Научная статья на тему 'Correlation of transversal dimensions of the jaws and sagittal characteristics of the dental arch with odontometric and cephalometric indices in boys with orthognathic bite'

Correlation of transversal dimensions of the jaws and sagittal characteristics of the dental arch with odontometric and cephalometric indices in boys with orthognathic bite Текст научной статьи по специальности «Клиническая медицина»

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Ключевые слова
BOYS WITH ORTHOGNATHIC BITE / CORRELATIONS / COMPUTED TOMOGRAPHY / TRANSVERSAL DIMENSIONS OF THE UPPER AND LOWER JAW / SAGITTAL CHARACTERISTICS OF THE DENTAL ARCH / ODONTOMETRIC AND CEPHALOMETRIC INDICES

Аннотация научной статьи по клинической медицине, автор научной работы — Marchenko A.V.

The article describes and analyzes the correlation of computer-tomographic characteristics of dental arcs with odontometric and cephalometric characteristics in boys with orthognathic bite. The greatest number of correlations of the size of the teeth with transversal dimensions of the upper and lower jaw are established with mesiodistal dimensions of the crowns of teeth (48.6%), vestibule-tongue sizes crowns of teeth (42.4%) and the width of the dentin-enamel border in the vestibule-tongue direction (41,7%); with the parameters of the maxillary dental arches in the sagittal plane a similar distribution is maintained (69.4% with mesiodistal crowns of teeth, 80.6% with vestibule-tongue sizes crowns of teeth, 77.8% with the width of the dentin-enamel border in the vestibule-tongue direction ); with the parameters of the maxillary dental arc in the vertical plane there is a completely different distribution the greatest number of correlations is established only with the width of the dentin-enamel border in the vestibule-tongue direction (22,2%). In analyzing the correlations of cephalometric indices in the general groups of boys, almost identical numbers with the transversal dimensions of the upper and lower jaw and the parameters of the maxillary dental arc in the vertical plane (24.8 and 25.7% respectively) and only 8.6% with the parameters of the maxillary dental arcs in the sagittal plane.

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Текст научной работы на тему «Correlation of transversal dimensions of the jaws and sagittal characteristics of the dental arch with odontometric and cephalometric indices in boys with orthognathic bite»

16. Ravel J. Vaginal microbiome of reproductive-age women. / J. Ravel, P. Gajer, Z. Abdo [et al.] //Proc Natl Acad Sci USA. -Vol.108. - 2011. - P.4680-4687.

17. Srinivasan S. Temporal variability of human vaginal bacteria and relationship with bacterial vaginosis / S.Srinivasan, C.Liu, C.M. Mitchell, T.L.Fiedler, K.K. Thomas. // PLOS One. - 2010. - 5. - el0197.

Реферати

ХАРАКТЕРИСТИКА ДИСБИОТИЧЕСКИХ НАРУШЕНИЙ ПОЛОВЫХ ПУТЕЙ У ЖЕНЩИН С ГИПЕРПЛАСТИЧЕСКИМИ ПРОЦЕССАМИ И ПОЛИПАМИ ЭНДОМЕТРИЯ Лисяна Т. О., Пономарьова И. Г., Ковальчук О. А., Каналам О. М., Горбань Н. Е. В работе проведена оценка состояния микробиоценоза и анализ ассоциативных форм инфицирования половых путей в 122 женщин с гиперпластическими процессами эндометрия и полипами матки. Полученные данные свидетельствуют, что микробиоценоз половых путей у больных с гиперпластическими процессами эндометрия и полипами характеризуется формированием бактериальных комплексов и отличается разной частотой патологических проявлений (анаэробный вагиноз, аэробный вагинит, кандидоз).

Ключевые слова: биоценоз влагалища, бактериальные биопленки, гиперпластические процессы эндометрия, полипы матки.

Стаття надшшла 9.10.2017 р.

DOI 10.26724 / 2079-8334-2017-4-62-58-63 UDС 616.314-089.23:616.314.2-053.6

CHARACTERISTICS OF DYSBIOTIC DISTURBANCES OF STATE WAYS IN WOMEN WITH HYPERPLASTIC PROCESSES AND POLYPES ENDOMETRY Lisiana T.O., Ponomarova I.G., Kovalchuk O.A.,

Katsalap O.M., Gorban N.E. In this work an estimation of microbiocenosis status and analysis of associative forms of infection of the genital tract in 122 women with hyperplastic processes of endometrium and uterine polyps were performed. The obtained data testify that microbiocenosis of the genital tract in patients with hyperplastic processes of endometrium and polyps is characterized by the formation of bacterial complexes and differs in different frequency of pathological manifestations (anaerobic vaginosis, aerobic vaginitis, and candidiasis).

