Method of diagnosing impairment of vegetative regulation in children with tuberculosis
SUBSTANCE: invention relates to medicine, namely to pediatrics. In children of pre-school age with tuberculosis of intrathotacic lymph nodes indices of heart rhythm variability are determined: rhythmograms - interinterval differences RMSSD (ms), coefficient of variability CV (%), spectrograms - total spectrum power TR (ms2), very low frequency waves of spectrum VLF (ms2), low frequency waves of spectrum LF (ms2), high frequency waves of spectrum HF (ms2). If their values equal: interinterval differences RMSSD - 76.8±3.92, coefficient of variability CV - 9.9±0.50, total spectrum power TR - 3437±175.3, very low frequency waves of spectrum VLF - 1067±54.4, low frequency waves of spectrum LF - 1003±51.2, high frequency waves of spectrum HF - 1900.2±96,9 vegetative dysfunction is diagnosed.
EFFECT: method increases reliability of diagnostics of impairment of vegetative regulation in children with tuberculosis.
1 tbl, 1 ex
The invention relates to medicine, namely to Pediatrics.
In recent years there has been an increase in the incidence of tuberculosis of the child population. The peak incidence of TB in children, as well as primary infection with Mycobacterium tuberculosis (MBT), accounted for preschool age children. In the structure of the forms of the disease in children of preschool age dominated by tuberculosis of intrathoracic lymph nodes (TGLU).
There are known: a method for early diagnosis of tuberculosis infection in children, when determining the level of lymphocyte proliferation in microculture whole blood by the reaction of blast transformation of lymphocytes (EN 2315315 C2, 20.01.2008), the method for diagnosis of active tuberculosis of the respiratory system in children with calcitonin in the lung tissue and intrathoracic lymph nodes on the results sonoluminescence analysis portion of blood plasma (EN 2219547 C2, 10.06.2003), a method for the diagnosis of tuberculosis of intrathoracic lymph nodes paraaortal group with complex laboratory and radiological examinations (EN 2339041 C2, 20.11.2008).
An important role in the response to chronic infection plays an autonomic nervous system (ANS). In this regard, it is important to develop criteria for diagnosing autonomic disorders for assessment of functional state of organism of the child and contact the Olya for treatment.
As a prototype of the chosen method of assessment of the VNS in patients with tuberculosis teenagers method kardiointervalografii (Tohtohodjaeva BORN, Aibekova M.K. Characteristic of the autonomic nervous system in adolescents with destructive pulmonary tuberculosis and its influence on the course of tuberculosis /TB in Russia. Year 2007: proceedings of the VIII Russian Congress of TB. - M.: OOO "Idea", 2007. - S-264). The authors examined adolescents with infiltrative, disseminated and cavernous tuberculosis of the lungs, and has determined that the surveyed children in the original vegetative tone prevailed hypersympathicotonia (45% of children with infiltrative form, 60% for disseminated tuberculosis of the lungs, from 100% at the cavernous form) and Hyper sympathicotonic autonomic reactivity (80%, 70% and 100% of children, respectively). Identified vegetative disturbances, according to the authors, contributed to the formation of resistant to therapy forms, marked symptoms of intoxication, both lungs, a large percentage of complications, long-term patients. Vagotonic the process was slow, kept the symptoms of intoxication, was not closed cavity decay. At the same time normotonikov studied destructive forms proceeded steadily and well managed specific therapy.
However, this with the royals has some disadvantages, as applied to characterize the autonomic nervous system and predicting the course of disease in children in the older age groups - teenagers, with destructive forms of pulmonary tuberculosis. Assessment of autonomic regulation carried out only by a method of kardiointervalografii, which makes it impossible to evaluate the spectral and biorhythm data of heart rate variability (HRV) and more fully assess the functional state of the organism.
The objective of the invention is to increase the reliability of diagnosis of autonomic dysfunction in patients with pre-school children with tuberculosis of intrathoracic lymph nodes.
