Method for predicting the phases of stress states

FIELD: medicine, physiology, diagnostics.

SUBSTANCE: in patient's blood one should detect the concentration of cortisol and fertile factors α2-microglobulin (AMGF), trophoblastic β1-1-glycoproteide (TBG) and α1-placental microglobulin (PAMG-1). The phases of stress states should be diagnosed by the coefficient calculated due to dividing the sum of AMGF and TBG concentrations by the sum of PAMG-1 and cortisol concentrations, moreover, the concentration should be expressed in % against average values in healthy persons. Coefficient's value being equal to 1.0-11 corresponds to the norm; at its value being 1.2-1.5 one should diagnose the phase of anxiety; at 0.7-0.9 - the phase of resistance; at 0.2-0.6 - the phase of exhaustion. The innovation provides the chance to program the flow of pathological process more accurately.

EFFECT: higher accuracy and efficiency of diagnostics.

4 ex, 2 tbl

 

The invention relates to medicine, in particular to physiology, and can be used to diagnose disadaptive processes in humans in various pathological conditions.

Known methods of diagnostics of violations disadaptive processes in humans in certain pathological conditions based on data Gsale (Selye,, 1982) on the inclusion of the hypothalamic-pituitary-adrenal system.

The latter defines adaptive capacity of the organism to the action of the emergency stimulus, but it is not considered a deterrent mechanisms, absence or lack of inclusion is accompanied by the development of pathological processes leading to death of the organism (shock, consumption coagulopathy, and others)

Analog is the definition of the degrees of stress conditions on the concentration of glucocorticoids (cortisol). The lack of similar in that only by changing the concentration of cortisol is difficult to diagnose the stage of stress as pronounced dependence on the nature of the stressor (Horizons P.D., 1981).

The prototype is the way to diagnose the severity of stress conditions on the study of blood and the concentration of glucocorticoids (cortisone) and the associated status of the white blood cells (Garkavi LH, Cucina E.B., Ukolova M.A., 1990). However, dannysoar difficult to accounting, because the state of the leukocyte formula is treated by different doctors in their own way, which is reflected in the treatment of this group of patients. It is difficult to agree with the authors about the division of the stress response reaction training, response activation and directly the stress response. The concept of training finds a large spread in sports and here it is combined with reactions not weak, but on the contrary, medium and strong stressors.

The disadvantage of this method is that it does not take into account the activity of reproductive factors more fully reflecting the functional state of the organism.

The present invention is most accurately show the functional state of the organism by searching for indicators that objectively reflects the nature of the containment phase of the stress response in the development of stress conditions. This enables more accurate programming during the pathological process.

The problem is solved due to the fact that the studied blood parameters reflecting the functional state of the organism and determine the concentration of glucocorticoids (cortisol) and reproductive factors (α2-microglobulin (AMHF), USSR β1-1-glikoproteid (TBG) and α1-placental microglobulin (PAMG-1)), diagnosing phase of stress conditions on the activity coefficient of sin is oxicash adaptation programs with regard to reproductive factors (CALPUFF), determined by the following dependencies:

where CAMGF- concentration α2-microglobulin fertility in %CTBGthe concentration of the USSR β1-1-glikoproteid in %CPAMG-1the concentration of placental α1-microglobulin in %, Withcortisolthe concentration of cortisol in %. The concentration or activity used to calculate the values expressed in % of the mean values in healthy people. The control were 20 healthy persons aged 18-25 years, CALPUFF have equal 1,07±0.01 fluctuations from 1.0 to 1.1.

Allocation of reproductive factors (AMGF and TBG) promotes the inclusion of adaptation programs, resulting in less development phases of stress by maintaining homeostasis. Cortisol taken in this formula as an indicator of activity catatoxic adaptation programmes, which counteracts syntaxchecker adaptation programmes, as they operate reciprocal. This also contributes to and PAMG-1.

The method is as follows: turning the patient to the doctor is given a full clinical assessment, and the degree of inclusion of adaptive programs with concentrations of reproductive factors. This ratio reflects the dynamic development of stress is eacli on activity levels of adaptation programs throughout the pathological process and is defined as follows. The patient is taken fasting blood from the cubital vein in the amount of 10 ml explores indicators of AMGF, TBG, PAMG-1 and cortisol on standardized methods. Then calculation of the activity coefficient syntaxchecker programs with regard to reproductive factors.

The study was conducted on 95 individuals of both sexes from 25 to 55 years. Data on reproductive factors and cortisol were investigated in the dynamics of cold exposure and climacteric syndrome and shows their role in the development of the stress response in phases.

Study of the development of the stress response during cold exposure was conducted on 80 individuals of both sexes from 25 to 35 years. Data on reproductive factors and cortisol are shown in table No. 1.

Table No. 1.

The change of reproductive factors and cortisol during the cold stress.
IndicatorsControlPhase alarmPhase resistanceThe depletion phase
AMGF, ug/l12,3±2,2817,8±1,02*14,3±1,23*11,2±1,39*
TBG, ug/l10,3±1,2618,6±1,14*16,5±2,416,9±0,41*
PAMH, ug/l7,5±1,948,6± 1,4519,1±0,67*24,2±4,63
Cortisol, nmol/lAZN 264.2±11,7328,6±21,4*223,7±12,6*95,7±10,1*
CALPUFF1,07±0,011,36±0,03*0,81±0,04*0,44±0,02*
* The reliability of p<0.05 compared to control.

