Prokhorov I. Patogenetic ground and optimization of anti-inflammatory therapy of joint form of Juvenile Rheumatoid Arthritis

Dissertation is devoted to the increase efficiency of anti-inflammatory therapy of active stage of joint form of Juvenile Rheumatoid Arthritis (JRA) on the basis of study of clinical, biochemical, immunological, including cytokines status and deter-mination of level of antibodies to collagen. 79 patients at the age of 6 to 16 years in active stage of JRA were examined. More frequent was observed oligoarthritis (46, 8%) and II stage of activity, mainly with the defeat of knee, and elbow joints. In 73,5% cases changes in joints corre-sponded to the mainly exudative phase of inflammation. The most informing clinical and laboratory criteria, reflecting activity of joint syndrome is the index of the slight swelling, duration of morning stiffness, maintenance of syalic acids, hyperleucosyto-sis, level of seromukoid. The active stage of JRA is accompanied by the disorders of immune status such as increase of the relative maintenance B-lymphocytes, de-creased of the relative maintenance of CD8, increases of the IgG, rises of the activity ІL-8, FNT-a, ІL-1, ІL-6 and rises of level of antibodies to collagen. Comparative estimation of efficiency of two variants of medical treatment of active stage of JRA testifies to obvious advantage of combined therapy of nimesulid and "Assaliks", which turned out on 60,1% more effectively than monotherapy with nimesulid. "Assaliks" increase the anti-inflammatory effect of nimesulid, that allows to get more expressed clinical effect in active stage of JRA. Key words: children, juvenile rheumatoid arthritis, anti-inflammatory therapy.