Применение бинокулярной пупиллометрии в дифференциальной диагностике сегментарной кардиалгии.

Приведены результаты исследования пупилломоторных реакций у пациентов с цервикальной и торакальной кардиалгией. Установлено, что в клинической картине и этиопатогенезе сегметарной цервикальной кардиалгии значительную роль играет патология вегетативной нервной системы, а именно гиперреактивность её симпатической части, сочетающаяся с гипофункцией парасимпатической. У пациентов с торакальной сегментарной кардиалгией нарушения вегетативной иннервации значительно менее выражены.

Application Binocular Pupillometry in Differential Diagnostics Segmentary Cardialgia.

The work purpose i is studying of possibility of use binocular pupillometry as method of differential diagnostics cervical or thoracal segmentary кардиалгии. 161 patient (83 women and 78 men) neurologic department at the age from 28 till 53 years with proved segmentary cardialgia has been surveyed. Two groups on the basis of clinical displays have been generated: 1) a pulling, pressing pain in the field of heart at loading on cervical department 69 patients age from 28 till 51 years, 2) an acute pain in the field of the heart, arising or amplifying at movement in chest department 72 patients at the age from 31 till 53 years. Registration зрачковых reactions was spent photoelectronic computer pupillograph Iritech DM-2000. Were investigated: The latent period of narrowing of a pupil, time of narrowing of a pupil, the latent period of expansion of a pupil, time of expansion of a pupil, time pupil reactions, amplitude pupil reactions. By us it is established that at 84 (49,4 %) patients in both groups during an attack it was observed анизокория with presence midriasis different degree of expressiveness on the pain party. At detailed research it is revealed that at patients of 1 group in 62 cases (89,8 %) have been considerably reduced the latent period of narrowing of a pupil, but is increased time of a plateau and time of expansion of a pupil mainly at the left. After course of treatment has increased and has come nearer to average at 54 (78,2 %), reduction of an indicator of time of expansion of a pupil has been registered at 64 (92,7 %) patients, indicator the latent period of narrowing of a pupil authentically has not changed. At patients 2nd groups of change the latent period of narrowing of a pupil were statistically doubtful, but time of expansion of a pupil therefore time зрачковой reactions was extended have been increased. On the basis pupillometric researches it has been established that the amplitude of narrowing of a pupil in process of increase in age of an organism steadily decreases in both groups, and falling of force of a parasympathetic tone makes 21 %. In a clinical picture and the reason segmentary cervical cardialgia the considerable role is played by a pathology of vegetative nervous system, hyperreactance of its sympathetic part, hypofunction of the parasympathetic part. At patients with thoracal segmentary cardialgia infringements vegetative innervations are considerably less expressed. Binocular pupillometry can be one of significant and authentic methods in differential topical to diagnostics segmentary cardialgia.