medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2017-18-124-128medsovet-2044Research ArticleМУКОВИСЦИДОЗCYSTIC FIBROSISВЛИЯНИЕ НЕОНАТАЛЬНОГО СКРИНИНГА НА ТЕЧЕНИЕ МУКОВИСЦИДОЗА НА ПРИМЕРЕ ГРУППЫ ПАЦИЕНТОВ МОСКОВСКОГО РЕГИОНАINFLUENCE OF NEONATAL SCREENING FOR CYSTIC FIBROSIS BY THE EXAMPLE OF PATIENTS OF THE MOSCOW REGIONШерманВ. Д.ShermanV. D.

к.м.н.

PhD in medicine

КондратьеваЕ. И.KondratievaE. I.

д.м.н., профессор

MD, Prof.

ВоронковаА. Ю.VoronkovaA. Y.

к.м.н.

PhD in medicine

КаширскаяН. Ю.KashirskayaN. Y.

д.м.н., профессор

MD, Prof.

ШабаловаЛ. А.ShabalovaL. A.

к.м.н

PhD in medicine

НиконоваВ. С.NikonovaV. S.

к.м.н.

PhD in medicine

ЖекайтеЕ. К.ZhekaiteE. K.КуцевС. И.KutsevS. I.

д.м.н., профессор, чл.-корр. РАН

MD, Prof., Corresponding Member of RAS

Медико-генетический научный центр, Москва; Московский областной консультативно-диагностический научный центр для детей, МоскваРоссияMedico-Genetic Scientific Center, Moscow; Moscow Regional Consultative Diagnostic Scientific Center for Children, MoscowRussian FederationМедико-генетический научный центр, Москва;РоссияMedico-Genetic Scientific Center, MoscowRussian Federation201703112017018124128Copyright © Шерман В.Д., Кондратьева Е.И., Воронкова А.Ю., Каширская Н.Ю., Шабалова Л.А., Никонова В.С., Жекайте Е.К., Куцев С.И., 20172017Шерман В.Д., Кондратьева Е.И., Воронкова А.Ю., Каширская Н.Ю., Шабалова Л.А., Никонова В.С., Жекайте Е.К., Куцев С.И.Sherman V.D., Kondratieva E.I., Voronkova A.Y., Kashirskaya N.Y., Shabalova L.A., Nikonova V.S., Zhekaite E.K., Kutsev S.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/2044Цель исследования

Цель исследования: сравнительная оценка клинического статуса пациентов с муковисцидозом (МВ) 6–9 лет, диагноз которым был установлен до начала неонатального скрининга (НС) на МВ в Московском регионе и в аналогичной возрастной группе с момента начала НС по данным регистра 2012 и 2015 гг. Пациенты и методы. Пациенты были разделены на 2 группы: I – 45 детей 6–9 лет, диагностированных до начала НС, II – 86 детей 6–9 лет, выявленных после начала НС. Результаты. При сравнительной оценке возраста установки диагноза получено достоверное различие между I и II группами. Средний возраст установления диагноза в группе I составил 2,29 (±2,29) года, в группе II средний возраст установления диагноза – 0,66 (± 1,13) года (p = 0,0000). По данным микробиологического статуса группа пациентов, диагностированных по программе НС (группа II), достоверно реже имела хроническое инфицирование дыхательных путей Ps. aeruginosa (37,78% пациентов в группе I против 14,10% в группе II) (р = 0,0026). В группе больных, выявленных по программе скрининга новорожденных (группа II), отмечено статистически значимое уменьшение объема проводимой внутривенной (р = 0,0000) и ингаляционной антибактериальной терапии (р = 0,0139) и снижение по сравнению с группой I числа пациентов, принимающих бронхолитики (р = 0,0322). Заключение. Продемонстрировано положительное влияние неонатального скрининга на МВ на возраст установки диагноза и ряд важных показателей течения заболевания.

 

 

Study objective

Study objective: comparative evaluation of clinical status of patients with cystic fibrosis (CF) 6–9 years, the diagnosis of which was established before the start of neonatal screening (NS) for MV in the Moscow region and in same age group since the start of the NS according to the register 2012 and 2015. Patients and methods. The patients were divided into 2 groups: I – 45 children aged 6–9 years, diagnosed before the beginning of the NS, II – 86 children aged 6–9 years, identified after the start of the NS. Results. A comparative assessment of the age of diagnosis had a significant difference between groups I and II. The average age of diagnosis in group I was 2.29 (±2.29) years, in group II the average age of diagnosis – 0.66 (± 1.13) years (p = 0.0000). According to the microbiological status diagnosed according to the NS program (group II), chronic infection of the respiratory tract by Ps. aeruginosa was less frequent in this group (37.78% of patients in group I vs. 14,10 % in group II) (p = 0.0026). In the group of patients identified by the newborns screening program directed at newborns (group II) a statistically significant decrease of the ongoing intravenous (p = 0.0000) and inhaled antibiotic therapy (p = 0.0139) and reduced compared with group I patients receiving bronchodilators (p = 0.0322). Conclusion. A positive impact of neonatal screening for MV at the age of diagnosis and a number of important indicators of the disease was demonstrated.

 

 

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The authors declare that there are no conflicts of interest present.