RU2719018C1 - Method of assessing meteosensitivity in patients with cardiovascular diseases - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to methods of assessing meteosensitivity in patients with cardiovascular diseases for subsequent therapy or preventive measures. For this purpose, during the week, the patient is offered daily verbal-communicative examination to note presence of the following complaints: headache (HA), sensation of air shortage (S), increased fatigue (IF), presence of muscle aches or feeling of aches and/or stiffness in joints (ASJ), presence of lightheadedness (LH), sensation of deterioration of state of health in comparison with usual state patient (C), subjective sensation of current weather conditions (SW). Additionally, cardiac rhythm is analyzed by electrocardiography (ECG). Further, the result of the examination is normalized to a four-level score with subsequent calculation of the integral severity index of the complaints (ISIC) according to the original formula. If the ISIC is up to 1.06 - no weather sensitivity is observed, from 1.07 to 1.11 - weak meteosensitivity, from 1.12 - 4 - strong meteosensitivity.

EFFECT: method provides an objective and fast assessment of meteosensitivity in patients with cardiovascular diseases by using available and small-size tests, use of the diagnostic criterion most accessible in any conditions, such as electrocardiogram data with further application of original formulas for calculating an integral indicator of complaints, based on which it is possible to assess severity of exposure of meteorological factors with highest accuracy.

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Description

The invention relates to medicine, namely to methods for assessing weather sensitivity in patients for the subsequent selection of therapy or preventive measures.

It is known that when the weather changes, some people experience a deterioration in well-being, expressed by various manifestations, for example, increased blood pressure, dizziness, etc. This deterioration in well-being is called meteorolability. The deterioration of the course of the disease with changing weather in the scientific literature is called meteopathology. All of the above has a generic name - meteosensitivity. The phenomenon is recognized around the world and the bibliography on this subject has several thousand publications.

Meteorologist determines the days unfavorable for meteorological factors, having data on weather changes in the radius of not less than one and a half to two thousand kilometers from the prediction point, divides the weather into four groups according to the maximum possible deviations of meteorological factors. At the same time, the necessary adjustments should be made to the forecast with the use of information about the electric state of the atmosphere and changes in the geomagnetic field of the Earth. Days with the most dramatic changes in the meteorological and geomagnetic characteristics are considered unfavorable for human health (I. I. Grigoriev, K. I. Grigoriev. Issues of balneology, physiotherapy and physiotherapy, 1993, N 6 pp. 42-45; Guide to the compilation of medical weather forecasts and integrated prevention of meteotropic reactions. - M .: Universum, 1993, p. 9-10).

Many different variables that are included in the group of meteorological factors, and the need to process the amount of information, for example, for Moscow from the whole of Europe make it difficult to associate the occurrence of meteosensitivity with a particular meteorological factor, or their group (I.E. Ganelina. Coronary heart disease. - M .: Medicine, 1977, p. 230). Predictions of weather sensitivity for changes in the Earth’s magnetic field alone are hindered by the fact that people are affected not by global magnetic storms, but by their unstable components, which have a special amplitude and frequency. It is very difficult to predict these components in advance. It is also noted that meteopathology is observed, including a few days after magnetic storms (AP Dubrov. Geomagnetic field and life. - L .: Gidrometeoizdat, 1974). Thus, not only geomagnetic, but also meteorological factors take part in the formation of meteopathology.

Under current conditions of global warming and climate change, there is a significant change in all meteorological parameters (increasing average annual temperatures, increasing day-to-day temperature amplitudes, fluctuations in atmospheric pressure, etc.), which, accordingly, causes strong changes in the state of health of people who are dependent on weather.

However, it was found that the human body is well adapted to the influence of the environment. At the same time, the ability to tolerate fluctuations in various environmental parameters is individual. It depends on age, gender, state of health, fitness, professional activity, etc. As mentioned above, the weather affects the well-being of individuals and groups of people, it is associated with the spread of certain types of diseases. It has been proven that among healthy ones, up to 35-45% are also meteosensitive.

In the case of increased solar and geomagnetic activity, adverse reactions from the human body can be observed in the form of disorders of the cardiovascular, endocrine, nervous systems, blood system, and respiratory system. The action of heliogeomagnetic factors leads to adaptive stress, accompanied by purely individual reactions of vascular tone, a change in blood pressure, an increase in blood coagulation, and cardiac arrhythmias. As a result, the number of hypertensive crises, acute cerebrovascular accidents, myocardial infarction, and sudden deaths are increasing. According to some reports, magnetic storms contribute, in particular, to an increase in the number of cases of myocardial infarction by 31%, and strokes by 23%. Moreover, the development of the mentioned exacerbations may be ahead of time, immediate or delayed in time.

In this regard, it is necessary to predict unfavorable days not only in Moscow, but also in the district center, where the possibility of obtaining information not only from all over Europe, but also from the neighboring region is very doubtful. In addition, for the needs of a particular person, it is necessary to predict not only the day, but also the exact point in time when it is necessary to start preventive measures. After all, if prophylaxis begins to worsen well-being, then it may be too late, since the disease process has already begun. If you take the medicine for the future, then the body may become insensitive to this drug or the number of drug complications will increase. It is always advisable to start preventive measures on time.

