ESTIMATION METHOD FOR THROMBOLYTIC THERAPY EFFICIENCY IN PATIENTS SUFFERING FROM ACUTE CORONARY SYNDROME Russian patent published in 2009 - IPC A61B5/452 

FIELD: medicine; cardiology.

SUBSTANCE: patients are analysed with electrocardiography in twelve amplitude deflections (I-V6) of Q, R, S waves, Q wave length, QT interval and required QTc interval calculated by Bazet's formula, elevation and depressions of ST segment, dispersion of QT interval, corrected dispersion of QT interval thus considering heart rate. Herewith prior to thrombolysis, and 180 minutes after system thrombolysis, all the deflections are evaluated for total deviations, total elevation and depression of ST segment, total amplitude and Q wave length, ratio of total Q and R wave amplitudes, ratio of QT interval length to required QTc interval, ratio of depolarisation and repolarisation durations corrected considering heart rate, duration of depolarisation initial and final phases in the left chest deflections (V4-V6). Total elevation and depression of ST segment up to 1000 mcV is considered to be small (I degree), while that of 1001-2000 mcV is considered to be moderate (II degree), and that exceeding 2000 mcV is supposed to be considerable (III degree). In view of the fact that dynamics differences of total deviations and total elevation of ST segment, ratio of measured interval QT to required QTc interval lengths, corrected dispersion DQTc between group of patients with effective and inefficient thrombolysis are highly important 180 minutes after thrombolytic therapy, these electrocardiographic parameters are used for modelling thus allowing to estimate efficiency of thrombolytic therapy therefore applying discriminant analysis with consecutive inclusion of variables. As a result model includes total elevation of ST segment, corrected dispersion of DQTc interval at hospitalisation and 180 minutes after system thrombolysis, ratio of measured QT interval to required QTc duration at hospitalisation. It is followed by evaluation of classification function for groups of patients with effective, doubtful and inefficient thrombolysis. Derived factors are substituted in discriminant analysis formula to calculated discriminators of groups (D_1-3) by original mathematical formula. Thereafter classification matrix is plotted thus enabling to classify subsequent monitoring results as to this or that group. Herewith the case is classified as to that group discriminator value of which is closest to average of all three discriminators of the specified case, D average = (D1+D2+D3)/3, that is, the new case is classified as to group with doubtful effect of thrombolytic therapy, if D average is equal to 89.86 and less, with inefficient thrombolysis if D is equal to 105.38 and more, and with effective thrombolysis if D is more than 89.86 and less 105.38, if group centre value is equal to 98.68.

EFFECT: higher efficiency of treatment in patients exposed to system thrombolysis, prevention of possible complications, reduced patients' stay in emergency cardiology department.

13 dwg, 3 ex, 6 tbl