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1.2 Physical development of children with a syndrome of Down

According to the spent researches, children with SD have the lowered rates of growth since a birth and before end of all period of growth, with the lowest indicators in infancy and a youth. On the average, final growth of women with a syndrome of Down 145см, and men-157sm.

It is noticed, that children with SD, brought up in families above the contemporaries who are in specialised establishments [100].

The growth inhibition reason unequivocally is not clear yet. Possibly, it is not rare in a basis the combination of some factors, such as a congenital heart disease, a sprue, a Gee's disease and others lays. It is noticed, that the growth inhibition at children with SD also can be bound to the lowered levels of somatotropic and insulinoid hormones of growth. Research interest of scientists has been concentrated to studying of influence of a role of a hormone of growth and somatomedinov \insulin-like of factors of growth as these hormones influence not only growth, but also on development of nervous system. Low value insulin-like of factors of growth have been found out in one research [13]. However the majority of works have taped normal secretion of a hormone of growth. Normal value of a hormone of growth have been taped even at treatment by a growth hormone at any initial level of own hormone of growth at children with a growth inhibition and SD [10, 128]. However, now, the role of such therapy remains disputable because of a disadvantage of results of the remote consequences and probability of development of possible complications. Therefore, use of hormonal therapy as standard treatment of a growth inhibition at children with a trisomy of 21st chromosome, as a whole, is not recommended.

According to the spent researches, at children with SD after the first year of a life prevalence of weight over growth, and superfluous mass of a body and predilection to a hyperalimentation - a frequent problem of adults with it becomes perceptible
Syndrome. Therefore, a regular estimation of the physical status and carrying out of preventive maintenance of adiposity it is actual from second year of a life of patients with SD [24, 99].

For an estimation of physical development since the first days of a life of the child

Anthopometrical indicators, such as growth, weight, a head and breast circle are estimated. The received results, considering features of physical development of children with SD it is expedient to compare to standard indicators (pertsentilnymi tables), developed specially for these children, instead of with those for healthy children [108]. The first normogrammy for an estimation of anthopometrical indicators of children with SD have appeared already in 1988 and long time they were the unique instrument in work of doctors - of pediatrists of the different countries [28] (fig. 5).

Drawing 5. Pertsentilnye tables of growth and weight of boys with SD.


Further, such tables and schedules have been developed and in other countries [44, 121, 98, 27]. The received results have shown, that rates of growth of children of different population groups differ.

Perfection and improvement of quality of medical aid, including surgical correction of congenital developmental anomalies, also has reflexion in indicators of physical development of children with a syndrome of Down.

1.3.

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Scientific source Semenova Natalia Aleksandrovna. STATE OF HEALTH of CHILDREN With the SYNDROME of Down. The dissertation on competition of a scientific degree of the candidate of medical sciences. Moscow - 2013. 2013

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