Method for predicting critical state outcomes in newborns

FIELD: medicine.

SUBSTANCE: method involves studying urine gas discharge visualization parameters at the first days of life. To do it, urine drops are placed into magnetic field of high intensity with bipolar pulses amplitude being equal to 16 kV pulse succession frequency of 1024 Hz and pulse series duration of 0.5 s. Time required for performing single study being equal to 10 min. The gas discharge visualization picture parameters like fractal discretization being equal to 2.07±0.05, fragmentation 13.93±1.81 and brightness 224.6±0.59, favorable newborn state outcome is to be predicted. The gas discharge visualization picture parameters like fractal discretization being equal to 1.873±0.11, fragmentation 5.909±2.64 and brightness 222.8±0.65, unfavorable newborn state outcome is to be predicted. Cases of gas discharge visualization picture parameters like fractal discretization being equal to 2.128±0.08, fragmentation 21.17±2.123 and brightness 226.8±0.8 are considered to be norm.

EFFECT: simplified noninvasive test.

3 dwg, 1 tbl

 

The invention relates to medicine, namely to laboratory diagnosis.

There is a method of predicting the outcomes of critical conditions in children, which consists in determining changes in the level of lactate dehydrogenase, aspartate aminotransferase, hydroxysteroiddehydrogenase in the biochemical analysis of blood of full-term newborns (Lackmann GM. The predictive value of elevation in specific serum enzymes for subsequent development of hypoxic-ischemic encephalopathy or intraventricular hemorrhage in full-term and premature asphyxiated newborns / G.M. Lackmann, U.Tollner // Neuropediatrics. - 1995. - Vol.26, 4. - P.192-198).

Well-known tests for determination in cerebrospinal fluid creatine kinase-BB, neurospecific enolase (Brain-specific proteins in the cerebrospinal fluid of severely asphyxiated newborn infants / m - Blennow, K.Savman, P.Ilves, M.Thoresen, L.Rosengren // Acta Paediatr. - 2001. - Vol.90, No. 10. - P.1103-1105) as a criterion for predicting the severity of perinatal pathology of the brain.

A known method for predicting outcomes of perinatal CNS damage by determining the level interleukin-6 in cord blood (Umbilical cord interleukin-6 levels are elevated in term neonates with perinatal asphyxia / C.Chiesa, G.Pellegrini, A.Panero, T. De Luca // Eur J Clin Invest. - 2003. - Vol.33. No. 4. - P.352-358).

There is a method of use as predictors of the severity of hypoxic-ischemic encephalopathy level of interleukin-1 in the blood and cerebrospinal fluid of newborn (Predictiv value of plasma and cerebrospinal fluid tumor necrosis factor-alpha and interleukin-1 beta concentration on outcome of full-term infants with hypoxic-ischemic encephalopathy / .Oygur, O.Sonmez, O.Saka, O.Yegin // Arch. Dis. Child Fetal Neonatal Ed. - 1998. - Vol.79, No.3. - P.190-193).

There is a method of determining neurospecific proteins: A2-globulin brain, piperylenes acidic protein amino acid to enolase, leucine-aminopeptidase, tumor necrosis factor and antibodies in serum, cord blood, and then in the serum in the dynamics (Neonatal-specific enolase levels and neuroimaging in asphyxiated term newborns / F.S.Ezgu, Y.Atalay, K.Gucuyener et al. // J. Children Neurol. - 2002. - Vol.17, No. 11. - P.824-829).

All of the above methods for diagnosis of invasive (for analysis needed blood, cerebrospinal fluid), and time-consuming, technically, require expensive equipment and reagents

Closest to the claimed is skanirujushie test to determine the ratio MK-creatinine in urine for the early diagnosis and determine the severity of brain lesions (Akiso M. Value of urinary uric acid to creatinine ratio in termin infants with perinatal asphyxia / M.Akiso, N.Koltorsay // Sourse Acta Paediatr. Jpn. - 1998. - Vol.40, No. 1. - P.78-81).