Key words: vaginal biocenosis, bacterial biofilms, hyperplastic processes of endometrium, polyps of the uterus.

Рецензент Лiхачов В.К.

А. V. Marchenko

HSEI of Ukraine "Ukrainian Medical Stomatological Academy", Poltava

CORRELATION OF TRANSVERSAL DIMENSIONS OF THE JAWS AND SAGITTAL

CHARACTERISTICS OF THE DENTAL ARCH WITH ODONTOMETRIC AND CEPHALOMETRIC INDICES IN BOYS WITH ORTHOGNATHIC BITE

e-mail: [email protected]

The article describes and analyzes the correlation of computer-tomographic characteristics of dental arcs with odontometric and cephalometric characteristics in boys with orthognathic bite. The greatest number of correlations of the size of the teeth with transversal dimensions of the upper and lower jaw are established with mesiodistal dimensions of the crowns of teeth (48.6%), vestibule-tongue sizes crowns of teeth (42.4%) and the width of the dentin-enamel border in the vestibule-tongue direction (41,7%); with the parameters of the maxillary dental arches in the sagittal plane - a similar distribution is maintained (69.4% with mesiodistal crowns of teeth, 80.6% with vestibule-tongue sizes crowns of teeth, 77.8% with the width of the dentin-enamel border in the vestibule-tongue direction ); with the parameters of the maxillary dental arc in the vertical plane there is a completely different distribution - the greatest number of correlations is established only with the width of the dentin-enamel border in the vestibule-tongue direction (22,2%). In analyzing the correlations of cephalometric indices in the general groups of boys, almost identical numbers with the transversal dimensions of the upper and lower jaw and the parameters of the maxillary dental arc in the vertical plane (24.8 and 25.7% respectively) and only 8.6% with the parameters of the maxillary dental arcs in the sagittal plane.

Key words: boys with orthognathic bite, correlations, computed tomography, transversal dimensions of the upper and lower jaw, sagittal characteristics of the dental arch, odontometric and cephalometric indices.

The work is a fragment RSW "Mechanisms of the influence of pathogenic factors on the dental status of persons with somatic pathology, ways of their correction and blocking" (state registration number: 0115U001138).

It is proved that dental status survey at the population level is extremely useful for assessing, developing or regulating the health care system, as well as evaluating the effectiveness of population programs. Conducting regulated screening studies is as successful as possible with the consideration of non-average values that characterize the parameters of the gnatic part of the head, and when evaluating the individual and craniotypological range of variability of anatomical signs in conditions of normal development of bite [4, 13, 19]. Available clinical guidelines for CT visualization contain very insignificant information about morphometric parameters of dental arches and teeth, often limited to mean values of signs [5, 21, 22].

Diagnosis of orthodontic pathology is based on a large number of different characteristics, therefore, the question arises about the application of mathematical methods for data processing, which

can significantly accelerate the process of diagnosis and choice of treatment tactics. As a matter of fact, for a steady and successful outcome of treatment, it is important for the physician to evaluate not a lot of quantitative indicators, but to establish the most informative interrelated parameters [3, 7, 8, 18]. From the standpoint of medical anthropology, it is important to establish internal connections between any components, including cephalometric and odontometric ones. Knowing their correlation can predict changes in other parameters, which is very important not only for improving the function, but also for achieving a certain aesthetic result [6, 15, 17, 23].

Research purpose - to analyze the correlations of computer-tomographic transversal dimensions of the upper and lower jaw and sagittal characteristics of the dental artery with odontometric and cephalometric characteristics of boys with orthognathic bite.

