ymjЯкутский медицинский журналYakut Medical Journal1813-19052312-1017ЯНЦ КМП10.1234/YMJ.2022.77.12ymj-93Research ArticleМЕТОДЫ ДИАГНОСТИКИ И ЛЕЧЕНИЯMETHODS OF DIAGNOSIS AND TREATMENTШкала оценки неврологического дефицита при ишемических инсультах у детей раннего возрастаAssessment of neurological deficit scale for ischemic stroke in early childhoodМининА. В.MininA. V.

Минин Алексей Владимирович – к.м.н., доцент.

Alexey V. Minin – M.D., Ph.D, Associate Professor of Neonatology Department (with courses in Neurology and Obstetrics-Gynecology), Faculty of Postgraduate and Additional Professional Education, St. Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation.

aleksey_minin@mail.ruПальчикА. Б.PalchikA. B.

Пальчик Александр Бейнусович – д.м.н., проф.

Alexander B. Palchik – M.D., Ph.D, Professor of Neonatology Department (with courses in Neurology and Obstetrics-Gynecology), Faculty of Postgraduate and Additional Professional Education, St. Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation.

ПшеничнаяК. И.PshenichnayaК. I.

Пшеничная Ксения Ивановна – д.м.н., проф.

Ksenia I. Pshenichnaya – M.D., Ph.D, Professor of Pediatrics, Endocrinology and Abilitology Department, Faculty of Postgraduate and Additional Professional Education, St. Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation.

ФГБОУ ВО СПбГПМУРоссияSt. Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian FederationRussian Federation202204022025014449Copyright © Минин А.В., Пальчик А.Б., Пшеничная К.И., 20252025Минин А.В., Пальчик А.Б., Пшеничная К.И.Minin A.V., Palchik A.B., Pshenichnaya К.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ymj.elpub.ru/jour/article/view/93

В статье раскрываются данные оригинального исследования по разработке клинической шкалы оценки выраженности неврологического дефицита у детей с ишемическими инсультами (ИИ) в возрасте до 2 лет (ШОНДИ РВ). Актуальность разработки ШОНДИ РВ обусловлена отсутствием возможности использования шкалы pedNIHSS у детей до 2 лет и ограниченными возможностями использования PSOM в острейшем и остром периодах ИИ у детей раннего возраста. Продемонстрированы клинические особенности течения ИИ у детей в возрасте до 2 лет, получавших лечение в детской клинической больнице №5 им. Н.Ф. Филатова за период с 2005 по 2021 г. Представлены данные статистического анализа, показывающие статистически достоверные связи результатов оценки по ШОНДИ РВ со значениями, полученными по шкалам PSOM и BMRC. Дополнительно статистический анализ продемонстрировал взаимосвязь между аллельными вариантами А/С и С/С гена MTHFR A1298C (p=0,044) у обследованных детей и более легкими вариантами течения ИИ при оценки по ШОНДИ РВ.

The article discusses the data of an original study on development of a clinical scale for neurological deficits severity assessing in children with arterial ischemic strokes (AIS) under the age of 2 years old (SANDYc). The relevance of SANDYc development is caused by inability to use pedNIHSS scale in children under 2 years of age and limitations of the PSOM using in the acute and subacute IS stages in young children. The study presents clinical features of IS course in 31 children aged up to 2 years old, being treated at children's clinical hospital N5 named after N.F. Filatova from 2005 to 2021. The statistical analysis data are presented, showing statistically significant correlations between the assessment results according to SANDYc and the values obtained according to the PSOM and BMRC scales. Additionally, statistical analysis demonstrated correlation between allelic variants A / C and C / C of the MTHFR A1298C gene (p = 0.044) in the examined children and milder clinical course of AIS as assessed by SANDYc.