This method only determines the severity of brain lesions, and not the outcome critical condition in General and is used only in full-term infants.

The technical result of our invention is to improve the accuracy of diagnosis and reduce trauma.

The technical result is achieved by the fact that takes a drop of urine of a newborn baby in the first days of life, is placed in electroma the magnetic field of high intensity with amplitude bipolar pulses 16 kV, the pulse frequency of 1024 Hz, the duration of a series of pulses of 0.5 s (e.g., device "Crown-TV), one studies for 10 minutes, then held a traditional computer processing.

The method is as follows: drawn into a syringe one millilitre of urine of the newborn includes the device's Crown "TV", is formed by the hanging drop over the insulator, the exposure, the resulting image is saved on the hard disk of the computer as a graphic file.

Indicators of GDV-grams of urine of children in the control group: the area of the image - 20790±2082; fragmentation - 21.17±2.123; shape factor - 213±26.57; brightness - 226.8±0.8; deviation - 27.6±1.27; fractal resolution 2.128±0.08. This is the normal range (table 1).

Indicators of GDV-grams of urine surviving children who were in critical condition: the area of the image - 16160±1595; fragmentation - 13.93±1.81; shape factor - 116.2±at 14.66; brightness - 224.6±0.59; deviation - 28.18±0.68; fractal resolution 2.07±0.05 (table 1).

Indicators of GDV-grams of urine deceased children who were in critical condition: the area of the image - 18220±5643; fragmentation - 5.909±2.64; shape factor - 78.88±25.34; brightness - 222.8±0.65; deviation - 27.69±0.59; fractal resolution 1.873±0.11 (table 1).

From the above figures the RV-grams urine disjoint ranges are indicators fractal discrete fragmentation and brightness. They can be used to predict the outcome of critical conditions in newborns.

Example 1

Child To., no history 3210, weight at birth 3420 g, height 53 cm, head circumference 35 cm, chest circumference 34 see was Born from 2 pregnancies, 1 birth. The gestation 38-39 weeks. Chest is applied on the first day of life.

In the first days of life a drop of urine was placed in the electromagnetic field of high tension with an amplitude of 16 kV, the pulse frequency of 1024 Hz, the duration of a series of pulses of 0.5 sec. The resulting image was saved on the hard disk of the computer as a graphic file and underwent traditional computer processing.

The following parameters of gas discharge visualization (GDV) of urine: the area of the image - 18405; fragmentation - 19; form factor - 188.39; brightness - 226.8 deviation - 29.66; fractal resolution 2.1. These parameters correspond to the norm. The child does not develop a critical condition. He was discharged home from the hospital on the 7th day. Diagnosis at discharge: perinatal hypoxic-ischemic brain damage is mild, acute period. The syndrome of hyperexcitability.

GDV-grams of urine to A.

Example 2

Child S., no history 7230, weight at birth 3120 g, height 53 cm, head circumference 34 cm, the district shall be breast 33 cm, score Apgar 1-4 points. Born from 2nd pregnancy (1 med. abortion)going on in the background threat of termination at 23 weeks of preeclampsia in the second half (swollen-hypertensive form). Childbirth is 1 in 40-41 week. In the delivery room rehabilitation of the upper respiratory tract, intubation of the trachea, the translation on a ventilator.

In the first days of life a drop of urine was placed in the electromagnetic field of high tension with an amplitude of 16 kV, the pulse frequency of 1024 Hz, the duration of a series of pulses of 0.5 sec. The resulting image was saved on the hard disk of the computer as a graphic file and underwent traditional computer processing.

The following parameters of GDV urine: the area of the image - 14637; fragmentation - 13; form factor - 107.17; brightness - 224.62 deviation - 27.89; fractal resolution 1.822. These settings correspond to the favorable outcome critical condition in the newborn child will survive).

