diameter of major cerebral blood vessels is small. As a result, it is necessary to be careful when using a thrombus recovery device during catheter treatment, and even when using it, it is preferable to use a thrombus recovery device having a smaller diameter than usual. it can.

Further, in the above embodiment, the server 250 includes at least one of a hospital information system server (HIS server 254) and a radiological information system server (RIS server 252) connected to a network in the hospital. With this configuration, the second information 242 can be generated and managed by the server (52 or 53) of the existing network constructed in the hospital. Further, since the second information 242 can be managed in each of the above servers (52 or 53), the second information 242 can be stored in the modality 105 (blood vessel X-ray imaging apparatus 270 and / or image viewing terminal 80). By acquiring, the second information 242 can be easily provided at the time of treatment.

Further, in the above embodiment, the detection device 210 refers to a biological sample 2 containing a sample containing blood or saliva collected from patient 1 and a reaction solution containing a component that suppresses the influence of an inhibitory substance in the sample. The gene amplification detection device 210 is configured to perform a real-time PCR method for performing gene amplification processing and labeling processing with a labeling substance in the gene amplification process. With this configuration, the detection device 210 directly measures the biological sample 2 collected from the patient 1 without purifying the gene by removing the inhibitory substance in the biological sample 2, and the first information 241 Can be generated. Therefore, as compared with the case where the purification treatment is performed, a part of the pretreatment (purification treatment) for the measurement by the detection device 210 becomes unnecessary, so that the first information 241 can be generated quickly. Therefore, the above configuration is particularly useful in that the first information 241 can be provided to the doctor as early as possible in an emergency such as the treatment of the patient 1 of the acute cerebral infarction. In addition, the first information 241 can be rapidly generated as compared with a normal (non-real-time) PCR method in which amplification is performed and then labeling is performed. Therefore, the above configuration is particularly useful in that the first information 241 can be provided to the doctor as early as possible in an emergency such as the treatment of the patient 1 of the acute cerebral infarction.

[Modification example]
It should be noted that the embodiments disclosed this time are exemplary in all respects and are not considered to be restrictive. The scope of the present invention is shown by the scope of claims rather than the description of the above-described embodiment, and further includes all modifications (modifications) within the meaning and scope equivalent to the scope of claims.

(First modification)
For example, in the above embodiment, after transmitting the first information 241 and / or the second information 242, the server 250 shows an example of a configuration in which the first information 241 is deleted based on the information 208 indicating the end of treatment. However, the present invention is not limited to this. For example, the server 250 may be configured to delete the first information 241 immediately after associating the second information 242 with the patient information 245.

A process in which the server 250 according to the first modification transmits the second information 242 after deleting the first information 241 will be described with reference to FIG. 20. The same processing as the flow in the transmission processing of the first information 241 and / or the second information 242 shown in FIG. 12 is designated by the same reference numerals, and detailed description thereof will be omitted.

In steps 301 to 304, the server 250 generates gene-related information 240 (first information 241 and second information 242), and patient 1 identification information 245a or patient 1 identification stored in the server 250. At least one of the patient information 245 of the patient 1 according to the information 240a is associated with the gene-related information 240.

In step 307, the server 250 deletes the first information 241.

In step 305, it is determined whether or not there is a request 206 from the blood vessel X-ray imaging apparatus 270. If there is a request 206 from the angiography device 270, the process proceeds to step 308. If there is no request 206 from the angiography device 270, the process ends.

In step 308, the server 250 transmits the second information 242 to the blood vessel X-ray imaging apparatus 270. After that, the process ends.

With the above configuration, the first information 241 is deleted immediately after associating the second information 242 with the patient information 245, so that the diffusion of the first information 241 can be reliably suppressed. ..

(Second modification)
Further, in the above embodiment, an example of the configuration in which the server 250 deletes the first information 241 based on the information 208 indicating the end of treatment is shown, but the present invention is not limited to this. For example, the server 250 may be configured to delete the first information 241 after a predetermined period of time has elapsed.

The deletion process of the first information 241 according to the second modification will be described with reference to FIG. 21. The same processing as the flow in the deletion processing of the first information 241 shown in FIG. 13 is designated by the same reference numerals, and detailed description thereof will be omitted.

