| 摘要 |
FIELD: medicine, cardiology. ^ SUBSTANCE: one should carry out two provocative samples under body state control to detect the signs of ischemic cardiac disease. Moreover, the first provocative sample should be carried out at medicine-free background, the second provocative sample should be conducted after introducing therapeutic dosage of anti-anginal or anti-ischemic preparation. One should measure the duration of provocative factor action. It is necessary to carry out a point evaluation for the signs of ischemic cardiac disease to determine their specificity. One should put 2 points if the sign of ischemic cardiac disease is high-specific by a doctor's opinion, 1 point - if the sign of ischemic cardiac disease is low-specific by a doctor's opinion. Then it is necessary to perform a point evaluation for the efficiency of application of anti-anginal or anti-ischemic preparation. One should calculate diagnostic coefficient due to summarizing point evaluation of the efficiency of applied anti-anginal or anti-ischemic preparation and point evaluations for the signs of ischemic cardiac disease during provocative sample upon medicine-free background, but not more than per one point evaluation for every applied control techniques for the body state. Moreover, except two obligatory control methods as questionnaire and electrocardiography one should apply about one-three additional control techniques for patient's body state out of the following 5: measurement of arterial pressure, echocardiography, myocardial scintigraphy, a single-photon emission computer tomography, positron-emission tomography. One should measure time from the onset of provocative factor's action till manifestation of every sign of ischemic cardiac disease; the signs of ischemic cardiac disease should be divided into pair - obtained in both provocative samples and odd - obtained in one of provocative samples only; then one should calculate the value for the increase of coronary reserve. Point evaluation for the efficiency of applied anti-anginal or anti-ischemic preparation should be fulfilled due to the value of increased coronary reserve being either equal or above 120 sec, 1 point - at the value of coronary reserve increase being 60-119 sec, 0 points - below 60 sec. Significance of the diagnosis of ischemic cardiac disease should be estimated due to comparing the obtained diagnostic coefficient by the following values: 0.5s+3 and more - the diagnosis of ischemic cardiac disease is considered to be significant, about 0.5s+2 up to 0.5s+2.5 - high probability, from 0 to 0.5s+1.5 - low probability, where s - the quantity of applied control techniques for body state. ^ EFFECT: higher accuracy of diagnostics. ^ 3 cl, 2 ex |
