Method of predicting progression of respiratory tract obstruction

FIELD: medicine.

SUBSTANCE: indices of densitometry (D) in % and planimetry (P) in % are measured in both lungs, value of forced exhale during first second (VFE1) is determined in % to proper volume, discriminant equation D=0.041×VFE1+0.182×D+0.126×P is solved. If D is less than 9.43 progression of respiratory tract obstruction is predicted.

EFFECT: method allows to increase accuracy of prognosis connected with combination of chronic obstructive lung disease with bronchopulmonary dysplasias.

2 ex

 

The invention relates to medicine, namely to pulmonology, and can be used to predict the progression of airway obstruction in patients with chronic obstructive pulmonary disease in combination with bronchopulmonary dysplasia.

The prototype was elected as a method for predicting the progression of airway obstruction using integrated assessment of prognostic risk factors [1]. The method is that the measured change of forced expiratory volume in the first second after bronchoprovocation sample and the index of the smoker. The forecasting exercise based on the values computed from the original mathematical formula that includes the measured and calculated parameters.

The known method has the following disadvantages:

1. Does not take into account the significant role of bronchopulmonary dysplasia in the progression of airway obstruction;

2. Holding bronchoprovocation sample limited initial level of bronchial obstruction and is associated with possible complications;

3. Does not take into account the significant role of regional disorders of pulmonary ventilation, associated with the presence of bronchopulmonary dysplasia in the progression of airway obstruction.

The purpose of the invention is to improve the effectiveness of forecasting progressive the Oia airway obstruction in patients with chronic obstructive pulmonary disease in combination with bronchopulmonary dysplasia through integrated assessment of regional pulmonary ventilation and bronchial obstruction respiratory ways.

The objective is achieved by the fact that the assessment of regional pulmonary ventilation and bronchial obstruction is carried out, respectively, on the basis of densitometric measurement (D) in % and planimetric (P) in % in both lungs and forced expiratory volume in the first second (FEV1) in percent (%) for granted.

The claimed method has the following methods:

a) using expiratory computed tomography according to standard methods densitometric measure (D) rate in % and planimetric (P) rate (%) in both lungs;

b) using spirometry to determine the value of FEV1measured in percent for granted;

C) solve discriminant equation:

D=0,041×FEV1+of 0.182×D+0,126×P,

where D is the discriminant function, a limit value which is 9,43.

The progression of bronchial obstruction predict when the value D is less than 9,43, and when D is greater predict lack of progression of airway obstruction.

Below are two examples of the claimed method:

Example 1. D., 40 years. Diagnosis: Chronic obstructive pulmonary disease, mild severity, remission stage.

The original data were, respectively: FEV1- 78% of need; D - 19,36%; P - 12,25%.

In order to predict the progression of airway obstruction resolved on scriminate equation:

D=0,041×78+0,182×19,36+0,126×10,25=8,0.

Since the discriminant function is less than the boundary value (9,43) predicted the Progression of airway obstruction. 12 months in a patient in remission FEV1decreased by 59 ml. Diagnosed the Progression of airway obstruction.

Example 2. Century, 53 years. Diagnosis: Chronic obstructive pulmonary disease, mild severity, remission stage.

The original data were, respectively: OOB1- 83% of need; D - 72,48%; P - 84,36%.

In order to predict the progression of airway obstruction resolved discriminant equation:

D=0,041×83+0,182×72,48+0,126×84,36=27,2.

Because discriminant function more boundary values (9,43) predicted neoprogressive airway obstruction. After 12 months, the patient was in remission chronic obstructive pulmonary disease FEV1has not changed and amounted to 78.9% of the need. Diagnosed neoprogressive airway obstruction.

The proposed method was tested on the basis of the pulmonary branch of the SE of the far Eastern scientific center of physiology and pathology of respiration SB RAMS. Using a forecasting method of the progression of obstruction in 42 patients with chronic obstructive pulmonary disease the combination with bronchopulmonary dysplasia.

The results of the verification of the claimed method has shown its effectiveness, a correct prediction was determined in 89.4% of cases.

Thus, the proposed method can be effectively used to predict the progression of obstruction in chronic obstructive pulmonary disease in combination with bronchopulmonary dysplasia.

Literature

1. Kolosov V.P., Kolosov AV // a method for predicting the progression of airway obstruction. Patent RU 2240725 C1. 27.11.2004, bull. No. 33.

A method for predicting the progression of airway obstruction, characterized in that the measured indicators densitometry (D) in % and planimetry (P) in % in both lungs, determine the forced expiratory volume in the first second (FEV1a percentage must decide discriminant equation:
D=0,041·FEV1+of 0.182·D+0,126·P
and when the value D is less than 9,43 predict the progression of airway obstruction in patients with chronic obstructive pulmonary disease in combination with bronchopulmonary dysplasia.



 

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2 tbl, 2 ex

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2 ex, 1 tbl

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