Method for detecting the activity of chronic hepatitis
FIELD: medicine, gastroenterology.
SUBSTANCE: in patient's blood serum it is necessary to detect the level of lipid peroxides (LP) and total antioxidizing activity (AOA) and at the level of LP being 83.9 and higher, AOA value being 15.5 and lower one should detect high activity of chronic hepatitis, at LP value ranged 83.8 to 74.5, AOA value ranged 24.3 to 15.6 - moderate degree of activity and at LP value ranged 74.4 to 66.0 and AOA value ranged 24.4 to 33.5 - inactive degree of activity should be detected. The method enables to accelerate and simplify testing in patients and detect indications for therapy and evaluate efficiency of therapy conducted.
EFFECT: increased information value and accuracy of detection.
3 ex, 2 tbl
The invention relates to medicine, in particular to a gastroenterologist. Currently, the primary method for determining the activity of chronic hepatitis (CH) is a morphological examination of the liver biopsy sample (Meyer C.P. Hepatitis and consequences of hepatitis. TRANS. with it. - M.: GEOTAR Medicine, 1999. - 424 C.). However, to perform a liver biopsy in outpatient conditions is not always possible because of the presence of those or other contraindications, and because of the refusal of the patient. You should take into account the fact that the liver biopsy sample we can estimate only 1/50000 part of it that is not always adequately reflect the condition of the whole body. Largely the result of morphological analysis depends on the individual qualities of the morphologist (experience, qualifications, etc).
There is a method of determining the degree of activity of chronic hepatitis by research in the serum activity of alanine aminotransferase (ALT). If the ALT activity in the serum for at least 3 standards, we refer to the degree of chronic inactive hepatitis, from 3 to 10 standards - moderate activity and more than 10 standards - high activity (Radchenko VG, Sabre A.V., V.V. Nechaev Chronic liver disease. - SPb.: DOE, 2000. - 30 seconds).
The disadvantages of this method is the high cost, complexity research, from the laboratory is the requirement of highly skilled, and the fact that ALT is a non-specific indicator, it is increased in myocardial infarction, cardiomyopathy, etc.
The goal is to increase the efficiency of diagnosing the degree of activity of chronic hepatitis by examining the level of lipid peroxides and total antioxidant activity in the serum of these patients.
The essence of the invention lies in the fact that in the serum to determine the level of lipid peroxides (LP) and total antioxidant activity (AOA), and the SQUARE value of 83.9 ated and above, the AOA 15,5 ated and below diagnosed with high activity of HCG when the value of PL within 83,8-74,5 oted, AAO - 24,3-15,6 UNED - moderate degree of activity, when DPS within 74,4-66,0 oted, AAO - 24,4-33,5 UNED - inactive level.
It is proved that the integrity of cell membranes is determined by the ratio of the indices of free radical oxidation of lipids (SRA) and antioxidant system. Processes SROL plasma reflect those in hepatocytes and change indicators SROL plasma it is possible to judge the status of these processes in the liver tissue. Increased activity indicators SROL and reduced antioxidant activity in the serum clearly indicates destabilization of cellular structures, i.e. in our case about the destruction of the membranes of hepatocytes.
The method is carried out by ledouxnebria: serum determine the level of DPS and the AOA through registration activated rhodamine W chemiluminescence in the presence of ferrous iron (Vladimirov, Y.A., Sherstnev BTW, azimbaev AS Evaluation of antioxidant and antiradical activity of the substances and biological objects using gelatinization chemiluminescence // Biophysics. - 1992. - No. 37. - S-1047) chemiluminometer IRA-03 using FEG-127.
OK AAO 33.6 ated and higher level PL - 65,9 ated and lower in the serum.