The child was on a ventilator for 4 days. In the ICU for 8 days. Then transferred to a neonatal care unit, where he was discharged home at the age of one month. Diagnosis clinical: perinatal hypoxic-ischemic brain damage, severe acute period. CNS depression syndrome. Natal trauma of the cervical spine (dislocation of C1-C3 vertebral bodies). Neonatal pneumatic the Oia.

GDV-grams of urine to B.

Example 3

The child So that no history of the disease 11072, weight at birth 3400 g, height 53 cm, head circumference 35 cm, chest circumference 33 cm, score Apgar 6-6 points. Born on the 4th of pregnancy (1st pregnancy childbirth, 2-3 pregnancy - med. the abortions going on in the background threat of termination, of preeclampsia in the second half (swollen-hypertensive form). Birth 2nd at 39 weeks by emergency caesarean section (operated uterus, the risk of rupture). At the age of 1 hours transferred on a ventilator, transported to the intensive care unit. Upon admission to the ICU without consciousness, pupils of average size, reaction to light sluggish.

In the first days of life a drop of urine was placed in the electromagnetic field of high tension with an amplitude of 16 kV, the pulse frequency of 1024 Hz, the duration of a series of pulses of 0.5 sec. The resulting image was saved on the hard disk of the computer as a graphic file and underwent traditional computer processing.

The following parameters of GDV urine: the area of the image - 14220; fragmentation - 3; form factor - 58.38; brightness - 222.8 deviation - 26.99; fractal resolution 1.858. These options correspond to the adverse outcome critical condition in the newborn (lethal).

The baby died in the ICU at the age of 2 days of life.

Diagnosis clinically, is: perinatal hypoxic-ischemic brain damage, severe acute period. Natal trauma to the Central nervous system. Neonatal pneumonia. The syndrome of ARF. Intrauterine infection.

Pathological diagnosis: perinatal hypoxic-traumatic lesion of the Central nervous system: the gap of the lower leaf of the Tentorium of the cerebellum on the right, subdural subtentorial hemorrhage in the posterior cranial fossa. Periventricular subependymal hemorrhage into the lateral ventricles of the brain. Bilateral waste focal bronchopneumonia.

GDV-grams of urine to Century

Our proposed method for predicting the development and outcomes of critical conditions in newborns based on the study parameters of gas discharge visualization urine non-invasive, technically simple, does not require expensive equipment. Is the criterion for differential treatment in the early postnatal period.

Table 1

Indicators of GDV-grams of urine.
OptionsNewborn control groupSurviving newbornDead newborn
Size of the image20790±2082*'16160±1595*18220±5643'
Fragmentation21.17±2.123*'13.93±1.81* 5.909±2.64'
To form213±26.57*'116.2±at 14.66*78.88±25.34'
Brightness226.8±0.8*'224.6±0.59*222.8±0.65'
Deviation27.6±1.2728.18±0.6827.69±0.59
Fractal resolution2.128±0.082.07±0.05"1.873±0.11"
* - statistically significant differences between children in the control group and the survivors

' - statistically significant differences between children in the control group and the dead

" - statistically significant differences between children of survivors and the dead

A method for predicting outcomes of critical conditions in newborn infants, including urine analysis, characterized in that in the first days of a child's life, are in critical condition, examine the parameters of gas discharge visualization (GDV) of urine, a drop which is placed in the electromagnetic field of high tension with the amplitude of the bipolar pulses 16 kV, the pulse frequency of 1024 Hz, the duration of a series of pulses of 0.5 s, the research time - 10 min; indicators of GDV-grams: fractal discrete - 2,128±0,08, fragmentation - 21,17±2,123, brightness - 226,8±0,8 please take the Ute norm; when indicators of GDV-grams: fractal discrete - 2,07±0.05, the fragmentation - 13,93±1,81 and brightness - 224,6±0,59 - predicts favorable outcome; when indicators of GDV-grams: fractal discrete - 1,873±0,11, fragmentation - 5,909±2,64 and brightness - 222,8±0,65 - predict adverse outcome critical condition of the newborn.



 

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