Method for diagnosing endotoxicosis condition in cows suffering from acute pyocatarrhal endometritis

FIELD: veterinary medicine.

SUBSTANCE: method involves determining low and middle molecular mass substances content in blood plasma and erythrocytes and general blood plasma albumin concentration. Integral index is calculated on basis of obtained values using formula II=100*S_{238-298(plasma)}/S_{238-298(erythrocytes)}*GAC, where S_{238-298(plasma)} and S_{238-298(erythrocytes)} are the low and middle molecular mass substances content in blood plasma and erythrocytes, respectively, determined from area of figures restricted by spectral curves in wavelength range of 238-298 nm and abscissa axis (conditional units²); GAC is the general blood plasma albumin concentration (g/l). The value being from 2.1 to 3.0, the first endotoxicosis degree is diagnosed. The value being from 3.1 to 4.5, the second endotoxicosis degree is diagnosed. The value being from 4.5 to 6.0, the third endotoxicosis degree is diagnosed. The value being greater than 6.0, the fourth endotoxicosis degree is diagnosed. The normal value is equal to 0.5-2.0.

EFFECT: high accuracy of diagnosis.

1 dwg, 1 tbl

The present invention relates to the field of veterinary medicine and can be used to diagnose the severity of endotoxemia body.

There is a method of diagnosing the degree of endotoxemia, including the measurement of the impact of the studied serum during filtration of red blood cells of healthy donors. Toxicity is determined by the increase in filtration time of donor erythrocytes after incubation with serum of a patient body [A.S. USSR №1475333, CL G 01 N 33/48].

One of the common methods of diagnosis of endotoxemia is the definition of the linking function of serum albumin [A.S. USSR №1409931, CL, G 01 N 33/48].

Barnhill Stephen Datall at al for the diagnosis of intoxication offer diagnostic index obtained in the processing of laboratory data [WO 9612187 class. G 01 N 33/53].

To increase the sensitivity of the assessment of the degree of endotoxemia know the use of data content in the blood plasma of molecules of average weight and effective concentration of albumin [Webhallen. Assessment of intoxication in violation of the balance between the accumulation and binding of toxins in the blood plasma / Webkatalog, Mel, Dagerman, Savchev, Obvalenicheva // Klin. lab. the automotive technician. - 1999. No. 2 - C-17]. If it is impossible to determine the effective concentration of albumin, the authors propose to determine ABSU the concentration of albumin and count criteria intoxication (KI) by the formulas:

KI₁=100· D₂₅₄/OKA)

KI₂=1000· D₂₈₀/OKA), where

D₂₅₄, D₂₈₀- the content of molecules of average weight, which is determined by the indices of the optical density of the plasma at wavelengths of 254 and 280 nm (srvc. units);

OKA - the total concentration of albumin in blood plasma (g/l).

The disadvantage of this method of diagnosis is limited in connection with the use of only imbalance between accumulation and binding of toxins albumin in blood plasma without taking into account sorption function of erythrocytes.

The objective of the invention is to improve the efficiency of evaluating the degree of endotoxemia body.

The problem is solved in that in the method of diagnosing the degree of endotoxemia by studies of blood plasma on the content of substances of low and medium molecular weight (UNSM) and the total concentration of albumin additionally determine in erythrocytes content VNSM, calculate the integral index (AI) based on the received parameters by the formula:

AI=100· S_{238-298 (plasma)}/S_{238-298 (erythrocytes)}·OKA, where

S_{238-298(plasma)}, S_{238-298(erythrocytes)}- content (VNSM) plasma and red blood cells, as defined by square shapes, limited spectral curves in the wavelength range 238-298 nm and the abscissa axis (srvc. units²);

OKA - the total concentration of albumin PLA is we blood (g/l),

and when it is from 2.1 to 3.0 diagnosed first degree of endotoxemia, from 3.1 to 4.5 - second, from 4.6 to 6.0 - third degree, more than 6,0 - fourth degree of endotoxemia, at the rate of 0.5 to 2.0.

In this regard, a cumulative index to determine the degree of intoxication in cows with acute purulent-catarrhal endometritis based on the analysis of the dynamics of the following indicators: albumin, VNSM plasma and VNSM of red blood cells. The total concentration of albumin was determined using a dye of bromocresol green (“Lachema” Czech Republic), the content VNSM - method Myamalfoy [Malakhov MY Method of registration of endogenous intoxication. - A manual for physicians. - SBP: Publishing house of St. Petersburg medical Academy of postgraduate education. - 1995. - 34 S.]. According to the degree of intoxication animals were divided into 3 groups according to the severity of the condition. In the 1st and 2nd group consisted of cows in a compensated state without the threat and risk of developing sepsis, respectively. The third group consisted of animals with developed sepsis and failure of any one or more of the functional systems (heart failure, respiratory failure, acute renal failure). The control group consisted of cows 2-3 years of red steppe breed with similar levels of weight and milk production, what are the values of routine biochemical parameters were within the physiological norm. Mathematical processing of results was performed using student's criterion, a comparative analysis of samples using Fisher's exact test.

Profiles of the spectrograms of plasma and red blood cells of animals of all studied groups have approximately one view. At wavelengths 238-246 nm are observed zero values of optical density. Starting with 250 nm, spectrograms are evenly ascending values of optical density with absorption maxima at wavelengths 274±8 nm and 286±4 nm for plasma and red blood cells respectively (see drawing).

