Оцінка лікування виразки дванадцятипалої кишки у дітей з точки зору відновлення репаративної функції = The estimation of treatment in children with duodenal ulcer from the perspective of reparative function recovery

Abstract

Dudnyk V. M., Buglova N. O. Оцінка лікування виразки дванадцятипалої кишки у дітей з точки зору відновлення репаративної функції = The estimation of treatment in children with duodenal ulcer from the perspective of reparative function recovery. Journal of Education, Health and Sport. 2016;6(7):579-588. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.59281

http://ojs.ukw.edu.pl/index.php/johs/article/view/3729

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755 Journal of Education, Health and Sport eISSN 2391-8306 7

© The Author (s) 2016;

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This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial

use, distribution and reproduction in any medium, provided the work is properly cited.

The authors declare that there is no conflict of interests regarding the publication of this paper.

Received: 02.07.2016. Revised 25.07.2016. Accepted: 28.07.2016.

УДК : 616. 342- 002.44-053.2:679.86

ОЦІНКА ЛІКУВАННЯ ВИРАЗКИ ДВАНАДЦЯТИПАЛОЇ КИШКИ У ДІТЕЙ З ТОЧКИ ЗОРУ ВІДНОВЛЕННЯ РЕПАРАТИВНОЇ ФУНКЦІЇ

В. М. Дудник, Н. О. Бугрова

Вінницький національний медичний університет ім. М.І.Пирогова, м.Вінниця кафедри педіатрії №2

The estimation of treatment in children with duodenal ulcer from the perspective of reparative function recovery

V. M. Dudnyk, N. O. Buglova

Department of Pediatrics No 2, National Pirogov Memorial Medical University Vinnitsya, Ukraine

Abstract

Background .Diseases of the upper gastrointestinal tract in children occupy a leading place in the structure of gastroenterological diseases, including the  duodenal ulcer, which is the actual problem of modern medicine throughout the world, characterized by  the progressive growth. Establishing the role of H. pylori in the mechanisms of a number of diseases of the upper gastrointestinal tract changed the approach to the problem of this disease. An important role in the development of infectious-inflammatory process induced by H. pylori play TLR4, having reactivity to lipopolysaccharide of Gram-negative bacteria. Much attention is being paid to determine the effect of H. pylori in the regeneration  damaged of duodenal mucosa, which by means of growth factors, such as epidermal growth factor(EGF).

EGF - a universal endogenous regulator of cell renewal, which accelerates migration and proliferation of the epithelium, enhances angiogenesis.

The aim of our study was to evaluate the results of complex treatment in children with duodenal ulcer according to the dynamics of TLR4 and EGF in  blood serum.

Materials and methods. The overall clinical group consisted of 54 children with duodenal ulcer aged 7-18 years. The control group consisted of 25 healthy children of similar age. The average age of patients was 13,3 ± 0,2 years.  The study used clinical, laboratory and instrumental  methods of  examination   used.  The content of  TLR 4 and EGF in serum were determined by ELISA.

Results and discussion. Children who were under supervision, were allocated based on the severity of the disease and the presence of H. pylori infection. Among the patients  H. pylori (+) duodenal ulcer had 40 (74.07%) children - 14 (25.93%) patients had no H. pylori infection. Severe degree of disease was observed in 16 (29.63%) children, 38 (70.37%) of the children had moderate course of duodenal ulcer. In patients with severe course of duodenal ulcer was  observed  the reduction of EGF and TLR4 ( 27.95%,19,65%) values before  treatment, but the figure was higher (47.11%) and ( 2,75 times) than in the group of healthy children. In  children with moderate duodenal ulcer the level of EGF and TLR4 after treatment was lower (by 23,24%) and (1,30 times)  indicators  before treatment, but higher than in the control group ( 1,55 times) and (  47,81%).

It was revealed  that in patients with H. pylori (+) duodenal ulcer after treatment were significant changes in the content EGF, TLR4 in serum, appearing in it’s decline (1,27 times) ,but exceeding the value of healthy children (1.76 times) and (1.98 times)  (р<0,05).  

Conclusion. Thus, monitoring the dynamics of TLR4 and EGF on the background of the pathological process can provide valuable information about  the mechanisms of  the disease and will optimize the  therapy by influencing on  the pathogenesis of  duodenal ulcer.

Keywords: children, duodenal ulcer, H. рylori, TLR4, EGF, treatment.