SU1169618A1 - Method of diagnostics of preasthma of patients having dust obstructive bronchitis - Google Patents

Abstract

METHOD OF DIAGNOSTICS OF PREDASTMS IN PATIENTS WITH DUSTY OBSTRUCTIVE BRONCHITIS by biochemical examination of blood and urine, due to the fact that, in order to speed up and simplify the method, serotonin and 5 oxyindole in the blood are determined by the content of serotonin in the blood and 5 oxyindole in the blood, and serotonin in the daily urine and 5 oxyindoles can be determined, blood pressure levels of serotonin and 5 oxyindoles are studied, and serotonin and 5 oxyindoles are relieved. then the ratio of the first value to the second value is calculated, and when the serotonin concentration is more than 1.70 µmol / l and the value of the ratio is less than 10.0, a preastma is diagnosed.

Description

Odd

The invention relates to medicine, in particular to occupational pathology, and can be used to diagnose a predastm in obstructive dust bronchitis.

The purpose of the invention is to accelerate and simplify the diagnosis of predastm in patients with dust obstructive bronchitis.

The method is carried out as follows.

The content of serotonin (C) in the blood and the content of the main metabolite of serotonin 5-hydroxyindole-acetic acid (5-HIAA) in the daily

urine and calculate the ratio of 5-HIAA

 .

When the content of serotokin in the blood is 1.70 μmol / l and above and the coefficient

 less than 10.0 in patients with dust

V

obstructive bronchitis diagnosed predastmy.

Example 1. Patient B, 53 years old. Upon admission to the clinic complaints of cough, mostly dry, intermittently with the release of scanty elizist sputum, shortness of breath with moderate exertion, pain in the interscapular region. Cough bothers you for years. In the last 2 years, the cough has increased, and one has come up when climbing stairs.

On examination: normostenic satisfactory nutrition. Skin-normal color, small acrocyanosis. The rib cage is slightly dilated in the lower lateral regions. Perkutorny sound over the lower-side sections of the chest with a box tint. Breathing is hard, on both sides dry wheezes are heard - bass and treble. The number of wheezing increases with force breathing. Borders of the heart in the normal range. Heart sounds are clean. rhythmic Pulse 80 beats per 1 min. Blood pressure 120/80 mm Hg Liver is not increased.

Radiograph of the lungs. Light increased transparency. Pulmonary risumok strengthened. To the right in the middle zone there is a thin interlobular pleural rinse. The right costal sine is zapann and the dome of the diaphragm is flattened.

Functional respiratory tests. VC-3,2 l (DZHEL-3.15 l). Pneumotachometry: Inspiration rate 3.2 l / s, expiratory rate 1.8 l / s. Tiffno's test of 48%.

Sputum analysis. The character of purulent. Leukocytes - a moderate amount. Alveolar cells in places. Mycobacterium tuberculosis is not detected.

Blood test: red blood cells - 4.6 x, hemoglobin - 144 g / l, color index 0.93. Leukocytes 5, 6-103 / l.

Leukocyte formula,%: eosinophil 1, bacillus neutrophils 2, segmented neutrophils 68, lymphocytes 26, monocytes 3, ESR - 11 mm / h.

Sialic acid - 250 opt. Units, Reactive protein (-), total protein 85.9 g / l. Protein fractions,%: albumin 47.3, globulins,%: oL 9.0; oi GO, O- 12.7; J 21.0; A / G 0.9.

Analysis of urine. Without abnormalities.

The results of the study showed that the serotonin content (C) in the blood was 1.13 µmol / L. The content of 5-hydroxyindolecetic acid (5-HIAA) in daily urine is 25.6 μmol / day.

 23.00.

Clinical diagnosis: drink obstructive bronchitis. Pulmonary emphysema, I degree Pulmonary insufficiency, I-II degree.

Thus, in a patient with dust obstructive bronchitis, the absence of allergization and, consequently, the threat of asthma is confirmed by a relatively low level of serotonin in the blood, which did not exceed 1.7 µmol / L and a high coefficient. 5-OIUK (significantly more

10.0).

Example 2. Patient K., 50 years old. Upon admission to the clinic of a complaint of persistent, paroxysmal cough with a slight separation of the mucous or mucopurulent sputum, shortness of breath with moderate exertion, intermittent nasal congestion, chest pain.

On examination: hypertonic satisfactory nutrition. Moderately infused acrocyanosis. The chest is dilated, mainly in the lower-lateral regions, above which the boxed sound is defined. During auscultation, 3 lungs are heard dispersed dry rales of different tonality (distant and bass), the borders of the heart are within normal limits. Pure heart sounds of satisfactory sonority. Heart activity is rhythmic. Blood pressure 140/90 - 130 / / 80 mm Hg Pulse 60 beats per minute. Abdominal organs without features. When examined by an otolaryngologist, you have been diagnosed with vasomotor rhinitis. Radiograph of the lungs. The lung pattern is diffusely strengthened, the vascular shadows are deformed. The roots are expanded compacted. Functional respiratory tests ZhEL-2,4l (JAL 3.7 l). Pneumotachometry: inspiratory speed — 3.2 HP, discharge rate — 2.4 l / s. Tiffno's test - 55%. Sputum analysis. Character mucous. There are Kurshman spirals and many eosinophils. Mycobacterium tuberculosis is not detected. Blood test: erythrocytes 4, 7-102 / l, hemoglobulin - 145 g / l, color indicator - 0.9, leukocytes 4.8 -10 / l. Leukocyte formula,%: eosinophils 5, bacillus neutrophils 2 segmented neutrophils 58, lymphocytes 30, monocytes 5%, ESR IImm / h. Total protein 89 g / l. Protein fractions,%: albumin 43,7j globulins,%, 8.7; 0 / 8.7, ft 10.0-, at 27.9; A / H - 0.7. Sialic acid - 145 opt. Units, C-reactive protein - (-). 18.4 Urine analysis. Without abnormalities. The serotonin content (C) in the blood was 3.18 µmol / L. 5-hydroxyindolucetic acid content (5-HALI in daily urine - 15.7 μmol / cjrr. 5: 2iuk with. Clinical diagnosis: dust obstructive bronchitis with signs of allergization (predastma). Pulmonary insufficiency of the II degree. Vasomotor rhinitis. In a patient with with dust obstructive bronchitis, with predastmy phenomena, a clear correlation of allergization signs with an increased level of serotonin in the blood (more than 1.7 µmol / l) and a decrease in the coefficient of 5-HIAA. in n -entra (less than 10.0 ;. a patient with dust obstructive bronchitis C content in Blood d-reaches 1.7 µmol / l or exceeds this uro-5-oracuminal venus, and its coefficient is less than 10.0, it should be diagnosed with predastm and prescribed the necessary therapeutic and preventive measures to prevent the development of asthma (observation 2). In the case when with a drunken obstructive bronchitis, the C content in the blood is less than 1.7 µmol / l, and the coefficient of 5th CCIA is equal to or greater than 10.0 there is no reason to diagnose predastum (observation 1)

Claims (1)

METHOD FOR DIAGNOSTIC OF A SUBSTANCE IN PATIENTS WITH DUSTY OBSTRUCTIVE BRONCHITIS by means of biochemical examination of blood and urine, with the aim of simplifying and simplifying the method, the content of serotonin and 5-hydroxyindoleacetic acid in the daily urine is determined , then the ratio of the first value to the second is calculated and, with a serotonin concentration of more than 1.70 μmol / L and a ratio of less than 10.0, a predastma is diagnosed. SU „1169618>