RU2445629C1 - Method for prediction of risk of decreasing body resistance to acute respiratory diseases in children between ages of 3 to 7 by degree of capillary red blood cell lysis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: capillary blood is examined to evaluate a degree of red blood cell lysis in a working urea solution (0.18 mole/l) with using a spectrophotometer. If observing the degree of red blood cell lysis being higher than 1.38 percent of optical density, a child is referred to a risk group with decreased body resistance to acute respiratory diseases.

EFFECT: use of the method enables high-accuracy prediction of decreased body resistance to acute respiratory diseases in children between the ages of 3 to 7.

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Description

FIELD OF THE INVENTION

The invention relates to medicine, namely to pediatrics.

State of the art

The modern assessment of the health status of children is based on 3 groups of factors that determine health (deviations in ontogenesis, intra- and early postnatal origin (biological history); genealogical history; social and environmental history) and 5 criteria characterizing health [in accordance with the order Ministry of Health of the Russian Federation No. 621 dated 12/30/2003 "On a comprehensive assessment of children's health"], one of which is the level of resistance of the body.

This is an indicator characterizing the resistance (resistance) of the child's body to pathogenic effects. It is determined by taking into account the frequency of acute diseases over one year of life.

If the observation was shorter, the assessment of resistance is carried out by the index of the frequency of acute diseases (IOS). It is equal to the ratio of the number of acute diseases transferred to the number of months of observation:

Resistance is considered:

- high (0 diseases per year, Ioz - 0);

- medium (1-3 diseases per year, Ios <0.33);

- low (4-7 diseases per year, Ios - 0.33-0.6);

- very low (8 or more times a year, Ios> 0.65).

A child is often ill if he suffers 4 or more acute diseases during a year and the acute disease frequency index is 0.33 and higher [Vinogradov AF, Akopov ES, Alekseeva Yu.A., Borisova MA Children's Hospital. - Tver., 2004. - 495 p.].

In recent years, interest has increased in studying the mechanisms of the involvement of the blood system in the body's response to stress. Damage to red blood cell membranes can be considered as an integral indicator of the toxicity of exo- and endotoxins.

Cell membranes respond to changes in the external and internal environment of the body, and this can be manifested by a change in its structure and impaired function [Brachet J. Living cell (translated from English) / Ed. G.M. Frank. - M .: World. 1966. - 237 p.]. Membrane damage should lead to disruption of the cells and the body as a whole [Ado A.D. Ecology and Allergology // Clinical Medicine. - 1990. - No. 9. - C.3-6]. RBC membranes can be used as a natural model to study the general characteristics of all cell membranes.

As a prototype, we have chosen "A method for predicting frequent morbidity in young children with minimal cerebral dysfunction" [Filkina OM, Kochereva O.Yu., Shanina TG, Vasiliev MD, Chinenova NS, Sotnikova N.Yu., Kudryashova A.V. A method for predicting frequent morbidity in young children with minimal brain dysfunction - RF patent for the invention No. RU 2142639 C1].

The essence of the method is that in the peripheral venous blood of a child after 1 year determine the content of CD72 + lymphocytes and with an increase of more than 20.31% predict frequent acute respiratory infections (ARI) in a child under 3 years old.

The disadvantage of this method is that:

- the prognosis applies only to children with minimal cerebral dysfunction,

- this method requires the availability of expensive equipment: flow cytometer, in particular, therefore, cannot be widely implemented in practical health care,

- venous blood is used for research.

In the claimed method, the listed disadvantages are eliminated.

Disclosure of invention

The objective of the invention is to improve the diagnosis of health (lowering the body's resistance to acute respiratory infections) in children aged 3-7 years.

The technical result of the method is to increase the information content of a clinical and laboratory examination of a child through the use of capillary blood research and quantitative determination of the degree of erythrocyte hemolysis using a spectrophotometer to identify risk groups for children aged 3-7 years that reduce the level of resistance of the body to acute respiratory diseases.