According to statistics in Europe, coronary heart disease and cerebral stroke account for up to 90% of all diseases. Mortality rates from coronary heart disease and cerebrovascular pathology continue to increase. Mortality from coronary heart disease and strokes is constantly growing. All this indicates the need to strengthen measures for early prevention and prevention of the progression of cardiovascular diseases, as well as assessing weather sensitivity in such patients, and, consequently, the subsequent prevention of meteopathic reactions.

According to studies conducted under the auspices of the World Health Organization (WHO, 2005), weather and meteorological and heliophysical factors are considered as external risk factors that create favorable soil for disruption of free radical oxidation in the vascular wall, the progression of atherosclerosis and coronary heart disease [V.Z. Lankin, 1989-1997; E.I. Chazov et al., 1990-2008; R.I. Mkrtchyan, I.I. Velikanov, L.I. Gerlitsin, 2000-2009].

In the patent for the invention RU 2422128 C1, 06.27.2011, a method for assessing meteosensitivity in patients with cardiovascular pathology is described, which consists in determining the integral meteopathic index (IMPI - the ratio of the sum of the "responses" from the tests of meteopathic reactions to the total number of tests examined). The closest relationship between IMPI according to the χ ² criterion (χ ² = 13.22; P <0.005) was established with the weather of the frontal type, which are characterized by variable weather conditions, as well as with cyclonic weather that forms in baric depressions, which are often accompanied by pronounced phenomena of atmospheric hypoxia and atmospheric “Stuffiness” (χ ² = 5.15; P <0.005), and with anticyclonic type weather, which is characterized by the phenomena of heat advection, atmospheric hypoxia, often with pronounced intraday fluctuations in medical and climatic modules (χ ² = 4.11; P <0.005). This method is accepted by us as the closest analogue.

However, the known method is difficult enough to carry out an assessment of meteorological sensitivity, since it requires the use of a huge number of different tests, comparing the test results with the weather, etc., which only delays the assessment and does not allow timely preventive measures.

The technical result of the claimed invention provides an objective and quick assessment of meteosensitivity in patients with diseases of the cardiovascular system through the use of accessible and small in content tests, the use of the most available diagnostic criteria in any conditions, such as electrocardiogram data, followed by the use of original integral calculation formulas indicator of the severity of complaints, on the basis of which it is possible to assess the severity of the impact m teofaktorov with the greatest accuracy.

The method is as follows.

During a week, the patient is invited to note the following complaints during a verbal-communicative examination: headaches (GB), feeling of lack of air (O), fatigue (PU), muscle pain or a feeling of aching and / or stiffness in the joints ( BST), the presence of dizziness (GC), a feeling of deterioration in health compared with the usual condition of the patient (C), a subjective sensation of current weather conditions (SP). Additionally, a heart rhythm study is performed by electrocardiography (ECG).

Further, the result of the study is normalized to a four-level assessment as follows:

A) headaches (GB):

- none - 0,

- headache 3 or less times a week - 1,

- pain 4-5 times a week - 2,

- pain daily for a week - 3;

B) feeling of lack of air (O):

- absent - 0,

- feeling of lack of air 3 or less times a week - 1,

- feeling of lack of air 4-5 times a week - 2,

- lack of air daily for a week - 3;

C) increased fatigue (PU):

- absent - 0,

- PU 3 or less than once a week - 1,

- PU 4-5 times a week - 2,

- PU daily for a week - 3;

E) the presence of muscle pain or a feeling of aching and / or stiffness in the joints (BLS):

- none - 0,

- the presence of pain 3 or less than once a week - 1,

- pain 4-5 times a week - 2,

- pain daily for a week - 3;

E) the presence of dizziness (GC):

- absent - 0,

- dizziness 3 or less times a week - 1,

- HA 4-5 times a week - 2,

- HA daily for a week - 3;

G) a feeling of deterioration in health compared with the usual condition of the patient (C):

- absent - 0,

- deterioration of health 3 or less than once a week - 1,

- deterioration of health 4-5 times a week - 2,

- deterioration in well-being is noted daily for a week - 3;

H) a sense of current weather conditions (SP):

- none - 0,

- a feeling of current weather conditions 3 or less times a week - 1,

- sensations 4-5 times a week - 2,

- a feeling of current weather conditions daily for a week -3;

I) the presence on the ECG of cardiac arrhythmias (CP):

- none - 0,

- violations of CP 3 or less than once a week - 1,

- CP violations 4-5 times a week - 2,

- CP violations daily for a week - 3.

