SU938157A1

SU938157A1 - Method of determination of human being microcirculator system state

Info

Publication number: SU938157A1
Application number: SU802961411A
Authority: SU
Inventors: Виктор Александрович Лапотников; Леонид Моисеевич Хараш
Original assignee: 1-Ый Ленинградский Медицинский Институт Им.Акад.И.П.Павлова
Priority date: 1980-07-25
Filing date: 1980-07-25
Publication date: 1982-06-23

Description

Изобретение относится к медицине в частности к метотрансфузиологии, и может быть использовано для контроля гемотрансфузионной терапии в хирургии, травматологии, реаниматологии, в клинике внутренних болезней ⁵для дифференцированной терапии ряда заболеваний, протекающих с нарушенияг ми в микроциркуляторном русле.The invention relates to medicine, in particular to metotransfusiology, and can be used to control blood transfusion therapy in surgery, traumatology, resuscitation, in the clinic of internal diseases ⁵ for differentiated therapy of a number of diseases that occur with disorders in the microvasculature.

Известен способ определения состояния микроциркуляторного русла путем клинического анализа крови, опре деляющего способность эритроцитов агрегировать в ответ на добавление агрегирующего агента [1 ]. _t5 A known method for determining the state of the microvasculature through a clinical blood test determines the ability of red blood cells to aggregate in response to the addition of an aggregating agent [1]. _t5

Однако известный способ не обеспечивает достаточной точности.However, the known method does not provide sufficient accuracy.

Цель изобретения -повышение точности; способа определения состояния микроциркуляторного русла путем 20 клинического анализа крови.The purpose of the invention is improving accuracy; a method for determining the state of the microvasculature through 20 clinical blood tests.

Указанная цель достигается тем, что согласно способу определения состояния микроциркуляторного рус2 ла человека путем клинического анализа крови, кровь больного в двух равных объемах смешивают с равными объемами изотоничных по pH растворов, один из которых содержит стабилизатор и фосфатный буфер, а другой - стабилизатор, фосфатный буфер и формалин, далее ставят реакцию для определения скорости оседания эритроцитов (СОЭ) в обеих пробах и по коэффициенту агрегации эритроцитовопределяют состояние микроциркуляторного русла.This goal is achieved by the fact that according to the method for determining the state of the microvasculature of a person by clinical blood analysis, the patient’s blood in two equal volumes is mixed with equal volumes of pH isotonic solutions, one of which contains a stabilizer and a phosphate buffer, and the other a stabilizer, phosphate buffer and formalin, then set the reaction to determine the erythrocyte sedimentation rate (ESR) in both samples and determine the state of the microvasculature by the aggregation coefficient of erythrocytes.

Способ осуществляют следующим образом.The method is as follows.

По 0,5 мл крови исследуемого, взятой из локтевой вены, разливают в две силиконированные центрифужные пробирки, которые содержат по 2,0 мл раствора 1 и раствора 2 соответственно,после чего кровь перемешивают с растворами неоднократным покачиванием пробирок и из обеих проб ставят реакцию для определения СОЭ при по3 938157 4 мощи капилляров и аппарата Панченко в термостате при 37°С. Состав раствора 1:3,0 мл 0,077 М двузамещенного ЭДТА и 17,0 мл 0,1 Мфосфатного буфера pH 7,4, Состав раствора 2:3,0 мл 5 0,077 И двузамещенного ЭДТА, 5,0 мл 42-ного осветленного формалина и 12,0 мл 0,1 М фосфатного буфера pH 7,4, Оба раствора должны быть изот тоничны по pH 7,4. Коэффициент агре-. to гацйи вычисляют путем отношения СОЭ из пробы 1 к величине СОЭ из пробы 2. При отсутствии эритроцитарных агрегатов в крови коэффициент агрегации равен 1,0 и уменьшается по мере их 15 увеличения. ' ' Пример . Больной Н. Диагноз: инсулинозависимый сахарный диабет в стадии компенсации. При обследовании СОЭ Г = 12 мм/ч, а СОЭ 2 = 20 мм/ч. ₂₀Коэффициент агрегации 12 мм/ч :0.5 ml of the blood of the test, taken from the cubital vein, is poured into two siliconized centrifuge tubes, which contain 2.0 ml of solution 1 and solution 2, respectively, after which the blood is mixed with solutions by repeatedly shaking the tubes and from both samples the reaction for determination of ESR at 3,938,157 4 powers of capillaries and Panchenko apparatus in a thermostat at 37 ° С. The composition of the solution 1: 3.0 ml of 0.077 M disubstituted EDTA and 17.0 ml of 0.1 Mphosphate buffer pH 7.4, The composition of the solution 2: 3.0 ml of 5 0.077 And disubstituted EDTA, 5.0 ml of 42th clarified formalin and 12.0 ml of 0.1 M phosphate buffer pH 7.4. Both solutions should be isotonic with pH 7.4. Aggregate coefficient. to gatsiyi is calculated by the ratio of ESR from sample 1 to the value of ESR from sample 2. In the absence of red blood cells in the blood, the aggregation coefficient is 1.0 and decreases as they increase 15. '' Example. Patient N. Diagnosis: insulin-dependent diabetes mellitus in the stage of compensation. When examining ESR G = 12 mm / h, and ESR 2 = 20 mm / h. ₂₀ Aggregation coefficient 12 mm / h:

i : 20 мм/ч = 0,6. Уменьшение коэффициента агрегации свидетельствует о нарушении состояния микроциркуляторного русла. После проведения кур- ₂₅са терапии препаратом Трентал, который как известно, уменьшает способность эритроцитов агрегировать, исследование проводят повторно. Получены следующие данные: СОЭ = 9 мм/ ₃₀/ч, а СОЭ 2=11 мм/ч. Коэффициент агрегации = 9:11 = 0,82, что. свидетельствует об улучшении состояния микроциркуляторного русла под влияние ем терапии препаратом Трентал.i: 20 mm / h = 0.6. A decrease in the aggregation coefficient indicates a violation of the state of the microvasculature. After the kur- ₂₅ sa drug Trental therapy which is known to reduce the ability of red blood cells to aggregate, the research carried out repeatedly. The following data were obtained: ESR = 9 mm / ₃₀ / h, and ESR 2 = 11 mm / h. Aggregation coefficient = 9:11 = 0.82, that. indicates an improvement in the state of the microvasculature under the influence of Trental therapy.

