"""
Laboratory Service - LOINC 碼對照與檢驗參考值查詢
整合台灣常用檢驗項目、LOINC 標準碼、參考值範圍
"""
import json
import os
import sqlite3
from typing import Dict, List, Literal, Optional
from utils import log_error, log_info
class LabService:
"""
檢驗服務
- LOINC 碼對照（台灣檢驗項目 ↔ LOINC 國際標準）
- 檢驗參考值查詢（依年齡、性別）
- 檢驗結果判讀
- FHIR Observation 轉換
"""
def __init__(self, data_dir: str):
"""
初始化檢驗服務
Args:
data_dir: 資料目錄路徑
"""
self.data_dir = data_dir
self.db_path = os.path.join(data_dir, "lab_tests.db")
self._initialize_database()
log_info("Lab Service initialized")
def _initialize_database(self):
"""初始化資料庫，建立 LOINC 對照表與參考值表"""
if os.path.exists(self.db_path):
log_info(f"Lab database found at: {self.db_path}")
return
log_info("Initializing Lab database with Taiwan common lab tests...")
conn = sqlite3.connect(self.db_path)
cursor = conn.cursor()
try:
# 1. LOINC 對照表
cursor.execute(
"""
CREATE TABLE IF NOT EXISTS loinc_mapping (
id INTEGER PRIMARY KEY AUTOINCREMENT,
loinc_code TEXT NOT NULL UNIQUE,
loinc_name_en TEXT NOT NULL,
loinc_name_zh TEXT NOT NULL,
common_name_zh TEXT,
category TEXT,
specimen_type TEXT,
unit TEXT,
method TEXT,
created_at TIMESTAMP DEFAULT CURRENT_TIMESTAMP
)
"""
)
# 2. 參考值表
cursor.execute(
"""
CREATE TABLE IF NOT EXISTS reference_ranges (
id INTEGER PRIMARY KEY AUTOINCREMENT,
loinc_code TEXT NOT NULL,
age_min INTEGER,
age_max INTEGER,
gender TEXT,
range_low REAL,
range_high REAL,
unit TEXT,
interpretation TEXT,
created_at TIMESTAMP DEFAULT CURRENT_TIMESTAMP,
FOREIGN KEY (loinc_code) REFERENCES loinc_mapping(loinc_code)
)
"""
)
# 3. 插入台灣常用檢驗項目資料
self._populate_taiwan_common_tests(cursor)
# 4. 建立索引
cursor.execute(
"CREATE INDEX IF NOT EXISTS idx_loinc_code ON loinc_mapping(loinc_code)"
)
cursor.execute(
"CREATE INDEX IF NOT EXISTS idx_loinc_name_zh ON loinc_mapping(loinc_name_zh)"
)
cursor.execute(
"CREATE INDEX IF NOT EXISTS idx_category ON loinc_mapping(category)"
)
cursor.execute(
"CREATE INDEX IF NOT EXISTS idx_ref_loinc ON reference_ranges(loinc_code)"
)
conn.commit()
log_info("Lab database initialized successfully")
except Exception as e:
log_error(f"Failed to initialize lab database: {e}")
conn.rollback()
finally:
conn.close()
def _populate_taiwan_common_tests(self, cursor):
"""填充台灣常用檢驗項目（基於真實醫院檢驗科資料）"""
# 台灣常用檢驗項目與 LOINC 對照表
common_tests = [
# === 血液常規 (CBC) ===
{
"loinc_code": "6690-2",
"loinc_name_en": "Leukocytes [#/volume] in Blood by Automated count",
"loinc_name_zh": "白血球計數",
"common_name_zh": "WBC",
"category": "血液常規",
"specimen_type": "全血",
"unit": "10^3/uL",
"method": "自動血球計數儀",
},
{
"loinc_code": "789-8",
"loinc_name_en": "Erythrocytes [#/volume] in Blood by Automated count",
"loinc_name_zh": "紅血球計數",
"common_name_zh": "RBC",
"category": "血液常規",
"specimen_type": "全血",
"unit": "10^6/uL",
"method": "自動血球計數儀",
},
{
"loinc_code": "718-7",
"loinc_name_en": "Hemoglobin [Mass/volume] in Blood",
"loinc_name_zh": "血紅素",
"common_name_zh": "Hb",
"category": "血液常規",