Material and methods. Primary indices of teeth and heads of youths from Podillia with orthognathic bite (n = 44, determined by 11 points according to M.G. Bushan et al. [2]) were obtained from the data bank of the Research center of the Vinnitsa National Medical University n.a. Pirogov within the framework of the agreement on creative cooperation between Vinnitsa National Medical University named after M.I. Pirogov and HSNIU "Ukrainian Medical Dentistry Academy" (Contract No. 1 dated 05.01.2015). For this study, a dental cone-ray tomograph was used - Veraviewepocs 3D, Moret (Japan). The studies were carried out in accordance with the self-developed scheme [9] within these characteristics. The volume of the three-dimensional image is a cylinder 8x8cm, - thickness of layer 0,2/0,125 mm, irradiation dose 0,11-0,48 mSv, voltage and current strength of 60-90kV/2-10mA. In the upper and lower incisors, the canines, small and first large angular teeth were measured: the length of the tooth; the length of the root in the vestibule-lingual and mesiodistal projections; mesiodistal crown size of the tooth; vestibule-lingual size; the width of the dentin-enamel border in the mesiodistal direction; the width of the dentin-enamel border in the vestibule-tongue direction. Since in previous studies, when comparing the computer-tomographic metric characteristics of the same tooth names on the right and left sides, there were no reliable or trend differences, we in subsequent studies used mean values of the corresponding teeth on the upper and lower jaws [10, 16].

The following transversal dimensions of the upper and lower jaw and sagittal characteristics of the dental arch were also determined: the distance between the tops of the palatal roots of the upper first large angular teeth; distance between tops of distal roots of the upper first large angular teeth; the distance between the tops of the medial roots of the upper first large angular teeth; the distance between the tops of the medial roots of the lower first large angular teeth; distance between tops of distal roots of the lower first large angular teeth; distance between the jaws of the upper jaw; the distance between the tops of the roots of the jaw of the upper jaw; the distance between the jaws of the lower jaw; the distance between the tops of the root of the jaw of the mandible; the distance between the points of Pon on the upper first large angular teeth; the distance between the points of Pon on the upper first small angular teeth; the distance between the vestibular medial bulges of the first large angular teeth; canine sagittal distance of the upper jaw; premolar sagittal distance of the upper jaw; molar sagittal distance of the upper jaw; depth of the palatine at the level of the canine; depth of the palate at the level of the first small angular teeth; the depth of the palate at the level of the first large angular teeth.

The following cephalometric dimensions were determined [1]: sagittal arc, transverse arc, greatest girth of the head, projection distance from the top of the head (vertex) to the upper edge of the auditory opening, largest head length, greatest head width, smallest head width, average face width, face width, external-eye width, between-eye width, nose basic width, oral cavity width, ear diameter, forehead height, physiological face length, nose length, nose height, nose depth, height of the upper face, distance between nasion and between-canine point, distance between nasion and prostpion, morphological length of face, height of upper lip, height of lower lip, height of lower face, height of red border of lips, width of mandible, body length of mandible, distance from auricular point to chin, distance from auricular points to the angle of the lower jaw, the distance from the auricular point to the glabella, the distance from the auricular point to the nazion, the distance from the auricular point to the subnazion, the distance from the auricular point to the intersection point.

The analysis of correlations of the obtained results was carried out using the Spirman statistical method in the statistical package "Statistica 6.0".

Results and its discussion. In young men with orthognathic bite, the following multiple bonds of reliable and average strength of false correlations of transversal dimensions of the upper and lower jaw and sagittal characteristics of the dental artery with odontometric and cephalometric indices are established: direct, mostly reliable, average strength (r from 0.31 to 0.56) connections of distances between the tops of the distal and medial roots of the upper first large angular teeth, between the points of the Pon on the upper first large

