Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Нарушения соединительной ткани у детей и подростков, занимающихся спортом
________________________________________________
Ivyanskiy S.A., Balykova L.A., Shchekina N.V. et al. Connective tissue violations in children and teenagers engaging in sport. Consilium Medicum. Pediatrics (Suppl.). 2016; 4: 94–101.
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Ключевые слова: дисплазия соединительной ткани, ремоделирование сердца, молодые спортсмены, L-карнитин (Элькар).
________________________________________________
The problem of the sudden death (SD) of young persons who involved in sports activities, and it interrelation with pathology of connective tissue is in the center of attention of medical experts. Special relevance and the predictive importance are presented by signs of connecting tissue disorders of heart such as small anomalies. Only medical tactics concerning mitral's valve prolapse in the Russian national and international recommendations about the admission of athletes to training competitively process is presented, whereas options of small anomalies of heart are much more diverse. It complicates an interpretation of heart's possibility with dysplasia to provide height work performance during intensive physical activities seriously. Modern ideas of the admission to sport of children and adolescents with small heart's anomalies and about their influence on processes of heart's adaptation to intensive loadings are presented in article. Higher probability of formation heart's disadaptation disorders in children and adolescents with signs of a connective tissue dysplasia is established. Also results of medication of stressinduced cardiomyopathy in young athletes by means of course reception of a L-carnitine are presented.
Key words: connective tissue dysplasia, heart remodeling, young athletes, L-carnitine.
omim/OMIM – elektronnyi katalog nasledstvennykh zabolevanii Natsional'nogo tsentra biotekhnologicheskoi informatsii (NCBI). http://www.ncbi.nlm.nih.gov/omim [in Russian]
2. Калаева Г.Ю., Зайцева А.Х., Хохлова О.И. и др. Клинико-функциональные проявления недифференцированной дисплазии соединительной ткани у подростков. Педиатрия. 2012; 91 (2): 135–9. / Kalaeva G.Yu., Zaytseva A.Kh., Khokhlova O.I. et al. Kliniko-funktsional'nye proiavleniia nedifferentsirovannoi displazii soedinitel'noi tkani u podrostkov. Pediatriia. 2012; 91 (2): 135–9. [in Russian]
3. Чемоданов В.В., Горнаков И.С., Буланкина Е.В. Дисплазия соединительной ткани у детей. Иваново: ГОУ ВПОИвГМА МЗ РФ, 2004. / Chemodanov V.V., Gornakov I.S., Bulankina E.V. Displaziia soedinitel'noi tkani u detei. Ivanovo: GOU VPOIvGMA MZ RF, 2004. [in Russian]
4. Медицинские противопоказания к учебно-тренировочному процессу и участию в спортивных соревнованиях. Методические рекомендации. ФГБУ «ЦСМ ФМБА России». Г.А.Макарова, Ю.В.Мирошникова, М.Д.Дидур, С.А.Парастаев, А.С.Самойлов. Москва, 2014: 106 с./ Medicinskie protivopokazanija k uchebno-trenirovochnomu processu i uchastiju v sportivnyh sorevnovanijah. Metodicheskie rekomendacii. FGBU «CSM FMBA Rossii». G.A.Makarova, Ju.V.Miroshnikova, M.D.Didur, S.A.Parastaev, A.S.Samojlov. Moskva, 2014: 106 s.
5. Спортивная медицина: национальное руководство. Под ред. акад. РАН и РАМН С.П. Миронова, проф. Б.А. Поляева, проф. Г.А.Макаровой. М.: ГЭОТАР-Медиа, 2013. 1184 с./ Sportivnaja medicina: nacional'noe rukovodstvo / Pod red. akad. RAN i RAMN S.P. Mironova, prof. B.A. Poljaeva, prof. G.A.Makarovoj. M.: GEOTAR-Media, 2013. 1184 s.
