Boyarchuk O. Clinical and pathogenetic aspects of the rheumatic disease course in children and optimization of the methods of its treatment and prevention

The thesis is devoted to the improvement of diagnostic methods, to increase the efficiency of treatment and to optimize preventive measures in children with acute rheumatic fever and chronic rheumatic heart disease based on a comprehensive study of clinical and pathogenetic mechanisms of the disease and risk factors. The features of diseases are identified and the importance of the disbalance Th1/Th2-cytokins in the pathogenesis of acute rheumatic fever and forming of rheumatic heart lesions has been proven. The activation of vascular-thrombocytic hemostasis, nitroxidergic system and reduction of antioxidant defense have been found in children with diseases. Persistence of Epstein-Barr virus is determined in 93.5% of children with chronic rheumatic heart disease, and its reactivation - in 37.1% of patients. The influence of reactivation of Epstein-Barr virus on the clinical course of the disease and immunological parameters has been investigated. This paper has theoretically grounded and practically demonstrated the application of immune-correcting means with antiviral activity in complex treatment of chronic rheumatic heart disease in children.