RU2426127C1 - Method of critical adaptability appraisal in adolescents - Google Patents

Abstract

FIELD: medicine. ^ SUBSTANCE: integrated diagnostic study involves typing, specifying a vegetative tone and adaptability of a cardiovascular system that is followed by determining an erythrocyte rate and making an integral estimate of the adaptability status in critical ontogenesis in the table of prognostic Cubalt coefficients. ^ EFFECT: use of the method allows evaluating the informative quantitative health and adaptability criteria in critical ontogenesis of the main systems - locomotor, cardiovascular, haematopoietic. ^ 2 tbl, 2 ex

Description

FIELD OF THE INVENTION

The invention relates to medicine, in particular to methods for assessing the adaptive capabilities of an organism in critical periods of ontogenesis in adolescents, and can be used in assessing the state of an organism: health, adaptation, and state of intense adaptation during critical periods of ontogenesis.

State of the art

There is a method of assessing the condition of the musculoskeletal, cardiovascular and respiratory systems of a child by measuring the electrocardiogram, blood pressure, temperature, linear and circumferential dimensions of the body, while the child determines the linear and circumferential dimensions of the body to the right and left, chest circumference during inspiration, pause and exhale, the temperature in the armpit of the right and left, in the oral cavity and in the rectum, record the electrocardiogram in the second standard lead, measure blood pressure on the right and left, determine t the numerical indicators of symmetry according to the "golden section" (S) and "wurf" (W) formulas, which are constant in a healthy body at rest (S = 0.618, W = 1.309), calculate the percentage of deviations in symmetry from these constants, and at deviation of the “wurf” in the musculoskeletal, cardiovascular and respiratory systems up to 3% (1,270-1,348), the state is assessed as adaptation, from 3 to 5% (1,244-1,270; 1,348-1,375) - intense adaptation; the “wurf” deviation at a temperature of up to 0.5% (1.303-1.316) corresponds to the adaptation process, from 0.5 to 1% (1.296-1.3003; 1.316-1.322) - intense adaptation; deviation of the "golden section" in the musculoskeletal, cardiovascular and respiratory systems up to 5% (0.587-0.649) is assessed as adaptation, from 5 to 7% (0.575-0.587; 0.649-0.661) - intense adaptation (see US Pat. RU No. 2143219, IPC A61B 5/00, publ. 12/27/1999).

The disadvantages of this method are its complexity and the need for special equipment.

There is a method of assessing the state of health, the adaptive capabilities of systems and the whole organism in various critical periods of ontogenesis. The Baevsky PM index is widely used, which characterizes the tension of the body's compensatory mechanisms, calculated by the indicators of variational pulsometry (see Baevsky PM Assessment of the body's adaptive capabilities and the risk of developing diseases) / PM Baevsky, AP Berseneva. - M .: Medicine, 1997. - 236 s).

The disadvantage of this method is that there is an assessment of the adaptive capabilities of one or two systems, and not the whole organism.

A known method in which to assess the adaptive capabilities of the circulatory system was proposed index of functional changes (IFI) - a combination of indicators of anthropometry, heart rate and blood pressure (see Agadzhanyan N.A. Actual problems of adaptive, environmental and rehabilitation medicine / Ed. N. A. Agadzhanyan, V.V. Uyba, M.P. Kulikova, A.V. Kochetkova. - M.: Medica, 2006 .-- 208 s).

This method of assessing the state of health and adaptation of the body is described by a combination of clinical signs and laboratory parameters: signs of full-term and level of immunoglobulins, physiological reflexes and the level of blood bilirubin; by a comprehensive laboratory examination: rheological characteristics of peripheral blood, morphological and functional indicators of red blood cells.

With such approaches, an assessment is made of the adaptive capabilities of one or two systems, and not of the whole organism.

