RU2020126704A - A method for determining the likelihood of tuberculosis, in contrast to pneumonia, according to five clinical signs - Google Patents

A method for determining the likelihood of tuberculosis, in contrast to pneumonia, according to five clinical signs Download PDF

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RU2020126704A
RU2020126704A RU2020126704A RU2020126704A RU2020126704A RU 2020126704 A RU2020126704 A RU 2020126704A RU 2020126704 A RU2020126704 A RU 2020126704A RU 2020126704 A RU2020126704 A RU 2020126704A RU 2020126704 A RU2020126704 A RU 2020126704A
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tuberculosis
patient
pneumonia
weight loss
clinical signs
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RU2020126704A
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Russian (ru)
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Владислав Семёнович Боровицкий
Лев Михайлович Железнов
Максим Петрович Разин
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Федеральное государственное бюджетное образовательное учреждение высшего образования "Кировский государственный медицинский университет" Министерства здравоохранения Российской Федерации (ФГБОУ ВО Кировский ГМУ Минздрава России)
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Способ определения вероятности туберкулеза в отличие от пневмонии при поступлении в стационар по ограниченному числу клинических проявлений заключается в использовании ряда клинических признаков включающих наличие сочетания признаков, отличающийся тем, что в качестве клинических признаков используются следующие клинические признаки: боль в грудной клетке (Б), контакт с больным туберкулезом (К), кровохаркание (К1), острое начало заболевания (О), похудание (П), при этом при наличии или отсутствии признака ему присваивается значение 1 или 0 с последующим вычислением по формуле, то есть каждому признаку придается установленное экспериментальным путем весовое значение в виде произведения постоянного коэффициента на 1 или 0:A method for determining the likelihood of tuberculosis, in contrast to pneumonia, upon admission to a hospital for a limited number of clinical manifestations, is to use a number of clinical signs, including the presence of a combination of signs, characterized in that the following clinical signs are used as clinical signs: chest pain (B), contact with a patient with tuberculosis (K), hemoptysis (K1), acute onset of the disease (O), weight loss (P), while in the presence or absence of a sign, it is assigned a value of 1 or 0, followed by calculation according to the formula, that is, each sign is given the experimentally established by a weight value as a product of a constant factor by 1 or 0: (-1,62709) при наличии боли в грудной клетке=1, отсутствии=0;(-1.62709) with chest pain=1, no=0; (-1,22670) при наличии контакта с больным туберкулезом-1, отсутствии=0;(-1.22670) in the presence of contact with a patient with tuberculosis-1, absence=0; (2,31381) при наличии кровохаркания=1, отсутствии=0;(2.31381) in the presence of hemoptysis=1, absence=0; (-6,45162) при наличии острого начала заболевания=1, отсутствии=0;(-6.45162) in the presence of an acute onset of the disease=1, no=0; (3,12576) при наличии похудания=1, отсутствии=0;(3.12576) with weight loss=1, no weight loss=0; и суммируется с константой, равной (3,68156) с последующим вычислением по формуле:and summed up with a constant equal to (3.68156) with subsequent calculation by the formula:
Figure 00000001
где е - основание натурального логарифма = 2,71828947,
Figure 00000001
where e is the base of the natural logarithm = 2.71828947,
z - сумма численных значений каждого из признаков,z - the sum of the numerical values of each of the signs,
Figure 00000002
Figure 00000002
где «Б» - боль в грудной клетке, «К» - контакт с больным туберкулезом, «К1» - кровохаркание, «О» - острое начало заболевания, «П» - похудание, по полученному значению вероятности делается вывод о наличии туберкулеза в отличие от пневмонии, то есть проводиться дифференциальная диагностика туберкулеза и пневмонии, при значении вероятности туберкулеза выше 50%, пациента необходимо госпитализировать в специализированное туберкулезное отделение и дообследовать, при значении вероятности ниже 50% больного госпитализируют в стационар пульмонологического профиля.where "B" - chest pain, "K" - contact with a patient with tuberculosis, "K1" - hemoptysis, "O" - acute onset of the disease, "P" - weight loss, according to the obtained probability value, a conclusion is made about the presence of tuberculosis, in contrast from pneumonia, that is, a differential diagnosis of tuberculosis and pneumonia is carried out, if the probability of tuberculosis is above 50%, the patient must be hospitalized in a specialized tuberculosis department and additionally examined, if the probability is below 50%, the patient is hospitalized in a pulmonological hospital.
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