The result of the development of the method is to increase the informativeness of the study of the ANS and the use of indicators of heart rate variability in children of preschool age with tuberculosis of non-invasive studies with simultaneous simplicity of violations through the use of known devices, the ability to assess the effectiveness of treatment of sick children, as well as prenosological diagnostics in children at increased risk of TB, as in hospital, tuberculosis hospital and sanatorium.
The task and its result is achieved by the fact that in the method for the diagnosis of disorders of the autonomic re is ulali children TB patients, including a study of clinical manifestations and data kardiointervalografii with the definition of autonomic reactivity, according to the invention in preschool children with tuberculosis of intrathoracic lymph nodes further define the parameters of heart rate variability: ramagrama - mediterannee differences RMSSD (MS), the coefficient of variation CV (%), spectrogram - total spectral power (TP MS2very low wave VLF spectrum (MS2), low wave spectrum LF (MS2), high waves HF spectrum (MS2), and when the following values:
- mediterannee differences RMSSD - 76,8±3,92;
the coefficient of variation CV - 9,9±0,50;
- total spectral power (TP - 3437±175,3;
- very low wave spectrum of VLF - 1067±54,4;
- low wave spectrum LF - 1003±51,2;
- high wave spectrum HF - 1900,2±96,9, diagnosed with autonomic dysfunction. In children of preschool age with tuberculosis of intrathoracic lymph nodes mainly determined asimpatikotonia autonomic reactivity.
The introduction of new indicators of heart rate variability in the diagnosis of impaired autonomic regulation in children of preschool age with tuberculosis of intrathoracic lymph nodes associated with the frequent use of spectral and biorhythm features and advantages of the IR HRV in pediatric practice in recent years, that allows one to determine precisely simpato-parasympathetic changes in the autonomic nervous system and impaired functional status of the organism. The studies were conducted in children's tuberculosis sanatorium. Of all indices of HRV presents reliable, which differ significantly from healthy children of the same age. In addition, the functional studies in children of preschool age with tuberculosis of intrathoracic lymph nodes is shown to clarify the clinical autonomic changes (weakness, fatigue, tachycardia), which have much in common with symptoms of chronic tubercular intoxication. Changes in autonomic regulation during treatment of children with tuberculosis of intrathoracic lymph nodes will help to evaluate its effectiveness.
The heart rate variability were studied using the ANS-spectrograph using vegetotester program Polyspectra" company "Neurosoft" (Russia). Were recorded from 300 to 500 cardiocycle with parallel recording of the piezosensor pneumogram to determine the contribution of vagusnye activation of respiration in simpato-parasympathetic balance. Estimated initial autonomic tone indicators ramagrama: mediterannee differences RMSSD (MS), the coefficient of variation CV (%); Spectro the scheme: total spectral power (TP MS 2very low wave VLF spectrum (MS2), low wave spectrum LF (MS2), high waves HF spectrum (MS2).
Statistical data processing included the following methods: determination of numerical characteristics (descriptive statistics), to check if the distribution of sample indices to the normal law on the characteristics of the skewness, the kurtosis and test of Lilliefors, testing statistical hypotheses for the one-dimensional samples was carried out by nonparametric Wilcoxon criterion, the method univariate univariate analysis implemented in two variants - parametric (ANOVA) and nonparametric Kruskal the Valls (Well-Walls), the level of significance was determined at p<0,05.
During processing of the material used personal computer Intel Pentium II using software packages Excel, Matlab 6,5" with the expansion pack Statistic Toolbox. The statistical study showed no normal distribution of parameters of heart rate variability, and therefore the processing of data was performed by non-parametric methods with the definition of a Chi-square (table 1).
A method for the diagnosis of impaired autonomic regulation in children TB patients is illustrated by the following examples.
