Method of prevention of pulmonary hypertension

 

(57) Abstract:

The invention relates to medicine, more specifically to pulmonology, and can be used for the prevention of pulmonary hypertension in patients with chronic obstructive lung disease. To do this, determine the level of angiotensin 2 in serum (A2), solve discriminant equation D = -0,797 A2, where A2 is a certain level of angiotensin 2 in mg/l, and when the value of the discriminant functions less -17,34 enter captopril in a daily dose of 25 mg for 4 weeks. The method allows to predict the effectiveness of prevention of pulmonary hypertension captopril in 85% of cases.

The invention relates to medicine, namely to pulmonology, and can be used in patients with chronic obstructive pulmonary disease (COPD). In the scientific literature known methods of prevention of pulmonary hypertension in patients with COPD by the use of oxygen therapy, calcium antagonists (N.To. Kazakbaev //Cardiology. - 1995. - N 8. - c. 87-90).

The prototype was elected as a method of prevention of pulmonary hypertension by use in patients HOST a calcium antagonist group of dihydropyridines - corinfar (C. P. Silvestrov et al.//TOSL without signs of pulmonary hypertension. Korinfar administered in conventional daily dose.

The known method has the following disadvantages:

1. Does not take into account the functional status of the renin-angiotensin-aldosterone system (RAAS) in the Genesis of pulmonary hypertension in COPD.

2. Does not contain quantitative and qualitative criteria for assessing the functional status of the renin-angiotensin-aldosterone system for differentiated selection of patients with COPD prevention of pulmonary hypertension by affecting the RAAS inhibitors angiotensin-converting enzyme (ACE) inhibitors.

3. The method does not allow to predict the effectiveness of prevention by inhibitors of pulmonary hypertension in COPD.

The purpose of the present invention is to improve the prevention of pulmonary hypertension in patients with COPD by applying as a prophylactic agent ACE inhibitors and prediction of their positive preventive effect depending on the functional state of the RAAS.

This goal is achieved by the fact that as an ACE inhibitor used captopril, evaluation of the functional state of the RAAS is performed based on the measurement of angiotensin 2 and pranzini 2 (A2).

The inventive method includes the following methods:

- using the radioimmunoassay method is determined by the initial level of angiotensin 2 in mg/l;

- the effectiveness of prevention is predicted by solving the discriminant of the equation D = -0,797 A2, where D is the discriminant function, a limit value which is -17,34.

The presence of positive prevention is predicted for D less -17,34, and when D is greater than or equal -17,34 predicted the absence of positive prevention.

- Captopril is used in a daily dose of 25 mg for 4 weeks. The forecast is calculated for a year. The prediction probability is 85%.

The fundamental difference between the proposed method against known is that as a preventive measure is used captopril is an ACE inhibitor and in the definition of a positive prognosis treatment with captopril.

Below are two examples of using the proposed method.

Example 1. C. , 40 years old diagnosis: Mixed bronchial asthma. Moderate severity. The remission phase. NAM 1.

The values of systolic pressure in the pulmonary artery was 18,3 mm RT.article The level of angiotensin 2 in saw the 0,797 32,85 = -25,70

the discriminant function is less than the boundary values -17,34 were predicted to positive prevention. Conducted preventive treatment with captopril at a daily dose of 25 mg for 4 weeks. During 12 months of follow-up systolic pulmonary artery pressure was kept within 17 - 22 mm RT. Art., pulmonary hypertension is not registered.

Example 2. K. , 43 years old, diagnosis: Mixed bronchial asthma. Moderate severity. The remission phase. NAM 1.

The values of systolic pressure in the pulmonary artery is 19.5 mm RT. senior Concentration of angiotensin 2 in serum 33,12 mg/L. in order To predict the prevention resolved discriminant equation:

-0,797 33,12 = -26,40

the discriminant function is less than the boundary values -17,34 were predicted positive prevention capterra. Conducted preventive treatment of pulmonary hypertension without the use of captopril. As a preventive measure was used corinfar in the dose of 0.01 x 3 times a day, for 4 weeks. After 7 months, the patient developed pulmonary hypertension. The systolic pressure in the remission phase increased to 37.4 mm RT. Art.

The inventive method was clinically the soba conducted forecasting and preventive treatment of pulmonary hypertension in 24 patients with bronchial asthma. The results of the validation of the proposed method has shown its effectiveness. Correct prediction was determined in 85% of cases.

Method of prevention of pulmonary hypertension in patients with chronic obstructive pulmonary diseases, including the introduction of captopril, characterized in that determine the level of angiotensin 2 (A2in the serum, solve discriminant equation D = -0,797 x A2where A2- the value of a certain level of angiotensin in mg/l, and when the value of the discriminant functions less -17,34 enter captopril in a daily dose of 25 mg for 4 weeks.

 

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