MPU 05 2023 Web

СУЧАСНА ISSN 26637553
П Е Д І АТ Р І Я
УКРАЇНА

MODERN PEDIATRICS. UKRAINE
©§¡
! "! ! # $ %
' %()*+!, # -+ .# /!
-. -+ ! 0
Читайте нас на сайті: http://medexpert.com.ua
SHUPYK NATIONAL HEALTHCARE UNIVERSITY OF UKRAINE
MODERN PEDIATRICS. UKRAINE

, Doctor of Medical Science, Professor of Pediatrics, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine

!, Doctor of Medical Science, Professor of Pediatrics, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
", Professor, CEO of Clinic of Asthma, Allergy and Chronic Lung Diseases, CEO of EduCom (postgraduate education), Executive
Committee member & Treasurer of European Academy of Paediatrics (EAP/UEMS SP), Vilnius, Lithuania
#$
% & %, Doctor of Medical Science, Professor of Pediatrics, Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine;
%& '() Doctor of Medical Science, Professor, Deputy Rector of the Shupyk National University of Health of Ukraine, Kyiv,
Ukraine
*
*$& +,) Academician of the National Academy of Medical Science of Ukraine, Director of the SI «Institute of Pediatrics, Obstetrics
and Gynecology named after academician O. Lukyanova of the NAMS of Ukraine», Kyiv

% & ', Doctor of Medical Sciences, SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova
of the NAMS of Ukraine», Kyiv
- # D.O. Bakhtiyarova
/ I.O. Sheiko
0 V.S. Scherbatykh
#!6('!* (*'#
Abaturov A.E. (Dnipro, Ukraine) Kvashnina L.V. (Kyiv, Ukraine) Prodanchuk M.G. (Kyiv, Ukraine)
Aryayev M.L. (Odesa, Ukraine) Kosakovskyi A.L. (Kyiv, Ukraine) Puzievicz—Zmonarska A. (Wroclaw, Poland)
Banadyga N.V. (Ternopil, Ukraine) Kramarev S.A. (Kyiv, Ukraine) Rosenthal M. (London, Great Britain)
Beketova G.V. (Kyiv, Ukraine) Curteanu A.M. (Chisinau, Moldova) Simanis R. (Riga, Latvia)
Bogmat L.F. (Kharkiv, Ukraine) Labbe A. (Clermont—Ferrand, France) Slabkiy G.A. (Uzhhorod, Ukraine)
Vaildeliene L. (Kauno, Lithuania) Livi P. (Florence, Italy) Smiyan A.I. (Sumy, Ukraine)
Veres Gabor (Budapest, Hungary) Linne T. (Stockholm, Sweden)
Umanets T.R. (Kyiv, Ukraine)
Volokha A.P. (Kyiv, Ukraine) Mazur A. (Warsaw, Poland)
Urbonas V. (Vilnius, Lithuania)
Gorovenko N.G. (Kyiv, Ukraine) Marushko Yu.V. (Kyiv, Ukraine)
Usonis V. (Vilnius, Lithuania)
Hubertus von Voss (Munich, Germany) Nakonechna A. (Liverpool, Great Britain)
Dudnik V.M. (Vinnytsia, Ukraine) Nyan’kovskyi S.L. (Lviv, Ukraine) Hadjipanayis A. (Nicosia, Cyprus)
Yemets I.M. (Kyiv, Ukraine) Ovcharenko L.S. (Zaporizhzhia, Ukraine) Husain S. (London, Great Britain)
Zaychenko A.V. (Kyiv, Ukraine) Okhotnikova E.N. (Kyiv, Ukraine) Chernyshov V.P. (Kyiv, Ukraine)
Zvolinska D. (Wroclaw, Poland) Pagava K.I. (Tbilisi, Georgia) Shadrin O.G. (Kyiv, Ukraine)
Ivanov D.D. (Kyiv, Ukraine) Pilossoff V. (Sofia, Bulgaria) Soder O. (Stockholm, Sweden)
Yspaeva Zh.В. (Almaty, Kazakhstan) Pochinok T.V. (Kyiv, Ukraine) Shun’ko E.E. (Kyiv, Ukraine)
1!2' ,'(1 (3 (% *4! %# 5 '6)

!"#$ % '# *
Published with the scientific support of the SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O. Lukyanova
of the National Academy of Medical Science of Ukraine»
Publishing frequency — 8 Times/Year
By the order of the Ministry of Education and Science of Ukraine No. 1166 from December 23, 2022, the journal «Modern Pediatrics. Ukraine» is included in the
List of specialized scientific editions of Ukraine in the field of medical sciences, 0 "
Recommended by the Shupyk National Healthcare University of Ukraine, Protocol No. 07 from 13.09.2023
Passed for printing 25.09.2023
% 0 ; > 8-0 ?@ + + All articles are reviewed. Total or partial
GROUP OF COMPANIES MED EXPERT, 3 $ +% * reproduction by any means of the materials
«MODERN PEDIATRICS. UKRAINE» 7 $ "$ 0 + published in this edition is allowed only by written
+-# 0 123 45 6 ?% - * permission of the publisher. Advertiser takes
7$- 89 :*0 66 6000 !% $ $ JQ" +W responsibility for the content of advertisements.
< $9 +% =%8+ " + " ! $ 2 Z
+9--%8+ " 123 $ [66\ 66
]^ 0
© Shupyk National Healthcare University of Ukraine, 2023

© Bakhtiyarova D.O., 2023
«MODERN PEDIATRICS. UKRAINE» Journal was indexed and/or presented in: Scopus, DOAJ, Hinari, BASE,
WordCat, Google Scholar, CrossRef, Ulrich’s Periodicals Directory, Sherpa Romeo, InfoBase Index, Scientific
Periodicals of Ukraine, Bibliometrics of Ukrainian Science (the Vernadsky National Library),
Ukrainian abstract journal «Dzherelo»
Attention! Subscribe to «MODERN PEDIATRICS. UKRAINE»

Subscription index 09850
7 898:
_]`jq_]z{_|} ~_j| qqq_| qq ~]_| j_j z ~|]
<=>"<?" @BFG"HJGL =QJ"V?"