6. Аббакумова Л.Н. Клинические формы дисплазии соединительной ткани у детей: Методические рекомендации. СПб.: СПбГПМА, 2006. / Abbakumova L.N. Klinicheskie formy displazii soedinitel'noi tkani u detei: Metodicheskie rekomendatsii. SPb.: SPbGPMA, 2006. [in Russian]
7. Гнусаев С.Ф. Синдром соединительнотканной дисплазии сердца у детей. Лечащий врач. 2010; 8: 40–4. / Gnusaev S.F. Sindrom soedinitel'notkannoi displazii serdtsa u detei. Lechashchii vrach. 2010; 8: 40–4. [in Russian]
8. Кадурина Т.И. Наследственные колагенопатии (клиника, диагностика, лечение и диспансеризация). СПб.: Невский диалект, 2000. / Kadurina T.I. Nasledstvennye kolagenopatii (klinika, diagnostika, lechenie i dispanserizatsiia). SPb.: Nevskii dialekt, 2000. [in Russian]
9. Кадурина Т.И., Аббакумова Л.Н. Алгоритм диагностики дисплазии соединительной ткани у детей. В кн.: Педиатрические аспекты дисплазии соединительной ткани. Достижения и перспективы. Под ред. С.Ф.Гнусаева, Т.И.Кадуриной, А.Н.Семячкиной. М.: Тверь; СПб.: ПРЕ100, 2010; с. 32–40. / Kadurina T.I., Abbakumova L.N. Algoritm diagnostiki displazii soedinitel'noi tkani u detei. V kn.: Pediatricheskie aspekty displazii soedinitel'noi tkani. Dostizheniia i perspektivy. Pod red. S.F.Gnusaeva, T.I.Kadurinoy, A.N.Semyachkinoy. M.; Tver'; SPb.: PRE100, 2010; s. 32–40. [in Russian]
10. Кильдиярова Р.Р. Соединительная ткань при патологии. Ижевск: ИГМА, 2011. / Kil'diyarova R.R. Soedinitel'naia tkan' pri patologii. Izhevsk: IGMA, 2011. [in Russian]
11. Нечаева Г.И., Викторова И.А. Дисплазия соединительной ткани: терминология, диагностика, тактика ведения пациентов. Омск: Типография БЛАНКОМ, 2007. / Nechaeva G.I., Viktorova I.A. Displaziia soedinitel'noi tkani: terminologiia, diagnostika, taktika vedeniia patsientov. Omsk: Tipografiia BLANKOM, 2007. [in Russian]
12. Земцовский Э.В., Малев Э.Г. Малые аномалии сердца и диспластические фенотипы. СПб.: Изд-во ИВЭСЭП, 2012. / Zemtsovskiy E.V., Malev E.G. Malye anomalii serdtsa i displasticheskie fenotipy. SPb.: Izd-vo IVESEP, 2012. [in Russian]
13. Шарыкин А.С., Субботин П.А., Павлов В.И. и др. Эхокардиографический скрининг детей и подростков при допуске к занятиям спортом. Рос. вестн. перинатологии и педиатрии. 2016; 1: 71–9. / Sharykin A.S., Subbotin P.A., Pavlov V.I. et al. Ekhokardiograficheskii skrining detei i podrostkov pri dopuske k zaniatiiam sportom. Ros. vestn. perinatologii i pediatrii. 2016; 1: 71–9. [in Russian]
14. Abouezzeddine O, Suleiman M, Buescher T et al. Relevance of endocavitary structures in ablation procedures for ventricular tachycardia. J Cardiovasc Electrophysiol 2010; 21: 245–4.
15. Hagen PT, Scholz DG, Edwards WD. Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts. Mayo Clin Proc 1984; 59: 17–20.
16. Cockerham JT, Martin TC, Gutierrez FR et al. Spontaneous closure of secundum atrial septal defect in infants and young children. Am J Cardiol 1983; 52: 1267–71.
17. Шарыкин А.С, Яшина М.А., Шилыковская Е.В. Клиническое наблюдение увеличения диаметра открытого овального окна в подростковом возрасте. Рос. вестн. перинатологии и педиатрии. 2013; 1: 40–3. / Sharykin A.S, Yashina M.A., Shilykovskaya E.V. Klinicheskoe nabliudenie uvelicheniia diametra otkrytogo oval'nogo okna v podrostkovom vozraste. Ros. vestn. perinatologii i pediatrii. 2013; 1: 40–3. [in Russian]
18. Barthelmess A, Harten M, Mein G et al. The incidence and associated abnormalities of atrial septal aneurysms – A review of 106,418 Echocardiograms. Heart, Lung and Circulation 2012; 21: S143–S316.
