MORPHOLOGICAL TRAITS OF A CHRONIC GASTRODUODENITIS AT PRESCHOOLERS WITH VARIOUS AMYLOLYTIC ACTIVITY OF THE MIXED SALIVA

Background: The aim of the study was to to estimate traits of the morphofunctional changes of a gastroduodenal mucous membrane at chronic inflammatory diseases of the upper digestive tract at preschoolers with various level of amylolytic activity of saliva. Patients and methods: 145 children at the age of 3–7 years with chronic inflammatory diseases of a stomach and duodenum are surveyed. The amylolytic activity of the mixed saliva by Smith-Roy-Ugolev amylolytic method was determined at patients. 2 clinical groups with account of median (the 50th percentile) distribution of amylolytic activity of saliva are created: the first — with indicators below the median (n =72), the second — with indicators above or equal to the median (n =73). The endoscopic research (all children), histological research bioptates (n =63), morphometric analysis of a duodenum mucous membrane (n =26) were applied for the purpose of assessment of a morphofunctional condition of a stomach and duodenum. Results: It is established that predominant duodenum involvement, high frequency of isolated duodenitis, subatrophic and dystrophic changes of a duodenal mucous membrane, bigger intensity and depth of inflammatory process against lower level of nonspecific tissue protection, existence of signs of an allergic inflammation are characteristic for patients with low amylolytic activity of saliva. Conclusion: Determination of amylolytic activity of the mixed saliva at children with inflammatory diseases of a stomach and duodenum is available, noninvasive informative diagnostic test orienting in assessment of a character and extent of involvement of a gastroduodenal mucous membrane and allowing in due time to reveal the patients needing the profound inspection of gastroduodenal area and also to exclude food allergy.

1. Ziatdinova N. V., Adel’shina N. V., Malanicheva T. G. Prakticheskaya meditsina — Practical medicine. 2011; 4: 103–105.

2. Malanicheva T. G., Ziatdinova N. V., Denisova S. N. Vopr. det. dietologii — Problems of pediatric nutritiology. 2011; 9 (1): 42–46.

3. Sazanova N. E. Mekhanizmy formirovaniya i klinicheskie varianty khronicheskikh zabolevanii zheludka i dvenadtsatiperstnoi kishki u detei doshkol’nogo vozrasta. Avtoref. dis. … dokt. med. nauk [Progress Mechanisms and Clinical Forms of Stomach and Duodenum Chronic Diseases in Children under School Age. Author’s abstract]. Nizhny Novgorod, 2002. 28 p.

4. Galova E. A. Kliniko-immunologicheskie osobennosti i korrektsiya terapii u detei doshkol’nogo vozrasta. Avtoref. dis. … kand. med. nauk [Clinical and Immunological Features and Therapy Correction in Children under School Age. Author’s abstract]. Nizhny Novgorod, 2008. 24 p.

5. Detskaya allergologiya: ruk-vo dlya vrachei. Pod red. A. A. Baranova, I. I. Balabolkina [Pediatric Allergology. Guideline. Edited by A. A. Baranov, I. I. Balabolkin]. Moscow, GEOTAR-Media, 2006. 687 p.

6. Nowak-Wegrzyn F. Food protein-induced enterocolitis syndrome. Curr. Opin. Allergy. Clin. Immunol. 2009; 4 (9): 371–377.

7. Ferreira C., Seidman J. Food allergy: a practical update from the gastroenterological viewpoint. Pediatr. (Rio J.). 2007; 3 (1): 7–20.

8. Sazanova N. E., Shabunina E. I., Shirokova N.Yu., Khokhlova N. M. Sib. med. zhurn — Siberian medical journal. 2009; 24 (4, iss.1): 24–27. 9. Shcheplyagina L. A., Kruglova I. V. RMZh — Russian medical journal. 2009; 23: 1564.

9. Aleksandrova V. A. Osnovy immunnoi sistemy zheludochnokishechnogo trakta. Metod. pos [The Basis of Immune System of Gastro-intestinal Tract. Guideline]. St. Petersburg, MAPO, 2006. 44 p.

10. Korot’ko G. F. Ross. zhurn. gastroenterol., gepatol., koloproktol — Russian journal of gastroenterology, hepathology and colopractology. 2011; 21 (4): 14–21.

11. Volkov A. I., Dorofeichuk V. G., Shkeneva L. N. Rol’ defitsita amilazy slyuny v narushenii zashchitnogo bar’era sistemy pishchevareniya u detei s zabolevaniyami gastroduodenal’noi zony [Ptyalin Deficiency Role in Digestive System’s Resisting Barrier Disorder in Children with Gastro-duodenal Diseases]. Mat-ly I Vserossiiskogo kongressa «Meditsina detyam» (Proceedings of the 1st Russian National Congress “Medicine for Children”). Nizhny Novgorod, 2003. 92 p.

12. Korot’ko G. F. Sekretsiya slyunnykh zhelez i elementy salivadiagnostiki [Salivary Glands’ Secretion and Elements of SalivaDiagnostics]. Moscow, Akademiya Estestvoznaniya, 2006. 191 p.

13. Beier L. V. Sistema mestnoi zashchity pishchevaritel’nogo trakta, prognozirovanie zdorov’ya i profilaktika zabolevanii u detei. Avtoref. dis. … dokt. med. nauk [Local Resisting Barrier of Digestive Tract, Prognosis of Health Status and Prophylaxis in Children. Author’s abstract]. Nizhny Novgorod, 1992. 21 p.

14. Komarova L. G., Alekseeva O. P. Salivalogiya [Salivalogy]. Nizhny Novgorod, NGMA, 2006. 180 p.

15. Shabunina E. I., Komarova L. G., Korkotashvili L. V. Spravochnik po laboratornoi diagnostike v pediatrii. Pod red. A. I. Volkova [Guideline on Laboratorial Diagnostics in Pediatrics. Edited by A. I. Volkov]. Nizhny Novgorod, 2007. 54 p.

16. Shumilov P. V., Dubrovskaya M. I., Yudina O. V., Mukhina Yu. G., Tertychnyi A. S. Vopr. sovr. pediatrii — Current pediatrics. 2007;6 (4): 43–53. 18. Sazanova N. E., Shabunina E. I., Shirokova N.Yu., Khokhlova N. M. Pediatriya — Pediatrics. 2013; 92 (3): 13–17.