A known method for assessing the adaptive capabilities of the body in adolescents, including the study of two conjugate functions that reflect the adaptive effect of the cardiovascular system using the methodology for calculating the index of functional stress (IFN) according to the formula IFN = √ (x-100) ² / a ² + (y- 100) ² / in ² , where "x" and "y" are the actual values of two conjugate, dependent on each other functions, expressed as% of average values,

"a" - doubled the standard deviation of the function "x" of healthy adolescents, expressed in% of average values,

“c” - twice the standard deviation of the function “y” in healthy adolescents, expressed in% of the average values, followed by an assessment of adaptive abilities using classification with a certain number of adaptation stages, while the indicators of spectral analysis of heart rate variability LF are used as two conjugate functions / HF, where LF is the power of low frequencies (ms ² ), HF is the power of high frequencies (ms ² ) and PVLF, where PVLF is the fraction of very low frequencies (%), and when calculating IFN, the actual value of PVLF is taken as “x” ( in% of rare), and for "y" take the actual value of LF / HF (in% of the average), for "a" - twice the standard deviation of the PVLF of healthy adolescents (% of the average), for "в" - the mean of the standard deviation of LF / IF healthy adolescents (in% of the average) and when assessing adaptive capabilities, a classification is used that includes 10 stages of adaptation.

In the method, the assessment of adaptive capabilities is carried out according to the classification with the following ten stages of adaptation:

with IFN values = 0.0-2.0 and PVLF = M _PVLF ± 2m _PVLF and LF / HF = M _{LF / HF} ± 2m _{LF / HF} - the stage of optimal adaptation,

with IFN values = 0.0-1.0 and PVLF> M _PVLF -2m _PVLF and LF / HF> M _{LF / HF} -2m _{LF / HF} , except when PVLF = M _PVLF ± 2m _PVLF , and LF / HF = M _{LF / HF} ± 2m _{LF / HF} - stage of physiologically adequate stress response,

with IFN values = 1.01-2.0 and PVLF> M _PVLF -2m _PVLF and LF / HF> M _{LF / HF} -2m _{LF / HF} values, except when PVLF = M _PVLF ± 2m _PVLF , and LF / HF = M _{LF / HF} ± 2m _{LF / HF} - stage of a stress reaction with a risk of transition to a pathological

with IFN values> 2.0 and PVLF> M _PVLF -2m _PVLF and LF / HF> M _{LF / HF} -2m _{LF / HF} , except when PVLF = M _PVLF ± 2m _PVLF , and LF / HF = M _{LF / HF} ± 2m _{LF / HF} - stage of "excessive" or pathological stress reaction,

at any IFN values and PVLF> M _PVLF -2m _PVLF and LF / HF <M _{LF / HF} -2m _{LF / HF} - the stage of transition to long-term adaptation,

if IFN = 0.0-2.0 and PVLF <M _PVLF -2m _PVLF and LF / HF <M _{LF / HF} + 2m _{LF / HF} - stage of long-term adaptation with positive cross-resistance,

with IFN values> 2.0 and PVLF <M _PVLF -2m _PVLF and LF / HF≤M _{LF / HF} + 2m _{LF / HF} - stage of long-term adaptation with negative cross-resistance,

if IFN = 0.0-1.0 and PVLF <M _PVLF -2m _PVLF and LF / HF> M _{LF / HF} + 2m _{LF / HF} - stage of exhaustion with reversible functional impairment,

with IFN values = 1.01-2.0 and PVLF <M _PVLF -2m _PVLF and LF / HF> M _{LF / HF} + 2m _{LF / HF} - the risk stage of formation of “true” depletion, with IFN values> 2 and PVLF < M _PVLF -2m _PVLF and LF / HF> M _{LF / HF} + 2m _{LF / HF} - the stage of "true" depletion,

where M _PVLF is the average PVLF of healthy adolescents, m _PVLF is the error of the mean PVLF.

M _{LF / HF} is the average LF / HF value of healthy adolescents, m _{LF / HF} is the error of the average LF / HF value (see Pat. RU No. 2344749, IPC A61B 5/00, published on January 27, 2009).

The disadvantages of this method of assessment are the complexity of its implementation, the low quality of clinical diagnosis.

