The way the daily kardiomonitorami to determine the presence and activity of human diseases infectious nature

 

The invention relates to medicine, cardiology. Continuously record the ECG during the day more than one standard abstraction. Analyze 300-600 ECG complexes. At each lead emit a series of QRS and time intervals between them. Calculate the average values of measured parameters. Build structured codogram separately for each ECG lead. Compare structured codogram examined with standard reference patterns of healthy and sick. The conclusion about the presence of the disease and its severity are based on % of incidence of the reference patterns. The method allows to judge the presence or absence of various diseases, their severity, and to exercise effective control over the individual. 1 C.p. f-crystals, 2 ill., table 1.

The invention relates to medicine, namely to functional diagnostics, and can be used for diagnosis and monitoring of activity of non-communicable diseases persons at any stage of their development through daily kardiomonitorami in any environment and professional activities, including the impact of extreme factors. The method may Vesti treatment, as well as identifying causes, provoking and development of the disease, when conducting a medical examination of the population and monitoring the health of workers.

The proposed method daily kardiomonitorami non-communicable diseases in man, using known principles Holter cardiac monitoring is a new stage in the development of technologies for information analysis electrocardiogram implemented in the RF patents for inventions 215793 "Method for the diagnosis of diseases of infectious etiology", 2000, 215974 "Device rapid diagnosis of diseases of internal organs and pathologies", 2000 and 2163088 "Method for diagnosis zabolevanii internal organs at any stage of their development", 2001,

The difference of the above diagnostic methods patent 215793, 215974 and 2163088 from similar, for example, patent of the Russian Federation 2092103, class. And 61 In 5/04, publ. 10.10.97, 2103911, class. And 61 In 5/04, publ. 10.02.98, is that the basis of their taken the analysis of amplitude, frequency and phase modulation cardiomegaly (teeth R), encoding the dynamics of their spatial-temporal changes compared with the reference patterns (standards) rules and diseases and making judgments about the state of the subject by comparing the results.

Clinical studies have shown that the minimum option multipole diagnosis can be simultaneously eat and information analysis electrocardiogram not less than three standard leads to Einthoven or four amplified unipolar leads from the limbs Goldberger, or in all of these leads at the same time.

The above known methods analogous to assume a one-time withdrawal of kardiosignalas without analyzing them during the day, he could not give Maxime allow to conduct a study during the day, but you can only diagnose disorders of the heart. These methods cannot be used to diagnose and monitor diseases other internal organs. As a prototype of the present invention is selected Holter monitoring, described in patent RU 2007954 C1, 28.02.94, Astrophysics, And 61 In 5/04. This method involves continuous recording of kardiosignalas during the day and their subsequent processing. However, as mentioned above, using this method it is impossible to diagnose the pathology of other internal organs.

The technical result of the claimed method of diagnosis is the diagnosis more (almost all) non-communicable diseases of internal organs, as well as the determination of their activity, to identify the impact on the course of diagnosed diseases of various methods of treatment and prevention of diseases and rehabilitation. This result is ensured by the fact that the inventive method allows to precisely determine the configuration of the QRS-complex patient-specific in the area of the affected organ, which different people have different and in each case depends on the ratio of this body with the main vector of the ESA in the course of its activities or diseases, influencing the orientation of the electric axis of the heart. Current measurements during the day help to mitigate the influence of these factors on electrocardiogram, which in turn provides a more effective control on the part of researcher activity information nature of disease within days or more, the identification of influence factors of life, professional activity and habitat causing or blocking the development of the disease.