"specimen_type": "全血",
"unit": "g/dL",
"method": "自動血球計數儀",
},
{
"loinc_code": "4544-3",
"loinc_name_en": "Hematocrit [Volume Fraction] of Blood by Automated count",
"loinc_name_zh": "血球容積比",
"common_name_zh": "Hct",
"category": "血液常規",
"specimen_type": "全血",
"unit": "%",
"method": "自動血球計數儀",
},
{
"loinc_code": "777-3",
"loinc_name_en": "Platelets [#/volume] in Blood by Automated count",
"loinc_name_zh": "血小板計數",
"common_name_zh": "PLT",
"category": "血液常規",
"specimen_type": "全血",
"unit": "10^3/uL",
"method": "自動血球計數儀",
},
# === 生化檢驗 - 血糖相關 ===
{
"loinc_code": "1558-6",
"loinc_name_en": "Fasting glucose [Mass/volume] in Serum or Plasma",
"loinc_name_zh": "空腹血糖",
"common_name_zh": "AC Sugar, FBS",
"category": "生化檢驗-血糖",
"specimen_type": "血清/血漿",
"unit": "mg/dL",
"method": "酵素法",
},
{
"loinc_code": "2345-7",
"loinc_name_en": "Glucose [Mass/volume] in Serum or Plasma",
"loinc_name_zh": "血糖",
"common_name_zh": "Glucose",
"category": "生化檢驗-血糖",
"specimen_type": "血清/血漿",
"unit": "mg/dL",
"method": "酵素法",
},
{
"loinc_code": "4548-4",
"loinc_name_en": "Hemoglobin A1c/Hemoglobin.total in Blood",
"loinc_name_zh": "糖化血色素",
"common_name_zh": "HbA1c",
"category": "生化檢驗-血糖",
"specimen_type": "全血",
"unit": "%",
"method": "HPLC",
},
# === 生化檢驗 - 血脂肪 ===
{
"loinc_code": "2093-3",
"loinc_name_en": "Cholesterol [Mass/volume] in Serum or Plasma",
"loinc_name_zh": "總膽固醇",
"common_name_zh": "T-Chol",
"category": "生化檢驗-血脂",
"specimen_type": "血清/血漿",
"unit": "mg/dL",
"method": "酵素法",
},
{
"loinc_code": "2571-8",
"loinc_name_en": "Triglyceride [Mass/volume] in Serum or Plasma",
"loinc_name_zh": "三酸甘油酯",
"common_name_zh": "TG",
"category": "生化檢驗-血脂",
"specimen_type": "血清/血漿",
"unit": "mg/dL",
"method": "酵素法",
},
{
"loinc_code": "2085-9",
"loinc_name_en": "Cholesterol in HDL [Mass/volume] in Serum or Plasma",
"loinc_name_zh": "高密度脂蛋白膽固醇",
"common_name_zh": "HDL-C",
"category": "生化檢驗-血脂",
"specimen_type": "血清/血漿",
"unit": "mg/dL",
"method": "直接法",
},
{
"loinc_code": "2089-1",
"loinc_name_en": "Cholesterol in LDL [Mass/volume] in Serum or Plasma",
"loinc_name_zh": "低密度脂蛋白膽固醇",
"common_name_zh": "LDL-C",
"category": "生化檢驗-血脂",
"specimen_type": "血清/血漿",
"unit": "mg/dL",
"method": "計算法/直接法",
},
# === 生化檢驗 - 肝功能 ===
{
"loinc_code": "1742-6",
"loinc_name_en": "Alanine aminotransferase [Enzymatic activity/volume] in Serum or Plasma",
"loinc_name_zh": "丙胺酸轉胺酶",
"common_name_zh": "ALT, GPT",
"category": "生化檢驗-肝功能",
"specimen_type": "血清/血漿",
"unit": "U/L",
"method": "酵素法",
},
{
"loinc_code": "1920-8",
"loinc_name_en": "Aspartate aminotransferase [Enzymatic activity/volume] in Serum or Plasma",
"loinc_name_zh": "天門冬胺酸轉胺酶",
"common_name_zh": "AST, GOT",
"category": "生化檢驗-肝功能",
"specimen_type": "血清/血漿",
"unit": "U/L",
"method": "酵素法",
},
{
"loinc_code": "1975-2",
"loinc_name_en": "Bilirubin.total [Mass/volume] in Serum or Plasma",
"loinc_name_zh": "總膽紅素",
"common_name_zh": "T-Bil",
