Method for determining individual sensitivity to beta-adrenoceptor blockers in arterial hypertension cases

FIELD: medicine.

SUBSTANCE: method involves determining diene conjugates, lipid hydroperoxides, malonic dialdehyde, cholesterol, beta-lipoproteins concentration and erythrocyte cell membrane adrenoreactivity level in blood serum. Modification coefficient is calculated for each characteristic under consideration from formula M=(Ai-Amin)/(Amax-Amin), where Ai is the value of one of blood characteristics, Amin and Amax are the laboratory value spread for healthy people and arterial hypertension patients. Then, metabolic coefficient MC is calculated having value of each laboratory value M in consideration from formula M=(MDC+MHPL+MMDA+MCh+MLP+Marm)/6, where MDC is the M for diene conjugates, MHPL is the M for lipid hydroperoxides, MMDA is the M for malonic dialdehyde, MCh is the M for cholesterol, MLP is the M for beta-lipoproteins, Marm is the M for erythrocyte cell membrane adrenoreactivity level. MC value being less than 8, favorable adrenoceptor blockers influence is to be diagnosed.

EFFECT: high accuracy of the method.

1 tbl

 

The invention relates to the field of biochemical pharmacology and cardiology.

Known methods of determining individual response to receiving beta-blockers, including an assessment of the impact of drugs on lipid metabolism (Pharmacological regulation of vascular tone, Ed. Pagamento-Yaroshevsky. - M.: Publishing house of the Russian Academy of medical Sciences. 1999. - S-127), carbohydrate metabolism (Albanska LI, Morozova I.E. Pharmacotherapy of hypertension. - M.: Publishing house "Russian doctor", 2002. - P.66).

However, in previously used methods for detecting individual response to receiving beta-blockers used individual laboratory performance. In addition, earlier when prescribing beta-blockers are not conducted a comprehensive evaluation of indices of lipid peroxidation and functional status of adrenalectomy cell membranes.

The technical objective of this development was the creation of a quantitative diagnostic criterion for determining individual sensitivity to beta-blockers in hypertension.

The technical problem is achieved by a method for determining individual sensitivity to beta-blockers for hypertension, serum, define the following parameters: concentration of diene conjugates (DC), headrope is ekisa lipids (CSR) malondialdehyde (MDA), cholesterol, beta-lipoproteins (β-PL), and the level of adrenalectomy cell membranes of erythrocytes (arm), followed by calculation of the coefficient modification for each of the identified parameters by the formula (1)

where M is the coefficient of modification of each indicator,

Ai is one of the studied parameters of the blood,

Amax and Amin - limits changes in laboratory parameters in healthy individuals and patients with arterial hypertension (see table), then given the value M of each laboratory indicator of metabolic expect the coefficient by the formula (2)

where MK is the metabolic factor. MDK - M diene conjugates, Mgpl - M of lipid hydroperoxides, MD - M malondialdehyde, MH - M cholesterol, MLP - M beta-lipoproteins, Marm - M level adrenalectomy cell membranes, and when the level MK less than 8 units determine the beneficial effects of beta-blockers.

In healthy individuals MK = 2-6%

When the level of MK more than 8%, the prognosis is poor, requires adjustment of therapy. The method is illustrated in the following specific clinical examples.

EXAMPLE 1: Grandfathers D.P., 36, hospitalized in the Road clinical hospital 11.10.2003 with a diagnosis of Hypertension II article, have the group senior risk 3, case history No. 6960. Admission AD=165/90 mm RT. Art., the results of laboratory tests (13.10.2003): the level of diene conjugates DK = 9.8 Ámol/ml of lipid hydroperoxides CSR=7,2% ml, malondialdehyde MDA=3.8 nmol/ml, cholesterol LDL=5.9 mmol/l, beta-lipoproteins β-PL=4.1 mmol/l, the value of adrenalectomy cell membranes In arm=16.5 $

