28 research outputs found
ΠΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ Π°Π»Π»Π΅ΡΠ³ΠΈΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ
Allergic disease is a serious problem in practical healthcare. Over the last 40 years there has been exponential growth in the prevalence. According to the world health organization information, allergic diseases are at the 2nd place in prevalence the children, behind the viral infections. Their frequency and severity are increasing. In this regard, the relevance of timely and skilled diagnostic allergopathology is most important. In this study the current state of the question of allergy diagnostics is considered, the international experience is summarized and the approach to the allergy diagnosis based on use of step-by-step identification of a causal and significant factor of allergic reactions is offered. On the basis of the analysis of relevance and the importance for patients of one or the other allergens (taking into account a source of allergens and age of patients) use of a step-by-step allergy diagnostics algorithm is offered. The first step is definition of clinical implications of an allergy. It means direct contact of the phisition with the patient, clarification of its complaints, clinical symptoms, medical history disease. The second step is the confirmation of IgE-dependent mechanism. It involves the using of screening tests that are selected depending on the clinical symptoms and seasonality manifestations (the screening module). The third step is to identify the source of the allergens that are most meaningful for the patient with using test panels (modules). The panels include the most common and clinically relevant triggers of allergic reactions. The fourth step is the search for an individual significant allergens, which were not included in the diagnostic modules. On the fifth step, we plan to conduct component-divided diagnostics and detect the antibodies to unique components of significant allergens. The developed diagnostics algorithm, corresponds to needs of both the adult, and childrenβs population and provides the personalized approach to the patients.ΠΠ»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ - ΡΠ΅ΡΡΠ΅Π·Π½Π°Ρ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ° ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎΒ ΠΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΡΠ΅ΠΌΠΈΡΠ½ΠΎΠΉ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠΈ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ,Β Π²Β Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΎΠ΄Π½ΠΎΠΉ ΠΈΠ· Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΡΡ
ΠΏΡΠΎΠ±Π»Π΅ΠΌ,Β ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΒ Π²Β ΠΏΠ΅Π΄ΠΈΠ°ΡΡΠΈΠΈ,Β ΡΠ²Π»ΡΡΡΡΡ Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ:Β ΡΒ Π΄Π΅ΡΠ΅ΠΉ Π΄Π°Π½Π½Π°Ρ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΒ ΠΏΠΎ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ Π·Π°Π½ΠΈΠΌΠ°Π΅Ρ Π²ΡΠΎΡΠΎΠ΅ ΠΌΠ΅ΡΡΠΎ. ΠΡΠΈ ΡΡΠΎΠΌ ΠΎΡΠΌΠ΅ΡΠ°ΡΡΡΡ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΡΠ°ΡΡΠΎΡΡ ΡΡΠΆΠ΅Π»ΡΡ
Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉΒ ΠΈΒ Π²ΡΠ΅ Π±ΠΎΠ»Π΅Π΅ ΡΠ°Π½Π½Π΅Π΅ Π½Π°ΡΠ°Π»ΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠΉ.Β ΠΒ ΡΠ²ΡΠ·ΠΈΒ ΡΒ ΡΡΠΈΠΌ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ΡΠ²ΠΎΠ΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉΒ ΠΈΒ ΠΊΠ²Π°Π»ΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ Π°Π»Π»Π΅ΡΠ³ΠΎΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΉΡΡΠ°Π½ΠΎΠ²ΠΈΡΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΠΌ.Β ΠΒ Π½Π°ΡΡΠΎΡΡΠ΅ΠΉ ΡΠ°Π±ΠΎΡΠ΅ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°Π΅ΡΡΡΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ Π²ΠΎΠΏΡΠΎΡΠ° Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ, ΠΎΠ±ΠΎΠ±ΡΠ΅Π½ ΠΌΠΈΡΠΎΠ²ΠΎΠΉ ΠΎΠΏΡΡΒ ΠΈΒ ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Β ΠΊΒ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ Π°Π»Π»Π΅ΡΠ³ΠΈΠΈ, ΠΎΠΏΠΈΡΠ°ΡΡΠΈΠΉΡΡ Π½Π° ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠΎΡΠ°Π³ΠΎΠ²ΠΎΠ³ΠΎ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΠΏΡΠΈΡΠΈΠ½Π½ΠΎ-Π·Π½Π°ΡΠΈΠΌΠΎΠ³ΠΎ ΡΠ°ΠΊΡΠΎΡΠ° Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉ. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ Π°Π½Π°Π»ΠΈΠ·Π° Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΠΈΒ ΠΈΒ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΠΈ ΡΠ΅Ρ
ΠΈΠ»ΠΈ ΠΈΠ½ΡΡ
Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ² Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²Β (ΡΡΡΠ΅ΡΠΎΠΌ ΠΈΡΡΠΎΡΠ½ΠΈΠΊΠ° Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ²Β ΠΈΒ Π²ΠΎΠ·ΡΠ°ΡΡΠ° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ²) ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½ΠΏΠΎΡΠ°Π³ΠΎΠ²ΡΠΉΒ Π°Π»Π³ΠΎΡΠΈΡΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ Π°Π»Π»Π΅ΡΠ³ΠΈΠΈ. ΠΠ΅ΡΠ²ΡΠΉ ΡΠ°Π³Β β ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠΉ Π°Π»Π»Π΅ΡΠ³ΠΈΠΈΒ β ΡΡΠΎΒ ΠΏΡΡΠΌΠΎΠΉ ΠΊΠΎΠ½ΡΠ°ΠΊΡ Π²ΡΠ°ΡΠ°-Π°Π»Π»Π΅ΡΠ³ΠΎΠ»ΠΎΠ³Π°Β ΡΒ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΌ, Π²ΡΡΡΠ½Π΅Π½ΠΈΠ΅ Π΅Π³ΠΎ ΠΆΠ°Π»ΠΎΠ±, ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ², ΡΠ±ΠΎΡ Π°Π½Π°ΠΌΠ½Π΅Π·Π° Π±ΠΎΠ»Π΅Π·Π½ΠΈ. ΠΡΠΎΡΠΎΠΉ ΡΠ°Π³Β β ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½ΠΈΠ΅Β IgE-Π·Π°Π²ΠΈΡΠΈΠΌΠΎΠ³ΠΎ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠ° Π°Π»Π»Π΅ΡΠ³ΠΈΠΈΒ β ΠΏΡΠ΅Π΄ΠΏΠΎΠ»Π°Π³Π°Π΅Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³ΠΎΠ²ΡΡ
