SU1497572A1 - Method of predicting the course of myocardial infarction - Google Patents

Abstract

This invention relates to medicine. The aim of the invention is to improve the accuracy of prediction of the course of myocardial infarction. The essence of the method lies in the fact that for 12-48 hours after the onset of the disease, immune complexes are determined in the patient's serum and at their level less than 0.2 used units. predict an unfavorable course of the disease. The reliability of the method exceeds 95%; it allows, taking into account the prognosis of the possible outcome of the disease, to choose the optimal tactics of management and treatment of patients with myocardial infarction. It is recommended for use in cardiology and cardio-resuscitation departments.

Description

The invention relates to medicine, namely to prognostic methods, and can be used in clinical practice to predict the course of myocardial infarction.

The purpose of the invention is to improve the accuracy of prediction of myocardial infarction.

Example 1, Patient K., 69 years old, was admitted to the hospital with complaints of squeezing pain behind the sternum, sabatism, sweating. During 5 years, the patient had increased blood pressure. Pain in the heart during exercise was disturbed for about 1 year. On the day of admission, early in the morning, the patient suddenly

There were dull, constricting pains behind the sternum, accompanied by weakness, sweating. The pain did not go away after taking 4 nitroglycerin tablets. The duration of the pain syndrome is more than 30 minutes. After the administration of narcotic analgesics, the pain somewhat decreased, the patient was hospitalized. On admission, the state of the ballast is average, the consciousness is clear, the skin is pale, warm, the temperature is 37 ° C, the number of heartbeats is 88 beats per minute, the tachycardia is insignificant, the arterial pressure is 150/100 mm Hg. Art. There are no signs of congestive heart failure. ECG sinus rhythm, rise

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On the first day of spraying, the level of circulating complexes of their complexes was determined by a patient; for this, EI blood was collected in centrifuge tubes (5-7 ml), then placed in a thermostat for 30 missions. Sucked 0 |, 3 Nm plas); 2.7 ml of laboratory buffer with a pH of 8.4 and /4 ml of 5% polyethylene glycol was added to the plasma (after dilution, the concentration of polyethylene glycol was 3.5%) This mixture was left at: + 4 ° C for 18 h. Then the mixture was centrifuged for tHH 30 at 3000 rpm. After four weeks, the supernatant portion and the c (the cage was added 2.7 ml of 0.1 N, dissolved aaOH, Then the immuno-magnetic magneto was spectrophotometrized with a fguine of 280 nm. The results were expressed in units of the density of | ata “which were determined on a scale on a (spectrophotometer, level of circulating immunity) x complexes was 0.110.

After 3 days, the patient's condition (thawing worsened, anginal seizures recurred, accompanied by asthma, weakness, reduction of abnormal pressure to 100/70 mm Hg | Heart rate is 100 gifts per 1 minute, insignificant ones were observed with signs of congestive heart failure. On the ECG danamic tpaHCMypanbHoro of the anterolateral myocardial infractor. There was no loss of consciousness of self-reliance and effective cardiac activity. Death stated

; Pathogenetic diagnosis; (rstryny transmurally myocardial infarction of the anterolateral wall of the left gastrointestinal tract; Ludochka and interventricular mutations; Partition of interventricular septum; licH, Atherosclerosis of the aorta, heart vessels, Atherosclerotic cardiosclerosis. was predicting the possibility of death, i.

PRI me R 2, Sick X., 72 years old, was admitted to the clinic with complaints of severe tearing pains in the lower third of the sternum, weakness, sweating, and a sense of lack of air.

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For 7 years, the patient had high blood pressure, 3 years was worried about pain in the heart area during physical exertion and with a significant increase in blood pressure. On the morning of the day of admission, a strong bolt suddenly appeared in the region of the heart, not. nitroglycerin intake by nadashka, weakness j due to which the patient is hospitalized, On admission the condition is as follows: skin, skin number 1, pale, moist, cyanosis tooth, number of respiratory movements 24 per minute, breathing hard in the lungs} left and right in the posterior non-lateral regions below the angle of the scapula, non-sound wet rales The borders of the heart are extended to the left. Heart sounds are deaf, arrhythmic, extrasystoles 1-2 in miuta, heart rate 136 beats in # 1nut | blood pressure 180 / SHO mm Hg, Art. The abdomen is soft and painless. The liver at the costal arch is painless. There is no edema. On the ECG, signs of the acute phase of myocardial .. r-iocardium, early ventricular extrasystoles. The activity of cardiopathogenic enzymes in the short course is increased by

When determining the circulating concentration of immune complexes following the example, the indicator was Oji67,

In the future, the mi e ball point state continued to deteriorate; pronounced anginal seizures recurred, the body temperature rose to, group supraventricular extrasystoles appeared, congestion in the lungs increased. During the day, coarse systolic murmur with a maximum above the lower third of the sternum was detected in the patient during auscultation. Blood pressure decreased to 100/60. 1 PMM rTo. Heart rate 150 beats / min. On the 5th day of the ball, fainted, self-sufficient breathing and effective heart activity were absent. Resuscitation without effect, death was stated,

Pathology Anatomical diagnosis: acute transmural myocardial infarction and interventricular septum and anterior wall of the left ventricle, acute aneurysm of the anterior wall at the apex, and tears in the myocardium of the interventricular septum. Congestion of internal HSix organs.

Example 3, Patient P., 47 years old, was admitted for treatment in the cardiology ward with a diagnosis of acute transmural anterior-lateral myocardial infarction, episthenocarditis of pericarditis 5, aneurysm of the left ventricle, 3.5 hours after the onset of an anginal attack, stopped by narcotic analgesics.

On admission to the ECG, signs of transmural anterolateral myocardial infarction, in the blood test 14,000 leukocytes, ESR - 17 mm / h, CK 2.4, ACT 395, ANT 417, the level of circulating immune complexes, determined in the first day of 0.205, which indicated a favorable prognosis despite the extensiveness of myocardial damage and signs of a massive necrotic process.

The prognosis was confirmed, the patient was discharged on the 38th day in a satisfactory condition,

The proposed method allows to predict the outcome of myocardial infarction in the early period regardless of

electrocardiographic card. hl:; - infarction and viral rhythm disturbance and instability, it is cheap, is performed on standard serial equipment and can be carried out by a medium pedal or laboratory assistant. The reliability of the prognosis of infarction 1 "{okarda exceeds. 95%, the method allows, taking into account the prognosis of the possible course of the disease, to choose the optimal tactics for the management and treatment of patients with myocardial infarction,

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Claims (1)

Claims A method for predicting the course of a heart attack infarction by examining a patient's blood, characterized in that, in order to increase the accuracy of the method, the serum levels of the circulating immune complexes are measured spectrally at 12-48 hours after the onset of the disease and at levels below 0 , 2 lips, units, predict an unfavorable course of the disease.