In step 403, the server 250 determines whether or not a preset period has elapsed after associating the second information 242 with the patient information 245. If the preset period has elapsed, the process proceeds to step 402, the first information 241 is deleted, and the process ends. If the preset period has not elapsed, the server 250 repeats the process of step 403.

With the above configuration, the first information 241 is deleted after the preset period has elapsed. Therefore, when a doctor or the like wants to directly check the first information 241 within the preset period. Can present the first information 241 to a doctor or the like.

(Other variants)
Further, in the above embodiment, an example of the configuration in which the step 302 for setting the identification information 245a of the patient 1 in the gene-related information 240 is executed by the detection device 210 is shown, but the present invention is not limited to this. For example, the step 302 of setting the patient 1 identification information 245a in the gene-related information 240 may be executed by a terminal that receives the patient 1 identification information 245a from the user. With this configuration, for example, from the viewpoint of personal protection, the detection device 210 cannot be used stand-alone (independently), or the detection device 210 cannot connect to the server 250 (HIS server 254) in a communicable manner. Even in this case, the user can set the identification information 245a of the patient 1 in the gene-related information 240. As a result, the degree of freedom in selection of the detection device 210 can be improved.

Further, in the above embodiment, the server 250 has shown an example of a configuration in which the patient information 245 is associated with at least one of the first information 241 and the second information 242, but the present invention is not limited to this. .. For example, the server 250 may be configured to associate patient information 245 with both first information 241 and second information 242.

Further, in the above embodiment, the server 250 transmits at least one of the first information 241 and the second information 242 to the blood vessel X-ray apparatus 270 based on the request 206 from the blood vessel X-ray apparatus 270. Although an example is shown, the present invention is not limited to this. For example, the server 250 can perform at least one of the first information 241 and the second information 242 to the blood vessel X-ray apparatus 270 even when the request 206 from the blood vessel X-ray apparatus 270 is not received. It may be configured to transmit to the photographing apparatus 270. For example, the server 250 associates the patient information 245 with at least one of the first information 241 and the second information 242, and then associates the first information 241 and the second information 242 with the angiography apparatus 270. It may be configured to transmit at least one of.

Further, in the above embodiment, an example of the configuration in which the server 250 deletes the first information 241 after associating the second information 242 with the patient information 245 is shown, but the present invention is not limited to this. For example, if the details of the first information 241 cannot be grasped even if the first information 241 is leaked to the outside, such as by encrypting the first information 241, the first information 241 is not deleted. You may. However, even if the first information 241 is encrypted, there is a possibility that a third party can grasp the first information 241. Therefore, it is better to delete the first information 241.

Further, in the above embodiment, an example of the configuration in which the server 250 includes the RIS server 252, the DICOM server 253, and the HIS server 254 is shown, but the present invention is not limited to this. For example, the server 250 may include a Clinical Laboratory Information System server and the like.

Further, in the above embodiment, an example of a configuration in which the second information 242 is associated with the CT image 6 or the MRI image 7 is shown, but the present invention is not limited to this. The second information 242 does not have to be associated with the CT image 6 or the MRI image 7. Further, the first information 241 may be associated with the CT image 6 or the MRI image 7.

Further, in the above embodiment, the second information 242 shows an example including at least one of information 42a regarding the type of cerebral infarction, information 42b regarding cerebrovascular disease, and device information 42c, but the present invention is not limited thereto. .. The second information 242 may include information other than the above-mentioned information as long as it is information derived from the first information 241.

Further, in the above embodiment, an example in which the detection device 210 is a direct PCR device is shown, but the present invention is not limited to this. The detection device 210 may perform a PCR treatment on the biological sample 2 prepared by performing a purification treatment for purifying DNA from the sample 2a.

Further, in the above embodiment, an example in which the detection device 210 performs the real-time PCR method is shown, but the present invention is not limited to this. The detection device 210 may be configured to perform a non-real-time PCR method.

[Aspect]
It will be understood by those skilled in the art that the above exemplary embodiments are specific examples of the following embodiments.

