RU2199743C2 - Method for identifying helicobacter pylori - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves bringing patient saliva drop and crystal-forming substance in contact, holding the preparation for 24 h and examining by means of microscope. Crystal pattern is interpreted in terms of helicobacteriosis development. Dark and light crystallization centers being found on crystallogram, feeble virulence Helicobacter pylori form is considered to be available in upper gastrointestinal tract stock. Up to three dark and light crystallization centers with radial beams emerging from all crystal corners being found, pathogenic Helicobacter pylori form availability is considered to be the case. Three-four crystallization centers with developed radial beam structure being found, chronic process development is to be diagnosed. More than three-four destroyed crystallization centers with radial beam structure being found, Helicobacter pylori exacerbation is to be diagnosed. Randomly arranged radial beams with no crystallization centers being observed, Helicobacter pylori eradication is to be diagnosed. EFFECT: high accuracy of diagnosis method. 5 dwg

Description

 This indirect method for the determination of Helicobacter pylori relates to medicine, in particular to the diagnosis of gastroduodenitis and peptic ulcer of the stomach and duodenum.

There is a direct invasive method for determining Helicobacter pylori - morphological [1]. The principle of the morphological method is based on the fact that during fibrogastroscopy, a biopsy is taken from the mucous membrane of the stomach or duodenum. A histological section is made from the biopsy specimen and stained with acridine orange, toluidine blue, according to Giemsa or Gram. The drug is examined under a microscope in order to diagnose the bacterium Helicobacter pylori. The most significant disadvantages of this method are:
1. The increased probability of false negative results associated with the locality of the selection of diagnostic material, a decrease in the number of Helicobacter pylori after monotherapy with bismuth-containing drugs, metronidazole, antibiotic therapy, proton pump blockers.

 2. The possibility of instrumental infection of the patient.

 3. Discomfort for patients.

 4. Limited use for children and in a number of diseases and conditions.

 5. The method is used to diagnose the eradication of Helicobacter pylori only in conjunction with bacteriological or urease tests.

 6. The high cost of research.

 The purpose of this invention is to increase the efficiency of diagnosis of chronic gastroduodenitis and peptic ulcer of the stomach and duodenum and control the effectiveness of eradication of Helicobacter pylori in the dynamics of treatment.

 The essence of the method is as follows. A drop of a biological substrate (saliva) and a drop of a crystal-forming substance are applied to a glass slide. The drug is kept for 24 hours in a strictly horizontal position at room temperature and normal humidity, away from direct sunlight and heating devices. After exposure, microscopy of the drug is carried out under a light microscope. The presence of Helicobacter pylori is determined by the nature of the crystalline pattern. The population of the mucosa of the upper floor of the gastrointestinal tract with weakly virulent saprophytic forms of Helicobacter pylori is characterized by the presence in the crystallogram of dark and light crystallization centers without radially diverging rays or with one ray (Fig. 1). The presence in the mucosa of the upper floor of the gastrointestinal tract of forms of Helicobacter pylori with pathogenic properties is expressed by the presence in the preparation of up to three crystallization centers (dark or light) with well-developed radial rays emanating from all angles of the crystals (Fig. 2). The development of a chronic process in the upper floor of the gastrointestinal tract without exacerbation is indicated by the presence in the preparation of more than 3-4 dark crystallization centers with a developed structure of radial rays separated by a certain distance from the crystal (Fig. 3). An exacerbation of Helicobacter pylori infection corresponds to the presence of more than 3-4 destroyed crystallization centers with radial rays in the preparation (Fig. 4). Successful treatment (eradication of Helicobacter pylori) corresponds to the preservation of randomly arranged radial rays of various configurations and the absence of crystallization centers (Fig. 5).

The method is as follows. Degrease a glass slide. One drop of saliva and one drop of isotonic sodium chloride (NaCl) solution are applied to it. The drug is kept for 24 hours in a strictly horizontal position at room temperature (20-25 ^o C), humidity 50-70%, away from direct sunlight and heating devices. Microscopy of the preparation is carried out using a Beam light microscope at a magnification of 7x8.

 The proposed method is simple to use, non-invasive, quite accurate, characterized by low labor intensity and does not require large material costs, they can diagnose the condition of the body several times a day without causing inconvenience and harm to the patient. There are no contraindications for the application of the method, preliminary preparation of the patient is not necessary and the technique of taking the biological substrate (saliva) is very simple.

 Example.

