RU2152615C1 - Method for predicting acute period outcome of burn disease - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves adding erythrocyte suspension to serotonin solution. Antiserotonin activity of erythrocytes is determined. The value becoming lower, acute period prognosis is evaluated as unfavorable. EFFECT: improved diagnosis accuracy.

Description

 The present invention relates to medicine, in particular to methods for predicting acute periods of burn disease.

 There is a method for predicting the outcome of an acute period of a burn disease, which consists in processing parameters reflecting the severity of a burn injury, the area of the lesion and the degree of burn, and allowing to predict the likelihood of survival and the critical period during a burn disease (I.R. Vazina et al. "Prediction of outcomes and critical periods of burn disease ". In the book. V scientific-practical conference on the problem of thermal damage. Gorky. 1986, pp. 142-143).

 However, this method has the significant drawback that forecasting is based only on the characteristics of the severity of the injury and does not take into account the specific individual characteristics of the victim’s body.

 As a prototype, we chose a method involving blood sampling, separation of blood into plasma and blood cells, determination of antitrobin III activity in plasma and assessment of the degree of its decrease in the outcome of burn shock (Garsia-Avello A., Lorente JACesar-Perez J /. Garcia-Frade LJ ea Degree of Hypercoagulability and hyperfibrinolysis is related to organ failure prognosis arter burn trauma // Thromb. Res., 1998, Jan 15; 89 (2), 59-64).

 However, the known method is not sufficiently informative, since it characterizes only one of the factors determining the severity and outcome of burn shock, as well as the activity of antitrimbin III - a variable indicator that largely depends not only on premorbid background, synthesizing liver functions, but also on the treatment , in particular from heparin therapy.

 The task of the invention is to expand the diagnostic capabilities of the method.

где L1 - содержание серотонина в стандартном растворе;
L2 - содержание серотонина после добавления эритроцитов, если антисеротонировая активность эритроцитов 60% и ниже, то прогноз острого периода ожоговой болезни оценивается как неблагоприятный.The posed problem is solved due to the fact that in a method that includes blood sampling, its separation into plasma and blood cells, a suspension of blood cells is added to a solution of serotonin - red blood cells, the antiserotonin activity of red blood cells is determined by the formula:

where L1 is the content of serotonin in a standard solution;
L2 - serotonin content after the addition of red blood cells, if the antiserotonous activity of red blood cells is 60% or lower, then the prognosis of an acute period of burn disease is assessed as unfavorable.

где L1 - содержание серотонина в стандартном растворе;
L2 - содержание серотонина после добавления эритроцитов.A method for predicting the outcome of an acute period of a burn disease is as follows: prepares a standard solution of serotonin (10 mg / l of distilled water). Produce a blood sampling in the amount of 0.9 ml in a test tube containing 0.1 ml of a solution of sodium oxalate. Centrifuged at 700 rpm for 7 minutes. The platelet-rich plasma is sucked off and the erythrocyte mass is left. To 1.0 ml of a standard solution of serotonin add 0.01 ml of red blood cell mass. After 10 minutes of incubation at room temperature after the onset of erythrocyte hemolysis, 1.0 ml of 10% perchloric acid solution is added to precipitate proteins and centrifuged at 3000 rpm for 30 minutes. The supernatant is placed in a cuvette of a spectrofluorimeter and the concentration of serotonin is determined. The calculation of the antiserotonin activity of the red blood cells of the patient is carried out according to the formula:

where L1 is the content of serotonin in a standard solution;
L2 - serotonin content after the addition of red blood cells.

 The degree of decrease in serotonin concentration is used to judge the antiserotonin activity of red blood cells, which characterizes the prognosis of the outcome of the acute period of a burn disease: if the antiserotonin activity of red blood cells is 60% or lower, then the prognosis is assessed as unfavorable.

Clinical examples
1. Patient S. 56 years old (and.b. N 175931)
Diagnosis: Burn with a flame of II-III AB-IV degree on an area of 75% of the body surface, burn of the respiratory tract. He died on the 6th day after the injury. The cause of death is sepsis. One day after receiving a burn in the venous blood, the antiserotonin activity of red blood cells was determined by the above method. It amounted to 99.2%.

2. Patient G., 39 years old (and.b. N 176046)
Diagnosis: Burn with a flame of ШБ-IV degree on an area of 40% of the body surface, burn of the respiratory tract. He died a day after the injury. The cause of death is burn shock. Red blood cell antiserotonin activity was 60%.

 3. Patient G. 52 years old (and.b. N 176299).

 Diagnosis: Burn with a flame of degree ShAB on an area of 55% of the body surface. He died 2.5 days after the injury. The cause of death is burn shock. The red blood cell antiserotonin activity after 10 hours was 54.6%.

 4. Patient T. 61 years old (IB N 176518) received a burn with a flame of II-III AB on an area of 70% of the body surface. The patient survived and was discharged from the hospital. The antiserotonin activity of red blood cells in the period of shock was 96.3%.

 Thus, we can conclude that the severity of the antiserotonin activity of red blood cells may indicate the outcome of the acute period of the disease. So in cases where the antiserotonin activity of red blood cells was low - 60% and 54.6%, respectively (see example N 2 and 3), both patients died 1 and 2.5 days after severe thermal injury (burn on an area of 40% and 55% of the body surface). With a high antiserotonin activity of red blood cells - 96.3% (Example 4), the patient survived, despite the severity of the lesion (70% of the body surface). In conditions of supercritical burn - 75% of the body surface of the II-III AB-IV degree, combined with a burn of the respiratory tract, which greatly aggravates the course of the burn disease, with a high antiserotonin activity of red blood cells - 99.2% (Example 1), the patient survived the period of burn shock and part of the period of acute toxemia and died from the joined generalized sepsis infection.

 The proposed method is quite simple and affordable, because determination of serotonin in the blood suggests the presence of standard equipment in biochemical laboratories. In addition, it is highly informative, as evidenced by the large difference in the rates of antiserotonin activity of red blood cells in surviving and dead patients. It is especially important that this indicator is quite stable and relatively little dependent on the treatment.

Claims (1)

A method for predicting the outcome of an acute period of a burn disease, which consists in blood sampling, its separation into plasma and blood cells, characterized in that a suspension of blood cells is added to a solution of serotonin - red blood cells, the antiserotonin activity of red blood cells is determined by the formula

where L1 is the content of serotonin in a standard solution;
L2 - serotonin content after the addition of red blood cells,
and if the antiserotonin activity of red blood cells is 60% or lower, then the prognosis of an acute period of burn disease is assessed as unfavorable.