(Item 1)
Steps to measure biological samples taken from patients and generate gene-related information related to susceptibility genes for stroke,
The step of setting the identification information of the patient in the gene-related information, and
A step of associating the set patient identification information with the patient identification information stored in the management unit, and
A cerebral infarction treatment support method comprising a step of associating and managing at least one of the patient's identification information or the patient's patient information related to the patient's identification information stored in the management unit and the gene-related information. ..

(Item 2)
The cerebral infarction treatment support method according to item 1, wherein the step of setting the identification information of the patient in the gene-related information is executed by a detection device that generates the gene-related information.

(Item 3)
The cerebral infarction treatment support method according to item 1, wherein the step of setting the patient identification information in the gene-related information is executed by a terminal that accepts input of the patient identification information from a user.

(Item 4)
The gene-related information includes first information on whether or not the biological sample has the susceptibility gene for cerebral infarction, and second information related to the susceptibility gene generated based on the first information.
It is stored in the management unit in the step of associating and managing at least one of the patient identification information or the patient information of the patient related to the patient identification information and the gene-related information stored in the management unit. Any of items 1 to 3 in which at least one of the patient's identification information or the patient's patient information related to the patient's identification information is managed in association with at least one of the first information and the second information. The method for supporting cerebral infarction treatment according to item 1.

(Item 5)
The second information includes at least one of information about the type of cerebral infarction, information about the patient's cerebrovascular disease, and information indicating a therapeutic device that is recommended or deprecated for use in the patient's cerebral infarction catheter treatment. , The cerebral infarction treatment support method according to item 4.

(Item 6)
Item 4 or 5, further comprising transmitting at least one of the first and second information to the device used to treat the patient, based on a request from the device used to treat the patient. The cerebral infarction treatment support method described in.

(Item 7)
After associating the second information with the patient information and associating the second information with the patient information, the first information is deleted and the second information in a state associated with the patient information is stored. The cerebral infarction treatment support method according to any one of items 4 to 6, further comprising the step of performing.

(Item 8)
After associating the second information with the patient information and associating the second information with the patient information, the first information is deleted and the second information in a state associated with the patient information is stored. Immediately after associating the second information with the patient information, or after a preset period of time has elapsed, or based on information indicating the end of treatment from a device used to treat the patient. The cerebral infarction treatment support method according to item 7, wherein the first information is deleted and the second information in a state associated with the patient information is stored.

(Item 9)
The cerebral infarction treatment support system according to item 7 or 8, further comprising associating the second information with a CT image or an MRI image of the patient using the identification information.

(Item 10)
Item 9 further comprises the step of transmitting the CT or MRI image of the patient and the second information to the device used to treat the patient based on the request from the device used to treat the patient. The cerebral infarction treatment support system described in.

(Item 11)
The susceptibility gene for cerebral infarction is described in RNF213p. The method for supporting cerebral infarction treatment according to any one of items 1 to 10, which comprises a gene polymorphism of R4810K.

(Item 12)
A detection device that measures biological samples collected from patients and generates gene-related information related to susceptibility genes related to cerebral infarction.
The patient's identification information is stored, and the patient's identification information set by being communicably connected to the detection device is associated with the stored patient's identification information, and the stored patient's identification information is stored. A cerebral infarction treatment support system comprising at least one of the patient information of the patient or the patient information of the patient related to the identification information of the patient and a management unit that manages the gene-related information in association with each other.

(Item 13)
The management unit includes a server that stores the patient information.
The cerebral infarction treatment support system according to item 12, wherein the server includes at least one of a hospital information system server and a radiological information system server connected to a network in the hospital.

(Item 14)
The detection device performs gene amplification processing on the biological sample containing a sample containing blood or saliva collected from the patient and a reaction solution containing a component that suppresses the influence of an inhibitor in the sample. The cerebral infarction treatment support system according to item 12 or 13, which comprises a gene amplification detection device configured to perform a real-time PCR method for performing labeling treatment with a labeling substance in the process of gene amplification.

