Method for examining liver detoxification function state

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to hepatology, and describes a method for examining the liver detoxification function state. The method involves measuring fasting blood AWM (average weigh molecule), ALT (alanine aminotransferase) and AST (aspartate aminotransferase), measuring the same values the night before at bedtime, as well as measuring a circulating blood volume and a packed cell volume in the morning and in the evening followed by determining a coefficient of the liver detoxification function state; and if observing the derived coefficient K≤0.6, the liver detoxification function state is considered to be satisfactory, while the coefficient K>0.6 shows the depressed liver detoxification function.

EFFECT: method provides the more reliable assessment of the liver detoxification function state.

1 ex

 

The invention relates to medicine, Hepatology and, directly, to the assessment of liver detoxification function.

There is a method of study of liver detoxification function, namely, that hold the concentration in the blood plasma content of average molecules of aminotransferases (ALT, ACT) and nitrogen products (creatinine, urea) (see Imanbaev A. K., "Pathophysiological features correction of liver detoxification function in the postoperative period in patients with abdominal sepsis", abstract of Diss. candidate of medical Sciences. - Bishkek, 2009. 22).

However, this technique is uninformative, because it allows to assess only the presence in the blood of the patient markers of intoxication at the current time, the accumulation of which may be associated not only with impaired liver function, but also delayed their excretion from the body with urine. Determination of urea and creatinine, in essence, the evaluation of detoxification functions of the liver, because they are formed from more toxic precursors in the liver, they are products of the detoxification functions of the liver.

The task of the invention is to increase the reliability assessment of liver detoxification function.

This is achieved by use of the method of study of liver detoxification function, allcauses in the definition in the morning on an empty stomach in the blood content of MSM (molecules of average weight), ALT (alanine aminotransferase) and ACT (aspartate aminotransferase), characterized in that these parameters specify the evening before bedtime, and morning and evening to determine blood volume and hematocrit, and then estimate the factor condition detoxification functions of the liver by the formula:

where:

K - coefficient of condition detoxification functions of the liver

MSMin the morning- the content of molecules of average weight in blood in the morning

MSMin the evening- the content of molecules of average weight in blood in the evening

ALTin the morning- concentration of ALT in the blood in the morning

ALTin the evening- concentration of ALT in the blood in the evening

ASTin the morning- the content of the ACT in the blood in the morning

ASTin the evening- the content of the ACT in the blood in the evening

BVin the morning- the volume of circulating blood in the morning

BVin the evening- the volume of circulating blood in the evening

Htin the morningthe hematocrit in the morning

Htin the eveningthe hematocrit in the evening.

For values of K≤0,6 detoxification function of the liver is regarded as satisfactory, when K>0.6 to as the reduction of liver detoxification function.

During the day the main resources of the organism designed to meet the vital processes in the daytime, which, according to the dominant Ukhtomsky, at the moment are PR is priority. Accordingly, the supply of other body functions, in particular detoxification function of the liver, produced as a residual. In contrast, at night, during sleep, the resources of the liver is aimed at neutralization accumulated during the day toxins. Molecules of average weight, by their nature, relate to protein toxins with a high content of dicarboxylic and low - aromatic acids have direct membranotoksicheskoe action. In the liver they are inactivated, that is the detoxification function of the liver. ALT ACT are markers of toxic disturbance of permeability of cell membranes.

The proposed method for the study of liver detoxification function allows to estimate the state at the current time, i.e. in the dynamics.

The method is as follows: in the evening before going to sleep make a determination in blood plasma content of MSM (molecules of average weight), ALT ACT, the volume of circulating blood and the hematocrit, in the morning on an empty stomach in the blood determine these parameters, and then calculate the ratio To reflect the detoxification function

where:

K - coefficient of condition detoxification functions of the liver

MSMin the morning- the content of molecules of average weight in blood in the morning

MSMin the evening- the content of the molecules of the medium m is piss blood in the evening

ALTin the morning- concentration of ALT in the blood in the morning

ALTin the evening- concentration of ALT in the blood in the evening

ASTin the morning- the content of the ACT in the blood in the morning

ASTin the evening- the content of the ACT in the blood in the evening

BVin the morning- the volume of circulating blood in the morning

BVin the evening- the volume of circulating blood in the evening

Htin the morningthe hematocrit in the morning

Htin the eveningthe hematocrit in the evening, when the values of K≤0,6 detoxification function of the liver is regarded as satisfactory, when K>0.6 to as the reduction of liver detoxification function.