ΡΠ΅ΡΡΠΎΠ², Π²ΡΠ±ΡΠ°Π½Π½ΡΡ
Β Π²Β Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ² Π°Π»Π»Π΅ΡΠ³ΠΈΠΈΒ ΠΈΡΠ΅Π·ΠΎΠ½Π½ΠΎΡΡΠΈ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠΉ (ΡΠΊΡΠΈΠ½ΠΈΠ½Π³ΠΎΠ²ΡΡ
ΠΌΠΎΠ΄ΡΠ»Π΅ΠΉ). Π’ΡΠ΅ΡΠΈΠΉ ΡΠ°Π³Β β Π²ΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΠΈΡΡΠΎΡΠ½ΠΈΠΊΠ° Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ², Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΠΎΠ³ΠΎ Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°,Β ΡΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΠ΅ΡΡΠΎΠ²ΡΡ
ΠΏΠ°Π½Π΅Π»Π΅ΠΉ, ΠΎΠ±ΡΠ΅Π΄ΠΈΠ½ΡΡΡΠΈΡ
Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠ΅Β ΠΈΒ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡΠ΅ ΡΡΠΈΠ³Π³Π΅ΡΡ Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ΅Π°ΠΊΡΠΈΠΉ. Π§Π΅ΡΠ²Π΅ΡΡΡΠΉΒ ΡΠ°Π³Β βΒ ΡΡΠΎ ΠΏΠΎΠΈΡΠΊ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΡΡ
ΠΏΡΠΈΡΠΈΠ½Π½ΠΎ-Π·Π½Π°ΡΠΈΠΌΡΡ
Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ², Π½Π΅ Π²ΠΎΡΠ΅Π΄ΡΠΈΡ
Β Π²Β Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠΎΠ΄ΡΠ»ΠΈ. ΠΡΡΡΠΉΒ β ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½Ρ-ΡΠ°Π·Π΄Π΅Π»Π΅Π½Π½ΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈΒ ΠΈΒ Π²ΡΡΠ²Π»Π΅Π½ΠΈΠ΅ Π°Π½ΡΠΈΡΠ΅Π»Β ΠΊΡΠ½ΠΈΠΊΠ°Π»ΡΠ½ΡΠΌ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠ°ΠΌ ΠΏΡΠΈΡΠΈΠ½Π½ΠΎ-Π·Π½Π°ΡΠΈΠΌΡΡ
Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ². Π Π°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½ΡΠΉ Π°Π»Π³ΠΎΡΠΈΡΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ, ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΠ΅Ρ ΠΏΠΎΡΡΠ΅Π±Π½ΠΎΡΡΡΠΌ ΠΊΠ°ΠΊ Π²Π·ΡΠΎΡΠ»ΠΎΠ³ΠΎ, ΡΠ°ΠΊΒ ΠΈΠ΄Π΅ΡΡΠΊΠΎΠ³ΠΎ Π½Π°ΡΠ΅Π»Π΅Π½ΠΈΡΒ ΠΈΒ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΠ²Π°Π΅Ρ ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Β ΠΊΠΏΠ°ΡΠΈΠ΅Π½ΡΡ
ΠΠΎΠ·ΡΠ°ΡΡΠ½Π°Ρ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ Π°Π½ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° Ρ Π΄Π΅ΡΠ΅ΠΈΜ Ρ ΠΏΠΈΡΠ΅Π²ΠΎΠΈΜ Π°Π»Π»Π΅ΡΠ³ΠΈΠ΅ΠΈΜ
Food allergy (FA) is an important health problem which determines lower life quality of a patient and his family. Egg proteins, milk, soy, wheat, and nuts provoke FA more often but any food product may potentially cause allergic reactions. So the aim was to study the age-specific dynamics of antibody response and select the most meaningful IgE production triggers in children with PA. Materials and Methods. The study included 682 children with FA divided into groups according to age: 2β5 months, 6β18 months, 1.5β4 years, 4β10 years, older than 10 years. The IgE levels to cereals, vegetables, bananas, meat, and poultry allergens were measured in blood samples. Results. The age dynamic of IgE-positive responses was detected. The frequency of positive responses was higher in older children. The most significant IgE production triggers for 2β5 months children were allergens of potatoes, pork and cereals (8β14%); for 6β18 month children potatoes (22.7%), buckwheat (19,3%), cereals (10β15%); for 1.5β4 years children β bananas (29.5%), cereals, carrots and potatoes (19,5β24%); for 4β10 years children β bananas, carrots and cereals (20β28%); for the senior children β carrots (47.5%), bananas, cereals and tomatoes (30β36%). Chicken-specific IgE-positive response was minimal for all ages, and meat or poultry specific IgE were observed in 8β15% of patients. Conclusion. Different groups of food allergens provoke sensitization in children during their life. The range of food products with low allergenic activity remains constant in various ages. Age characteristics of IgE production requires differentiated diagnosis approach.Β ΠΠΈΡΠ΅Π²Π°Ρ Π°Π»Π»Π΅ΡΠ³ΠΈΡ (ΠΠ) β Π²Π°ΠΆΠ½Π°Ρ ΠΏΡΠΎΠ±Π»Π΅ΠΌΠ° Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ, Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΡΡ
ΡΠ΄ΡΠ°ΡΡΠ°Ρ ΠΊΠ°ΡΠ΅ΡΡΠ²ΠΎ ΠΆΠΈΠ·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° ΠΈ ΡΠ»Π΅Π½ΠΎΠ² Π΅Π³ΠΎ ΡΠ΅ΠΌΡΠΈ. ΠΠ Ρ Π΄Π΅ΡΠ΅ΠΈΜ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π° Π±Π΅Π»ΠΊΠ°ΠΌΠΈ ΡΠΈΜΡΠ°, ΠΌΠΎΠ»ΠΎΠΊΠ°, ΡΠΎΠΈ, ΠΏΡΠ΅Π½ΠΈΡΡ ΠΈ ΠΎΡΠ΅Ρ
ΠΎΠ², ΠΎΠ΄Π½Π°ΠΊΠΎ Π»ΡΠ±ΠΎΠΈΜ ΠΏΠΈΡΠ΅Π²ΠΎΠΈΜ ΠΏΡΠΎΠ΄ΡΠΊΡ ΠΌΠΎΠΆΠ΅Ρ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΠΎ Π²ΡΠ·Π²Π°ΡΡ Π°Π»Π»Π΅ΡΠ³ΠΈΡΠ΅ΡΠΊΡΡ ΡΠ΅Π°ΠΊΡΠΈΡ. Π ΡΠ²ΡΠ·ΠΈ Ρ ΡΡΠΈΠΌ ΡΠ΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΈΠ·ΡΡΠΈΡΡ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΡΡ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΡ Π°Π½ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° ΠΈ Π²ΡΠ±ΡΠ°ΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΡΠ΅ ΡΡΠΈΠ³Π³Π΅ΡΡ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΈΡ
