Method for predicting bronchial asthma clinical development severity in adolescent patient at puberty transition time

FIELD: medicine.

SUBSTANCE: method involves determining thyroid gland hormone of triiodothyronine (T3 in IU/l) and thyroxin (T4 in IU/l), pituitary hormones - thyrotropic hormone (TTH in IU/l), follicle-stimulating hormone (FSH in IU/l) and luteinizing hormone (LH in IU/l) concentration using radio isotope method and physical adolescent growth and development level with somatometric type being equal to 1 in microsomatic type cases, 2 in mesosomatic type cases and 3 in macrosomatic type cases. Discriminant function is determined in male adolescent case as D=19.535x(T3)+3.973x(T4)-27.38x(TTH)-11.028x(1.2 or 3)-307.473x(FSH)-17.585x(LH). The discriminant function value D>116.44 being the case, worsening bronchial asthma clinical course is predicted. D<116.44 being the case, bronchial improving asthma clinical course is predicted. Discriminant function is determined in female adolescent case as D=-4.908x(T3)-0.052x(T4)-0.355x(TTH)-3.166x(1.2 or 3)-0.769x(FSH)-0.144x(LH). The discriminant function value D>-24.23 being the case, worsening bronchial asthma clinical course is predicted. D<-24.23 being the case, improving bronchial asthma clinical course is predicted.

EFFECT: high accuracy in detecting severe bronchial asthma adolescent risk group.

 

The invention relates to medicine, namely Pediatrics, in particular, Allergology, and can be used for differential screening of adolescents threatened by development and course of severe bronchial asthma (BA).

There are various mathematical methods for predicting adverse outcomes BA in children [1, 2, 3], which includes such characteristics as gender, early onset, the presence of atopic dermatitis, inadequate care, abuse of antibiotics, the frequency of hospitalizations and more.

As the closest analogue to consider the method described in Besh L.V. [1].

The disadvantage of these methods is that not studied the hormonal status of adolescents. Because adolescence is a reorganization of the endocrine system, accelerate the processes of physical development. In patients with BA happen deviations from these parameters [4, 5]. Therefore, it is necessary to predict the severity of BA in the transition of adolescents in puberty, assessing their hormonal and physical status.

A method of predicting the severity of bronchial asthma as in boys and girls separately in the transition to puberty.

The method consists in determining the level of thyroid hormones - triiodothyronine (T3in honey/l) and thyroxine (T 4in honey/l), hormones of the pituitary - thyroid stimulating hormone (TSH, Miu/l), follicle-stimulating hormone (FSH, IU/l) and lyuteoniziruyuschego hormone (LH, mIU/ml) radioisotope method and physical development of adolescents with the definition of somatic, where microgametocyte corresponds to 1, metasomatite - 2, macrocomparative - 3.

Decide discriminant equation, which for boys is as follows:

D=19,535×T3+3,973×T4-27,38×TSH-11,028×(1, 2 or 3)-307,473×FSH-17,585×LH,

and when the value of the discriminant function D>116,44 predict worsening BA, and if D<116,44 predict improvement course BA.

Decide discriminant equation for the girls:

D=-4,908×T3-0,052×T4-0,355×TSH-3,166×(1, 2 or 3)-0,769×FSH-0,144×LH,

and when the value of the discriminant function D>-24,23 predict worsening BA, and if D<-24,23 predict improvement course BA.

Below are examples of the use of the claimed method.

Example 1. Patient K., age 16. Diagnosis: Atopic bronchial asthma, mild persistent during the period of exacerbation.

Growth -173 cm, weight - 48 kg, the Per - 76 cm (metasomatite=2)

T3- 2.1 Miu/l, T4- 110 honey/l, TSH - 2.0 Miu/l, FSH and 0.8 IU/l, LH is 0.8 mIU/ml

Solved discriminant equation.

D=19,535×2,1+3,973×110-27,38×2,0-11,028×2-307,473#x000D7; 0,8-17,585×0,8=141,23

Because the value of D is greater than 116,44, it is assumed that the deterioration in the current BA in young men. Clinical observation for 2 years confirmed this prediction.

Example 2. Patient S., age 17. Diagnosis: Atopic bronchial asthma, lung intermittently for a period of remission.

