The method for determining the increment of the radius of the peripheral veins

 

The invention relates to medicine, particularly cardiology and functional diagnostics. Register plethysmogram. Carry out reactive hyperemia. Determine venous capacity in the initial state and on the background of reactive hyperemia. Calculate the increase in the radius of the small veins and venules in relation to the initial radius in percent on a mathematical formula using these parameters. Determine the normal amount of increase of the radius value calculated value for the forearms and shins. The method allows non-invasive to determine normal or abnormal amount of increase of the radius of the small peripheral veins in response to reactive hyperemia. table 2.

The invention relates to medicine, namely to instrumental diagnostics in cardiology, and can be used when examining healthy volunteers and patients with various pathologies of the cardiovascular system to assess relaxing ability of small veins and venules in terms of increase of the radius according to the occlusive plethysmography combined.

There is a way for ultrasonic determination of increase of the radius of the peripheral arteries in the background of reactive hyperemia (sinoway swamp L. I., C. Hendrickson, W. R. Davidson et al. / Circulat. Re is a significant drawback of this method is that what you can't use it to determine the change in the radius of the veins. In addition, technically not provided a permanent fixed position of the sensor and the reproducibility of the results depends heavily on the experience of the operator, which reduces the accuracy of the study. The method is costly.

The closest analogue to the present invention is a method of determining the increase of the radius of the peripheral arteries in the background of reactive hyperemia using occlusive plethysmography combined combined with direct measurement of arterial pressure and blood flow velocity (Staikova A. A., Staikov D. A. Endothelial regulation of vascular tone: research methods and clinical significance / Cardiology. - 1998. - So 38. - 9. - S. 68-80). When this curve plethysmogram determined by the amount of blood flow and measures the volume of the limb. The increase of the radius of the vessel is calculated by the formula:wherer - increase the radius of the artery, QRef- volumetric flow source, Vl- the volume of the limb of the source, VRef- blood flow velocity of the source, Q - volume blood flow on the background of reactive hyperemia, Vol - volume limbs on the background of reactive hyperemia, VG is the velocity of the blood flow on the background of reactive Hyper is elite change the radius of the small veins and venules.

The invention is aimed at solving problems: determination of increase of the radius of the small venous sragow, noninvasive way.

Problem solving is achieved by the fact that the examined determine the growth of the radius of the small veins and venulesrinbased on the values of venous capacitance in the region of the leg and/or arm when you register occlusal plethysmogram in the initial state and on the background of reactive hyperemia, according to the following formula:
whererin- increase the radius of the small veins and venules in relation to the initial radius,
Weish - venous capacity of the source,
The Verga - venous capacitance on the background of reactive hyperemia
and when the value ofrinfrom 3.3% to 22.3% for the forearm, and from 6.2% to 26.4% for tibia determine the normal amount of increase of radius.

The method is as follows. The examined after 10 analnogo rest in the supine position register circumference of the shoulder or hip. Then write plethysmogram device "Fluvoschrift forte" in the initial state. For this occlusion cuff placed on the shoulder or thigh of the examinee registration cuff on the forearm PII pressure, equal to 10 mm RT.article In the occlusive cuff in the period of the study support the pressure of 50 mm RT.article Further study is repeated in the conditions of reactive hyperemia caused a 2-minute arterial occlusion at a pressure in the occlusive cuff 250 mm RT. senior Reactive hyperemia register during the first 15 s after occlusion.

On plethysmographically curve determine venous capacity (BE, ml/100 g). Venous capacity is calculated as the difference between the top of the rapid flow of blood in the venous occlusion (occlusion pressure of 50 mm RT.CT.) and bottom of plethysmogram after emptying veins.

This indicator is defined as in the initial state, and in reactive hyperemia.

According to the above formula in accordance with the values Weish and Verga expect the growth of the radius of the small veins and venules.

The results obtained from the survey of healthy volunteers and patients with newly diagnosed arterial hypertension of I degree, are presented in tables 1 and 2.

For normal accepted values increase with radius in the range M- from 3.3% to 22.3% for the forearm and from 6.2% to 26.4% for the tibia. Whenrin>22,3% for forearm andrin>26,4% for tibia as pronounced.

Examples of specific implementation method
Example 1.

Patient S., 35 years. Diagnosis: essential arterial hypertension, 1 tbsp., low risk. Determined the increase of the radius of the small venous vessels of the forearm and lower leg at rest in the supine according to the following program.