19. Ozcelik N, Atalay S, Tutor E, Ekici F. Prevalence of inter atrial septal aneurysm in newborns and their natural course. Pediatr Cardiol 2006; 27: 343–6.
20. Di Tulllo MR, Sacco RL, Sciacca RR et al. Patent foramen ovale and the risk of ischemic stroke in a multiethnic population. J Am Coll Cardiol 2007; 49: 797–802.
21. Faggiano P, Frattini S, Piovesana P et al. Low cerebrovascular event rate in subjects with patent foramen ovale and different clinical presentations. Results from a prospective nonrandomized study on a population including patients with and without patent foramen ovale closure. Intern J Cardiol 2012; 156: 47–52.
22. De Mozzi P, Longo UG, Galanti G, Maffull N. Bicuspid aortic valve: a literature review and its impact on sport activity. Br Med Bull 2008; 85: 63–85.
23. Hepnera AD, Morrella H, Greavesa S et al. Prevalence of mitral valvar prolapse in young athletes. Cardiology in the Young 2008; 18: 402–4.
24. Шарыкин А.С. Пролапс митрального клапана – изменения в критериях диагностики и варианты течения заболевания. Consilium medicum. Педиатрия (Прил.). 2013; 2: 43–8. / Sharykin A.S. Prolaps mitral'nogo klapana – izmeneniia v kriteriiakh diagnostiki i varianty techeniia zabolevaniia. Consilium medicum. Pediatrics (Suppl.). 2013; 2: 43–8. [in Russian]
25. Avierinos J-F, Gersh BJ, Melton J et al. Natural history of asymptomatic mitral valve prolapse in the community. Circulation 2002; 106: 1355–61.
26. Шарыкин А.С., Попова Н.Е., Бадтиева В.А. и др. Пролапс митрального клапана у юных спортсменов. Рос. вестн. перинатологии и педиатрии. 2014; 59: 6: 40–5. / Sharykin A.S., Popova N.E., Badtieva V.A. et al. Prolaps mitral'nogo klapana u iunykh sportsmenov. Ros. vestn. perinatologii i pediatrii. 2014; 59: 6: 40–5. [in Russian]
27. Wand O, Prokupetz A, Grossman A, Assa A. Natural history of mitral valve prolapse in military aircrew. Cardiology 2011; 118: 1: 50–4.
28. De Paepe A, Devereux RB, Dietz HC et al. Revised diagnostic criteria for the Marfan syndrome. Am J Med Genet 1996; 62 (4): 417–26.
29. Loeys BL, Dietz HC, Braverman AC et al. The revised Ghent nosology for the Marfan syndrome. J Med Genet 2010; 47 (7): 476–85.
30. Roman MJ, Devereux RB, Kramer-Fox R, O’Loughlin J. Two-dimensional echocardiographic aortic root dimensions in normal children and adults. Am J Cardiol 1989; 64: 507–12.
31. Beighton P, De Paepe A, Steinmann B et al. Ehlers-Danlos syndromes: Revised nosology, Villefranche, 1997. Am J Med Genet 1998; 77 (1): 31–7.
32. Беленький А.Г. Гипермобильность суставов и гипермобильный синдром: распространенность и клинико-инструментальная характеристика. Автореф. дис. … д-ра мед. наук. М., 2004. / Belen'kiy A.G. Gipermobil'nost' sustavov i gipermobil'nyi sindrom: rasprostranennost' i kliniko-instrumental'naia kharakteristika. Avtoref. dis. … d-ra med. nauk. M., 2004. [in Russian]
33. Grahame R, Bird HA, Child A. The revised (Brighton, 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol 2000; 27 (7): 1777–9.
