Syndrome of Systemic Inflammatory Response in Patients With Acute Respiratory Viral Infections of Children

Бабаченко, И. В.; Алексеева, Л. А.; Ibragimova, O. M.; Бессонова, Т В; Evdokimov, K. V.

doi:10.24110/0031-403x-2017-96-4-22-27

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“…Необходимо также отметить, что среди детей с лабораторно подтвержденной этиологией ОРВИ у 19 детей (38%) выявлено моно РСВ-инфекция, у 16 пациентов (32%), наряду с РНК РСВ, выделяли при бактериологическом посеве отделяемого из ротоглотки и носа разнообразную условно-патогенную флору (УПФ), у 15 (30%) детей при лабораторном обследовании установлена сочетанная РСВИ с другими респираторными вирусами (риновирусная, аденовирусная) и УПФ. Это соответствует результатам наших предшествующих исследований [6,14,16] и обусловливает актуальность работы, т.к. позволяет оценить роль системного воспаления в патогене вирусных респираторных инфекций, в том числе при наличии сочетанного инфицирования, а значит, обосновать тактику противомикробной терапии.…”

Section: материалы и методыunclassified

“…Предшествующими работами Детского научно-клинического центра инфекционных болезней (ДНКЦИБ) было показано, что лабораторными маркерами системной воспалительной реакции являются гематологические и биохимические показатели (преобладание нейтрофилов над лимфоцитами, повышенная СРБ), которые достоверно коррелируют между собой и позволяют прогнозировать течение вирусной инфекции [14,15,16]. Вопрос этиотропной терапии респираторно-синцитиальной вирусной инфекции в настоящее время не решен и широко обсуждается в литературе [17].…”

Section: Introductionunclassified

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Syndrome of system inflammation in the pathogenesis of respiratory syncitial viral infection

Бабаченко¹,

Алексеева²,

Усков³

et al. 2020

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The aim of the study was to obtain new biochemical data on the pathogenesis of respiratory syncytial viral infection (RSVI) in children.Object and methods: 60 children aged 1 month to 5 years, treated in the clinic of Pediatric Research and Clinical Center for Infectious Diseases, from which in 50 patients RNA RSV was isolated in smears from the oropharynx. The comparison group consisted of 10 children who failed to verify RSVI by laboratory methods. All children at admission and before discharge from the hospital (after-7-9 days) underwent a clinical blood test a Sysmex XP-300 hematology analyzer (Japan). Alpha-1-antitrypsin and alpha-2-macroglobulin were determined in blood serum by quantitative immunoturbidimetry on a biochemical analyzer CLIMA-15 (Spain) using Sentinel test systems (Italy). Determination of the amount of total protein, albumin and C-reactive protein in serum was carried out on an automatic analyzer Taurus (Instrumentation Laboratory, Italy) using reagents of the company «Vector-best» (Russia). The study of protein fractions in blood serum was carried out by capillary electrophoresis on the device Minicap company Sebia (France) with the help of test systems «Minicap Protein(e) 6» of the same manufacturer. The levels of cytokines (IL-6, IL-10) in serum were determined by ELISA on ELISA analyzer «INFINITI» (TECAN, Austria) using reagents firm «Vector-best» (Russia).Results: RSVI occurs with lesions of the lower respiratory tract in 42% of cases, with the development of complications in 44% of sick children. The study revealed a prolonged increase in serum alpha-2 fraction of globulins, immunoregulatory cytokines with pro-inflammatory (IL-6) and anti-inflammatory (IL-10) action and, which may indicate the presence of subacute inflammatory process associated with the persistence of RS-virus. Lower levels of gamma-globulin fraction, including the main specific and nonspecific immunoglobulins, in children with PCR-proven RSVI, both in the acute period and in the period of convalescence, probably can cause repeated RSV-diseases, as well as an increase in the risk of atopic diseases.Conclusion. The long-term increase in the level of subacute inflammation markers, established in the course of the study, even against the relieve of clinical picture of the disease, makes the question of developing an etiopathogenetic treatment of respiratory syncytial viral infection with the use of drugs with antiviral and anti-inflammatory action relevant.

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Section: материалы и методыunclassified

Section: Introductionunclassified