This object is achieved in that in the known method the daily kardiomonitorami to determine the presence and activity of non-communicable diseases of nature to man, including continuous registration electrocardiogram during the day, and their subsequent analysis by mathematical processing of indicators, comparing the received data with the data standards-standards and making judgments regarding the presence of pathology and its activity according to the results of the comparison register electrocardiogram simultaneously by more than one standard abstraction for analysis use not less than 300-600 electrocardiological, each lead emit series QRSn(f) and the time intervals TA(f) between them, appropriate byvalov TP(f) between them, determine the parameters RSn(f) - complexes and the time intervals TA(f) between them, in each series, calculate the average value of each measured parameter QRSn(f) is complex and time interval TA(Wed) by mathematical processing of those parameters QRSn(f) - complexes and the time intervals TA(f), which have identical sequence numbers, compare options QRSn(f) - complexes and each of the analyzed time interval TA(f) with corresponding average values obtained for similar parameters to those QRSn(f) complexes and the time intervals TA(f), which correspond to identical to the series and have the same sequence number, encode the results of the comparison using one-two-three and more dimensional characters, structure codogram with one-two-three or more polynomial code combinations by the method of successive displacement of each one symbol along the entire codogram from beginning to end, with subsequent distribution code combinations with respect to their occurrence, for each abstraction removal electrocardiogram, compare structured codogram surveyed with standards-benchmarks structured to the owls and allocation of symbols used coding with regard to the frequency of their occurrence, determine the percentage of those reference code combinations, which according to the distribution of frequency of their occurrence in a structured codogram surveyed are among the first places corresponding to the number of code combinations of standard wide codogram, and making conclusions about the presence or absence of pathology carry out the analysis summarized the results obtained for each of the leads, while in the case of 0% occurrence reference code combinations diagnose the risk of disease or persistent remission formed of the disease, with prevalence up to 30% of premorbid stage of an emerging disease or unstable remission already established chronic disease, when the value of 30-50% - the initial stage of the formation of the disease or starting exacerbation of chronic disease, with the value of more than 50% of the acute phase of illness or exacerbation of chronic disease.

Check electrocardiogram as surveyed and construction standards standards can be done in 3 standard bipolar leads on Einthoven or 4 amplified unipolar leads from the limbs Goldberger, or all of oksanacherkasova, which are similar to those on the extremities (scheme 2).

The method is as follows undergo simultaneous constant within 24, 48 hours or more registration electrocardiogram simultaneously by more than one standard abstraction. Point removal electrocardiogram on his chest similar to those on the limbs, when checking electrocardiogram in three bipolar leads and four amplified unipolar leads from the extremities is presented in scheme 2. The right hand corresponds to the middle of the right subclavian area, left hand - middle of the left subclavian zone, right leg - the intersection of the right mid-clavicle line with the right costal arch and the left leg is the intersection of the left mid-clavicle line with the left costal arch. Accordingly the 1st standard lead right hand - left hand - the same as a-b, 2-e standard abstraction right arm - left leg - same as a-C and 3-e standard abstraction left arm - left leg matches In a-C. Therefore, check electrocardiogram at specified points of removal on the chest corresponds to the three standard bipolar leads on Einthoven or four unipolar power oted not less than 300 600 electrocardiological, each lead emit series QRSn(f) and the time intervals TA(f) between them, appropriate respiratory waves, and containing the same number of constituent cardiocondyla QRSn(f) and the time intervals TA(f) between them.

Determine the parameters QRSn - complexes and the time intervals TA(f) between them, to do this, carry out the measurement of the main parameters of the QRS - complex: amplitudes of teeth R1, R2, S, scale QR1, R1S, SR2as well as the time interval TA between the main teeth (R1, S, or R2) recorded QRS - complexes electrocardiogram.

In each series, calculate the average value of each measured parameter QRSn(cf) is a complex and time interval TA(Wed) by mathematical processing of those parameters QRSn(f) - complexes and the time intervals TA(f), which have identical sequence numbers (see RF patent 2163088, 2001).

Compare options QRSn(f) - complexes and each of the analyzed time interval TA(f) with corresponding average values obtained for similar parameters to those QRSn(f) - complexes and the time intervals TA(f), which correspond to identical to the series and have Mnogomernye characters.

Structure codogram with one-two-three or more polynomial code combinations by the method of successive displacement of each one symbol along the entire codogram from beginning to end, with subsequent distribution code combinations with respect to their occurrence, for each abstraction removal electrocardiogram, i.e. analyze electrocardiogram one of the methods described in patents for inventions (see assumption C. M. , RF patent 2157093, 2000; assumption C. M., RF patent 2163088, 2001).

Determine the type of QRS - complexes for each lead, i.e., classify each lead according to the type of configuration of the QRS complex recorded in it electrocardiograma (the main types of QRS - complexes are presented in table).

