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CONCLUSIONS

1. Children and the teenagers who have arrived in a children's antituberculous hospital, have been taped at verifying surveys on a Mantoux test 2ТЕ and Diaskintestjv 51 %; at fluorographic inspection in 25 %, at the reference with complaints from the general medical network of 17 %, from the tuberculosis centres on contact of 7 %.

Among clinical forms the primary tuberculosis - 52 % prevailed, from them in 50 % the tuberculosis of intrathoracic lymph nodes is diagnosed. From forms of a secondary tuberculosis, focal and infiltrativnyj a pulmonary tuberculosis in 37 %. Bakteriovydeliteljami there were 12 % of children with local forms of a tuberculosis.

2. At children at the local forms of a tuberculosis which are in a phase of an exudative inflammation, higher sensitivity tuberkulinovyh assays became perceptible: on a Mantoux test 2ТЕ the expressed positive assays are taped at 43 %, giperergicheskie in 16 %; on assay Diaskintestj - 31 % and 17 % accordingly. Correlation communication a straight line (0,3), average degree of expression.

3. At children with local forms of a tuberculosis in 16 % and at children with "bend" tuberkulinovyh assays in 15,6 % the result on assay with preparation Diaskintestj was negative; thus they had the lowered sensitivity at a Mantoux reaction 2 THOSE (the average size of a papule 10,3 yo 2,3 mm). At negative result of assay on preparation Diaskintestjbyli the limited processes, processes in a phase of a productive inflammation and an involution are is more often taped vnelegochnye the forms.

4. Features of reaction of immune system are taped at the tubercular infection, differing by depression CD4 + - rising CD16 + - lymphocytes, rising of level IgE in peripheric blood, depression of level of production stimulirovannogo IFN-y in the test - system with FGA,
Rising with preparation Diaskintest ®in vitro. Degree of expression of changes depended on activity of tubercular process.

5. Level stimulirovannoj production IFN-y in the test - system in vitro has taped its depression in 1,8 times with FGA at children with local forms of a tuberculosis, and during too time, rising with preparation Diaskintest jkak at children with "bend" tuberkulinovyh assays (41,2 pg/ml), and at children with local forms of a tuberculosis (38,8 pg/ml), in the absence of it in group of the healthy.

6. Negative results on assay Diaskintestjpri of the positive

Mantoux tests 2ТЕ and definition of a phenomenon of emission IFN-y in the test - system with DST in vitro more than 18 pg/ml testify to activity of tubercular process.

PRACTICAL REFERENCES

1. At children at inspection at the phthisiatrician it is recommended to estimate a complex of diagnostic data, both results of dermal assays, and risk factors, and first of all, search of possible contact to a sick tuberculosis in an environment of the child.

2. For improvement of quality of diagnostics of a tubercular infection at children it is possible

To apply the complex of inspection including definition in blood serum of level CD4 +, CD16 + - lymphocytes, IgE and production level

stimulirovannogo IFN-y in the test - system with preparation Diaskintest ®in vitro.

3. In case of "bend" revealing tuberkulinovoj Mantoux reactions 2ТЕ at children, presence of risk factors on a tuberculosis (contact, a HIV-infection, noneffective bacterination, etc.), but thus, negative reaction to preparation Diaskintestj, it is recommended doobsledovanie with level definition

105
Production IFN-y In the test - system with preparation Диаскинтест®in vitro.

Definition of emission IFN-y in system with DST in vitro more than 18 pg/ml,

To estimate as a sign of an active tubercular infection.

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Scientific source Ahmerova Tatyana Efimovna. IMMUNODIAGNOSIS OF DIFFERENT MANIFESTATIONS OF TUBERCULOSIS INFECTION IN CHILDREN. Thesis for the degree of candidate of medical sciences. SAMARA - 2014. 2014

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