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7.2 Clinical characteristic bolnyhs a long subfebrile condition at reaktivirovannoj GVI after treatment

The clinical characteristic of patients with a long subfebrile condition at reaktivirovannoj GVI after treatment is shown on an example of 40 children in
Age from 6 months till 15 years with duration of a subfebrile condition от3 months till 1 year.

I group have made — 20 patients receiving, besides

Standard, complex pathogenetic therapy. II group — 20 patients, kotoryepoluchali the standard therapy for unit. Both groups were representative on age, nozoformam, gravities of disease, to clinical implications and terms of the beginning of treatment.

In resulted table 19 the basic clinical implications, in both groups, reaktivirovannojgvi before treatment are presented. As the indicators characterising expression of an immunodeficiency, also, as well as at primary active, the number of acute respiratory virus diseases and frequency of occurrence of anginas was estimated.

Table 19

Clinical symptoms and syndromes at children with a long subfebrile condition at reaktivirovannoj GVI before treatment, n=40

Patients

The pathological

Conditions

Etiopatogeneticheskja therapy

n=20 (Ігруппа)

The standard therapy n=20 (II group)
Abs. % Abs. %
Frequency ORVI more than 5 times a year 15 75 15 75
Frequency of anginas more than 5 times a year 6 30 5 25
Oligotrophy 4 20 2 10
Obstructive bronchitis 12 60 10 50
Intoxication 16 80 10 50
Subfebrile condition 20 100 20 100
Tonsillitis 8 40 8 40
Zalozhennost a nose 5 25 3 15
Lymphadenopathy 13 65 9 45
Hepatomegalia, 13 65 11 55
Splenomegaly 4 20 6 30
Pathology GASTROINTESTINAL TRACT 7 35 8 35
Pathology serdechnoyososudistoj systems 2 10 3 15
Pathology of nervous system 1 5 2 10

The note: to all signs 0,05

Etiopatogenetichesky therapy was prescribed the patient after acknowledgement reaktivirovannoj GVI.

In both observable groups of patients by the appointment moment etiopatogeneticheskoj therapies became perceptible frequent ORVI, an obstructive bronchitis, intoxication signs, a subfebrile condition more than 3 months, gepatosplenomegalija, at third of children the accompanying somatic pathology became perceptible.

Frequency vstrechaemostiosnovnyh clinical implications at children with a long subfebrile condition at reaktivirovannoj GVI, in the basic and control group, is reflected in table 20.

Table 20 Frequency of occurrence of the basic clinical symptoms and

Syndromes at children with reaktivirovannoj GVI, receiving and not receiving etiopatogeneticheskuju therapy in dynamics of treatment, n=40

Patients

Pathological conditions

Etiopatogenetichesky therapy n=20 (I group), Abs. (%) The standard therapy n=20 (II group), Abs. (%)
In 3 months In 6 months In 3 months In 6 months
Frequency ORVI more than 5 times in

Year

11 (55) 5 (25) * 11 (55) 11 (55) *
Frequency of anginas more than 5 times in

Year

0 1 (5) * 0 4 (20) *
Oligotrophy 1 (5) 0 1 (5) 0
Obstructive bronchitis 3 (15) 3 (15) 2 (10) 7 (35)
Intoxication 10 (50) 2 (10) 9 (45) 8 (40)
Subfebrile condition 11 (55) 4 (20) * 12 (60) 12 (60) *
Tonsillitis 4 (20) 3 (15) 7 (35) 6 (30)
Zalozhennost a nose 0 0* 5 (25) 3 (15) *
Lymphadenopathy 9 (45) 4 (20) * 11 (55) 9 (45) *
Hepatomegalia, 4 (20) 0 6 (30) 0
Splenomegaly 0 0 0 0
Pathology GASTROINTESTINAL TRACT 7 (50) 2 (5) * 11 (55) 13 (65) *
Pathology serdechnoyososudistoj systems 3 (15) 2 (5) * 6 (30) 10 (50) *
Pathology of nervous system 1 (5) 1 (5) * 3 (15) 6 (30) *

The note: authentic difference in sravnimaemyh groups *

At patients of I group within 3 months it has been registered 11

Episodes ORVI, they proceeded without complications and carrying out have not demanded
Antibacterial therapy. In the subsequent 3 mesjatsa.v to this group 5 more cases ORVI are fixed, antibacterial therapy has been used only at 1 child with an obstructive bronchitis.

In group of comparison ORVI it was registered also often, as well as in I group, however, this indicator did not vary all 6 months of observation. At 5 children for this period ORVI it was registered twice, and at three - three times. Antibacterial therapy has been used at 7 children with obstruktivnym a bronchitis.