?WXYZ[Z\]WY^_à_b \cdeW^]_à_b fX]aWg
hci]cdWY^Z]
jc]cfa_b kk _~q ~ z ~
lZgZ[a_b ]cdWY^Z]
>c]a_mZ[W nG _~q ~ z ~
kWgeXgeo " ¡ ¢ £ <%"
[¤ \ ¥ ¡ ¦ § [<Q!-4<¨Z Z!\ £ z
pWo^X\a_Y_ qZgZ[aZqZ ]cdWY^Z]W
rWscaYZ rt _~q ~ z ~
rZeocuaYZ Jv, ¡ ¢ ¡ ¦ _~q ~
z
lZgZ[a_b aWXYZ[_b YZaoXgw^Wa^
"a^_\Yea xl) _]_ ~ ~ Jj] q z ¤ _]_ ~W
?WXYZ[_b ]cdWY^Z]
rW]XmYZ Jk ~ Jj] q z ¤ _]_ ~W
F_]cY^Z] \]ZcY^X q © ¤
ked\Z[edWgwa_b ]cdWY^Z] jq
kc]o^YW ^W d_yWba ª¦
JBF"Q{G~?" QvnBlGL
]¦ q§ [ ~\ ° z [ ~\ ¡ [ ~\
]¤® z [q ~\ ]z [ ~\ ¢®¡ ] [¬ ³\
© _ [ ~\ q [ ~\ ¢ [z ©¤\
© [ ~\ ¤ ] [° \ [ z¤\
© z² [ ~\ z¦¦ ] [² ²¬¤\ ¦ q [~ ~\
® z [ z\ z [²¬¤ j¤\ ¤ ]j [ ~\
° ¦ [©° ~³\ z [ ¬¤\
~¬ [ ~\
] [ ~\ ¢ ] [° ³\
~¦ [£ z\
_ [ ~\ ° µ [ ~\
~ [£ z\
¦ ² [£ _¡¡\ _¡ ] [z ©¤\
[¬¤ ~\ _¤ z [z ~\ ] [_¤ \
§¬ j [ ~\ q¡ z [¤ ~\ [z ©¤\
¡ [ ~\ q q [ ~\ ¥° [ ~\
[¬ ³\ j [¦ ¢¤\ q [ ~\
j [ ~\ [¤ ©¤\ q [ ¬¤\
j® ´© [] ¢ \ ¡ [ ~\ §§ [ ~\
kzF"kB{| Hvk }lJ=@" Qvr@"?G~ rBF BQ<@BJH

¬ ®¬£ | ¯
®¤ ¢ ~ Jj ° q z ¤ _]_ ~W
®¤ ¢ ¤ *
@c]eZd_àeo^w [_ZdX ]Wye[ aW ]eY
_¢ q_ ~ * ¯ J¡ ¤ ~W £¡ YW^cqZ]e "
¬¢ ~ ¢ ¡ ~ ¦ ¦ ¢
¬ ¦
pW^[c]dfcaZ ¡£ £ _¬ ¢ ¤ ~ z ** ¯
*
"d]coW dg g_o^X[Waa; ² 8-0 ] ¯ 0
q J W ~ ~¡ * ¬¢ ¦ ¡
J¡ ¤ ~W 0 ¤ ¦¤ ¦
- 0 ~ 6 - * ¦ ¬
Hcg iWYo; :*0 66 6000 _ ¢ ®¤ ¢ ¢
; +% =%8+ " J]W ¡ ¬
$; /$ [66\ 66 ¢ ¢
¬ ¦ ® ¡ 9 ¬
± _¬ ¢ ¤ ~ z *

± © ¤ q *
Журнал «Сучасна педіатрія. Україна» включено до науковометричних, реферативних та пошукових баз даних:
Scopus, DOAJ, Hinari, BASE, WordCat, Google Scholar, CrossRef, Ulrich’s Periodicals Directory, Sherpa Romeo,
InfoBase Index, «Бібліометрика української науки», «Наукова періодика України»
(Національної бібліотеки України імені В.І. Вернадського), «Джерело».
"" #$% &'$()% **+, -/%1

2" 34# $ )*6 **%%+6 7:+7-$ -/%",
%"; *%-) <=>?<
Q_[ 898:
?"{Gv?"n|?z~ =?GkBJ<zHBH 21 +7 4*6!(4*

vvJv?z pFvJvkL =QJ"V?z 2*62*' 14!'!6+
GrB?G @n h=@zQ" (3 17'*!4
<=>"<?" @BFG"HJGL
=QJ"V?"
?WXYZ[Z\]WY^_à_b \cdeW^]eà_b fX]aWg
MODERN PEDIATRICS.
UKRAINE

:: 898:
CONTENT
ƧƩơƜƐƦƙƤƵƦƐƝƧƪƤƐƝƟƞƦƦƸ 36-+-2%0%68-'0)7
ǃǗǢǱǜǠǔǒƩǐƼǢǒǞǒǢǮǠǔǃǀ 6 6HULDNRYD,<X.UDPDURY62
ƧǔǤǥǪǗǟǜǠƴƴƼǚǢǚǨǱƿǃ <HYWXVKHQNR99.\U\WVLD16
ǊǒǖǢǷǟƴǀƴǠǢǠǟǠǔǀǀ 6KDGULQ929RURQRY22
ǊǡǒǜƩƴǁǒǝǒǤǟǒƽǀ 6KSDN,93DODWQD/2
ƼǥǢǒǜǠǔǒƽǂǈǚǞǓǒǝǗǟǜǠƲƾ .XUDNRYD/57V\PEDOHQNR$0
$ + / 1 % , 289:;<=8>?@A89>B>CDE:8E8FD;G
.234561 %# ?H;A:9DGI;CH234561;GJK98;G;8G
ƿǷǜǥǝǷǟǒƲ M 1LNXOLQD$
L + 9>MNO' P;FG;Q?8G?D<RCHD9>MNO=89;8GC
! / <RCHD?H<AD?B>C<K;G;GFDGD;GCHD
. + :D=DA<SEDGC<R<TD>;CB;G?H;A:9DG;G
'# UGFA;>H
ǄǜǒǩǥǜǂƴƼǠǝǠǣǜǠǔǒǀƼƵǒǢǒǣƾƿ N 7NDFKXN59.RORVNRYD2.*DUDV
ƳǷǝǠǥǣǄƾƲǟǤǠǟǷǛǩǥǜƴƩ 01%LORXVǄƾ$QWRQLLFKXN9,
V "/% W<>>;T;A;C;D><R=D9;Q?8C;<G<R
.' # % , % ?<EE@G;CB18?X@;9D:SGD@E<G;8
..,, ;G?H;A:9DGTB?H8GFD>;G
-' , % E@AC;S898EDC9;?S<A89;Y8C;<G1SH8>D
+ ./ 1". %, % E;?9<>?<SB<RS<AB?9B>C8AA;GD
! ' ' EDET98GD><RS@AE<G89BDZS;98C<9B
%# ?<G:DG>8CD;GJK98;G;8G
ƾǒǜǵǵǔǒƿƩƲǟǖǢǥǫǗǟǜǠƴƴ 0DNLHLHYD1,$QGUXVKFKHQNR99
[ - +, \HD=<G];AADT98G:R8?C<9
+ # % 8>8E89KD9<RS89C;8AAB
- !# %, ?<GC9<AAD:8>CHE8>D=D9;CB
'# ;G?H;A:9DG;GUGFA;>H
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 3

