Method of monitoring the effectiveness of the sanatorium stage of rehabilitation of patients with myocardial infarction

 

(57) Abstract:

The invention relates to medicine, particularly cardiology, and can be used to monitor the effectiveness of the sanatorium stage of rehabilitation of patients with myocardial infarction. The method consists in the fact that the admission to the sanatorium and after a four-week stay in the patient determine the time stability of red blood cells to peroxide hemolysis initiated by ferrous iron and autologous blood hemolysate and with increasing time stability of red blood cells to peroxide hemolysis effect sanatorium stage of rehabilitation regarded as satisfactory, and in the absence of improvement - as unsatisfactory. Effect: method provides the ability to control the influence of the sanatorium stage of rehabilitation on the state of the cell membranes, which is considered one of the most important components of rehabilitation of patients after myocardial infarction, which allows time to correct treatment.

The invention relates to medicine, particularly cardiology, and can be used to monitor the effectiveness of the sanatorium stage of rehabilitation of patients with myocardial infarction.

The known method of monitoring the spine by inspection and survey of the patient (L. F. Nikolaev, D. M. Aronov. Rehabilitation of patients with ischemic heart disease. - M.: Medicine, 1988, 288 S. (S. 14-16)).

The disadvantage of this method is its lack of accuracy. The known method of monitoring the effectiveness of the sanatorium stage of rehabilitation of patients with myocardial infarction according to the results of stress tests, in particular, the Bicycle ergometry (L. F. Nikolaev, D. M. Aronov. Rehabilitation of patients with ischemic heart disease. - M.: Medicine, 1988, 288 S. (S. 40-60)).

The disadvantage of this method, taken as a prototype, is that its application is not taken into account the nature of the changes of metabolism, in particular lipid peroxidation, affecting the stability of cell membranes, which reduces its accuracy as a way of monitoring the effectiveness of the sanatorium stage of rehabilitation of patients with myocardial infarction.

The essence of the invention lies in the fact that according to the method of monitoring the effectiveness of the sanatorium stage of rehabilitation of patients with myocardial infarction, which includes the determination of physiological parameters, for admission to the sanatorium and after a four-week stay in it determine when the resistance of erythrocytes to peroxide hemolysis initiated by double-shaft is in effect the sanatorium stage of rehabilitation regarded as satisfactory, if no improvement is as unsatisfactory.

The proposed method of monitoring the effectiveness of the sanatorium stage of rehabilitation of patients with myocardial infarction allows you to control the influence of the sanatorium stage of rehabilitation of patients with myocardial infarction on the state of the cell membranes, which is considered one of the important components of stroke rehabilitation of patients after myocardial infarction, which allows time to correct treatment.

The method is performed in the following way. When arriving at the resort and after a four-week stay in it by a known method (Patent of Russia №2102766, CL G 01 No. 33/86) determine the time stability of red blood cells to peroxide hemolysis initiated by ferrous iron and autologous blood hemolysate and with increasing time stability of red blood cells to peroxide hemolysis effect sanatorium stage of rehabilitation regarded as satisfactory, and in the absence of improvement - as unsatisfactory.

Examples of specific implementation of the method.

Example 1. Patient K., 66 years old, diagnosis: ischemic heart disease, acute krupnooptovyj rear myocardial infarction one month old H-I. the background of the complex of rehabilitation measures, vklyuchavshie is rennosti to physical activity, however, the time stability of red blood cells to peroxide hemolysis has not increased: before treatment - 145 after treatment 131 S. Rehabilitation unsatisfactory recommended its continuation with the inclusion of antioxidants (a-tocopherol).

Example 2: Patient Days, 56 years old, diagnosis: ischemic heart disease, acute small anterior myocardial infarction one month old H-I. the background of the complex of rehabilitation measures, including physical therapy, preformed physical factors and medication (nitrates + beta blockers + aspirin) increased tolerance to physical activity, the time stability of red blood cells to peroxide hemolysis increased: before treatment - 140, after treatment - 163 C. Rehabilitation considered satisfactory, recommended outpatient administration of beta blockers and aspirin.

Method of monitoring the effectiveness of the sanatorium stage of rehabilitation of patients with myocardial infarction, which includes the determination of physiological parameters, wherein when entering the resort and after a four-week stay in it determine when the resistance of erythrocytes to peroxide hemolysis initiated by ferrous iron and autologous blood hemolysate, and with increasing time of year is satisfactory, if no improvement is as unsatisfactory.

 

Same patents:

The invention relates to medicine, namely to the study of blood, and can be used for laboratory diagnosis of thrombophilia, due to the high activity of coagulation factor VIII

The invention relates to medicine, in particular to the treatment with anticoagulants of indirect action

The invention relates to medicine, in particular to surgery

The invention relates to medicine, in particular to Pediatrics and neonatology

The invention relates to medicine, namely to Pediatrics, neonatology, and can be used to predict bacterial infection in newborn infants

The invention relates to medicine, in particular to hamostaseologie

The invention relates to medicine, in particular to Hematology

The invention relates to medicine, in particular for laboratory diagnosis
The invention relates to medicine, in particular to ophthalmology

FIELD: medicine, laboratory diagnostics.