Identify options for distribution of the symbols used coding taking into account their frequency of occurrence across codogram relevant leads. For example, the encoding used, including the symbols a, b, C, D and E. After you build codogram lead count the number of each character in codogram and according to their frequency of occurrence receive a distribution of symbols (for example, ASWAD or STEVE), which can provide structured codogram surveyed with standards-benchmarks structured patterns of norms and various diseases for each lead separately, taking into account the identity type QRS - complexes and allocation of symbols used coding taking into account their frequency of occurrence.

Determine the percentage of those reference code combinations, which according to the distribution of frequency of their occurrence in a structured codogram surveyed are among the first places corresponding to the number of code combinations of standard wide codogram.

Determination of the presence or absence of pathology carry out the analysis summarized the results obtained for each lead.

To assess dynamics of activity implementation of the information entity diseases we propose a method for estimating the activity of combinations of standard disease in the subject. It is noted that at high disease activity code combination pattern of the disease in codogram the subject, in which all code combinations, its components, ranked by frequency of occurrence, are among the most common. In this regard, at the stage when you establish a presence in codogram surveyed full (100%) of the set of code combinations that make up a code pattern of a disease is the same procenta in the number of first places, corresponding to the number of code combinations that make up the standard wide codogram surveyed. For example, if the pattern of the disease is 10 code combinations, the percentage of activity information entity diagnosed disease in the examined will be equal to the percentage that will be combination of standard codogram surveyed, including the first 10 places. If their will be six, the percentage of activity, respectively, will be equal to 60%.

If 0% of incidence of the reference code combinations diagnose the risk of disease or persistent remission formed of the disease.

When the occurrence of up to 30% of premorbid stage of an emerging disease or unstable remission already established chronic disease.

When the value of 30-50% of the initial stage of the formation of the disease or starting exacerbation of chronic disease.

When the value is more than 50% of the acute phase of illness or exacerbation of chronic disease.

To implement the described diagnostic algorithm implemented standardization of electrocardiogram-type configuration of the QRS complex in all your leads. The configuration of the QRS - complex Limberger as well as with similar points of removal on the chest depends on the orientation in space of the main vector and the plane of the loop relative to the QRS points of removal electrocardiograma. Therefore, each lead for pickup electrocardiograma has its own variant of the configuration of the complex.

The configuration of the QRS complex can be influenced by various adaptive and pathological changes of the heart and, primarily, its ventricles: hypertrophy, dilatate, cicatricial changes and infarction, myocarditis, pericarditis, blockade feet beam gissa, heart defects and other types of heart failure. Can also be affected by features of the thorax, the height of the diaphragm and a number of other anatomical and physiological factors.

Given that the information is laid modulating mechanism in electrocardiogram (QRS) of any configuration, it is obvious the importance of the classification of the most common configurations of a QRS - complex. The most common variants of the QRS complexes of the electrocardiogram shown in the table.

Based on the classification of leads, according to the configuration of the QRS - complexes, recorded in them, and spacing of characters in the designated is(patterns) norms and various diseases.

For the implementation of the diagnostic algorithm in subjects previously carried out a similar classification leads on the configuration of the QRS - complexes and spacing of characters of each respective lead. The diagnostic algorithm is activated only when the identity of the discharge, type of QRS complex recorded therein, allocation of symbols encoding the examined and standards-norms and patterns of diseases Daily cardiac monitoring diseases of the subject can be performed in two modes: continuous mode and the sequential mode, the information of the quantization. Continuous mode provides diagnostics on the database, with at least 300-600 QRS - complexes, where each subsequent electrocardiogram considered closing the database. Information analysis kardiosignalas when this mode starts on the achievement of set including 300-600 QRS - complexes, and is continuous, i.e., with each subsequent QRS complex, which represents respectively the serial shift database on one cardioembolic. This mode allows information cardiac monitoring diseases VA based on sequential diagnosis after each set of the database, including at least 300-600 QRS - complexes. The "quantum information", including the standard number of QRS - complexes, and determines the delay of diagnosis from real-time 6-10 minutes, i.e. the time required to set the database the next "quantum information", which depends on the number of QRS - complexes that are in him, and frequency of contractions.

