Method of estimating state of vegetative nervous system

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to functional diagnostics. Cardiorhythmographic examination with analysis of heart rhythm is carried out. Vegetative reactivity is determined from the fifth minute of staying in orthoposition, coefficient of adaptation reserve (CAR) is calculated by formula: CAR=TI3/TI2, where TI3 is tension index, calculated by Baevskiy, starting from the fifth minute of staying on orthoposition; TI2 is tension index, calculated by Baevskiy, immediately after transition into orthostasis. By specific values of tension index and CAR and their combination level of vegetative reactivity and state of vegetative adaptation reserve are estimated.

EFFECT: method makes it possible to reduce examination time preserving high result accuracy.

6 tbl, 3 ex

 

The invention relates to medicine, namely to functional diagnostics, and can be used to determine the allowance adaptation of the autonomic nervous system in patients and healthy people.

To assess the state of the autonomic nervous system using instrumental techniques to determine the source of the autonomic tone and autonomic reactivity. Using the method of cardiotocography (CWG) evaluate initial autonomic tone (IWT) and autonomic reactivity (VR). Methodology AWG implies registration short period of sinus rhythm with subsequent mathematical analysis of the variability of the RR interval and calculation of indicators of changes in the transition to orthopaedie as indicators of restructuring the regulatory influences of the autonomic nervous system (autonomic reactivity), including the calculation of the tension index (ti), which informs about the state of IWT and BP, level of functioning of the Central loop regulation of heart rhythm.

Table 1.
Evaluation of IWT and BP on the index IN2/IN1when the CPC (Belokon N.A., Koberger MB heart Disease and blood vessels in children. Moscow, 448 S., 1987).
IN1alone, c.u (IWT) Autonomic reactivity
normalHyper sympathicotonicasimpatikotonia
less than 30 (vagotonic)1-3>3<1
30-60 (atonia)1-2,5>2,5<1
61-90 (sympathicotonia)0,9-1,8>1,8<0,9
91 or more(sympathicotonia)1,5-0,7>1,5<0,7

The disadvantages are the complexity and the duration of the study.

Technical result: simplification with high precision, reducing the time spent on the study.

The essence of the method is to use each body position cardiotocographic studies with the standard analysis of variability and the subsequent calculation of a coefficient characterizing the standby state of the autonomic nervous system.

The method is as follows.

The patient cardiotocographic research on hardware-software complex "Valens" (S.-Petersburg NGO "Neo" Russia"), which is designed for visual observation and graphic registration of the bioelectric potentials of the heart, measuring time parameters the duration of the cardiac cycle. Electrodes placed on the limbs of a patient according to standard methods: the red electrode - right hand, yellow - left hand, green - left leg, black - right leg. Registered II standard lead ECG duration 200 RR intervals in clinopyroxene, then right after entering orthopaedie and since the fifth minute stay in anthopology perform permanent visual control of the correct stable sinus rhythm. Calculate the rate of tension index (ti) Bersenev (Rembowski, Guy. Ultrasound and functional diagnostics. - 2001. No. 3. - S-127):

JN=AMO(%)/mo×Δ(C)

where

Mo - fashion - duration of most frequent values cardiointervals in seconds; AMO - mode amplitude - frequency cardiointervals equal to the value of Mo, expressed in percent; ΔX is the variance of RR R-interval in seconds; the average duration of the R-interval (M) in seconds.

JOHN is calculated separately for each of the fragments: IN12- orthopaedie the first episode; IN3- orthopaedie the second episode. Next, calculate the coefficients of the autonomic reactivity with the 1st minute stay in anthopology (JN2/IN1), autonomic reactivity with 5-th minute of the stay in anthopology (JN3/IN1) and the ratio of the allowance adaptation (CF3/IN2). When the value IN1less than 30 units, and the ratio of IN3to IN1from 1.0 to 3.0 autonomic reactivity with 5-th minute of the stay in anthopology assessed as normal, when the value IN3/IN1<1,0 BP - as asimpatikotonia, when the value IN3/IN1>3,0 - as Hyper sympathicotonic, when the value of the EDGE from 0.33 to 3 - reserve autonomic adaptation is considered normal when the indicator KRA<0,33 insufficient, KRA>3 - redundant if the value IN1from 30 to 60 units and the ratio of IN3to IN1from 1,0 to 2, autonomic reactivity with 5-th minute of the stay in anthopology assessed as normal, with the index IN3/IN1<1,0 - as asimpatikotonia, when the value IN3/IN1>2,5 - like Hyper sympathicotonic, when the value of the EDGE from 0.25 to 2.5 reserve autonomic adaptation is considered normal when the indicator KRA<0.25 to insufficient, KRA>2,5 - excess, if value is IN 1from 61 to 90 units and the ratio of IN3to IN1from 0.9 to 1.9 autonomic reactivity with 5-th minute of the stay in anthopology considered as normal, when the value IN3/IN1<0,9 - as asimpatikotonia, when the value IN3/IN1>1,8 - as Hyper sympathicotonic, when the value of the EDGE from 0.5 to 2 reserve autonomic adaptation define normal, indicators KRA<0.5 to insufficient, KRA>2 - redundant if the index IN1is more than 91 units and the ratio of IN3to IN1from 0.7 to 1.5 autonomic reactivity with 5-th minute of the stay in anthopology defined as normal, when the value IN3/IN1<0,7 - as asimpatikotonia, when the value IN3/IN1>1,5 - as Hyper sympathicotonic, when the value of the EDGE from 0.47 to 2.14 reserve autonomic adaptation appreciate normal, indicators KRA<0,47 insufficient, KRA>2,14 - redundant.