The high activity of HCG is diagnosed when the value of PL 83,9 ated and above, the AOA 15,5 ated and below the moderate level of activity when the value of PL within 83,8-74,5 ated and AAO - 24,3-15,6 ated and the inactive level when PL - 74,4-66,0 oted, AAO - 24,4-33, 5 oted
Example 1. Patient K., 32 years. Was admitted with complaints of pain in the right hypochondrium, severe weakness, decreased performance, increased drowsiness, periodically nosebleeds, nausea, decreased appetite. Ill for 2 years, notes in the history of 3-fold transfusion. Objective examination revealed mild tenderness in the right hypochondrium. The liver acts from under the edge of the costal arch on 4 see Dimensions 10-15-13 see Spleen not palpated. Sizes 6-8, see the CBC - hypochromic anemia, urine - without features. The obtained serum and carried out the determination of the level of DPS. He reached 84.2 Rel. units, AAO - 14,1 ated On the basis that the values are within: PL 83,9 ated and above, the AOA 15,5 ated is diagnosed below the high activity of HCG. This was confirmed by biochemical analysis of blood (about. protein - 72, albumin - 55, globulins - 46 (α1- 3, α2- 11, β - 12, γ - 20), ALT - 854, ACT 379, GGT - 124, SF 138, thymol test - 8,5). Virological tests: HBs - Ag - positive. Ultrasound: liver considerably enlarged, the reflection from the parenchyma increased, coarse-grained, intrahepatic veins are enlarged, the spleen is not enlarged. It is recommended to conduct a comprehensive treatment of HG with the use of antioxidant drugs.
Example 2. Patient M., aged 45. Was admitted with complaints of weakness, fatigue, reduced appetite. Ill for 5 years. Objective examination: liver protrudes from under the edge of the costal arch on 2 see Dimensions on 10-12-11 see Spleen not palpated. Sizes 6-8 see General analysis of blood, urine normal. The biochemical analysis of blood and research settings SROL. The level of PL was 79.3 Rel. units, AAO - 21,5 atmospheric air.. On the basis that the values are within: PL 83,8-74,5 oted, AAO 24,3-15.6 Rel. unit diagnosed with a moderate degree of activity of HCG. This was confirmed by biochemical analysis of blood (about. protein - 72, albumin - 58, globulins - 39 (α1- 3, α2- 11, β - 10, γ - 15), ALT - 231, ACT 174, GGT - 90, SP - 107, thymol test - 4,5). Virological tests: HBs-Ag - lay is compulsory. Ultrasound: liver is increased, the reflection from the parenchyma reinforced, medium-grained, intrahepatic veins are enlarged, the spleen is not enlarged.
Example 3. Patient A., 38 years. Suffering from chronic viral hepatitis C for 3 years. No complains. Objective examination: liver edge of the costal arch. Dimensions on 8-9-10 see Spleen not palpated. Sizes 6-8 see General analysis of blood, urine normal. The biochemical analysis of blood and research settings SROL. The level of PL was 71,1 oted, AAO - 25,2 ated On the basis that the values are within: PL 74,4-66,0 oted, AAO 24,4-33,5 oted diagnosed inactive the degree of HCG. When the biochemical analysis of blood (about. protein - 80, albumin - 53, globulins - 46,9 (α1- 4,2,02 to 10.5, β and 16.2, γ - 16), ALT-80, ACT 54, GGT - 20, SF - 127, thymol test - 4,0) defined inactive the degree of HCG. Virological tests: HCV - positive. Ultrasonography: the liver is not increased, the reflection from the parenchyma reinforced, fine-grained, intrahepatic veins are enlarged, the spleen is not enlarged. Shows dynamic observation, when the deterioration of the complex treatment with antioxidants.
