SU1404951A1 - Method of determining personal sensitivity to chemosorption - Google Patents

Abstract

This invention relates to the field of medicine. The purpose of the invention is to improve the accuracy of the method. They take blood before and after hemosorption. The plasma is separated, hemolysis is obtained from the shaped elements. In hemolysate, the concentration of leukocyte alpha glycoprotein is determined by double immunodiffusion. The test specimen in serial dilutions is applied to the wells in the agar gel so that they are located around the test system. Max. The sample of the hemolysate sample under study, which records the hem of precipitation of the test system, is the leukocyte apf glycoprotein titer. The test system for determining the leukocyte alpha glycoprotein is a monospecific antiserum against this protein and a solution of the leukocyte alpha glycoprotein at standard dilution. The increase in the concentration of leukocyte alpha glycoprotein after hemosorption in two or more times reflects the stimulating effect of hemosorption. 9 (L

Description

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The invention relates to medicine and concerns the evaluation of the effectiveness of the treatment by the method of hemosorption in various diseases,

The purpose of the invention is to improve the accuracy of the method.

The method is carried out as follows.

Take 3.0 ml of blood from a vein before and after the procedure. Plasma is separated, hemolysate is obtained from formed elements by freezing and thawing. In hemolysate, the concentration of leukocyte alpha glycoprotein is determined by double immunodiffusion with a standard test system for which the sample under study is diluted (1: 1, 1: 2). , 1: 4, etc.) are added to the wells in the agar gel so that they are located around the test system. The maximum dilution of the hemolysate specimen to be examined, at which the arch of precipitation of the test system is recorded, is the titer of the leukocyte alpha glycoprotein. The concentration of leukocyte alpha-glycoprotein can also be expressed in mg-%, for this it is necessary 0.5 mg-% multiplied by the dilution at which this is still more found in the hemolysate (i.e., the reciprocal of the titer). The test system for determining the leukocyte alpha glycoprotein is a monospecific antiserum against this protein and a solution of the leukocyte alpha glycoprotein at standard dilution.

PRI me R 1. Patient G., 49 years old diagnosis: rheumatoid arthritis in the acute stage, articular-visceral form with predominant lesion of the joints, kidneys (nephrotic syndrome with intact kidney function), treatment with criszanol and steroid hormones .

At clinical examination: pain and limitation of mobility in joints, morning stiffness up to 2 hours, Raynaud syndrome, Sjogren's syndrome, edema. Treatment - prednisone 20 mg per day with the development of severe bleeding from the gastrointestinal tract. ESR 53 mm / h, proteinuria up to 7 g / l.

Taking into account the severity of the disease, high activity of the process, inefficiency, as well as acceptability.

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intolerance to drug therapy, treatment is prescribed by the hemo .COp6lpiH method.

The concentration of leukocyte alpha glycoprotein before and after hemosorption turned out to be 1:16 and 1:64 (or 8 mg-% and 32 mg-%), respectively, on the basis of which it was concluded that there is a stimulating effect on hemosorption and a week later, hemosorbtion was repeated, after the concentration of leukocyte alpha glycoprotein increased 4 times (1: 8 before the procedure and 1:32 after it). After 6 days, a third procedure of hemosorption was performed with a stimulating effect (concentration of leukocyte alpha glycoprotein 1:16 before the procedure and 1:48 after it). The patient's condition after three sessions of hemosorption improved significantly: there was no pain in the joints, the edema disappeared. There was also an improvement in laboratory data by the end of the treatment cycle: hemoglobin 8-11 units. (at the beginning and at the end of treatment), leukocytes 9500-10100, eosinophils. 2 - 0%, ESR 53–17 mm per hour, rheumatoid factor 1: 3 200–1: 800, daily proteinuria 5–1 g / l. Remissi lasted 1 year and 8 months.

Thus, a good treatment effect was observed in a patient: reduction of edema, arrest of articular syndrome, reduction of rheumatoid factor, after three procedures of hemosorption. The increase in the concentration of leukocyte alpha glycoprotein after hemosorption by 3-4 times, reflecting the stimulating effect of this procedure, was recorded every time. At the same time, there were no other objective indicators indicating the presence of a stimulating effect, the possibility and expediency of continuing treatment, since the laboratory data did not change much after each hemosorption, the clinical effect developed gradually. After the first hemosorption in this patient: leukocytes; 8900-8300 (before and after the procedure), ESR 49-50, rheumatoid factor 1: 4200-1: 2: 800, etc.

Example 2: Patient S., 45 years old, diagnosed with laryngeal cancer, condition after a full course of radiotherapy.