Thus, use etiopatogeneticheskoj to therapy at children with a long subfebrile condition at reaktivirovannoj GVI promoted more smooth current ORVI, in 3 months, frequency of registration ORVI remained high in both groups, however, in 6 months, at children of I group, authentic depression of frequency of diseases ORVI, to 26 % whereas against the standard therapy this indicator remained former became perceptible and has made 55 %, (р=0,002).

Application antiviral and immunomodulirujushchej to therapy at children with a long subfebrile condition at reaktivirovannoj GVI promoted authentic disappearance of a subfebrile condition at 80 % of patients in 6 months of observation. Only at 20 % of children from I group, the low changeable subfebrile condition, against good state of health has been noted, and in II group this sign was registered much more often, at 60 %, and, all time of observation.

In both groups, in 6 months after observation, at children normalizovyvalis masso-rostovye indicators.

In comparison with the patients receiving the standard therapy, patients of I group, along with a long subfebrile condition, have a cupping of the basic clinical symptoms reaktivirovannoj GVI more dynamically. Only at 10 % of patients implications remained
Intoxications, in that time as, at 40 % of children of II group remained complaints to delicacy, giddiness, dream disturbance, a nausea, 2 children have been translated on house training.

The tonsillitis is taped at third of patients in both groups, but against pathogenetic therapy, is noted frequencies of augmentation of this symptom, and at children of II group, in 3 months of observations, the augmentation of frequency of occurrence in 1,5 times is noted, and in 6 months - in 2 times the number of patients with a hypertrophy of tonsils was enlarged.

Expression of a lymphadenopathy has considerably decreased in I th group, in II th - remained in 45 % of cases.

At children against pathogenetic therapy frequency of revealing of a hepatolienal syndrome, a pathology GASTROINTESTINAL TRACT (from 50 % до5 %) became perceptible to depression. It is noted augmentations of frequency of registration of pathology SSS and TSNS.

At observation over children sdlitelnym subfebrilitetompri reaktivirovannoj GVI, against the standard therapy, it is noticed, that with duration of a current of a subfebrile condition, the quantity of often ill children does not change, frequency registratsiigastroenterologicheskoj pathologies is enlarged (from 50 % to 65 %), the augmentation of quantity of children with a pathology warmly — vascular system (about 5 % to 50 %) also became perceptible, the quantity of children with a pathology of nervous system (tserebrastenichesky, subthalamic, astenovegetativnyj a syndrome) also has considerably increased (with 5%до 30 %), these changes were registered along with augmentation of detection of quantity of antigens gerpesvirusov in leucocytes of blood from 55 % before treatment, to 60 % in 3 months of observation, and in 6 months of observation against the standard therapy, already at 75 % of children antigens GV in blood leucocytes were taped. Whereas at children with including etiopatogeneicheskoj therapies authentic depression of number infected gerpesvirusami cells from 65 % to 25 % in 3 months of observation, and in 6 months, only at 10 % of patients was observed
Antigens in leucocytes have been found out. Along with these changes, absence of DNA gerpesvirusov in blood, and takzhe.dostovernoe depression of quantity of children with taped DNA gerpesvirusov in a saliva and urine became perceptible. Dynamics of detection of markers at reaktivirovannoj GVI is presented in таблице21.

111

Table 21

Results of repeated research of markers GVI at children with a long subfebrile condition at reaktivirovannoj GVI, receiving and not receiving, a causal treatment, n=40

Groups

Indicators

After etiopatogeneticheskoj therapies n=20 (Ігр.)

Abs. (%)

After symptomatic therapy n=20 (Pgr.).

Abs (%)

Before Treatment In 3 months In 6 months Before treatment In 3 months Through 6 mes
IFA IgM (+) 7 (35) 2 (10) 0 6 (30) 3 (15) 1 (5)
IgG (+) 20 (100) 20 (100) 20 (100) 20 (100) 20 (100) 20 (100)
titr 1:4000-1:8000 1:6000-1:8000 1:2000-1:4000 1:4000-1:8000 1:6000-1:12000 1:6000-1:8000
PTSR Blood (+) 6 (30) 2 (10) * 0* 8 (40) 5 (25) * 2 (10) *
Saliva (+) 16 (80) 9 (45) 4 (20) * 15 (75) 12 (60) 9 (45) *
Urine (+) 17 (85) 9 (45) 2 (10) * 13 (65) 12 (60) 9 (45) *
NRIF (+) 13 (65) 5 (25) * 2 (10) * 11 (55) * 12 (60) * 15 (75) *

The note: authentic difference in compared groups, r

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Scientific source Lebedeva Tatyana Mihajlovna. Clinico-pathogenetic value gerpesvirusov at long subfebrile conditions at children. The dissertation on competition of a scientific degree of the candidate of medical sciences. Moscow - 2014. 2014

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