SUBSTANCE: the suggested studying should be carried out on the glass simultaneously with several inductors by applying minimal inter-taking antilogarithms concentrations of aggregation inductors which correspond at double combination of inductors: ADP 5.0 x 10-8 M, adrenaline 3.0 x 10-9, collagen - dissolving the main suspension 1:8, thrombin 0.075 U/ml; at triple combination of inductors: ADP 10-9 M, adrenaline 10-9, collagen - dissolving the main suspension 1:9, thrombin 0.060 U/ml. The development of aggregation means thrombocytic activation in patients with arterial hypertension at metabolic syndrome. The method enables to evaluate the changes of thrombocytic functional state with combination of inductors more probably present in area of vascular lesion by applying minimal necessary concentrations that develops real conditions at hemostatic initiation in human vessels.

EFFECT: higher efficiency of studying.

3 dwg, 3 ex, 2 tbl

FIELD: medicine.

SUBSTANCE: method involves checking consciousness, blood coagulation state, peripheral blood leukocytes number, K+ ions, bilirubin, fibrinogen, hemolysis and hemoglobinuria availability, prothrombin index and exotoxic shock development. Each value is calculated in points as follows. Lucidity is evaluated as -2 points; depression - +3 points; coma - +6 points; lack of changes in blood coagulation system - -2 points; coagulation availability without clinical injuries - +2 points; coagulopathy with clinical manifestation signs - +19 points; K+ ions concentration being less than 3.0 mmole/l - +3 points, from 3.1 to 3.5 mmole/l - -5 points, from 3.6 to 5.0 mmole/l - 0 points, greater than 5.0 points - +7 points, failure in determining K+ ions concentration - 0 points; hemolysis availability - +6 points, its lack - -3 points; hemoglobinuria availability - +8 points, its lack - -1 points; leukocytes number being less than 12.0x109/l - -2 points, from 12,1 to 18.0x109/l - 0 points, higher than 18.0x109/l - +8 points; hourly urine output being less than 30 ml/h - +6 points, greater than 30 ml/h - -2 points; bilirubin content being less than 31 mcmole/l - -2 points, from 30.1 to 50.0 mcmole/l - 0 points, greater than 50.0 mcmole/l - +2 points, failure in determining bilirubin content due to hemolysis being available -+6 points; prothrombin index being equal to or less than 60% - +3 points, greater than 60% - 0 points, failure in determining prothrombin index due to hemolysis being available - +12 points; fibrinogen concentration in blood plasma being less than 2.1 g/l - +4 points, from 2.1 to 4.0 g/l - -1 point, from 4.1 to 6.0 g/l - +1 point, failure in determining fibrinogen concentration due to erythrocyte hemolysis being available - +13 points; exotoxic shock development - +9 points, its lack - -1 point. The points are summed up. The value being greater than +13, admission for treatment in resuscitation department is indicated. The value being less than -13, admission for treatment in therapeutics department is indicated. The value being from -13 to +13, resuscitation expert consultation is advised.

EFFECT: high evaluation accuracy.

3 tbl

FIELD: medicine, laboratory diagnostics.

SUBSTANCE: one should evaluate the time for clotting of plasma under testing in phospholipid-dependent test, moreover, one should apply high- and low-sensitive thromboplastin reagents to lupus anticoagulant to calculate the ratio of indices of prothrombin time prolongation and at its value being either equal to or above 1.1 one should diagnose APS.

EFFECT: shortened terms of research.

1 ex, 4 tbl

FIELD: medicine.

SUBSTANCE: method involves analyzing symptoms manifesting initial disseminated intravascular blood coagulation syndrome danger like burn area, availability of upper air passages burn, shock with its severity degree taken into consideration, sepsis development; clinical manifestations of disseminated intravascular blood coagulation syndrome like lung, kidney, liver function insufficiency, cerebral dysfunction, local and multiple hemorrhages, thrombosis, infarction; homeostasis system laboratory analysis data, hyper- and hypocoagulation based on chronometry test data, number of blood platelets, fibrin-monomer complexes, D-dimers, activity of antithrombin III, C and S proteins, XIIa-dependent fibrinolysis plasminogen content, availability of injured erythrocytes, combinations of laboratory tests for recognizing disseminated intravascular blood coagulation syndrome. Each sign under consideration receives a number of points corresponding to its diagnostic significance and integral value is calculated DIBCSIV=(X1+X2+…+Xn)/n, where n is the number of signs taken into consideration. DIBCSIV value equal to 1.0-1.5 units shows physiological norm. The value being between 1.6 and 2.5 units, light disseminated intravascular blood coagulation syndrome is diagnosed. The value being between 2.6 and 3.5 units, disseminated intravascular blood coagulation syndrome of medium severity is diagnosed; 3.6-4.5 points to one heavy severity degree; 4.6 and greater indicates highly severe case of disseminated intravascular blood coagulation syndrome.