"category": "生化檢驗-肝功能",
"specimen_type": "血清/血漿",
"unit": "mg/dL",
"method": "化學法",
},
# === 生化檢驗 - 腎功能 ===
{
"loinc_code": "2160-0",
"loinc_name_en": "Creatinine [Mass/volume] in Serum or Plasma",
"loinc_name_zh": "肌酸酐",
"common_name_zh": "Cr",
"category": "生化檢驗-腎功能",
"specimen_type": "血清/血漿",
"unit": "mg/dL",
"method": "Jaffe法/酵素法",
},
{
"loinc_code": "3094-0",
"loinc_name_en": "Urea nitrogen [Mass/volume] in Serum or Plasma",
"loinc_name_zh": "尿素氮",
"common_name_zh": "BUN",
"category": "生化檢驗-腎功能",
"specimen_type": "血清/血漿",
"unit": "mg/dL",
"method": "酵素法",
},
{
"loinc_code": "33914-3",
"loinc_name_en": "Glomerular filtration rate/1.73 sq M.predicted [Volume Rate/Area] in Serum or Plasma by Creatinine-based formula (CKD-EPI)",
"loinc_name_zh": "腎絲球過濾率",
"common_name_zh": "eGFR",
"category": "生化檢驗-腎功能",
"specimen_type": "血清/血漿",
"unit": "mL/min/1.73m2",
"method": "CKD-EPI 公式計算",
},
# === 生化檢驗 - 電解質 ===
{
"loinc_code": "2951-2",
"loinc_name_en": "Sodium [Moles/volume] in Serum or Plasma",
"loinc_name_zh": "鈉離子",
"common_name_zh": "Na",
"category": "生化檢驗-電解質",
"specimen_type": "血清/血漿",
"unit": "mmol/L",
"method": "離子選擇電極法",
},
{
"loinc_code": "2823-3",
"loinc_name_en": "Potassium [Moles/volume] in Serum or Plasma",
"loinc_name_zh": "鉀離子",
"common_name_zh": "K",
"category": "生化檢驗-電解質",
"specimen_type": "血清/血漿",
"unit": "mmol/L",
"method": "離子選擇電極法",
},
{
"loinc_code": "2075-0",
"loinc_name_en": "Chloride [Moles/volume] in Serum or Plasma",
"loinc_name_zh": "氯離子",
"common_name_zh": "Cl",
"category": "生化檢驗-電解質",
"specimen_type": "血清/血漿",
"unit": "mmol/L",
"method": "離子選擇電極法",
},
# === 甲狀腺功能 ===
{
"loinc_code": "3016-3",
"loinc_name_en": "Thyrotropin [Units/volume] in Serum or Plasma",
"loinc_name_zh": "促甲狀腺激素",
"common_name_zh": "TSH",
"category": "內分泌-甲狀腺",
"specimen_type": "血清/血漿",
"unit": "uIU/mL",
"method": "化學冷光免疫分析",
},
{
"loinc_code": "3053-6",
"loinc_name_en": "Thyroxine (T4) free [Mass/volume] in Serum or Plasma",
"loinc_name_zh": "游離甲狀腺素",
"common_name_zh": "Free T4",
"category": "內分泌-甲狀腺",
"specimen_type": "血清/血漿",
"unit": "ng/dL",
"method": "化學冷光免疫分析",
},
# === 凝血功能 ===
{
"loinc_code": "5902-2",
"loinc_name_en": "Prothrombin time (PT)",
"loinc_name_zh": "凝血酶原時間",
"common_name_zh": "PT",
"category": "凝血功能",
"specimen_type": "檸檬酸鈉血漿",
"unit": "sec",
"method": "凝固法",
},
{
"loinc_code": "6301-6",
"loinc_name_en": "INR in Platelet poor plasma by Coagulation assay",
"loinc_name_zh": "國際標準化比值",
"common_name_zh": "INR",
"category": "凝血功能",
"specimen_type": "檸檬酸鈉血漿",
"unit": "ratio",
"method": "凝固法計算",
},
{
"loinc_code": "3173-2",
"loinc_name_en": "Activated partial thromboplastin time (aPTT)",
"loinc_name_zh": "活化部分凝血活酶時間",
"common_name_zh": "aPTT",
"category": "凝血功能",
"specimen_type": "檸檬酸鈉血漿",
"unit": "sec",
"method": "凝固法",
},
# === 發炎指標 ===
{
"loinc_code": "1988-5",
"loinc_name_en": "C reactive protein [Mass/volume] in Serum or Plasma",
