Dissertation work is devoted to questions of pathogenic explaning of treatment at children with chronic tonsillitis, on the basis of studying of clinical picture, a functional condition of cardiovascular system, a microbiocenosis of intestines and dynamics of the content in blood of patients, immunomicroelementary indicators, and also to increase of efficiency of therapy of children with chronic tonsillitis. The main violations of warm activity are analysed at a secondary cardiopathy at children with chronic tonsillitis, by results of an electrocardiography, test with physical activity cardiointervalography with clinostatics test. The main ultrasonographic changes of palatal almonds according to ultrasonic research at children with chronic tonsillitis are established. At children with chronic tonsillitis the immune status in the first days of an aggravation was characterized by oppression of the T-cellular link, violation of phagocytosis activity of neutrophils, activation of the B-cellular link of immunity with development of a hyperimmunoglobulinemia of M and G, and also increase of concentration pro-inflammatory interleukin-6 and anti-inflammatory interleukin-4. At respondents with chronic tonsillitis of all groups at the time of hospitalization reliable decrease in the content of iron and zinc, and in serum of blood of children with tonsilogenic not inflammatory defeats of cardiovascular system - decrease in magnesium was observed. At all patients in the first days of an exacerbation of chronic tonsillitis violations of a microbiocenosis of a large intestine which were characterized by decrease in quantity of bifidobacterias and lactobacilli, an intestinal stick and increase in number of yeast-like fungi, staphylococci and representatives of opportunistic flora were observed. At a secondary cardiopathy with chronic tonsillitis at children at the time of hospitalization took place increasing of a marker of defeat of a myocardium creatinphosphokinase-MB. It is proved that appointment of symbiotic "Acidolac Junior" at children having chronic tonsillitis without defeat of cardiovascular system promoted normalization of the immune status, and also structure of intestinal microflora. It is established that at appointment of synbiotics at children with a secondary cardiopathy with chronic tonsillitis, took place reliable increasing of the level of the majority of immune indicators, improvement of qualitative and quantitative structure of the intestinal microflora, however full of normalization of the immune status and microbiocenosis of large intestine didn't manage to be reached. Thus, on the basis of the conducted researches for an assessment of a course of chronic tonsillitis and secondary сardiopathy, monitoring of efficiency of the entered medical actions and the disease forecast at children it is recommended to investigate in clinical practice immunological parameters (T-lymphocytes, T-helpers, T-suppressors, ІgG, ІgM, indicators of phagocytosis, the level of IL-4 and IL-6), the content in serum of blood of microelements of iron and zinc, a macroelements of magnesium, level of creatinphosphokinase-MB, and also the microbiological status of intestines. For increase of efficiency of treatment of children with a secondary cardiopathy with chronic tonsillitis, the complex scheme of treatment with introduction symbiotic and a magnesium preparation is developed.
