refactor(miniprogram): 体征阈值改用动态 API — 替代硬编码参考范围

- health.ts 新增 getHealthThresholds/findThreshold/DEFAULT_THRESHOLDS - 24h storage 缓存 + 降级到内置默认值 - health/index.tsx: REF_RANGES → buildRefRange(thresholds) - pkg-health/input: WARN_THRESHOLDS → getWarnForIndicator(thresholds)
2026-05-02 11:40:54 +08:00
parent e8ee441ae1
commit 2cc0f5af25
3 changed files with 131 additions and 22 deletions
--- a/apps/miniprogram/src/pages/health/index.tsx
+++ b/apps/miniprogram/src/pages/health/index.tsx
@@ -3,7 +3,7 @@ import { View, Text, Input } from '@tarojs/components';
 import Taro, { useDidShow } from '@tarojs/taro';
 import { useHealthStore } from '../../stores/health';
 import { useAuthStore } from '../../stores/auth';
-import { inputVitalSign, getTrend } from '../../services/health';
+import { inputVitalSign, getTrend, getHealthThresholds, findThreshold, DEFAULT_THRESHOLDS, type HealthThreshold } from '../../services/health';
 import { listPendingSuggestions, type AiSuggestionItem } from '../../services/ai-analysis';
 import Loading from '../../components/Loading';
 import './index.scss';
@@ -17,12 +17,21 @@ const VITAL_TABS: { key: VitalType; label: string }[] = [
  { key: 'weight', label: '体重' },
 ];

-const REF_RANGES: Record<VitalType, { range: string; warn: string }> = {
-  blood_pressure: { range: '收缩压 90-140 / 舒张压 60-90 mmHg', warn: '血压偏高，确认提交？' },
-  heart_rate: { range: '60-100 bpm', warn: '心率异常，确认提交？' },
-  blood_sugar: { range: '空腹 3.9-6.1 / 餐后 <7.8 mmol/L', warn: '血糖偏高，确认提交？' },
-  weight: { range: '根据 BMI 18.5-24 计算', warn: '' },
-};
+/** 根据阈值列表构建参考范围文案 */
+function buildRefRange(t: HealthThreshold[]): Record<VitalType, string> {
+  const bpSys = findThreshold(t, 'systolic_bp', 'high')?.threshold_value ?? 140;
+  const bpDia = findThreshold(t, 'diastolic_bp', 'high')?.threshold_value ?? 90;
+  const hrHigh = findThreshold(t, 'heart_rate', 'high')?.threshold_value ?? 100;
+  const hrLow = findThreshold(t, 'heart_rate', 'low')?.threshold_value ?? 60;
+  const bsFasting = findThreshold(t, 'blood_sugar_fasting', 'high')?.threshold_value ?? 6.1;
+  const bsPp = findThreshold(t, 'blood_sugar_postprandial', 'high')?.threshold_value ?? 7.8;
+  return {
+    blood_pressure: `收缩压 90-${bpSys} / 舒张压 60-${bpDia} mmHg`,
+    heart_rate: `${hrLow}-${hrHigh} bpm`,
+    blood_sugar: `空腹 3.9-${bsFasting} / 餐后 <${bsPp} mmol/L`,
+    weight: '根据 BMI 18.5-24 计算',
+  };
+}

 interface TrendPoint {
  date: string;
@@ -43,11 +52,13 @@ export default function Health() {
  const [trendData, setTrendData] = useState<TrendPoint[]>([]);
  const [trendLoading, setTrendLoading] = useState(false);
  const [aiSuggestions, setAiSuggestions] = useState<AiSuggestionItem[]>([]);
+  const [thresholds, setThresholds] = useState<HealthThreshold[]>(DEFAULT_THRESHOLDS);

  useDidShow(() => {
    refreshToday();
    loadTrend(activeTab);
    loadAiSuggestions();
+    getHealthThresholds().then((t) => { if (t.length > 0) setThresholds(t); });
  });

  const loadAiSuggestions = async () => {
@@ -86,18 +97,29 @@ export default function Health() {
    if (type === 'blood_pressure') {
      const sys = parseFloat(systolic);
      const dia = parseFloat(diastolic);
-      if (sys > 140 || dia > 90) return REF_RANGES.blood_pressure.warn;
+      const sysMax = findThreshold(thresholds, 'systolic_bp', 'high')?.threshold_value ?? 140;
+      const diaMax = findThreshold(thresholds, 'diastolic_bp', 'high')?.threshold_value ?? 90;
+      if (sys > sysMax || dia > diaMax) return '血压偏高，确认提交？';
    } else if (type === 'heart_rate') {
      const val = parseFloat(heartRateVal);
-      if (val > 100 || val < 60) return REF_RANGES.heart_rate.warn;
+      const hrHigh = findThreshold(thresholds, 'heart_rate', 'high')?.threshold_value ?? 100;
+      const hrLow = findThreshold(thresholds, 'heart_rate', 'low')?.threshold_value ?? 60;
+      if (val > hrHigh || val < hrLow) return '心率异常，确认提交？';
    } else if (type === 'blood_sugar') {
      const val = parseFloat(sugarVal);
-      if (sugarPeriod === 'fasting' && val > 6.1) return REF_RANGES.blood_sugar.warn;
-      if (sugarPeriod === 'postprandial' && val > 7.8) return REF_RANGES.blood_sugar.warn;
+      if (sugarPeriod === 'fasting') {
+        const bsMax = findThreshold(thresholds, 'blood_sugar_fasting', 'high')?.threshold_value ?? 6.1;
+        if (val > bsMax) return '血糖偏高，确认提交？';
+      } else {
+        const bsMax = findThreshold(thresholds, 'blood_sugar_postprandial', 'high')?.threshold_value ?? 7.8;
+        if (val > bsMax) return '血糖偏高，确认提交？';
+      }
    }
    return null;
  };

