Khlunovs'ka L. Predictors of prognosis and efficacy of treatment of ulcer disease in children

Object -the stomach ulcer associated with Helicobacter pylori at children; the purpose - improve forecasting of course and to optimize efficiency of treatment of a stomach ulcer at children on the basis of studying features of her clinical - endoscopic displays, Helicobacter pylori, levels of melatonin metabolite and nitrogen monoxide metabolites; methods - clinical, tool, biochemical, mathematicaland the results -In the thesis highlights the in-depth examination of children with ulcer disease: the role of cumulative impact of a number of factors that are not able to act alone as trigger of the disease; analysed the frequency of H. pylori infection in children population of Chernivtsy and Chernivtsy region and possible reasons for its growth; studied clinical and endoscopic peculiarities of disease, properties and nature of the child's personality, depending of the H. pylori infection; defined levels of melatonin metabolite and nitrogen monoxide metabolites, depending on the course of ulcer disease; confirmed the efficacy of complex treatment of children with ulcer disease. Study of the melatonin metabolite level, depending on the clinical and endoscopic features of ulcer disease, enabled to propose non-invasive method of predicting the severity of the disease. Sets the level of nitrogen monoxide metabolites allowed to assess the degree of inflammation in the gastroduodenal mucosa. A model of predictors of H. pylori-associated ulcer disease consist of 3 groups of factors: predictors that determine susceptibility of the disease, predictors that contribute to the implementation of disease and predictors that implement disease. Using a complex treatment with addition of citrarginine to standard schemes allows to improve the efficacy of anti-H. pylori therapy, to accelerate normalization of stomach acid production, to reduce the time of pain elimination and length of children's inpatient stay, and to reduce the frequency of recurrence of ulcer disease.