 Patient A., 42 years old, was admitted on January 31, 2000 (April 5, 00) to the departmental hospital, st. Gorky-Sorting with a diagnosis of first identified duodenal ulcer, stage of exacerbation, medical history 265 (999). Complaints at admission: intense pain of aching and paroxysmal in the upper abdomen, fasting and nocturnal, relieved by eating or antacids. Decreased appetite, nausea, dryness, bitterness in the mouth, heartburn, bloating, constipation, pain in the heart, weakness. Objectively: the general condition is satisfactory. The physique is correct, asthenic, low nutrition. The skin and visible mucous membranes of normal color, clean. The tongue is densely lined with white coating. Above the lungs, percussion clear pulmonary sound. The respiration in the lungs is vesicular. Heart sounds are clear, rhythmic. Pulse - 72 in 1 minute, blood pressure 120/80 mm Hg. The abdomen is slightly swollen, painful on palpation in the epigastrium, pyloroduodenal zone. Liver 10, 9, 7 cm along the edge of the costal arch, the edge is elastic. Spleen 7x5 cm. Chair with a tendency to constipation. There is no dysuria.

General blood test from 02/01/00 (05/15): Нb - 137 (140) g / l, ESR - 5 (3) mm / h, L - 4.0 (5.8) • 10 ⁹ / _l , E - 4.0 (4.5) • 10 ¹² / _l .

 02/01/00 (15.05) Total protein - 71 (67) g / l, fibrinogen 2.0 (2.5) g / l, urea 3.0 (3.0) mmol / l, AcAT - 0.09 (0.09) μmol / mlh, AlAT - 0.1 (0.67) μmol / mlh, total bilirubin - 12.2 (14.4) μmol / L, direct - 1.1 (3.3) μmol / l, indirect - 11.1 (11.1) μmol / l, amylase - 10.8 (7.6).

 General analysis of urine from 02/01/00 (05/15): specific gravity - 1007 (1010), sugar - neg. , protein - no, epithelium - 0-1 (7-10) in s / sp, L - 0-1 (1-2) in s / sp.

 Diastase - 34 (60.0) mg / s.

 Blood sugar - 4.1 (3.6) mmol / L.

 EFGDS from 02.02.00: The mucosa of the duodenum is hyperemic, edematous. In the bulb of the duodenum 12 on the posterior wall of the ulcer is 0.5x0.5 cm in diameter with an inflammatory shaft.

 EFGDS dated 02.15.00: There is a red scar in the bulb of the duodenum 12 on the back wall.

 EFGDS from 04/07/00: The mucosa of the duodenum is hyperemic, edematous. In the bulb on the back wall of the ulcer is 0.6 x 0.6 cm in diameter with an inflammatory shaft.

 EFGDS from 04/21/00: In the bulb of the duodenum 12 there is a red scar on the back wall.

 Histology from 02.15.00: diffuse antrum gastritis, diffuse duodenitis. H. pylori ++.

 Histology from 04/07/00: diffuse antrum gastritis, diffuse duodenitis. H. pylori ++.

 De-nol test from 02.02.00: H.pylori +++.

 De-nol test from 04/07/00: H.pylori +++.

 Ultrasound of the liver, biliary tract, pancreas from 02/11/00, fibrotic changes in the pancreas.

 Treatment: omeprazole 20 mg 2 times a day, de-nol 120 mg 4 times a day, tetracycline 500 mg 4 times a day, metronidazole 250 mg 4 times a day. The course of treatment is 7 days.

 Saliva crystallography from 02.02.00, (NaCl): Multiple destroyed crystallization centers with radially diverging rays.

 Crystallography of saliva from 02/15/00 (NaCl): Multiple dark and light crystallization centers with radially diverging rays.

 Crystallography from 04/07/00 (NaCl): Multiple destroyed centers of crystallization with radially diverging rays.

 Crystallography from 04/21/00 (NaCl): Multiple dark and light crystallization centers with radially diverging rays.

 The dynamics of treatment is positive.

 The patient recovered and was discharged from the hospital on 02.21.00 (04.29.00).

 Histology from 05/28/00: superficial antral gastritis, duodenitis of 1 degree. H. pylori -.

 De-nol test from 05/28/00: H.pylori -.

 Crystallography of 05/28/00 (NaCl): Irregular radially diverging rays.

Sourse of information
1. V.T. Ivashkin, F. Megro, T.L. Lapina "Helicobacter pylori: a revolution in gastroenterology." Moscow. Publishing house "Triad-X". 1999 year.

Claims (1)

 A method for determining helicobacteriosis by microscopic examination of biological material, characterized in that the patient’s saliva is examined in the dynamics of treatment by adding a drop of a crystal-forming substance in a droplet of saliva, the resulting preparation is kept for 24 hours in a horizontal position at room temperature, normal humidity, away from direct sunlight and heating devices and examined under a microscope, while the presence in the crystallogram of dark and light crystallization centers determine the presence in the mucosa of the upper floor of the gastrointestinal tract of weakly virulent Helicobacter pylori, by the presence of up to three dark or light crystallization centers with radial rays from all angles of the crystals - the presence of pathogenic forms of Helicobacter pylori, with more than 3-4 crystallization centers with a developed radial structure rays determine the development of the chronic process, by the presence of more than 3-4 destroyed crystallization centers with radial rays - exacerbation of Helicobacter pylori infection, by the presence of random radial rays and the absence of c crystallization centers - eradication of Helicobacter pylori.

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