IgE Ρ Π΄Π΅ΡΠ΅ΠΈΜ Ρ ΠΠ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 682 ΡΠ΅Π±Π΅Π½ΠΊΠ° Ρ ΠΠ, ΡΠ°Π·Π΄Π΅Π»Π΅Π½Π½ΡΠ΅ Π½Π° Π³ΡΡΠΏΠΏΡ Π² ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠΈ Ρ Π²ΠΎΠ·ΡΠ°ΡΡΠΎΠΌ: 2β5 ΠΌΠ΅ΡΡΡΠ΅Π², 6β18 ΠΌΠ΅ΡΡΡΠ΅Π², 1,5β4 Π³ΠΎΠ΄Π°, 4β10 Π»Π΅Ρ, ΡΡΠ°ΡΡΠ΅ 10 Π»Π΅Ρ. ΠΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ ΡΡΠΎΠ²Π΅Π½Ρ IgE ΠΊ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ Π·Π»Π°ΠΊΠΎΠ², ΠΎΠ²ΠΎΡΠ΅ΠΈΜ, Π±Π°Π½Π°Π½Π°, ΠΌΡΡΠ° ΠΈ ΠΏΡΠΈΡΡ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΡΠ²Π»Π΅Π½Π° Π²ΠΎΠ·ΡΠ°ΡΡΠ½Π°Ρ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ°ΡΠΈΡΠ»Π° IgE-ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΡ
ΠΎΡΠ²Π΅ΡΠΎΠ². ΠΠ»Ρ Π΄Π΅ΡΠ΅ΠΈΜ 2β5 ΠΌΠ΅ΡΡΡΠ΅Π² Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΡΠΌΠΈ ΡΡΠΈΠ³Π³Π΅ΡΠ°ΠΌΠΈ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ IgE ΡΠ²Π»ΡΠ»ΠΈΡΡ ΠΊΠ°ΡΡΠΎΡΠ΅Π»Ρ, ΡΠ²ΠΈΠ½ΠΈΠ½Π° ΠΈ Π·Π»Π°ΠΊΠΈ (8β14%). ΠΡΡΠΎΠΊΠ°Ρ ΡΠ°ΡΡΠΎΡΠ° ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΡΡ
ΠΎΡΠ²Π΅ΡΠΎΠ² Π½Π°Π±Π»ΡΠ΄Π°Π»Π°ΡΡ Ρ Π±ΠΎΠ»Π΅Π΅ ΡΡΠ°ΡΡΠΈΡ
Π΄Π΅ΡΠ΅ΠΈΜ. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΡΠΌΠΈ ΡΡΠΈΠ³Π³Π΅ΡΠ°ΠΌΠΈ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ IgE Π΄Π»Ρ Π΄Π΅ΡΠ΅ΠΈΜ 6β18 ΠΌΠ΅ΡΡΡΠ΅Π² ΡΠ²Π»ΡΠ»ΠΈΡΡ Π°Π»Π»Π΅ΡΠ³Π΅Π½Ρ ΠΊΠ°ΡΡΠΎΡΠ΅Π»Ρ (22,7%), Π³ΡΠ΅ΡΠΊΠΈ (19,3%), Π·Π»Π°ΠΊΠΎΠ² (10β15%), Π΄Π»Ρ Π΄Π΅ΡΠ΅ΠΈΜ 1,5β4 Π»Π΅Ρ β Π°Π»Π»Π΅ΡΠ³Π΅Π½Ρ Π±Π°Π½Π°Π½Π° (29,5%), Π·Π»Π°ΠΊΠΎΠ², ΠΌΠΎΡΠΊΠΎΠ²ΠΈ ΠΈ ΠΊΠ°ΡΡΠΎΡΠ΅Π»Ρ (19,5β24%), Π΄Π»Ρ Π΄Π΅ΡΠ΅ΠΈΜ 4β10 Π»Π΅Ρ β Π°Π»Π»Π΅ΡΠ³Π΅Π½Ρ Π±Π°Π½Π°Π½Π°, ΠΌΠΎΡΠΊΠΎΠ²ΠΈ ΠΈ Π·Π»Π°ΠΊΠΎΠ² (20β28%), Π΄Π»Ρ Π΄Π΅ΡΠ΅ΠΈΜ ΡΡΠ°ΡΡΠ΅ 10 Π»Π΅Ρ β Π°Π»Π»Π΅ΡΠ³Π΅Π½Ρ ΠΌΠΎΡΠΊΠΎΠ²ΠΈ (47,5%), Π±Π°Π½Π°Π½Π°, Π·Π»Π°ΠΊΠΎΠ² ΠΈ ΡΠΎΠΌΠ°ΡΠΎΠ² (30β36%). Π‘ΡΠ΅Π΄ΠΈ Π²ΡΠ΅Ρ
Π΄Π΅ΡΠ΅ΠΈΜ, Π²ΠΊΠ»ΡΡΠ΅Π½Π½ΡΡ
Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅, ΡΠΈΡΠ»ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΡΠΌ ΠΎΡΠ²Π΅ΡΠΎΠΌ Π½Π° ΠΊΡΡΠΈΡΡ Π±ΡΠ»ΠΎ ΠΌΠΈΠ½ΠΈΠΌΠ°Π»ΡΠ½ΡΠΌ, Π° IgE ΠΊ ΠΆΠΈΠ²ΠΎΡΠ½ΡΠΌ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ Π²ΡΡΡΠ΅ΡΠ°Π»ΠΈΡΡ Ρ 8β15% ΠΈΠ· Π½ΠΈΡ
. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π£ Π΄Π΅ΡΠ΅ΠΈΜ ΡΠ°Π·Π½ΡΡ
Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΡΡ
ΠΏΠ΅ΡΠΈΠΎΠ΄ΠΎΠ² ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΡ ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π° ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌΠΈ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌΠΈ, ΠΎΠ½Π° ΡΠ°ΡΡΠΈΡΡΠ΅ΡΡΡ ΠΏΠΎ ΠΌΠ΅ΡΠ΅ Π²Π·ΡΠΎΡΠ»Π΅Π½ΠΈΡ, ΠΏΡΠΈ ΡΡΠΎΠΌ ΡΠΏΠ΅ΠΊΡΡ ΠΏΠΈΡΠ΅Π²ΡΡ
ΠΏΡΠΎΠ΄ΡΠΊΡΠΎΠ² Ρ Π½ΠΈΠ·ΠΊΠΎΠΈΜ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π½ΠΎΠΈΜ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡΡ ΠΎΡΡΠ°Π΅ΡΡΡ Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΏΠΎΡΡΠΎΡΠ½Π½ΡΠΌ. ΠΠΎΠ·ΡΠ°ΡΡΠ½ΡΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ Π°Π½ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΡΠ²Π΅ΡΠ° ΡΡΠ΅Π±ΡΡΡ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π° Π² Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅.
Π ΠΌΠΈΠ½ΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ Π·Π°ΡΡΠ°Ρ Π½Π° Π²ΡΡΠΎΠΊΠΎΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ Π°Π»Π»Π΅ΡΠ³ΠΈΠΈ Ρ Π΄Π΅ΡΠ΅ΠΉ: Π°Π½Π°Π»ΠΈΠ· ΡΠΎΠ³Π»Π°ΡΠΎΠ²Π°Π½Π½ΠΎΡΡΠΈ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Π°Π»Π»Π΅ΡΠ³ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ in vitro- ΠΈ in vivo-ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ
High morbidity rate of atopic diseases among children, including high importance of grass pollen as a sensitizing agent, determine the relevance of studies on diagnostic examination systems for appointment of adequate therapy. The research of the most relevant allergens for patients to exclude of duplicating and uninformative tests became urgent after development of a new type of diagnostic tests that does not require expensive equipment.Β The objectiveΒ of this research was to evaluate the results of in vitro- and in vivo-diagnostic examinations of children with various forms of atopic disease caused by pollen of meadow grasses, and to choose the most significant prognostic parameters for the diagnosis.Β Methods: 277 children aged 4β16 years with various forms of atopic disease were included in the study. There were performed skin prick tests and determination of IgE-antibodies levels to allergen extracts of cocksfoot (g3), meadow fescue (g4), timothy grass (g6).Β Results: In the studied group of patients 32β50% of children have antibodies to grass allergens. There was a close correlation of antibody response on the investigated allergens, quantitative coincidence of IgE-antibodies to g3 and g4 allergens levels. IgE (g6) concentration was close to the IgE(g3) and IgE(g4) levels (85,0Β±21,6%). Analysis of the skin tests results showed that 44% of patients have a positive response to grass allergens, and in vivo-tests results coincide with serological tests results, mostly in a qualitative sense. The most significant relationship was noted between in vivo and in vitro-tests in the results of testing the response to meadow fescue pollen.Conclusion: Based on these data IgE concentration index to meadow fescue allergens can be used as a prognostic marker to determine the sensitization of patients with different nosology forms of allergy and can help to improve allergic diagnostics.Π Π°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ Π°ΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΈΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Π²ΡΡΠΎΠΊΠ°Ρ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ ΠΏΡΠ»ΡΡΡ Π·Π»Π°ΠΊΠΎΠ²ΡΡ
