RU2018833C1 - Method for forecasting tendency of adaptation process at schoolchildren by their returning from south sanatorium - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: content of sodium and potassium and lysozyme activity is determined in child's saliva, the process takes place on the third day of his returning from south sanatorium. On the fifth day cardiointervalography is carried out to determine stress index. If ratio of sodium and potassium content is more 0.3, activity of lysozyme is more 7% and stress index is more 200 or less 50 then complicated tendency of adaptation process is forecast. EFFECT: increases accuracy of the method. 2 tbl

Description

 The invention relates to medicine, to pediatrics, it allows to predict violations of the state of health in children in the process of rehabilitation when returning from a southern sanatorium to the middle region of Russia.

 The study of readaptation processes is a new aspect of the effectiveness of spa treatment and allows a differentiated approach to the selection of children in order to timely correct the revealed health disorders.

 The issues of readaptation remain poorly studied, mainly boiling down to the study of several leading anatomical and physiological systems of the body, however, adaptive changes were not compared with the final adaptive effect, their features in children recovering in the sanatorium were established either by comparison with healthy children who came to rest, or with an identical group of local residents. In these works, an assessment was made of some functional systems of children and adolescents during their stay at the resort during the first days of their stay in the sanatorium and at the end of the course of treatment. The return of children after spa treatment again requires adaptation to climatic conditions and social environment.

 The closest in its decision to the claimed method is a study on the characteristics of the adaptation of children with chronic foci of nasopharyngeal infection, considered as a risk group for the formation of chronic bronchopulmonary pathology. If during the adaptation period changes in immunological reactivity, oxygen supply, and electrocardiography were detected, then changes in functional parameters in the readaptation period were reduced only to cardiac arrhythmias. The examination of children was carried out only on the 1st and 30th days after returning from the sanatorium.

 However, according to observations, the adaptation syndrome when returning from the sanatorium lasts up to 14 days, and the maximum change in functional indicators occurs in 1 week of rehabilitation (3-5 days).

The disadvantages of this work were as follows: the prognostic value of changes in functional parameters revealed at the beginning of re-adaptation was not evaluated in terms of worsening health status;
there is no dynamics of indicators to identify the highest tension of adaptive mechanisms during the rehabilitation period;
the period of readaptation is characterized by a change in heart rate, while the return from the contrasting climatic zone is characterized by a violation of the mental sphere, metabolic processes, thermoregulation, weight loss, increased acute morbidity and hemodynamics.

 The aim of the invention is the prediction of health disorders in children during the rehabilitation period when returning from a southern sanatorium.

 This goal is achieved by identifying critical values, indicators characterizing the degree of tension of adaptive mechanisms necessary and available for predicting clinical deviations of the state of health.

 We studied the structure of the adaptation syndrome in children when they return from the contrasting climatic zone according to the final adaptive effect in order to maintain their state of health.

 For the first time typological features of adaptive reactions are revealed depending on the outcome of readaptation. At the same time, it was found that schoolchildren who had health problems experienced greater emotional stress, manifested by the tension of regulatory adaptive mechanisms.

 High salivary Na / K ratios were established, which are regarded as an overstrain of the neuro-endocrine regulation compared with the favorable group, as well as excessively high or very low values of the stress index, which is also associated with the strain or overstrain of the autonomic regulation. In addition, a significant change in local nonspecific protection was found, manifested in high values of saliva lysozyme in this group of children.

For the first time, their critical values were established in a group of children with favorable readaptation:
- the ratio of sodium to potassium in saliva is 0.3
- indicator of lysozyme activity of saliva - 7% on the 3rd day of readaptation;
- the value of the voltage index (IN) is 200 units of unit, or - 50 units of unit on day 5 of rehabilitation.

 When the content of lysozyme in saliva is more than 7%, the ratio of sodium to potassium in saliva is more than 0.3, the voltage index is more than 200 units or less than 50 units predict the threat of disruption of readaptation and health disorders.

 A significant difference between the proposed method and the prototype method is the determination of the critical values of the functional parameters of the leading systems, which allow predicting already at 1 week of readaptation resulting in subsequent deterioration of health. These criteria are evaluated only in aggregate. Only their simultaneous deviation from critical values in schoolchildren after the southern sanatorium makes it possible to predict a deterioration in health status. Using the proposed set of indicators allows you to tentatively assess the main levels of the functional adaptation system. The data were obtained from the perspective of a systematic approach, and determined taking into account the final result of readaptation - the safety of various health indicators, the presence of acute respiratory viral infections, and fluctuations in blood pressure. In this regard, the proposed method allows to predict the increase in morbidity, the manifestation of chronic infections.

 It is known that the nature of adaptive restructuring of various body systems when changing social conditions depends on the age and nature of the adaptation situation.

 According to the teaching of Selye G., the adaptation syndrome is nonspecific, includes regulatory levels. But in each specific situation, its own adaptation system is formed, it is specific and due to the fact that it includes not only regulatory levels, but also executive functions. In addition, the specificity of a functional system is determined by the degree of participation of this system in adaptation. The invention used a unified methodological approach based on a systematic analysis of adaptive reactions at the level of the whole organism with the identification of the main response levels - psychoemotional, neurohumoral and autonomic regulation, local nonspecific protection, metabolic processes, hemodynamics, determination of mental, physical performance. The choice of indicators for predicting health disorders in schoolchildren during the rehabilitation period is due to the active involvement of indicators of operational regulation, local nonspecific protection, and neuro-endocrine regulation.

