RU2292043C2 - Method for diagnosing hepatic steatosis cases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves carrying out microscopic study of biological material in which blood serum sample taken strictly on empty stomach is hold during 24 h at 5-8°C. Then it is deposited over degreased glass surface as drops in the amount of 01-0.02 ml in the amount of 0.01-0.02 ml and dried at 18-30°C under relative humidity of 55-65% for 18-24 h. At least one cleared zone being detected along radial cracks as lacunas in marginal fascia zone, hepatic steatosis showing no inflammation elements is to be diagnosed. Additional triangular structures of white color in marginal fascia zone being found, hepatic steatosis showing inflammation elements is diagnosed.

EFFECT: enhanced effectiveness in detecting early stage fatty liver degeneration.

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Description

The invention relates to medicine, in particular to a laboratory research method.

It is known that steatosis (fatty hepatosis, fatty infiltration), which is one of the stages in the development of steatohepatitis, which can transform into cirrhosis of the liver, is referred to diffuse liver diseases. Early diagnosis of steatosis is difficult, since the clinical picture and laboratory parameters are not specific, and radiation diagnostic methods (ultrasound, computer examination of the abdominal organs) can not always confirm the diagnosis of steatosis.

A known method for the diagnosis of diffuse steatosis, based on echodysitometry in two special projections, which are used to calculate the objective parameters of histograms (RF Patent No. 2204327, IPC A 61 V 8/00, publ. 2003).

The disadvantage of this method is its complexity, it requires a lot of time, and in this regard, it does not find wide application.

Closest to the claimed method is a method for diagnosing liver steatosis, including microscopic examination of biological material by puncture biopsy of the liver followed by morphological examination of punctate (Severov M.V., Namestnikov E. et al. Liver biopsy: feasibility, contraindications and complications. Journal "Doctor" No. 10, 2002, p. 36-38).

The disadvantage of this method is its complexity, the high risk of complications up to death and the inability to use it as a screening of a wide population.

The task was to eliminate the above drawbacks and create an effective diagnostic method that would allow, at an early stage, the patient's blood serum to judge the fatty degeneration of the liver.

This is achieved by the fact that in a method for diagnosing liver steatosis, including microscopic examination of biological material, blood is taken from a patient strictly on an empty stomach. Blood serum is examined, which is kept for 24 hours at a temperature of 5-8 ° C, then it is applied to the surface of low-fat glass in an amount of 0.01-0.02 ml, dried at a temperature of 18-30 ° C and a relative humidity of 55-65 % within 18-24 hours. If there are radial cracks in the marginal zone of the facies and at least one lighter area along the fissure, liver steatosis without inflammatory elements is diagnosed, and if additional triangular structures are detected against the background of lighter areas, liver steatosis with inflammatory elements is diagnosed.

A prerequisite for creating this method was the discovery of the possibility of studying the structure of biological fluids and deciphering the markers of many pathological processes - inflammation, stone formation, etc. (Shabalin V.N., Shatokhina S.N. Morphology of human biological fluids. M. - 2001).

Figure 1 shows a fragment of the facies with pronounced areas of enlightenment along radial cracks; figure 2 - sections of enlightenment along the radial cracks and structures of a triangular shape, figure 3 - fragments of the facies of blood serum without signs of manifestation of steatosis.

The implementation of the method shown in specific clinical examples.

Example 1

Patient K., 66 years old. Dispensary examination.

Blood was taken from a patient strictly on an empty stomach in the morning, serum was obtained by sedimentation (centrifugation can also be used), which was kept for 24 hours at a temperature of +5 - + 8 ° C, then it was applied to the surface of a fat-free glass slide in an amount of 0.01-0 , 02 ml in the form of a drop, dried at a temperature of 25 ° C at a relative humidity of 65% for 24 hours, examined under a microscope under normal lighting.

When microscopy of a blood serum sample by the proposed method, marked areas of enlightenment along radial cracks in the form of "gaps" were noted (Fig. 1).

Conclusion: liver steatosis.

Data of a liver biopsy: fatty hepatocyte infiltration - steatosis.

Example 2

Patient Y. 64 l. Dispensary examination.

Microscopy of a sample of blood serum according to the method described above. marked areas of enlightenment along radial cracks in the form of "gaps" and a triangular white structure are marked (Fig. 2).

Conclusion: steatohepatitis.

Data of a liver biopsy: fatty infiltration of hepatocytes, fibrosis and severe lymphocytic infiltration - steatohepatitis.

Example 3

Patient K., 51. Clinical examination.

Microscopy of a sample of blood serum did not reveal any structures along the radial cracks (figure 3).

Conclusion: there were no signs of fatty degeneration of the liver.

Ultrasound data of the liver: the ultrasound picture is represented by an unchanged liver.

The method is technically simple, quickly feasible, minimally invasive, and can be successfully used as screening studies for the examination of a wide population.

Claims (1)

A method for the diagnosis of liver steatosis, including microscopic examination of biological material, characterized in that they examine blood serum taken strictly on an empty stomach, maintain it for 24 hours at a temperature of 5-8 ° C, then apply it to the surface of low-fat glass in the form of a drop in the amount of 0 , 01-0.02 ml, dried at a temperature of 18-30 ° C at a relative humidity of 55-65% for 18-24 hours, and in the presence of at least one area of enlightenment along radial cracks in the form of gaps in the edge zone facies diagnosed with steatosis of the liver without elements of inflammation, and in identifying additional triangular-shaped structures in the white edge region fades, diagnose steatosis with inflammation elements.

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