ΡΡΠ°Π² ΠΊΠ°ΠΊ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·ΠΈΡΡΡΡΠ΅Π³ΠΎ Π°Π³Π΅Π½ΡΠ°, ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡ Π°ΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ ΠΏΠΎΠΈΡΠΊΠ° ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π°Π»Π»Π΅ΡΠ³ΠΎΠ΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ Ρ ΡΠ΅Π»ΡΡ ΠΏΠΎΡΠ»Π΅Π΄ΡΡΡΠ΅Π³ΠΎ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΡ Π°Π΄Π΅ΠΊΠ²Π°ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. Π ΡΠ²ΡΠ·ΠΈ Ρ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠΎΠΉ Π½ΠΎΠ²ΠΎΠ³ΠΎ ΡΠΈΠΏΠ° Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΡ-ΡΠΈΡΡΠ΅ΠΌΡ, Π½Π΅ ΡΡΠ΅Π±ΡΡΡΠ΅ΠΉ Π΄ΠΎΡΠΎΠ³ΠΎΡΡΠΎΡΡΠ΅Π³ΠΎ ΠΎΠ±ΠΎΡΡΠ΄ΠΎΠ²Π°Π½ΠΈΡ, Π°ΠΊΡΡΠ°Π»ΡΠ½ΡΠΌΠΈ ΡΡΠ°Π»ΠΈ ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΡΡ
Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ², ΠΈΡΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅ Π΄ΡΠ±Π»ΠΈΡΡΡΡΠΈΡ
ΠΈ ΠΌΠ°Π»ΠΎΠΈΠ½ΡΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΡΡ
ΡΠ΅ΡΡΠΎΠ².Β Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΎΡΠ΅Π½ΠΈΡΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡΒ inΒ vitro- ΠΈΒ inΒ vivo-ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΡΠ°Π·Π½ΠΎΠΉ Π½ΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΡΠΌΠΎΠΉ Π°Π»Π»Π΅ΡΠ³ΠΈΠΈ, ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π½ΠΎΠΉ ΠΏΡΠ»ΡΡΠΎΠΉ Π·Π»Π°ΠΊΠΎΠ²ΡΡ
ΡΡΠ°Π², ΠΈ Π²ΡΠ±ΡΠ°ΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΡΠ΅ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΡ Π΄Π»Ρ ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ.Β ΠΠ΅ΡΠΎΠ΄Ρ:Β Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π±ΡΠ»ΠΈ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 277 Π΄Π΅ΡΠ΅ΠΉ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ 4β16 Π»Π΅Ρ Ρ ΡΠ°Π·Π½ΡΠΌΠΈ Π½ΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΡΠΎΡΠΌΠ°ΠΌΠΈ Π°ΡΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ. ΠΠ°ΡΠΈΠ΅Π½ΡΠ°ΠΌ Π±ΡΠ»ΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½Ρ ΠΊΠΎΠΆΠ½ΡΠ΅ ΡΠ΅ΡΡΡ ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡΒ IgEΒ ΠΊ ΡΠ΅Π»ΡΠ½ΡΠΌ ΡΠΊΡΡΡΠ°ΠΊΡΠ°ΠΌ Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ² Π΅ΠΆΠΈ ΡΠ±ΠΎΡΠ½ΠΎΠΉ (g3), ΠΎΠ²ΡΡΠ½ΠΈΡΡ Π»ΡΠ³ΠΎΠ²ΠΎΠΉ (g4), ΡΠΈΠΌΠΎΡΠ΅Π΅Π²ΠΊΠΈ Π»ΡΠ³ΠΎΠ²ΠΎΠΉ (g6).Β Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ:Β ΠΎΡ 32 Π΄ΠΎ 50% Π΄Π΅ΡΠ΅ΠΉ Π² ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΠΌΡΡ
Π³ΡΡΠΏΠΏΠ°Ρ
ΠΈΠΌΠ΅ΡΡ Π°Π½ΡΠΈΡΠ΅Π»Π° ΠΊ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ Π·Π»Π°ΠΊΠΎΠ²ΡΡ
ΡΡΠ°Π². ΠΡΠΌΠ΅ΡΠ΅Π½Ρ ΡΠ΅ΡΠ½Π°Ρ ΡΠ²ΡΠ·Ρ ΠΌΠ΅ΠΆΠ΄Ρ Π°Π½ΡΠΈΡΠ΅Π»ΡΠ½ΡΠΌ ΠΎΡΠ²Π΅ΡΠΎΠΌ Π½Π° ΠΈΠ·ΡΡΠ°Π΅ΠΌΡΠ΅ Π°Π»Π»Π΅ΡΠ³Π΅Π½Ρ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ΅ ΡΠΎΠ²ΠΏΠ°Π΄Π΅Π½ΠΈΠ΅ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡΒ IgE-Π°Π½ΡΠΈΡΠ΅Π» ΠΊ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌΒ g3 ΠΈΒ g4, Π±Π»ΠΈΠ·ΠΊΠΎΠ΅ ΠΊΒ IgE(g3) ΠΈΒ IgE(g4) Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈΒ IgEΒ ΠΊΒ g6 (85,0 Β± 21,6%). ΠΠ½Π°Π»ΠΈΠ· ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΊΠΎΠΆΠ½ΡΡ
ΡΠ΅ΡΡΠΎΠ² ΠΏΠΎΠΊΠ°Π·Π°Π», ΡΡΠΎ 44% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΈΠΌΠ΅ΡΡ ΠΏΠΎΠ·ΠΈΡΠΈΠ²Π½ΡΠΉ ΠΎΡΠ²Π΅Ρ Π½Π° Π°Π»Π»Π΅ΡΠ³Π΅Π½Ρ Π·Π»Π°ΠΊΠΎΠ²ΡΡ
ΡΡΠ°Π², ΠΈ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠΌ ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ ΠΎΡΠ²Π΅ΡΡΒ in-vivo-ΡΠ΅ΡΡΠΎΠ² ΡΠΎΠ²ΠΏΠ°Π΄Π°ΡΡ Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌΠΈ ΡΠ΅ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΠ°Ρ ΡΠ²ΡΠ·Ρ ΠΌΠ΅ΠΆΠ΄ΡΒ inΒ vivo- ΠΈΒ inΒ vitro-ΡΠ΅ΡΡΠ°ΠΌΠΈ ΠΎΡΠΌΠ΅ΡΠ΅Π½Π° ΠΌΠ΅ΠΆΠ΄Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌΠΈ ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Ρ ΡΠ΅Π»ΡΠ½ΡΠΌ ΡΠΊΡΡΡΠ°ΠΊΡΠΎΠΌ Π°Π»Π»Π΅ΡΠ³Π΅Π½ΠΎΠ² ΠΎΠ²ΡΡΠ½ΠΈΡΡ.Β ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅:Β ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈΒ IgEΒ ΠΊ Π°Π»Π»Π΅ΡΠ³Π΅Π½Π°ΠΌ ΠΎΠ²ΡΡΠ½ΠΈΡΡ Π»ΡΠ³ΠΎΠ²ΠΎΠΉ ΠΌΠΎΠΆΠ½ΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΌΠ°ΡΠΊΠ΅ΡΠ° Π΄Π»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ°Π·Π½ΠΎΠΉ Π½ΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠΎΡΠΌΠΎΠΉ Π°Π»Π»Π΅ΡΠ³ΠΈΠΈ, ΠΎΠ±ΡΡΠ»ΠΎΠ²Π»Π΅Π½Π½ΠΎΠΉ ΡΠ΅Π½ΡΠΈΠ±ΠΈΠ»ΠΈΠ·Π°ΡΠΈΠ΅ΠΉ ΠΊ ΠΏΡΠ»ΡΡΠ΅ Π·Π»Π°ΠΊΠΎΠ²ΡΡ
ΡΡΠ°Π², ΠΈ Π½Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΡΡΠΎΠ³ΠΎ ΠΎΠΏΡΠΈΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠ½ΡΡ Π°Π»Π»Π΅ΡΠ³ΠΎΠ΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ
Π‘ΠΠΠΠ ΠΠ ΠΠΠ‘Π’Π Π£ΠΠ’ΠΠΠΠΠΠ ΠΠΠΠΠ Π‘ΠΠ Π£ ΠΠΠ’ΠΠ ΠΠΠ Π ΠΠ‘Π Π ΠΠΠΠΠ’ΠΠ― Π‘ΠΠ ΠΠΠ§ΠΠ-Π‘ΠΠ‘Π£ΠΠΠ‘Π’ΠΠ ΠΠΠ’ΠΠΠΠΠΠ
