A method for the treatment of ari in children in the first year of life
(57) Abstract:The invention relates to medicine, namely to Pediatrics, and can be used for the treatment of respiratory viral infections in children in the first year of life. The proposed addition to the complex therapy assign instillation into the nose grapperon 3 times daily 1000 IU the course of 3-5 days. The method allows to increase the level of interferon in the blood, improve the performance of cellular and humoral immunity and reduce for 1-2 days duration manifestations of SARS. The invention relates to medicine, in particular to the treatment of infectious diseases.Known methods of complex treatment of SARS with the use of antiviral drugs: rimantadine, Arbidol; donor immunoglobulins with high content of antiviral antibodies (C. F. Uchaikin, O. C. shamshev "prevention and treatment of influenza in children. Information collection the influenza vaccine, M. 1998, S. 20-27).However, these methods of treatment of viral respiratory infections are most often used in severe forms of the disease in older children, drugs are limited to a narrow spectrum of antiviral activity, are enterline and parenteral, i.e., more traumatic.In kacee.M.Fedorov and others "Principles of treatment of acute respiratory infections in children," methodological recommendations. M., 1989, S. 8), including the combined therapy that includes vitamin, water regime, distraction procedures, intranasal purpose leukocyte interferon 5 drops in each nostril (ME 500 single dose), after 1.5-2 hours for 3 days and other symptoms.Being a common non-specific method of treatment of ARI in children, it has a number of disadvantages: a drug made from the blood of donors, little concentrated (1 ml contains not more than 1000 IU), require pre-dilution prior to application, frequent instillation of a sufficiently large volume of drug (0.25 ml).The problem posed by the authors, is to eliminate the mentioned disadvantages, to increase the efficiency and reduce the time of treatment of ARI in children in the first year of life by intranasal drug - grapperon, allowing to increase the level of interferon in the blood and secretory immunoglobulin a in saliva.For this purpose, the method of treatment of ARI in children in the first year of life, including the combined therapy, proposed to assign the instillation into the nose grapperon 3 times the La (a mixture of polyethylene oxide, polyvinylpyrrolidone and trylon B), which gives the drug the greater the viscosity, which increases the exposure of interferon on the mucous membrane.Grapperon has all the properties of interferon, well purified, highly concentrated (dropper bottle of polymeric material contains 10 ml of the drug with antiviral activity 10000 ME in ml, 500 ME in the drop).The significance of differences of the proposed method lies in the fact that for the first time for the treatment of respiratory viral infections in children in the first year is used recombinant interferon - grapperon prepared without the use of human blood containing 10 times more alpha-2 interferon in 1 ml, with greater duration of action of the drug on the mucous membrane. Does not require pre-breeding and the use of pipettes, has less administration frequency is 5 times smaller dose.Inclusion in the complex of therapeutic agents - grapperon with strong antiviral and immunomodulatory effects, improves the level of interferon in the blood, improve some parameters of cellular and humoral immunity, reduces to 1-2 days duration local prowl the persons is as follows.Patient SARS under the age of 1 year receives a comprehensive conventional therapy (rational water, vitamins, antitussives, antihistamines, antipyretics, if necessary, antibiotics). Additionally, in the acute period of 3-5 days to kill the patient from the bottle-dropper in each half of nose 1 drop (500 ME) grapperon 3 times a day with an interval of 6-8 hours. After putting hold a light massage with the fingers of the wings of the nose to distribute the drug in the nasal cavity.The use of grapperon promotes intensification of therapy and improve outcomes, because ARI in children under one year often has severe with complications and often has a poor outcome. One of the causes of severe and complicated course of respiratory infections in children under one year is low compared with children older than 1 year and adults (4-11 times) interferonbeta the ability of blood cells, the smaller its antiviral activity, the rapid depletion of interferon (IFN). Furthermore, the characteristics of the immunological status of children under 1 year: low production of immunoglobulins (IgA, IgM, IgG), low phagocytic is conducive generalization of the viral process.In addition, children in the first year of life have a greater number of aggravating premorbid background of the child the first year of the factors supressive operating on the level of interferon in the blood and immunological status.Introduction of exogenous IFN accompanied by stimulation of the endogenous production of IFN throughout the disease and is extended to several months, enhances T and B lymphocytes in the blood, strengthening the absorptive and digestive functions of neutrophils, increased levels of secretory IgA in the respiratory tract mucosa.Example 1
