КЛИНИКО-УЛЬТРАЗВУКОВАЯ И МОРФОЛОГИЧЕСКАЯ ХАРАКТЕРИСТИКА ЦЕРЕБРАЛЬНОЙ ИШЕМИИ ТЯЖЕЛОЙ СТЕПЕНИ У НОВОРОЖДЕННЫХ С ВНУТРИУТРОБНОЙ МОНО- И МИКСТ-РЕСПИРАТОРНОЙ ВИРУСНОЙ ИНФЕКЦИЕЙ

Abstract

The contents of the tumor necrosis factor-alpha (TNF-α) in the serum of the umbilical blood as well as ultrasound and morphologic composition of liquor ways of the brain at severe cerebral ischemia was studied in 103 full-term newborns. The first group included 30 newborns from mothers with a physiologic course of pregnancy (subgroup A) and 20 dead newborns with antenatal anamnesis with uncomplicated virus infection, severe somatic pathology and late gestosis in their mothers during gestation (subgroup B); the second one included 28 newborns with severe cerebral ischemia against intrauterine parainfluenza infection (parainfuenza of 1 and 3 type), and 18 of them died at 3-6th day. The third group consisted of 25 newborns with severe cerebral ischemia against antenatal mixed-respiratory virus infection (parainfluenza of 1 and 3 types and influenza A(H3N2), and 16 of them died at the 2-4 days). It was found out that in the patients of the third group the contents of TNF-α increased till 62.7±2.14 pg/L (in the first and second groups it was 17.6±1.53 pg/L, p1<0.001 and 34.6±2.04 pg/L, respectively, p1<0.001). High values of pro-inflammatory cytokine were caused by the development of system inflammation reaction as a result of direct and mediated influence of some respiratory viruses. In the third group periventricular ischemia was found statistically oftener in 88% of newborns and brain immaturity in 48% of children (in the second group it was 32.1 and 10.7% of newborns, respectively); under pathomorphological study there were revealed big haematomas, subarachnoid haemorrhages, full-blown hyperemia and haematomas in the vascular plexus, karyorhexis, severe perivascular and pericellular edema, vasculitis as well as big focuses of atelectasis, aspirating pneumopathy and pneumonia. This suggested an important role of antenatal mixed-respiratory virus infection and pro-inflammatory cytokines in the improvement of penetrance of blood vessels wall under severe cerebral ischemia in newborns.