and small angular teeth, between the vestibular medial bulges the first large angular teeth and between the tubercles of the canines of the upper and lower jaws with the majority of mesiodistal dimensions of the crowns of the teeth, the parameters of the width of the dentin-enamel border in the vestibule-tongue direction (with the exception of the distance between the tops of the distal roots of the upper first large angular teeth), more than half the vestibule-language size of crowns of teeth, practically all distances from auricular point to glabella, nasion, subnasion and to intercaniel point; direct reliable average strength (r from 0.31 to 0.49), the distance between the tops of the medial roots of the upper first large angular teeth with the majority of teeth length indices; direct reliable average strength (r from 0.31 to 0.58) connections of premolar and molar sagittal distances of the upper jaw with the majority of mesiodistal and vestibule-lingual dimensions of the crowns of the teeth, as well as the width of the dentin-enamel border in the vestibule-language direction; direct reliable average strength (r from 0.35 to 0.45); the connections of the cervical sagittal distance of the upper jaw with most indicators of the width of the dentin-enamel border in the vestibule-language direction; direct, reliable mean power (r from 0,32 to 0,44), the connections of all parameters of the maxillary dental arch in the sagittal plane with the width of the mouth gap; direct reliable average force (r from 0.37 to 0.56), the connections of all parameters of the maxillary dental arch in a vertical plane with sagittal and transverse arcs, height of the upper part of the face, the distance between the nasion and the intercanine point, and between the nasion and the prosthion. Some studies have proved the existence of connections of teeth and dental arches with parameters of the craniofacial complex, taking into account racial and constitutional features [10, 12]. Both dental arches, as part of a single functional apparatus, are associated with strong correlations among themselves, and therefore integrated with the whole morphological system of the head and, possibly, the whole body [21]. Interesting and undeniably important are the results of the study of germane scientists M. L. Nobe and K. Harvati [17], which thoroughly confirmed the existence of strong correlations between the size of the dental arc and other parts of the dento-jaw system and, to a lesser extent, with cephalometric indices and the skull in general. Also, a characteristic feature of the variability of dental arches, not characteristic of other morphological systems, is the dependence of the shape of the arc on its size [17, 20]. This is probably the result of the presence of two morphogenetic growth fields and, consequently, differences in the complexes of factors affecting the anterior and posterior sections of the dental arches [24] (which in our study manifested itself in the differences between the covariants of the parameters of different parts of the dental arc by their direction and force).

According to the data of M. M. Yaradaykina et al. [23] in physiological occlusion of permanent teeth, there are three variants of the form of dental arches, depending on the parameters of the cranio-facial complex: mesognathic, dolichognathic and brachygnathic, and the length of the arches is determined by the size of the teeth: normodontism, microdontism, and macrodontism. The form of dental arches is determined by the main dimensions of the head and face, and the size of the teeth determine the design parameters of the dental arches [11]. In analyzing the reliable and average strength of the unreliable correlations of the transversal dimensions of the upper and lower jaw and sagittal characteristics of the dental artery with odontometric and cephalometric characteristics of boys with orthognathic bite, 306 of the 1,116 possible connections (27.4%, of which 2.0% false median force) with dental arch parameters in the front plane (of which 7 - 0.6% of direct forces, 275 - 24.6% of direct average strength, 22 - 2.0% of false direct average forces, 2 - 0.2 % of reciprocal average force); 87 connections from 279 possible (31.2%, of which 0.4% of false median power) with parameters of maxillary dental arches in the sagittal plane (of which 1 - 0.4% of direct strong, 85 - 30.5% direct average strength; 1 - 0.4% of false direct middle forces); 39 connections from 279 possible (14.0%, of which 2.2% of false median force) with the parameters of the maxillary dental arch in the vertical plane (of which 32 - 11.5% of direct average strength, 6-2.2 % of false direct average forces; 1 - 0.4% of the reciprocal average force). In the analysis of odontometric and cephalometric indices, the following distribution was established: with the dental arc parameters in the front plane - mesiodistal dimensions of the crown of the teeth (70- 48.6% of the total number of these indicators, of which 0.7% are unreliable mean forces, of which 2.8% direct forces, 44.4% direct average strength, 0.7% unreliable direct mean strength, 0.7% reciprocal average strength); vestibule-language dimensions of the crown of the teeth (61 - 42.4% of the total number of these indicators, of which 1.4% direct strong, 41.0% of direct average strength); length of teeth (23 - 19.2% of the total number of data, all direct mean forces); the width of the dentin-enamel border in the mesiodistal direction (7 - 9.7% of the total number of these indicators, of which 8.3% of direct average strength, 1.4% of the reciprocal average force); the width of the dentin-enamel border in the vestibule-language direction (30-41.7% of the total number of these indicators, of which 1.4% of direct strengths, 40.3% of direct mean strength); the length of the root in the vestibule-lingual projection (4-5.6% of the total number of these indicators, all direct mean forces); the length of the root in the mesiodistal projection (7 - 9.7% of the total number of these indicators, of which 1.4% are unreliable average forces, of which 8.3% of direct average strength, 1.4% of