ǂǒǜƽƩƼǒǪǷǟǒǑǢǞǒǜƴƽ 5DN/,.DVKLQD<DUPDN9/
ƧǫǗǟǜǠƲƴ <HVKFKHQNR$9
[.# WHB>;?8A8?C;=;CB<RCDDG8FD9>
, ! /# ' -, + ;G?<G:;C;<G><R><?;8A9D>C9;?C;<G
%# ;GJK98;G;8G
ǄǠǜǒǢǩǥǜƿƩǀǔǗǢǩǥǜƲƲ NM 7RNDUFKXN1,2YHUFKXN$$
L ++ %, 48A@D<R=8>?@A89?DAA8:HD>;<G
% ' .%1-22O E<AD?@AD18G:22OS9<CD;G;G
- ! # ' T9<G?H;<A;C;>;GB<@GF?H;A:9DG;G
%# JK98;G;8G
ƶǢǥǨǥǝƾǗǝǮǟǚǜƿƴƩǔǒǟǠǔǒƽƲ 'UXWVXO0HOQ\N19,YDQRYD/$
ƵǠǢǓǒǤǰǜƩƳǊǜǷǝǮǟǰǜƲǀ +RUEDWLXN,%6KNLOQLXN$2
^ - -'234561 `D8C@9D><R234561;GCDDG8FD9>0
0_ 2A;G;?8A?8>D>;GUGFA;>H
'#
ƼǠǢǟǷǛǩǥǜǀǁǄǚǞǩǥǜƩƴ .RUQL\FKXN237\PFKXN,9
ǆǗǢǗǟǨƿƾƼǠǟǗǩǟǚǛǐǄ )HUHQWV10.RQHFKQ\L<7
a , ., - + c98E1S<>;C;=DE;?9<T;<C8
/" /* 8>S<CDGC;8AR8?C<9>
b+.!. +,, % <RHD8ACH?89D18>><?;8CD:;GRD?C;<G>
, '* ! ;G?H;A:9DG8G:8:@AC>
%# ;GJK98;G;8G
ƳǗǢǗǣǤǠǔǚǛƴǀƹǗǝǷǟǣǮǜǒǀƴ O %HUHVWRY\L92=HOLQVND29*HUHYLFK
ƵǗǢǗǔǚǩƿƴƵǠǔǣǵǵǔƶǀ 19*RYVLHLHY'2
[ . + f;>KR8?C<9>R<9
+ / SA8?DGC8S9D=;88E<GF
'!_d*$ %e S9DFG8GCI<EDG<RgB;=*
' JK98;GDe89DC9<>SD?C;=D
+'# ?<H<9C>C@:B;GUGFA;>H
ƼǠǝǠǣǜǠǔǒǀƼǄǒǢǟǒǔǣǮǜǒǃƩ M .RORVNRYD2.7DUQDYVND6,
ƳǥǢǚǟǰǜƵǝǠǔϙǱǜǇǁǊǒǧǠǔǒǀǀ %XU\QǷXN+ORYǷDNƼ36KDNKRYD22
ǁǚǤǝǚǜǑǫǗǟǜǠƾǀ 3\WO\N<DVKFKHQNR02
_ 1 , #*/ ' 2A;G;?8A1;G>C9@EDGC8A*
", , , ?BC<A<F;?8A8G:;Gi8EE8C<9B
, ' !#!h+! E89KD9><R8;9I8B9DE<:DA;GF
! !- !#, ;G?H;A:9DGI;CHT9<G?H;8A8>CHE8
%# ;GJK98;G;8G
ƽǱǧƼƴƼǠǣǒǜǠǔǣǮǜǚǛƲƽ /LDNK.9.RVDNRYVN\L$/
ǊǜǠǢǓǠǤǥǟǑƴ 6KNRUERWXQ<D9
^/ /% - ' j>>D>>EDGCCHD;ES8?C<RCHDC<9@>
, - ,, , C@T89;@>?<99D?C;<GTBS<ID91
"/! % 8>>;>CD:CD?HG;X@D<GCHDDX@;S9D>><9
-'# D@>C8?H;8GC@TDR@G?C;<G;GUGFA;>H
ǁǥǕǒǩƲƾƳǠǟǖǒǢǗǟǜǠƲƴ 3XJDFK$0%RQGDUHQNR$9
^-.#,-!-#k jI89DGD>><RR@C@9DS89DGC>8T<@C
//% %# =8??;G8C;<G;GJK98;G;8G
4 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

ƧƜƤƸƝơ 6):-);7
ƾǒǢǥǪǜǠǐƴƵǚǫǒǜǄƴ 0DUXVKNR<X+\VKFKDN7
ƶǞǚǤǢǚǪǚǟǀƲ 'P\WU\VK\Q2
ƶǞǚǤǢǚǪǚǟƳǑƾǚǜǒƾǐ 'P\WU\VK\Q%0\ND0
l #,' '.,. % m8FGD>;@Eb>9<AD;G8HD8ACHBSD9><Gb>
-' -/% + T<:B*;GCHD?<@9>D8G:9DH8T;A;C8C;<G
%" / % '% 8RCD9;GRD?C;<@>9D>S;98C<9BS8CH<A<FB
234561 , * 8G:234561A;CD98C@9D;GR<9E8C;<G*
%# <IG:8C8;GJK98;G;8G
ƣƤƐƦƐưƦơƢƛơƨƙƝƧƣ '0-2-'%0'%7)
ƵǷǝǮǦǒǟǠǔǒƲƾƹǒǓǒǢǒƶƴ M +LOIDQRYD$0=DEDUD'9
ƽǚǣǚǨǱǀƴƴǠǝǜǠǔǒƲƴ /\V\WV\D299RONRYD$9
n /+' , ! oDE8C<S<;DC;?>CDE?DAA
- ! /d C98G>SA8GC8C;<G;GS8C;DGC
. "/ ,632ge %# I;CH632g:DQ?;DG?Be
'# JK98;G;8GDZSD9;DG?D;GUGFA;>H
ǁǠǩǚǟǠǜǄƴƽǥǤǒǛǄƩƵǠǢǠǓǗǨǮƿƩ 3RFK\QRN79/XWDL7,*RUREHWV1,

p k ' - 6;8FG<>C;??<ESA;?8C;<G>;GCHD:DT@C
, ' ' <R>B>CDE;?A@S@>D9BCHDE8C<>@>;G
%# ?H;A:9DG;GJK98;G;8G
ƳǠǱǢǩǥǜǀǂƴǠǝǱǟǣǮǜǒƽƲ %R\DUFKXN259ROLDQVND/$

p , , + PD;Y@9D>;G8CDDG8FD98>8
+ , /%X0 E8G;RD>C8C;<G<RX0:DADC;<G
%# >BG:9<ED;GJK98;G;8G
ƶǥǤǩǒǜƵƾǃǚǟǠǔǗǢǣǮǜǒǀƳ 'XWFKDN+06\QRYHUVND2%

