RU2226689C2 - Method for determining organism resistibility - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves carrying out formed peripheral blood element composition examination with weighting coefficient (K₁-K_n) being introduced for formed blood elements leukocytes and lymphocytes from common use standard blood analysis in individual way for each patient. Integral blood index (IBI) is built as IBI = K₁•K₂•... ...K_i•... ...•K_n, where K_i = (1-α_i)•β_i for leukocytes, where β_i= 0.55-0.65; and K_i = α_i•β_i, for lymphocytes, where β_i=0.20-0.30 and α_i = X_i/ПН_i, where X_i is the particular value of a formed element, ПН_i is the norm value of the same formed element. α_i = (X_i/ПН_i)^-1 is applied to leukocyte case under X_i>ПН_i condition. IBI value being greater than 1.0, organism resistibility is considered to be high. IBI value being lower than 1.0 and greater than 0.6, organism resistibility is considered to be low. IBI value being lower than 0.6, risk zone is considered to be the case. EFFECT: high accuracy of the method.

Description

The present invention relates to medicine, in particular for determining the body's resistance based on the counting of blood cells.

A known method for diagnosing the adaptive stress response (application No. 98103973/14 of 02.12.99, Russia), in which first they are exposed to laser radiation, and then the formed elements of the blood are analyzed. At the same time, a histogram of leukocytes is built and the adaptive stress response is diagnosed by the numerical value of the excess.

The disadvantages of the method are that only white blood cells are analyzed, which significantly limits the amount of information received and the diagnostic ability to assess the body's resistance.

The known method [6127184, October 3, 2000 "Calibration of a whole blood sample analyzer", USA] analysis of the formed elements of whole blood or another sample of biological fluid using an optical slit analyzer, which is an optical scanning tool. The width of the spectrum (gap) of the analyzer is set in accordance with the function of the emission signal passing through the stained plasma. The emission signal in this case is the result of the fluorescence of the sample or the density of the sample. Particle sizes can be represented as a function of attenuation of signal emission due to the uniform elements of whole blood.

The scanning instrument is calibrated by testing with a known blood sample. Such a calibration is needed in order to establish the level of the emission signal, to obtain a correlation between the signal and the upcoming measurements at standard volumes. Instrumental recording of information from the calibrated measurement area is carried out and then it is processed. Thus, as a result of the analysis, data are obtained on the bulk density of blood cells per standard unit of a blood or fluid sample.

The disadvantages of the method are that by the density of the formed elements of the blood it is not possible to assess the condition of the body and, moreover, its resistance.

There is a method of evaluating the increase in body resistance by the percentage of lymphocytes in the leukocyte formula and their ratio with segmented neutrophils [Increasing the body's resistance using adaptive training and activation reactions at different levels of body reactivity. Guidelines. - Rostov-on-Don, 1982, 13 pp.]. The remaining white blood cells and the total number of leukocytes were only additional signs of reactions. At the same time, it was possible to differentiate the reactions of training, activation, acute stress, chronic stress, reactivation and inferiority of the reaction.

The disadvantages of the method are that in assessing the significance of the reaction, attention is drawn to the quantitative values of lymphocytes, white blood cells, neutrophils, eosinophils and monocytes. Moreover, a number of indicators may not coincide with the values indicated for the norm in each reaction.

The prototype of the invention is a method for assessing nonspecific resistance of the body [Lopatin V.F., Bizer V.A., Key V.E. Nonspecific resistance in preoperative chemoradiotherapy and UHF hyperthermia of osteogenic sarcoma // Medical Radiology, 1989, No. 1, p. 46-49]. The essence of the method lies in the fact that the nonspecific reaction of the body is determined by the ratio of the formed elements of the blood in the leukocyte formula and the total number of peripheral blood leukocytes. The reserve function of the whole organism was conditionally evaluated in terms of resistance: chronic stress - 0 points (zero resistance), training and activation reactions with tension elements - 0.5 points, training reaction - 1 point, activation reaction - 2 points, etc. Clinical experience has confirmed the appropriateness of using such an assessment of the state of the body to increase the effectiveness of complex treatment of patients.

The disadvantage of the prototype is the subjectivity of scoring, which leads to a distortion of the result. In addition, not all blood cells take part in the final assessment of the state of the body.

Our invention allows us to eliminate identified shortcomings in previous developments and introduce objective evaluation criteria.

The essence of the invention lies in the fact that to assess the resistance of the body, as in the prototype, use shaped elements of peripheral blood.

At the same time, at the beginning of each examination, their weight coefficients are determined, and then the integral blood index (IPC) is set equal to the product of the weight coefficients and when IPC> 1.0 is characterized as the zone of increased resistance (adaptive reaction) of the body, 0.6 <IPC <1.0 - a zone of reduced body resistance and with an IPC <0.6 risk zone. If the patient enters the risk zone, appropriate medical measures are carried out to increase the body's resistance.

Examples of the method.

The technological approach for determining the IPC in the proposed method is general and we select it in an independent section. In this case, the IPC is set in the form of a product:

where K _i are the weights of peripheral blood elements, which are determined from a standard general blood test individually for each patient. Wherein

set for white blood cells, red blood cells and monocytes. For other blood elements

where x _i is the specific value of the peripheral blood element, PN _i is the norm indicator for the same blood element.

