RU2187109C2 - Method for determining metabolic disorders - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method includes the selection of expired air samples, then this air is supplied to a sensor to determine alterations in sensor's values. It is necessary to selectively measure the concentration of gases peculiar to only one of broken metabolic types: NH₃ - at protein exchange disorders, CH₄ - at lipid exchange disorders, HCHO at carbohydrate exchange disorders and by the values' set it is possible to conclude on metabolic disorders. The method suggested is simple and convenient in usage. EFFECT: higher efficiency of determination. 1 cl, 1 tbl, 3 ex

Description

 The invention relates to medicine and can be used for rapid diagnosis of the degree of metabolic disorders in the body.

 It is known that in the exhaled air of a healthy person there are about 150 microimpurities of various gases, and when metabolic disorders occur, the Krebs cycle is disturbed and the concentration (microimpurities) of individual gases increases sharply. Violation of the Krebs cycle occurs in various diseases: for diabetes, all types of metabolism are disturbed, primarily carbohydrate and fat (lipid), which leads to ketosis and an increase in the content of acetone in the blood, urine and expired air, and in violation of protein metabolism - to increase the ammonia content (V.V. Potemkin. Endocrinology. M: Medicine, 1987. - P.223-227).

 A known method for assessing metabolic processes in the body by the presence of alcohol vapor in exhaled air. The method includes taking a sample of exhaled air, supplying it to the sensor and determining the state of the sensor (USSR Author's Certificate 252590).

 The method is not sensitive enough, and to increase the sensitivity, a sorbent has been introduced into it, selectively adsorbing only alcohol vapor.

 There is a method of assessing metabolism in the body, including sampling exhaled air, supplying it to a gas analyzer, which determines the amount of carbon dioxide exhaled and the amount of oxygen absorbed, which determine the respiratory coefficient (Dictionary of physiology and pathophysiology of respiration, Kiev: Naukova Dumka, 1984 . - 112 p.).

 The disadvantage of this method is its complexity and overall complexity, because to determine the proportion of carbon dioxide and oxygen involved in the carbon-lipid metabolism of the body, it is necessary to determine the nitrogen content in the urine and feces, which are used to calculate the amount of carbon dioxide produced during the breakdown of proteins and the amount of oxygen consumed for their oxidation, and subtract these values from the total gas exchange. However, trace gases have small concentration values and their measurement presents certain difficulties. Complex and expensive photocalorimetric and gas chromatographic methods are used for their separate determination, and the available adsorption optical gas analyzers for hydrocarbons and carbon dioxide have limited selectivity and high cost.

 There is a method of assessing a person’s condition (intoxication) by the presence of alcohol vapor in exhaled air, where the state of the body is assessed by the integral indicator of trace amounts of combustible gases. The method does not allow differentially determining the type of impaired metabolism (Technical description and operating instructions for the Alkotest device, approved by NIISPETSTECHNIKA of the Ministry of Internal Affairs of the Russian Federation, manufactured by META, 1999).

 The objective of the invention is to simplify and reduce the cost of the method for determining the degree of metabolic disorders.

The problem is solved in that in the method for determining metabolism, including sampling exhaled air, supplying it to the sensor and determining the change in the state of the sensor, selectively measure the concentration of gases inherent in only one of the types of impaired metabolism: NH ₃ - in violation of protein metabolism, CH ₄ - in case of lipid disorder, HCNO - in case of carbohydrate disturbance, and the state of the body is judged by the totality of these indicators.

 When analyzing the products of metabolism in exhaled air in healthy people (200 men aged 21-31 years), the results are presented in the table (Problems of space biology. - T. 42. - 1980. - P.13).

To simplify the method of measuring and using it by medical staff, as well as at home to monitor treatment, for example, diabetes mellitus, the authors propose to divide trace gases into 3 groups characterizing metabolic disturbance:
1st group of trace gases - aldehydes, ketones, alcohols, methyl ketones - violation of carbohydrate metabolism;
2nd group of gases - ammonia, dimethylamine - protein metabolism;
3rd group of gases - hydrocarbons, CO, fatty acids, ketones, methyl ethyl ketone - lipid metabolism disorder.

