Objective is to evaluate the effectiveness of intermittent normobaric hypoxi therapy as the means that can posi tively influence on the different links in the pathogenesis of endothelial dysfunction in children residents of radioactively contaminated areas.
Materials and methods: Disorders of personal and emotional sphere, symptoms of asthenic vegetative and neurot ic character, the signs of the cardiovascular and respiratory systems, abdominal and dyspeptic syndromes are attrib uted to the clinical signs of endothelial dysfunction. There were determined the biochemical parameters of the con tent of stable metabolites of NO, L arginine, lipid peroxidation, antioxidant enzymes in the blood serum; the indices of cellular and humoral immunity; the instrumental indices of vascular endothelium dependent reaction to occlu sion test, ventilating ability of the lungs, the bioelectric activity of the myocardium. Intermittent normobaric hypoxi therapy (INHT) was performed using the individual device of mountain air of the «Borei» type produced by State Research Medical Engineering Center «NORT» NAS of Ukraine (Kyiv).
Results and conclusions: The clinical examination showed that the administration of additional intermittent nor mobaric hypoxi therapy to the basic treatment of 44 children with endothelial dysfunction who live in the radioac tively contaminated areas, promoted to reduce the frequency of complaints and intensity of clinical manifestations in the mentioned symptom complex. An increase of serum L arginine in the absence of significant changes in the content of NO stable metabolites was revealed in the most examined children residents of radioactively contami nated areas by studying NO system after using the course of intermittent normobaric hypoxi therapy. Positive changes in vascular endothelium dependent reaction to occlusion test, indicating the reduction length of the recovery period for thermographic circulation index after occlusive test, were determined. The decrease in the inten sity of lipid peroxidation processes - a reduction of serum LPO end products content that react with thiobarbituric acid - was observed. The bronchospasm elimination was revealed in a large number of children with the study of the lung ventilation capacity. There were trends to reduce the imbalance of different chain of the heart rhythm man agement. The immunomodulatory effect was detected as: the increase in the functional activity of neutrophils, the normalization of humoral immunity link indices. Intermittent normobaric hypoxi therapy is an effective tool that can positively affect the condition of nitric oxide system and endothelium dependent functions of the organs and systems in children residents of radioactively contaminated areas.
Meta doslidzhennia – otsinyty efektyvnist' pereryvchastoï normobarychnoï gipoksyterapiï iak zasobu, shcho zdatnyy̆ pozytyvno vplyvaty na rizni lanky patogenezu endotelial'noï dysfunktsiï u ditey̆ meshkantsiv radioaktyvno zab rudnenykh terytoriy̆. Materialy ta metody. Do klinichnykh oznak endotelial'noï dysfunktsiï vidneseni porushennia osobystisno emotsiy̆noï sfery, symptomy asteno vegetatyvnogo ta nevrotychnogo kharakteru, symptomy z boku sertsevo sudyn noï systemy, systemy dykhannia, abdominal'ni ta dyspeptychni syndromy. Vyznachalysia biokhimichni pokaznyky vmistu stabil'nykh metabolitiv NO, L argininu, perekysnogo okyslennia lipidiv, antyoksydantnykh fermentiv u syrovattsi krovi; pokaznyky klitynnogo ta gumoral'nogo imunitetu; instrumental'ni pokaznyky endoteliy̆zalezhnoï reaktsiï sudyn na okliuziy̆nu probu, ventyliatsiy̆noï spromozhnosti legeniv, bioelektrychnoï aktyvnosti miokardu. Pereryv chastu normobarychnu gipoksyterapiiu provodyly za dopomogoiu indyvidual'nogo aparata girs'kogo povitria typu «Borey̆» vyrobnytstva derzhavnogo naukovo doslidnogo medyko inzhenernogo tsentru «NORT» NAN Ukraïny (Kyïv). Rezul'taty ta vysnovky. Klinichne obstezhennia pokazalo, shcho pryznachennia 44 ditiam z endotelial'noiu dys funktsiieiu, iaki meshkaiut' na radioaktyvno zabrudnenykh terytoriiakh, dodatkovo do bazysnoï terapiï pereryvchastoï normobarychnoï gipoksyterapiï, spryialo znyzhenniu chastoty skarg ta intensyvnosti klinichnykh proiaviv u navede nykh symptomokompleksakh. Pislia zastosuvannia kursu pereryvchastoï normobarychnoï gipoksyterapiï u bil'shosti obstezhenykh ditey̆ meshkantsiv radioaktyvno zabrudnenykh terytoriy̆ doslidzhennia systemy NO vyiavylo pidvyshchen nia v syrovattsi krovi L argininu, pry vidsutnosti suttievykh zmin vmistu stabil'nykh metabolitiv NO. Vyznacheni po zytyvni zminy endoteliy̆zalezhnoï reaktsiï sudyn na okliuziy̆nu probu, na shcho vkazuvalo zmenshennia tryvalosti periodu vidnovlennia termografichnogo pokaznyka krovoobigu pislia okliuziy̆noï proby. Vidmicheno znyzhennia intensyvnosti protsesiv perekysnogo okyslennia lipidiv i znyzhennia vmistu v syrovattsi krovi kintsevykh produktiv POL, shcho reaguiut' z tiobarbiturovoiu kyslotoiu. Doslidzhennia ventyliatsiy̆noï spromozhnosti legeniv vyiavylo usu nennia bronkhospazmu u znachnoï chastyny ditey̆. Maly mistse tendentsiï do znyzhennia rozbalansovanosti riznykh lan tsiugiv keruvannia sertsevym rytmom. Vyiavliavsia imunomoduliuiuchyy̆ efekt: pidvyshchennia funktsional'noï aktyv nosti ney̆trofiliv, normalizatsiia pokaznykiv gumoral'noï lanky imunitetu. Pereryvchasta normobarychna gipoksy terapiia ie efektyvnym zasobom, zdatnym pozytyvno vplyvaty na stan systemy oksydu azotu ta endoteliy̆zalezh nykh funktsiy̆ organiv ta system u ditey̆ meshkantsiv radioaktyvno zabrudnenykh terytoriy̆.
Keywords: children; correction hypoxi therapy; endothelial dysfunction; radioactively contaminated territories.
Ye.I. Stepanova, V.Ya.Berezovsky, I.Ye.Kolpakov, V.H.Kondrashova, V.Yu.Vdovenko, O.M. Lytvynets, L.M. Lisukha, V.M. Zyhalo, V.I. Kolos, L.P. Mishchenko.