Results were examined in 58 children aged 4-7 years, including in the study group included 26 de is her patients with tuberculosis of intrathoracic lymph nodes. 32 healthy child with the natural flow of the post-vaccination process was the control group. The survey was conducted for all children in the first half of the day, between 9 a.m. till 12 hours a day, no earlier than 2 hours after a meal, in the same setting.
A feature of the clinical picture in preschool children, the sick, TUGLU, was the presence of fatigue (34,6%), weakness (26,9%), fever (23,1%), cough (19,2%) and dyspnea on exertion (26,9%), pallor (46,2%), insufficient development of the subcutaneous fat layer (46,2%), the presence of abnormalities in physical development due to the shortage of length (19,2%) or body mass (19,2%), tachycardia (26,9%), generalized lymphoadenopathy (100%) with photoelasticity (92,3%), painless on palpation (65,4%) lymph nodes, and phenomena of periadenitis (26,9%), and data from x-ray studies, which verify the diagnosis of tuberculosis of intrathoracic lymph nodes in the phase of infiltration (73,1%), in the phase of consolidation and calcined (19,2%) or in the phase of resorption (7,7%). In all cases of tuberculous process was characterized by the absence of selection office (BC-). In most patients, TUGLU noted Mantoux test medium intensity (61,5%), giperergicakie sample was 26.9%.
When conducting cardiointervals the guide is installed, that children TUGLU, in the original vegetative tone dominates sympathicotonia, which was detected in 61.5% of children in this group, which is 4 times the frequency sympathicotonia orientation initial autonomic tone in the control group (15,6%, p<0,001). When determining autonomic reactivity (AutoProbe) 69,2% of TB cases in children was registered simpaticotonici option autonomic reactivity, which is 2.5 times higher compared with healthy preschool children (28,1%, p<0,05).
Table 1 presents significantly different indices of HRV in children 2 groups.
|Indices of HRV in children of preschool age (M±m)|
|Options||Groups of children:||p|
|Patients TUGLU (n=26)||Healthy (n=32)|
|CV %||9,9±0,50||16,1±0,69||TP, MS2||3437,0±175,29||8076,0±347,27||p<0,05|
|Note: p - significance of differences between 2 groups.|
As can be seen from table 1, in the group of patients with tuberculosis in children has decreased parameters characterizing the parasympathetic activity: indicator magisterially differences (RMSSD) - 38.1% and the coefficient of variation of RR interval (CV) - 38.5%). In addition, it was found a decrease of all parameters characterizing the power spectrum in the high frequency range (HF) - by 53.9%, low frequency range (LF) - 56.5%, very low frequencies of the spectrum, characterizing the activity of the humoral channel regulation (VLF) - by 66.9%to the data group of healthy children. Accordingly, the total capacity of the JV is CTR (TP) in the group of patients with tuberculosis was by 57.4% less than in the control, which was confirmed by high sympathetic activity in children TUGLU.
Thus, in children of preschool age with TUGLU revealed characteristics of HRV, which is characterized by increased sympathetic with the decline of parasympathetic activity of the ANS, which allows us to diagnose autonomic dysfunction.
The patterns formed the basis of the developed method for the diagnosis of impaired autonomic regulation, ensuring the adequacy of adaptive reactions in children of preschool age with tuberculosis intrathoracic lymph nodes. Its essence consists in the following: chronic TB infection invariably, even on the background of therapy, resulting in reduced vegetative protection of the child's body in her asthenia.
Nastya K., 5 years, 9 months. (No. East. 07495). Diagnosis: Tuberculosis of intrathoracic lymph nodes in the phase of infiltration, MBT(-). Comorbidities: timomegalia, anemia of mixed Genesis mild.
Girl from unidentified contact on TB, from a second pregnancy occurring with toxemia of the first half and anemia in the second degree, the second term birth by caesarean section, vaccinated with BCG vaccine in the hospital (hem 8 mm), the second is months of life on artificial feeding, refers to a group of sickly children are infected with the office more than one year, within two months receives standard therapy for the disease in the hospital.