+  const refRanges = buildRefRange(thresholds);
+
  const handleSave = async () => {
    const patientId = currentPatient?.id;
    if (!patientId) {
@@ -245,7 +267,7 @@ export default function Health() {
              value={diastolic}
              onInput={(e) => setDiastolic(e.detail.value)}
            />
-            <Text className='input-ref'>{REF_RANGES.blood_pressure.range}</Text>
+            <Text className='input-ref'>{refRanges.blood_pressure}</Text>
          </View>
        )}

@@ -259,7 +281,7 @@ export default function Health() {
              value={heartRateVal}
              onInput={(e) => setHeartRateVal(e.detail.value)}
            />
-            <Text className='input-ref'>{REF_RANGES.heart_rate.range}</Text>
+            <Text className='input-ref'>{refRanges.heart_rate}</Text>
          </View>
        )}

@@ -287,7 +309,7 @@ export default function Health() {
                <Text className='period-btn-text'>餐后 2h</Text>
              </View>
            </View>
-            <Text className='input-ref'>{REF_RANGES.blood_sugar.range}</Text>
+            <Text className='input-ref'>{refRanges.blood_sugar}</Text>
          </View>
        )}

@@ -301,7 +323,7 @@ export default function Health() {
              value={weightVal}
              onInput={(e) => setWeightVal(e.detail.value)}
            />
-            <Text className='input-ref'>{REF_RANGES.weight.range}</Text>
+            <Text className='input-ref'>{refRanges.weight}</Text>
          </View>
        )}

--- a/apps/miniprogram/src/pages/pkg-health/input/index.tsx
+++ b/apps/miniprogram/src/pages/pkg-health/input/index.tsx
@@ -2,7 +2,7 @@ import { useState } from 'react';
 import { View, Text, Input, Picker } from '@tarojs/components';
 import Taro, { useDidShow } from '@tarojs/taro';
 import { z } from 'zod';
-import { inputVitalSign } from '../../../services/health';
+import { inputVitalSign, getHealthThresholds, findThreshold, DEFAULT_THRESHOLDS, type HealthThreshold } from '../../../services/health';
 import { useAuthStore } from '../../../stores/auth';
 import { useHealthStore } from '@/stores/health';
 import { usePointsStore } from '@/stores/points';
@@ -29,14 +29,30 @@ const vitalSignSchema = z.object({
  note: z.string().max(200, '备注不能超过200字').optional(),
 });

-const WARN_THRESHOLDS: Record<string, { max?: number; min?: number; warning: string }> = {
-  blood_pressure: { max: 180, warning: '收缩压偏高，建议及时就医' },
-  heart_rate: { max: 120, min: 50, warning: '心率异常，请注意休息' },
-  blood_sugar_fasting: { max: 11.0, warning: '血糖偏高，建议就医检查' },
-};
+/** 根据动态阈值生成警告配置 */
+function getWarnForIndicator(
+  thresholds: HealthThreshold[],
+  indicator: string,
+): { max?: number; min?: number; warning: string } | null {
+  const high = findThreshold(thresholds, indicator === 'blood_pressure' ? 'systolic_bp' : indicator, 'high');
+  const low = findThreshold(thresholds, indicator === 'blood_pressure' ? 'systolic_bp' : indicator, 'low');
+  if (!high && !low) return null;
+  const warningMap: Record<string, string> = {
+    blood_pressure: '收缩压偏高，建议及时就医',
+    heart_rate: '心率异常，请注意休息',
+    blood_sugar_fasting: '血糖偏高，建议就医检查',
+    blood_sugar_postprandial: '血糖偏高，建议就医检查',
+  };
+  return {
+    max: high?.threshold_value,
+    min: low?.threshold_value,
+    warning: warningMap[indicator] ?? '数值异常，请关注',
+  };
+}

 export default function HealthInput() {
  const [indicatorIdx, setIndicatorIdx] = useState(0);
+  const [thresholds, setThresholds] = useState<HealthThreshold[]>(DEFAULT_THRESHOLDS);
  const [value, setValue] = useState('');
  const [systolic, setSystolic] = useState('');
  const [diastolic, setDiastolic] = useState('');
@@ -47,6 +63,7 @@ export default function HealthInput() {

