No abstract

Цель исследования. Оценить распространенность и годовую динамику гемолитических анемий (ГА) у детей в Республике Беларусь за период с 2005 по 2020 г. Материалы и методы. Использованы данные официальной статистической отчетности Республики Беларусь с 2005 по 2020 г. Учитывались следующие показатели в целом и отдельно по областям и возрастным группам: количество выявленных случаев ГА в детском и подростковом возрасте (0-17 лет), впервые выявленные случаи ГА в текущем году, количество детей с ГА, состоящих на диспансерном учете (ДУ) на конец года. Для расчета интенсивных показателей (на 100 тыс. детского населения) использованы данные о половозрастной структуре населения Республики Беларусь из статистических бюллетеней Национального статистического комитета. Результаты. В Республике Беларусь за 16-летний период (с 2005 по 2020 г.) зарегистрировано 4043 случая ГА (ежегодно от 200 до 328) у детей и подростков, впервые выявлено 522 случая (от 21 до 51 за год), на конец года состоит на ДУ у гематолога от 167 до 301 пациента в возрасте от 0 до 18 лет. Средняя заболеваемость ГА за анализируемый период составила 1,79 на 100 тыс. детского населения, причем наибольшая заболеваемость ГА отмечена в Гродненской, Витебской и Минской областях, наименьшая - в городе Минске, Брестской и Могилевской областях. Динамика количества впервые выявленных случаев ГА была стабильна, среднегодовой темп прироста заболеваемости ГА за оцениваемый период составил 0,03±0,05 случая в год (р>0,05). Тенденция к некоторому повышению заболеваемости (р≤0,1) присутствовала в городе Минске (р=0,09) и в Гомельской области (р=0,1). Впервые выявленные случаи ГА регистрируются преимущественно у детей раннего возраста: на первом году жизни (69,6%; заболеваемость 11,0 на 100 000 населения в данной возрастной группе) и в возрасте 1-4 лет (15,9%; заболеваемость 2,5 на 100 000). Выводы. За проанализированный 16-летний период заболеваемость ГА в детском возрасте остается относительно стабильной, данное заболевание выявляется в большинстве случаев (85,5%) в возрасте до 4 лет. Полученные результаты могут применяться в работе врачейпедиатров и детских гематологов. The purpose of the study was to assess the prevalence and annual dynamics of hemolytic anemias (HA) in children in the Republic of Belarus for the period from 2005 to 2020. Materials and methods. The data of the official statistical reporting of the Republic of Belarus from 2005 to 2020 were used. The following indicators were analyzed as a whole and separately by regions and age groups: the number of detected cases of HA in childhood and adolescence (0-17 years), newly diagnosed cases of HA in the current year, the number of children with HA registered at the dispensary follow-up for the end of the year. To calculate the intensive indicators (per 100,000 children’s population), data on the sex and age structure of the population of the Republic of Belarus from the statistical bulletins of the National Statistical Committee were used. Results. In the Republic of Belarus, over a 16-year period (from 2005 to 2020), 4043 cases of HA were registered (annually from 200 to 328) in children and adolescents, 522 cases were newly diagnosed (from 21 to 51 per year), 167 to 301 patients aged 0 to 18 years were seen at the dispensary follow- up for the end of the year. The average incidence of HA for the analyzed period was 1.79 per 100,000 children’s population, and the highest incidence was noted in Grodno, Vitebsk and Minsk regions, the lowest - in the city of Minsk, Brest and Mogilev regions. The dynamics of newly diagnosed cases of HA was stable, the average annual rate of increase in the incidence of HA for the estimated period was 0.03±0.05 cases per year (p>0.05). The trend towards a slight increase in morbidity (p≤0.1) was present in the city of Minsk (p=0.09) and in the Gomel region (p=0.1). Newly diagnosed cases of HA were recorded mainly in young children: in the first year of life (69.6%; incidence 11.0 per 100,000 population in this age group) and at the age of 1-4 years (15.9%; incidence 2.5 per 100,000). Conclusion. Over the analyzed 16-year period, the incidence of HA in childhood remains relatively stable, these diseases are detected in most cases (85.5%) at the age of 0 to 4 years. The obtained results can be applied in the work of pediatricians and pediatric hematologists.

Objective: to assess the state of the pro-oxidant/antioxidant system in children with hereditary spherocytosis (HS) depending on its severity.Material and methods. The study involved 44 HS patients at the age from 1 to 17 who were divided into 2 groups depending on the disease severity: mild course (n = 24) and moderate or severe course (n = 20). The control group included 23 practically healthy children who were comparable with the main group by gender and age. The state of the pro-oxidant/antioxidant balance of blood plasma was assessed by the method of luminol-dependent chemiluminescence (LDCL) with the determination of the maximum luminescence intensity (Imax, %) and the light sum of chemiluminescence (S, %). The activity of superoxide dismutase (SOD) and catalase was determined in the erythrocytes of the examined children.Results. On average, the parameters of the pro-oxidant/antioxidant status in the HS patients significantly differed from those of the control group (p <0.05), which corresponded to moderately pronounced oxidative stress. The activity of SOD and catalase in the erythrocytes of the patients was higher as compared with that of the control group (p = 0.0001 and p <0.0001, respectively). The comparison of the severity of oxidative stress depending on HS severity has determined that the degree of stress was more pronounced in patients with moderate or severe course of the disease (p <0.05).Conclusion. HS patients develop oxidative stress (decreased activity of the antioxidant system associated with increased accumulation of prooxidant substances), the degree of which is higher in patients with a severe course of the disease. This allows of considering plasma LDCL indicators as an additional marker for the assessment of the severity of the disease and of justifying the necessity to include antioxidants in the HS treatment regimen.