Method for prediction of developing hypoxia in pregnant women of third trimester of gestation had episode of herpes virus infection

FIELD: medicine.

SUBSTANCE: developing hypoxia in a pregnant woman of the third trimester of gestation is predicted by evaluating peripheral blood oxyhemoglobin (HbO2) and 2,3 diphosphoglycerate phosphatase (2,3DPG) concentrations. A discriminator (D) is calculated by formula D=+17.072·2.3DPG + (-0.041·HbO2), 2,3DPG - concentration, mol/l, HbO2 - amount, %. The D value within 97.09-112.37 enables to predict threatened hypoxia in a pregnant woman had an acute condition of herpes virus infection.

EFFECT: use of the method allows well-timed detection of a risk group and correct prediction of developing hypoxia.

2 ex

 

The aim of the research is to study the nature of the violation of oxygenize of hemoglobin in erythrocytes in peripheral blood of pregnant women after the outbreak of herpes viral infection in the third trimester of gestation, resulting in excessive switching in the hemoglobin 2,DFG reducing the formation of HbO2.

It is established that the affinity of Hb for O2will change if the ligand different interacts with 2 forms of hemoglobin. The ligand, which reduces the affinity of Hb for O2must join deoxy-Hb (I. Wyman, 1948; Fedorov, N.A., 1976). Specific effect on the affinity of Hb for O2connected, as shown by studies, with accession to the Hb in disciforme 2·3 FGD. The equilibrium constants for the joining of the first 3 molecules Of2reduced in the presence of 2,DFG (Rorth M., 1972; Rorth M., P. Astrup, 1972).

Consider that 2,DPG increases the rate constant for the removal of O2and reduces the rate constant of its accession to Hb (Baner Ch., 1969).

Nonspecific effect 2,DPG on the affinity of Hb for O2in case of an increase of 2,DFG above physiological levels (5 ml mol/l) in intact erythrocytes leads to a decrease attach Hb to About2and increases the rate constant of cleavage O2associated with Hb.

These processes can be affected by many factors: the decrease in intra-erythrocytic pH, accumulation of a large number of electrooptical the x ions or metabolic products, changing electrostatic equilibrium in the haemoglobin system (Rorth M., R. Astrup, 1972; Perutz M., L. Mazzarella, 1963).

Thus, if the rate of turn 2,DFG will be increased with the outbreak of herpes viral infection, when viral antigen intensively increases, the hemoglobin will not receive the oxygen and the concentration of HbO2in the blood begins to drop.

As a prototype used data obtained Iainglasgow (2008), which States that with an increase in the titer of antibodies to the herpes virus during gestation reduced blood HbO2. However, the author does not specify the reason for the decrease in the percentage of HbO2with an increase in maternal blood titer of antibodies to the herpes virus.

This study provides data indicating that a cause of hypoxia is an increase in blood 2,DPG, which blocks the hemoglobin to communicate with the oxygen.

Studying the literature, the authors could not find information showing that the presence of the antigen of herpes virus in the blood of pregnant women affects the peripheral blood erythrocytes, resulting in excessive addition of 2,DFG to the Hb molecules, resulting in lower blood concentrations HbO2.

The claimed method has the following methods.

1. Investigated peripheral blood of pregnant women, the PE Inessa in the third trimester outbreak of herpes viral infection, and 20 pregnant, not ill during the whole period of gestation (control). Research was conducted on the basis of hospital obstetric clinic of the far Eastern scientific center of physiology and pathology of respiration SB RAMS. All studies were conducted with regard to the requirements of the Helsinki Declaration of the world Association "Ethical principles for medical research with regard to person" with amendments of 2000, and the "Rules of clinical practice in the Russian Federation", approved by Order of Ministry of health of the Russian Federation dated 19.06.2003, No. 266.

2. Contents Hb2in peripheral blood erythrocytes of pregnant women was determined on spectrophotometer "Stat-Fax-2100x screen" (USA) Moscosco (1968).