________________________________________________
1. OMIM – elektronnyi katalog nasledstvennykh zabolevanii Natsional'nogo tsentra biotekhnologicheskoi informatsii (NCBI). http://www.ncbi.nlm.nih.gov/omim [in Russian]
2. Kalaeva G.Yu., Zaytseva A.Kh., Khokhlova O.I. et al. Kliniko-funktsional'nye proiavleniia nedifferentsirovannoi displazii soedinitel'noi tkani u podrostkov. Pediatriia. 2012; 91 (2): 135–9. [in Russian]
3. Chemodanov V.V., Gornakov I.S., Bulankina E.V. Displaziia soedinitel'noi tkani u detei. Ivanovo: GOU VPOIvGMA MZ RF, 2004. [in Russian]
4. Medicinskie protivopokazanija k uchebno-trenirovochnomu processu i uchastiju v sportivnyh sorevnovanijah. Metodicheskie rekomendacii. FGBU «CSM FMBA Rossii». G.A.Makarova, Ju.V.Miroshnikova, M.D.Didur, S.A.Parastaev, A.S.Samojlov. Moskva, 2014: 106 s.
5. Sportivnaja medicina: nacional'noe rukovodstvo / Pod red. akad. RAN i RAMN S.P. Mironova, prof. B.A. Poljaeva, prof. G.A.Makarovoj. M.: GEOTAR-Media, 2013. 1184 s.
6. Abbakumova L.N. Klinicheskie formy displazii soedinitel'noi tkani u detei: Metodicheskie rekomendatsii. SPb.: SPbGPMA, 2006. [in Russian]
7. Gnusaev S.F. Sindrom soedinitel'notkannoi displazii serdtsa u detei. Lechashchii vrach. 2010; 8: 40–4. [in Russian]
8. Kadurina T.I. Nasledstvennye kolagenopatii (klinika, diagnostika, lechenie i dispanserizatsiia). SPb.: Nevskii dialekt, 2000. [in Russian]
9. Kadurina T.I., Abbakumova L.N. Algoritm diagnostiki displazii soedinitel'noi tkani u detei. V kn.: Pediatricheskie aspekty displazii soedinitel'noi tkani. Dostizheniia i perspektivy. Pod red. S.F.Gnusaeva, T.I.Kadurinoy, A.N.Semyachkinoy. M.; Tver'; SPb.: PRE100, 2010; s. 32–40. [in Russian]
10. Kil'diyarova R.R. Soedinitel'naia tkan' pri patologii. Izhevsk: IGMA, 2011. [in Russian]
11. Nechaeva G.I., Viktorova I.A. Displaziia soedinitel'noi tkani: terminologiia, diagnostika, taktika vedeniia patsientov. Omsk: Tipografiia BLANKOM, 2007. [in Russian]
12. Zemtsovskiy E.V., Malev E.G. Malye anomalii serdtsa i displasticheskie fenotipy. SPb.: Izd-vo IVESEP, 2012. [in Russian]
13. Sharykin A.S., Subbotin P.A., Pavlov V.I. et al. Ekhokardiograficheskii skrining detei i podrostkov pri dopuske k zaniatiiam sportom. Ros. vestn. perinatologii i pediatrii. 2016; 1: 71–9. [in Russian]
14. Abouezzeddine O, Suleiman M, Buescher T et al. Relevance of endocavitary structures in ablation procedures for ventricular tachycardia. J Cardiovasc Electrophysiol 2010; 21: 245–4.
15. Hagen PT, Scholz DG, Edwards WD. Incidence and size of patent foramen ovale during the first 10 decades of life: an autopsy study of 965 normal hearts. Mayo Clin Proc 1984; 59: 17–20.
16. Cockerham JT, Martin TC, Gutierrez FR et al. Spontaneous closure of secundum atrial septal defect in infants and young children. Am J Cardiol 1983; 52: 1267–71.
17. Sharykin A.S, Yashina M.A., Shilykovskaya E.V. Klinicheskoe nabliudenie uvelicheniia diametra otkrytogo oval'nogo okna v podrostkovom vozraste. Ros. vestn. perinatologii i pediatrii. 2013; 1: 40–3. [in Russian]
18. Barthelmess A, Harten M, Mein G et al. The incidence and associated abnormalities of atrial septal aneurysms – A review of 106,418 Echocardiograms. Heart, Lung and Circulation 2012; 21: S143–S316.