Indicator CALPUFF clearly indicated on the phase of stress depending on the strength and duration of the stimulus. In phase alarm indicator CALPUFF ranged from 1.2 to 1.5, the average of 1.36±0,03 by increasing the activity of reproductive factors, which was accompanied by the inclusion of adaptation programs in the first year of exposure to the stimulus. Further, during the development phase resistance, the concentration of reproductive factors decreased with increased activity of the adrenal cortex and is therefore a measure of CALPUFF decreased on average to 0.81±0,04 vary from 0.7 to 0.9. Further action chlorastrolite has led to the development stage of exhaustion (this phase usually occurs after 5 years long-term cold exposure or exposure to irritant moderate) with fluctuation of CALPUFF from 0.2 to 0.6, the average of 0.44±0,02, by reducing the activity of the adrenal cortex.

Therefore, the coefficient CALPUFF can diagnostirovat the phase stress at cryogenic.

Example 1. Patient C., 40 years old, came to the clinic 16.01.1997 year with complaints of pain in right hand and a small swelling, numbness. On the night 16.01.1997, there was frostbite while walking, when the temperature was -18°and her right hand was without gloves. Home brush warmed with warm water and the next day went to the polyclinic. Objective: the redness of the right hand with slight swelling. Pulsation of the radial artery is normal. Diagnosis: frostbite weak severity (I-II). Was taken blood from the left cubital vein on the study CALPUFF, which in this patient was 1.45 and corresponded to the stages of anxiety.

Example No. 2. Patient M., 48 years old, came to the clinic 20.02.1997 year with complaints of pain in both feet with their swelling, numbness and a violation of their movement. 19.02.1997 year was fishing and wet my feet, the air temperature was -16°C. the House has warmed the feet with warm water and smeared with fat, but swelling is not reduced, and appeared vesicles with serous content. Objective: both feet and fingers swollen, swelling on the left reaches the lower third of the leg, blisters on fingers with serous content, the movement of the toes is limited due to swelling, sensitivity is reduced. Diagnosis: frostbite stop moderate (second degree). Taken blood from the cubital vein in the study CALPUFF. His figure was R the veins of 0.85, which corresponded to the stage of resistance and corresponded to moderate damage.

Example No. 3. Patient A., 32 years old, came to the clinic 22.01.1995 year complaining of sharp pains in both hands and considerable swelling of both hands and fingers, restriction of movement, numbness. Frostbite has occurred in the night of 20 to 21 01.1995 year during operation, when the air temperature -25°C for 1.5 hours was without gloves. At home both hands warmed in hot water, smeared with fat, but later appeared bubbles with hemorrhagic content. Objective: both brushes and fingers dramatically swollen, swelling on the right reaches the elbow joint, the blisters on my fingers with hemorrhagic content, movements of the fingers is limited due to swelling and sensitivity is reduced. The pulsation of the radial artery saved. Diagnosis: frostbite brushes strong grade (III-IV degree). Taken blood from the cubital vein in the study CALPUFF. This index patient, 0.38 and corresponds to the stage of exhaustion, which is typical for a strong degree of damage, with a sharp prevalence catatoxic adaptation programmes and depression syntaxchecker mechanisms.

Such shifts in the characteristics of the phases of stress syndrome occur in other pathological processes, such as menopausal syndrome. The data presented in table No. 2.

Table No. 2.

The change of reproductive factors and cortisol in the climacteric syndrome.
IndicatorsControlPhase alarmPhase resistanceThe depletion phase
AMGF, ug/l12,3±2,2822,5±0,76*24,2±3,12*9,7±0,14*
TBG, ug/l10,3±1,2615,9±0,14*17,0±1,83*7,3±0,12*
PAMH, ug/l7,5±1,9410,1±0,31*19,1±0,14*25,0±1,16*
Cortisol, nmol/lAZN 264.2±11,7350,4±21,8*390,8±32,6*537,8±28,6*
CALPUFF1,07±0,011,26±0,03*0,89±0,05*0,27±0,01*
* The reliability of p<0.05 compared to control.

Example 4. Sick,, 52 years old, came to the clinic 21.02.2006 year with complaints of frequent flushing of blood to the head (five times daily), heart pain, palpitations, numbness, upper limbs, deterioration of health, strong sweating. Objective: increased blood pressure. The diagnosis of climacteric syndrome of moderate severity. Taken the blood of cubicals the th Vienna to study CALPUFF. His ratio was 0.88, which corresponds to the phase resistance and moderate severity.

Therefore, the activity of adaptation programs, determining the resistance to extreme stimulus, depends on the concentration of reproductive factors.

Thus, determining the ratio of CALPUFF or concentration of reproductive factors, we can talk about the diagnosis phase of stress conditions.

The way to diagnose phases of stress conditions, including the study of blood, reflecting the functional state of the organism and the concentration of glucocorticoids, characterized in that to determine the concentration of cortisol and reproductive factors α2-microglobulin (AMHF), USSR β1-1-glikoproteid (TBG) and α1-placental microglobulin (PAMG-1), phase stressful conditions diagnosed by coefficient defined by the following dependencies:

where CAMGF- concentration α2- microglobulin fertility, %CTBGthe concentration of the USSR-β1-1-glikoproteid, %CPAMG-1the concentration of placental α1-microglobulin, %Ccortisolthe concentration of cortisol, %, and the concentration used to calculate the value of the expression is t in % of the mean values in healthy people, the value of the coefficient equal to 1.0-1.1, corresponds to the norm, when the value of the coefficient of 1.2 to 1.5 diagnosed anxiety phase, 0.7 to 0.9 - phase resistance of 0.2-0.6 - depletion phase.



 

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