Height - 167 cm, weight - 65 kg, the Per - 90 cm (macroanatomy=3)

T3- 2.2 Miu/l, T4- 100 Miu/l TSH - 2.7 Miu/l, FSH to 0.9 IU/l, LH - and 1.0 mIU/ml

Solved discriminant equation.

D=19,535×2,2+3,973×100-27,38×2,7-11,028×3-307,473×0,9-17,585×1,0=105,145

Because the value of D is less than 116,44, it is assumed that for BA the boy is not to deteriorate. Clinical supervision within 1 year confirmed this prediction.

Example 3. Patient A., aged 15. Diagnosis: Atopic bronchial asthma, moderate, acute.

The growth of 148 cm, weight 35 kg, the Per - 66 cm (micromatter=1)

T3- 2.0 Miu/l, T4- 100 Miu/l TSH - 2.1 Miu/l, FSH of 4.1 IU/l, LH is 1.9 mIU/ml

Solved discriminant equation.

D=-4,908×2-0,052×100-0,355×2,1-3,166×1-0,769×4,1-0,144×1,9=-22,364

Because the value of D is greater than -24,23, it is assumed that the development of the girl's heavy flow of BA. Clinical observation within 1.5 years confirmed this prediction.

Example 4. Patient W., 15 years. Diagnosis: Atopic bronchial asthma, srednestan of gravity, exacerbation.

Height - 167 cm, weight - 56 kg, the Per - 76 cm (metasomatite=2)

T3- 1.9 Miu/l, T4- 100 Miu/l TSH - 2.6 Miu/l, FSH and 8.3 IU/l, LH - 11,7 mIU/ml

Solved discriminant equation.

D=-4,908×1,9-0,052×100-0,355×2,6-3,166×2-0,769×8,3-0,144×11,7=-29,823

Because the value of D is less than -24,23, be an improvement in the flow of ad in women. Clinical observation for 2 years confirmed this prediction.

When using this method in the clinic for 2 years found that its sensitivity was 79.3%.

Thus, the proposed method can be used for differential screening of adolescents threatened by development and for heavy (BA), with the aim of developing individual preventive measures to reduce disability among children.

The list of references

1. Besh L.V. An analysis of the information value of certain factors in the prognosis of the severe form of bronchial asthma in adolescents // Lik. Sprava. - 1999. - V.3. - p.106-108.

2. Lieu T.A., C.P. Quesenberry, Sorel M.E. Computer-based models to identify high-risk children with asthma // Ibid. - 1998. - V.157, No. 4. - p.1173-1180.

3. Provotorov V.M., Kuznetsov, S.I., et al. Classification approach to prognostication of bronchial asthma //Med. Tekhn. - 1997. No. 3. - p.7-10.

4. Kolosova astray freight Particular hormonal status in children with bronchial asthma and the influence of adaptation to chronic intermittent hypobaric hypoxic stimulation: AB is ore. dis ... KMN - Orenburg, 2003. - 20 S.

5. Uhtina MV Immune and hormonal factors in the development and course of asthma in children. Of thesis ... Dr. M.N. - Moscow, 1998. - 234 S.

A method for predicting the severity of bronchial asthma (BA) in adolescents in the transition to puberty, including the identification of prognostic factors, characterized in that determine the level of thyroid hormones triiodothyronine (T3honey/l) and thyroxine (T4honey/l), hormones of the pituitary - thyroid stimulating hormone (TSH, Miu/l), follicle-stimulating hormone (FSH, IU/l) and lyuteoniziruyuschego hormone (LH, mIU/ml) radioisotope method and level of physical development of the adolescent with the definition of somatic, where microgametocyte corresponds to 1, metasomatite - 2, macrogametocyte - 3, solve discriminant equation, which for boys is as follows:

D=19,535×(T3)+3,973×(T4)-27,38×(TSH)-11,028×(1, 2 or 3)-

307,473×(FSH)-17,585×(LH),

and when the value of the discriminant function D>116,44 predict worsening BA, and if D<116,44 predict improvement course BA, similarly solve discriminant equation for the girls:

D=-4,908×(T3)-0,052×(T4)-0,355×(TSH)-3,166×(1, 2 or 3)-0,769×(FSH)-0,144×(LH)

and when is D>-24,23 predict worsening of the tip is of BA, and if D<-24,23 predict improvement course BA.



 

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