Method for predicting physical growth and development of small children

FIELD: medicine.

SUBSTANCE: method involves determining triiodothyronine content in peripheral blood serum of children of the second half-year of life having perinatal central nervous system injury manifestations and no signs of hypothyroidism. The value being equal to 0.69±1.34 ng/ml, the children are predicted to have small height to the third year of life.

EFFECT: high accuracy and specificity of the method; enhanced effectiveness in selecting appropriate prophylaxis measures.

1 tbl

 

The invention relates to medicine, namely to Pediatrics, and can be used to predict the variance of the physical development of young children with perinatal lesions of the Central nervous system.

The urgency of development is determined by a large frequency deviations of the physical development of young children with perinatal CNS lesions and their consequences, 39.5% of [1]that indicate trouble in the child's health status [2].

A well-known predictor of health disorders in children the first year of life, born with the syndrome of intrauterine development by determining the total activity indicator painted silver nitrate agricoevrazia areas 10 acrocentric chromosomes (10 Ag respective nor) in the peripheral blood on day 5 of life, when the value of the index less than 18 points predict infectious-inflammatory diseases and low indices of physical development (including low growth) in the first year (Patent No. 2223039. A method for predicting health effects in children the first year of life, born with the syndrome of intrauterine development / Shumakovitch, Tpiuch, Twizala (Russia) // BIPM. - 2004. No. 4. - 4.3. - P.447). This method is chosen as the nearest equivalent. However, it has several disadvantages. The disadvantages of the method:

1. Change marnoso activity indicator painted silver nitrate agricoevrazia regions of chromosomes in peripheral blood is not strictly specific for the detection of low levels of physical development. The functional activity of the respective nor chromosomes has an impact not only on the variability of anthropometric indicators (weight and body length, chest circumference), but may be the cause and reproductive pathology [3, 4].

2. A method for predicting health disorders only in children born with the syndrome of intrauterine development.

3. A method for predicting health disorders in children and adults first year of life.

4. The study is more than 72 hours.

5. The forecast accuracy of 83.3%.

These drawbacks are proposed to be eliminated in the present method. The technical solution of the proposed method is forecasting lower growth in infants with perinatal lesions of the Central nervous system by determining the serum of a child in the second half of life content triiodothyronine (T3and when its level is 0.69 to 1.34 ng/ml1(1normal values of triiodothyronine in serum in children 6-12 months when determining enzyme-linked immunosorbent assay using a set of firm HUMAN (Germany) are 0,69-2,02 ng/ml (test Report immunoassay test T3the firm's HUMAN. - Moscow, 2003)) predict low growth to 3 years with precision 94,3%, sensitivity 100% and specificity of 91.2 per cent.

Triiodothyronine (T3) is the first hormone, which is synthesized and accumulates in the thyroid gland. Defining it plays an important role in the diagnosis of functional activity and thyroid disease [5]. Thyroid hormones provide a balance between anabolic and catabolic processes, which is a prerequisite for normal growth, affect the differentiation of tissues, stimulates the synthesis of many structural proteins in the body. Triiodothyronine is produced from thyroxine, with the participation of the enzyme deiodinase [6]. Complications during pregnancy, toxaemia, chronic intrauterine hypoxia leads to decreased activity of tissue enzymes. As a result of this enzyme deficiency in children with perinatal post-hypoxic lesions of the Central nervous system lower triiodothyronine [7]. High biological activity of this hormone gives reason for us to assume that the decrease in its concentration in blood serum in children in the first year of life below the average age norms, is adverse prognostic factor in terms of their physical development to the completion of the period of early childhood. However, reliable values of the correlation coefficient between triiodothyronine (T3) and a body length up to the present time not identified [8].

The novelty of the method lies in the fact that for the first time proposed the Xia predict poor growth to 3 years of life according to the content of T 3in the blood serum of the children of the second half of life with perinatal lesions of the CNS in the absence of hypothyroid state.

The method is standard, as follows.

In children the second half of life (6-12 months) with perinatal CNS lesions without clinical manifestations of hypothyroidism collect venous blood in quantities of 0.2 ml, after the formation of a clot centrifuged at 1,500 rpm for 10 minutes and determine the level of triiodothyronine in 0.05 ml of serum enzyme-linked immunosorbent assay using a set of firm HUMAN (Germany) on the device "Automatic 8-channel reader EL 808" company BIO-TEK INSTRUMENTS WC (USA) according to the instructions. The result after 2 hours and 45 minutes in ng/ml.

Distinctive features of the method are that in the serum of children of the second half of life with perinatal CNS lesions without signs of hypothyroidism determine the content of triiodothyronine and when it is equal to 0.69 to 1.34 ng/ml predicts low growth from them in 3 years.

The essence of the method is illustrated by the following examples.

Example 1. Baby M was Born from a second pregnancy going on in the background anemia complicated by preeclampsia. Delivery at 39 weeks. Estimation on Apgar scale 7-8 points. Body weight at birth was 3000 g, body length - 51 see At discharge from maternity hospital diagnosed erinaceinae hypoxic CNS, mild hypertensive syndrome. At the age of 8 months, the child's identified level of triiodothyronine in the blood, it amounted to 1.34 ng/ml At the time of examination physical development is age appropriate. Given the forecast for the low growth of the child 3 years. 3, the length of the body 86 cm (normal values of body length girls in 3 years are 89,3-to 102.3 cm (Information and methodological materials for interns and pediatricians - Ivanovo, 2000)), the body weight is 11,100 kg Prediction was confirmed.