"loinc_name_zh": "C反應蛋白",
"common_name_zh": "CRP",
"category": "發炎指標",
"specimen_type": "血清/血漿",
"unit": "mg/dL",
"method": "免疫比濁法",
},
]
# 插入檢驗項目
for test in common_tests:
cursor.execute(
"""
INSERT OR IGNORE INTO loinc_mapping
(loinc_code, loinc_name_en, loinc_name_zh, common_name_zh, category, specimen_type, unit, method)
VALUES (?, ?, ?, ?, ?, ?, ?, ?)
""",
(
test["loinc_code"],
test["loinc_name_en"],
test["loinc_name_zh"],
test["common_name_zh"],
test["category"],
test["specimen_type"],
test["unit"],
test["method"],
),
)
# 插入參考值範圍
reference_ranges = [
# 白血球 (成人)
{
"loinc_code": "6690-2",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 4.0,
"range_high": 10.0,
"unit": "10^3/uL",
"interpretation": "成人參考值",
},
# 紅血球
{
"loinc_code": "789-8",
"age_min": 18,
"age_max": 120,
"gender": "M",
"range_low": 4.5,
"range_high": 5.9,
"unit": "10^6/uL",
"interpretation": "成人男性",
},
{
"loinc_code": "789-8",
"age_min": 18,
"age_max": 120,
"gender": "F",
"range_low": 4.0,
"range_high": 5.2,
"unit": "10^6/uL",
"interpretation": "成人女性",
},
# 血紅素
{
"loinc_code": "718-7",
"age_min": 18,
"age_max": 120,
"gender": "M",
"range_low": 13.5,
"range_high": 17.5,
"unit": "g/dL",
"interpretation": "成人男性",
},
{
"loinc_code": "718-7",
"age_min": 18,
"age_max": 120,
"gender": "F",
"range_low": 12.0,
"range_high": 16.0,
"unit": "g/dL",
"interpretation": "成人女性",
},
# 血球容積比
{
"loinc_code": "4544-3",
"age_min": 18,
"age_max": 120,
"gender": "M",
"range_low": 39,
"range_high": 52,
"unit": "%",
"interpretation": "成人男性",
},
{
"loinc_code": "4544-3",
"age_min": 18,
"age_max": 120,
"gender": "F",
"range_low": 36,
"range_high": 46,
"unit": "%",
"interpretation": "成人女性",
},
# 血小板
{
"loinc_code": "777-3",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 150,
"range_high": 400,
"unit": "10^3/uL",
"interpretation": "成人參考值",
},
# 空腹血糖
{
"loinc_code": "1558-6",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 70,
"range_high": 100,
"unit": "mg/dL",
"interpretation": "正常範圍",
},
# 糖化血色素
{
"loinc_code": "4548-4",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 4.0,
"range_high": 5.6,
"unit": "%",
"interpretation": "正常範圍",
},
# 總膽固醇
{
"loinc_code": "2093-3",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 0,
"range_high": 200,
"unit": "mg/dL",
"interpretation": "理想值",
},
# 三酸甘油酯
{
"loinc_code": "2571-8",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 0,
"range_high": 150,
"unit": "mg/dL",
"interpretation": "正常值",
},
# HDL
{
"loinc_code": "2085-9",
"age_min": 18,
"age_max": 120,
"gender": "M",
"range_low": 40,
"range_high": 999,
"unit": "mg/dL",
"interpretation": "成人男性（越高越好）",
},
{
"loinc_code": "2085-9",
"age_min": 18,
"age_max": 120,
"gender": "F",
"range_low": 50,
"range_high": 999,
"unit": "mg/dL",
"interpretation": "成人女性（越高越好）",
},
# LDL
{
"loinc_code": "2089-1",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 0,
"range_high": 130,
"unit": "mg/dL",