In addition, α _i = (x _i / PN _i ) ^-1 - for leukocytes with x _i > PN _i . For all elements α _i = 1 with x _i = ПН _i ; β _i <1,0 is a correction factor characterizing the significance of the blood parameter (determined empirically depending on the condition of the patient). For example, for white blood cells β _i = 0.55-0.65, for lymphocytes β _i = 0.20-0.30, etc.

Coefficients are set individually for each element of the blood formula.

In general, the IPC reflects the level of body resistance at the time of taking blood from the patient’s finger and allows you to observe a change in resistance in the dynamics during and after treatment, without resorting to complex and expensive methods that take time, for example, more than a day.

When using the program embedded in the computer, the IPC is determined in a matter of minutes, since it is only necessary to enter the indicators x _i from the general blood test of the patient.

Clinical implementation of the method.

EXAMPLE 1

Patient K., 10 years old. Medical history No. 2650-85.

Received September 4, 1985; issued on October 30, 85.

Clinical and radiological diagnosis: osteogenic sarcoma of the lower third of the right femur. Confirmed by morphological data.

Thermoradiation therapy was performed - SOD 36 Gy + UHF-hyperthermia (4 sessions of 60 min each) + adriamycin - 400 mg

upon receipt of the IPC = 1.16 (09/05/85).

before discharge IPC = 0.75.

Alive for more than 12 years. Operations are not. Relapse - no. No metastases.

EXAMPLE 2

Patient T. 10 years. The medical history No. 1997-84.

Received June 21, 84. Discharged 08/03/84.

Clinical and radiological diagnosis: osteogenic sarcoma of the lower third of the left femur. Confirmed by morphological data.

Thermoradiation therapy was performed - SOD 36 Gy + UHF-hyperthermia (4 sessions of 60 min each) + adriablastin 120 mg.

Upon receipt of the IPC = 0.90 (06.22.84).

Before discharge, IPC = 0.73.

Alive for more than 10 years. Relapse after 7 years.

EXAMPLE 3

Patient I. 15 years. Medical history No. 1685-81.

Received June 17, 81; discharged August 4, 81.

Clinical and radiological diagnosis: osteogenic sarcoma of the lower third of the left tibia. Confirmed by morphological data.

Thermoradiation therapy was performed - SOD 84 Gy + UHF-hyperthermia (4 sessions of 60 min each) + adriamycin - 400 mg. 07/13/84 (?)

Upon receipt of the IPC = 0.88 (06/11/81).

Before discharge, IPC = 0.66.

Life expectancy 2 years. Operation - amputation - 04/28/82. Pulmonary metastases - 08/14/82.

EXAMPLE 4

Patient O. 13 years old. Medical history No. 3753-86.

Received November 27, 86, discharged January 9, 87.

Clinical and radiological diagnosis: osteogenic sarcoma of the right tibia. Confirmed by morphological data.

Thermoradiation therapy was performed - SOD 36 Gy + UHF-hyperthermia (4 sessions of 60 min each) + polychemotherapy,

Upon receipt of the IPC = 0.98 (11/28/86).

Before discharge, IPC = 0.22.

Life expectancy 10 months. Operation - amputation - 05.06.86. Metastases in the lungs 08/17/87.

The social significance of body resistance was studied in 259 cancer patients. Of these: osteogenic sarcoma of the tubular bones of the lower extremities - 68 patients, larynx cancer - 48 patients, cancer of the oral cavity and oropharynx in 143 patients. From our data it follows that IPC decreases by the end of treatment by 24-49% for all damaging effects on the tumor and the body as a whole (for example, radiation and chemo-radiation therapy). Subjectively, patients with a higher resistance to IPC> 1.0 feel better than patients with an average level of resistance. Therefore, at the end of treatment, the higher the IPC, the higher the survival rate of patients. By increasing the resistance of their body or keeping it at a relatively high level, we reduce the likelihood of relapses and metastases and, accordingly, increase the likelihood of a cure for the patient. Patients with an IPC <0.6 are, as a rule, difficult patients and the probability of their survival is very low. Nevertheless, among patients who received thermotherapy, the survival rate was significantly higher than only after radiation therapy.

IPC is no less important prognostic value than the degree of tumor damage and the severity of its regression in the middle and at the end of a course of complex treatment. Moreover, an operational assessment of the body's resistance allows timely adjustment of the patient’s treatment tactics. Ways to increase the body's resistance are known. However, in practical medicine they have not yet become widespread.

Claims (1)

A method for determining the body's resistance in cancer patients by analyzing the formed elements of peripheral blood, characterized in that they determine the weight coefficients (K ₁ ÷ K _n ) for the formed elements of the blood of leukocytes and lymphocytes from a standard general blood test individually for each patient, then set the integral blood indicator (IPC) as the product of IPC = K ₁ · K ₂ · ...... K _i · ...... · K _n , where K _i = (1-α _i ) · β _i for white blood cells, where β _i = 0,55-0,65, and lymphocytes K _i = α _i · β _i, where β _i = 0,20-0,30, where α _i = X _i / PN _i, where X _i - s specific Achen shaped element Mo _i - rate rules for the same blood cell, and for leukocyte α _i = (X _i / PN _i) ^-1 at X _{i> i} and Mo at a value greater than 1.0 PKI determine resistance to both increased, when the value of the IPC is less than 1.0 and more than 0.6 - as a reduced resistance of the body, and when the value of the IPC is less than 0.6 is defined as the risk zone.