false direct average forces); cephalometric indices (104 - 24.8% of the total number of these indicators, of which 4.8% are unreliable average forces, of which 20.0% of direct average strength, 4.8% of false direct average forces). With the parameters of the maxillary dental arches in the sagittal plane, mesiodistal dimensions of the crown of the teeth (25-69.4% of the total number of these indicators, of which 2.8% of direct strong, 66.7% of direct mean strength); vestibule-tongue size of the crown of the teeth (29-80.6% of the total number of these indicators, all direct mean forces); length of teeth (4-13.3% of the total number of indicators, all direct mean forces); the width of the dentin-enamel border in the mesiodistal direction (6 -33.3% of the total number of these indicators, all direct mean forces); the width of the dentin-enamel border in the vestibule-lingual direction (14-77.8% of the total number of these indicators, all direct mean forces); cephalometric indices (9-8.6% of the total number of these indicators, of which 0.9% of the unreliable average strength, of which 7.6% of direct average strength, 0.9% of false direct average forces). With the parameters of the maxillary dental arc in the vertical plane, the vestibule-tongue size of the crown of the teeth (2 - 5.6% of the total number of these indicators, all direct mean forces); length of teeth (3 - 10,0% of the total number of these indicators, all direct average forces); the width of the dentin-enamel border in the vestibule-tongue direction (4-22.2% of the total number of these indicators, of which 5.6% of the unreliable average strength, of which 16.7% of direct average strength, 5.6% of the false lines medium strength); the length of the root in the vestibule-tongue projection (2 - 11.1% of the total number of these indicators, of which 5.6% of direct average strength, 5.6% of the reciprocal average force); the length of the root in the mesiodistal projection (1 - 5.6% of the total number of these indicators, all direct mean forces); cephalometric indices (27 - 25.7% of the total number of these indicators, of which 4.8% are unreliable average forces, of which 21.0% of direct average strength, 4.8% of false direct average forces). There was no reliable or average strength of false connections between the length of the root in the vestibule-tongue or mesiodistal projections and the parameters of the maxillary dental arches in the sagittal plane, as well as between the mesiodistal dimensions of the crown of the teeth or the width of the dentin-enamel border in the mesiodistal direction and the parameters of the maxillary dental arc in the vertical plane.

Until now, in most works, the structure of the variability of correlations in groups differing in degree of deformity of dental arches is established. In the group, which includes people with bite pathology, the increase of the variability of bonds is shown, namely, their divergence for the upper and lower dental arches [11, 14]. Since the sample without bite pathology was studied, in most cases (this also applies to the general group and groups of meso- and brachycephals), the connection between parameters of dental arches with odonto-cephalometric indices is most often unidirectional.

The data obtained by us extends the modern possibilities of jaw-facial and dental reconstruction, which require the obligatory determination of the transversal size of the jaws, sagittal characteristics of the dental arch, taking into account the cephalometric indices, which in turn gives an idea of the characteristics of the brain and facial sections of the human skull, their mutual relation both in the absence, and in the presence of teeth-jaw pathology.

1. In young men with orthognathic occlusion within the linear dimensions necessary for the construction of the correct form of the dental arch, the relative majority of mostly direct average forces, correlations with the size of the teeth and cephalometric indices are established with the parameters of the maxillary dental arch in the sagittal plane (31.2% of the total number of between the given indicators), and the smallest - with the parameters of the maxillary dental arc in the vertical plane (14,0%). With the transversal dimensions of the upper and lower jaw, the relative number of such correlations is 27.4%.

2. Relative majority of the correlations of the parameters of the maxillary dental arches in the sagittal plane and the transversal dimensions of the upper and lower jaw are established with mesiodistal (correspondingly 69,4 and 48,6% of the total number of connections between these indices) and vestibule-tongue (respectively 80, 6 and 42.4%) with the size of the crowns of the teeth and with the width of the dentin-enamel border in the vestibule-tongue direction (77.8 and 41.7% respectively); and the parameters of the maxillary dental arc in the vertical plane - with cephalometric indices (25.7%).

ill

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КОРЕЛЯЦП ТРАНСВЕРЗАЛЬНИХ РОЗМ1Р1В ЩЕЛЕП ТА САГ1ТАЛЬНИХ ХАРАКТЕРИСТИК ЗУБНО1 ДУГИ З ОДОНТОМЕТРИЧНИМИ I ЦЕФАЛОМЕТРИЧНИМИ ПОКАЗНИКАМИ ЮНАК1В I3 ОРТОГНАТИЧНИМ ПРИКУСОМ Марченко А. В. У стати встановлена та npoaHani30Bam корелящя комп'ютерно-томогрaфiчних характеристик зубних дуг з одонтометричними та цефалометричними