Examples of specific performance.

Example 1. The patient Gulin Roman, 12 years. Diagnosis: syndrome of a vegetative dystonia of vacatoncustom type permanent for the period of exacerbation.

IN1IN2IN3 IN2/IN1IN3/IN1IN3/IN2(ADC)
1281766,756,330,94

Conclusion. Initial autonomic tone (IWT) - vagotonic; autonomic reactivity with the 1st minute stay in anthopology Hyper sympathicotonic; autonomic reactivity with 5-th minute of the stay in ortopilot - Hyper sympathicotonic; reserve autonomic adaptation (CRA) is normal.

Example 2. The patient Bakharov Daniel, age 14. Diagnosis: syndrome of a vegetative dystonia of vacatoncustom type permanent for a period of remission.

IN1IN2IN3IN2/IN1IN3/IN1IN3/IN2(ADC)
2561192,440,760,31

Conclusion. IWT - vagotonic; BP 1-th minute of the stay is in ortopilot - normal; BP from the 5-th minute of the stay in ortopilot - asimpatikotonia; KRA - sufficient.

Example 3. Nikita Kuznetsov, 8 years. Diagnosis: healthy.

IN1IN2IN3IN2/IN1IN3/IN1IN3/IN2(ADC)
40631721,584,32,73

Conclusion. IWT - Estonia; BP 1 minute stay in anthopology normal; BP from the 5-th minute of the stay in ortopilot - Hyper sympathicotonic; EDGE - redundant.

The sample of 49 people.

The method of assessment of the autonomic nervous system using cardiotocographic studies with standard analysis rate variability by determining the initial autonomic tone, autonomic reactivity, characterized in that it further determine vegetative jet is th and 5-th minute of the stay in anthopology and additionally evaluate the ratio of the allowance adaptation (CRA) by the formula: ADC=JN 3/IN2where JN3- tension index, calculated by Baevsky, starting with the fifth minute stay in anthopology; IN2- tension index, calculated by Baevsky, immediately after the transition to orthostasis, and if the index value of the voltage calculated by Baevsky, clinopyroxene (JN1) less than 30 units, and the ratio of IN3to IN1from 1.0 to 3.0 autonomic reactivity with 5-th minute of the stay in anthopology assessed as normal, when the value IN3/IN1<1,0 BP - as asimpatikotonia, when the value IN3/IN1>3,0 - as Hyper sympathicotonic, when the value of the EDGE from 0.33 to 3 - reserve autonomic adaptation is considered normal when the indicator KRA<0,33 insufficient, KRA>3 - redundant if the value IN1from 30 to 60 units and the ratio of IN3to IN1from 1.0 to 2.5 autonomic reactivity with 5-th minute of the stay in anthopology assessed as normal, with the index IN3/IN1<1,0 - as asimpatikotonia, when the value IN3/IN1>2,5 - like Hyper sympathicotonic, when the value of the EDGE from 0.25 to 2.5 - reserve autonomic adaptation is considered normal when the indicator KRA<0.25 to insufficient, KRA>2,5 - redundant, if the value IN1from 61 to 90 units and the ratio of IN3to IN1from 0.9 to 1,95 - vegetative R. the activity of the 5-th minute of the stay in anthopology considered as normal, when the value IN3/IN1<0,9 - as asimpatikotonia, when the value IN3/IN1>1,8 - as Hyper sympathicotonic, when the value of the EDGE from 0.5 to 2 - reserve autonomic adaptation define normal, indicators KRA<0.5 to insufficient, KRA>2 - redundant if the index IN1is more than 91 units and the ratio of IN3to IN1from 0.7 to 1.5 autonomic reactivity with 5-th minute of the stay in anthopology defined as normal, when the value IN3/IN1<0,7 - as asimpatikotonia, when the value IN3/IN1>1,5 - as Hyper sympathicotonic, when the value of the EDGE from 0.47 to 2.14 - reserve autonomic adaptation appreciate normal, indicators KRA<0,47 insufficient, KRA>2,14 - redundant.



 

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