Clinically, the girl was showing signs of chronic intoxication (weakness, fatigue, periorbital shadows, retarded physical development, deficiency of subcutaneous fat, anemia mild tachycardia, systolic murmur functional character over heart area), expressed lymphoproliferative syndrome, objective symptoms of disorders of the respiratory system.
Data ANS spectrometry: RMSSD - 74 MS; CV - 10,1%; TP - 3521 MS2; VLF - 1023 MS2; LF - 988 MS2; HF - 1810 MS2- indicate the depletion of adaptive regulatory mechanisms, that is, in this patient there is a dysfunction of the autonomic nervous system.
The proposed method for the diagnosis of impaired autonomic regulation in children of preschool age with tuberculosis of intrathoracic lymph nodes, confirmed the objective nature of the performance, highly informative, non-invasive examination, the technical simplicity of studies using well known and widely used devices for ECG, assessment of effectiveness (token) in the treatment of tuberculosis, prenosological diagnostics in children of high-risk groups sableman the I TB use of the method in terms of primary health care, TB dispensary, hospital, preschools and schools. The obtained criteria to establish the presence or absence of the functional reserve of adaptation.
In the present invention is undergoing clinical trials.
1. A method for the diagnosis of impaired autonomic regulation in children, TB patients, including a study of clinical manifestations and data kardiointervalografii with the definition of autonomic reactivity, characterized in that preschool children with tuberculosis of intrathoracic lymph nodes further define the parameters of heart rate variability: ramagrama - mediterannee differences RMSSD (MS), the coefficient of variation CV (%), spectrogram - total power spectrum TR (MS2very low wave VLF spectrum (MS2), low wave spectrum LF (MS2), high waves HF spectrum (MS2), and when the following values:
- mediterannee differences RMSSD - 76,8±3,92
the coefficient of variation CV - 9,9±0,50
- total power spectrum TR - 3437±175,3
- very low wave spectrum of VLF - 1067±54,4
- low wave spectrum LF - 1003±51,2
- high wave spectrum HF - 1900,2±96,9
diagnosed with autonomic dysfunction.
2. The diagnostic method according to claim 1, characterized in, h what about the children of preschool age with tuberculosis of intrathoracic lymph nodes mainly determined asimpatikotonia autonomic reactivity.
SUBSTANCE: invention relates to medicine, namely to pediatrics. Parameters of cardiorhythmogram (CRG) are registered in lying position: at rest - heart rate, SDNN index; tension index (TI); total spectrum power - Total; value of power in range VLF; value of power in range LF; value of power in range HF. After that in standing position reactivity of sympathetic nervous system is determined by Lf/HF index. In five minutes in lying position recovery of initial heart rate, total spectrum power - Total, increase or reduction of initial power in range of waves: VLF, LF, HF are determined. On the basis of CRG indices, it is estimated which type of cardiac rhythm regulation level prevails: reflex or humoral-metabolic; vegetative balance of sympathetic and parasympathetic impact on cardiac rhythm; reactivity of sympathetic nervous system to functional load: adequate or inadequate. Favourable adaptation is predicted if reflex type of cardiac rhythm regulation prevails over humoral-metabolic, at rest balance of sympathetic and parasympathetic impact on cardiac rhythm is determined, under functional load adequate reactivity of sympathetic nervous system is observed. Unfavourable prediction of adaptation is made if reflex type of cardiac rhythm regulation prevails, but at rest sympathetic or parasympathetic impact on cardiac rhythm is observed, under functional load adequate or increased reactivity of sympathetic nervous system is observed. Unfavourable prediction is made if humoral-metabolic type of level of cardiac rhythm regulation prevails, at rest sympathetic impact on cardiac rhythm prevails and under functional load - inadequate: increased or reduced reactivity of sympathetic nervous system is observed.
EFFECT: method makes it possible to increase reliability of prediction of children's adaptation school.