3. The titer antithical to the herpes virus was determined by ELISA on spectrophotometer "Stat-Fax-h" (USA).

4. 2,DFG (2.3 diphosphoglycerate-phosphatase) in peripheral blood erythrocytes of pregnant women was determined on spectrophotometer "Stat-Fax-1900+" method Ellinogermaniki, Shubhranshu and Gvers (1980).

5. The content analysis 2,DFG and HbO2when the titer of antibodies to the herpes virus in the blood of pregnant women were processed by the statistical method of discriminant analysis.

Studies have shown that when an outbreak of herpes viral infection in pregnant women in the third trimester in peripheral blood erythrocytes increases the end of the filtration 2,DFG. When the titer of antibodies to herpes virus 1:12800 concentration of 2,DPG increased to 6.81±0.15 mmol/l (control - 4,9±0.02 mmol/l). Simultaneously in the peripheral blood erythrocytes from the same pregnant decreased the content of HbO2to 95,87±2,6% (control - 99,5±2,0%).

Discriminant analysis shows:

D=+17,072·2,DPG+(-0,041·HbO2)

D=+17,072·6,81+(-0,041·95,87)

D=+116,30+(-3,93)=112,37

Within discriminant functions 112,37 and boundary values 97,09 there is the threat of the formation of hypoxia in pregnant women.

Example 1

Pregnant K. arrived on the 30th week of pregnancy with acute exacerbation of herpes viral infection with the titer of antibodies to the pathogen 1:12800.

In the peripheral blood contained 6.5 mmol/l 2,DFG. The amount of oxyhemoglobin was 95,1%.

Making discriminant equation, we obtain:

D=17,072·6,5+(-0,041·95,1)=107,07

Discriminant function above boundary values:

D(107,07)>97,09 (boundary value)

A pregnant woman predicted the development of hypoxia.

Example 2

Pregnant A. was admitted at 33 weeks pregnant. During the whole period of gestation signs of herpes virus infection was not observed.

In the peripheral blood contained 99.6% of HbO2and 5.2 mmol/l 2,DFG.

Making discriminant equation with this indicator, we find that the discriminant function when such indicators are:

D=17,72·5,2+(-0,041·99,6)=84,69

D=88,77+(-4,08)=84,69

Discriminant function (84,69) A. pregnant, not ill with herpes, is less than the boundary value (97,09).

Therefore, the risk of hypoxia it is not expected.

Literature

1. Andrievsky I.A. Respiratory function of the blood in pregnant women with herpes viral infection / Bulletin SB RAMS. - 2008. No. 3. - p.56-65.

2. Vinogradova IA, Bagryanzeva HE, Motto, GV Method of simultaneous determination of 2,DPG AND ATP in erythrocytes / Laboratory work. - 1980. No. 7. - s-426.

3. Kushakovskij MS Clinical forms of damage to the hemoglobin // Len. Department of Medicine, 1968. - 324 S.

4. Fedorov N.A. Normal hematopoiesis and its regulation. - M.: Medicine, 1976. - 543 S.

5. Baner Ch. Antogonistic influence of CO2and 2,3-α-diphosphoglicerate on the Bohr effect of human haemoglobin // "Life Shi.", 1969, v.8, p.1041.

6. Perutz, M., Mazzerella L. Preliminary X-ray analysis of haemoglobin H. - Nature, 1963, v.199, p.639.

7. Rorth M. Haemoglobin inteactions and red cell metabolism // "Ser. Haematol", 1972, v. p.1.

8. Rorth M, Astrup P. Oxygen affinity of haemoglobin and red cell acidbase status // Copenhagen, 1972, 371 S.

A method for predicting the development of hypoxia in pregnant in the third trimester of gestation, who had exacerbation of herpes viral infections, including the determination of the content of oxygenated hemoglobin in the peripheral blood, characterized in that it further determine the content of 2.3 FGD (2.3 diphosphoglycerate-phosphatase), calculate the discriminant function (D) by the formula D=+17,072·2,3 is FG+(-0,041·b 2), where 2,DPG - concentration, mol/l, b2- the number, percent, and when the value of D 97,09-112,37 predict the threat of hypoxia pregnant woman undergoing an exacerbation of herpes virus infection.



 

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