Стан перекисного окиснення ліпідів при різних схемах лікування гострого інфекційного міокардиту у дітей

Abstract

Изучены динамика интенсивности процессов перекисного окисления липидов и изменение состояния антиоксидантной защиты при различных схемах лечения острого инфекционного миокардита у детей. Установлено, что оксидативный статус при остром инфекционном миокардите характеризуется активацией перекисного окисления липидов при достаточном уровне антиоксидантной защиты, а при тяжелом течении — углублением оксидативного стресса и угнетением активности антиоксидантной защиты. Анализ эффективности проведенной комплексной терапии острого инфекционного миокардита у детей показал статистически достоверное преимущество предложенного комплекса лечения с включением в стандартную терапию препаратов антигипоксического и антиоксидантного действия.

Among the factors of nonspecific protection affecting the onset and course of acute infectious myocarditis (АІМ), the state of the system of lipid peroxidation is important, which, on the one hand, is an important part of the mechanisms of adaptation of the organism, and, on the other hand, is in a position lead to significant violations of the function of other protective systems. Excessive levels of intermediate and end-products of lipids peroxidation become toxic to the cells of most organs and are one of the mechanisms for the development of a false cycle of pathological processes in the development of myocarditis. The aim of the study was to study the dynamics of the intensity of lipid peroxidation and changes in the state of antioxidant protection in different regimens of treatment of AIM in children. The indexes of lipid peroxidation were studied in this work, which was judged by the concentration in the serum of the intermediate product of lipids peroxidation — diene conjugates and terminal — malonic dialdehyde in children with AIM. The state of antioxidant protection was evaluated by studying the activity of enzyme factors — superoxide dismutase and catalase in serum of sick children. The study cohort included 89 children with AIM. Depending on the treatment regimen, the children were divided into four groups: the control group included 21 patients who received standard therapy. 1st group consisted of 23 children, who along with the standard treatment were prescribed antihypoxic drug; in the 2nd group 22 patients received standard treatment in combination with an antioxidant drug; in the 3rd group 23 children received standard therapy in combination with antihypoxic and antioxidant drugs. It has been established that the oxidative status in acute infectious myocarditis is characterized by activation of lipid peroxidation at a sufficient level of antioxidant protection, and in severe course — by deepening of oxidative stress and inhibition of antioxidant protection activity. The analysis of the effectiveness of the complex therapy of acute infectious myocarditis in children showed a statistically significant advantage of the proposed treatment package with the inclusion in standard therapy of antihypoxic and antioxidant drugs.