Варианты течения псевдотуберкулеза у детей и вклад активации перекисного окисления липидов, дисбаланса антиоксидантной системы в их развитие

The objective is to compare clinical symptoms, lipid peroxidation indicators, the state of the antioxidant system and assess their impact on the severity and progression of pseudotuberculosis in children. Materials and methods. We examined 125 children with pseudotuberculosis divided into 4 groups according to the severity and nature of the disease progression and 45 healthy children. The material for the study was red blood cells and blood plasma of patients received in the dynamics – the acute period (during hospitalization); 3-4 weeks later – the phase of early convalescence with a non-smooth progression and moderate and heavy severity; the recovery period with a smooth progression and mild and moderate severity; 5-6 weeks later – the recovery period with a non-smooth progression and moderate and heavy severity. The spectrophotometric method was used to study lipid peroxidation (the concentration of diene conjugates, TBA-reactive substances) in the blood plasma and components of the antioxidant support system (the content of reduced glutathione; the activity of glutathione reductase, glutathione peroxidase, and catalase) in red blood cells. Results. It was determined that moderate and heavy pseudotuberculosis forms prevail in hospitalized children, the disease progression in 35.2% of them was non-smooth; lipid peroxidation products accumulate in the blood plasma and the concentration of reduced glutathione decreases in red blood cells during the acute period of pseudotuberculosis in all children relative to the parameters in the control group. In the period of early convalescence an imbalance in the functioning of antioxidant enzymes of red blood cells, as well as the accumulation of TBA-reactive substances and a decrease in the content of reduced glutathione were observed in patients with moderate and heavy pseudotuberculosis. Conclusion. The impact of the imbalance of pro-/antioxidants on the formation of predominantly moderate and heavy pseudotuberculosis in children is shown. Prognostic criteria for the development of a non-smooth progression of pseudotuberculosis are a high level of lipid peroxidation products in the blood plasma, no normalization in values of glutathione system components and the activity of erythrocyte catalase during early convalescence.