ƲǝǗǜǣǗǵǔǒǐƩǈǒǢǥǜǀǑ $OHNVHHYD<X,7VDUXN2<
ƼǥǙǗǟǜǠǀƴ .X]HQNR29
q /" % r<G>SD?;Q?8<9C<89CD9;C;>
! -n+e \8K8B8>@b>:;>D8>De
/ 8?A;G;?8A?8>D;GSD:;8C9;?
%# S98?C;?D;GJK98;G;8G
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 5

ÎÐÈÃ²ÍÀËÜÍ² ÄÎÑË²ÄÆÅÍÍß
~ 9:
1 1 1
1 1 1 1

! " 1 # 2$%&' " 2
$ + / 1 % ,

.234561
1
2 ! " #
Modern Pediatrics. Ukraine. (2023). 5(133): 6-16. doi 10.15574/SP.2023.133.6
`<9?;C8C;<GeSeriakova IYu, Kramarov SO, Yevtushenko VV, Kyrytsia NS, Shadrin VO, Voronov OO et al.(2023). Cardiovascular system
damage in children with COVID-19. Modern Pediatrics. Ukraine. 5(133): 6-16. doi 10.15574/SP.2023.133.6.
V
!"#$%&'
V , 0( )* ) ++ , %
%+ * !"#$%& - - '.
/0(1/ 2 2 3 4'5* * 6- 7
) 8 9: , * !"#$%&; 2 9< , *
6- '= 6 2 3>/?@) , '(
* 66 8 ** * , 2
8 2 3 '= )
'. 6 62 1ABCBDEBDFCGEHIBJCKLMNOP'%'Q94'
l .#0R , 2 %:)S:T%)U V)
*%Q)S9T%)& V>WXS)SY9@'Z - ) %S V
- 6 !"#$%&
>[S)SQ@'\ - 6*], 6 /?'
0= !"#$%&
'Z %S V -, 2 6
>[S)SQ@ *], 6 2* >[S)%@'
. ?2 2 '( 6 ^ 2
* '( 2 , * ) 2 2 6
, '
_ - 2 23 '
_ e!"#$%&) ) ) ) ) '
289:;<=8>?@A89>B>CDE:8E8FD;G?H;A:9DGI;CH234561
()*+,-./034/1+56-/7/-34188),49*:;,<031=+6>->9:./185+;/?-.<1
5583-3<341(8+;@/01A5B/C/9</1AD6*-/034/2EFG:>7H/C,<032
%`HaHbHGLBEcCBDHdCGeLfDFCGgdDPLKEDBh)ihDP)gjKCDdL
:ihDPDBhkDGfKLd]EGDdDFCG#dILFBDHlE$DELCELEmHEWDBCG)gjKCDdL
W@9S<>DBHCEELEEBkLfDCadHEBDFCdfWKHadHEBDFPCGlLHIBkLMELGLFBDdbCKjLKDdKLGCBDHdBHbCdDILEBCBDHdEHIfCbCaLBHBkLFCKfDHPCEFlGCK
EhEBLbDdFkDGfKLdJDBk!"#$%&'
m8CD9;8A>8G:EDCH<:>0nLFHdflFBLfCFHkHKB)HoELKPCBDHdCG)KLBKHEWLFBDPLEBlfhDdPHGPDda++WCBDLdBECaLf%bHdBkBH%+hLCKEJDBk
GCoHKCBHKhFHdIDKbLf!"#$%&ohWHGhbLKCELFkCDdKLCFBDHd'pkLFkDGfKLdJLKLkHEWDBCGDqLfDdihDPDBhkDGfKLd]EGDdDFCG#dILFBDHlE$DELCEL
mHEWDBCG'nLfDPDfLfBkLLrCbDdLfFHkHKBDdBHBJHaKHlWECFFHKfDdaBHBkLFHlKELHIBkLfDELCELBkLbCDdaKHlW)JkDFkDdFGlfLf9:WCBDLdBE
JDBkCFHbWGDFCBLfFHlKELHI!"#$%&)CdfBkLFHdBKHGaKHlW9<WCBDLdBEJDBkCdldFHbWGDFCBLfFHlKELHIBkLfDELCEL'#dBkLEBlfh)JL
BHHjDdBHCFFHldBBkLfCBCHIMs)WCBDLdBFHbWGCDdBECdfFGDdDFCGEhbWBHbE'$lKDdaBkLFHbWKLkLdEDPLLrCbDdCBDHdHIBkLWCBDLdBEHdBkLIDKEB
fChHIBkLDKEBChDdBkLkHEWDBCG)BkLoGHHfELKlbHIBkLWCBDLdBEJCEFHGGLFBLfIHKBkLWlKWHELHIDBEIlKBkLKLrCbDdCBDHdIHKBkLGLPLGHIMELGLFBDd
ohLdqhbLDbbldHCEECh'ABCBDEBDFCG)CdCGhBDFCGbLBkHfECdfBkLbLBkHfHILbWDKDFCGKLELCKFkJLKLlELfDdBkLKLELCKFk'pHFCGFlGCBLBkL
HoBCDdLfKLElGBE)JLlELfBkLEBCBDEBDFCGWKHaKCb1ABCBDEBDFCGEHIBJCKLMNOP'%'Q94'
fD>@AC>0 #d WCBDLdBE HI BkL FHdBKHG aKHlW) MELGLFBDd JCE HoELKPLf CB BkL GLPLG HI %:'S:T%'U daVbG) JkDGL Dd BkL FkDGfKLd HI BkL bCDd HdL)
BkL DdfDFCBHK JCE kDakLK) DB JCE %Q'S9T%'& daVbG >WXS'SY9@' tFFHKfDda BH BkL CEELEEbLdB HI BkL WKHadHEBDF PCGlL) JL IHldf BkCB Cd
DdFKLCELDdBkLGLPLGHIMELGLFBDdCoHPL%SdaVbGDECEEHFDCBLfJDBkCEDadDIDFCdBDdFKLCELDdBkLKDEjHIBkLCWWLCKCdFLHIFGDdDFCGEhbWBHbE
HIBkLFCKfDHPCEFlGCKEhEBLbDdFkDGfKLdJDBk!"#$%&>W[S'SQ@'nLCGEHdHBLfCBLdfLdFhIHKBkLbCKjLKBHaKHJJDBkHouLFBDPLFkCdaLEHd
BkLMs'
2<G?A@>;<G>0 nL fDEFHPLKLf BkL fDCadHEBDF Cdf WKHadHEBDF PCGlL HI BkL MELGLFBDd bCKjLK Dd FkDGfKLd JDBk !"#$%& KLaCKfDda
BkLbCdDILEBCBDHdEHIfCbCaLBHBkLFCKfDHPCEFlGCKEhEBLbDdFkDGfKLdJDBk!"#$%&'tdDdFKLCELDdBkLGLPLGHIMELGLFBDdCoHPL%SdaVbG

