RU2445630C1 - Method for prediction of risk of decreasing body resistance to acute respiratory diseases in children between ages of 3 to 7 by immunological criteria - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: child's peripheral blood is examined to evaluate the percentage of lymphocytes and the concentration of immunoglobulin M by turbidimetric method in g/l. If the concentration of immunoglobulin M is higher than 1.125 g/l, while the percentage of lymphocytes is higher than 47% (oppositely directed deviances), then a child is referred to a risk group with decreased body resistance to acute respiratory diseases.

EFFECT: use of the method allows high-accuracy prediction of the risk of decreased body resistance to acute respiratory diseases in children between the ages of 3 to 7 in a relatively short time.

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Description

FIELD OF THE INVENTION

The invention relates to medicine, namely to pediatrics.

State of the art

Often sick children due to significant prevalence have become not only a medical, but also a social problem [Kuchma V.R. School Hygiene and Health Guide. M .: Russian Association of Public Health, 2000. - P.18]. There is an acute question about the development of generally accessible, inexpensive, informative methods for predicting the frequent incidence of acute respiratory diseases (ARI) in preschool children. Such screening is necessary when children are admitted to the childcare center and to monitor their health in the future.

The modern assessment of the health status of children is based on 3 groups of factors that determine health (deviations in ontogenesis, intra- and early postnatal origin (biological history); genealogical history; social and environmental history) and 5 criteria characterizing health [in accordance with the order Ministry of Health of the Russian Federation No. 621 dated 12/30/2003 "On a comprehensive assessment of children's health"], one of which is the level of resistance of the body.

This is an indicator characterizing the resistance (resistance) of the child's body to pathogenic effects. It is determined by taking into account the frequency of acute diseases over one year of life.

If the observation was shorter, the assessment of resistance is carried out by the index of the frequency of acute diseases (IOS). It is equal to the ratio of the number of acute diseases transferred to the number of months of observation

Resistance is considered:

- high (0 diseases per year, Ioz - 0);

- medium (1-3 diseases per year, Ios <0.33);

- low (4-7 diseases per year, Ios - 0.33-0.6);

- very low (8 or more times a year, Ios> 0.65).

A child is often ill if he suffers 4 or more acute diseases during a year and the acute disease frequency index is 0.33 and higher [Vinogradov AF, Akopov ES, Alekseeva Yu.A., Borisova MA Children's Hospital. - Tver, 2004. - 495 p.].

As a prototype, we have chosen "A method for predicting the incidence of acute respiratory viral infections of children of the first year of life" [Zheleznikova GF, Ivanova VV, Kurbatova GP, Gnilevskaya Z.U. A method for predicting the incidence of acute respiratory viral infections of children of the first year of life - RF patent for the invention No. RU 2097763 C1].

The essence of the method is that in the umbilical cord blood of a child after birth, the absolute content of lymphocytes and T-lymphocytes is determined and at a level of lymphocytes less than 1.5 * 10 ⁹ / l, and T-lymphocytes - less than 0.4 * 10 ⁹ / l increased incidence of the child.

The disadvantage of this method is that:

- the study can be performed once and only at the time of birth, as it is used to study cord blood,

- It does not indicate how long the forecast is designed.

In the claimed method, the listed disadvantages are eliminated.

Disclosure of invention

The objective of the invention is to improve the diagnosis of health (lowering the body's resistance to acute respiratory infections) in children aged 3-7 years.

The technical result of the method is to increase the information content of a clinical and laboratory examination of a child through the use of a study of the peripheral blood of a child with the determination of the percentage of lymphocytes in the blood and the concentration of immunoglobulin M by the turbodimetric method in g / l to identify risk groups for children aged 3-7 years that decrease the level of resistance body to acute respiratory infections.

Brief Description of the Drawings

Figure 1 shows the distribution of the examined children in the two-dimensional space of signs (the X axis is the percentage of lymphocytes in the peripheral blood of the child,%; the Y axis is the concentration of immunoglobulin M in the venous blood of the child). The ο symbol indicates children with a low level of the body's resistance to acute respiratory diseases, the × symbol indicates children with a high level of the body's resistance to acute respiratory diseases.

The implementation of the invention

The claimed technical result is achieved by determining in the peripheral blood of a preschooler the percentage of lymphocytes and the concentration of immunoglobulin M in g / l by a turbo-measuring method, and if the concentration of immunoglobulin M is higher than 1.125 g / l and the percentage of lymphocytes is lower than 47%, or the concentration of immunoglobulin M is lower than 1.125 g / l, and the percentage of lymphocytes is above 47% (multidirectional deviations - Fig. 1), the child is at risk for a decrease in the body's resistance to acute respiratory diseases.

