design of research, criteria of including and an exception, grouping surveyed

Work is supported by grant Howard University, Washington, DC, USA.

The design of research assumed carrying out of the meta-analysis of the contemporary records which have been saved up for the period before introduction genno-engineering antitsitokinovyh of preparations in clinical pediatrics, and also kogortnye researches.

For a basis for model construction was it is taken juvenilnyj a pseudorheumatism (JURA), as one of the most widespread variants of chronic arthritises from children. Besides, the anaemia at JURA is a typical example of an anaemia which complicates a current of chronic illnesses.

Research has met with approval of ethical committee at GOU VPO the St.-Petersburg state pediatric medical academy of Ministry of Health of the Russian Federation (the report № 7/6 from January, 28th, 2010).

As criteria of including in research have served:

1. Age of the patient less than 18 years.

2. Signing by the patient or its official representative of the informed consent to participation in research;

3. The diagnosis juvenilnogo a pseudorheumatism, established according to criteria of the American board of rheumatologists:

■ Age of the beginning of disease less than 16 years;

■ Duration of disease more than 6 weeks;

■ the Arthritis: pripuhanie either an exudate, or two following signs - morbidity or restriction of mobility of a joint, a pain or a joint hyperthermia;

Criteria of an exception of research:

■ the Chronic arthritis of other aetiology.

Depending on character of therapy juvenilnogo a pseudorheumatism all patients have been parted on 2 groups.

Patients from the first group received standard therapy JURA: gljukokortikosteroidy (Prednisolonum, Methylprednisolonum), cytostatics (Methotrexatum, cyclophosphamide), resolvents (diclofenac, indometacin, Brufenum, piroksikam, Rheopyrinum, aspirin, Penicillaminum), antimalarial preparations (chloroquine, gidroksihlorohin).

Patients of the second group received treatment biological illness - modifying medical products (BBMLS) - totsilizumabom and golimumabom.

• Totsilizumab - rekombinantnye gumanizirovannye monoclonal antibodies of class IgG1 to human receptor ИЛ-6.

• Golimumab - rekombinantnye gumanizirovannye the monoclonal antibodies of class IgG1 forming vysokoaffinnye stable complexes "antigen-antibody" both with soluble, and with transmembrane bioactive forms of the factor of a necrosis of a tumour an alpha (FNO), preventing linkage FNO with its receptors.

In both groups depending on a clinical variant of a current juvenilnogo a pseudorheumatism all patients have been parted on following subgroups:

JОлигоартикулярный a variant juvenilnogo a pseudorheumatism (oligo JURA) - a lesion less than 5 joints;

JПолиартикулярный variant JURA (weed JURA) - 5 and more joints;

JСистемный variant JURA (sist JURA) - a persistent intermittent fever and-or a rhematoid eruption and-or extraarticular lesions.

At patients of the first group following clinical indicators - the general condition, a fever, lymphonoduses, an eruption, the sizes of a liver and a lien, a lesion of heart, lungs, kidneys, eyes were estimated, articulate a syndrome, the estimation of laboratory indicators also was spent - concentration of haemoglobin and From reactive fiber, quantity of erythrocytes and leucocytes, a colour indicator and a blood sedimentation rate was defined. For research cards of a dispensary observation of children suffering juvenilnym by a pseudorheumatism have been used, which were on inspection and treatment in clinic of the Leningrad pediatric medical institute (Sankt - the Petersburg state pediatric medical university) during the period with 1973 for 1996.

Patients of the second group received therapy BBMLS (totsilizumab, golimumab), as in a combination with synthetic illness-modifying preparations (Methotrexatum), gljukokortikosteroidami (Prednisolonum, Methylprednisolonum), etc., and in the form of monotherapy. Children from the second group passed stationary inspection and treatment in pediatric unit №3 (zav.otd. k.m.n. Kalashnikov O. V) clinics GBOU VPO Sankt - the Petersburg state pediatric medical university Ministries of Health of the Russian Federation during the period with 2009 for 2013.

To children from the second group it was spent the complex inspection including anamnestic data about character of a current of disease, a clinical estimation of a condition of joints with use visual, palpatornyh methods and scoping of active and passive movements in joints with goniometer use.


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Scientific source EGOROV Andrey Sergeevich. THE GEPSIDIN-INTERLEUKIN-6 SYSTEM AS A FACTOR FOR MANAGING THE COURSE OF ANEMIA IN CHRONIC ARTHRITIS IN CHILDREN DISSERTATION for the degree of candidate of medical sciences. St. Petersburg - 2016. 2016

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