4 tbl, 3 ex
SUBSTANCE: invention refers to medicine, pulmonology and perinatology. A pregnant woman suffering bronchial asthma of slight severity, in an attack-free period is examined for the functional state of the vegetative nervous system by cardiorhythmography. Detecting a prevailing effect of the sympathetic nervous system by regional lung rheography technique is used to determine a degree of involvement (%) of a medium region of a left lung in air fill (DOmrll%) and a pulse wave propagation time between the heart and the medium region of the left lung (gamrll). It is followed by a discriminant equation: D=-0.054×DOmrll%-11.781×gamrll. If the value D is equal to or more than -2.55, a baby in a in satisfactory condition is expected to be born, while D being less than -2.55, a baby in asphyxia is predicted.
EFFECT: method provides higher prediction reliability.
SUBSTANCE: invention relates to the field of medicine, namely to methods of heart functional state diagnostics. Cardiorhythmogram is registered, integral and amplitude parameters are determined, their phase characteristics are fixed. As position of phase characteristics vector changes, building of elementary geometric figures of said vector travel on phase plane is carried out. From obtained building of elementary geometric figures number of geometric figures with sides '2', '3', '4',…'15', as well as number of elementary figures "point", reflecting zero increments of R-R cardiointervals are determined, plotting them on diagram of ratings of elementary geometric figures as "1". Presence of pathology is determined if value of number of said figures is higher than 3% from total number of figures.
EFFECT: method extends arsenal of means for control of heart functional state.
14 dwg, 4 tbl
SUBSTANCE: invention relates to medicine and can be used in cardiology, cardiac surgery, physiology. In patients with ischemic heart disease thermographic examination of upper extremities is carried out. ECG monitoring is performed. Analysis of heart rhythm variability is realised. Test with sublingual introduction of nitroglycerin is carried out. Presence of vasodilating reaction to nitroglycerin is determined by values of temperature of left hand fingers, index of tension (voltage) and RMSSD index.
EFFECT: claimed invention extends functional possibilities of determining clinical efficiency of nitrates in treatment of patients with IHD.
2 ex, 1 tbl
SUBSTANCE: invention refers in particular to instant diagnosis the CSV of the patient on the basis of the cardiac rhythm variability test. RR intervals (RRI) of the patient are registered and their length is measured. Then the dynamic range of RRI by means of excluding extra systoles which length T3 exceeds double value of the minimum length of RRI 2Tmin and the average length of RRI Tavr in the dynamic range with excluded extra systoles is calculated and changed by the extra systoles on the RRI of length Tavr. Autocorrelation function of the dynamic range RRI is formed and converted to the autocorrelation matrix. The state of the patient's cardiovascular system P is judged by the value of the composite index of the patient's health P, which contains the new index of the regulatory systems tension taking into account maximum and minimum proper values of the autocorrelation matrix and age of the patient in years.
EFFECT: means provides simplification, urgency, advanced objectiveness and accuracy of the diagnosis the cardiovascular system of the patient.
2 cl, 2 dwg, 3 ex
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
SUBSTANCE: invention relates to medicine, in particular, to cardiology, therapy, rehabilitating and preventive medicine. In patients after myocardium infarction, at the background of drug treatment, impact is performed on central and autonomous nerve systems by method of biological feedback. Patient in state of relaxed wakefulness is shown formed on the basis of their cardiorhythmogram periodic curve and their registered cardiorhythmogram. 5 seconds after beginning of active test sound signal is automatically switched on. In each further test on superposing cardiorhythmogram with periodic curve, the latter is corrected in such a way that period varies within 4-12 seconds, heart rate - within 60-75 beats per minute.
EFFECT: method makes it possible in a stable way to recover and/or form cardiorespiratory synchronisation, achieving normal values of heart rate and arterial pressure in treatment of patients after myocardium infarction, with recovery of parasympathetic activity.