  /** 从 storage 中读取设备同步回传的数据并自动填充表单 */
  useDidShow(() => {
+    getHealthThresholds().then((t) => { if (t.length > 0) setThresholds(t); });
    try {
      const raw = Taro.getStorageSync('device_sync_result');
      if (!raw) return;
@@ -102,7 +119,7 @@ export default function HealthInput() {
      return;
    }

-    const threshold = WARN_THRESHOLDS[currentIndicator];
+    const threshold = getWarnForIndicator(thresholds, currentIndicator);
    if (threshold) {
      const val = input.value;
      if ((threshold.max && val > threshold.max) || (threshold.min && val < threshold.min)) {
--- a/apps/miniprogram/src/services/health.ts
+++ b/apps/miniprogram/src/services/health.ts
@@ -1,3 +1,4 @@
+import Taro from '@tarojs/taro';
 import { api } from './request';

 export interface VitalSignInput {
@@ -36,6 +37,10 @@ export async function inputVitalSign(patientId: string, data: VitalSignInput) {
      if (data.extra?.systolic) body.systolic_bp_morning = data.extra.systolic;
      if (data.extra?.diastolic) body.diastolic_bp_morning = data.extra.diastolic;
      break;
+    case 'blood_pressure_evening':
+      if (data.extra?.systolic) body.systolic_bp_evening = data.extra.systolic;
+      if (data.extra?.diastolic) body.diastolic_bp_evening = data.extra.diastolic;
+      break;
    case 'heart_rate':
      body.heart_rate = Math.round(data.value);
      break;
@@ -45,6 +50,12 @@ export async function inputVitalSign(patientId: string, data: VitalSignInput) {
    case 'blood_sugar':
      body.blood_sugar = data.value;
      break;
+    case 'body_temperature':
+      body.body_temperature = data.value;
+      break;
+    case 'spo2':
+      body.spo2 = Math.round(data.value);
+      break;
    case 'water_intake':
      body.water_intake_ml = Math.round(data.value);
      break;
@@ -113,3 +124,62 @@ export async function listDailyMonitoring(
    params,
  );
 }
+
+// ---- Health Thresholds (健康阈值) ----
+
+export interface HealthThreshold {
+  id: string;
+  indicator: string;
+  direction: string;
+  threshold_value: number;
+  level: string;
+  department: string | null;
+  age_min: number | null;
+  age_max: number | null;
+  is_active: boolean;
+}
+
+const THRESHOLD_CACHE_KEY = 'health_thresholds';
+const THRESHOLD_TTL = 24 * 60 * 60 * 1000; // 24h
+
+/** 从缓存或 API 获取健康阈值列表 */
+export async function getHealthThresholds(): Promise<HealthThreshold[]> {
+  try {
+    const cached = Taro.getStorageSync(THRESHOLD_CACHE_KEY) as
+      | { data: HealthThreshold[]; ts: number }
+      | undefined;
+    if (cached && Date.now() - cached.ts < THRESHOLD_TTL) {
+      return cached.data;
+    }
+  } catch { /* cache miss */ }
+
+  try {
+    const data = await api.get<HealthThreshold[]>('/health/critical-value-thresholds/public');
+    Taro.setStorageSync(THRESHOLD_CACHE_KEY, { data, ts: Date.now() });
+    return data;
+  } catch {
+    return [];
+  }
+}
+
+/** 查找匹配的阈值，缓存未命中时返回 undefined */
+export function findThreshold(
+  thresholds: HealthThreshold[],
+  indicator: string,
+  direction: string,
+  level = 'warning',
+): HealthThreshold | undefined {
+  return thresholds.find(
+    (t) => t.indicator === indicator && t.direction === direction && t.level === level && t.is_active,
+  );
+}
+
+/** 内置默认阈值（API 不可用时的降级方案） */
+export const DEFAULT_THRESHOLDS: HealthThreshold[] = [
+  { id: '_bp_sys_high', indicator: 'systolic_bp', direction: 'high', threshold_value: 140, level: 'warning', department: null, age_min: null, age_max: null, is_active: true },
+  { id: '_bp_dia_high', indicator: 'diastolic_bp', direction: 'high', threshold_value: 90, level: 'warning', department: null, age_min: null, age_max: null, is_active: true },
+  { id: '_hr_high', indicator: 'heart_rate', direction: 'high', threshold_value: 100, level: 'warning', department: null, age_min: null, age_max: null, is_active: true },
+  { id: '_hr_low', indicator: 'heart_rate', direction: 'low', threshold_value: 60, level: 'warning', department: null, age_min: null, age_max: null, is_active: true },
+  { id: '_bs_fasting_high', indicator: 'blood_sugar_fasting', direction: 'high', threshold_value: 6.1, level: 'warning', department: null, age_min: null, age_max: null, is_active: true },
+  { id: '_bs_pp_high', indicator: 'blood_sugar_postprandial', direction: 'high', threshold_value: 7.8, level: 'warning', department: null, age_min: null, age_max: null, is_active: true },
+];