Objective. The study examined the features of functional state of the autonomic nervous system in children having endothelial dysfunction and permanently residing in contaminated areas. Materials and methods. Clinical and instrumental examination of 101 children aged 7-18 years that were born and are domiciled in contaminated territories, including 37 persons with signs of endothelial dysfunction (subgroup IA) and 64 ones with no signs of endothelial dysfunction (IB subgroup) was conducted. The control group being comparable to the subgroups IA and IB by age, gender and clinical examination results included 37 children neither been domiciled in contaminated areas nor were belonging to the contingent of Chornobyl accident survivors. There were 20 apparently healthy children also examined. Results. Due to peculiarities of physiological pathways providing adaptive responses the children having signs of endothelial dysfunction are characterized by a more pronounced dysregulation of autonomous nervous system both in a resting state and under a functional load simulation, and also by a high strain of adaptation pathways. The lack of autonomous support of cardiovascular system is caused by inadequate adaptive responses of both central regulatory bodies (hypothalamus, vasomotor center) and peripheral receptors. Mainly the failure of segmental autonomous (parasympathetic) structures was revealed. The mode of their response to stress in this case corresponds to that in healthy individuals but at a lower functional level. There is a reduced aerobic capacity of the organism by the Robinson index, contributing to low adaptive range to non-specific stress in children being domiciled on contaminated territories including children having the endothelial dysfunction. Conclusions. Endothelial dysfunction was associated with more pronounced manifestations of autonomic dysregulation and reduced aerobic capacity of the organism being the risk factors of development of a range of somatic diseases requiring the development of prevention measures in children permanently residing in contaminated areas.
Keywords: autonomous nervous system balance, endothelial dysfunction, children, Chornobyl accident.
Meta: vyvchyty osoblyvosti funkcional'nogo stanu vegetatyvnoi' nervovoi' systemy u ditej z endotelial'noju dysfunkcijeju, jaki postijno prozhyvajut' na radioaktyvno zabrudnenyh terytorijah. Materialy i metody. V hodi doslidzhennja bulo provedeno klinikoinstrumental'ne doslidzhennja 101 dytyny u vici 7–18 rokiv, jaki narodylysja ta postijno prozhyvajut' na radioaktyvno zabrudnenyh terytorijah, z nyh 37 ditej z oznakamy endotelial'noi' dysfunkcii' (IA pidgrupa) ta 64 dytyny bez oznak endotelial'noi' dysfunkcii' (IB pidgrupa). Kontrol'na grupa, spivstavna z osnovnoju za vikom, stattju ta danymy klinichnogo obstezhennja, skladalasja z 37 ditej, jaki prozhyvaly v “chystyh” shhodo radioaktyvnogo zabrudnennja regionah i ne nalezhaly do postrazhdalyh vnaslidok Chornobyl's'koi' avarii' kontyngentiv. Praktychno zdorovyh ditej bulo obstezheno 20 osib. Rezul'taty. Ditjam z oznakamy endotelial'noi' dysfunkcii' prytamanna najavnist' bil'sh vyraznoi' dyzreguljacii' vegetatyvnoi' nervovoi' systemy u stani vidnosnogo fiziologichnogo spokoju ta pry modeljuvanni funkcional'nogo navantazhennja i vysokyj stupin' napruzhennja adaptacijnyh mehanizmiv organizmu, obumovlenyj osoblyvostjamy fiziologichnyh mehanizmiv, jaki zabezpechujut' adaptacijni procesy. Nedostatnje vegetatyvne zabezpechennja dijal'nosti sercevo-sudynnoi' systemy zumovlene neadekvatnistju adaptyvnyh reakcij na rivni jak central'nyh reguljatornyh lanok (gipotalamus, sudynno-ruhovyj centr), tak i peryferychnyh receptoriv. U ditej z endotelial'noju dysfunkcijeju vidmichalasja, perevazhno, nedostatnist' segmentarnyh vegetatyvnyh struktur (parasympatychnyh), pry c'omu harakter i'h reaguvannja na navantazhennja vidpovidaje takomu u zdorovyh osib, ale na bil'sh nyz'komu rivni funkcionuvannja. Dity-meshkanci radioaktyvno zabrudnenyh terytorij, v tomu chysli j z endotelial'noju dysfunkcijeju, majut' znyzheni aerobni mozhlyvosti organizmu za indeksom Robinsona, shho spryjaje nyz'komu adaptyvnomu diapazonu shhodo nespecyfichnogo stresu. Vysnovky. Vstanovleno, shho u ditej, jaki postijno prozhyvajut' na radioaktyvno zabrudnenyh terytorijah, endotelial'na dysfunkcija asocijuvalasja z bil'sh vyraznymy projavamy vegetatyvnoi' dyzreguljacii' ta znyzhenymy aerobnymy mozhlyvostjamy organizmu, shho je faktoramy ryzyku rozvytku riznomanitnyh form somatychnoi' patologii' ta potrebuje rozrobky zahodiv z profilaktyky.
Keywords: Chornobyl accident; autonomous nervous system balance; children; endothelial dysfunction.
V. G. Kondrashova, I. E. Kolpakov, V. Yu. Vdovenko, O. S. Leonovych, O. M. Lytvynets, E. I. Stepanova.