Values of average peak heights of the spectrograms of plasma and red blood cells healthy cows respectively 0,144 and 0,383 srvc. units

About the content VNSM in biological fluids makes it possible to judge the area of the region bounded by the spectral curve and the x-axis. This indicator for the above group of animals has the following average values: for plasma - 5,5±0,7, and for red blood cells to 15.1±1,6 services. units²

In the early stages of endotoxemia on the spectrogram cows with purulent-catarrhal endometritis there is an increase in sorption capacity of red blood cells, because the erythrocyte due to protein glycophorin adsorbs on its surface substances of different classes, including average molecular weight. At the same time, the concentration VNSM in plasma also is slightly increased. Value space of the spectrograms of plasma and red blood cells respectively equal to 11.5±1,2 and 20.3±2,4 services. units²On the spectrograms corresponding to the second stage of endotoxemia, a moderate increase in the content VNSM in both plasma and red blood cells. Value space of the spectrograms of plasma and red blood cell counts are within 18,0±1.8 and 26,7±2.7 services. units²respectively. At the third stage there is a significant increase in the concentration VNSM in the blood plasma, while on the red blood cells it remains practically unchanged. Area values ranging 25,3±2,6 and 27.8±2,6 services. units²plasma and red blood cells respectively.

The content of albumin in the blood plasma of healthy cows in the period of milk production is equal to 31.4±2.8 g/l with the development of toxicity values for this indicator are reduced.

The integral index of endotoxemia in cows with purulent-catarrhal endometritis has the following form:

AI=100· S_{238-298 (plasma)}/S_{238-298 (erythrocytes)}·OKA, where

S_{238-298(plasma)}, S_{238-298(erythrocytes)}content VNSM plasma and red blood cells, as defined by square shapes, limited spectral curves in the wavelength range 238-298 nm and the abscissa axis (srvc. ed²);

OKA - the total concentration of albumin plasma cu is TS (g/l).

The method is as follows: calculate the integral of the index according to the formula above. When it is from 2.1 to 3.0 diagnosed first degree of endotoxemia, from 3.1 to 4.5 - second, from 4.6 to 6.0 - third degree, more than 6,0 - fourth degree of endotoxemia. The index value in the rate from 0.5 to 2.0.

The proposed index is analyzed within 7 days for the two groups of animals with first and second degree of endotoxemia. The data given in the table.

In these groups of animals index values decrease, and in the group of cows with the first degree of endotoxemia back to normal.

Example 1. A sick cow, age 5 years, red steppe breed. Diagnosis: acute postpartum catarrhal-purulent endometritis. The animal was oppressed. It was noted the deterioration of the General condition, reduced appetite, reduced milk production. Observed low-grade fever permanent type, a slight increase in pulse and breathing, increased body temperature. During laying, defecation, urination, as well as by rectal massage of the uterus from the cervix of the uterus stood out thick turbid exudate grayish color mixed with pus. By rectal examination there was an increase in uterine asymmetry - the right horn is much more left. According to clinical and laboratory studies of endogenous intoxication: the amount of hemoglobin - 85 g/l; erythrocytes - 5,1· 10¹²/l; leukocyte - 6,93· 10⁹/l; the amount of albumin - of 22.3 g/l, the content VNSM plasma - 11,9 srvc. ed²; contents VNSM red - 20,1 srvc. ed². The value AI is 2.6.

On a set of clinical data - a state of moderate severity, the value AI is the first degree of endotoxemia. Complex treatment was aimed at raising the General tone of the body, increasing socratically the th ability of the uterus, remove exudate from its cavity, creating in the uterus antiseptic conditions. Ongoing therapy led to complete recovery on the 7th day, the value of AI was equal to 1.9.

Example 2. A sick cow, age 4 years, red steppe breed. Diagnosis: acute postpartum catarrhal-purulent endometritis. The animal was oppressed, moaned, curved back. It was noted shortness of breath, fever, fever, reduced milk production, from the external genital organs abundantly stood out mucopurulent exudate viscous consistency fetid smell dull yellowish and brown. Rectal examination revealed an increase of both horns of the uterus. According to clinical and laboratory studies of endogenous intoxication: the amount of hemoglobin - 63 g/l, erythrocytes - 3,7· 10¹²/l; leukocyte - 4,1· 10⁹/l; the increase of certain types of leukocytes; ESR method Panchenkov - 1 hour; the amount of albumin is 20.1 g/l; content VNSM plasma - 19,7 srvc. ed²; contents VNSM red - 26,3 srvc. ed². The value AI is 3.7.

For the totality of the clinical data special gynecological studies General condition recognized as heavy. The value AI 2-I degree of endotoxemia, the risk of developing sepsis. A comprehensive treatment. To suppress the development of pathogenic microfil the market in the uterus appointed local and General protivosepticheskie therapy taking into account the sensitivity of selected microbes to the use of the drug. Ongoing therapy resulted in recovery on the ninth day. The value of AI was equal to 2.1.

A method for diagnosing the degree of endotoxemia in cows with acute purulent-catarrhal endometritis, characterized by the fact that determine the content of substances of low and medium molecular weight in the plasma and in red blood cells, the total concentration of albumin in blood plasma, calculate the integral index (AI) based on the received parameters by the formula

AI = 100 · S_{238-298(plasma)}/ S_{238-298(erythrocytes)}·OKA,

where S_{238-298(plasma)}, S_{238-298(erythrocytes)}- substances of low and medium molecular weight plasma and red blood cells, respectively, defined on the space of shapes, limited spectral curves in the wavelength range 238-298 nm and the abscissa axis (used²);

OKA - the total concentration of albumin in blood plasma (g/l),

and when it is from 2.1 to 3.0 diagnosed first degree of endotoxemia, from 3.1 to 4.5 - second, from 4.6 to 6.0 - third degree, more than 6,0 - fourth degree of endotoxemia, at a rate of from 0.5 to 2.0.