3 ex, 7 dwg
SUBSTANCE: invention refers to medicine, namely to therapy. It involves 24-hour electrocardiographic monitoring and calculation of a circulatory heart rate index. Besides, a heart rhythm variability value LF/HF is measured, and an integrated coefficient is calculated by formula: K=CIn/ln (LF/HF), where Cln is a circadian heart rate index, ln(LF/HF) is the LF/HF value is logarithmic form. If the coefficient is less than 0.8, the unfavourable course of cardiopsychoheurosis is predicted.
EFFECT: method provides higher prediction reliability of the clinical course of cardiopsychoheurosis.
2 tbl, 2 ex
SUBSTANCE: invention relates to medicine, cardiology. Electrocardiographic examination is carried out. Late ventricular potentials are recorded by high resolution electrocardiography. The QT interval dispersions are calculated. If an arterial hypertension experience exceeds 1.3 years, while observing the late ventricular potentials combined with the QTapex interval dispersion gain ≥40 ms and the corrected QTapex interval dispersion gain ≥42 ms1/2, disturbed left ventricular geometry is detected and suggested to hypertrophy in children and adolescents suffering arterial hypertension.
EFFECT: method provides higher prediction accuracy with using electrocardiography for the prediction procedure.
SUBSTANCE: indices of heart rhythm variability are determined: normalised power in low frequency range, mode amplitude, maximal cardiointerval in sample. Values of coefficients F1 and F2 are calculated by formulas: F1=-13.46+35.1 × x1-8.04 × x2+7,48 × x3; F2=-12.17+27.97 × x1+4.41 × x2+7.76 × x3; where x1-LFnorm is normalised power in low frequency range; x2-AMo is mode amplitude (share of cardiointervals, corresponding to mode value); x3-max. is maximal cardiointerval in sample. Of F2 value is higher than F1, presence of intracranial hypertension of more than 20 mm Hg, and with F1 higher than F2, its absence is diagnosed.
EFFECT: method makes it possible to eliminated examination trauma and reduce diagnostics time.
3 tbl, 2 ex
SUBSTANCE: invention relates to medical equipment, namely to devices for remote monitoring of physiological parameters of human organism. System contains sensor of heart activity control, sensor of respiratory activity control, sensor of hemodynamics control, unit of data introduction and central computer. Additionally system contains microprocessor, GSM mobile connection net, which supports transmission of GPRS data packet, and function of location determination in PRCF radiosystem, data of motor activity control, two GPRS modems and multi-channel microcontroller. System also includes display, two telephones of mobile connection, database containing anamnesis, passport data, as well as contact information with patient's confidant.
EFFECT: realisation of invention makes it possible to perform mobile control of physiological state of organism of people, who are in helpless state.
5 cl, 2 dwg
SUBSTANCE: invention relates to medicine and can be used in cardiology. Registration of signal-averaged electrocardiography of high resolution is performed before and after physical exercise on the treadmill. Assessment of dynamics of changes of index of filtered complex QRS (Total QRS) duration is carried out. On the basis of the analysis of HR ECG data, before and after physical exercise, percent of increase of filtered complex QRS duration - Δ% TotalQRS is calculated by formula. If Δ% TotalQRS value is higher than 30% probability of arrhythmia development is estimated as high, if values are in the range from 20% to 29% including - as medium and if values are lower than 20% - as low.
EFFECT: method makes it possible to increase accuracy of arrhythmia prediction in patients with arterial hypertension due to taking into account dynamics of changes of electric inhomogeneity of myocardium under physical exercise.
SUBSTANCE: invention relates to medicine, namely to devices for registration, analysis and transmission of electric cardiosignal (ECS). Device for ECS registration contains successively connected amplifier and analogue-digital converter with multiplexor, as well as arithmetic device, two memory units, digital modem, analyser of increment codes, counter of increment code number, first unit of switching, control unit. Device for ECS registration differs from those known from the equipment level by introduction into it of successively connected decomposition unit and second arithmetic-logic device. Decomposition unit contains second unit of switching, two adders, two units for extremum determination, two interpolation filters and register. Decomposition unit is intended for realisation of step-by-step mode of signal decomposition into empiric modes. Second arithmetic-logic device is intended for checking conditions of stop of signal decomposition process, storage and summing up obtained empiric modes.