Brief Description of Drawings - No Illustrations

The implementation of the invention

The claimed technical result is achieved by determining on a spectrophotometer at a wavelength of 414 nm in a cell with an absorbing layer of 1 cm against distilled water the degree of hemolysis of the erythrocytes of a particular child in a working solution of urea (0.18 mol / l), and with a degree of hemolysis above 1.38 percent of the optical density of the child is selected in the dispensary observation group "often ill children" and conduct health measures (risk group for reducing the body's resistance to acute respiratory diseases).

In total, the claimed method examined 105 children aged 3-7 years, of which 73 children often (more than 6 times a year) suffer from acute respiratory diseases (main group) and 32 children who suffer from acute respiratory diseases 1-3 times a year and do not have chronic diseases (control group).

The material for the study is capillary blood in an amount of 0.02 μl. Blood sampling is carried out in special tubes for capillary blood with potassium salt of ethylenediaminetetraacetic acid. Blood sampling was performed in the morning on an empty stomach from 8 to 10 am from the pulp of 4 fingers of the left hand of the subjects. Disposable scarifiers were used.

The degree of hemolysis was expressed in units of optical density.

The novelty of the proposed method lies in the fact that for the first time it is proposed to predict a decrease in the body's resistance to acute respiratory diseases in children aged 3-7 years by the degree of hemolysis of red blood cells of capillary blood. The method is widely available, cheap, does not require expensive equipment.

Distinctive features of the method:

- the degree of hemolysis of the erythrocytes of a particular child is determined in the working solution of urea (0.18 mol / l);

- when the degree of hemolysis of erythrocytes is higher than 1.38 percent of the optical density of the child, they are considered at risk of a decrease in the body's resistance to acute respiratory diseases.

The studies were carried out in the research center of the State Educational Institution of Higher Professional Education "Tver State Medical Academy of Roszdrav". Statistical data processing included the use of a nonparametric method for assessing the reliability of results - the Fisher angular transformation method, the significance level was determined at p <0.05 [Gubler E.V. Computational methods for the analysis and recognition of pathological processes. - L. - 1978. - P.296].

A method for predicting the risk of a decrease in the body's resistance to acute respiratory diseases in children aged 3-7 years by the degree of hemolysis of red blood cells of capillary blood is illustrated by the following examples.

Clinical example No. 1

Child 3 years old, formalized card No. 54.

A child from the fourth pregnancy, the first birth, proceeding with a complication: weakness of labor. Breastfeeding up to 3 months. In the first year, I had ARI 3 times, in 2 years - 2 times, in 3 - 4 times. He settles in a kindergarten. The analysis of capillary blood.

The degree of hemolysis of a blood sample in a working solution of urea is 1.45 percent optical density. Frequent incidence was predicted.

The child was observed during the year. The number of acute respiratory infections per year is 8. The forecast was confirmed.

Clinical example No. 2

Child 6 years old, formalized card №29.

The child from the third pregnancy, the second birth is a cesarean section. Breastfeeding up to 2 months. Visits kindergarten from 3 years. Until 3 years he was ill 3-4 times a year. From 3 to 6 years he was ill 5-6 times a year. Directed to the immunologist after the next ARI. An analysis of capillary blood was carried out: the degree of hemolysis of a blood sample in a working solution of urea was 0.85 percent optical density.

A favorable forecast was predicted. The child was observed during the year. During the year there were 4 acute respiratory infections. The forecast was confirmed.

Claims (1)

A method for predicting the risk of reducing the body's resistance to acute respiratory diseases in children aged 3-7 years by the degree of capillary blood erythrocyte hemolysis, including the study of capillary blood and the quantification of the degree of erythrocyte hemolysis using a spectrophotometer, characterized in that the specific child’s erythrocyte hemolysis is determined in a working solution of urea (0.18 mol / l) and with a degree of erythrocyte hemolysis higher than 1.38% of the optical density of the child, they are at risk of a decrease the level of resistance of the organism to acute respiratory diseases.