The way to diagnose stages of gastric ulcer and 12 duodenal ulcer

 

(57) Abstract:

The invention relates to medicine, namely to a gastroenterologist, and relates to a method of diagnosis of the stage of gastric ulcer and 12 duodenal ulcer. The invention consists in that in the saliva of patients under investigation determines the amount of content peptides and when it is 0,882 units of optical density (TU) and higher judge about the ulcers; when it is within 0,881-0,539 TU - on the stage of incomplete remission; if the value is within 0,538-0,359 TU - on the stage of remission. Value content of peptides less 0,358 TU suggests that the patient is not suffering from a peptic ulcer. The advantage of the invention lies in the fact that the proposed method is informative, objective and does not require complicated invasive procedures. table 1.

The invention relates to medicine, in particular to a gastroenterologist.

Currently, the main method of diagnosis of gastric ulcer and 12 duodenal ulcer is a method of fibroesofagogastroduodenoscopia. However, this procedure is not always possible due to the hyperresponsiveness of the patient, impaired patency of privratnika (sub - and decomposion Anacostia and so on).

There is a method of diagnosing stages of peptic ulcer disease (PUD) of stomach and duodenum 12 by determining epithelial index (EI) of the gastric mucosa, which is the ratio of the total number of epithelial cells to the number of the remaining cells (Patent 2098814).

The main disadvantage of this method is a great complexity to it (you need to count all available cells per square millimeter slice of the gastric mucosa) and low specificity, which is determined by a large variety of cells, affecting the value of EI.

A known method for the diagnosis of gastric ulcer and 12 duodenal ulcer by defining in the gastric juice of molecules of average weight (MSM). If the value of the content of MSM is in the range of 0.82-1.42 are units of optical density (TU) at a wavelength of 254 nm and 0.8 of 1.52 at a wavelength of 280 nm, it is judged on the presence of the ulcer of the mucous membrane and the exacerbation of the disease (Patent 2051388).

The main disadvantages of this method are: the inability to use it to differentiate all stages of peptic ulcer disease (worsening, incomplete remission and in remission), and that it was not acceptable as a screening test, i.e., usnot invention is what in the saliva of patients under investigation determines the amount of content peptides and when it is 0,882 units of optical density (TU) and higher judge about the ulcers; when it is within 0,881-0,539 TU - on the stage of incomplete remission; if the value is within 0,538-0,359 TU - on the stage of remission. Value content of peptides less 0,358 TU suggests that the patient does not suffer from peptic ulcer disease.

The method is as follows: the examined patients, pushing a sterile tube to the outlet duct of the salivary gland, receive a portion of the saliva. 5-8 ml her centrifuged for 15 minutes at 3000 revolutions per minute. The supernatant in a volume of 0.1 ml is poured into the centrifuge tube, was added to 4.9 ml of 96% ethanol, then centrifuged for 20 minutes at 3000 revolutions per minute. Then the supernatant examined for the spectrophotometer against 96% ethanol at a wavelength of 220 nm. This wavelength is determined by the content of peptides in biological fluids. The results are expressed in units of optical density (TU).

Exacerbation of peptic ulcer disease is diagnosed when the value of the content of the peptides in saliva of patients 0,882 TU and above; if it is within 0,881-0,539 TU diagnosed with the peptides less 0,358 TU judge about the patient does not suffer from peptic ulcer disease.

Example 1. Patient D., aged 26. He complained of recurrent pain in the epigastric region, appearing through 1.0 to 1.5 hours after a meal, nausea, vomiting, heartburn. Patients consider themselves to be within 4 days. Objective examination revealed tenderness in the epigastric region. General blood and urine analysis, biochemical analysis of blood within normal limits. The content of peptides in saliva of the patient was 1,214 TU. On the basis that the value of the content of the peptides in saliva was higher 0,882 TU, the patient was diagnosed with ulcers. At endoscopy in the bulb 12 duodenal ulcer detected ulcer size 0,40,30,3 see the Patient assigned to the appropriate treatment.

Example 2. Patient P. 45 years. Within 1 month were outpatients regarding exacerbation of peptic ulcer of the stomach, which affects about 4 years. At the time of the survey no complaints. The content of peptides in saliva was 0,671 TU. On the basis of the fact that the value of the content of the peptides in saliva was within 0,881-0,539 TU was diagnosed with stage incomplete remission. Endoscopically detected ulcers “corner” of the stomach in a study of the venous disease 12 duodenal ulcer within 6 years. Complains of an unstable chair (alternating diarrhea and constipation), spastic pain during defecation. General blood and urine analysis, biochemical analysis of blood and coprological examination is within normal limits. The content of peptides in saliva was MX 0.317 TU. On the basis of the fact that the value of the content of the peptides in saliva were lower 0.358 TU was diagnosed with persistent clinical and morphological remission. Endoscopic examination revealed moderate deformation of the bulb 12 duodenal ulcer. Patient recommended further examination of the gastrointestinal tract, after which he was expelled organic pathology and diagnosed with irritable colon.

Only offered by way of the surveyed 117 people. 41 during acute PUD 31 in the stage of incomplete remission, 27 - stage clinical-morphological remission and 18 healthy individuals.

Normal value content of peptides in saliva was 0,291±0,021 TU.

The obtained data are presented in below table.

The proposed method is quite informative and does not require complicated invasive procedures. It eliminates the impact on the diagnosis of peptic ulcer subjective Issei. You can use it as a screening test in the examination of a large cohort of patients, including during routine examination. Weight it can be used for differential diagnosis, selection of the means and duration of treatment, and to assess the effectiveness of therapy.

The way to diagnose stages of gastric ulcer and 12 duodenal ulcer, characterized in that in the saliva of patients under investigation determines the amount of content peptides and when it is 0,882 units of optical density (TU) and higher judge about the ulcers; when it is within 0,881-0,539 TU - on the stage of incomplete remission; if the value is within 0,538-0,359 TU - on the stage of remission, the value of the content of peptides less 0,358 TU suggests that the patient is not suffering from a peptic ulcer.

 

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