The estimated value MK=14,5%

The patient was assigned to pharmacotherapy with atenolol dose of 50 mg/day. During the control study (27.10.2003) AD=155/90 mm RT. Art., diene conjugates DK=8.34 per Ámol/ml of lipid hydroperoxides CSR=8,0 u/ml, malondialdehyde MDA=3.8 nmol/ml, cholesterol LDL=5.9 mmol/l, beta-lipoproteins β-LP=4.0 mmol/l, the value of adrenalectomy cell membranes In arm= $ 36,2

The estimated value MK=15,17%, reflecting the adverse individual metabolic response to ongoing pharmacotherapy.

EXAMPLE 2: Elgin GV, 34 g, hospitalized in the Road clinical hospital 30.10.2003 with a diagnosis of Hypertension article II, exacerbation history No. 6013. Admission AD=170/90 mm RT. Art., the results of laboratory tests (31.10.2003): level denovich conjugates DK=2,18 Ámol/ml of lipid hydroperoxides CSR=1,2 units/ml, malondialdehyde MDA=1.8 nmol/ml, cholesterol LDL=5.0 mmol/l, beta-lipoproteins βPL=2.8 mmol/l, the value of adrenalectomy cell membranes In arm=23 $

The estimated value MK=5,95%

The patient was assigned to pharmacotherapy atenololum dose of 50 mg/day. During the control study (21.11.2003) AD=135/80 mm RT. Art., diene conjugates DK=1,14 Ámol/ml of lipid hydroperoxides CSR=1,08 u/ml, malondialdehyde MDA=0.8 nmol/ml, cholesterol LDL=5.0 mmol/l, beta-lipoproteins β-PL=was 2.76 mmol/l, the value of adrenalectomy cell membranes In arm=22 $

The estimated value MK=4,7%, reflecting favorable metabolic response to ongoing pharmacotherapy.

The technical result of the proposed method is to expand the Arsenal of methods for determining sensitivity to beta-blockers in patients with arterial hypertension, which uses individual sets of laboratory parameters blood. To assess the magnitude of adrenalectomy cell membranes of erythrocytes used reagents domestic producers.

No.IndexAminAmaxAmax-Amin
1Diene conjugates, umol/ml11413
2The gidroperekisi lipids, units/ml0,5 18of 17.5
3Malonic diallelic, nmol/ml0,57,57.0
4Cholesterol, mmol/l3,584.5
5Beta-lipoprotein, mmol/l1,553.5
6The level of adrenalectomy cell membranes (arm), USD89587

The method of determining individual sensitivity to beta-blockers for hypertension, characterized in that in the serum, define the following parameters: concentration of diene conjugates (DC), lipid hydroperoxides (CSR), malondialdehyde (MDA), cholesterol, beta-lipoproteins (β-PL), and the level of adrenalectomy cell membranes of erythrocytes (arm), followed by calculation of the coefficient modification for each of the identified parameters by the formula (1)

where M is the coefficient of modification of each indicator.

Ai is one of the studied parameters of blood;

Amin and Amax - limits changes in laboratory parameters in healthy and hypertensive patients whose values were

the La DK, Ámol/ml: Amin=1, Amax=14;

for CSR, IU/ml: Amin=0.5 a, Amax=18;

for MDA, nmol/ml: Amin=0.5 a, Amax=7,5;

for cholesterol, mmol/l: Amin=3,5, Amax=8;

for β-PL, mmol/l: Amin=1,5, Amax=5;

for In-arm, c.u.: Amin=8, Amax=95,

then given M values each laboratory indicator of metabolic expect the coefficient by the formula (2)

where MK - metabolic factor;

MDK - M diene conjugates;

Mgpl - M of lipid hydroperoxides;

MDA - M malondialdehyde;

MX - M cholesterol;

MLP - M beta-lipoproteins;

Marm - M level adrenalectomy cell membranes of erythrocytes,

and if MC is less than 8 units determine the beneficial effects of beta-blockers.



 

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