Baby K-0 And, 8 months, history 16721.Clinical diagnosis of SARS, stenosing laryngotracheitis 1 tbsp.Child 1 of pregnancy occurring with toxemia 1 half of pregnancy, premature birth at 37 weeks weighing 2460. From birth on artificial feeding, in the dispensary with a neurologist about PEP.Ill 14.10.2000, acute: fever up to 37.5-37,7o, runny nose. In a few hours from the onset of the disease was noted deterioration in connection with the development of croup syndrome on the background of SARS: hoarseness, barking rough cough, difficult breath. Ambulance, Ino fever, retraction jugular fossa and shortness of breath for a breath, a dry, unproductive cough. The mucous membranes of the oropharynx hypermonogenic, rhinitis, respiration takes place in all departments of the lungs, wheezing no. Virological examination of smears from the nose method immunofluorescence was negative. The level of interferon in the blood of 20 IU/mlThe child is assigned in the first hour of hospitalization grapperon 1 drop in each nostril, 3 times a day and pointloma therapy: expectorant medicine, suprastin, Acipol - enterline, alkaline inhalations, the UHF region of the larynx.Grapperon used within 5 days. Single dose of grapperon amounted to 1000 IU daily - 3000 ME. Dose rate to 15000 ME. Allergic reactions and side effects of grapperon not marked.On the background of complex therapy with recombinant alpha-interferon condition quickly improved. Stenosis of the larynx were stopped in the early days, cough and rhinitis - 4 days from the start of treatment, catarrhal changes in the oropharynx in 5 days.Complications were noted. The level of interferon in the peripheral blood after gripperdon therapy has increased in 2 times - 40 ME/ml. the Girl was discharged on day 6 bale. Clinical diagnosis: viral respiratory infections, obstructive syndrome.The girl from 1 pregnancy and childbirth occurring physiologically, are on mixed feeding, pain in acute 28.09.2000, when there was an increase of temperature up to 37.5, runny nose, cough, shortness of breath on the exhale. On the second day of the disease hospitalized in a state of moderate severity. It was noted the pallor of the skin, loss of appetite, nasal congestion, wet with viscous sputum cough. The mucous membranes of the oropharynx hypermonogenic. Auscultation over the surface of the lungs to listen to the sparse, dry and moist rales, exhale longer. Started a common treatment for SARS syndrome obstruction: Cefazolin/m, suprastin, medicine with aminophylline enterline, chest massage. Additional treatment was conducted by gripperdon. The drug was buried on 1 drop in each nostril 3 times a day every 6 hours for 5 days. Single dose was 1000 IU daily 3000 ME, foreign exchange ME 15000 activity of interferon. On the background of therapy of the disease proceeded smoothly, without complications. Temperature normalized on the first day, the symptoms of intoxication were short (2 days). Rhinitis, cough, redness of the mucous company on 7 day stay in the hospital in satisfactory condition.A comparative analysis of two groups of 45 patients with SARS in the first year of life, treated and not treated with grapperon showed that the inclusion of grapperon in the complex treatment of SARS contributed to the reduction of the duration of the reaction temperature for 1 day, rhinitis 1.5 days, catarrhal changes in the mucous membranes of the oropharynx and cough for 2.5 days, the number of complications decreased by 11%. A method for the treatment of ARI in children in the first year of life, including the combined therapy, characterized in that it further buried in the nose grapperon 3 times daily 1000 IU the course of 3-5 days.
< / BR>where R1is hydrogen or heteroaromatic, R2is a group selected from CH2-O-aralkyl, CH2OCO-alkyl, CH2ОСОNН2CH2ОСОРh, CH2LLC-alkyl; R3- C3-alkyl; R4- dichlorophenyl, including interaction of the compounds of formula I
< / BR>where R1, R2and R3such as defined above, with a compound of formula II: R4-S-Hal, where R4like is definitely above and Hal represents halogen, in the presence of a base
< / BR>where R represents isopropyl, neopentyl or cyclohexyl,
containing pharmaceutical compositions
FIELD: medicine, anesthesiology-resuscitation, infectology, detoxication.
SUBSTANCE: the innovation suggested interrupts infectious-toxic shock, moreover, after that it is necessary to prescribe peroral intake of Reaferon-EC-Lipint at the dosage of 10000 - 15000 U/kg. Then one should sample patient's blood to obtain leukocytes to be washed and diluted in 0.9%-NaCl solution, activated due to incubation with immunophan and intravenously injected for a patient. Then comes peroral intake of Reaferon-EC-Lipint at the dosage of 10000 - 15000 U/kg once daily for 5 d. The innovation enables to decrease the number of complications and lethality due to decreasing immunodeficiency.
EFFECT: higher efficiency of therapy.
3 ex, 1 tbl