Objective: Our aim was to examine the predictors of cardiovascular disorders in children affected by obstructive sleep apnea syndrome (OSAS) based on the results of polysomnography and continuous monitoring of blood glycose. Πethods: Before the examination, parents filled in questionnaires concerning their children sleep quality. The procedure was followed by the study of the sleep by means of polysomnography (Embla s 7000, USA). A system of continuous monitoring of blood glucose was applied (Guardianreal-time, Medtronicminimed, USA) by means of which a glycemic profile tissue fluid was studied. Results: A night sleep research of 120 children aged 3β16 y.o. is presented. There were 4 groups depending on the pathology: diseases of the nervous system (nΒ =31), ENT-pathology (nΒ =18), bronchial asthma (nΒ =24) and overweight and obesity (nΒ =34). The comparison group consisted of 13 apparently healthy children. The study has shown that the parents of every second child with sleep disorders did not know about the fact. The 60 % of the patients with high body mass index (BMI) had a snore, which was significantly higher the in children with normal body mass index β 35% (ΡΒ =0.012). The index of apnea-hypopnea (AHI) was higher in the patients with ENT-pathology 17 times (pΒ 0.001) and the patients with obesity 7 times (pΒ 0.001) in comparison to the comparison group. In the analysis of the overall sample (nΒ =120) was obtained significant negative correlation with heart rate variability and heart rate (rΒ =Β 0.405; pΒ 0.001). It is also shown that among 14 investigated children with OSAS only 8 had episodes of hypoglycemia (less than 3.3Β mmol/l) during night sleep. All of them were with a high body mass index and with above average stature (1sd). Conclusion: Children with ENT-pathology and with high high body mass index have high risk of cardio-vascular diseases. Children with above average stature and with increased body mass index affected by OSAS have additional backgrounds for cardiovascular diseases development as a result of the latent periods of hypoglycemia at night.Β Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: Π²ΡΡΠ²ΠΈΡΡ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΡ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ
Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ Ρ Π΄Π΅ΡΠ΅ΠΉ Π½Π° ΡΠΎΠ½Π΅ Β ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΎΠ±ΡΡΡΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π°ΠΏΠ½ΠΎΡ ΡΠ½Π° (Π‘ΠΠΠ‘) ΠΏΠΎ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ°ΠΌ ΠΏΠΎΠ»ΠΈΡΠΎΠΌΠ½ΠΎΠ³ΡΠ°ΡΠΈΠΈ ΠΈ Π½Π΅ΠΏΡΠ΅ΡΡΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ½ΠΈΡΠΎΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π³Π»ΡΠΊΠΎΠ·Ρ. ΠΠ΅ΡΠΎΠ΄Ρ: ΠΏΠ΅ΡΠ΅Π΄ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΠΎΠ΄ΠΈΡΠ΅Π»ΠΈ Π·Π°ΠΏΠΎΠ»Π½ΡΠ»ΠΈ Π°Π½ΠΊΠ΅ΡΡ-Π²ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊ ΠΏΠΎ ΠΊΠ°ΡΠ΅ΡΡΠ²Ρ ΡΠ½Π°, ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ½Π° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΏΠΎΠ»ΠΈΡΠΎΠΌΠ½ΠΎΠ³ΡΠ°ΡΠΈΠΈ (Embla S7000,Π‘Π¨Π). Π‘ΠΈΡΡΠ΅ΠΌΠΎΠΉ Π½Π΅ΠΏΡΠ΅ΡΡΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ½ΠΈΡΠΎΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π³Π»ΡΠΊΠΎΠ·Ρ (Guardian Real-Time, Medtronic MiniMed, Π‘Π¨Π) ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π»ΠΈ Π³Π»ΠΈΠΊΠ΅ΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΏΡΠΎΡΠΈΠ»Ρ Π² ΡΠΊΠ°Π½Π΅Π²ΠΎΠΉ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠΈ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ: ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΎ 120 Π΄Π΅ΡΠ΅ΠΉ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ 3β16Β Π»Π΅Ρ. ΠΠ΅ΡΠ΅ΠΉ ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈ ΠΏΠΎ Π³ΡΡΠΏΠΏΠ°ΠΌ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΉ: 31 β Ρ Π±ΠΎΠ»Π΅Π·Π½ΡΠΌΠΈ Π½Π΅ΡΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ, 18 β Ρ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠ΅ΠΉ ΠΠΠ -ΠΎΡΠ³Π°Π½ΠΎΠ², 24 β Ρ Π±ΡΠΎΠ½Ρ
ΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π°ΡΡΠΌΠΎΠΉ ΠΈ 34 β Ρ ΠΈΠ·Π±ΡΡΠΎΡΠ½ΡΠΌ Π²Π΅ΡΠΎΠΌ ΠΈ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ (ΠΠ²ΠΈΠ); 13 ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π΄ΠΎΡΠΎΠ²ΡΡ
Π΄Π΅ΡΠ΅ΠΉ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ Π³ΡΡΠΏΠΏΡ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ. Π ΠΎΠ΄ΠΈΡΠ΅Π»ΠΈ ΠΊΠ°ΠΆΠ΄ΠΎΠ³ΠΎ Π²ΡΠΎΡΠΎΠ³ΠΎ ΡΠ΅Π±Π΅Π½ΠΊΠ° Π½Π΅ Π·Π½Π°Π»ΠΈ ΠΎ Π½Π°ΡΡΡΠ΅Π½ΠΈΡΡ
Π΄ΡΡ
Π°Π½ΠΈΡ Π²ΠΎ Π²ΡΠ΅ΠΌΡ ΡΠ½Π° Ρ ΡΠ²ΠΎΠΈΡ
Π΄Π΅ΡΠ΅ΠΉ. Π₯ΡΠ°ΠΏ Π² ΠΎΠ±ΡΠ΅ΠΉ Π²ΡΠ±ΠΎΡΠΊΠ΅ ΠΏΡΠΈ ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΠΎΠΌ ΠΠΠ’ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ Ρ 60% Π΄Π΅ΡΠ΅ΠΉ, ΡΡΠΎ Π·Π½Π°ΡΠΈΠΌΠΎ ΡΠ°ΡΠ΅, ΡΠ΅ΠΌ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ Π½ΠΎΡΠΌΠ°Π»ΡΠ½ΡΠΌ ΠΠΠ’ (35%; ΡΒ =0,012). ΠΠ½Π΄Π΅ΠΊΡ Π°ΠΏΠ½ΠΎΡΒ /Β Π³ΠΈΠΏΠΎΠΏΠ½ΠΎΡ (ΠΠΠ) Π±ΡΠ» Π²ΡΡΠ΅ ΠΏΡΠΈ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΠΠ -ΠΎΡΠ³Π°Π½ΠΎΠ² Π² 17 ΡΠ°Π· (pΒ 0,001) ΠΈ Π² Π³ΡΡΠΏΠΏΠ΅ Ρ ΠΠΠΈΠ β Π² 7 ΡΠ°Π· (pΒ 0,001) ΠΏΠΎ ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ ΠΊ Π³ΡΡΠΏΠΏΠ΅ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ. Π ΡΡΠΈΡ
ΠΆΠ΅ Π³ΡΡΠΏΠΏΠ°Ρ
