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IMMUNE STATUS PARAMETERS IN PERIOD OF THE VACCINAL PROCESS IN CHILDREN WHO HAVE HAD SEVERE BACTERIAL INFECTIONS

L.D.Mullaeva

 Republican Specialized Scientific-Practical Medical Center of Pediatrics the Ministry of Health of the Republic of Uzbekistan

 

The consequences of transferred or carried septic infection are violations of the functioning of various organs and systems, including the immune system, which plays an important role in the outcome of this disease. Follow-up study revealed the preservation of these disorders during the first year of life of child, what could reduce the effectiveness of immunization against preventable diseases in this category of children. This circumstance led to the purpose of the present investigation in the need for a deeper study of parameters of the immune system in children who have had bacterial sepsis.

Materials and methods: We had been lead research of immune status in 74 children after transferred or carried sepsis first few months of life, before the introduction of vaccination in the ages of 6 months to 1 year. Assessment of immunological parameters was performed prior to vaccination with the definition of cellular and humoral of immunity as well as non-specific defense. For a more detailed assessment of immune disorders assessed the degree of immunological disorders (IDAs) by a universal formula proposed by AM Zemskov (1986) and by method of frequency analysis. Additionally diagnostic value of the coefficient was calculated using the formula by AD Gorelik and VA Skrypkina (1974), followed by determination of leading immunological parameter  -  formulas of disorders of immune system   (FDIS) by method of  A.M. Zemskov (1986).

Results: In children who had undergone sepsis, prior to vaccination revealed serious violation of immune status, expressed in short supply of T-cell system, by phagocytosis and dissimmunoglobulinemia. Frequency analysis allows to objectively characterizing the risk of forming of pathological changes of high 2-3 degree of immunological parameters   in the surveyed groups of children. In children who had undergone sepsis immune disorders are characterized by a decrease of lymphocyte 2nd degree in 91.3% of T-cell 2nd degree in 86.9% and 3rd degree in 13.1% of examinees, B-lymphocytes 2nd degree in 80.4% and 3rd degree in 19.6% of children. In this category of children revealed a significant reduction in the absolute number of CD4, CD8, and CD16 in the range degree 2-3, indicating a depression of T-cellular link of immunity. As well there was a slight decrease in phagocytic activity of neutrophils - FAN (19.6%) and the level of IgG (8,7%) second degree, in children who had  undergone sepsis. In the study of immunoglobulin IgA revealed a reliable increase in the third degree, 100% of examinees children. Analysis of the degree of immune disorders and the calculation of the coefficient diagnostic value gave the possible to compile a list of changed immunological parameters in children who undergone sepsis: Lymph²-CD4 ³-CD8 ²-T ² - SD16 ²-Vl ²-IgA ³ + FAN ¹-IgM ¹ + IgG ¹-. Key indicators were entered into the formula disorders of the immune system (FDIS) Lymph ²-³-CD4 CD8 ²-T ² -.

In such a way, children who have had sepsis were observed the significant suppression of the immune status, the high frequency of immune disorders degree 2-3. About a third of children have had undergone sepsis, on the named parameters, in period of the introduction of preventive vaccinations are stored important changes of immunological parameters. Consequently, to this category of children necessary in period of disease corrections of immunological parameters for the purpose of rehabilitate and prepare them for subsequent vaccination against preventable diseases.