 The salivary lysozyme activity index was previously used for a nonspecific characterization of the course of the stress reaction.

 The value of the stress index, the ratio of Na / Potassium in saliva, saliva lysozyme in the present method is used for the first time to predict health disorders in the period of rehabilitation.

 The method is as follows: when students return from the southern sanatorium on the 3rd day of rehabilitation before the 1st lesson, mixed saliva is collected in an amount of 1.5-2 ml. The concentration of sodium and potassium in it is determined by flame photometry according to the generally accepted method, and the ratio of sodium to potassium in saliva is calculated. The lysozyme activity of saliva was determined by the nephelometric method according to V.G. Dorofeychuk. The stress index was determined using standard mathematical analysis of heart rate.

 PRI me R 1. Child Marina S., 12 years old. On the 5th day of readaptation, the indicator of lysozyme activity in saliva is 10.5%, the ratio of sodium to potassium is 0.45, and the stress index on day 5 of readaptation is -263. A total of 3 signs (lysozyme activity of saliva, the ratio of sodium to potassium of saliva, the value of the stress index) predicted a complicated course of readaptation. In a child in the period of readaptation, an increase in blood pressure was noted that went beyond the age limits.

 PRI me R 2. Child Anya V., 12 years old. On the 3rd day of readaptation, the indicator of salivary lysozyme activity is 11.5%, the ratio of sodium to potassium of saliva is 0.41, the stress index on the 5th day of readaptation is 42. A complicated course of readaptation is predicted. During the observation period, she had ARVI. The forecast was confirmed.

 PRI me R 3. Child Misha L., 12 years old. On the 3rd day of readaptation, the salivary lysozyme activity indicator is 6.0, the ratio of sodium to potassium is 0.23, the stress index on the 5th day of readaptation is 25. An uncomplicated readaptation course is predicted. During the observation period, health disorders were not observed. The forecast was confirmed.

 PRI me R 4. Child Tanya M., 13 years old. On the 3rd day of readaptation, the content of salivary lysozyme activity is 5.0, the ratio of sodium to potassium is 0.28, and the stress index on the 5th day of readaptation is 100.0. Uncomplicated readaptation course is predicted. There were no violations of the state of health during the rehabilitation period.

 The modes of the method are confirmed by the following clinical examples.

 PRI me R 5. The child Marina S., 12 years old. On the 3rd day of readaptation, the indicator of lysozyme activity of saliva is 10.5%, the ratio of sodium to potassium is 0.45, the stress index on the 5th day of readaptation is 264 units. All three indicators exceeded the declared parameters (see table 1); according to their totality, a complicated course of readaptation was predicted. A child in the period of readaptation showed deviations in blood pressure that went beyond age limits. The forecast was confirmed.

 PRI me R 6. Child Anya V., 12 years old. On the 3rd day of readaptation, the salivary lysozyme activity indicator is 11.5%, the ratio of sodium to potassium is 0.41, the voltage index value on the 5th day of readaptation is 42. All three indicators exceeded the declared parameters (see table 1), in the aggregate of all three signs, a complicated course of readaptation was predicted. The course was complicated by the addition of ARVI. The forecast was confirmed.

 PRI me R 7. Child Misha L., 13 years old. On the 3rd day of readaptation, the indicator of lysozyme activity of saliva is 6.0%, the ratio of sodium to potassium is 0.23, and the stress index on the 5th day of readaptation is 25 unit units. Only one indicator - the stress index - was higher than the declared parameter (see table 1). Uncomplicated readaptation course is predicted. During the observation period, health disorders were not observed. The forecast was confirmed.

 PRI me R 8. Child Tanya M., 13 years old. On the 3rd day of readaptation, the content of salivary lysozyme activity is 5.0%, the ratio of sodium to potassium is 0.28, the stress index on the 5th day of readaptation is 100.0 unit units. All three indicators did not exceed the declared parameters (see table 1). Uncomplicated readaptation course is predicted. There were no violations of the state of health during the rehabilitation period.

 These examples are presented in the form of table 1 for better comparison with the claimed parameters.

A total of 60 children were examined after spa treatment. The results show that the inventive method allows to predict a complicated course of readaptation in schoolchildren with an accuracy of 85% (Table 2). Using the proposed method for predicting health disorders in schoolchildren during the rehabilitation period has the following advantages:
- high accuracy of the forecast of 85%;
- accessibility for mass examinations of schoolchildren upon returning from spa treatment from a contrasting climatic and geographical zone.

 The positive effect is the timely prediction of health disorders in children already at the 1st week of rehabilitation, which allows timely correction of these disorders.

Claims (1)

 METHOD FOR PREDICTING THE COURSE OF ADAPTATION PROCESS IN SCHOOLCHILDREN RETURNING FROM SOUTHERN SANATORIUM, including instrumental and laboratory examination, characterized in that, in order to improve the accuracy of the method, the level of sodium and potassium, lysozyme activity are determined on the third day after the child returns, the ratio of levels is calculated. sodium and potassium, then on the fifth day cardiointervalography is performed, according to the results obtained, the voltage index is determined and when the value of the ratio of sodium and potassium levels is more than 0.3, ak lysozyme activity is more than 7% and a stress index of more than 200 or less than 50 conventional units predict the complicated course of the adaptation process.

Images