The way to diagnose the severity of the exacerbation of bronchial asthma in children

 

(57) Abstract:

The invention relates to medicine, namely to pulmonology. To diagnose the severity of the exacerbation of bronchial asthma in children assessment of the level Danilovich acid AMP, ADP and ATP in the serum, calculate the rate of ATP/AMPAD and its value 33,032,54 judge lightweight, 25,002,11 - about moderate, 14,291,65 - about severe bronchial asthma attack. The method improves the accuracy of diagnosis. table 1.

The invention relates to medicine (pulmonology, Pediatrics), namely, to the diagnosis of the severity of the exacerbation of bronchial asthma.

A prototype of the invention taken method for determining the activity of lactate dehydrogenase, creatine kinase, asparaginases in the serum of patients with various severity of bronchial asthma attacks (Lavrent'ev A. C. et al. Clinical diagnostic values of enzymatic activity of serum in the assessment of severity of acute asthma in children // Pediatrics. -2001 no.1.-C. 19-25).

Diagnosis of severity of bronchial asthma (BA) today is largely based on clinical assessment, functional is ronhof) and laboratory data (acid-alkaline state) (global strategy for treatment and prevention of bronchial asthma /national Institute of health, USA, National Institute of Heart, Lung, Blood. - 2002. - 160). Given the high incidence of this disease among the child population, the increase of severe and disability of children, the search for additional methods that can improve the efficiency of diagnosis, treatment and rehabilitation activities. All this will contribute to the improvement of the prognosis in this group of patients.

The technical result of the invention is to improve the accuracy, efficiency and timeliness of diagnosis of the severity of the exacerbation of bronchial asthma by determining the concentrations of AMP, ADP, ATP in the serum and calculate the phosphate potential.

69 children in the acute period studied BA levels Danilovich acid (AMP, ADP, ATP) in the serum. In addition to the level of makroergov, we have determined the phosphate potential ATP/AMPAD (Handbook of functional diagnostics in Pediatrics / edited by Y. E. Ultidev, N. With. Kislyak. - M.: Medicine, 1979. - S. 113).

Studies have shown that in the acute period was increasing concentrations of AMP and ADP, reduced levels of ATP and phosphate potential. Marked disturbance depended on the severity of BA (table).

This is IKI severity BA.

Example 1. Patient C., 11 years old, suffers from bronchial asthma for 2 years, was admitted with complaints of shortness of breath, paroxysmal unproductive cough. Objectively: the skin is pale pink color, respiratory rate 20 per minute, the act of breathing participates auxiliary muscles. Over the entire surface of the lungs tympanic sound, auscultation - hard breathing, a large number of dry wheezing. Data analysis of respiratory function: VC - 81%, FVC - 67%, FEV166% OF PSV - 74%, MOS25- 81%, MOS50- 79%, MOC75- 68%. Daily bronchial lability - 21%. Data of pulmonary ventilation and bronchial obstruction was possible to judge the presence of a child's lung bronchial asthma attack. In the study of the concentration of the components Danilovo blood system showed increased levels of AMP (of 0.075 mmol/l) and ADP (and 0.37 mmol/l), compared to the normal concentration of ATP (0.96 mmol/l). The phosphate potential was 34,59 that significantly differs from the control group and confirms light attack BA.

Example 2. Patient M., aged 11, bronchial asthma suffers 2 years, was admitted with complaints of shortness of breath, paroxysmal unproductive cough. Objectively: the skin is pale zweet lung sound box, auscultation - hard breathing, a large number of dry wheezing. Data analysis of respiratory function: VC - 82%, FVC - 61%, FEV1- 59%, PSV - 60%, MOS25- 77%, MOS50- 71%, MOS75- 64%, daily bronchial lability was 25%, which allowed to talk about moderate attack. In the study of the concentration of the components Danilovo blood system showed increased levels of AMP (0.08 mmol/l) and ADP (0.45 mmol/l), compared to the normal concentration of ATP (0.90 mmol/l). Phosphate capacity totaled 25.0, which is significantly different from the parameters of the control group and patient V., confirming moderate attack BA.

Example 3. Patient E., age 11, who suffers from bronchial asthma for 4 years, was admitted with complaints of shortness of breath, paroxysmal unproductive cough. Objectively: the child is forced position, pale skin color, respiratory rate 20 per minute, the act of breathing participates auxiliary muscles. Over the entire surface of the lungs tympanic sound, auscultation - hard breathing, a large number of dry wheezing. Data analysis of respiratory function: VC - 60%, FVC - 49%, FEV1- 48%, PSV - 43%, MOS25- 51%, MOS50- 42%, MOSTherefore, the proposed method for the diagnosis of the severity of the exacerbation of bronchial asthma is to facilitate the timely diagnosis of the severity of bronchial asthma attacks, which will increase the effectiveness of treatment and rehabilitation activities and improve the prognosis for this disease.

The way to diagnose the severity of the exacerbation of asthma in children, including biochemical study of blood serum, wherein assess the level Danilovich acid AMP, ADP and ATP, calculate the rate of ATP/AMPAD and its value 33,032,54 judge lightweight, 25,002,11 - about moderate, 14,291,65 - about severe bronchial asthma attack.

 

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