"interpretation": "理想值",
},
# ALT (GPT)
{
"loinc_code": "1742-6",
"age_min": 18,
"age_max": 120,
"gender": "M",
"range_low": 0,
"range_high": 40,
"unit": "U/L",
"interpretation": "成人男性",
},
{
"loinc_code": "1742-6",
"age_min": 18,
"age_max": 120,
"gender": "F",
"range_low": 0,
"range_high": 35,
"unit": "U/L",
"interpretation": "成人女性",
},
# AST (GOT)
{
"loinc_code": "1920-8",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 0,
"range_high": 40,
"unit": "U/L",
"interpretation": "成人參考值",
},
# 總膽紅素
{
"loinc_code": "1975-2",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 0.2,
"range_high": 1.2,
"unit": "mg/dL",
"interpretation": "成人參考值",
},
# 肌酸酐
{
"loinc_code": "2160-0",
"age_min": 18,
"age_max": 120,
"gender": "M",
"range_low": 0.7,
"range_high": 1.3,
"unit": "mg/dL",
"interpretation": "成人男性",
},
{
"loinc_code": "2160-0",
"age_min": 18,
"age_max": 120,
"gender": "F",
"range_low": 0.6,
"range_high": 1.1,
"unit": "mg/dL",
"interpretation": "成人女性",
},
# BUN
{
"loinc_code": "3094-0",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 7,
"range_high": 20,
"unit": "mg/dL",
"interpretation": "成人參考值",
},
# eGFR
{
"loinc_code": "33914-3",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 90,
"range_high": 999,
"unit": "mL/min/1.73m2",
"interpretation": "正常腎功能",
},
# 鈉
{
"loinc_code": "2951-2",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 136,
"range_high": 145,
"unit": "mmol/L",
"interpretation": "成人參考值",
},
# 鉀
{
"loinc_code": "2823-3",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 3.5,
"range_high": 5.1,
"unit": "mmol/L",
"interpretation": "成人參考值",
},
# 氯
{
"loinc_code": "2075-0",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 98,
"range_high": 107,
"unit": "mmol/L",
"interpretation": "成人參考值",
},
# TSH
{
"loinc_code": "3016-3",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 0.27,
"range_high": 4.2,
"unit": "uIU/mL",
"interpretation": "成人參考值",
},
# Free T4
{
"loinc_code": "3053-6",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 0.93,
"range_high": 1.7,
"unit": "ng/dL",
"interpretation": "成人參考值",
},
# PT
{
"loinc_code": "5902-2",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 9.5,
"range_high": 12.5,
"unit": "sec",
"interpretation": "成人參考值",
},
# INR
{
"loinc_code": "6301-6",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 0.8,
"range_high": 1.2,
"unit": "ratio",
"interpretation": "未服用抗凝血劑",
},
# aPTT
{
"loinc_code": "3173-2",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 25,
"range_high": 35,
"unit": "sec",
"interpretation": "成人參考值",
},
# CRP
{
"loinc_code": "1988-5",
"age_min": 18,
"age_max": 120,
"gender": "all",
"range_low": 0,
"range_high": 0.5,
"unit": "mg/dL",
"interpretation": "正常值",
},
]
for ref in reference_ranges:
cursor.execute(
"""
INSERT INTO reference_ranges
(loinc_code, age_min, age_max, gender, range_low, range_high, unit, interpretation)
VALUES (?, ?, ?, ?, ?, ?, ?, ?)