ΠΎΠΊΠ°Π·Π°Π»Π°ΡΡ ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΠΎΠΉ ΡΠ°ΡΡΠΎΡΠ° ΡΠ΅ΡΠ΄Π΅ΡΠ½ΡΡ
ΡΠΎΠΊΡΠ°ΡΠ΅Π½ΠΈΠΉ (Π§Π‘Π‘) ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π³ΡΡΠΏΠΏΠΎΠΉ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ (ΡΒ =0,002). ΠΡΠΈ Π°Π½Π°Π»ΠΈΠ·Π΅ Π² ΠΎΠ±ΡΠ΅ΠΉ Π²ΡΠ±ΠΎΡΠΊΠ΅ (nΒ =120) Π±ΡΠ»Π° ΠΏΠΎΠ»ΡΡΠ΅Π½Π° Π·Π½Π°ΡΠΈΠΌΠ°Ρ ΠΎΡΡΠΈΡΠ°ΡΠ΅Π»ΡΠ½Π°Ρ ΡΠ²ΡΠ·Ρ ΠΌΠ΅ΠΆΠ΄Ρ Π²Π°ΡΠΈΠ°Π±Π΅Π»ΡΠ½ΠΎΡΡΡΡ ΡΠΈΡΠΌΠ° ΡΠ΅ΡΠ΄ΡΠ° ΠΈ ΡΠ°ΡΡΠΎΡΠΎΠΉ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΡΡ
ΡΠΎΠΊΡΠ°ΡΠ΅Π½ΠΈΠΉ (r=Β -0,405; pΒ 0,001). ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ ΠΈΠ· 14 ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π½ΡΡ
ΡΠΎΠ»ΡΠΊΠΎ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΡΠΌ ΠΠΠ’ ΠΈ ΡΠΎΡΡΠΎΠΌ Π²ΡΡΠ΅ ΡΡΠ΅Π΄Π½Π΅Π³ΠΎ (1SD; nΒ =8) Π±ΡΠ»ΠΈ Π·Π°ΡΠ΅Π³ΠΈΡΡΡΠΈΡΠΎΠ²Π°Π½Ρ ΡΠΏΠΈΠ·ΠΎΠ΄Ρ Π½ΠΎΡΠ½ΠΎΠΉ Π³ΠΈΠΏΠΎΠ³Π»ΠΈΠΊΠ΅ΠΌΠΈΠΈ (3,3Β ΠΌΠΌΠΎΠ»Ρ/Π»). ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅: Π΄Π΅ΡΠΈ Ρ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠ΅ΠΉ ΠΠΠ -ΠΎΡΠ³Π°Π½ΠΎΠ² ΠΈ ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΡΠΌ ΠΠΠ’ Π½Π° ΡΠΎΠ½Π΅ Π‘ΠΠΠ‘ ΠΏΠΎΠ΄Π²Π΅ΡΠΆΠ΅Π½Ρ ΡΠΈΡΠΊΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ. ΠΠ΅ΡΠΈ Ρ ΡΠΎΡΡΠΎΠΌ Π²ΡΡΠ΅ ΡΡΠ΅Π΄Π½Π΅Π³ΠΎ ΠΈ ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΡΠΌ ΠΠΠ’ Π½Π° ΡΠΎΠ½Π΅ Π‘ΠΠΠ‘ ΠΈΠΌΠ΅ΡΡ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΏΡΠ΅Π΄ΠΏΠΎΡΡΠ»ΠΊΠΈ Π΄Π»Ρ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ Π² Π²ΠΈΠ΄Π΅ ΡΠΊΡΡΡΡΡ
ΠΏΠ΅ΡΠΈΠΎΠ΄ΠΎΠ² Π³ΠΈΠΏΠΎΠ³Π»ΠΈΠΊΠ΅ΠΌΠΈΠΈ Π² Π½ΠΎΡΠ½ΠΎΠΉ ΠΏΠ΅ΡΠΈΠΎΠ΄.Β
ΠΠ΅Π½Π΄Π΅ΡΠ½ΡΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΡΠ΅ΡΠΊΠΈΡ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° Ρ ΠΆΠΈΡΠ΅Π»Π΅ΠΉ Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π°
Background: In developed countries there are significant gender differences in lifetime expectancy that can be explained by behavioral risk factorsΒ (RF).Objective: The aim of our study was to estimate gender features of behavioral RF in general population of Saint-Petersburg, Russia.Methods:Β As a part of all-Russian epidemiology survey ESSE-RF a random sampling of 1600 Saint-Petersburg inhabitants (25-64 y.o.) stratified by age andΒ sex was performed. All participants filled in the questionnaire. Anthropometry (weight, height, body-mass index (BMI), waist circumference (WC))Β and fasting blood-tests (lipids, glucose by Abbott Architect 8000 (USA)) were performed.Results: There were examined 573 (36%) men and 1027Β (64%) women. No gender differences in obesity were found according to BMI criteria β in 178 (31.2%) women and 352 (35.1%) men. ObesityΒ was more often detected in females according to WC criteria: ΠΠ’Π III β 44.1 vs 30.3%; IDF 51.2 vs 66.4% (p 0.001 for both). Linear regressionΒ analysis was performed and age was associated with BMI β 1.6 kg/m2/decade, WC in women β 5,2 cm/decade and WC in men β 2.8 cm/decade,Β Ρ 0.001 for all anthropometric parameters. Optimal level of physical activity was equally documented in both genders β 540 (61.2%) women andΒ 286 (58.9%) men. Daily intake of sweets was lower in men β 228 (39.8%) vs 539 (52.5%) in women (p 0.001). 810 (50,6%) of trial subjects wereΒ non-smokers, 395 (24,7%) were former smokers, and 395 (24,7%) were smokers at the moment of trial. The higher number of female smokersΒ was observed β 194 (19.1%).Conclusion: A high prevalence of obesity is observed in sample of Saint-Petersburg inhabitants β it is higher amongΒ women according to WC criteria regardless of menopause, possibly due to bigger sweets consumption. Males smoke more often and consume lessΒ fresh fruits and vegetables which is accompanied by a higher prevalence of hyperglycemia and hypertriglyceridemia.Π ΡΠ°Π·Π²ΠΈΡΡΡ
ΡΡΡΠ°Π½Π°Ρ
ΠΎΡΠΌΠ΅ΡΠ°ΡΡΡΡ Π³Π΅Π½Π΄Π΅ΡΠ½ΡΠ΅ ΡΠ°Π·Π»ΠΈΡΠΈΡ Π² ΠΎΠΆΠΈΠ΄Π°Π΅ΠΌΠΎΠΉ ΠΏΡΠΎΠ΄ΠΎΠ»ΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΆΠΈΠ·Π½ΠΈ, ΡΡΠΎ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΎΠ±ΡΡΡΠ½Π΅Π½ΠΎ ΠΏΡΠΎΡΠΈΠ»Π΅ΠΌΒ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΡΠ΅ΡΠΊΠΈΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ°.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΈΠ·ΡΡΠΈΡΡ Π³Π΅Π½Π΄Π΅ΡΠ½ΡΠ΅ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΏΡΠΎΡΠΈΠ»Ρ ΠΏΠΎΠ²Π΅Π΄Π΅Π½ΡΠ΅ΡΠΊΠΈΡ
ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ° Π² ΠΏΠΎΠΏΡΠ»ΡΡΠΈΠΈ ΠΆΠΈΡΠ΅Π»Π΅ΠΉ Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π°. ΠΠ΅ΡΠΎΠ΄Ρ: Π² ΡΠ°ΠΌΠΊΠ°Ρ
ΠΌΠ½ΠΎΠ³ΠΎΡΠ΅Π½ΡΡΠΎΠ²ΠΎΠ³ΠΎ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π½Π°Π±Π»ΡΠ΄Π°ΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎΒ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΠ‘Π‘Π-Π Π€ Π±ΡΠ»Π° ΡΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½Π° ΡΠ»ΡΡΠ°ΠΉΠ½Π°Ρ Π²ΡΠ±ΠΎΡΠΊΠ° ΠΈΠ· ΠΆΠΈΡΠ΅Π»Π΅ΠΉ Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π°, ΡΡΡΠ°ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Π½Π°Ρ ΠΏΠΎ ΠΏΠΎΠ»Ρ ΠΈ Π²ΠΎΠ·ΡΠ°ΡΡΡ. Π£ΡΠ°ΡΡΠ½ΠΈΠΊΠΈ Π·Π°ΠΏΠΎΠ»Π½ΠΈΠ»ΠΈ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΠΉ ΠΎΠΏΡΠΎΡΠ½ΠΈΠΊ, Π±ΡΠ»Π° Π²ΡΠΏΠΎΠ»Π½Π΅Π½Π° Π°Π½ΡΡΠΎΠΏΠΎΠΌΠ΅ΡΡΠΈΡ: ΡΠΎΡΡ, Π²Π΅Ρ, ΠΈΠ½Π΄Π΅ΠΊΡ ΠΌΠ°ΡΡΡ ΡΠ΅Π»Π° (ΠΠΠ’), ΠΎΠΊΡΡΠΆΠ½ΠΎΡΡΡ ΡΠ°Π»ΠΈΠΈ (ΠΠ’). ΠΠ°ΡΠΎΡΠ°ΠΊ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ Π»ΠΈΠΏΠΈΠ΄Π½ΡΠΉ ΡΠΏΠ΅ΠΊΡΡ, ΡΡΠΎΠ²Π΅Π½Ρ Π³Π»ΠΈΠΊΠ΅ΠΌΠΈΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ: ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ 1600 ΡΠ΅Π»ΠΎΠ²Π΅ΠΊ, ΠΈΠ· Π½ΠΈΡ