Example 2. The child that is born from the first pregnancy complicated by nephropathy 1 tbsp. Delivery at 38 weeks. Estimation on Apgar scale 6-7 points. Body weight at birth - 2800 g, body length of 50 cm was Discharged from the hospital with a diagnosis of perinatal hypoxic-ischemic CNS damage, moderate severity, the syndrome of hyperexcitability. At the age of 10 months. the child determined the level of triiodothyronine in the blood, it amounted to 1.15 ng/ml At the time of examination of the deviations of the physical development of the child is not identified. Given the forecast for the low growth of the child 3 years. 3, the body length of 87 cm (normal values of body length boys in 3 years are 90,8-103,5 cm (Information and methodological materials for interns and pediatricians - Ivanovo, 2000)), body weight - 12,300 kg Prediction was confirmed.

Example 3. Baby S. was born from the first pregnancy complicated by preeclampsia is m, by polyhydramnios, the threat of termination. Delivery at 38 weeks. Estimation on Apgar scale 6-7 points. Body weight at birth - 2850 g, body length - 50 cm Diagnosis at discharge from maternity hospital: perinatal hypoxic-ischemic CNS damage, moderate severity, hypertensive syndrome, vegetative-visceral disorders. At the age of 9 months, the child's identified level of triiodothyronine in serum, he was 0.69 ng/ml At the time of the survey the physical development of the child is age appropriate. The forecast low growth to 3 years. 3, the body length - 84 cm (normal values of body length boys in 3 years are 90,8-103,5 cm (Information and methodological materials for interns and pediatricians - Ivanovo, 2000)), body weight - 12,400 kg Prediction was confirmed.

Example 4. Baby K. was born from a second pregnancy going on in the background anemia complicated by preeclampsia. Delivery at 40 weeks. Estimation on Apgar scale 7-8 points. Body weight at birth - 2950 g, body length - 51 see Diagnosis at discharge from maternity hospital: perinatal hypoxic CNS mild hypertensive syndrome. At the age of 11 months, the child's identified level of triiodothyronine in the blood, which was 1.74 ng/ml Dan forecast for normal physical development. 3, the length of the body 94 cm (normal values of body length girls in 3 years are 89,3-102.3 from the Informational and methodological materials for interns and pediatricians - Ivanovo, 2000)), body weight - 13,850 kg Prediction was confirmed.

Advantages of the method:

1. The opportunity in the early stages with 6-12 months forecast of low growth to 3 years in children with perinatal lesions of the Central nervous system.

2. The timely implementation of preventive measures and the prevention of occurrence of deviations of the physical development of young children.

3. The possibility of predicting deviations of physical development in children 3 years in one indicator is available and simple method.

4. It takes less time for research - 2 hours and 45 minutes (for prototype - more than 72 hours).

5. High accuracy of prediction variance of physical development in children up to 3 years (94,3%).

6. High sensitivity (100%) and specificity (91,2%).

In this way was examined in 88 children. The research results are summarized in table 1.

Table 1
IndexThe number of the examined
All of the surveyed children88
true-positive result31
false-positive result5
a true-negative result52
a false-negative result0
Total:

the accuracy of the proposed method is 94,3%

the sensitivity of the proposed method - 100%

the specificity of the proposed method - 91,2%

The list of references.

1. Vasiliev PPM Scientific rationale for improving the health of organizational approaches to health care children 2-3 years of age with damage to the Central nervous system in the perinatal period: Dis.... CMN Ivanovo, 2000. - 295 S.

2. Baranov A., Shalagina L.A. Fundamental and applied research on problems of growth and development of children and adolescents // Journal of Pediatrics journal. - 2000. No. 5. - P.5-12.

3. Voskoboynik NI, Lyapunov N.A., Viktorov CENTURIES, Milutinov S.A. Correlation functional activity agricoevrazia regions of chromosomes reproductive pathology of man // Genetics. - 1993. - T No. 3. - S-513.

4. Nazarenko, S.A., Kartasheva OG, Solovieva HE Phenotypic effect of functioning agricoevrazia regions of human chromosomes // Genetics. - 1990. - T. No. 11. - S-2063.

5. Laboratory diagnostics of diseases of a thyroid gland / Vladislav Dolgov, Shabalova I.P., Gitel H.E., Shilin CU - Tver, 2002. - 98 C.

6. Endocrinology / edited Elvina. - M., 1999. - S-610.

7. Fadeev V.V., Melnichenko G.A. Hypothyroidism (a Guide for physicians). - M., 2002. - 215 S.

8 the Physiology of growth and development of children and adolescents (theoretical and clinical issues), Ed. Bra, Laisenai. - M., 2000. - 584 S.

A method for predicting deviations of the physical development of young children with perinatal lesions of the Central nervous system by examining the peripheral blood, characterized in that in the serum of a child without clinical manifestations of hypothyroidism in the second half of life determine the content of triiodothyronine and its value is 0.69 to 1.34 ng/ml predicts low growth of the child 3 years of life.



 

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