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Vegetative status characteristics in children with neurological pathology on the background of undifferentiated connective tissue dysplasia 

SOVREMENNAYA PEDIATRIYA.2016.2(74):139-142; doi 10.15574/SP.2016.74.139 

Vegetative status characteristics in children with neurological pathology on the background of undifferentiated connective tissue dysplasia 

Tyazka O. V., Gorobets N. I., Pochinok T. V., Gorobets A. O., Znova I. B., Gorobets N. M., Daniluk N. V., Reznikov J. P., Shkot A. V.

National Bogomolets medical university, pediatric department №1

Kyiv children's clinical hospital № 4 

Background. Disorders of the autonomic nervous system are the most common pathological conditions detected in 20% – 85% of children and adolescents according to different authors' data. Assessment of the vegetative status in the period of intensive growth and differentiation of organs and tissues that is characteristic of childhood is of great practical importance. Identification of vegetative dysregulation is an important diagnostic measure in children's health status evaluation especially in patients with undifferentiated connective tissue dysplasia (UNDCT) taking into account its genetic determinism and debut in childhood. Genetically determined biochemical disorders in the connective tissue followed by formation of characteristic pathological substrates cause dysregulation of sympathoadrenal system and correlate with UNDCT severity degree. 

Material and methods. There were 100 children aged from 5 to 16 years engaged in the investigation. All of them were treated in the neurological department of the City clinical hospital №4. All patients were divided into two groups: basic group, which included 50 children with neurological disorders and UNDC, and control one, which consisted of 50 children with neurological disorders without UNDCT. The survey included obstetric history analysis, anthropometry to determine the ratio of longitudinal and transverse dimensions (the index of Vervica); clinical and neurological examination (study of reflex&motor areas, sensory function, coordination); laboratory methods (clinical blood count and biochemical blood tests to determine the level of potassium and calcium ions), instrumental methods (electroencephalography, rheoencephalography, magnetic resonance imaging of the brain). Osokina's table was used for baseline autonomic tone assessment. The evaluation was conducted by counting the number of signs. Subsequently was performed the summation of the scores with the determination of the percentage of predominant influence of one or another of the divisions of the ANS, which served as the basis for determining the severity of the impact of the components of autonomic regulation. Autonomic reactivity was assessed on the basis of reflex of samples Danin-Aschner and Chermak-Goering in statistical analysis for Galu. Support for the activities was set according to clinortotation samples. UNDCT diagnosis and severity was Dagestanis on the basis of criteria proposed by T. Milkovsky-Dimitrova (1985) in modification of L. N. Abakumova. 

Results. Therefore, children with neurological pathology on the background of undifferentiated connective tissue dysplasia have a deeper down-the vegetative, the severity of which correlates with the degree of NDCT (P<0.05). The prevalence parasympathicotonia and low sympathetic reactivity in children with UDCT, perhaps due to metabolic disorders: increased average potassium-calcium ratio, which serves as one of the criteria the predominance of vagotonia, and lower levels of total calcium and inorganic phosphorus, which point to insufficient provision of vitamin D.

Inadequate functioning of the sympathetic division of ANS leads to decrease of adaptive&trophic processes in situations requiring intense mental activity, and hence the adaptive capacity of the organism. Patients with insufficient vegetative support amid NDCT form a group of psychological risk, which is characterized by reduced subjective assessment of their own capabilities, emotional instability, and repressive conformism. Conclusion. Deficit vegetative maintenance in children with NDCT is potentially dangerous during physical paranavitana in the untrained conditions, dysplastic modified myocytes, including cardiomyocytes, which may poyasnite ciselements (deficiency of vitamin D3, hypocalcaemia and gphotospace), which, in turn, contributes to a violation of biochemically-colloidal processes and bioenergetic reactions in children and more severe manifestations of the UNDCT. Given the above, children with autonomic disregulation on the background of UNDCT for the correction of mineral metabolism, improvement of connective tissue metabolism and targets negativnogo status can be recommended intake of vitamin D3 and Calcium supplementation in prophylactic doses; the inclusion in the diet of foods rich in vitamin D3, Ca and Ph; optimal mode of physical activity without physical overload (swimming, tennis, a special complex of physical exercises). 

Ключевые словаundifferentiated connective tissue dysplasia; вегетативная нервная система; vegetative dysregulation; neurological pathology. 

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