After a 10-minute rest in the supine position imposed occlusive cuff to shoulder and hip. I measured the circumference and put the recording cuff on the upper third of the forearm and lower leg, so that the distance between the occlusal and recording cuffs amounted to more than 5 cm were Included plethysmograph, filed in the registering cuff pressure equal to 10 mm RT.art., have calibrated the device. In the occlusive cuff filed a pressure of 50 mm RT. century , and recorded occlusive plethysmogram in the initial state. Next, filed in the occlusive cuff pressure equal to 250 mm RT.art., 2 minutes After cessation of arterial occlusion in the first 15 recorded occlusive plethysmogram on the background of reactive hyperemia. Calculated venous capacity as the difference between the top of the rapid blood flow etc the forearms and shins.

The examined its value in the initial state was in the region of the forearm to 21.4 ml/100 g tissue in the region of the Shin - 22.5 ml/min100, against the background of reactive hyperemia venous capacity in the region of the forearm of 40.0 ml/100 g tissue in the region of the Shin - 41,1 ml/100 g

When the respective values Weish=21,4 ml/100 g, Verga=40,0 ml/100 g of the aforesaid formula calculatedrinsmall venous vessels of the forearm, which is 36.7 per cent.


Similarly, we expect the growth of the radius of the small venous vessels of the lower leg, which is 35.2 per cent.


Thus, the patient C. noted the excessive increase of the radius of the venous vessels of the forearm and tibia.

Example 2.

Surveyed I. , 19 years. Determined the increase of the radius of the small venous vessels of the forearm and lower leg at rest in the supine according to the following program.

After a 10-minute rest in the supine position imposed occlusive cuff to shoulder and hip. I measured the circumference and put the recording cuff on the upper third of the forearm and lower leg, so that the distance between the occlusal and recording cuffs amounted to more than 5 cm cclusion cuff applied pressure, 50 mm RT. Art. and recorded occlusive plethysmogram in the initial state. Next, filed in the occlusive cuff pressure equal to 250 mm RT.art., 2 minutes After cessation of arterial occlusion in the first 15 recorded occlusive plethysmogram on the background of reactive hyperemia. Calculated venous capacity as the difference between the top of the rapid flow of blood in the venous occlusion and bottom of plethysmogram after emptying veins using data from the circumference of the forearm and tibia.

The examined its value in the initial state was in the region of the forearm of 56.7 ml/100 g tissue in the region of the Shin - 51,3 ml/min100, against the background of reactive hyperemia venous capacity in the region of the forearm accounted for 66.7 ml/100 g tissue in the region of the Shin - 71,3 ml/100 g

When the respective values Weish=56,7 ml/100 g, Verga=66,7 ml/100 g of the aforesaid formula calculatedrinsmall venous vessels of the forearm, which is 8.5%.


Similarly, we expect the growth of the radius of the small venous vessels of the lower leg, which amounts to 17.9%.


Thus, the increase of the radius of the small vessels of the forearm and lower leg and consists in the following. The method allows to determine the increase of the radius of the small veins and venules in the region of the forearm and lower leg, which is currently using known methods cannot, furthermore, the method is simple in execution, objective and non-invasive.


Claims

The method for determining the increment of the radius of the peripheral veins in the background of reactive hyperemia in the region of the forearm and/or tibia using occlusive plethysmography combined, wherein the determined venous capacity in the initial state and on the background of reactive hyperemia and calculate the increase in the radius of the small veins and venules in relation to the initial radius in percent according to the formula

whererin- increase the radius of the small veins and venules in relation to the initial radius;

Weish - venous capacity of the source;

The Verga - venous capacitance on the background of reactive hyperemia,

and when the value ofrinfrom 3.3 to 22.3% for the forearm and from 6.2 to 26.4% for tibia determine the normal amount of increase of radius.

 

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FIELD: medicine.

SUBSTANCE: method involves carrying out ultrasonic scanning examination of subclavian artery over its whole extent in physiological arm position with arterial blood pressure being measured in the middle one third of the arm. Next, when applying compression tests, blood circulation parameters variations are recorded in distal segment of the subclavian artery with arterial blood pressure being concurrently measured. Three degrees of superior thorax aperture syndrome severity are diagnosed depending on reduction of linear blood circulation velocity and arterial blood pressure compared to their initial values. Mild one takes place when linear blood circulation velocity reduction reaches 40% and arterial blood pressure 20% of initial level, moderate one when linear blood circulation velocity reduction reaches 70% and arterial blood pressure 50% and heavy one when linear blood circulation velocity reduction is greater than 70% of initial level and arterial blood pressure is greater than 50% to the extent of no blood circulation manifestation being observed in the subclavian artery.

EFFECT: high accuracy of diagnosis.

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