ΠΌΡΠΆΡΠΈΠ½ 573Β (35,9%), ΠΆΠ΅Π½ΡΠΈΠ½ 1027 (64,1%). ΠΠΆΠΈΡΠ΅Π½ΠΈΠ΅ Ρ ΠΌΡΠΆΡΠΈΠ½ ΠΈ ΠΆΠ΅Π½ΡΠΈΠ½ Π²ΡΡΡΠ΅ΡΠ°Π»ΠΎΡΡ Π² 31β66% ΡΠ»ΡΡΠ°Π΅Π² (ΠΏΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡ ΠΠΠ’ β Ρ 31,2% ΠΌΡΠΆΡΠΈΠ½ ΠΈΒ 35,1% ΠΆΠ΅Π½ΡΠΈΠ½; ΠΏΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° (ΠΠ’Π III) β Ρ 30,3 ΠΈ 44,1%; ΠΏΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡ IDF β Ρ 51,2 ΠΈ 66,4%, ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ; ΠΏΠΎ ΠΎΠ±ΠΎΠΈΠΌ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌ ΠΠ’ Π·Π½Π°ΡΠΈΠΌΠΎ ΡΠ°ΡΠ΅ Π²ΡΡΡΠ΅ΡΠ°Π»Π°ΡΡ Ρ ΠΆΠ΅Π½ΡΠΈΠ½, (p 0,001). ΠΠΈΠ½Π΅ΠΉΠ½ΡΠΉ ΡΠ΅Π³ΡΠ΅ΡΡΠΈΠΎΠ½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΠ» ΡΡΡΠ°Π½ΠΎΠ²ΠΈΡΡΒ Π°ΡΡΠΎΡΠΈΠ°ΡΠΈΡ Π²ΠΎΠ·ΡΠ°ΡΡΠ° Ρ ΠΠΠ’ (1,6 ΠΊΠ³/ΠΌ2 Π½Π° 1 Π΄Π΅ΠΊΠ°Π΄Ρ), Ρ ΠΠ’ Ρ ΠΆΠ΅Π½ΡΠΈΠ½ (5,2 ΡΠΌ/Π΄Π΅ΠΊΠ°Π΄Π°) ΠΈ Ρ ΠΌΡΠΆΡΠΈΠ½ (2,8 ΡΠΌ/Π΄Π΅ΠΊΠ°Π΄Π°; Π΄Π»Ρ Π²ΡΠ΅Ρ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉΒ Ρ 0,001). ΠΠΏΡΠΈΠΌΠ°Π»ΡΠ½ΡΠΉ ΡΡΠΎΠ²Π΅Π½Ρ Π΄Π²ΠΈΠ³Π°ΡΠ΅Π»ΡΠ½ΠΎΠΉ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π½Π΅ ΡΠ°Π·Π»ΠΈΡΠ°Π»ΡΡ Ρ ΠΌΡΠΆΡΠΈΠ½ (286; 58,9%) ΠΈ ΠΆΠ΅Π½ΡΠΈΠ½ (540; 61,2%). ΠΠΆΠ΅Π΄Π½Π΅Π²Π½ΠΎΠ΅Β ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΠ΅ ΡΠ»Π°Π΄ΠΎΡΡΠ΅ΠΉ Π·Π½Π°ΡΠΈΠΌΠΎ ΡΠ΅ΠΆΠ΅ ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ Ρ ΠΌΡΠΆΡΠΈΠ½ (228; 39,8%) ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ ΠΆΠ΅Π½ΡΠΈΠ½Π°ΠΌΠΈ (539; 52,5%; Ρ 0,001). ΠΠ΅ ΠΊΡΡΠΈΠ»ΠΈΒ 810 (50,6%), 395 (24,7%) ΠΊΡΡΠΈΠ»ΠΈ Π² ΠΏΡΠΎΡΠ»ΠΎΠΌ ΠΈ 395 (24,7%) ΠΊΡΡΠΈΠ»ΠΈ Π² ΠΌΠΎΠΌΠ΅Π½Ρ ΠΎΠΏΡΠΎΡΠ°; Π½Π°Π±Π»ΡΠ΄Π°Π»ΠΎΡΡ Π±ΠΎΠ»ΡΡΠΎΠ΅ ΡΠΈΡΠ»ΠΎ ΠΊΡΡΡΡΠΈΡ
ΠΆΠ΅Π½ΡΠΈΠ½ β 194Β (19,1%).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅: ΡΡΠ΅Π΄ΠΈ ΠΆΠΈΡΠ΅Π»Π΅ΠΉ Π‘Π°Π½ΠΊΡ-ΠΠ΅ΡΠ΅ΡΠ±ΡΡΠ³Π° ΡΠ΅Π³ΠΈΡΡΡΠΈΡΡΠ΅ΡΡΡ Π²ΡΡΠΎΠΊΠ°Ρ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΡ (Π·Π½Π°ΡΠΈΠΌΠΎ ΡΠ°ΡΠ΅ ΡΡΠ΅Π΄ΠΈΒ ΠΆΠ΅Π½ΡΠΈΠ½, ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡ ΠΠ’, Π²Π½Π΅ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Π½Π°Π»ΠΈΡΠΈΡ ΠΌΠ΅Π½ΠΎΠΏΠ°ΡΠ·Ρ, Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ, Π·Π° ΡΡΠ΅Ρ Π±ΠΎΠ»ΡΡΠ΅Π³ΠΎ ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΡ ΡΠ»Π°Π΄ΠΊΠΈΡ
ΠΏΡΠΎΠ΄ΡΠΊΡΠΎΠ²).Β ΠΡΠΆΡΠΈΠ½Ρ Π·Π½Π°ΡΠΈΠΌΠΎ Π±ΠΎΠ»ΡΡΠ΅ ΠΊΡΡΡΡ ΠΈ ΡΠ΅ΠΆΠ΅ ΠΏΠΎΡΡΠ΅Π±Π»ΡΡΡ ΡΠ²Π΅ΠΆΠΈΠ΅ ΠΎΠ²ΠΎΡΠΈ ΠΈ ΡΡΡΠΊΡΡ, ΡΡΠΎ ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ Π±ΠΎΠ»ΡΡΠ΅ΠΉ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΡΡΒ Π³ΠΈΠΏΠ΅ΡΠ³Π»ΠΈΠΊΠ΅ΠΌΠΈΠΈ ΠΈ Π³ΠΈΠΏΠ΅ΡΡΡΠΈΠ³Π»ΠΈΡΠ΅ΡΠΈΠ΄Π΅ΠΌΠΈΠΈ
ΠΠΠ’ΠΠ₯ΠΠΠΠ ΠΠΠΠ¬ΠΠΠ― ΠΠΠ‘Π€Π£ΠΠΠ¦ΠΠ― Π£ ΠΠΠ’ΠΠ Π‘ ΠΠΠ§ΠΠΠΠ§ΠΠ«ΠΠ Π€ΠΠ ΠΠΠΠ ΠΠΠΠΠΠΠΠΠΠΠΠ ΠΠΠΠΠΠΠ
Aim: The purpose of the study was to assess mitochondrial dysfunction severity in patients with hepatic forms of glycogen storage disease (GSD). Patients and methods: We examined 53 children with GSD in the dynamics. Distribution of children by disease types was: 1st group β children with GSD type I, 2nd group β children with GSD type III, 3rd group β children with GSD type VI and IX; comparison group consisted of 34 healthy children. Intracellular dehydrogenases activity: succinate dehydrogenase (SDH), glycerol-3-phosphate-dehydrogenase (GPDH),nicotinamideadenin-Π-dehydrogenase (NADH-D) and lactatdehydrogenase (LDH) was measured using the quantitative cytochemical method in the peripheral lymphocytes. Results: It was revealed decrease of SDH- (Ρ 0.001) and GPDH-activities (Ρ 0.001), along with increase of the NADH-D activity (Ρ 0.05) in all patients with GSD, (SDH / NADH-D) index was decreased (Ρ 0.001). LDH activity was increased in groups 1 (Ρ 0.05) and 3 (p 0.01), compared with comparison group. The most pronounced intracellular enzymes activity deviations were observed in children with GSD type I, that correspond to more severe clinical form of GSD. It was found strong correlation between intracellular enzymes activity and both hepatomegaly level (R =0.867) and metabolic acidosis severity (R =0.987). Conclusion: Our investigation revealed features of mitochondrial dysfunction in children with GSD, depending on the GSD type. Activities of lymphocytes enzymes correlates with the main disease severity parameters and can be used as an additional diagnostic criteria in children with hepatic form of GSD.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΠΎΡΠ΅Π½ΠΈΡΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ ΠΌΠΈΡΠΎΡ
ΠΎΠ½Π΄ΡΠΈΠ°Π»ΡΠ½ΡΡ
Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΉ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΏΠ΅ΡΠ΅Π½ΠΎΡΠ½ΡΠΌΠΈ ΡΠΎΡΠΌΠ°ΠΌΠΈ Π³Π»ΠΈΠΊΠΎΠ³Π΅Π½ΠΎΠ²ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ (ΠΠ). ΠΠ°ΡΠΈΠ΅Π½ΡΡ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ: Π² Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΎ 53 ΡΠ΅Π±Π΅Π½ΠΊΠ° Ρ ΠΠ, ΠΊΠΎΡΠΎΡΡΠ΅ Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΡΠΈΠΏΠ° Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ Π±ΡΠ»ΠΈ ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Ρ Π½Π° 3 Π³ΡΡΠΏΠΏΡ: 1-Ρ β Π΄Π΅ΡΠΈ Ρ ΠΠ ΡΠΈΠΏΠ° I; 2-Ρ β Ρ ΠΠ ΡΠΈΠΏΠ° III; 3-Ρ β Ρ ΠΠ ΡΠΈΠΏΠ° VI ΠΈ IX. ΠΡΡΠΏΠΏΡ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 34 ΡΡΠ»ΠΎΠ²Π½ΠΎ Π·Π΄ΠΎΡΠΎΠ²ΡΡ