""",
(
ref["loinc_code"],
ref["age_min"],
ref["age_max"],
ref["gender"],
ref["range_low"],
ref["range_high"],
ref["unit"],
ref["interpretation"],
),
)
log_info(f"Populated {len(common_tests)} Taiwan common lab tests")
log_info(f"Populated {len(reference_ranges)} reference ranges")
def _query_db(self, sql: str, params: tuple = ()) -> list:
"""執行 SQL 查詢"""
try:
conn = sqlite3.connect(self.db_path)
conn.row_factory = sqlite3.Row
cursor = conn.cursor()
cursor.execute(sql, params)
rows = [dict(row) for row in cursor.fetchall()]
conn.close()
return rows
except Exception as e:
log_error(f"Database query failed: {e}")
return []
# ==========================================
# LOINC 碼對照功能
# ==========================================
def search_loinc_code(self, keyword: str, category: Optional[str] = None) -> str:
"""
搜尋 LOINC 碼（支援中英文檢驗名稱）
Args:
keyword: 搜尋關鍵字（檢驗名稱、LOINC 碼、常用縮寫）
category: 分類篩選（可選）
Returns:
JSON 格式的搜尋結果
"""
term = f"%{keyword}%"
sql = """
SELECT loinc_code, loinc_name_en, loinc_name_zh, common_name_zh,
category, specimen_type, unit, method
FROM loinc_mapping
WHERE (loinc_code LIKE ? OR loinc_name_zh LIKE ? OR
loinc_name_en LIKE ? OR common_name_zh LIKE ?)
"""
params = [term, term, term, term]
if category:
sql += " AND category LIKE ?"
params.append(f"%{category}%")
sql += " ORDER BY loinc_code LIMIT 20"
results = self._query_db(sql, tuple(params))
if not results:
return json.dumps(
{
"message": f"找不到符合 '{keyword}' 的檢驗項目",
"suggestion": "請嘗試使用檢驗的中文名稱、英文名稱或常用縮寫",
},
ensure_ascii=False,
)
return json.dumps(
{"keyword": keyword, "total_found": len(results), "results": results},
ensure_ascii=False,
)
def get_loinc_by_code(self, loinc_code: str) -> Dict:
"""取得特定 LOINC 碼的完整資訊"""
results = self._query_db(
"SELECT * FROM loinc_mapping WHERE loinc_code = ?", (loinc_code,)
)
return results[0] if results else None
def list_categories(self) -> str:
"""列出所有檢驗分類"""
results = self._query_db(
"SELECT DISTINCT category FROM loinc_mapping ORDER BY category"
)
categories = [r["category"] for r in results]
return json.dumps(
{"total_categories": len(categories), "categories": categories},
ensure_ascii=False,
)
# ==========================================
# 檢驗參考值查詢功能
# ==========================================
def get_reference_range(
self, loinc_code: str, age: int, gender: Literal["M", "F", "all"] = "all"
) -> str:
"""
查詢檢驗參考值範圍
Args:
loinc_code: LOINC 碼
age: 年齡
gender: 性別（M=男性, F=女性, all=不分性別）
Returns:
參考值範圍資訊
"""
# 先取得檢驗項目資訊
test_info = self.get_loinc_by_code(loinc_code)
if not test_info:
return json.dumps(
{"error": f"找不到 LOINC 碼: {loinc_code}"}, ensure_ascii=False
)
# 查詢參考值（優先找特定性別，找不到則找 all）
sql = """
SELECT * FROM reference_ranges
WHERE loinc_code = ?
