SU1288607A1 - Method of diagnosis of acute myocardial infarction - Google Patents

Abstract

This invention relates to medicine and allows the diagnosis of small-focal forms of myocardial infarction. The purpose of the invention is to improve the accuracy of diagnosis. The biochemical parameters of peripheral blood are investigated: the relative number of monocytes, phagocytic index, phagocytic number and total lysosome luminescence index. An increase in these indicators relative to the norm makes it possible to diagnose acute myocardial infarction. (L with you 00 ace O5

Description

The invention relates to experimental and clinical medicine and can be used as an additional method for the diagnosis of small focal myocardial infarction forms.

The purpose of the invention is to improve accuracy by determining the amount and functional activity of peripheral blood monocyto.

Example 1. Patient O., 56 years old, was admitted with a diagnosis of acute transmural myocardial infarction in the area of the septum, apex, anterolateral wall of the left ventricle. Upon admission, the patient was disturbed by severe pains of a pressing nature behind the sternum, general weakness. When viewed from the rhythm of the heartbeat is correct. Heart rate 108 beats. in 1 min., DC 160/95 mm Hg. On the ECG - signs of transmural myocardial infarction in the area of the septum, apex, anterolateral wall of the left ventricle (Qr-1, AVZ, QS-, QrS) in Vg; VT .. contours in 1. AVZ,, T. / + - /. ACT activity from 2 / ri 2.92 mmol / l. In general, a blood test. 2 / II: leukocytes 7.0 10 / l, ESR 8 mm / h. Along with the above mentioned parameters, the patient's phagocytic number increased to 370 (in abs. Numbers), the phagocytic index was 59%, the lysosomal luminescence level was 456 sr. units, monocytes, 4%.

Example 2. Patient J., 58 years old, was admitted with a diagnosis of acute large-focal myocardial infarction of the posterior flank wall of the left ventricle. On admission, complaints about the intense, sometimes burning pains behind the sternum and to the left of the sternum were received. Heart rate 60 beats. in 1 min HELL 160/100 mm Hg On the ECG of 15/11, the ST segment is raised above the isoline by 2 mm of arcuate shape in II, III, AVF leads. High T wave in V, V ,, V. Activity

5 .ACT from 16/11 - 0.75 mmol / l. Generally

blood test from 15/11: leukocytes 9 ,, ESR 3 mm / h. The level of indicators characterizing the amount and functional activity of monocyto from 15/11 is as follows: monocytes 19%, phagocytic index 56%, phagocytic number 202, lysosomal luminescence level 354 sr. units

Example

Patient A., 41 years old.

admitted with a diagnosis of acute croup

five

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nocular myocardial infarction in the posterior diaphragmatic wall of the left ventricle. On admission, complaints about burning, rending pains behind the sternum radiating to the epigastrium and left hypochondrium were received. The patient was faint, covered with cold, sticky sweat. Then, for the first time, severe pain behind the sternum appeared during physical exertion. When viewed from the rhythm of the heartbeat is correct, the heart rate is 68 beats. in 1 min, blood pressure 140/90 mm Hg On ECG, signs of large-focal posterior diaphragmatic myocardial infarction (Qr and / - / T in II, III. AVF). In general, the analysis of blood from leukocytes 8 ,, ESR 5 mm / h. ACT activity 0.5 mmol / l. Indicators characterizing the quantity and functional activity of monocytes from 12 / IX: monocytes 13%, phagocytic index 52%, phagocytic number 184, level of luminescence 5 zosome 578 services. units

Example 4. Patient C., 51, was admitted with a diagnosis of acute myocardial infarction in the area of the septum, the apex and side wall of the left ventricle. The patient was worried about the feeling of discomfort in the left half of the chest, cutting weakness. The number of heartbeats 84 beats. in 1 min., HELL 170/100 mm Hg On ECG, signs of a large-focal myocardial infarction in the area of the septum, apex spreading to the side wall of the left ventricle (abnormal Q tooth in I, AVZ, V-Ve leads, ST segment above the isoline, merges with T wave 1.11, AVZ, V - Vg leads). A1: ACT 0.5 mmol / l. Indicators characterizing the number and functional activity of monocytes: monocytes 16%, phagocytic index 45%, phagocytic number 152, lysosomal luminescence level 324 used units.

Example 5. Patient K., 57 years old, arrived with a diagnosis of acute recurrent small-focal myocardial infarction in the anterior-lateral wall, apex of the left ventricle. Patient admission

I was worried about squeezing pain in the sternum radiating to the left shoulder blade, dizziness, and dry mouth. The patient's condition is a moderate degree of heart rate 88 beats. in 1 min., blood pressure

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130/80 mm Hg On the ECG, the ST Bbmie segment of the isolines in I, II, AVZ, V. -Vg leads. / - / T in the same lead. ACT activity 0.66 mmol / l. Indicators characterizing the number and functional activity of monocytes: monocytes 11%, phagocytic index 54%, phagocytic number 278, lysosomal luminescence level 276 used units.

Example 6. Ill. O., 60 years old, was admitted with a diagnosis of acute small focal myocardial infarction of the posterolateral wall of the left ventricle On admission, she was disturbed by dull pains to the left of the sternum, numbness of the left arm. During the last week, transient pains to the left of the chest during exertion began to appear more frequently. On examination, the number of sedentary contractions 94 beats. in 1 min., HELL 160/90 mm Hg On ECG depression of the ST segment in II, III, AVF, V, Vc / - / T in

 g / - / JL iiu II, III, AVF / - + / T in Vg, V .. ACT activity 0.33 mmol / l. Po6

indicators characterizing the quantities and functional activity of monocytes: monocytes 9%, phagocytic index 52%, phagocytic number 230, lysosomal luminescence level 404 standard units

In the study of the number and functional activity of monocytes in patients with stable angina, no deviations of indicators from the level of donors were detected.

Upon admission of patients with nesta

angina pectoris to the hospital when there was an increase in both the number and functional active. Editor O. Bugir Order 7802/43

Compiled by L.Shilina Tehred V. Kadar

Corrector

Circulation 799 Subscription

VNIIPI USSR State Committee

for inventions and discoveries 113035, Moscow, Zh-35, Raushsk nab., 4/5

. Production and printing company, Uzhgorod, Projecto st., 4

. 10 th

2886074

monocytes, the average level of AcAT was 0.4 7 ± 0.03, which is in the generally accepted norms. At the same time, on electrocardiogram 5, 82.8% of patients had hypoxic and ischemic changes in the myocardium, rhythm and conduction disturbances - in 20.3% of patients, signs of myocardial hypertrophy - in 10.9% of cases. Pathognomonic signs for necrosis of the heart muscle in patients with unstable angina pectoris have not been identified.

Thus, the results of the study suggest that determining the number and functional activity of peripheral blood monocytes is a more sensitive diagnostic test for acute myocardial infarction, suggesting the presence of micronecrosis in the heart cavity when electrocardiography and the determination of serum AcAT activity is not yet reg15

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Claims (1)

Invention Formula Method for the diagnosis of acute myocardial infarction by biochemical blood analysis, characterized in that, in order to improve the accuracy of the method, the relative amount of Mf nocytes is determined, the phagocytic index, phagocytic number and total lysosome luminescence indicator are diagnosed with acute myocardial infarction as they increase relative to the norm . Proofreader E.Roshko,