Ischenko T. Role of endothelium-dependent factors in the Henoch's purpura pathogenesis in children

Subject of investigation: pediatric patients with Henoch's purpura. Objective of the work: To raise the effectiveness of Henoch's purpura treatment on the basis of study of endothelium-depended factors and platelet and plasma haemostasis links interrelations' mechanisms, as well as non specific and specific protection factors. Theoretical novelty: The novelty of the dissertation is based on the factor that in pediatric patients with Henoch's purpura the presence of endothelial dysfunction is registered, the degree of which depends on the disease severity and stage. The maximal endothelial dysfunction degree is shown in patients with maximal activity of the process with abdominal syndrome and glomerulonephritis. Interrelations of endothelium-depended factors (nitric oxide and endothelin-1) and platelet-plasma haemostasis links' indices, parameters of cellular, humoral immunity and phagocytosis are revealed, that permits to prove from the systematic approach positions that endothelial dysfunction is oneof the possible mechanisms of HP progression. Practical novelty: Criteria of assessment of HP process activity in dependence from ET-1 and NO levels, peripheral circulation indices, parameters of acute phase, acute inflammatory proteins levels are proposed and introduced in the practical health care, that has applied significance for HP prognosis and choice of therapy composition and volume. HP therapy schemes with the use of nitrovasodilators (nitrogranulong) and ACE inhibitor (Kozaar), aimed on endothelial dysfunction removal and HP progression prevention, are worked out and introduced in the practical health care. Degree of introduction. Recommendations, worked out for optimization of HP patients' treatment with the use of ACE inhibitors and nitrovasodilators, are introduced in the practice of profile wards of pediatric hospitals in Kharkov and Ukraine. As a result of introduction, the number of HP severe complications (abdominal syndrome and glomerulonephritis) have been decreased, that enabled to reducethe hospitalization terms in HP patients. Sphere of application: The work relates to medicine, particularly to pediatrics, the results may be introduced in the treatment of pediatric patients with HP on all the levels of medical care - in rural, regional, urban health care institutions, as well as they can be used for scientific-and-research activities. Activities