1 patient
2 Biological sample
6 CT image
7 MRI image
200 Cerebral infarction treatment support system
206 Request (Request from the treatment device)
208 Information indicating treatment completion 210 Detector
240 Gene-related information
241 First information
242 Second information
245 patient information
245a Identification information
250 server (administrative department)
252 RIS server (radiology information system server)
253 DICOM server (medical image management system server)
254 HIS server (hospital information system server)
270 Vascular X-ray equipment (device used to treat patients)

Claims (14)

Steps to measure biological samples taken from patients and generate gene-related information related to susceptibility genes for stroke,
The step of setting the identification information of the patient in the gene-related information, and
A step of associating the set patient identification information with the patient identification information stored in the management unit, and
A cerebral infarction treatment support method comprising a step of associating and managing at least one of the patient's identification information or the patient's patient information related to the patient's identification information stored in the management unit and the gene-related information. .. The cerebral infarction treatment support method according to claim 1, wherein the step of setting the identification information of the patient in the gene-related information is executed by a detection device that generates the gene-related information. The cerebral infarction treatment support method according to claim 1, wherein the step of setting the patient identification information in the gene-related information is executed by a terminal that accepts input of the patient identification information from a user. The gene-related information includes first information on whether or not the biological sample has the susceptibility gene for cerebral infarction, and second information related to the susceptibility gene generated based on the first information.
It is stored in the management unit in the step of associating and managing at least one of the patient identification information or the patient information of the patient related to the patient identification information and the gene-related information stored in the management unit. The first to third aspects of claim 1 to 3, wherein at least one of the patient's identification information or the patient's patient information related to the patient's identification information is managed in association with at least one of the first information and the second information. The cerebral infarction treatment support method according to any one item. The second information includes at least one of information about the type of cerebral infarction, information about the patient's cerebrovascular disease, and information indicating a therapeutic device that is recommended or deprecated for use in the patient's cerebral infarction catheter treatment. , The cerebral infarction treatment support method according to claim 4. 4. The step further comprises transmitting at least one of the first information and the second information to the device used for the treatment of the patient based on the request from the device used for the treatment of the patient. Alternatively, the cerebral infarction treatment support method according to 5. After associating the second information with the patient information and associating the second information with the patient information, the first information is deleted and the second information in a state associated with the patient information is stored. The cerebral infarction treatment support method according to any one of claims 4 to 6, further comprising the step of performing. After associating the second information with the patient information and associating the second information with the patient information, the first information is deleted and the second information in a state associated with the patient information is stored. Immediately after associating the second information with the patient information, or after a preset period of time has elapsed, or based on information indicating the end of treatment from a device used to treat the patient. The cerebral infarction treatment support method according to claim 7, wherein the first information is deleted and the second information in a state associated with the patient information is stored. The cerebral infarction treatment support method according to claim 7 or 8, further comprising associating the second information with a CT image or an MRI image of the patient using the identification information. A claim further comprising transmitting the CT or MRI image of the patient and the second information to the device used to treat the patient, based on a request from the device used to treat the patient. 9. The cerebral infarction treatment support method according to 9. The susceptibility gene for cerebral infarction is described in RNF213p. The method for supporting cerebral infarction treatment according to any one of claims 1 to 10, which comprises a gene polymorphism of R4810K. A detection device that measures biological samples collected from patients and generates gene-related information related to susceptibility genes related to cerebral infarction.
The patient's identification information is stored, and the patient's identification information set by being communicably connected to the detection device is associated with the stored patient's identification information, and the stored patient's identification information is stored. A cerebral infarction treatment support system comprising at least one of the patient information of the patient or the patient information of the patient related to the identification information of the patient and a management unit that manages the gene-related information in association with each other. The management unit includes a server that stores the patient information.
The cerebral infarction treatment support system according to claim 12, wherein the server includes at least one of a hospital information system server and a radiological information system server connected to a network in the hospital. The detection device performs gene amplification processing on the biological sample containing a sample containing blood or saliva collected from the patient and a reaction solution containing a component that suppresses the influence of an inhibitor in the sample. The cerebral infarction treatment support system according to claim 12 or 13, further comprising a gene amplification detection device configured to perform a real-time PCR method for performing labeling treatment with a labeling substance in the process of gene amplification.

Images