Patent RU-2742342-C1 (RU)
Title: Method for selecting probationers of chemical production in group of high risk of developing conditioned cardiorespiratory pathology
Inventor: VLASOVA ELENA MIKHAJLOVNA
IPC: A61B5/0205
Filed: 2020-06-02
Granted: 2021-02-04
Abstract: FIELD: medicine. 
     SUBSTANCE: invention refers to medicine, namely to preventive and rehabilitation medicine, occupational health, and can be used for selection of trained chemical workers in a group of high risk of developing conditioned cardiorespiratory pathology. Medical examination of chemical industry workers with experience of more than 10 years is carried out by determining diagnostic laboratory and functional indicators. Laboratory factors are hemoglobin (Hb), erythrocytes, lipid hydroperoxides (LHP), malonic dialdehyde (MDA), antioxidant activity of plasma (AAP), erythropoietin, nitrogen oxide, vascular endothelium growth factor (VEGF), homocysteine and highly sensitive C-reactive protein (hs-CRP). Functional parameters are the signs of the left and right ventricles increase by the electrocardiography method by the electric heart axis position setting, the ST segment position relative to the isoline in V 6  and the T wave in V1; type of ventricular complex; through the size of the voltage of the tooth R', height R in lead V 6 , tooth P on electrocardiogram (ECG). Fixed exhalation volume in 1 s (FEV1 1 ), forced vital capacity of lungs (FVC); ratio of FEV 1 /FVC and average volume rate of forced exhalation (COC25-75) by spirography. Performing the functional test using a bronchodilator with the "incremental exhalation rate per second" gain estimate, and establish an annual decline in FEV 1  compared with the previous year and the rate of decrease in endothelial reaction for the year. Results of obtained values are compared with physiological norm. Those workers who have the following deviations in terms of physiological norm, namely: exceeding the upper limit of the standard by more than 10 % of the level of Hb, erythrocytes, LHP, MDA, VEGF, homocysteine and hs-CRP, exceeding the upper limit of the norm by more than 20 % of the AAP level, reducing the level of erythropoietin and nitrogen oxide from the lower limit by more than 10 %, with simultaneous electrocardiography by electric heart deviation to right to 100 degrees; steeply descending depression of ST segment in V 6 ; negative T wave in standard leads; negative tooth T in V 1 ; ventricle-type complex of rSR' type; voltage of R' wave more than 7 mm, high R wave in V 6  lead, voltage P increase greater than 2 mm on ECG electrocardiogram; with FEV 1  spiography setting less than 80 % of the norm; ratio of FEV 1 /FVC equal to 65 %–70 %; COC25-75 - 70 %–75 %; when performing a functional test using a bronchodilator, an increase in the "FEV score per second" value by 8–12 % of the expected value; annual reduction of FEV 1  35–50 ml a year, rate of reducing endothelial functional activity per year by more than 0.3 %, referred to a group of workers with a high risk of developing conditioned cardiorespiratory pathology. 
     EFFECT: method enables to develop criteria for selection of trained chemical workers in a high-risk group of developing conditioned cardiorespiratory pathology by determining a set of laboratory and physiological indicators and comparing the values with standard values. 
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