DEVELOPMENT OF EXPERT PREDICTIVE SYSTEM STAGES OF CHRONIC BRAIN ISCHEMIA
The aim of the study: to study, evaluate and prove the diagnostic significance of the platelet functional receptors’ activity of in chronic brain ischaemia (CBI) and to develop regression models for predicting the stages of the diseaseMaterial and methods. The study was prospective and included 107 patients with clinical and neuroimaging signs of CBI. The examination was carried out before treatment and included a clinical neurological and neuropsychological study; Doppler ultrasound of the brachiocephalic arteries, computed and magnetic resonance imaging of the brain. To study the functional activity of platelet receptors, we used agonists of receptors involved in the pathogenesis of CBI particularly: ADP (purine P2Y receptor ligand), angiotensin-2 (AT1 receptor ligand), platelet activation factor (FAT receptor ligand), adrenaline (non-selective α2 adrenoreceptor ligand); type IV collagen (GPVI receptor ligand). Platelet aggregation was evaluated by a turbidimetric method on a ChronoLog analyzer (USA). To assess the relationship between IBP stage and the value of aggregation parameters of platelet-induced agonists, we used the methods of pair correlation analysis and construction of multivariate linear regression models.The results of the study. We analyzed 7 factor signs and revealed 3 significant risk factors strongly associated with the stage of CBI: the activity of angiotensin AT1 receptors, purine P2Y receptors and α2-adrenergic receptors. The logistic model of regression based on the selected features is adequate (2 = 123.3 with 3 degrees of freedom, p <0.001); the area under the curve of the operational characteristics of the model AUC = 0.99 (95% VI- 1.00). The sensitivity of the proposed diagnostic test is 95.2% (95% CI 83.8% - 99.4%) and specificity 100% (95% CI 94.2% -100%). An analysis of the functional activity of platelet receptors in vitro opens up the possibility of determining the leading pathogenetic factors of CBI (risk factors), which determine the expression / sensitivity of the corresponding receptors on target cells. This methodological approach allows to create algorithms for choosing the optimal treatment plan, taking into account individual characteristics of CBI duration.