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АннотацияЦель работы: определение уровня цитокинов у недоношенных новорожденных с пневмониями. Материал и методы. Цитокины определяли в крови и трахеальном содержимом (ТА) у 20 здоровых новорожденных и 38 недоношенных c неонатальными пневмониями. Результаты. Содержание ИЛ-4 в сыворотке крови у новорожденных с благоприятным течением пневмонии значительно превышало его уровень в контрольной группе в дебюте пневмоний (107,4±9,4 против 6,9±7,4) (р<0,001). На шестые -седьмые сутки жизни содержание ИЛ-4 в сыворотке крови пациентов с пневмониями было существенно более высоким (82,7±12,7 и 47,5±6,7 соответственно) сравнительно с контрольной группой (р<0,001). Повышение уровня ИЛ-4 в трахеобронхиальном содержимом (34,9±8,7 -на 6-7 сутки пневмонии, контроль -18,5±4,7) указывало на благоприятную динамику заболевания. Увеличение ФНОα (48,4±9,3 в начале пневмонии и 89,6±13,7 на 6-7 сутки и высокий уровень ИЛ-8 (3108,6±315,4) в трахеобронхиальном секрете было характерным для неблагоприятного тече ния пневмоний. Ключевые словаНоворождённые, пневмония, диагностика, иммунный статус, цитокины, недоношенные дети. SummaryThe aim of our investigation was to determine the level and role of cytokines in preterm newborns with pneumonia. Material and methods. Cytokine status in blood serum and tracheal aspirate (TA) was studied in 20 healthy newborns and 38 children with neonatal pneumonia. Results. The content of IL-4 in the blood serum of patients with a favorable course of neonatal pneumonia was ten times higher than in the control group during the onset of neonatal pneumonia (107.4 ± 9.4 vs. 6.9 ± 7.4, respectively) (p <0.001). By the sixth to seventh days of life, the content of IL-4 in the blood serum of patients with favorable and unfavorable course remained significantly higher (82.7 ± 12.7 and 47.5 ± 6.7, respectively) in comparison with the control group (p <0.001 ). In dynamics increasing of IL-4 in the tracheobronchial aspirate (34.9 ± 8.7 -on the 6-7th day of the disease versus 18.5 ± 4.7) was consistent with the favorable prognostic dynamics of the inflammatory process. The increase in TNF-α (48.4 ± 9.3 in the onset of the disease and 89.6 ± 13.7 on the 6-7th day of the disease) during the course of the disease and initially high levels of IL-8 (3108.6 ± 315.4) in the TA pointed to an unfavorable outcome of the disease.

Aim. To assess the effects of the four-month trimetazidine MR therapy on the parameters of 24-hour electrocardiogram (ECG) monitoring and heart rate variability (HRV) in patients with stable coronary heart disease (CHD).Material and methods. This prospective, non-randomised study, with the inclusion of 66 consecutive patients who had stable CHD and stable stress test results, investigated the effects of trimetazidine MR therapy on the parameters of 24-hour ECG monitoring and HRV.Results. Trimetazidine MR did not markedly affect the 24-hour, daytime, or nighttime levels of heart rate. Trimetazidine MR therapy was not associated with any substantial changes in frequency and time-domain HRV parameters or in the incidence of cardiac arrhythmias. However, there was a significant reduction in the number of patients with ST segment depression (from 66,7% to 43,8%; p<0,001) and in the duration of ischemic episodes (from 10 (6,2;21) minutes to 7,42 (5;12,3) minutes (p=0,025)).Conclusion. Adding trimetazidine MR to the treatment of patients with stable CHD provides an additional beneficial antiischemic effect.

Introduction. One of the leading causes of morbidity in newborns is the pathology of the respiratory tract. Among this group of patients, and especially premature newborns, congenital pneumonia takes the leading role among diseases of the respiratory system. The aim of the work was to identify the relationship between the level of vitamin D and endogenous antimicrobial peptides in congenital pneumonia of premature infants. Material and methods. We observed 2 groups of premature newborns: 32 newborns with congenital pneumonia, and the comparison group consisted of 20 "almost healthy" newborns without respiratory tract pathology. Results. In patients with pneumonia, the level of vitamin D was significantly lower (9,57 [6,57-17,25]) when compared with conventionally healthy newborns (21,1 [9,2-32,02]), p<0.01. However, in the group with congenital pneumonia, the levels of cathelicidin LL-37 and HBD-2 were significantly higher (2,87 [2,3-4,43] and 240,4 [132,4-406,7]) compared with another group (1,6 [0,8-2,5] and 156,7 [82,4-208,7]), p<0,01. Moreover, patients with severe congenital pneumonia had significantly lower concentration of vitamin D (7,6 [5,7-13,2]) and higher cathelicidin LL-37 (3,75 [2,8-4,26]) compared with patients with moderate pneumonia (13,7 [9,7-16,5] and 2,5 [2,1-3,7], respectively). But we did not observe such a relationship with HBD-2 (in severe congenital pneumonia, there was a decrease in HBD-2 (220,4 [142,6-401,6] and 278,2 [154,6-378,6], respectively). Conclusion. Lower vitamin D concentrations in serum may be have significant associatiation with congenital pneumonia. Also, vitamin D levels can predict the need for mechanical ventilation and the duration of hospitalization for congenital pneumonia in premature infants.

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