RU2403865C1 - Diagnostic technique for structural popliteal artery remodelling in arterial hypertension - Google Patents

Abstract

FIELD: medicine. ^ SUBSTANCE: invention refers to medicine, namely to functional diagnostics and can be used for diagnosis of structural popliteal artery remodelling in arterial hypertension. It involves Doppler ultrasound of the brachial (BA) and popliteal (PA) arteries and measurement of internal diastolic diametre (Ddiast). A coefficient is calculated by formula If the coefficient is more than 56.4%, the structural popliteal artery remodelling is diagnosed. ^ EFFECT: technique is simple, allows the life-time diagnosis of the structural popliteal artery remodelling in arterial hypertension. ^ 3 ex, 1 tbl

Description

The invention relates to medicine, namely to functional diagnostics, and can be used to diagnose structural vascular remodeling of the popliteal artery in patients with arterial hypertension.

The closest analogue of the proposed method for the diagnosis of vascular remodeling processes is the determination of the Kernogan index, which is used in pathological practice during morphometry of arteries and is calculated as the ratio of the thickness of the middle membrane of the artery to its internal diameter (I.V. Timofeev. Treatment pathology. St. Petersburg, 1999, p.656).

The disadvantage of the prototype is the difficulty of using the index in intravital diagnostics of remodeling processes due to the impossibility of functional methods to accurately determine the boundaries of the middle membrane of the arteries, as well as the lack of clear standards.

Effect: simplification of the method, increased accuracy and the possibility of intravital diagnostics of structural remodeling of the popliteal artery.

The essence of the method is to use ultrasound Dopplerography to determine the internal diastolic diameters of the brachial (Ddiast PA) and popliteal (Ddiast PPodA) arteries and determine the remodeling coefficient according to the formula:

and with its value of more than 56.4%, structural remodeling of the popliteal artery is diagnosed.

The method is as follows.

The patient undergoes standard ultrasound dopplerographic examination of the brachial (PAP) and popliteal (PPaA) arteries with measurement of the internal diastolic diameter (Ddiast) using the ALOCA 5000 (Japan).

The obtained indicators are used in the formula:

The coefficient value of more than 56.4% indicates the development of structural remodeling of the popliteal artery.

Case Studies

Example 1. Surveyed S., 42 years. A practically healthy person with a blood pressure of 110/70 mm Hg On a dopplerographic study, Ddiast PA on the right is 3.4 mm, Ddiast PodA on the right is 6.7 mm. The coefficient is 50.74%. There is no structural remodeling of the popliteal artery.

Example 2. Patient K., 59 years old. Diagnosis: Arterial hypertension of the I degree. Blood pressure 140/90 mm Hg On a Doppler study, Ddiast PA on the right is 3.8 mm, Ddiast PodA on the right is 5.1 mm. The coefficient is 74.51%. There is structural remodeling of the popliteal artery.

Example 3. Patient G., 59 years old. Diagnosis: Arterial hypertension of the II degree. Blood pressure 150/100 mm Hg On a Doppler study, Ddiast PA on the right is 4.1 mm, Ddiast PodA on the right is 5.9 mm. The coefficient is 69.49%. There is structural remodeling of the popliteal artery.

In total, 104 people took part in the study, including 61 people with grade 1–11 arterial hypertension and 43 people with normal blood pressure (according to the “National Recommendations for the Prevention, Diagnosis, and Treatment of Arterial Hypertension” of the second revision of 2004).