Применение предлагаемого способа ³⁵позволяет более точно оценить наличие эритроцитарных агрегатов в крови по “коэффициенту агрегации за счет того, что фиксированные форма лином эритроцитарные агрегаты имеют большой вес пр сравнению с отдельными эритроцитами, что и обуславливает изменение СОЭ в пробе 2, использовать небольшое количество крови (1,0 мл вместо 5,0 мл согласно известному^ а также назначать адекватную терапию при ряде заболеваний, протекающих с нарушениями в микроциркуляторном русле. Простота осуществления способа делает его доступным широкому кругу медицинских учреждений практического здравоохранения.The application of the proposed method ³⁵ allows a more accurate assessment of the presence of erythrocyte aggregates in the blood by the “aggregation coefficient due to the fact that the fixed-form erythrocyte aggregates have a large weight compared to individual red blood cells, which leads to a change in ESR in sample 2, to use a small amount of blood ( 1.0 ml instead of 5.0 ml according to the known ^ and also prescribe adequate therapy for a number of diseases that occur with disorders in the microvasculature. The simplicity of the method makes it accessible to a wide range of medical institutions of practical health care.

Claims

The invention relates to medicine, in particular, to metotransfusiology, and can be used to control blood transfusion therapy in surgery, traumatology, resuscitation, in the clinic of internal diseases for differentiated therapy of a number of diseases occurring in violation of the microvasculature. A known method for determining the state of the microvasculature by means of a clinical blood test, which determines the ability of red blood cells to aggregate in response to the addition of an aggregating agent l. However, the known method does not provide sufficient accuracy. The purpose of the invention is. improving the accuracy of the method for determining the state of the microvasculature through clinical blood analysis. This goal is achieved by the fact that according to the method of determining the state of a human microvasculature by means of a clinical blood test, the patient's blood is mixed in two equal volumes with equal volumes of solutions isotonic in pH, one of which contains a stabilizer and phosphate buffer, and the other - a stabilizer, phosphate the buffer and formalin, then set the reaction to determine the erythrocyte sedimentation rate (the ESR in both samples and determine the state of the microvasculature by the coefficient of erythrocyte aggregation). They are dissolved as follows: 0.5 ml of the test blood taken from the ulnar vein is poured into two siliconized centrifuge tubes, each containing 2.0 ml of solution 1 and solution 2, respectively, after which the blood is mixed with the solutions by repeatedly shaking the tubes and from both samples, the reaction was performed to determine the ESR with the aid of the capillaries and the Panchenko apparatus in a thermostat at 37 C. The composition of the solution is 1: 3.0 ml of M disubstituted EDTA and 17.0 ml of 0.1 M: pH 7 phosphate buffer. m 0.077 M disubstituted EDTA, ml of 4th clarified Formalin and 12.0 ml of 0.1 M phosphate buffer pH 7. Both solutions should be isotonic with pH 7. The aggregation coefficient is calculated by the ratio of ESR from sample 1 to the ESR value from sample 2 In the absence of erythrocyte aggregates in the blood, the aggregation coefficient equals 1.0 and decreases as they increase. An example. Patient N. Diagnosis: insulin-dependent diabetes mellitus in the compensation stage. When examining ESR 1 12 mm / h and ESR 2 20 mm / h. The aggregation coefficient is 12 mm / h: 20 mm / h. A decrease in the aggregation coefficient indicates a violation of the state of the microvasculature. After the course of therapy with Trenthal, which is known to reduce the ability of erythrucytes to aggregate, the study is repeated. The following data were obtained: ESR of 9 mm / / h, and ESR of mm / h. The coefficient of aggregation 9:11 0,82, that. indicates the improvement of the microvasculature under the influence of Trental therapy therapy. The application of the proposed method allows more accurate assessment of the presence of erythrocyte aggregates in the blood according to the aggregation coefficient due to the fact that the erythrocyte aggregates fixed by formalin have a large weight compared to individual erythrocytes, which causes a change in erythrocyte sedimentation rate in sample 2, use a small amount of blood (l, 0 ml instead of 5.0 ml according to the known and also assign adequate therapy for The ease of implementation of the method makes it available to a wide range of medical institutions of practical public health. Formula of the invention A method for determining the state of the human microvasculature by means of a clinical blood test, characterized in the patient's blood is mixed in equal volumes with equal volumes of solutions isotonic in pH, one of which contains a stabilizer and phosphate buffer, and the other is stabilized The torus, phosphate buffer and formalin further set up the reaction to determine the erythrocyte sedimentation rate (ESR in both samples and determine the state of the microvasculature by the coefficient of erythrocyte aggregation. Sources of information taken into account during the examination 1. Ashkinazi I.Ya. Erythrocyte aggregation and thromboplastin formation. - Byul.exp.bil, and medicine, 1972, No. 7, 27-31.