характеристиками у хлоичиюв з ортогнатичним прикусом. Найбшьше число кореляцш розтрш зубш з поперечними розмрами верхньо! та нижньо! щелеп встановлено з мезюдютальними розмiрaми коронок зубш (48,6%), вестибуло-язичними розмiрaми коронок зубш (42,4%) та шириною дентинно-емалево! межi у вестибуло-язичному напрямку (41,7%); з параметрами верхньощелепних зубних дуг в сагггальнш площиш - збершаеться аналопчний розподш (69,4% з мезюдгстальними розмрами коронок зубiв, 80,6% з вестибуло-язичними розмрами коронок зубiв, 77,8% з шириною дентинно-емалево! межi у вестибуло-язичному напрямку); з параметрами верхньощелепно! зубно! дуги у вертикальнш площиш виникае зовим шший розподш - найбшьша кшьюсть кореляцш встановлюеться лише з шириною дентинно-емалево! межi у вестибуло-язичному напрямку

КОРРЕЛЯЦИЯ ТРАНСВЕРЗАЛЬНЫХ РАЗМЕРОВ ЧЕЛЮСТЕЙ И САГИТТАЛЬНЫХ ХАРАКТЕРИСТИК ЗУБНОЙ ДУГИ С ОДОНТОМЕТРИЧЕСКИМИ И ЦЕФАЛОМЕТРИЧЕСКИМИ ПОКАЗАТЕЛЯМИ ЮНОШЕЙ С ОРТОГНАТИЧЕСКИМ ПРИКУСОМ Марченко А. В.

В статье определена и проанализирована корреляция компьютерно-томографических характеристик зубных дуг с одонтометрическими и цефалометрическими характеристиками у мальчиков с ортогнатическим прикусом. Наибольшее число корреляций размеров зубов с поперечными размерами верхней и нижней челюстей установлено с мезиодистальными размерами коронок зубов (48,6%), вестибуло-язычными размерами коронок зубов (42,4%) и шириной дентинно-эмалевой границы в вестибуло-язычном направлении (41 7%); с параметрами верхнечелюстных зубных дуг в сагиттальной плоскости -сохраняется аналогичное распределение (69,4% с мезиодистальными размерами коронок зубов, 80,6% с вестибуло-язычными размерами коронок зубов, 77,8% с шириной дентинно-эмалевой границы в вестибуло-язичном направлении); с параметрами верхнечелюстной зубной дуги в вертикальной плоскости возникает совсем иное распределение - наибольшее количество корреляций устанавливается с шириной дентинно-эмалевой границы в

(22,2%). Анал1зуючи стввщношення головних показниюв у загальних групах хлопчиюв, майже однаков1 числа з поперечними розм1рами верхньо! та нижньо! щелепи та параметрами верхньо! верхньощелепно! дуги у вертикальнш площит (в1дпов1дно 24,8 та 25,7%) та лише 8,6% з параметрами верхньощелепних зубних дуг у саптальнш площиш.

КЛючовi слова: хлопчики з ортогнатичним прикусом, кореляцп, комп'ютерна томограф1я, поперечш розм1ри верхньо! та нижньо! щелеп, саптальш характеристики зубно! дуги, одонтометричш та цефалометричш показники.

Стаття надшшла 7.10.2017 р.

вестибуло-язычном направлении (22,2%). Анализируя соотношение главных показателей в общих группах мальчиков, почти одинаковые числа с поперечными размерами верхней и нижней челюсти и параметрами верхней верхнечелюстной дуги в вертикальной плоскости (соответственно 24,8 и 25,7%) и лишь 8,6% с параметрами верхнечелюстных зубных дуг в сагиттальной плоскости.

Ключевые слова: мальчики с ортогнатическим прикусом, корреляции, компьютерная томография, поперечные размеры верхней и нижней челюстей, сагиттальные характеристики зубной дуги, одонтометрические и цефалометрические показатели.

Рецензент Гунас 1.В.

