Khyzhnyak O. Diagnostic and prognostic significance of examining the subfractional composition of blood serum in patients with acute myocardial infarction.

complications of myocardial infarction (MI). Purpose of the research: an increase in the efficacy of early diagnosis and prognostication of the MI course with regard for the materials of the study of the subfractional content of blood serum (SСBS) on the basis of using the method of laser correlation spectroscopy (LCS). Methods of the research: clinical, biophysical, statistical ones. Theoretical and practical results: an additional diagnostic criterion Q-MI is suggested in patients with the acute coronary syndrome on the basis of detecting the level of troponine I (TnI) in blood plasma. Criteria were worked out for an early diagnosis of AMI, including Q and non-Q MI, on the basis of the study of SCBS with help of LCS. Additional criteria were established for revealing a risk of the development of acute cardiac failure (ACF) in AMI patients, taking into account the data of materials of the study of peculiarities in serum homeostasis on the basis of LCS. An effective method was mastered for assessing the development of AMI complications on the basis of a combined use of the results of the detection of TnI level and the study of SCBS on the basis of LCS. Novelty: a quantitative assessment of the diagnostic and prognostic significance of myocardial necrosis markers, including TnI and creatine phosphokinase IM-fraction (CPK-IM), in AMI patients in the dynamics, from the beginning of the disease up to 7 days, was suggested. It was found out that 3 hours after the beginning of the disease, the patients with Q-positive AMI revealed the presence of their LC spectrum of blood serum the presence of light-diffusing particles with a hydrodynamic radius (HR) of up to 70 nm, while in the patients with Q-negative AMI the larger part of the spectrum was represented by light-diffusing particles with HP within 70-150 nm and over the above level of parameters. In the patients with AMI, the development of ACF was associated with an absolute predominance of light-diffusing particles with HR of up to 70 nm in their SCBS, including particles with a radius of up to 10 nm. Serum homeostasis changes in those AMI patients, who received thrombolytical therapy, were characterized by an increase in the proportional content of light-diffusing particles with HR within 71-150 nm. The priority of the research is confirmed by the patent on invention “A way of early diagnosis of myocardial infrction” No. 64115 A. Degree of introduction: results of the thesis work were introduced into the therapeutic-diagnostic process of cardiological departments of Odessa Regional Hospital and Odessa City Hospital No. 1, as well as they were published in the Register of Branch Innovations of the Ministry of Health of Ukraine (Register No. 46/26/07, Issue 26-27, 2007). Sphere of application: medicine, cardiological departments.