RU2185625C2 - Method for predicting flow of celiac disease and chronic enteritis in children - Google Patents

Abstract

FIELD: medicine, gastroenterology. SUBSTANCE: laboratory testing of a patient is conducted to study blood erythrocytes and detect the activity value of superoxidedismutase. At its value being constant at 338 U/min gram hemoglobin and lower at the phase of noncomplete clinicolaboratory remission of celiac disease and chronic enteritis the unfavorable course of the disease is predicted. At the value of 339 U/min gram hemoglobin and higher the favorable course of the disease is established. EFFECT: higher accuracy of prediction. 4 ex, 1 tbl

Description

 The invention relates to medicine, namely to gastroenterology, and can be used to predict the occurrence of relapse of celiac disease and chronic enteritis in children and the timely appointment of adequate therapy.

 Prediction of chronic diseases of the small intestine and the appointment of timely treatment is an important medical and social problem. Occurring, as a rule, in early childhood, these diseases last for many years, are prone to relapse and, with the development of severe syndrome of impaired intestinal absorption, lead to disability.

 A known method for assessing the state of the small intestine in children, including the determination of malondialdehyde in red blood cells (MDAe): the higher the value of MDAe, the more the hydrolytic-absorption capacity of the small intestine is violated (Slobodyan L.M.// Maternal and Child Health Issues. - 1990. - 4 - p. 7-9). However, in our studies it was established that with severe pathological changes in the body, both maximally increased MDAe and maximally reduced indicators are observed, which indicates the depletion of the oxidation substrate, a far-reaching pathological process. Thus, the known method does not provide prediction accuracy.

 The aim of the invention is to improve the accuracy of prediction of the course of celiac disease and chronic enteritis in children.

 Superoxide dismutase (SOD) is an antioxidant enzyme that controls the processes of lipid peroxidation in the initial stage. SOD activity is reduced in exacerbation of celiac disease and chronic enteritis. In the phase of incomplete clinical and laboratory remission, there is a tendency to restore SOD activity, which leads to a limitation of the damaging effect of lipid peroxidation on cell membranes. But if the activity of SOD in the phase of incomplete clinical and laboratory remission does not rise above 338 u / min gnv, this fact indicates the intensity of antioxidant protection, the possibility of an exacerbation of the disease in the near future.

 The efficiency of the method was proved by examining 20 children, of which 12 patients with chronic enteritis and 8 with celiac disease (see table).

 The method is as follows.

 1 ml of capillary or venous blood is taken from the patient, placed in a test tube with 3.8% sodium citrate solution (in a 10: 1 ratio). Red blood cells are isolated from plasma by centrifugation (10 min, 3000 rpm) and washed twice with a double volume of 0.15 M sodium chloride. A hemolysate of 1:25 is prepared, in which the SOD activity is determined. SOD activity was determined by the method of P. Kakkar et al. A modified spectrophotometric assay of superoxide dismutase // Indian J. Biochem. and Biophys. - 1984. - V.21, N 2. - p. 130-132.

 When the SOD value is less than 339 u / min gnv, an unfavorable course of the disease is diagnosed in relation to the occurrence of relapse in the near future.

 Examples of specific performance are given in the form of extracts from the medical history.

Example 1. Maxim S., 4 years old, medical history 531/98
The boy has been observed in the clinic since 1.5 years old, when celiac disease was first diagnosed. In this hospitalization complaints of rare abdominal pain. The results of clinical, laboratory and morphological studies allowed us to make the diagnosis: Celiac disease, phase of incomplete clinical and laboratory remission. Lactase deficiency.

 The activity of erythrocyte SOD in this hospitalization was 338 u / min gnv. A forecast was made about the deterioration in the near future. After discharge from the hospital, the recommendations were not followed. After 6 months, he was hospitalized with an exacerbation of the disease.

 Example 2. Alyosha P., 4 years old, medical history 90/98.

 At 1 year 3 months, the child was diagnosed with celiac disease. The clinic is observed regularly. There are no complaints upon receipt. As a result of the examination, the diagnosis was made: Celiac disease, phase of incomplete clinical and laboratory remission. SOD activity was 339 u / min gnv. A prediction was made about the favorable course of the disease. With further observation in the clinic, an improvement in the functional state of the intestine was established.

 Example 3. Sasha G., 2 years old, and.b. 1212/98.

 As a result of the examination conducted in the clinic, the diagnosis was made: Chronic enteritis, mixed etiology, moderate severity, phase of incomplete clinical and laboratory remission.

 SOD activity was 401 u / min gNv. A prediction was made about the favorable course of the disease. When observed for 1.5 years, relapse of the disease was not observed.

 Example 4. Eldar Z., 5 years old, medical history 502/98.

 During the examination in the clinic the diagnosis was made: Chronic enteritis, mixed etiology, phase of incomplete clinical and laboratory remission. Disaccharidase deficiency.

 A biochemical blood test revealed an activity of SOD of 300 u / min gnv. After 6 months, the boy was admitted to the hospital with an exacerbation of the disease.

 The use of this method for predicting diseases of the small intestine (chronic enteritis and celiac disease) provides a positive effect in the form of increasing the accuracy of predicting the course of the disease.

Claims (1)

 A method for predicting the course of celiac disease and chronic enteritis in children, including a biochemical analysis of red blood cells of a patient, characterized in that the red blood cells determine the activity indicator of superoxide dismutase and, with a value of 338 u / min gNv and lower, predict an unfavorable course of the disease, and with a value of 339 u / min gnv and higher - favorable.

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