Complaints of indisposition, weakness, low-grade fever, pain in

31404951

throat With indirect ligationoscopy: individual response to hemosorption

the tumor occupies all parts of the larynx; to resolve the question of the possibility of re-spreading the second procedure to the medial wall;

Pharyngeal pharynx and softness possible. Leukocyte count

neck tissue. In the study of blood: 7000-7200 (before and after hemosorption),

ESR 29, leukocytes 7600, C-reactive C-reactive protein +4 - 4+, fibrin-protein +4, fibrinogen 672 mg-%, circus gene 640-580 mg-%, circulating immune complexes 0.420, immune complexes 0.420-0.440,

Taking into account the presence of a patient with endozy; Absence of positive clinigenic intoxication, due to the effect after hemosorption,

malignant common tumor-unfavorable course of postoperative larynx, exposure to the full-on period, presence of complications

a course of radiation therapy, as well as a pre-infectious nature confirm

a worthy extended operation was 15 that the patient did not have hemosorbtsy

appointed hemosorbtsi. After hemo-stimulating effect. Purpose

sorption was evaluated stimulating the effect of re-hemosorption in this case

The effect of this procedure on changing the con-would be not stimulating, but historical

leukocyte alpha glycosylation leukocyte system action system

peripheral blood proteid. Because of this, 20 could lead to even greater measurement of this indicator by the complexity,

analogously to example 1, Concentration EXAMPLE 3, Patient H ,, 44 years old,

leukocyte alpha glycoprotein diagnosis: laryngeal cancer, prior to hemosorption 1:16 (8 mg -%), after a full course of radiation therapy after hemosorption 1: 8 (4 mg-%), 25pee,

decreased by half. After hemosorption Complaints to indisposition, the subfebrile patient did not notice an improvement in the general temperature, a decrease in the working condition, a subfebrile ability remained, hoarseness. When nepry my temperature. Since, when evaluating kelaringoscopy: a tumor of a whitish leukocyte concentration {5 n alpha Color, with a ulcerated surface, the glycoprotein in the peripheral bloodstream of all parts of the larynx. In the absence of stimulating blood, 7800 leukocytes, a hematical effect, hemosorption, as well as C-reactive protein 3+, fibrinogen, taking into account the absence of a positive666 mg-%, circulating immune dynamics, repeated complexions, were found.

the hedosorption procedure was not performed. Considering the fact that the patient has an endosse 4 days after hemosorption, the patient has an intoxication caused by

surgery: complete removal; malignant tumor of the larynx,

larynx with resection of the laryngopharynx and the impact of the full course of radiation

soft tissues of the neck. Postoperative otherapies, as well as the impending widened period, were complicated by purulent-necrotic surgery, were prescribed by hemosorbic wound inflammation with the formation of detoxification and stimulation

resistant pharyngostomy, raising the temperature of the protective and adaptive forces

tours marked up to 39, in the organism of the organism. After hemosorption, bronchropneumonia was detected, the patient's lesion somewhat improved,

requiring conservative treatment, according to the appetite, decreased symptomatically. Thus, the patient after we had intoxication. Blood counts of hemosorption were found to decrease con-after hemosorption: leukocytes 8000, concentration of leukocyte alpha-glyco-C-reactive protein 3+, proteid fibrinogen in peripheral blood, by 440 mg-%, circulating immune components of which concluded that antiplexes 0.340, Changes in concentration when reappointment of an alpha-glycoprotein leukocyte in this procedure. The reason for the detection of peripheral blood was assessed by an analogous individual reaction to the procedure in Example 1; Before hemosorption of urine hemosorption, there was probably a presentation of leukocyte alpha glycoprotein radiation therapy and, possibly, amounted to 1:36 (16 mg-%) after lio, a long-term tumor process, hemosorption is 1:32 (16 mg-%), based on the other results of the wedge, a conclusion was made that, by scientific examination, it is not advisable to reappoint hemosorbtion, since it does not increase fun the national activity of peripheral blood leukocytes in a patient, and because of this, can lead to the depletion of the body's defenses. Sput 4 days after hemosorption the operation was performed: complete removal of the larynx and lymph nodes of the neck. In the postoperative period, the issue of re-hemosorption was considered, since wound healing proceeded to a state of health, the patient's condition and blood parameters returned to normal slowly. However, taking into account the results of the evaluation of the stimulating effect of hemosorption in this patient and the detected lack of dynamics of the leukocyte alpha glycoprotein after the first hemosorption, it was decided that it would not be expedient to repeat hemosorption in the postoperative period.

Claims (1)

Claims t The method for determining individual sensitivity to hemosorption by biochemical blood tests, characterized in that, in order to increase the accuracy of the method, the content of leukocyte alpha glycoprotein is determined before and after hemosorption, and with an increase of this indicator two or more times compared to the initial level, sensitivity to hemosorption is determined.