EFFECT: application of claimed invention will make it possible to qualitatively suppress noise of various types, efficiently detect and classify informative ECS sections (complexes, teeth, intervals) and measure their parameters with high accuracy.
2 cl, 8 dwg
SUBSTANCE: invention relates to medical equipment. An electrocardiograph measures coordinates and parameters of a cardiac electrical activity source. The electrocardiograph comprises electrodes placed on a patient's body and an assembly of electrode potential amplifiers, a programmed assembly of electrode coordinates measurement by patient's body geometry and an assembly of result visualisation. For the purpose of measuring the coordinates of the cardiac electrical activity source, the electrodes are placed so that to cover a myocardial contour, and there are also integrated complementary assembly of subtraction, assembly of calculation and search assembly of the coordinates and parameters of the cardiac electrical activity source. The assembly of subtraction subtracts actual electrode potentials from the potentials calculated by the coordinates and parameters of the cardiac electrical activity source. The assembly of calculation calculates the electrode potentials by the coordinates and parameters of the cardiac electrical activity source. The search assembly of the coordinates and parameters is designed to enable a search pause after achieving minute errors and to transfer the found coordinates and parameters to the assembly of visualisation.
EFFECT: use of the given invention enables higher diagnostic effectiveness of electrocardiography, early diagnostic of the diseases and determination of disorder coordination.
1 cl, 6 dwg
SUBSTANCE: invention relates to medicine, namely to cardiology, and can be used for predicting in patients with proved isolated stable stenocardia of atherosclerotic origin development of occlusion of coronary arteries in form of myocardial infarction or diagnostics of old subclinical versions of myocardial infarction in form of post-infarction cardiosclerosis in case if there are no or it is impossible to obtain direct clinical-instrumental data proving presence of said pathology. Anamnestic risk factors, as well as echocardiographic indices of hemodinamics are determined and prognostic coefficient (PC) is calculated by formula elaborated by the author. If value PC>1, conclusion about liability to myocardial infarction or possibility of old (sub clinical) one, is made, if value PC≤1 - about absence of said disease.
EFFECT: method makes it possible to increase prediction accuracy.
SUBSTANCE: invention refers to medicine, specifically cardiology. A subcutaneous ECG monitor is fixed to a programmer head thereby mapping a patient's thorax out with a recording surface pressed to patient's skin at least in six thoracic zones. R wave signal amplitude and purity are evaluated on a programmer monitor. The area of the greatest R wave amplitude and the least noise voltage is considered to be optimal for implantation of the subcutaneous ECG monitor.
EFFECT: method provides higher effectiveness of localising the implantation site of the subcutaneous ECG monitor.
2 tbl, 3 dwg, 1 ex
SUBSTANCE: invention refers to medicine, namely systems and diagnostic techniques for functional body state. Method involves biological signal reading by at least one sensor, recording, automatic analysis, including calculation of the variability of cardiac rhythm and index of activity of regulatory systems, extraction of the parameters specifying a risk of cardiac disturbances, cardiac arrest emergency, and also diagnosed cardiac rhythm disorder, and functional state data display. Additionally, personal information on current patient's state as of the time of biological signal reading is recorded; probable reasons of the functional state variation in accordance with pre-recorded history, current health and parameters exceeding the threshold values of normal ECG or parameters of previous ECGs are listed; the functional state assessment is expressed in the form to be presented to an individual being examined. A system for implementing the method comprises biological signal sensors, a recorder and an analysis unit for recorded biological signals. Besides, it is provided with a user terminal to input health data, a unit for automatic listing of probable reasons of the functional state variation and functional state assessment to be presented to an individual, connected with the analysis unit for recorded biological signals. A second version of the system is characterised by the fact that it comprises the user terminal to input health data from the biological signal recorder or current health values.