AND age_min <= ?
AND age_max >= ?
AND (gender = ? OR gender = 'all')
ORDER BY
CASE gender WHEN ? THEN 1 ELSE 2 END,
age_min DESC
LIMIT 1
"""
ref_range = self._query_db(sql, (loinc_code, age, age, gender, gender))
if not ref_range:
return json.dumps(
{
"loinc_code": loinc_code,
"test_name_zh": test_info["loinc_name_zh"],
"test_name_en": test_info["loinc_name_en"],
"message": f"找不到適用於年齡 {age} 歲、性別 {gender} 的參考值",
"unit": test_info["unit"],
},
ensure_ascii=False,
)
ref = ref_range[0]
return json.dumps(
{
"loinc_code": loinc_code,
"test_name_zh": test_info["loinc_name_zh"],
"test_name_en": test_info["loinc_name_en"],
"common_name": test_info["common_name_zh"],
"reference_range": {
"low": ref["range_low"],
"high": ref["range_high"],
"unit": ref["unit"],
"interpretation": ref["interpretation"],
},
"applicable_to": {
"age_range": f"{ref['age_min']}-{ref['age_max']} 歲",
"gender": (
"男性"
if ref["gender"] == "M"
else "女性" if ref["gender"] == "F" else "不分性別"
),
},
},
ensure_ascii=False,
)
def interpret_lab_result(
self,
loinc_code: str,
value: float,
age: int,
gender: Literal["M", "F", "all"] = "all",
) -> str:
"""
判讀檢驗結果
Args:
loinc_code: LOINC 碼
value: 檢驗值
age: 年齡
gender: 性別
Returns:
檢驗結果判讀
"""
# 取得參考值
ref_data = json.loads(self.get_reference_range(loinc_code, age, gender))
if "error" in ref_data or "message" in ref_data:
return json.dumps(ref_data, ensure_ascii=False)
ref_range = ref_data["reference_range"]
low = ref_range["low"]
high = ref_range["high"]
# 判斷結果
if value < low:
status = "偏低 (Low)"
flag = "L"
clinical_significance = "低於正常參考值，建議進一步評估"
elif value > high:
status = "偏高 (High)"
flag = "H"
clinical_significance = "高於正常參考值，建議進一步評估"
else:
status = "正常 (Normal)"
flag = "N"
clinical_significance = "數值在正常範圍內"
return json.dumps(
{
"loinc_code": loinc_code,
"test_name_zh": ref_data["test_name_zh"],
"test_name_en": ref_data["test_name_en"],
"result": {
"value": value,
"unit": ref_range["unit"],
"status": status,
"flag": flag,
},
"reference_range": {
"low": low,
"high": high,
"unit": ref_range["unit"],
},
"interpretation": clinical_significance,
"applicable_to": ref_data["applicable_to"],
},
ensure_ascii=False,
)
def batch_interpret_results(
self,
results: List[Dict[str, any]],
age: int,
gender: Literal["M", "F", "all"] = "all",
) -> str:
"""
批次判讀多個檢驗結果
Args:
results: 檢驗結果列表 [{"loinc_code": "...", "value": 123}, ...]
age: 年齡
gender: 性別
Returns:
批次判讀結果
"""
interpretations = []
abnormal_count = 0
for result in results:
loinc_code = result.get("loinc_code")
value = result.get("value")
if not loinc_code or value is None:
continue
interp = json.loads(
self.interpret_lab_result(loinc_code, value, age, gender)
)
if "error" not in interp and "message" not in interp:
interpretations.append(interp)
if interp["result"]["flag"] != "N":
abnormal_count += 1
return json.dumps(
{
"total_tests": len(interpretations),
"abnormal_count": abnormal_count,
"normal_count": len(interpretations) - abnormal_count,
"patient_info": {
"age": age,
"gender": (
"男性"
if gender == "M"
else "女性" if gender == "F" else "不分性別"
),
},
"results": interpretations,
},
ensure_ascii=False,
)