The closest in technical essence and the achieved positive effect and accepted by the author as a prototype is a method for assessing the adaptive capabilities of the body during critical periods of ontogenesis in adolescents, including determining the type of constitution, the index of vegetative tone and the index for assessing the adaptive capabilities of the cardiovascular system, hemoglobin concentration, and the number of red blood cells indicators (see. Study of the blood system in clinical practice / Edited by G.I. Kozinets and V.A. Makarov. - M., 1998. - 482 p.).

Given that in the process of individual development, the body changes as a whole, its structural, functional and adaptive features are due to the interaction of all organs and systems at different levels of integration - from intracellular to intersystem. In this regard, one of the important aspects is the consideration of the specific features of the functioning of the whole organism.

The adolescent period as a critical period of ontogenesis is characterized by a certain vulnerability, hormonal restructuring, which is an independent stress factor. At this time, adolescents observe physiological catecholaminergic and sympathicotonic hyperreactivity and, accordingly, physiological imbalance, which, with prolonged exposure to any stress factor, leads to the appearance of various motor-vegetative-trophic disorders of the heart and blood vessels.

The cardiovascular system of adolescents has its own characteristics. During all periods, up to adulthood, there is a continuous and uneven development of the heart and blood vessels: the mass and volume of the heart cavities increase, the ratios of its departments and position in the chest change, the nervous regulation of the circulatory system improves, the histological structure of the heart and blood vessels differentiates.

The kinetics of hematopoiesis and hemorrhage is also an important indicator of the quality of the functional work of the blood system, key to understanding the pathogenesis of the effects of various adverse factors on the human body (see Study of the blood system in clinical practice).

Currently, health is assessed by the degree of adaptability of the body to environmental conditions. In the adaptation mechanisms, the autonomic nervous system plays an important role in maintaining homeostasis, while vegetative regulation is used to assess various levels of the functional adaptation system. It is believed that a certain ratio of structures and functions in the body corresponds to ideal health. The process of adapting the body to specific environmental conditions is provided by certain physiological reactions at the cellular, organ, systemic and organismic levels. The search for additional criteria for assessing the state of health and the degree of adaptability of the body to changing living conditions due to androtechnogenic activity is currently possible thanks to modern high-tech research methods. However, earlier there were no attempts to assess the degree of contribution of morphofunctional variability of indicators of the erythron system to the adaptive capabilities of the adolescent organism.

Disclosure of invention

The objective of the invention is to develop a method for assessing the adaptive capabilities of the body in critical periods of ontogenesis in adolescents, with the ability to determine informative quantitative criteria of health and adaptive capabilities of the body in critical periods of ontogenesis by the main systems: musculoskeletal, cardiovascular, hematopoietic.

The technical result that can be achieved using the present invention is reduced to the possibility of determining informative quantitative criteria of health and adaptive capabilities of the body during critical periods of ontogenesis by the main systems: musculoskeletal, cardiovascular, hematopoietic.

The technical result is achieved using a method for assessing the adaptive capabilities of an organism in critical periods of ontogenesis in adolescents, including determining the type of constitution, vegetative tone index and an index for assessing adaptive capabilities of the cardiovascular system, hemoglobin concentration, red blood cell count, and additionally determine the average diameter of red blood cells, fraction of microcytes, macrocytes and discocytes, erythrocyte formula with subsequent calculation of reversibility indices and transform of erythrocytes and the establishment of criteria for the risk of failure of adaptation, while the risk of failure of adaptation is established with a decrease in the average diameter of erythrocytes less than 7.17 microns, hemoglobin concentration less than 137 g / l, discocyte fraction less than 94%, stress index less than 5.0 points and increase poikilocytosis more than 4.7%, red blood cell reversibility index more than 2.9%, functional change index more than 2.1 units, red blood cell transformability index more than 0.06%.

