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Honkeldieva Hurmathon Kamchievna, Andizhan State medical institute, assistant chair of hospital and outpatient pediatrics, scientific competitor, Uzbekistan
Alimdzhanov Ibrahim Inamovich, Andizhan State medical institute, professor chair of hospital and outpatient pediatrics
Abdullaeva Mavjuda Ergashevna, docent of chair of hospital and outpatient pediatrics
Tojiboev Temur Topvoldiygli, Student of Andizhan State medical institute
Mamatkhyjaev Mirhojiddin Sadriddinkhoji ygli, Student of Andizhan State medical institute E-mail: evovision@bk.ru
Functional state of the autonomic nervous system in bronchial asthma in children
Abstract: These shifts vegetative status have undoubted positive effect on the microcirculation and the rhythm of the circulatory system, facilitating a more rapid liquidation of clinical manifestations of autonomic dysfunction and create psi-hoemotsinalnogo patient comfort mode.
Keywords: nervous system, bronchial asthma, children.
As is known, autonomic tone has significant impact on the clinical manifestations of asthma (BA) [1; 4; 5; 7; 11]. Identified psychovegetative violations necessitate further development ofAD therapies in terms of vegetative homeostasis correction using vegetotropic drugs [6; 8; 9; 10]. The purpose of the study. Was to examine the influence of a tranquilizer Phenibutum on vegetative status and clinical manifestations of asthma in children with initial sympathicotony.
Material and methods. All observed patients with initial sympathicotony divided into 2 groups. Patients of the first group (n = 40) ssceived standard therapy alone (control group), and the second group ofpatients (n = 37) along with conventional methods
therapy plus Phenibutum. For greater reliability of observation and treatment of these children were held over the pair factor. Indicators reflecting the state the vegetative status of patients before and after one month of treatment are shown in Table I.
Results
Studies have shown that prior to the appointment of complex therapy in patients of both groups on the studied parameters revealed no significant differences. On the background of generally accepted standard therapy in patients of group 1 was observed a tendency to a decrease in heart rate, the number ofbreaths intersystem index. But after a month of therapy, none of the indicators were not significantly different from those on admission.
Table 1. - Dynamics of some vegetative parameters in patients with asthma (M ± m)
Index Patients in group 1 Patients in group 2 P1 P2 P3
Hr 108.01 ± 2.21 104.34 ± 2.23 105.82 ± 2.34 90.48 ± 3.04 > 0.05 < 0.001 < 0.001
Number of breaths 19.12 ± 0.96 18.23 ± 0.78 18.85 ± 0.64 16.61± 0.83 > 0.05 > 0.05 > 0.05
Intersystem index 5.68 ± 0.17 5.67 ± 0.16 5.58 ± 0.15 5.01± 0.14 > 0.05 < 0.01 < 0.01
Sbp 91.45 ± 1.89 91.29 ± 1.29 92.01 ± 1.78 95.34 ± 1.13 > 0.05 > 0.05 < 0.05
Dbp 60.42 ± 2.42 60.26 ± 2.62 61.76 ± 2.78 60.71 ± 2.29 > 0.05 > 0.05 > 0.05
Functional state of the autonomic nervous system in bronchial asthma in children
The patients of the second group above figures differed sig- the number of breaths that led to a decrease (P < 0.01) coefficient nificantly from that of patients in the first group. During treatment Hildebrant, reflecting the state of intersystem relations. Most of Phenibutum patients of the second group showed a significant slow- these indices is the activation of parasympathetic tone. ing of the heart rate (HR) (P < 0.001), a significant reduction in
Table 2. - Dynamics of heart rhythm in patients with asthma initial sympathicotony (M ± m)
Index Patients in group 1 Patients in group 2 P1 P2 P3
Mo, sec. 0.537 ± 0.011 0.571 ± 0.014 0.544 ± 0.012 0.669 ± 0.021 > 0.05 < 0.001 < 0.01
AMo, % 36.56 ± 0.22 30.04 ± 0.41 37.11 ± 0.31 24.19 ± 0.47 < 0.001 < 0.001 < 0.001
AH, sec. 0.089 ± 0.002 0. I27 ± 0.004 0.094 ± 0.003 0.291 ± 0.005 < 0.001 < 0.001 < 0.001
CDF., Conv 0.089 ± 0.002 0.127 ± 0.004 0.094 ± 0.003 0.291 ± 0.005 < 0.001 < 0.001 < 0.001
INI., Conv 21.87 ± 0.36 9.26 ± 0.49 20.69 ± 0.63 5.14 ± 0.27 < 0.001 < 0.001 < 0.001
AMo/AH 384.2 ± 10.3 207.1 ± 12.9 362.9 ± 13.6 62.1 ± 4.7 < 0.001 < 0.001 < 0.001
AMo/Mo 410.8 ± 16.8 236.5 ± 6.3 394.8 ± 13.4 84.3 ± 4.9 < 0.001 < 0.001 < 0.001
1N2, Conv 68.08 ± 1.24 52.61 ± 0.98 68.22 ± 1.27 36.16 ± 2.01 < 0.001 < 0.001 < 0.001
IN2/IN1 762.2 ± 37.7 435.9 ± 45.3 812.0 ± 43.6 189.6 ± 21.4 > 0.05 < 0.001 < 0.001
Note:
in the numerator — the figures before treatment in the denominator — after 1 month of starting treatment; P1 — a significant difference before and after treatment in Group 1; P2 — a significant difference before and after treatment in group 2;
P3 — the accuracy of the difference between groups after one month from the beginning of therapy.
