The way to diagnose the severity of ischemic stroke

 

(57) Abstract:

The invention relates to medicine, can be used to diagnose the severity of ischemic stroke and is that on the 1st day in the venous blood by way of immunophenotyping determine the level antigenpositive cells (CD95-lymphocytes) as the percentage of fluorescent cells while browsing 200 lymphocytes minus the percentage of fluorescent cells observed in the preparation of the negative control. With increasing values of CD95-lymphocytes to 9,63,65% diagnose ischemic stroke in mild severity. With increasing values of CD95-lymphocytes to 16,82,7% of ischemic stroke in moderate severity. With increasing values of CD95-lymphocytes to 28,13,2% of ischemic stroke in heavy gravity. The method allows to reduce the rates of morbidity and mortality by improving the reliability of determination of the severity of ischemic stroke and allow for timely and adequate therapy. table 2.

The invention relates to medicine, namely to neurology. The problem of ischemic stroke is deeply relevant to contemporary clinical neurology. In Russia annually registrirueshsya stroke are persons of working age. Only one-fifth of returns to labor. The mortality rate for the last time remains at the same level, and in some countries, particularly in Russia, tends to increase. Therefore, the prediction of the severity of ischemic stroke and the respective adequate treatment is of great importance in practical neurology that will allow you to make timely adjustments in the treatment of acute cerebrovascular disease and thereby reduce mortality and disability.

As a prototype, the authors propose “a Method of predicting the course of ischemic stroke” (patent No. 2195672 from 30.03. 2001, BI No. 36 dated 27.12.2002. M. M. Gerasimova, G. N. Zhdanov and Y. the Century Already), consisting in the determination in the serum of patients with ischemic stroke level of anti-DNA method enzyme immunoassay. The method consists in determining the level of anti-DNA in units of optical density (OP units) in the serum of patients. Indicator anti-DNA increased with the severity of patients and was the 1st day in patients with mild severity 0,2680,02 OP units, with an average severity - 0,3830,03 OP units, in patients with severe over - 0,6010,04 OP units.

Some disadvantage of this is the Gnostics severity of ischemic stroke by way of immunophenotypically lymphocytes. Lymphocytes isolated from heparinized blood by centrifugation on a gradient ficoll-urografin (density of 1.077 g/ml). 1 ml of cells in a volume of 50 μl contribute to the centrifuge tube and add 5 µl of the tested monoclonal antibodies CD-95, followed by incubation for 30 minutes Then add 150 μl of Hanks solution and centrifuged 5 min at 200 g, remove the supernatant, then again make 150 μl of Hanks solution, suspended and centrifuged again. To the precipitate add 50 ál of fragments of sheep antibodies labeled with fitzum, followed by suspendirovanie and incubation. Double-washed cells are ready for viewing in a fluorescent microscope. To diagnose the severity of use level antigenpositive cells (CD95 - lymphocytes). Their number is defined as the percentage of fluorescent cells while browsing 200 lymphocytes minus the percentage of fluorescent cells observed in the preparation of the negative control (Annex to licence No. 42/ 98-065-0509 from 06.05.1998. The list of medical devices allowed to be used by the limited liability company (LLC) Sorbent, , Podolsk, Moscow region). The obtained result is compared with the control group, which ischemic stroke. In accordance with the scale of Glasgow, one of them was allocated to 3 groups (table. 1).

4-I group, the control, which consisted of 30 healthy persons.

All patients were extracted venous blood on the 1st day of the disease and has been found to increase the level of CD95 relative to the control group, in which the level of CD-95 was 7,22,8%.

In the 1st group the level of CD-95 - 9,63,65%, in the 2nd group level CD-95 - 16,82,7%, in the 3rd group - 28,13,2%. Revealed a positive significant relationship (r = +0,8 between the severity of ischemic stroke and the level of CD95 - lymphocytes.

Clearly the obtained data are presented in table 2.

Reliability P0,05

The proposed method does not require expensive equipment and allows to reliably determine the severity of ischemic stroke and to carry out adequate therapy, which will reduce the rates of morbidity and mortality.

Clinical example

Patient Travkina T. I., 58, and/b 381.

s: ischemic stroke in the basin of the vertebrobasilar arteries in hypertension.

The level of CD95 - 25%, which corresponds to severe severity of ischemic stroke. The average score on a scale of Glasgow 11%, which corresponds to schematic with depression of consciousness, in subsequent death.

Thus, from the above example shows that the level of CD95 - lymphocytes in peripheral blood of patients in the 1st day more accurately reflects the severity of ischemic stroke.

The way to diagnose the severity of ischemic stroke, including the study of blood, characterized in that on the 1st day in the venous blood by way of immunophenotyping determine the level antigenpositive cells (CD95-lymphocytes, %) as a percentage fluorochrome cells while browsing 200 lymphocytes minus percent fluorochrome cells observed in the preparation of the negative control and with increasing values D95-lymphocytes to (9,63,65)% diagnosed with ischemic stroke in mild severity, with higher values CD95-lymphocytes to (16,82,7)% of ischemic stroke in moderate severity, and with increasing values of CD95-lymphocytes to (28,13,2)% of ischemic stroke in heavy gravity.

 

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