The essence of the invention consists in a comprehensive diagnostic study, in which the type of constitution, vegetative tone, and adaptive capabilities of the cardiovascular system are determined, then the degree of change of red blood cells is established, and an integral assessment of the state of adaptive capabilities of the body during critical periods of ontogenesis is carried out according to the table of prognostic factors of Kubalt.

The implementation of the invention

Examples of specific implementation of the method for assessing the adaptive capabilities of the body in critical periods of ontogenesis in adolescents.

Example.

To optimize the process of assessing the adaptive capabilities of the body, the level and frequency of a number of anthropometric, functional features and laboratory parameters for assessing the morphofunctional properties of red blood cells, changing under the influence of damaging environmental factors in groups of adolescents living in different ecological and biogeochemical regions, were studied.

Anthropometric data are obtained using medical scales, a height meter and a centimeter tape. The Pinier index (PI) is calculated according to the scheme of MV Chernorutsky, reflecting the relationship between the circumference of the chest during exhalation, growth and weight.

PI = P- (B + OGK),

where P - height (cm), B - body weight (kg) - measured by medical scales, OGK - chest circumference on exhalation (cm).

IP allows you to establish the type of constitution and physique. If the IP value is more than 30, the type of constitution is defined as asthenic, from 10 to 30 - normosthenic, less than 10 as hypersthenic.

To study the features of the functioning of the circulatory system and the degree of tension of regulatory systems in adolescence, the method of variational pulsometry on a cardiograph is used. Then the numerical characteristics of the variational pulsograms are calculated: heart rate - heart rate; Mo (ms), indicating the most likely level of functioning of the circulatory system; IN - stress index (see Baevsky PM Assessment of the adaptive capabilities of the body and the risk of developing diseases / PM Bayevsky, AP Berseneva. - M .: Medicine, 1997. - 236 p.), Characterizing the stress of the body's compensatory mechanisms, calculated by the formula :

IN = AMo / 2ΔX × Mo (conventional units)

Assessing the status of regulatory systems by the values of the voltage index allows you to determine the status of regulatory systems; so, with a value of more than 200, the predominance of the sympathetic nervous system is recorded, from 50 to 200 - vegetative homeostasis is normal, and less than 50 - the predominance of the parasympathetic nervous system.

Measurement of systolic (SBP) and diastolic (DBP) blood pressure is carried out according to the Korotkov method.

To assess the level of functioning of the circulatory system and determine its adaptive capabilities, the Index of Functional Changes (IFI) is used (see N. Agadzhanyan, Actual Problems of Adaptation, Environmental and Restorative Medicine / Edited by N. A. Agadzhanyan, V.V. Uyba, M.P. Kulikova, A.V. Kochetkova. - M.: Medica, 2006 .-- 208 p.).

IFI = 0.011 × PE + 0.014 × GARDEN + 0.008 × DBP + 0.014 × B + 0.009 × MT-0.009 × P-0.27,

where PE is the pulse rate (beats per minute), SBP is systolic blood pressure (mmHg), DBP is diastolic blood pressure (mmHg), P is height (cm), MT is body weight ( kg), B - age (years).

The level of functioning of the circulatory system is considered satisfactory with an IFI value of up to 2.10, with a value of 2.11 to 3.20, the voltage of the adaptation mechanisms is determined, with a value of 3.21 to 3.49, the state is assessed as poor adaptation, above 3.50 failure of adaptation.

To assess the state of the autonomic nervous system, the Kerdo Vegetative Index (IR) is determined, which is calculated by the formula:

IR = (1-DBP / HR) × 100,

where DBP is diastolic blood pressure (mmHg), heart rate is the heart rate (beats per minute).

If the Kerdo index is in the range from +0.9 to -0.9, then this indicates a vegetative balance. The resulting (in conventional units) positive integer means a shift in the autonomic tone in the sympathetic direction, and a negative number means the prevalence of parasympathetic tone.

Er counting is carried out by a unified method in the Goryaev chamber. The concentration of HB is determined by a unified hemiglobincyanide method (see Dolgov V.V. Laboratory diagnosis of anemia: A manual for doctors / V.V.Dolgov, S.A. Lugovskaya, V.T. Morozova, M.E. Pochtar. - Tver: Provincial medicine, 2001 .-- 88 s.).

