You are on page 1of 4

-

.. , .. , ..
Use of immunomodulatory therapy in children with pyoinflammatory diseases
S.V. Minayev, R.A. Motorina, S.V. Timofeyev


( 60,5 ) , , ,
, . .
( -, -1), - . ,
- ,
5 .
2,7 ( 50 18,75%), 2,4 ( 15 6,25%).
: , - , .
The addition of licopid to the complex therapy of children with the local form of acute hematogenic osteomyelitis allowed their earlier
(by an average of 60.5 days fewer) activation, body temperature normalization, reductions in ESR and leukocytosis, and blood count
normalization. The use of licopid caused a treatment time reduction. The significant decrease in the blood levels of proinflammatory
cytokines (tumor necrosis factor-, interleukin-1) and C-reactive protein suggested that the intensity of the inflammatory process
became less. Furthermore, a rapider healing of postoperative wounds was noted in licopid-treated children with pyoinflammatory
diseases of soft tissues, which reduced the duration of antibacterial therapy by an average of 5 days. Treatment with licopid decreased
the frequency of septic complications by 2,7 times (from 50 to 18,75%) and mortality rates by 2,4 times (from 15 to 6,25%).
Key words: children, pyoinflammatory diseases, licopid.

- .
, , , .

, ,
. .
[14].
70- ,
.

.
,
, 2009
Ros Vestn Perinatol Pediat 2009; 5:9397
: ..., .,
. .
..., .

. .
355017 , . , 310

[59].

. ,
,
, .
,
[10, 11].

, 30% [12, 13].
, ,
, ,

. ,

- ,
. , -

, 5, 2009

.
.
(). ,

[1416].

. .

- .
( ), , .
,
[17, 18].
[1922] , PRR-NOD2.
NOD2 . ,
NOD2 .
NF-B (
-),
, ( ).
, , , ,
. ,
, ;
[23]. ,
. , , , ,

[14].
,

.
. ,
(-1, -6) - [24, 25].
. 10 1
7- , .
100 / 8


, [24, 25]. , ,

, . ,
, -1, , , .

,
1000 -
[2634].
,

, , , , [27, 30].
[27, 29, 31, 32] ,
- ,

5 . , .
90%

50%
6 .
. 66%
. .


- . ,
- .
.
.
, ,
,
. :

12,33,4 ,
,

, 5, 2009

.. . -

,
6,72,3 ( <0,05) [28, 30].


, [27,
32]. 2,7 ( 50 18,75%), , , 2,4 ( 15 6,25%).
, . 2
( 61 28,6%) 2
( 27 14,3%) ( 2139086) [3335].


( 60,5 ),
,
, ,
, ,
[11, 36].
21 , 24 .
( -, -1),
-

(. 1).

[37].
-

, ,
(. 2) .

-
. ,

. , (
, ) ( , , ). ,

-450 . ,
, , , [29, 31].
,
, . ,
.
.

- , , ,

.

1. [36]

7-

14-

-, /

91,84,1

93,67,1

44,38,3**

92,02,0

-1, /

120,030,8

160,040,0

80,015,3

100,52,4

, /

47,040,9

68,121

12,90,4*

22,94,1

. - -; - .
: * p<0,05; ** p<0,01.

2. [37]

,
-

0,310,17*

15,340,94*

2,450,43

19,051,49

, %

()

()

1,070,05

100,0

0,0

1,300,12

97,4

2,6

. * p<0,05.

, 5, 2009


1. Butler K.H. Incision and drainage. Clinical Procedures in
Emergency Medicine. 4th ed, 2004. . 739744.
2. Klenerman L. A history of osteomyelitis from the Journal of
Bone and Joint Surgery: 1948 to 2006 // J. Bone Joint Surg.
Br. 2007. Vol. 89. 5. . 667670.
3. Klosterhalfen B. Local and systemic inflammatory mediator
release in patients with acute and chronic posttraumatic osteomyelitis // J. Trauma. 1996. Vol. 40. 3. . 372378.
4. Korakaki E. Methicillin resistant Staphylococcus aureus osteomyelitis and septic arthritis in neonates: diagnosis and management // Jpn. J. infect. Dis. 2007. Vol. 60. 2-3. . 129131.
5. .. // . . 2005. 2.
. 104112.
6. Arnold S.R. Changing patterns of acute hematogenous osteomyelitis and septic arthritis: emergence of community-associated methicillin-resistant Staphylococcus aureus // J. Pediat.
Orthop. 2006. Vol. 26. 6. . 701702.
7. Al-Nammari S.S. Methicillin resistant Staphylococcus aureus
versus Methicillin sensitive Staphylococcus aureus adult hematogenous septic arthritis // Arch. Orthop. Trauma Surg.
2007. Vol. 27. . 9192.
8. Arnold S.R. Changing patterns of acute hematogenous osteomyelitis and septic arthritis: emergence of community associated methicillin-resistant Staphylococcus aureus // J. Pediat.
Orthop. 2006. Vol. 26. . 701702.
9. Gilbert D.N., Moellering R.C., Eliopoulis G.M. Stanford Guide
to Antimicrobial Therapy. 35th ed., 2005. . 6670.
10. .., .., .. .
/ . .,
2005. . 1123.
11. .. // . . . .
2007. . 7. 3. . 6467.
12. .., .., .. - Staphylococcus aureus // . . 2006. 2.
. 110114.
13. Elizabeth S. ntibiotic treatment of Gram-positive bone
and joint infections // J. Antimicrob. Chemotherapy. 2004.
Vol. 53. . 928935.
14. .. / . . .
. 10- .
., 2005. . 2934.
15. .., .., ..
/ . . . . 10-
. ., 2005. . 618.
16. .., .. : //
. 2001. 3. . 4850.
17. P. M., . ., .. . N- // Rus.
J. Immunol. 1996. 1. . 58.
18. Chu R.S., Targoni O.S., Krieg A.M. et al. CpG oligodeoxynucleotides act as adjuvants that switch on T helper 1 (Th1) immunity // J. Exp. Med. 1997. Vol. 186. 10. . 16231631.
19. .. h1- h2 // . 2006. 4. . 203208.
20. .. -:
// . 2005.

6. . 368376.
21. Vasselon T., Detmers P.A. Toll receptors: a central element in
innate immune responses // Infec. Immun. 2002. Vol. 189.
14. . 10331041.
22. Wright S.D. Toll, a new piece in the puzzle of innate immunity
// J.Exp. Med. 1999. Vol. 189. 4. . 605609.
23. .., T.M., .. .
. .: ,
2004. . 2331.
24. .., . ., .. . ,


// . 2000.
. 2. 1. . 6976.
25. .., .., .. // . 2005. 1. . 3133.
26. .., .. // . . . 2002. .2. 1. . 5156.
27. .., ..

/ . . .
. 10- . ., 2005. . 225230.
28. .., .., .. // .
. . . 2001. 5. . 1419.
29. .., .. // .
. 2000. 2. . 2021.
30. .. - : . . ... . . . ,
2004. . 24.
31. . ., ..

// . 2000. 3. . 28.
32. P. M., .., .. .
//
. 1994. 2. . 4750.
33. .., ..
// . . 2003. 1. . 35.
34. .
- / . .
.
. 10- . ., 2005. . 219224.
35. 2139086 14 1992 .
.
36. .., .., ..
//
. . .. . 2009. 8. . 5861.
37. .. -

- : . . ... - . . ., 2009. . 42.
20.06.09

, 5, 2009