DECEEHFDCBLfJDBkCEDadDIDFCdBDdFKLCELDdBkLKDEjHIBkLCWWLCKCdFLHIFGDdDFCGEhbWBHbEHIfCbCaLBHBkLFCKfDHPCEFlGCKEhEBLb>W[S'SQ@
CdfHouLFBDPLFkCdaLEflKDdaDdEBKlbLdBCGLrCbDdCBDHd>W[S'%@'
pkLKLELCKFkJCEFCKKDLfHlBDdCFFHKfCdFLJDBkBkLWKDdFDWGLEHIBkLmLGEDdjD$LFGCKCBDHd'pkLEBlfhWKHBHFHGJCECWWKHPLfohBkLvHFCGMBkDFE
HbbDBBLLHIBkLWCKBDFDWCBDdaDdEBDBlBDHd'nKDBBLdFHdELdBIKHbWCBDLdBEJCEdHBKLwlDKLf)CEBkLEBlfhDEKLBKHEWLFBDPLCdflELEfCBCIKHb
KHlBDdLbLfDFCGKLFHKfE'
cHFHdIGDFBHIDdBLKLEBEJCEfLFGCKLfohBkLClBkHKE'
gDBI<9:>e!"#$%&)FCKfDHPCEFlGCKEhEBLb)MELGLFBDd)FkDGfKLd)bCKjLK)FHbWGDFCBDHdE'
ko^X\ ¬ ¢£

[]²\ ]² £¤
~
¡ £ ° ¬ ³ °¤
¤ ¡ ® ¢ ¤¡ ¢¤ ¤¬ ¬ ¬ Â0Ã
¢ £ £ £ ¿ ¥ £
¬ [?ÀÁ'\ ¤ ¦¡
¢¬ ¢ ¤ ?ÀÁ' ¤££¡
* ¬ ¡¢ ¤
¢® ¦ ¢¤ ¬ ]² ¡
¢ £¤ ¬ ¡¢ ¦ ¡
~ ¿ ¤¬ ¦ ¬
¢¤¬ Ç5%$ [\
Â0Ã ¡ ¤¤ ¦¢¡ ¬® ¢ ¤£ £ ?ÀÁ' ¢¡
¢ ¡ ¢ ¡ ¢ £ ³®¤ ¢ ¦¢
¤ £ ¢ ¦¦ ¦¦
¢ ¡ ¤¤ ³ ÂÃ
¬ ¢ £¤ ® ¤ ?ÀÁ' ¢
¤ ¦ ¤ ¦ ¤£®¤
ZQÆZ À
¢¤ ¢ ¬ ¢ ¤
Â*Ã ¢ ¡ ¢ ¡
?ÀÁ' ¢®¤ ° ¡ ¬£¢ ³
¤ ¢ ¤ °¡
Ä ¦¤¬ °¡ ÂÃ
¢ ¬® ¢ ?ÀÁ' ¤¤£¤ ~ ¢ ¤ ¬
¬¤ ¤ *Ä ?ÀÁ' ¦ ¢¤
® ¬ Ä ¢9 ¤ °¤
®¤ °¤ ZQÆZ ÀÈ ¤È
° Å66Ä ¿ ÂÃ ]² È
¤ ¢¤ [J¬ °W\
?ÀÁ' ¬¤ °¤ ¤ ¬ ¤
ZQÆZ À ¬ ¤ ¢¦°¤
¡ ¦®¤ ¬¤ ¤ ¢
¢ ¤ ££ °¤ ¡ ¦
¢ ¢¤ ¡ ¤ ¡ ¢
¬¤ ³¤ ¤ ¢ ° ¢
¬ Â*Ã ÂÃ
¬ ® £ ¡ ³ ¦ ®® ³
£ ¬® ¢ ?ÀÁ' ³ ® ® ¤ £
¤ ¢ ¢ ¬ ¢ ¡¢
¤ £¡ ¦¡ ¢ ¢¡¤ ZQÆZ À ® £¡
¤ ¤ ZQÆZ À ¤® ¢® ¢
¢ £ ¡¢ ¢ ¤¢¤ ¬ ³ ¤® ¢
Z+5 ¤ ¢ ¦¤ ¦¢
¬ ¦£ ¢£ ~ É À [\
¤ ®£ ¡£ ®¤ ¢¤ ¢ ¤ ZQÆZ À
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 7