Daily (multiple) information cardiac monitoring state standards and diseases of the subject can be carried out according to the specified algorithm or randomly. The specified algorithm assumes cardiac monitoring information at certain periods of the day: during professional activity, in the period of rest, physical or psycho-emotional stress, applying different treatments and so on, This option information monitoring assumes at the preceding stage of the development of targeted monitoring program under the supervision of physicians with other professionals and the subject.

For an arbitrary version information cardiac monitoring health is on the personal initiative of the subject. However, even in this case, monitoring is preceded by the period of the task definition wide-angle and is accompanied by a diary, in which are registered in time all the events and observations that may be relevant to the solution of challenges: complaints, symptoms, feelings, experiences, activities, environmental factors, work and rest. Requirements for the diary as well as target setting with the program information of cardiac monitoring, are determined in the preparatory phase and will meet the goals and objectives.

The results of their research Approbation of the proposed method daily simultaneous multi-channel cardiac monitoring state standards and diseases of internal organs in the dynamics of the activity of their information entities confirmed new features to the effectiveness of treatment methods and profilaktiki diseases, professional and social rehabilitation of the subject. The proposed method objectivesare pathogenetic link between environmental factors, professional activities and habits of the subject existing diseases, helps to identify the risk factors for their occurrence and development. Experience in the use of cardiac monitoring diseases can fill their primary and secondary prevention of specific activities, strictly the options P. M. Forecasting on the verge of norm and pathology, M., 1979, S. 295.

2. Vohralik Century, "Neurohumoral dysregulatory viscerate as a prestage of many organic lesions of the internal organs" in kN. XVIII Vsesojuzn. Congress therapists. Proc. Dokl., M., 1981, H. 1, S. 24-25.

3. Assumption C. M. Functional morphology of the stomach. Leningrad, Nauka, 1986, S. 291.

4. Assumption C. M. "Information system modeling of the emergence and development of diseases of infectious nature". Certificate of utility model 14305, 2000

Claims

1. The way the daily kardiomonitorami to determine the presence and activity of human diseases non-infectious nature, including continuous registration electrocardiogram during the day, and their subsequent analysis by mathematical processing of indicators, comparing the received data with the data standards-standards and making judgments regarding the presence of pathology and its activity according to the comparison results, wherein the register electrocardiogram simultaneously by more than one standard abstraction for analysis use not less than 300-600 electrocardiological, each lead emit series izmerenii parameters QRSn(f) and between them TP(Wed) by mathematical processing of those parameters QRSn(f)complexes and the time intervals TA(f), which have identical sequence numbers, compare options QRSn(f)-complexes and each of the analyzed time interval TA(f) with corresponding average values obtained for similar parameters to those QRSn(f)-complexes and the time intervals TA(f), which correspond to identical to the series and have the same sequence number, encode the results of the comparison using one-, two-, three - and higher-dimensional characters, structure codogram using one-, two-, three or more polynomial code combinations by the method of successive displacement of each one symbol along the entire codogram from beginning to end, with subsequent distribution code combinations with respect to their occurrence, for each abstraction removal electrocardiogram, compare structured codogram surveyed with standards-benchmarks structured patterns of norms and various diseases for each lead separately, taking into account the identity of the type of configuration of the QRS-complexes and allocation of symbols used coding taking into account their frequency of occurrence, determine the percentage of the reference combinations, which are among naibolee determination of the presence or absence of pathology carry out the analysis summarized results, obtained for each lead, while in the case of 0% occurrence reference code combinations diagnose the risk of disease or persistent remission formed of the disease, with prevalence up to 30% of premorbid stage of an emerging disease or unstable remission already established chronic disease, when the value of 30-50% of the initial stage of the formation of the disease or starting exacerbation of chronic disease, with the value of more than 50% of the acute phase of illness or exacerbation of chronic disease.

2. The method according to p. 1, characterized in that the check electrocardiogram spend in 3 standard bipolar leads on Einthoven or 4 unipolar leads from the limbs Goldberg or simultaneously in all 7 leads.

 

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