Abstract
The actuality of multiple surveys concerning NEC in pediatric surgery is explained by its Widespread, pathoge netic difficulties and is dedicated to delineate effective management and preventive strategies.
The aim of the study is assessement of clinical and immunological characteristics of newborns with NEC and efficiency of immunomodulatory therapy at different stages of the disease and during postoperative period.
The study was carried out at the departments of neonatal surgery and intensive care unit on the bases of G. Zhvania Pediatric Clinic of TSMU. All patients referred to the neonatal surgery department from 1999 — 2006 with the diagnosis of NEC were included in the study. The diagnosis was based on clinical, anamnestic and laboratory data. Immune system parameters were studied (B and T-lymphocytes, their subpopulations, G, A and M immunoglobulins, phagocytic activity of blood neutrophils, activity of 6 and г interferons).
The data was analyzed using SPSS V 11 .5. Quantitative data was represented by mean and standard deviation. Quantitative data was analyzed by Student t-test or Whitney’s U test depending on the distribution of the variables. Qualitative data was compared using chi-square test. P value of < 0.05 was presumed as coefficient of confidentiality. All parameters were studied at different stages of the disease, before and in the process of treatment. As immunomodulator — Plaferon LB was studied — produced by Institute of Biotechnology of Georgian Academy of Sciences.
Immune homeostasis was investigated in 55 newbom with NEC. Among which I stage was estimated in 20, II stage — 15 and at stage III — 20 patients. Immunomodulatory effects of PlaferonLB were observed using its lingual forms according to standard administration protocol (1 ampoule per day : 10- 10 drops 3-4 times) .
On the bases of obtained data we can conclude that PlaferonLB acts as immunoprotector improving pathological state of the patients at the theurapeutic stage of the disease and neutralizes immunodepressive effects of surgical intervention at III stage of NEC. Thus, PlaferonLB exerts preventive effects on the immunodepressive influence of surgical intervention and prevents disease progression.
References
ი. დავითაია, ლ.გოგიაშვილი, ბ.კორსანტია, გ. დავითაია. იმუნური მაჩვენებლებისა და სისხლის ფორმიანი ელემენტების მნიშვნელობა ახალშობილთა ნეკროზული ენტეროკოლიტის განვითარებაში. თსსუ სამეცნიერო შრომათა კრებული ტ. 41 2005/2006, 134- 137
ი.დავითაია, ბ. კორსანტია, მ. გიორგობიანი, გ. დავითაია. ახალშობილთა ნეკროზული ენტეროკოლიტის კლინიკურ-იმუნოლოგიური ასპექტები. ექსპერიმენტული და კლინიკური მედიცინა. 2006. 4 (29). 76-79.
Бахуташвили В.И.‚ Чиковани Т.И. Плаферон — новый иммуномодулятор. //Int. J. Immunorehabilitation. 1995, 1‚ 29-33.
С,А.Караваева — Хирургическое лечение некротического энтероколита. Автореф. Докг. Дисс.СПб‚ 2002
Ситко Л.А., Чернышев AK Критерии тяжести и прогноза некрагизирующею энгероколита у новорожденных.” Детская Хирургия 2003, 6, 46-48
Eibl MM. et аl.- Prevention of necrotizing enterocolitis in low birthweight infants by IgA-IgG feeding. //N Engl J Med. 1988;3 1911-7.
Foster J, Cole M. - Oral immunoglobulin for preventing necrotizing enterocolitis in preterm and low birth-weight neonates [review].//Cochrane Database Syst Rev. 2004;(l)
OhlssonA. Lacy JB. - Intravenous immunoglobulin for preventing infection in preterm and/or low birthweight infants. Cochrane Database Syst Rev. 2004;(1)
Rubaltelli FF. et a1. - Prevention of necrotizing enterocolitis in neonates at risk by oral administration of monomeric IgG //Dev Pharmacol Ther 1991;17 :138—143
Lawrence G. et al. - Enteral human IgG for prevention of necrotising enterocolitis a placebo-controlled. randomised trial. //Lancet. 2001;357 :2090 —2094
Walsh MC. et a1. - Necrotizing enterocolitis. Treatment based on staging criteria. //Pediatr Clin North A 1986,33: 179-201