ΡΠ΅Π±Π΅Π½ΠΊΠ°. ΠΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π²Π½ΡΡΡΠΈΠΊΠ»Π΅ΡΠΎΡΠ½ΡΡ
Π΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π·: ΡΡΠΊΡΠΈΠ½Π°ΡΠ΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π·Ρ (Π‘ΠΠ), Π³Π»ΠΈΡΠ΅ΡΠΎΠ»-3-ΡΠΎΡΡΠ°ΡΠ΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π·Ρ (ΠΠ€ΠΠ), Π½ΠΈΠΊΠΎΡΠΈΠ½Π°ΠΌΠΈΠ΄Π°Π΄Π΅Π½ΠΈΠ½-Π-Π΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π·Ρ (ΠΠΠΠ-Π) ΠΈ Π»Π°ΠΊΡΠ°ΡΠ΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π·Ρ (ΠΠΠ) ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΠΌ ΡΠΈΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π² Π»ΠΈΠΌΡΠΎΡΠΈΡΠ°Ρ
ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ: ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΎ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π‘ΠΠ (Ρ 0,001) ΠΈ ΠΠ€ΠΠ (Ρ 0,001) Π½Π° ΡΠΎΠ½Π΅ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ ΠΠΠΠ-Π (Ρ 0,05), Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠ΅ ΠΈΠ½Π΄Π΅ΠΊΡΠ° Π‘ΠΠ / ΠΠΠΠ-Π (Ρ 0,001) Ρ Π²ΡΠ΅Ρ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² c ΠΠ. ΠΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΠΠ ΠΏΠΎ ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ ΠΊ Π³ΡΡΠΏΠΏΠ΅ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Π±ΡΠ»Π° ΠΏΠΎΠ²ΡΡΠ΅Π½Π° Π² 1-ΠΉ (Ρ 0,05) ΠΈ 3-ΠΉ (p 0,01) Π³ΡΡΠΏΠΏΠ΅. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΡΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΠΈ Π²Π½ΡΡΡΠΈΠΊΠ»Π΅ΡΠΎΡΠ½ΡΡ
Π΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π· ΠΈΠΌΠ΅Π»ΠΈ ΠΌΠ΅ΡΡΠΎ Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΠ ΡΠΈΠΏΠ° I, ΡΡΠΎ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΠ΅Ρ Π±ΠΎΠ»Π΅Π΅ ΡΡΠΆΠ΅Π»ΠΎΠΌΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌΡ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π΄Π°Π½Π½ΠΎΠΉ ΡΠΎΡΠΌΡ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π²Π½ΡΡΡΠΈΠΊΠ»Π΅ΡΠΎΡΠ½ΡΡ
Π΄Π΅Π³ΠΈΠ΄ΡΠΎΠ³Π΅Π½Π°Π· Π»ΠΈΠΌΡΠΎΡΠΈΡΠΎΠ² ΡΠΈΠ»ΡΠ½ΠΎ ΠΊΠΎΡΡΠ΅Π»ΠΈΡΡΠ΅Ρ Ρ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΡΡ Π³Π΅ΠΏΠ°ΡΠΎΠΌΠ΅Π³Π°Π»ΠΈΠΈ (R =0,86) ΠΈ ΡΡΠ΅ΠΏΠ΅Π½ΡΡ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π°ΡΠΈΠ΄ΠΎΠ·Π° (R =0,987). ΠΡΠ²ΠΎΠ΄Ρ: Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΏΠ΅ΡΠ΅Π½ΠΎΡΠ½ΡΠΌΠΈ ΡΠΎΡΠΌΠ°ΠΌΠΈ ΠΠ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Ρ ΠΏΡΠΈΠ·Π½Π°ΠΊΠΈ ΠΌΠΈΡΠΎΡ
ΠΎΠ½Π΄ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ, ΡΡΠ΅ΠΏΠ΅Π½Ρ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΡΡΠΈ ΠΊΠΎΡΠΎΡΡΡ
Π·Π°Π²ΠΈΡΠΈΡ ΠΎΡ ΡΠΈΠΏΠ° Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ. ΠΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΡΠ΅ΡΠΌΠ΅Π½ΡΠΎΠ² Π»ΠΈΠΌΡΠΎΡΠΈΡΠΎΠ² ΠΊΠΎΡΡΠ΅Π»ΠΈΡΡΠ΅Ρ Ρ ΠΎΡΠ½ΠΎΠ²Π½ΡΠΌΠΈ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ°ΠΌΠΈ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΡΠΆΠ΅ΡΡΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ, ΡΡΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡ Π΄Π°Π½Π½ΡΠ΅ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΠΈ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ Π΄ΠΎΠΏΠΎΠ»Π½ΠΈΡΠ΅Π»ΡΠ½ΡΡ
Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² Ρ Π΄Π΅ΡΠ΅ΠΉ Ρ ΠΠ.
Baccharis rufescens Spreng. var. tenuifolia (DC.) Baker: contribuição ao estudo farmacognóstico
MUCOPOLYSACCHARIDOSIS TYPE II
Article is devoted to one of the orphan diseases β mucopolysaccharidosis (MPS), which is the result of any lysosomal enzyme deficiency (which determines the type of illness). The most common is the MPS type II (Hunter syndrome), developing as a result of deficiency of the enzyme alpha-L-iduronosulphatsulphataze. The authors are observing the largest group of children with this pathology in the Russian population β 40 patients. On the example of their own clinical cases the only existing on the date the pathogenetic treatment is provided β replacement therapy with idursulphase that significantly improves the disease prognosis.Key words: MPS, types, Hunter syndrome, clinical course, diagnosis, treatment, prognosis, children
MUCOPOLYSACCHARIDOSIS TYPE II
Article is devoted to one of the orphan diseases β mucopolysaccharidosis (MPS), which is the result of any lysosomal enzyme deficiency (which determines the type of illness). The most common is the MPS type II (Hunter syndrome), developing as a result of deficiency of the enzyme alpha-L-iduronosulphatsulphataze. The authors are observing the largest group of children with this pathology in the Russian population β 40 patients. On the example of their own clinical cases the only existing on the date the pathogenetic treatment is provided β replacement therapy with idursulphase that significantly improves the disease prognosis.Key words: MPS, types, Hunter syndrome, clinical course, diagnosis, treatment, prognosis, children