A computer cytomorphometric study of Er is carried out on the MEKOS-C hardware-software complex (CJSC Medical Computer Systems, Russia), indicators are evaluated: average diameter of Er, average area of Er, Er formula (percentage of discocytes, reversibly and irreversibly deformed Er) , coefficient of poikilocytosis.

For a general assessment of the cell transformation process, the morphological transformation index Er (IT) is calculated (see. V. Kidalov. Modern technologies for the study of erythron in clinical and laboratory practice / V.N. Kidalov, A.A. Khadartsev, G.N. Yakushina, V.V. Ignatiev. - Tula: Lidar, 2006. - 35 p.) According to the formula:

IT = (% OD +% ND) /% D,

where D is the percentage of discocytes, OD is the percentage of reversibly deformed Er,

ND - the percentage of irreversibly deformed Er.

Given the literature data that the ER transformation can be reversible, having adaptive-adaptive value (see. Study of the blood system in clinical practice / Edited by G.I. Kozints and V.A. Makarov. - M., 1998. - 482 pp .; TP Bondar, Computer cytomorphometry of peripheral blood erythrocytes - an innovative method of clinical laboratory diagnostics / TP Bondar, OI Zaparozhtseva, TV Karchinskaya // Bulletin of Stavropol State University. - 2006. - Issue .47. - S.267-272), the index of reversibility (IO) is calculated by the formula:

AI =% OD /% ND.

To highlight the most informative signs and preliminary judgments about the possibility of disruption of the adaptive capabilities of the body of healthy adolescents, analysis of the survey data using a consistent Wald analysis (see Gubler E.V. Computational methods for the analysis and recognition of pathological processes / E.V. Gubler. - L. : Medicine, 1978.- 296 p.). A diagnostic coefficient of each trait is obtained and, for judging the likelihood of a breakdown in the adaptive-adaptive reactions of the body under the ecological and biogeochemical conditions of residence, the obtained coefficients are summarized. The smaller the error value (in%), the higher the probability of the expected tension of the adaptive-adaptive reactions of the body in the environment of the biogeochemical environment of the adolescent. With an error value of more than 5%, the assumption is unlikely. The digital value of the algebraic sum corresponds to a certain percentage of the assumption error (Table 1.). The assumption of adaptation stress becomes statistically possible with a score of at least +13, probable with a score of at least +18 and characterizes the likely satisfactory adaptation with a score of -13 or less.

In order to identify the most informative combination of signs for prediction and prenosological identification of the state of adaptive resources of a holistic activity of an organism, its adaptation to various conditions of existence, Bayes's theorem is used as a method of probable assessment, the calculations are carried out according to the formula:

- вероятность определенного уровня адаптации D при наличии конкретных симптомов S_1,2,…,x;Where

- the probability of a certain level of adaptation D in the presence of specific symptoms S _{1,2, ..., x} ;

- частота симптомов при конкретном варианте адаптации к различным условиям существования в конкретном районе проживания D₁, D₂ и т.д.

- the frequency of symptoms in a particular variant of adaptation to various conditions of existence in a particular area of residence D ₁ , D ₂ , etc.

This method of statistical analysis allows you to identify violations of the health status of adolescents in the prenosological period of the development of diseases.

To solve the problem posed in this section, an assessment is made of the frequency of a number of indicators of constitutional somatotype, hemodynamics, heart rate variability, adaptation, as well as erythrocyte parameters obtained with the help of CCER, in groups of adolescents from an ecologically safe and environmentally disadvantaged area. The results of the statistical analysis are presented in table 2, and only indicators that reliably differ in the indicated groups are given. In the table, the criterion for the allocation of red blood cell counts is the average value of the indicator calculated for all examined adolescents, for example, the average diameter of Er is more or less 7.17 microns or the age norm, as for the proportion of microcytes - 19.4%. For indicators characterizing the type of constitution, autonomic homeostasis, and the adaptive capabilities of the circulatory system, generally accepted levels serve as criteria for the selection.