EFFECT: use of the invention provides more reliable functional state assessment.
6 cl, 2 dwg
SUBSTANCE: invention relates to medical equipment, namely to devices of long-term ECG monitoring. Electrode device for wearable ECG-monitor contains system of on-skin electrodes and monitoring unit, electrically connected to each other and placed on pendant fixed on the body. System of on-skin electrodes consists of two matrices of pin electrodes, whose free butt end parts have salient spherical surface and are installed on belt part of pendant, tightly filling the body with possibility of providing "dry" galvanic contact with areas of chest anterior surface in conditions of patient's free movements. Each matrix consists of two groups, pin electrodes in each of them are galvanically connected to each other. One of the groups, which has larger area, is intended for ECG signal registration, the other, with smaller area, for connection to means of cophasal noise suppression. Butt end fixing parts of electrode pins are fixed on flexible dielectric padding, connected with pendant, made from elastic textile material.
EFFECT: invention makes it possible to increase reliability of galvanic contact between patient's body and system of "dry" electrodes and improve ratio signal/noise of ECG signal in process of long-term application.
5 cl, 4 dwg
SUBSTANCE: invention relates to medicine, namely to functional diagnostics. Simultaneously electrophysiological indices are registered, coefficient of deviation of parameters from average static value is calculated. Into model of ideal state, which represents internal and external circles, which limit range of change of parameters without pathognomonic value, inscribed is pentagon whose apexes reach values of measured parameters. With step-by-step from right to left rotation of pentagon coefficients of ratios of physical parameters are determined by formula (XnXn+8)/(XnXn+8-y), where XnXn+8 is length of line, connecting the 1-st and the 3-rd apexes of pentagon starting with point 15 o'clock in the direction from right to left, y is segment of said line, limited by points of it intersection by other two sides of pentagon. Determined coefficients are compared with standard value and classification of functional state is carried out by value of deviation of calculated coefficients from standard value.
EFFECT: method makes it possible to increase reliability of determination of the level of person's functional state.
3 tbl, 6 dwg, 1 ex
SUBSTANCE: invention relates to medical equipment, namely to devices of long-term ECG monitoring. Monitor contains unit of electrocardiogram registration, ADC, replaceable memory map, connected with microcontroller, means of SMS messages formation via GSM-modem of telephone, three-coordinate accelerometer, real time clock, USB-port, unit of cophasal noise suppression, connected with microcontroller and operative random access memory (RAM). Unit of ECG registration consists of two matrices of electrodes, made with possibility of fixation and "dry" contact with precardial area. Each matrix contains two groups of electrodes, one of which is connected to unit of cophasal noise suppression, the other one - to inlets of operative amplifier, whose outlet via filter is connected to ADC. Microcontroller is made with possibility of entry into RAM of patient's individual ECG parameters and comparing them by set criteria with parameters of ECG of current monitoring taking into account ECG parameters obtained in absence of motion artifacts. If parameters of current monitoring EWCG differ from patient's individual ECG parameters by value higher than critical, SMS message with diagnosis is formed via GSM-modem of telephone.
EFFECT: invention makes it possible to improve ratio signal/noise in process of application by patients with ECG pathologies, reduce quantity of false responses, as well as increase term of monitor operation without replacement of accumulators.
5 cl, 5 dwg
SUBSTANCE: method involves carrying out pulsating Doppler echocardiographic examination. Mean pressure is determined in pulmonary artery. Mean pressure in pulmonary artery being less than 13 mm of mercury column, no cardiac rhythm disorders risk is considered to take place. The value being greater than 13 mm of mercury column, complex cardiac rhythm disorder occurrence risk is considered to be the case.
EFFECT: accelerated noninvasive method.