 The authors suggest taking the concentration of the gas involved only in the type of metabolism of interest as an indicator in determining metabolic disorders. So, for example, the content of ketones is increased in case of violation of all types of metabolism and therefore cannot be used to determine the violation of one of the exchanges. The concentration of aldehydes and alcohols is increased only with a violation of carbohydrate and protein metabolism, and an increase in the concentration of hydrocarbons occurs with a violation of lipid metabolism.

 It must be borne in mind that fasting, temperature and humidity of the environment have a noticeable effect on the composition of exhaled air in healthy people. At high values of temperature and humidity, the concentration of acetone and ammonia in exhaled air will be increased by 1.5-2 times compared with indicators in normal conditions. The concentration of alcohols and aldehydes will decrease by the same amount. Therefore, these features should be taken into account when assessing the state of metabolism in the body.

When measuring metabolic disorders, a selective sensor type was used: NH ₃ - in determining metabolic disturbances; CH ₄ - in determining the violation of lipid metabolism; HCNO - with a violation of carbohydrate. As a sampling device, a glass syringe and a container were used to prepare homogeneous mixtures of the analyzed air with clean air.

 EXAMPLE. Patient S., 37 years old, was treated in the endocrinology department of the clinical hospital 5 of Omsk from 06/17/99 to 07/05/99. Diagnosis: type I diabetes mellitus, ketosis, polyneuropathy. Received complaints of thirst, weakness, pain in the legs, polyuria. Sick for over 17 years. During the examination, blood sugar during the day ranged from 10-17 mmol / l, acetone in urine was positive on test strips from Boehringer Mannheim, and sugar in urine was 3%. A blood test - without features. The fundus is angiopathy of the first degree.

When researching the proposed method, the following results were obtained: the concentration of NH ₃ in the range of 5-10 mg / m ³ , HCNO in the range of 15 to 20 mg / m ³ , CH ₄ from 7 to 10 mg / m ³ . As follows from the results, all types of metabolism are impaired. Particularly large deviations in carbohydrate metabolism.

 EXAMPLE. Patient D., 58 years old, was treated in the gastroenterological department of the clinical hospital 5 of Omsk from 03.23.99 to 04.16.99. Diagnosis: chronic gastritis with reduced secretion, II degree dysbiosis, biliary dyskinesia, sick for 28 years. Complaints of a feeling of heaviness in the epigastric region of the abdomen. Pain in the right hypochondrium, weakness. A blood test, urine test - without much change. Fecal analysis - undigested muscle fibers, dysbiosis. Ultrasound - signs of cholecystitis. There is no acetone in the urine.

When researching the proposed method, the following concentration data were obtained, mg / m ³ : NH ₃ from 1 to 2, HCNO from 0.05 to 0.3, CH ₄ from 5 to 15. Based on the data obtained, lipid metabolism disturbance can be judged.

EXAMPLE. Student L., 23 years old. There are no complaints. Is healthy. An objective laboratory study revealed no changes in the organs. When examining the proposed method, the following results were obtained, mg / m ³ : NH ₃ in the range from 1 to 2, HCNO in the range from 0.03 to 0.25, CH ₄ from 0.7 to 1.5. As follows from the data, an analysis of deviations in metabolism has not been identified.

 The proposed method for determining the degree of metabolic disorders is simple, convenient to use and will be widely used in medicine.

Claims (1)

A method for determining metabolic disorders, including sampling exhaled air, supplying it to a sensor and measuring sensor performance, characterized in that it selectively measures the concentration of gas inherent in only one of the types of metabolic disorders: ammonia (NH ₃ ) - in case of protein, methane ( CH ₄ ) (hydrocarbons) - in violation of lipid, aldehydes (HCNO) - in violation of carbohydrate, and when the sensor readings on the content of trace elements of methane (CH ₄ )> 2.5 mg / m ³ , ammonia (NH ₃ )> 2.0 mg / m ³ , aldehydes (HCNO)> 0.32 mg / m ³ judge violation of exchange of substances.

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