Only offered by way of the surveyed 79 people. 18 of them with high potency HGH, 20 - otmerennoy degree of activity, 18 - inactive degree and 23 healthy individuals. The data summarized in tables, where the values of the AOA (UNED) of blood serum in patients with chronic hepatitis with varying degrees of disease activity (table. 1) and level C (UNED) of blood serum in patients with chronic hepatitis with varying degrees of activity (table. 2). OK AAO 33.6 ated and higher level PL - 65,9 ated and lower in the serum. We all studied patients (table 1, 2) is the higher level PL and the decrease in antioxidant activity in the serum regardless of the degree of activity of the CG relative to the control group (P3-4<0,05). When comparing the changes in the degree of disease activity and levels of PL and antioxidant activity in serum of patients with HCG it is noted that the increase in the degree of disease activity corresponds to an increase of the level of DPS and reducing the AOA. Thus, high activity corresponds to the greatest HCG level PL and the lowest antioxidant activity in serum (P1-2<0,05, P1-3<05).
The proposed method is quite informative. It fully reflects the state of the membranes of hepatocytes, which provides high accuracy in combination with the simplicity and accessibility, eliminates the influence of subjective factors and can be used as a rapid method of diagnosing the degree of activity of chronic hepatitis b outpatient us what the conditions. All this allows to speed up and simplify the survey data of patients with minimal costs, determines the indication for use of antioxidant drugs, and to assess the effectiveness of therapy.
THE METHOD FOR DETERMINING THE ACTIVITY OF CHRONIC HEPATITIS.
|The high activity||Moderate activity||Inactive degree||Healthy|
|M±m (atmospheric air)||10,56±2,28||20,45±1,82||28,31±2,52||38,82±1,95|
|And (atmospheric air)||15.5 and below||24,3 to 15.6||24,4 and 33.5||33,6 and above|
|The high activity||Moderate activity||Inactive degree||Healthy|
|M±m (atmospheric air)||89,25±3,50||78,62±1,51||70,43±261||61,62±2,15|
|And (atmospheric air)||83,9 and above||83,8-74,5||74,4-66,0||65,9 and below|
The method for determining the activity of chronic hepatitis by biochemical analysis of blood serum, characterized in that determine the level of lipid peroxides (LP) and total antioxidant activity (AOA) and the SQUARE value of 83.9 and above, the AOA 15.5 and below define the high activity of chronic hepatitis b in SQUARE within 83,8 is 74.5, AAO 24,3 to 15.6 moderate degree of activity, when DPS within 74,4-66,0, AAO 24,4-33,5 atmospheric air is an inactive level.
FIELD: biotechnology, vaccines.
SUBSTANCE: invention proposes an oligomeric particle that is able to induce immunity against hepatitis C virus. Particle consists of purified proteins or their parts, hepatitis C virus envelope (HCV) E1, E1s and E2. Proposed particle has diameter from 5 to 100 nm. Also, invention proposes a method for preparing such particle. Method involves purification of proteins HCV in solution, formation of oligomeric particles by replacing purified proteins with detergent solution or salt solution and purification of oligomeric particles. Also, invention proposes a composition for inducing immunity against HCV that comprises the proposed particle, antibody specific to particle, sets for detection of antigens HCV, immunological analysis for detection of antibodies to HCV, and vaccine against hepatitis C virus (HCV) that comprises the oligomeric particle. Proposed inventions provide carrying out the induction of specific humoral and cellular immunity to HCV envelope proteins and to carry out diagnosis of HCV. Invention can be used in medicine.
EFFECT: valuable medicinal properties of particle, improved preparing methods.
71 cl, 27 dwg, 6 tbl, 14 ex
FIELD: medicine, biochemistry.
SUBSTANCE: in blood serum one should detect the level of lactoferrin and biliary acids. At their ratio being equal to 5-17 it is necessary to detect chronic hepatitis of high activity.
EFFECT: higher accuracy of detection.
SUBSTANCE: method involves additionally studying spontaneous luminol-dependent chemiluminescence of patient venous whole blood with maximum luminescence luminosity and optical sum being determined. Articulocutaneous, mixed or renal disease form is diagnosed from increase in the values being found relative to reference values.
EFFECT: high accuracy and improved efficiency characteristics of diagnosis method.