¢ ³ ¢® °
¢®¢ ¤¢ ® ]² ¡ £ Â0Ã
?ÀÁ' Â*Ã ZQÆZ À ¤¡ ³
Q²¬ ¡¤£ °¤ ?ÀÁ' ® ¢
¬ ¢ [¨ÁZ\ ` ®
[]]\ `¤ ® ¢ ¦ ¤ ¢¡®¤ ÊÄ
¢ £ ¬®£ ZQÆZ À ÂÃ
~ ¬ ¤£® ¢ ` £
¤ £ ?ÀÁ' ]² ¢ £ ['\ ¡
¦ ¡ ¢ ¤¬ ]] ¤ * ] ¢®
£¡ ]² _° ¬ ]²¢ 6 ¨ÁZ ¢ ¤
¢ ÁÁ ¢ ¬® ¢
¢ ¤ ¨ÁZ Â*Ã
¢ ¢¡ £ ¬®£
¬® ® ¤£ ¨ÁZ
Â6Ã ¬ ]² ]² ¢¤ ° ~ ¡ ¤
¬ ¦¬ ]² ¢³£® £ [Ä\ ¢ °
¦ ¢ ¦ ¢ ° ¢9 ¦
Q¦ ¤ ¢³££¤ ¦£¤ £ [ÅÄ\ [6ÅÄ\
®£ ]² ~ ¢ ¦¤ Q² £ [*Å0Ä\ ¤ ¢
¡®¤ ¢Q¦ ®£ ¤ ¦ [ ¦¤ ¦ J
£¤ ¤ ¦¬ ¡W ¤¢\ [ÅÄ\
] ¦¬ ££¤ [ ¦ ¤
¢¡ °° ¢ \ [Å0Ä\
¡ ³ ¬® ¢ ?ÀÁ' ¡®¤ [ÅÄ\ ¦ [ÅÄ\ £
³ ¬ ¢ ³ ® [0ÅÄ\ ¦¤ - [0ÅÄ\
¢ ¤ ¦¢ ÂÃ £ [ÅÄ\ ÂÃ
q ¢ ¦° ~ ¢ ¨ÁZ ®
³ ¤ ?ÀÁ' ¤ ¤ ¤ ³ £¡® ¢
¬ ¦ ¤ ¬ °¡ [¢¡®¤
¦ § ¤ ¬¤ ÊÄ\ 0ÅÄ ¬®
¢ ¡£ ¦ ¡ ¢°¤ ¦ ¢
¤ ¡ ¬ ¢ £ ÅÄ Å0Ä
¦ ZQÆZ À *Ä °
¬® ° ® ¦ ¬¤
¢ ¦ ?ÀÁ' ¡ [\ ¢ ¤
¬£¤ ¢ ³ ¢ ¬ ¤ Ë7 ¦ ¢ Z7
¢ £ ¢ ~ ¢ ¤¤£¤ ³ ¢
¬® ¢ ?ÀÁ' ¦ [©\
° * ¤ ¤ 0 ¢ ³ ¦ ÂÃ
¦ ¢ ~ ¡
¤ ¬ ¢ ¤ ¤¤ ¤ ¬
°®¤ ³ ¢ ZQÆZ À ® ¦
0 ¤¬ ÂÃ ¤ ¿ ¬
ª ¡ ¢¡¤ ¬ ¡ Ç
?ÀÁ' ¦ ¢ ¬
_ ?ÀÁ' ¤ £ ¿ Â*Ã
¡ ¬® 6Ä ¦® ¦¢ ®
¦ ¦ ¢ ` ¿
ÂÃ ¢ ¦ ¬ ¦ ¤ ¢¦¢¡® ¢
¢ ¤¢ ®
¢¤ ® ¢¡ £
¤£ ® £¡ ¢

¬ ¡ ¬ Ð * - < Ð * - Î
ÂÃ ¢®¤ ¢¡ Ð * - ¦¢ ¦
¦ ¡¢ 6Å ¦¡ ¢ Ä Ä Ä ¡£
¤ ¢ D ¢ ³ ¡
J ¦ ¤ ¦ ¢¤
¡ ¬¬ ¢ ¬ ¤ ¦¢ ¤ ¢ °
¬ ¢ ¢¤ ÂÃ q ] ° ³
¦¡ ¢¡¤ ¤® ¤ ¤ ¢¡ ¬®
¢ ¢ ?ÀÁ' ¦¡
³ ¤® £ ¤ ¢ ¢ ¦¢ ® ¬ ¤
¡ ¬ ³ ¢¤ ¢ ¬ ¬® ¤ ¦£
¡ ¤ ÂÃ
ÂÃ ³ ¢¡¤ ¦
® ° [j\ ® °
¬ ¤ ¡ ?ÀÁ' ¡
?ÀÁ' ¢¤®¤ ¡ ¤ ¬ ¢¡¤ £ ¡
¤ ¢ £¤ ¬ ¢ ?ÀÁ'
¢ ~ ¦¬ ] ?$3 ¢¤ ¬
[\ ¬ ¤ ¢ ¤ ?ÀÁ'
¢ ¬® ¢ ?ÀÁ' ® ¤ ~
¤ ¢¡ ° ¡
¬ Ì** - ! ?->? Ê ¢ ?ÀÁ'
! ?->? Å* ¦ ® ¤¢ ¤¬ ¢ ¤ ¤
¢ ³ ¢ ¢¬ ¬
¤ ¡¤ < @ ¤ ¿ ¬ ¡
¢¡ £ ¢ £ ¡ ¢¡¤
[ÆÍ* +Í\ £ ³ ¤ ¬
¤ ¢¬ [ÆÍ0 ¢ ?ÀÁ'
+Í6\ ` £ ¤ ¢¬
¤
rW^c]eWg_ ^W sc^Zd_ dZogedfcaa
?ÀÁ' ¡ ¿ ¦¬
¤ ¢¬ ¬® ¢ ?ÀÁ' ¬ ¤
¤ ÂÃ ~ ¢ Å
° 6 ¦
¢ ¢¡¤ * ¢ ¬® ?ÀÁ' ¢ £
¢ ?ÀÁ' ¤ ° ¢¬£ ¬ [z\
¢ ¦ ¤¬¤ 0 ¤
! < ¬ ¤ _ J
Î ¢ £ <ÎÁZQ ¤¡ ¡ ¬ ¤W
¬® ¦ [_ JjzW\ ~
¿ ¢ ¦¢ ¦¢ ³ ¤ ¤ ¦
¦ ¤ ¬
¬® ¢ ?ÀÁ' ¤ ¢ £ ¤ 00 ¬® ¢
£ [0Ï - Ï0 -È ¡ ¦ ¢¡
Ï0 - *Ï* -
6Ï0* - Ï - ¤ 6 9 ¤
! < Î ¤¬
\ ¬® ¢ ¦¢ 0 ¦
¦ ¤ ¢¡ ³ ¢ ¦ ¢ £
¤ ¢ ¬® ¤ ¢ ¤9 ¤ ° 6 ¬®
¤ ¦¢ ¡ ¤ ¤¬£ ¢ ¦ ?ÀÁ'È
¢ ¡ ¦ ¦ ¿ 6 ¬® ¢ ¦
¤ ¢ £¤ ! ¢ £¤ ~ ¦
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 9


1 ! ' +*-0s
_ _ #' GtNO ^ ' GtN P

= S %: :Y>QS@ U>%<)U@ W[S)SS%
= % < %<>Y9)+@ %Y>YS)&@ WXS)U
= < %S Y><)Q@ <>%9)Y@ WXS):Y
= %S %+ 9>+)U@ %<>Y+)%@ WXS)SS:

x :Q>Q9)Y@ ::>Q:)9@ WXS)+
. :%>9Q)U@ :S>9U)<@ WXS)+
¤ JcyXgw^W^_ dZogedfcaa ^W ZqZ[Z]caa

