Pathogenetically Grounded Approach to the Treatment of Children who Underwent Perinatal CNS Lesions

Abstract

The aim of this study was to evaluate, based on the analysis of neurobiochemical markers, the effectiveness of pathogenetically substantiated therapy for disorders of the psychomotor and physical development of children in the first year of life who underwent perinatal hypoxia. Materials and Methods:The study included 419 patients (52% boys and 48% girls) aged from 1 to 6 months. The main group included 336 patients in the first year of life who received inpatient treatment for perinatal CNS damage of different degrees of severity. The main group was divided into two subgroups according to age: Group 1 (n=163) between the ages of 1 and 3 months and Group 2 (n=173) between the ages of 4 and 6 months. In accordance with the severity of the CNS lesion, the main group was also divided into 3 subgroups: mild degree (n=122), moderate degree (n=118), and severe degree (n=96). The control group included 83 apparently healthy children (n=43 between the ages of 1 to 3 months and n=40 between the ages of 4 to 6 months). The analysis of individual physical development of the children was carried out using Z scores (weight, age, head circumference) and centiles (7 intervals ("corridors")) according to the WHO standard program WHO AnthroPlus, The concentrations of biochemical markers (L-Homocysteine, beta-NGF, S100 protein, angiotensin II) in the blood were evaluated in all children at admission, as a routine entry investigation. In accordance with a treatment regimen, the main group was also divided into 2 subgroups: subgroup A (n=170), patients who received therapy depending on a general clinical manifestation; and subgroup B (n=166), patients who received therapy depending on a dominant syndrome and variability of neurobiochemical markers.Results: We found that Scheme B showed advantages for all studied neurobiochemical markers, with statistical significance for L-Hcy regardless of the age group. The positive dynamics were found in the ND severity against the background of Scheme B regardless of the age group and the degree of severity of the CNS lesion. Thus, the pronounced positive dynamics in the levels of neurotrophic and neurovascular markers of the CNS lesion in all age groups reflects the advantage of pathogenetic therapy. (International Journal of Biomedicine. 2018;8(3):192-196.)Key Words: neurological deficit • nervous system • nerve growth factor • homocysteine Abbreviations AII, angiotensin II; Hcy, homocysteine; CNS, central nervous system; ND, neurological deficit; NGF, nerve growth factor; SOCG, Scale of the optimal course of gestation; SOCD, Scale of the optimal course of delivery.