The method of study of liver detoxification function was developed in the evaluation of biochemical blood tests in 136 volunteers who have pathology of the liver, with a comprehensive survey was excluded in age from 26 to 39 years. Studies in each subject performed 3 times with one week interval. Of them were 92 men and 44 women.

The results of the survey indices (K) is less than or equal to 0.8 were considered as conditionally normal.

The method of study of liver detoxification function was applied to assess the dynamics of the detoxification functions of 67 patients with pathology of the liver (hepatitis). On initial examination it was observed an increase of the coefficient To 0.16-0.31 in higher than normal, indicating that the reduction of detoxification functiion. During treatment, there was a gradual decline in the ratio to 0.55 To-0,62, that is, there was a trend toward normalization of liver detoxification function, which is consistent with the normalization of clinical and laboratory parameters.

Example: a Patient Century, 37 years. Diagnosis: Chronic hepatitis. Parenchymatous jaundice. On initial examination: blood night MSM - 0,34; Alat - 0.89 mmol/(h·l); AST - of 0.53 mmol/(h·l); Ht is 50.9%, BCC 4,74 L. With the re-examination in the morning MSM - 0,32; Alat - 0,79 mmol/(h·l); AST - 0.52 mmol/(h·l); Ht - 51,2%, BCC br4.61 L. the K-Factor was 0.8, which was much higher than normal values and evidence of decreased detoxification functions of the liver. After the treatment has improved the General condition of the patient, there was a decrease in blood MSM, Alat, ASAT. Blood in the evening MSM - 0,29; Alat - 0.73 mmol/(h·l); AST - 0.49 mmol/(h·l); Ht - 46,9%, BCC 4,81 L. With the re-examination in the morning MSM - 0,23; Alat - 0.64 mmol/(h·l); AST - 0.46 mmol/(h·l); Ht - 47,8%, BCC 4,74 HP Ratio amounted To - 0,61 that only slightly exceeded the normal values, i.e. detoxification function of the liver is almost normalized. The positive dynamics of the ratio To coincide with the positive dynamics of other biochemical parameters (total and direct bilirubin, alkaline phosphatase, Tim the gross sample, nitrogen balance, leukocyte formula). The result indicated that the application of the proposed method for the study of liver detoxification function allows not only to evaluate its status in the current time, but may be a criterion for the effectiveness of the treatment in liver pathology.

Thus, the inventive method can improve the accuracy assessment of liver detoxification function.

The method of the research, detoxification functions of the liver, which consists in determining in the morning on an empty stomach in the blood content of MSM (molecules of average weight), ALT (alanine aminotransferase) and ACT (aspartate aminotransferase), characterized in that these parameters specify the evening before bedtime, and morning and evening to determine blood volume and hematocrit, and then estimate the factor condition detoxification functions of the liver by the formula:

where:
K - coefficient of condition of liver detoxification function,
MSMin the morning- the content of molecules of average weight in blood in the morning,
MSMin the evening- the content of molecules of average weight in blood in the evening,
ALTin the morning- concentration of ALT in the blood in the morning,
ALTin the evening- concentration of ALT in the blood in the evening,
ASTin the morning- the content of the ACT in the blood in the morning, ASTin the evening- the content of the ACT in the blood in the evening,
BVin the morning- the volume of circulating blood in the morning,
BVin the evening- the volume of circulating blood in the evening,
Htin the morningthe hematocrit in the morning,
Htin the eveningthe hematocrit in the evening,
and for values of K≤0,6 detoxification function of the liver is regarded as satisfactory, when K>0.6 to as the reduction of liver detoxification function.



 

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7 dwg, 1 ex, 6 tbl

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2 tbl

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1 cl, 3 dwg, 4 ex

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3 ex

FIELD: medicine.

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3 ex

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EFFECT: higher efficiency of diagnostics.

2 ex

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