DOI 10.26724 / 2079-8334-2017-4-62-63-66

УДК 616.155.194-06:616-056.52]-055.2-085:615.356:613.99

В. М. Недоборенко

у 1\|>|||11м краш1ька медмчма саома|олоа 1чма ¡ImI.U'MI КОМПЛЕКСНЕ Л1КУВАННЯ ЗАЛ1ЗОДЕФ1ЦИТНО1 АНЕМ11 З ОЖИР1ННЯМ У Ж1НОК

e-mail: [email protected]

В дослщженш взяли участь 30 хворих жiнок на ЗДА i3 супутшм ОЖ, якi були розподшеш на основну групу -15 хворих (n =15), що приймали базисне лжування препарат сульфат затза з додатковим призначенням перорально препарату кверцетину та контрольну групу - 15 хворих (n =15), що приймали базисне лжування. Групу п^вняння склали 10 жгнок (n =10) хворих на ЗДА без ОЖ на базисному лжуванш. Оцшювали показники гемограми та якicть життя за опитувальником SF-36. Вci пащенти жшочо! стат з cереднiм вiком 40,3±7,59 рокiв. При розподiлy хворих за причиною виникнення та ступенем тяжкост ЗДА встановлено вiдcyтнicть вiрогiдноI рiзницi м1ж групами. По вciх групах ввдм1чено статистично значиму позитивну динамжу гематологiчних показникiв вже на 21±3 днi лiкyвання по всих дослвджуваних параметрах та вiдcyтню доcтовiрнy розбiжнicть м1ж групами в показниках гемограми на 60±3 дт лжування. В процеа лiкyвання було вiдмiчено достжрна розбiжнicть показниюв по шкалам рольове фiзичне фyнкцiонyвання (РФФ) та життездатшсть (Ж) на 60±3 день у основнш грyпi в порiвняннi з контрольною групою (р<0,05) за вщсутносп розбiжноcтi з групою пор1вняння (р>0,05). Включення кверцетину до комплексу лжування затзодефщитно! анемл з ожирiнням покращуе фiзичний компонент здоров'я якоста життя за шкалами РФФ та Ж опитувальника SF-36 у жшок хворих на залiзодефiцитнy анем1ю з ожиршням.

Ключов! слова: зал1зодефщитна анемш, ожиршня, яюсть життя.

В останш роки дослщження довели тюний зв'язок обмшу зал1за та ожиршня (ОЖ) на молекулярно - бюлопчному р1вш, який базусться на низько штенсивному системному запаленш з характерним тдвищенням в плазм1 кров1 кл1тинних бюмаркер1в запалення без будь-яких видимих клш1чних ознак, часто вщбуваеться за рахунок фактор1в транскрипци, зокрема нуклеарного kB (NF-kB), найбшьш важливого прозапального ядерного транскрипцшного фактора, який вщповщае на бшьшу частину зовшшшх i внутршшх стимул1в та ировокуе запалення, активуючи або пригшчуючи транскрипщю безл1ч1 гешв, що беруть участь у запальнш реакцп [5].

Внаслщок тдвищеного вмюту прозапальних цитоюшв, шдвищуеться експрес1я гену гепсидина [2] - пептидного гормону, який е основним регуляторним бшком системного метабол1зму зал1за, посередником 1мунного захисту та запалення [4]. Як наслщок ще! взаемодн, поглинання зал1за з 1ж знижуеться шляхом гепсидин - опосередкованого зменшення експресп феропортину ентероципв (единим вщомим на сьогодш експортером зал1за), що призводить до зниження вмюту циркулюючого р1вшв зал1за, яке посилюеться пригшченням експорту його з макрофапв шляхом того ж мехашзму. Численш дослщження кверцетину показали, що вш волод1е сильним иротизаиальним ефектом, сприяе зниженню NF-kB-оиоcередкованоI сигнал1зацп i тим самим знижуе продукщю прозапальних цитоюшв [1].

Зал1зодефщитна анем1я (ЗДА) мае суттевий вплив на життя жшок в перюд пременопаузи, що проявляеться зниженням якост життя - низькою продуктивнютю роботи, труднощ1в з концентращею уваги, зниженням когштивних функцш, слабюстю, втомою, безплщдям [3].

Метою роботи було визначити вплив включення кверцетину до комплексного лшування хворих жшок на ЗДА з ОЖ на гематолопчш параметри та ЯЖ.

Матертл та методм дослщження. Дослщження було проведене тсля дозволу комюн з бюетики Укра1нсько1 медично! стоматолопчно! академп, yci обстежеш особи тдписали добровшьну шформовану згоду.

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