The effect of the reparative action drug in treatment of pediatric duodenal ulcer

V. Dudnyk, N.O. Buhlova, I. Morozova, T.Y. Kukuruza
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Abstract

Background. Digestive tract diseases occupy one of the first places in the structure of childhood pathology, including duodenal ulcers (DU), the development of which in 70-100% of cases is associated with H.pylori infection. It is found that the important role in the development of inflammatory process in digestive tract have toll-like receptors 4 (TLR4), due to reactiveness to H.pylori. It is proved that growth factors, in particular epidermal growth factor (EGF), are able to influence on the healing processes in the mucous membrane. It is advisable to include drugs of reparative action in complex treatment of pediatric DU. Purpose - to evaluate the effect of the reparative action drug in the treatment of pediatric DU, taking into account the dynamics of TLR4 and EGF in blood serum. Materials and methods. The total clinical group consisted of 39 children aged 7-18 years with H.pylori-associated duodenal ulcer. In 20 patients of the group 1 with DU a standard triple regimen was used. In 19 patients of the group 2 a drug of reparative action was included. The content of TLR4 and EGF in serum were determined by ELISA. Results. It was found that the level of TLR 4 decreased by 15.1% and 27.5% after a course of treatment in patients of the group 1 and in the group 2, respectively сompared to a level before treatment. It is showed that in patients of the group 1 and the group 2 after 3 weeks from the start of treatment there were changes in the content of EGF manifested by a decrease by 19.81% and 23.3%, сompared to a level before treatment. Сonclusions. Our results indicated that after the course of treatment the content of TLR4 and EGF in the group 1 of patients was lower by 12.37% and 3.49% respectively, than in the group 2. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
修复作用药物治疗小儿十二指肠溃疡的疗效观察
背景。消化道疾病在儿童病理结构中占有重要地位,包括十二指肠溃疡(DU),其发展在70-100%的病例中与幽门螺杆菌感染有关。发现toll样受体4 (TLR4)由于对幽门螺杆菌的反应,在消化道炎症过程的发展中起重要作用。事实证明,生长因子,特别是表皮生长因子(EGF)能够影响粘膜的愈合过程。在小儿DU的综合治疗中,建议使用具有修复作用的药物。目的——考虑血清中TLR4和EGF的动态变化,评价修复作用药物治疗小儿DU的效果。材料和方法。临床组包括39例7-18岁幽门螺旋杆菌相关十二指肠溃疡患儿。1组20例DU患者采用标准三联治疗方案。2组19例患者采用修复作用药物治疗。ELISA法测定血清中TLR4和EGF的含量。结果。结果发现,1组和2组患者治疗一个疗程后,tlr4水平分别较治疗前下降15.1%和27.5%。结果表明,1组和2组患者在治疗3周后EGF含量发生变化,与治疗前相比分别下降19.81%和23.3%。Сonclusions。我们的研究结果显示,治疗过程后,1组患者TLR4和EGF的含量分别比2组低12.37%和3.49%。这项研究是按照《赫尔辛基宣言》的原则进行的。研究方案经参与机构当地伦理委员会批准。获得患者的知情同意进行研究。作者未声明存在利益冲突。
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