Table 3. - Dynamics VPI after orthosample
Dynamics VPI after orthosample
Patients with baseline sympathicotonia Amphotonic Vagotonia sympathicotonia
n % n % n %
1-group (n = 40) 0 0 0 0 40 100.0
9 22.5 7 17.5 24 60.0
2-group (n = 37) 0 0 0 0 37 100.0
17 45.9 9 24.3 11 29.7
Index evaluation cardiointervalography also revealed certain changes vegetative parameters in both groups (Table 2), which is reflected in the significant increase in indicators such as AMo, INI, the CDF, and the reduction of Mo, AH. This proves the increase in sympathetic activity in the cardiovascular system, decreased activity of independent regulatory circuit activation and higher levels of management that is to centralize control.
After a month from the start of standard therapy in patients of the first group compared with the data on admission noted nonsignificant increase in channel activation of humoral heart rate regulation (P > 0.05), a significant decrease in the activity of the sympathetic the autonomic nervous system (P < 0.001) and increased activity of the parasympathetic division of the autonomic nervous system (ANS) (P < 0.001) reduction in the degree of tension of regulatory mechanisms of the body and the level of centralization of control circulation (P < 0.001). Complex therapy fenibuta resulted in a significant increase compared with those of the first group of Mo (P < 0.01), AH (P < 0.001) and reduction of indicators such as AMo, CDF, INI, AMo/AH, AMo/Mo (P < 0.001). It should be emphasized that a significant decrease in relations AMo/Mo (P < 0.001) and AMo/AH (P < 0.001) compared with patients in
the first group indicates sufficiendy compensatory possibilities of restoring the parasympathetic division of the ANS and a significant reduction in the central (nervous) circuits and reducing the degree of centralization of heart rhythm.
Patients in both groups decreased during orthostatic test values AH and Mo (heart rate quickens) larger rate AMo, CDF, IN2 and derivatives AMo, Mo, and AH (P < 0.05-0.001). In both groups prior to the appointment of complex therapy autonomic reactivity hyper-sympathicotonic reaction characterized by a significant increase in the CDF, provided less pronounced compensatory parasympathetic reactions — AH low reserves, indicating that excessive tension in the sympathetic ANS and exhaustion function of the parasympathetic division. During treatment in patients with 1-group. There have been some favorable changes in vegetative tonus — appeared hey patients with (22.5 %) and vagotonia (17.5 %), which was manifested by reducing the number of cases from 100.0 sympathicotonia to 60.0 % (P < 0.01).
Dynamics of vegetative tonus (ICT) In patients the original sympathicotony orthostasis (in %) showed in Table 3.
Distinct results were obtained in patients receiving Phenibutum. Thus, the majority of these patients responded to therapy veg-
etative balance (45.9 %) and vagotonia (24.3 %) and only 29.7 % of patients continued sympathicotonic reaction. 1 patients group common standard therapy resulted in an increase in the number of patients with type normotonicheskim BP 10.8 % asimpatikotoniches-kim type — by 3.5 %, which contributed to a decrease by 14.3 % of patients with type gipersimpatiko-tonic autonomic reactivity.
Conclusions:
1. Conducted by standard therapy had no significant effect on the vegetative state patients with asthma sympathicotony original.
Continued gipersimpatikotonicheskaya vegetative reactivity in children is characterized by tensions adaptation reactions, which certainly requires medical correction.
2. Influenced fenibuta in patients with baseline sympathicotony positive adaptive changes occur, activation of parasympathetic ANS by reducing the activity of the sympathetic nervous system, reducing the sympathicotonic reactions by 68 % by increasing the number of patients with and hey vagotonia.
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Khegay Olga Aleksandrovna, a senior fellow of the Department of Obstetrics, Gynecology and Perinatal Medicine of the Tashkent Institute of Postgraduate Medical Education Asatova Munira Miryusupovna, MD, Professor, Head of the Department of Obstetrics E-mail: ohegay899@gmail.com
The relationship between immune and endocrine abnormalities in women with reproductive dysfunction and autoimmune thyroiditis
Abstract: The aim of the study was to examine the state of the immune and hormonal status of 90 women with reproductive dysfunction and autoimmune thyroiditis (AIT). To study the serum concentrations of the thyroid-stimulating hormone, free thyroxin, antithyroid peroxidase antibodies, antithyroglobulin antibodies and anti-inflammatory cytokines (IL-1^, IL-6, IL-18, TNF-a), depending on the stage ofAIT.
Keywords: autoimmune thyroiditis, cytokines, infertility, miscarriage.
One of the most common causes of infertility and miscarriage is a hormonal and immune imbalance occurs on the background ofthy-roid pathology [3, 14]. Carriage of antibodies to the thyroid gland is a common phenomenon among women of childbearing age (5-10 %) and well-known risk factor for hypothyroidism [12]. In women suffering with infertility, hypothyroidism diagnosis occurs in 2-34 % [11]. However, to date there is no single point ofview on the role of antithyroid autoantibodies in the formation ofreproductive disorders. On the one hand, antithyroid antibodies can serve as a marker of autoimmune
dysfunction and combined with other autoimmune process [7; 8], on the other hand, antithyroid antibodies can be an independent factor that has a direct negative impact on the fetus [10] and the implantation process [16]. There is no consensus regarding to the correction of the reproductive function in women with autoimmune thyroiditis yet. It is known that disturbances in the immune status forms to the clinical manifestations of both AIT and disorders in the reproductive system, which affects to the course of the disease, the severity of which is directly related to the intensity of the immune changes [2].