EFFECT: high accuracy and objectiveness in differentiating syndrome severity degrees.

1 tbl

FIELD: medicine, diagnostics.

SUBSTANCE: one should study blood components to detect anticoagulant-fibrinolytic activity. Moreover, patient's blood should be sampled: in whole blood one should detect the presence of affected erythrocytes and evaluate the quantity of thrombocytes, in plasma it is necessary to study the activity of antithrombin III, XIIa-dependent fibrinolysis, the content of soluble fibrin-monomeric complexes, in blood serum of the sample taken one should detect the concentration of urea, creatinine, sodium, albumin, total cholesterol and the activity of aspartate aminotransferase, moreover, one should calculate integral value of renal-hepatic deficiency, to put corresponding point for the degree of parameters under testing, then one should calculate integral value of disseminated intravascular clotting (IVDIC) and at its value being 6.3 U and more DIC-syndrome should be diagnosed, moreover, at IVDIC value ranged 6.3-10.1 U it is possible to diagnose latent DIC-syndrome, at 10.2-14.6 - subacute DIC-syndrome and at 14.7 and higher - acute DIC-syndrome should be concluded.

EFFECT: higher accuracy and efficiency of diagnostics.

4 ex, 2 tbl

FIELD: medicine, obstetrics.

SUBSTANCE: the present innovation deals with predicting disadaptive processes in women in dynamics of menstrual cycle. During menstrual cycle beginning since the 1st d to the 21st d one should detect the dynamics for alteration in coefficient of activity of syntoxic adaptation programs (CASAP), calculated by the following formula:

where CST - concentration of blood serotonin, AAT-III - activity of antithrombin III, Aaoa - total antioxidizing activity of plasma, CCD8+ - concentration of T-suppressors, Cad - concentration of blood adrenalin, Cα2MG - concentration of α2-macroglobulin, CMDA - concentration of malonic dialdehyde, CCD4+ - concentration of T-helpers. Moreover, normally CASAP value alters two-fold against the first day of the cycle - since 0.70 up to 1.40 on the 21st d of the cycle, at no alterations in CASAP value one should diagnose female disadaptive alterations leading to failed pregnancy. The innovation enables to perform diagnostics of disadaptive processes in women in dynamics of menstrual cycle followed by prognostic conclusion upon future pregnancy.

EFFECT: higher accuracy of diagnostics.

2 ex

FIELD: medicine.

SUBSTANCE: method involves determining spontaneous blood platelets aggregation and one induced by adrenalin and collagen, thrombocytospecific peptides activity of β-thromboglobulin and thrombocytic factor 4 in blood plasma.

EFFECT: high accuracy of diagnosis.

2 tbl

FIELD: medicine.

SUBSTANCE: method involves determining coagulating blood viscosity values like reaction period r, thrombin constant K, maximum amplitude MA, time T for forming fibrin-thrombocytic blood clot, spontaneous blood platelets aggregation intensity Ar, retraction and spontaneous clot lysis total FA. The r being within 5-7 min, Ar from -2 to -6 relative units, K being within 4-6 min, MA within 500-700 relative units, T within 40-60 min and FA equal to 10-20%, low inflammatory process activity is considered to be the case. The r being less than 5 min, Ar equal to -8 to -12 relative units, T less than 40 min and FA less than 10% with no changes in K and MA being observed, inflammatory process activity in chronic glomerulonephritis case is considered to be of high severity degree.

EFFECT: high accuracy of diagnosis; enhanced effectiveness of treatment method selection.

1 dwg

FIELD: medicine, clinical neurology, neurosurgery.

SUBSTANCE: one should study both activation and aggregation of thrombocytes in blood of carotid artery, at the quantity of thrombocytic active forms being above 70% and the number of aggregated thrombocytes being above 9.0% one should predict the development of cerebral ischemic lesion along with stable focal neurological symptomatology, and at the quantity of thrombocytic active forms being below 30% and the number of aggregated thrombocytes being below 8.0% it is possible to predict positive dynamics in the course of the disease mentioned without developing cerebral ischemic lesion.

EFFECT: higher accuracy of prediction.

2 ex

FIELD: medicine, clinical neurology, neurosurgery.

SUBSTANCE: one should study the level of von Willebrand's factor in patient's carotid artery blood. At its content being below 105% one should predict the development of repeated AICH. The innovation improved information value of testing due to possibility to obtain reliable prediction in latent period, as well.

EFFECT: higher accuracy of prediction.

2 ex, 1 tbl

Up!