The most significant sign of tension in the adaptive capabilities of the body is a combination of signs No. 1-10, of which such as the average diameter of Er less than 7.17 microns, characterizing blood microcytosis, the proportion of reversibly altered Er more than 4.3% and the proportion of discocytes less than 94%, indicating about violation of the correlation of forms of Er, have the highest prognostic coefficients of Kubalt. No less significant are ID less than 50, which characterizes the stresses of the compensatory mechanisms of the body, the Pinier index is less than 10 or more than 30 (hypersthenic or asthenic body type).

A good adaptation is determined by such signs as a decrease in the magnitude of poikilocytosis of less than 4.7%, i.e. homogeneity of the Er population, a decrease in the proportion of microcytes of less than 19.4% and an average diameter of Er of more than 7.17 microns. Also informationally significant are: the Pinier index is more than 10, which determines the normosthenic type of constitution, and the voltage index is more than 50, at which it is believed that autonomic homeostasis is normal.

If we denote the value of the ecological disadvantage of the area of residence in the development of diseases in adolescents as D1, the negation of this value as D2, the frequency of signs (%) is borrowed from table 2, we get that the probability of developing a violation of adaptive mechanisms in adolescents in the presence of signs, for example, 1, 2, 5, 8 and 10 (the sum of 25.2 points, the error is less than 0.5%) is:

Consequently, with a combination of the listed characteristics for a particular teenager, the probability of adaptation stress is high.

Similarly, with a combination of signs 21, 22, 23, 24 and 25 (the sum of 20.2 points, the error is less than 1%), the probability that the adaptive potential of a teenager is satisfactory is 99.06%.

Thus, when using two different methods of statistical processing of anthropometry data, variational pulsometry and CCEr, similar results are obtained, indicating a high information content of the selected set of signs for judging the likelihood of the development of adaptation stress in adolescents.

Clinical examples

Example 1. Teenager V., 14 years old, lives in a district of the city located near the industrial zone and recognized as environmentally disadvantageous.

No complaints. Considers himself healthy.

On examination, it was revealed: height - 166 cm, weight - 68 kg, chest circumference - 89 cm. Pigne index - 9 points, which corresponds to the hypersthenic body type (+3.3).

The survey includes methods of functional and laboratory diagnostics, the results do not go beyond age norms, however, the use of integral indicators revealed some features characterizing the level of adaptive capabilities of the body of the examined adolescent B. In brackets are the prognostic coefficients of a significant sign in points from table 2, compiled with using consistent Wald analysis.

Evaluation of ECG data using the method of variational pulsometry shows: heart rate - 76 beats. min; Mo - 708 ms; AMo - 37%; ΔХ - 285 ms; SKO - 50 ms. The voltage index is 46 units. (+4.9).

Blood pressure - 125/77 mm Hg The estimated index of functional changes in IFI is 2.61 units. (+1.3).

Analysis of the morphological and functional state of the peripheral erythron unit according to the general blood analysis and computer morphometry of red blood cells revealed: the number of red blood cells - 5.1 × 10 ¹² / l; hemoglobin concentration - 156 g / l (+3.7); the average diameter of the red blood cell is 7.1 microns (+7.1): the average area of the red blood cell is 40.1 microns ² ; form factor - 14.1 units; poikilocytosis - 5.6%; discocytes - 94.8%; the proportion of reversibly altered forms of red blood cells - 4.8% (+6.7); the proportion of irreversibly altered forms of red blood cells is 0.4%. The proportion of microcytes in the drug was 21%. The calculated indices for assessing the process of transformation and the reversibility of red blood cells are: Engineering - 0.08 units. (+1.7); AI - 2.8 units.

The algebraic sum of prognostic coefficients is 28.7, which corresponds to the error of the assumption of a high voltage of the adaptive capabilities of the body of adolescent V. in 0.1% of cases. The use of the probable estimation method (Bayes theorem) confirmed this assumption in 99.9%.