No. p / p Arterial hypertension Ddiast PA (mm) Ddiast PodA (mm) Coefficient (%) Remodeling Under one no 3.4 6.5 52.31 no 2 no 3.9 7 55.71 no 3 no 4.4 8 55 no four no 3.6 7.1 50.7 no 5 no 3.4 6.7 50.74 no 6 no 3,5 6.5 53.84 no 7 no 3,5 7.7 45.45 no 8 no 3.8 7 54.28 no 9 no 3.8 6.9 55.07 no 10 no four 7.6 52.63 no eleven no 3,5 6.5 53.84 no 12 no 4.1 7.3 56.16 no 13 no 3,7 6.6 56.06 no fourteen no 3.6 6.7 53.73 no fifteen no 3,5 6.2 56.4 no 16 no 4.4 7.8 56.4 no 17 no 3,7 6.6 56.06 no eighteen no 3,7 6.7 55.22 no 19 no 3.9 7 55.71 no twenty no 3,5 6.7 52.23 no 21 no 4.1 7.4 55,4 no 22 no 3.6 6.8 52.94 no 23 no 3,1 5.5 56.36 no 24 no 3.3 5.9 55.93 no 25 no 3,1 5,6 55.35 no 26 no 3.4 6.1 55.73 no 27 no 3.2 5.7 56.14 no 28 no 2.6 5.3 49.05 no 29th no 3.6 6.4 56.25 no thirty no 3.3 5.9 55.93 no 31 no 3.3 6 55 no 32 no 3,1 5.5 56.36 no 33 no 4.1 7.3 56.16 no 34 no 3,1 5,6 55.35 no 35 no 2.9 5.2 55.77 no 36 no 3,1 5.5 56.36 no 37 no 3.3 6.2 53.22 no 38 no 3,1 5.5 56.36 no 39 no 3.3 6.3 52.38 no 40 no 3,5 6.4 54.6 no 41 no 3.6 6.5 55.38 no 42 no 3,7 6.6 56.06 no 43 no 3.3 6.1 54.09 no 44 there is 3,5 5.1 68.62 there is 45 there is 3.3 4.7 70.21 there is 46 there is 4.3 4.7 93.61 there is 47 there is four 5.7 70.17 there is 48 there is 3.2 4,5 71.11 there is 49 there is 3.6 5.9 61.02 there is fifty there is 3,7 5.9 62.71 there is 51 there is 3,7 4,5 82.22 there is 52 there is 3.8 5.1 74.51 there is 53 there is 3.6 4.7 76.59 there is 54 there is 4.6 6.7 68.65 there is 55 there is four 5.7 70.17 there is 56 there is 3,7 6.7 55.22 no 57 there is 3,5 4.6 76.08 there is 58 there is 3.9 5,4 72.22 there is 59 there is 4.1 5.9 69.49 there is 60 there is 3 4.9 61.22 there is 61 there is 3,7 5.7 64.91 there is 62 there is 3.6 6 60 there is 63 there is 3,1 5,4 57.4 there is 64 there is 2.6 5,4 48.14 no 65 there is 3.6 5.8 65.07 there is 66 there is 3.8 4.9 77.55 there is 67 there is 5.2 7.9 65.82 there is 68 there is 2.9 4.9 59.18 there is 69 there is four 5.3 75.47 there is 70 there is four 6.1 65.57 there is 71 there is 3 5.1 58.82 there is 72 there is 3.2 5.1 62.74 there is 73 there is 3.8 5 76 there is 74 there is 3.3 5.3 62.26 there is 75 there is 4.3 5.8 74.13 there is 76 there is 4.1 6.1 67.21 there is 77 there is 3.8 6.2 61.29 there is 78 there is 3.4 5.5 61.81 there is 79 there is 3.8 6.1 62.29 there is 80 there is 3.3 5,6 58.92 there is 81 there is 3.6 4.9 73.46 there is 82 there is 3.8 5.2 73.07 there is 83 there is 3.3 6.6 fifty no 84 there is 4.2 6.5 64.61 there is 85 there is 3.8 4.8 79.16 there is 86 there is 3.6 6.1 59.01 there is 87 there is 3,5 6.4 54.68 no 88 there is 4.1 6.1 67.21 there is 89 there is 3.8 5.3 71.69 there is 90 there is 3,5 6.4 54.68 no 91 there is 5.8 7 82.85 there is 92 there is 3.3 5,6 58.93 there is 93 there is 2,4 4.9 48.98 no 94 there is 3.8 5.8 65.51 there is 95 there is 3 5,4 55.55 no 96 there is 4.1 5.8 70.68 there is 97 there is four 5.8 68.96 there is 98 there is 4.4 6.2 70.96 there is 99 there is 4.1 5.2 78.84 there is one hundred there is 4.3 6.1 70.49 there is 101 there is 4.6 6.6 69.69 there is 102 there is 3.2 5.2 61.53 there is 103 there is 3.8 6 63.33 there is 104 there is 4.6 6.8 67.64 there is

The advantages of the method are the possibility to diagnose structural remodeling of the popliteal artery in case of arterial hypertension in an affordable way according to the established standard.

Claims (1)

A method for diagnosing structural remodeling of the popliteal artery in case of arterial hypertension by measuring the internal diameter of the brachial and popliteal arteries, characterized in that the dopplerographic method for examining the brachial and popliteal arteries is used, and the coefficient is calculated by the formula

where Ddiast PA - internal diastolic diameter of the brachial artery, mm,
Ddiast PodA - internal diastolic diameter of the popliteal artery, mm,
and with a coefficient value of more than 56.4%, structural remodeling of the popliteal artery is diagnosed.