шкала оценки неврологического дефицитаишемический инсультдетиострый периодклиническая оценкаneurological deficits severity assessment scaleischemic strokechildrenacute stageclinical assessmentReferencesМинин А.В. Факторы, влияющие на развитие и течение ишемических инсультов у детей/ Минин А.В., Пальчик А.Б., Плотникова С.Д. // Педиатр. – 2016. – Т. 7, № 4. – С. 102–108Minin A.V., Palchik A.B., Plotnikova S.D. Factors affecting on development and clinical course of ischemic stroke in children. Pediatrician. 2016; 4:102-108Особенности вариабельности сердечного ритма у пациентов с острым нарушением мозгового кровообращения в зависимости от локализации ишемического повреждения/ Николаев В.И., Денисенко Н.П., Брега А.В. [и др.] // Педиатр. – 2019. – Т. 10, № 3. – С. 63–69Nikolaev V.I., Dinisenko N.P., Brega A.V. [et al.] Peculiarities of the heart rate variability at patients with acute disorder of cerebral circulation depending on localization of ischemic damage. Pediatrician. 2019; 3:63-69Пальчик А.Б. Лекции по неврологии развития. 4-е изд. / Пальчик А.Б. – М.: МЕДПрессинформ, 2021. - 468 с.Palchik A.B. Lectures on Developmental Neurology/ Palchik A.B.// 4th ed.- MEDPressinform, M. -2021. - 468 p.Топическая диагностика заболеваний нервной системы. 8-е изд. / Скоромец А.А., Скоромец А.П., Скоромец Т.А. и др. // Политехника. - СПб., 2012. -622 с.Skoromec A.A., Skoromec A.П., Skoromec T.A. [et al]. Topical diagnosis of nervous system diseases. 8th ed. // Polytechnics. SPb;2012. - 622 p.Freundlich C.L. Pediatric stroke. / Freundlich C.L., Cervantes-Arslanian A.M, Dorfman D.H. // Emerg Med Clin N Am. – 2012. -30(3). -805–828Freundlich C.L. Pediatric stroke. / Freundlich C.L., Cervantes-Arslanian A.M, Dorfman D.H. // Emerg Med Clin N Am. – 2012. -30(3). -805–828Gemmete, J.J. Arterial ischemic stroke in children/ J.J. Gemmete, I. Davagnanam, A.K. Toma et al. // Neuroimaging Clinics of North America. – 2013. – Vol. 23. - №4. – P. 781-798Gemmete, J.J. Arterial ischemic stroke in children/ J.J. Gemmete, I. Davagnanam, A.K. Toma et al. // Neuroimaging Clinics of North America. – 2013. – Vol. 23. - №4. – P. 781-798Ichord R.N., Inter-rater Reliability of the Pediatric NIH Stroke Scale (PedNIHSS) in a Multicenter Study. Stroke; a journal of cerebral circulation/ Ichord R.N., Bastian R., Abraham L. [et al.] // 2011. -42(3). -613-617Ichord R.N., Inter-rater Reliability of the Pediatric NIH Stroke Scale (PedNIHSS) in a Multicenter Study. Stroke; a journal of cerebral circulation/ Ichord R.N., Bastian R., Abraham L. [et al.] // 2011. -42(3). -613-617Kitchen, L. The pediatric stroke outcome measure: a validation and reliability study / L. Kitchen, R. Westmacott, S. Friefeld [et al.] // Stroke. – 2012. –Vol. 43. - № 6. – P. 1602-1608Kitchen, L. The pediatric stroke outcome measure: a validation and reliability study / L. Kitchen, R. Westmacott, S. Friefeld [et al.] // Stroke. – 2012. –Vol. 43. - № 6. – P. 1602-1608Lopez-Vicente M. Diagnosis and management of pediatric arterial ischemic stroke/ Lopez-Vicente M., Ortega-Gutierrez S., Amlie-Lefond C. [et al.] // J Stroke Cerebrovasc Dis. – 2010. -19(3). -175–183Lopez-Vicente M. Diagnosis and management of pediatric arterial ischemic stroke/ Lopez-Vicente M., Ortega-Gutierrez S., Amlie-Lefond C. [et al.] // J Stroke Cerebrovasc Dis. – 2010. -19(3). -175–183Medical Research Council (Great Britain). Aids to the examination of the peripheral nervous system. - Memorandum no. 45. - Her Majesty's Stationery Office: London. – 1976. – 11 p.Medical Research Council (Great Britain). Aids to the examination of the peripheral nervous system. - Memorandum no. 45. - Her Majesty's Stationery Office: London. – 1976. – 11 p.Prechtl H.F.R. The Neurological Examination of the Full Term Newborn Infant/ Prechtl H.F.R. // Clinics in Development Medicine, №63. – London–Philadelphia, SIMP/Heinemann. – 1977Prechtl H.F.R. The Neurological Examination of the Full Term Newborn Infant/ Prechtl H.F.R. // Clinics in Development Medicine, №63. – London–Philadelphia, SIMP/Heinemann. – 1977Tong, E. The role of imaging in acute ischemic stroke / E. Tong, Q. Hou, J. B. Fiebach [et al.] // Neurosurgical Focus. - 2014. - Vol. 36. - №1. - P. 3-13Tong, E. The role of imaging in acute ischemic stroke / E. Tong, Q. Hou, J. B. Fiebach [et al.] // Neurosurgical Focus. - 2014. - Vol. 36. - №1. - P. 3-13Volpe J.J. Neurology of the newborn./ Volpe J.J. // 5th ed. – Philadelphia: Elsevier. - 2008. – 1094 p.Volpe J.J. Neurology of the newborn./ Volpe J.J. // 5th ed. – Philadelphia: Elsevier. - 2008. – 1094 p.

The authors declare that there are no conflicts of interest present.