Thus, adolescent V., who lives in an ecologically unfavorable area of the city, has health according to objective indicators, but there is a high degree of tension in the adaptive capabilities of the body. This is an indication for the inclusion of a teenager in a risk group and the appointment of preventive measures to improve the body of adolescent B.

Example 2. Teenager K., 13 years old, lives in a district of the city located in a park area and recognized as environmentally friendly.

No complaints. Considers himself healthy.

On examination, it was revealed: height - 165 cm, weight - 61 kg, chest circumference - 85 cm. Pigne index - 19 points, which corresponds to the normostenic type of physique (-2.7).

The survey includes methods of functional and laboratory diagnostics, the results do not go beyond the age norms, however, the use of integral indicators revealed some features characterizing the level of adaptive capabilities of the body of the examined adolescent K. In parentheses are the prognostic coefficients of the significant sign in points from table 2, compiled with using consistent Wald analysis.

Evaluation of ECG data using the method of variational pulsometry shows: pulse rate - 72 beats. min; Mo - 876 ms; AMo - 45%; ΔХ - 209 ms; RMS - 64 ms. The stress index is 94 units. (-4.4).

Blood pressure - 110/72 mm Hg The estimated index of functional changes in IFI is 1.83 units. (-1.6).

Analysis of the morphological and functional state of the peripheral erythron unit according to the general blood analysis and computer morphometry of red blood cells revealed: the number of red blood cells - 5.5 × 10 ¹² / l (+2.2); hemoglobin concentration - 147 g / l; the average diameter of the red blood cell is 7.3 microns (-5.9): the average area of the red blood cell is 42.1 microns ² ; form factor - 14.0 units; poikilocytosis - 4.75%; discocytes - 95.4% (-2.1); the proportion of reversibly altered forms of red blood cells is 3.9% (-2.2); the proportion of irreversibly altered forms of red blood cells is 0.7%. The proportion of microcytes in the preparation was 10.3% (-4.7). The calculated indices for assessing the process of transformation and the reversibility of red blood cells were: Engineering - 0.064 units; AI - 2.7 units. (-4.4).

The algebraic sum of the prognostic coefficients was 25.8, which corresponds to the error of the assumption of a satisfactory adaptation of the adolescent organism K. from 0.2 to 0.5% of cases. The use of the probable estimation method (Bayes theorem) confirmed this assumption in 99.58%.

Thus, adolescent K., who lives in an ecologically favorable area of the city, has been preserved in objective health indicators, and there is a satisfactory adaptation of the body.

The invention in comparison with the prototype and other known technical solutions has the following advantages:

- the ability to determine informative quantitative criteria of health and adaptive capabilities of the body in critical periods of ontogenesis by the main systems: musculoskeletal, cardiovascular, hematopoietic.

Table 1 Error probability depending on the sum of diagnostic coefficients Threshold amount Mistake in % thirty 0.1 27 0.2 24 0.5 twenty one eighteen 2 fifteen 3 13 5 eleven 7 10 10 6 twenty