¬® ¡
¡ ¦¤ ~ ¦¬
¤ ¦ ¦¤ ¬ ¢¦ ¢ ¤ ¢
¬® ¤ ° ¤ ¤ ® ¢¬
¤ ¢ £ £ ¬®
¢ [j²]\ ¦
¦ JÑ" < $ Z<Î< Ç7Î # 1W ¢ [+Í0\
¦¡ ¢ £ Å6 - £ £ [¦ \
¡£ - ¬®
¤9 ¤¬ ¿ * [Ä\ +Ê
0 ³ ¬® ¢ ¦ £
¬ ¤ ¦ 0 ¿ [*0Ä\
?ÀÁ' ¦
¬® 0 ¤ ° ¡£ ¿ * [Ä\ ¬®
° ¬ £ [6*Ä\
¦ ¢ ?ÀÁ' ¡ ¤¤
¦ ¤ ¢ ¦ ¬ ¦° ¢¡³ ¤¤
¤ ¤¬ [Ä
¤ Ä \ +Ê
¬ ¬ [0Ä
¤ z ¡ *0Ä \ +Í ~ ¦
_ JjzW ¢ ¬® ¢ °¤
¦¡¤ ¤ ¤ ¦
¤ ¤ ¬
® ¡ [6Ä\ 6
¬ ¬® ¢ ?ÀÁ'
¡ ¡ ¢
¡ ¤ ¤ ¢
¤ ¡ ¦¦ ¡¤ 6 [Ä\ ¬® +Ê
¬® ¢ ¤ ¢ _¡°£ ¢ £ ¦ ¦
¢ ¡ ¡ ¿ 6 [6Ä\
JZ $ Ò <ÉÆ 3 6W _£ ¢ ¤£ ¦
¢¡ [\ ¤ ¤ ¿ *6 [*Ä\ ¬®
[Z'\ ¢¬ ¡ ¤ ¤
¢ ¢¡ ¢ £ [6Ä\ ¦¤ 0 [6Ä\
£ £ ¤ ~ * [6Ä\ ¤
¢¬£ ¢¡ ¦ Ê ³¤ ¦¬ °¡
¬ ¢ ¢ [0Ä\ ¿
Ó ¢¡
¡ ¢¡¤ ¢ ° ¤ ¢
°¤ ° ¡

46,4%
50,0%
29,5% 40,0%
24,9%
30,0% 23,5%
20,5%
20,0%
10,0%
0,0%
Задишка Біль в грудній клітці Тахікардія
4,0%
11,4% #I K !!" #$%# !!& # # %
1,8% COVID-19
4,9%
23,5% 24
22
20
Неповна блокада правої ніжки пучка Гіса 18
Синусова аритмія 16
Синусова тахікардія 14
Синусова брадикардія 12
10
Вільна рідина в перикардіальній порожнині
Підвищення біопотенціалів правого шлуночка Основна група Контрольна група
Без патологічних змін #I L '! % ! $!* #!+ ! 8!!" %!" #* ! %
# % $ *% ;%* ! ! < # ! ! %= -
#IJ !!"<>?@'A
* [Ä\ ¢ 00 ~ ¤ ¬ ¦ °£ ³ ¢¡¤

¢ ¤ ® £ ¬£¤
[ 0 [**Ä\ ¬®\ ¦ ¢ ¢ ° ¦
¡ [ * [6Ä\ \ ¢
_° ¡ ¤¤ ¦¤ ¢ ¬®
¤ [ [ *0Ä\ \ ¤
³¤ ¦¬ °¡ Ï - ¤
[ [Ä\ \ ¦¢ ¢ ¦ ³ ¿ 6Ï -
¡ ¢ ¤ [*Ä\ ¬® ` 6 ¤
¢ ¦ ¬ ¤ ¬ ¬ ¤ ¢
0 [*0Ä\ [+Ê\ ¦ ¢ Ó® ¬
00 ¬® ¢ ¬ ¢¤£¤ ¢¡³
£ +Í*6
¤ ¬
¢ ?ÀÁ' ¬ ¤ ¦ ¬®
¤ [ * [66Ä\ ¬®\ _ ¤ ³ ¢
¢ ¡£ ¦ ¦ ¬ < ¤ ¢ ¬®
[ 0 [0Ä\ \ ° ¦ [Ä\ £ +Í*6 [ *\ q ¢
¬® +Ê ¢ ³ ¬® ¢
¤ ¤ ¡ ¢ ¢ ¦ ?ÀÁ' ¤
£ ¤¤ ³ < ¤ ¢
¢ ¬ ¤ ¦ ¦ ¦ ¦¢
¬® ¢ ?ÀÁ' ¦ ¢
¦¬ < £ -
¦¡ ¢ £ ¤ *** - ¬® ¢
Å6 - ¦ ³

v # /, w1 /d.234561
. a V xP6 V,, V,, yszv szv
2 %:)S:T%)U S)<% Y%)Y +)& %Q)U

%Q)S9T%)& 9)U YY)Y %S): :9)+
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 11

2,0
1,4
1,8
1,6 1,2
1,4 1,0
1,2 0,8
1,0
0,6
0,8
0,6 0,4
0,4 0,2
0,2 0,0
0,0 5 10 15 20 25 30
5 10 15 20 25 30
#IMB+!# 8!! 8!!"E#* !F% *# % #INB+!# 8!! 8!!"E#* !F% *!!
!!"#$%# !!&# #
¡ ¤ ¬ Qgeaeà_b [_\WdZY