In total, the claimed method examined 73 children aged 3-7 years, of which 56 children, often (more than 6 times a year) suffering from acute respiratory diseases (main group), and 17 children suffering from acute respiratory diseases 1-3 times a year and not having chronic diseases (control group).

The material for the study is peripheral venous blood in an amount of 1 ml. Blood sampling is carried out in special tubes for sampling and centrifugation of venous blood. Blood sampling was performed in the morning on an empty stomach from 8 to 10 in the morning. The percentage of lymphocytes and the concentration of immunoglobulin M in g / l were determined by the turbodimetric method.

The novelty of the proposed method lies in the fact that for the first time it is proposed to predict a decrease in the body's resistance to acute respiratory diseases in children aged 3-7 years, directly examining the intensity of the immune response. The method is widely available, cheap, does not require expensive equipment.

Distinctive features of the method:

- the child determines the percentage of lymphocytes in the blood and the concentration of immunoglobulin M by the turbodimetric method in g / l

- when the concentration of immunoglobulin M is higher than 1.125 g / l, and the percentage of lymphocytes is lower than 47%, or the concentration of immunoglobulin M is lower than 1.125 g / l, and the percentage of lymphocytes is higher than 47%, the child is at risk of a decrease in the level of resistance of the body to acute respiratory diseases.

The studies were carried out in the research center of the State Educational Institution of Higher Professional Education “Tver State Medical Academy of Roszdrav”. Statistical data processing included the use of a nonparametric method for assessing the reliability of results - the Fisher angular transformation method, the significance level was determined at p <0.05 [Gubler E.V. Computational methods for the analysis and recognition of pathological processes. - L., - 1978. - P.296].

A method for predicting the risk of lowering the body's resistance to acute respiratory diseases in children aged 3-7 years by immunological parameters is illustrated by the following examples.

Clinical example No. 1. Outpatient card number 24.

The child from the second pregnancy, the first birth, proceeding with complication: weakness of labor. Breastfeeding up to 1 year 2 months. In the first year, I suffered from acute respiratory infections 2 times, in 2 years - 3 times, in 3 years - 2 times. He settles in a kindergarten. The analysis of peripheral venous blood: lymphocytes 52%, the concentration of immunoglobulin M 0.9 g / l. Frequent incidence was predicted. The child was observed during the year. The number of acute respiratory infections per year - 6 times. The forecast was confirmed.

Clinical example No. 2. Outpatient card number 41.

A child from the third pregnancy, the first birth: a cesarean section, a narrow pelvis in the mother. Breastfeeding up to 8 months. Visits kindergarten from 3 years. Up to 3 years old, ARI was sick 3-4 times a year. From 3 to 6 years he was sick 4-5 times a year. Directed to the immunologist after the next ARI. The analysis of peripheral venous blood: lymphocytes 43%, the concentration of immunoglobulin M 1,07 g / L. A favorable forecast was predicted. The child was observed during the year. During the year there were 4 cases of ARI. The forecast was confirmed.

Clinical example No. 3. Outpatient card number 57.

The child from the first pregnancy, the first birth. Artificial feeding from birth. Unstable chair. Reactive lymphadenopathy. In the first year there was no ARI. At year 2, 5 acute respiratory infections per year. He settles in a kindergarten. The analysis of peripheral venous blood: lymphocytes 39%, the concentration of immunoglobulin M 2.1 g / L. Frequent incidence was predicted. The child was observed during the year. He underwent recreational activities, and nevertheless 6 acute respiratory infections per year. The forecast was confirmed.

Claims (1)

A method for predicting the risk of a decrease in the body's resistance to acute respiratory infections in children aged 3-7 years by immunological parameters, which consists in the study of peripheral blood, characterized in that the percentage of lymphocytes in the blood and the concentration of immunoglobulin M are determined in a child by the turbodimetric method in g / l and if the concentration of immunoglobulin M is higher than 1.125 g / l, and the percentage of lymphocytes is lower than 47% or the concentration of immunoglobulin M is lower than 1.125 g / l, and the percentage of lymph itov above 47% (omni directional deviation), then the child carry a risk reduction of organism resistance to acute respiratory diseases.

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