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research methods

For an estimation of activity of disease, and also efficiency of spent therapy scale ACRpedi developed for use in practice of children's rheumatologists was used.

Scale ACRpedi includes 6 indicators:

1.

The general estimation of a state of health on a visually-analogue scale "YOURS" the patient or his parents, where «0» - very good state of health, «100» - very bad state of health.

2. A global estimation of activity of illness on a scale YOURS the doctor, where «0» - absence of activity, «100» - very high activity of disease.

3. An estimation of functional activity of the patient on questionnaire CHAQ (Childhood Health Assesment Quesnionnaire).

4. Definition of number of joints with an active arthritis (from 75 joints).

5. Definition of number of joints with function disturbance (from 75 joints).

6. Definition of laboratory indicators of activity of disease (an ESR and SRB).

ACRpedi 30, 50, 70 mean, that 30, 50 or 70 % improvement, at least on 3 of 6 criteria are reached, at possible deterioration on 30 % no more than one indicator, in comparison with a reference value [236].

Besides, at children from the second group definition of following laboratory indicators was spent: concentration of haemoglobin, quantity of erythrocytes and reticulocytes, erythrocyte indexes - average volume of an erythrocyte (MCV), an average haemoglobin content in an erythrocyte (MCH) and average concentration of haemoglobin in an erythrocyte (MCHC); quantities of leucocytes and the leukocytic formula, with definition of absolute quantity of cells of a myeloid number; quantities of thrombocytes; for definition of paraclinic activity of disease the blood sedimentation rate and level From reactive fiber was defined; for the purpose of an estimation of a metabolism of iron in an organism level of a ferritin of Serum, serumal iron, by the general and latent zhelezosvjazyvajushchej abilities of Serum, factor of saturation of a serumal transferrin, level of soluble receptors of a transferrin of Serum (rrtf), and also level gepsidina Serums, as key were defined
Regulator of a homeostasis of iron in a human body.

All laboratory researches were spent in the certificated clinical and biochemical laboratories by the standardised techniques, results of research are presented in SI. Data about quantity and methods of clinico-biochemical researches, and also about used units of measure are presented in table 2.1.

Table 2.1.

The characteristic of clinico-biochemical methods of researches

Indicator Research method n Units of measure
Concentration of haemoglobin TSianmetgemoglobinovyj a method 546 G/l
G ematologichesky the analyzer 554
Quantity of erythrocytes The unified method of calculation of erythrocytes in cytometer Gorjaeva 417 H1012/l
G ematologichesky the analyzer 554
MCV G ematologichesky the analyzer 236 fl
MCH G ematologichesky the analyzer 241 pg
MCHC G ematologichesky the analyzer 191 G/l
Quantity of leucocytes The unified method of calculation of leucocytes in cytometer G orjaeva 536 H109/l
G ematologichesky the analyzer 554
ESR Method Panchenkova 543 Mm/hour
Method Vestergrena 554
Level S-rb The unified semiquantitative method koltsepretsipitatsii in capillaries 363 +
Nefelometrichesky method 383 Mg/l
Serum ferritin Chemiluminescent method 154 Mkg/l
Serum iron The colorimetric test with ferrozinom 76 Mkmol/l
LZHSS Direct definitions with ferrozinom (on a difference between sizes added in assay and remained untied a gland) 60 Mkmol/l
OZHSS ОЖСС=Железо Serums + LZHSS 60 Mkmol/l
rtfr Nefelometrichesky method 35 Mg/l
Gepsidin Serums Method of a highly effective liquid chromatography with tandemnoj mass spectrometry (ZHH/MS-MS) 25 Ng/ml

For diagnostics of an anaemia and degree of its gravity criteria of the World organisation of public health services for various age and gender groups [83] were used. The anaemia was defined on the basis of depression of concentration of haemoglobin less than 110 g/l at children at the age from 6 till 59 months without dependence from a floor; less than 115 g/l at children at the age of 5 - 11 years without dependence from a floor; less than 120 g/l at children 12 - 14 years without dependence from a floor; at girls of 15 years also is more senior - concentration of haemoglobin less than 120 g/l, at boys of this age group - concentration of haemoglobin less than 130 g/l.

Criteria of diagnostics of an anaemia and degree of its gravity are presented in table 2.2.

Table 2.2.

Criteria of diagnostics of an anaemia and degree of its gravity on the basis of concentration of haemoglobin of a g/l (the CART, 2011)

Population group Not an anaemia Anaemia
The easy The moderated The serious
Children at the age of 6 - 59 months 110 and above 100 - 109 70 - 99 Less than 70
Children at the age of 5 - 11 years 115 and above 110 - 114 80 - 109 Less than 80
Children at the age of 12 - 14 years 120 and above 110 - 119 80 - 109 Less than 80
Not pregnant women

(Is more senior 15 years)

120 and above 110 - 119 80 - 109 Less than 80
Pregnant women 110 and above 100 - 109 70 - 99 Less than 70
Men (is more senior 15 years) 130 and above 110 - 129 80 - 109 Less than 80

2.3.

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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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