19. Ozcelik N, Atalay S, Tutor E, Ekici F. Prevalence of inter atrial septal aneurysm in newborns and their natural course. Pediatr Cardiol 2006; 27: 343–6.
20. Di Tulllo MR, Sacco RL, Sciacca RR et al. Patent foramen ovale and the risk of ischemic stroke in a multiethnic population. J Am Coll Cardiol 2007; 49: 797–802.
21. Faggiano P, Frattini S, Piovesana P et al. Low cerebrovascular event rate in subjects with patent foramen ovale and different clinical presentations. Results from a prospective nonrandomized study on a population including patients with and without patent foramen ovale closure. Intern J Cardiol 2012; 156: 47–52.
22. De Mozzi P, Longo UG, Galanti G, Maffull N. Bicuspid aortic valve: a literature review and its impact on sport activity. Br Med Bull 2008; 85: 63–85.
23. Hepnera AD, Morrella H, Greavesa S et al. Prevalence of mitral valvar prolapse in young athletes. Cardiology in the Young 2008; 18: 402–4.
24. Sharykin A.S. Prolaps mitral'nogo klapana – izmeneniia v kriteriiakh diagnostiki i varianty techeniia zabolevaniia. Consilium medicum. Pediatrics (Suppl.). 2013; 2: 43–8. [in Russian]
25. Avierinos J-F, Gersh BJ, Melton J et al. Natural history of asymptomatic mitral valve prolapse in the community. Circulation 2002; 106: 1355–61.
26. Sharykin A.S., Popova N.E., Badtieva V.A. et al. Prolaps mitral'nogo klapana u iunykh sportsmenov. Ros. vestn. perinatologii i pediatrii. 2014; 59: 6: 40–5. [in Russian]
27. Wand O, Prokupetz A, Grossman A, Assa A. Natural history of mitral valve prolapse in military aircrew. Cardiology 2011; 118: 1: 50–4.
28. De Paepe A, Devereux RB, Dietz HC et al. Revised diagnostic criteria for the Marfan syndrome. Am J Med Genet 1996; 62 (4): 417–26.
29. Loeys BL, Dietz HC, Braverman AC et al. The revised Ghent nosology for the Marfan syndrome. J Med Genet 2010; 47 (7): 476–85.
30. Roman MJ, Devereux RB, Kramer-Fox R, O’Loughlin J. Two-dimensional echocardiographic aortic root dimensions in normal children and adults. Am J Cardiol 1989; 64: 507–12.
31. Beighton P, De Paepe A, Steinmann B et al. Ehlers-Danlos syndromes: Revised nosology, Villefranche, 1997. Am J Med Genet 1998; 77 (1): 31–7.
32. Belen'kiy A.G. Gipermobil'nost' sustavov i gipermobil'nyi sindrom: rasprostranennost' i kliniko-instrumental'naia kharakteristika. Avtoref. dis. … d-ra med. nauk. M., 2004. [in Russian]
33. Grahame R, Bird HA, Child A. The revised (Brighton, 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol 2000; 27 (7): 1777–9.
1 ФГБОУ ВО Национальный исследовательский Мордовский государственный университет им. Н.П.Огарева. 430005, Россия, Саранск, ул. Большевистская, д. 68;
2 ГБУЗ РМ Детская республиканская клиническая больница. 430032, Россия, Саранск, ул. Розы Люксембург, д. 15
*larisabalykova@yandex.ru
________________________________________________
S.A.Ivyanskiy1, L.A.Balykova*1, N.V.Shchekina2, A.A.Aritkina1, K.A.Varlashina1, A.A.Shirokova1, E.V.Gromova1
1 N.P.Ogarev National Research Mordovia State University. 430005, Russian Federation, Saransk, ul. Bol'shevistskaia, d. 68;
2 Children Republican Clinical Hospital. 430032, Russian Federation, Saransk, ul. Rozy Liuksemburg, d. 15
*larisabalykova@yandex.ru