On the basis of the data obtained, the integral indicator of the severity of complaints (IOL) is calculated:

IPVZH = (8hGBhOhPUhBSThGKhSRhShSP) / (GBhOhPUhBSThGKh SRhS GBhOhPUhBSThGKhSRhSP + + + GBhOhPUhBSThGKhShSP GBhOhPUhBSThSRhShSP GBhOhPUhGKhSRhShSP + + + GBhOhBSThGKh CPhShSP GBhPUhBSThGKhSRhShSP OhPUhBSThGKhSRhShSP +).

If IOLI is up to 1.06 - there is no weather sensitivity, from 1.07 to 1.11 - weak weather sensitivity, from 1.12 to 4 - severe weather sensitivity.

Examples.

Two groups of patients were examined, a total of 30 people, ages 41 to 70 years old, suffering from diseases of the cardiovascular system (arterial hypertension of various stages, coronary heart disease, atherosclerotic and postinfarction cardiosclerosis).

The first group consisted of 15 people (10 women and 5 men aged 41 to 60 years). At stage I, 12 people suffered, II - three patients. Three people also suffered from angina pectoris, two patients from the group revealed atherosclerotic cardiosclerosis. Patients received conventional therapy: nitrates, β-blockers, calcium antagonists, ACE inhibitors (angiotensin converting enzyme), antiplatelet agents and diuretics.

The second group also consisted of 15 people (9 women and 6 men aged 52 to 70 years). AT patients of II degree suffered from three patients, III degree - 12. In five patients, post-infarction cardiosclerosis was detected, in eight patients - atherosclerotic cardiosclerosis. Patients on the background of traditional therapy received melatonin (melaxen, Unipharm, USA) at a dose of 3 ... 6 mg in 22 hours.

A control group of 10 people without signs of diseases of the cardiovascular system.

In the first group, the indicators were as follows: in 6 people, when calculating IPVZHM ranged from 1.07 to 1.11, which corresponds to a weak manifestation of meteosensitivity; in 4 people, IPVM was from 1.12 to 2, which corresponds to a pronounced manifestation of meteosensitivity.

In the second group, in 9 people, IPVM was from 1.12 to 4, which corresponds to a pronounced manifestation of meteosensitivity, in 1 person, IPVM was 1.10, which corresponds to a weak manifestation of meteosensitivity.

In the control group, IPVM was from 0 to 1.06, which indicates the absence of meteosensitivity.

The data obtained helped to draw up a program of preventive measures for this category of patients, taking into account their weather sensitivity, namely, its specific parameters, in accordance with the questionnaire, which were not previously taken into account.

Claims (13)

A method for evaluating weather sensitivity in patients with diseases of the cardiovascular system, characterized in that the patient is questioned daily for the following complaints: headaches, feeling of lack of air, increased fatigue, muscle pain or a feeling of aches and / or stiffness joints, dizziness, a feeling of deterioration in comparison with the usual condition of the patient, a subjective sensation of current weather conditions, additionally conduct a study of heart rhythm after by means of electrocardiography (ECG), the resulting parameters are assigned points: - headaches (GB): none - 0, headache 3 or less times a week - 1, pain 4-5 times a week - 2, daily pain for a week - 3; - feeling of lack of air (O): absent - 0, feeling of lack of air 3 or less times a week - 1, feeling of lack of air 4-5 times a week - 2, lack of air daily for a week - 3; - increased fatigue (PU): absent - 0, PU 3 or less than once a week - 1, PU 4-5 times a week - 2, PU daily for a week - 3; - the presence of muscle pain or a feeling of aching and / or stiffness in the joints (BLS): none - 0, pain 3 or less times a week - 1, pain 4-5 times a week - 2, pain daily for a week - 3 ; - the presence of dizziness (GC): absent - 0, dizziness 3 or less times a week - 1, GC 4-5 times a week - 2, GC daily for a week - 3; - a feeling of deterioration in health in comparison with the usual condition of the patient (C): none - 0, deterioration of health 3 or less times a week - 1, deterioration of health 4-5 times a week - 2, deterioration of health is noted daily for a week - 3; - sensation of current weather conditions (SP): none - 0, sensation of current weather conditions 3 or less times a week - 1, sensations 4-5 times a week - 2, sensation of current weather conditions daily for a week - 3; - presence of cardiac arrhythmias (CP) on the ECG: none - 0, CP disorders 3 or less once a week - 1, CP disorders 4-5 times a week - 2, CP violations daily for 3 weeks - 3; based on the data obtained, the integral indicator of the severity of complaints (IOL) is calculated IPVZH = (8hGBhOhPUhBSThGKhSRhShSP) / (+ GBhOhPUhBSThGKhSRhS GBhOhPUhBSThGKhSRhSP GBhOhPUhBSThGKhShSP + + + GBhOhPUhBSThSRhShSP GBhOhPUhGKhSRhShSP GBhOhBSThGKh CP hShSP + + + GBhPUhBSThGKhSRhShSP OhPUhBSThGKhSRhShSP) and if IOLI is up to 1.06 - there is no weather sensitivity, from 1.07 to 1.11 - weak weather sensitivity, from 1.12 to 4 - very pronounced weather sensitivity.