table 2 The comparative frequency of indicators in adolescents, depending on the ecological-biogeochemical situation in the region of residence No. p / p Rank Indicators The surveyed groups P ₁ / P ₂ PAC 10 log (P ₁ / P ₂ ) II group P ₁ I group P ₂ one. Average diameter Er <7.17 μm 0.811 0.157 5.17 +7.1 2. The proportion of reversibly altered Er> 4.3% 0.410 0,087 4.71 + 6.7 3. HB less than 137 g / l 0.192 0,041 4.68 + 6.7 four. The proportion of discocytes <94% 0.412 0,089 4.63 + 6.7 5. Stress index <50 0.401 0.130 3.08 +4.9 6. Poikilocytosis> 4.7% 0,501 0.182 2.75 +4.4 7. HB more than 154 g / l 0.212 0,091 2,33 +3.7 8. Pigne Index <10 and> 30 0.233 0.108 2.16 +3.3 9. Er less than 4.8 · 10 ¹² / l 0.192 0,091 2.11 +3.2 10. Reversibility Index Er> 2.9 0.535 0.257 2.08 +3.2 eleven. Er more than 5,4 · 10 ¹² / l 0.288 0.174 1.66 +2.2 12. Transformability Index Er> 0.06 0.523 0.352 1.48 +1.7 13. Kerdo Index <-0.9 0.603 0.423 1.42 +1.5 fourteen. IFI> 2.1 0.617 0.455 1.36 +1.3 fifteen. Er 4.8-5.4 · 10 ¹² / l 0.521 0.736 0.71 -1.5 16. Ifi <2.1 0.372 0.543 0.69 -1.6 17. Reversibility Index Er <2.9 0.477 0.742 0.64 -1.9 eighteen. The proportion of discocytes> 94% 0.569 0.914 0.62 -2.1 19. Transformability Index Er <0.06 0.393 0.644 0.61 -2.2 twenty. Reversible Er <4.3% 0.557 0.935 0.60 -2.2 21. Poikilocytosis <4.7% 0.476 0.849 0.56 -2.5 22. Pigne Index> 10 and <30 0,067 0.123 0.54 -2.7 23. Voltage Index> 50 and <200 0.176 0.491 0.36 -4.4 24. The proportion of microcytes <19.4% 0.164 0.489 0.34 -4.7 25. Average diameter Er> 7.17 μm 0.169 0.655 0.26 -5.9

Bibliography

1. Baevsky P.M. Assessment of the adaptive capabilities of the body and the risk of developing diseases / P.M. Baevsky, A.P. Berseneva. - M.: Medicine, 1997 .-- 236 p.

2. Agadzhanyan N.A. Actual problems of adaptation, environmental and rehabilitation medicine / Ed. N.A. Agadzhanyan, V.V. Uyba, M.P. Kulikova, A.V. Kochetkova. - M .: Medica, 2006 .-- 208 p.

3. The study of the blood system in clinical practice / Ed. G.I.Kozintsa and V.A. Makarov. - M., 1998 .-- 482 p.

4. Dolgov V.V. Laboratory diagnosis of anemia: A manual for doctors / V.V.Dolgov, S.A. Lugovskaya, V.T. Morozova, M.E. Pochtar. - Tver: Provincial medicine, 2001. - 88 p.

5. Kidalov V.N. Modern technologies for the study of erythron in clinical and laboratory practice / V.N. Kidalov, A.A. Khadartsev, G.N. Yakushina, V.V. Ignatiev. - Tula: Lidar, 2006 .-- 35 p.

6. Cooper T.P. Computer cytomorphometry of peripheral blood erythrocytes - an innovative method of clinical laboratory diagnosis / T.P. Bondar, O.I. Zaparozhtseva, T.V. Karchinskaya // Bulletin of the Stavropol State University. - 2006. - Iss. 47. - S.267-272.

7. Gubler E.V. Computational methods of analysis and recognition of pathological processes / E.V. Gubler. - L .: Medicine, 1978.- 296 p.

Claims (1)

A method for assessing the adaptive capabilities of the body during critical periods of ontogenesis in adolescents, including determining the type of constitution, the index of vegetative tone and the index for assessing the adaptive capabilities of the cardiovascular system, hemoglobin concentration, the number of red blood cells, characterized in that it further determines the average diameter of red blood cells, the proportion of microcytes, macrocytes and discocytes, erythrocyte formula with the subsequent calculation of the index of reversibility and transformability of red blood cells and the establishment of criteria for the risk of failure of adaptation, while the risk of failure of adaptation is established when the average diameter of red blood cells is less than 7.17 microns, the concentration of hemoglobin is less than 137 g / l, the proportion of discocytes is less than 94%, the stress index is less than 5.0 points and the increase in poikilocytosis is more than 4, 7%, erythrocyte reversibility index more than 2.9%, functional change index more than 2.1 units, erythrocyte transformability index more than 0.06%.