Русский
The state of the vegetative homeostasis and the quality of life of children with neurogenic urination disorders against the background of connective tissue dysplasia
D.Yu. Latyshev, Yu.F. Lobanov, N.M. Mikheeva, N.A. Tekutyeva, A.A. Kvasova
Aim. To investigate the characteristics of vegetative homeostasis and quality of life indicators in children with neurogenic bladder disorders, depending on the manifestations of the syndrome of connective tissue dysplasia (CTD).
Material and methods. The study comprised 26 children aged 5 to 12 years (mean 8.3±1.7 years) diagnosed with "neurogenic bladder dysfunction" (NBD). Diagnostic evaluation included genealogical history, clinical manifestation of the disease, complete blood count and chemistry profile, kidney and bladder ultrasound, duplex scanning of brachiocephalic vessels, echocardiography (EchoCG). The severity of urinary disorders was assessed using a clinical qualimetric table for children aged 4 to 15 years. CTD was diagnosed by scoring external and visceral signs of systemic involvement of connective tissue ranked by importance. Quality of life was assessed using a PedsQL™ questionnaire (J. Varni, 1999).
Results. Clinical symptoms of autonomic dysfunction were more often detected in NBD patients who had more severe manifestations of mesenchymal dysplasia. Cardiointervalography (CIG) showed that major changes in the initial autonomic tone regardless of the degree of dysplasia were sympathetic – hypersympathicotonia type changes. Quality of life assessment in children with NBD showed a significant reduction of scores on all scales regardless of CTD severity.
Conclusion. Clinical signs of autonomic dysfunction were most often detected in patients with moderate CTD. The average number of vegetative symptoms per child in this group was 5.5 versus 2.2 in the group with mild dysplasia. CIG results did not depend on the severity of the CTD, and were characterized by sympathicotonia-type changes in the initial autonomic tone, which was observed in 55.5% of children with moderate CTD and in 64.8% of children with mild CTD. There was a significant decline in the quality of life in NBD patients with concurrent CTD. No association between the quality of life and CTD severity was observed.
Material and methods. The study comprised 26 children aged 5 to 12 years (mean 8.3±1.7 years) diagnosed with "neurogenic bladder dysfunction" (NBD). Diagnostic evaluation included genealogical history, clinical manifestation of the disease, complete blood count and chemistry profile, kidney and bladder ultrasound, duplex scanning of brachiocephalic vessels, echocardiography (EchoCG). The severity of urinary disorders was assessed using a clinical qualimetric table for children aged 4 to 15 years. CTD was diagnosed by scoring external and visceral signs of systemic involvement of connective tissue ranked by importance. Quality of life was assessed using a PedsQL™ questionnaire (J. Varni, 1999).
Results. Clinical symptoms of autonomic dysfunction were more often detected in NBD patients who had more severe manifestations of mesenchymal dysplasia. Cardiointervalography (CIG) showed that major changes in the initial autonomic tone regardless of the degree of dysplasia were sympathetic – hypersympathicotonia type changes. Quality of life assessment in children with NBD showed a significant reduction of scores on all scales regardless of CTD severity.
Conclusion. Clinical signs of autonomic dysfunction were most often detected in patients with moderate CTD. The average number of vegetative symptoms per child in this group was 5.5 versus 2.2 in the group with mild dysplasia. CIG results did not depend on the severity of the CTD, and were characterized by sympathicotonia-type changes in the initial autonomic tone, which was observed in 55.5% of children with moderate CTD and in 64.8% of children with mild CTD. There was a significant decline in the quality of life in NBD patients with concurrent CTD. No association between the quality of life and CTD severity was observed.
Keywords: vegetative homeostasis, neurogenic bladder disorders, connective tissue dysplasia, children
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