¤ ¢ ¢
< ¢ ¤ ¡ _ JjzW ¢
¢ ¦ ¬ **q ¢¦°¤ ¡ ¢
¤ ¬® ¢ ¢¡ ¦ ¦ ¢ ¢¤
°¤ ° [\ ¤ ¢ ¢¡ ¢¤
< £¡ - ¢ ¢ £¤ ³
¢ 6 ¢ ¢ ¦ ¢¬
6 ¡ ¦ ¦ °
¢¡¤ ¢ < ³ ¢¦° ¢ ¢
- ® ¤ ¢ ¢ ¢¡¤
` ® ³ ¢¤ ¬£ _ ¤ ¢ ¤¤
¤ ¬£®¤ ¢ ³¤ ¢ ¤ ³¤
¤ ¡ ¤ ¬ ¦ ¬ ¡ ¦ ¦
[+Ê\ ¦ ¦
£¡ ¢ ¦ ¡
° ¤ ¢ ¤¢ ¬ ]¢ ¤
¢ ¦¤
¬ ¬® ¤ ¬® _ ¢¬ ¢
¢ ¢¡ ¤ ¢ J ¬¤ ¢ ¢
¢¡ < £¡ [Ç06\ ° [Î6\ ¢
- ¢ [\W
~ ¢ ¢ ¬® ¢¬
¡ ¢¡¤ < ³ ¢ [*¤ ¦ ¦\ ¿ ¤ ¤
¢ ¢ ¦ ¤
[ \ ¤ ¬£ ¿ ¤ ¿
³¤ ¢ ¢ ¡ ¢ ¢ ¢
¢¡ ¢ ¦ ¤
< ³ - [Ê\ _¢¡ ¦ ¿ [¢\
¢¤ < Å - ¢ ¦ ¦
¤¢ ¢ ¢ ¢ ¢¦° ¢ Ô* ¿ ³
¦ ¬® _¢£¡ ¡ ¦£¡ ¬
¬ ¤ ¬¤ ¢¢®¤ ¤ ¦£ _ ¤
¤ ° ¢ ¢ ¢¦°¤ ¤ ¢ ® ]
¬® ° ¡ ¤ ¬¤ ¢¡
¢ ¡ ´ ¤ ¦¢¦ ¡
¡ ¤ ¦¤ ¦ £ ¢ £¤
¬¤ ¢ ?ÀÁ' ¤ ¤ ²¢¡ ¤ ¿ _
¡ ¿ ¦¢ ¦ ¦
#I O ! +!+ G"+ !%8%!&! ! $H! ! J #I P # G! * ! !Q # # 8!Q G!*-
L=%L $HQL=R!8*%
¤ ¢¡ ¦¤ ¡®¤ ¬ ¢ ³
¦ ¤ ¦ ³ ¬¤ ¢° [ \
¦ ¤ ¦ [6Å ¦
~ ¬ ¦ ¢ ¢ ¡ ¦\ ¬® ¢°¤ ¤
¡ ¡ ¦
¢ ¦ ¢¦¤ ¬
¢ ¢ ¤ ³¤ ¢¦°¤ ° ¤ ¿ ¬
¤ ¬ [ÓÇ ¿ Ô-\ ¢ ¤ ¢ ¡
¬ ¡ [¡¤ ¤ ¡ ° ¢
¿ 6Ä ¤ ¿ Ä\È ¢ ¬¢
** -È © ¿ Ì - ¦ ¦ °¤
¢ ¢ ¡ ¦ ¡ ¢ ¢ ¬
[¡ ¦ ¢
¬ ° ~ ¢ ¤¢ ¢ ¬
£¢ \ ¿ ¤ ¬
[ ¢¬\ ¿ ZQÆZ
À ¤ z ¢ _ 0 ¦ ¢ £¤ ¢
¢ ?ÀÁ' [ ¢¬\ ¿ ¦ ¤ ¦
_ ZQÆZ À ¤ ¬£ £ ¬
¢ ¤ [~\ ¢ £¤
¡ ¤ ¢ ¢ °£ ¢ [\ ¿ 6 ¦
¢¦°¤ ¡ * ~ ° ¤ [6À6\ ¿ °¤ ¤
¢ ¦¡ ¤ ° ¤¡
_ ¦ ¦ ¦ ¦
£ ¡ ~ ¢ ¿ *Õ ¦
¡¬ [®¬¤ ° ¤ ¿ ¬
Z\ ¤ ¤ ³¤ ¢ ¡
¬ ° ¿ ¦¢ ¦ ¤ ¡ ° ¢
³ ¢ z ¦ ¦ ¢
£ ¢ ¦ ³
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 13

¢° ¦ ¢ ³ vqZ[Z]caa ¦ ¤¡
¬¤¬¤ ° ¤ £ ¤ °
¢ ¡£ ¡ ¡ ¢¡¤
¤ Z+? ³ ¤ ¬
¤ ¿ ÅÄ ¡ ¤ ¿ ¢ ?ÀÁ'
66Å- q 6- Z+? ¿ 0Ä ¤ ¦ ?ÀÁ'
¡ ¤ ¿ 6Å- ] ® ¤
¤ ¦ £¡ ¬¡ ¤
£¤ ¬¤ ¦ ¢¡ ¦¢ ³
³ ° ¡ ¢¡ ¢
¦ ¥ ¬ ¡ ¿ ¢ ¤
- ¿ 0-6 q ¢ ¬ ®
¬® ¦ ® ¢¡¤ ¢
[ \9 ¢ ¢ ¢ ¬ ¬
£ ¡£ ¬®£ ¦ °¡ ¢ ¦¢ ¢
[¬¤ ¿ *Ä\ °¡ °¤ °
¤ ¿ ¦¢ ¬¤ ÂÃ ® ¦
¦ °¡ ¬ ¡ ¬ ¢
¢ ~ ¿ ¬ ¦ £¡ ¬
° ¢¡³ ¢
_ ¦ ¦ j²] ¤ ¬ ¬ ?ÀÁ'
¢ Á¨ ÁÖ ZQÆZ À ³ ³ ¢¤
¬ ¿ ¤ ¬£¤ ¢ ³£ ¡£ ¬
ZQÆZ À ¤ ?ÀÁ'
£¡ ¢ ¦ ³ ¬ ¢¤
¤ ¡ ?ÀÁ' ¬ ¡
¢ ¬ ¦ ~
¤ ¬¢ ¦ '¨ Z %× [\
[¢ Á¨ ÁÖ ZQÆZ À\ ¢¡¤ ¬
¢ ?ÀÁ' ¦ 6 ¬®
¢ J ¢ ¢ ?ÀÁ' ¤ ¬
¤¢ ¢ ?ÀÁ' ¢ ¤ ¬® ¦ ¢
¢ ¢°£ ¡£ ¤ ¡
¬®£ ¦ °¡ [¬¤ ¿ ° £ ¢¤ Z+?
*Ä\ ¢ ¦¡ ³¤ ¤ ©
¤ ¢¡ ¬
j ¬¤ ¬® ¦ ¢¡ ³ [Í\ ÂÃ
¢ ¢ ` ¢ ££ ¢ °£ ¦£
]¤ j W ~ ¡
¬®¬ ¢¡ ¤9 ¢ ¤£ £ ?ÀÁ' ³
¦£ ¬ [ ¦\ ¤ ¢
[ ¦\ ¬ [ ¦\È ¦ ¤ ³
£ ¤ ° ¤ © ¢¤ Z+?
[ -\È £ ¿ q ¢ ¬® ¬
¢ [ ¦\È ¤ ¢ ¬
£ ¿ [* ¦\È ¬® ®£ £ ¬®£ ¢¡¤
¢ £È ¡ ¬ ® ¡ ¢¡
£ ¤ ¬¬ ¤
_ ¤ ¬® ° ¦¬
°¤ ¢ ¬ °¤ £
¦ ¦ ¤ ° ¤ ¢ ?ÀÁ' ¤ ¢¡¤
¤ ¤ ¢ ¬ ¢ ¤¢ ¢ £ ¬®
¤ ¤ ¢¡ *0

¬® ¢ ?ÀÁ' ¢ ¤ ³ ® ¢

¡ ¡ ¢ ¬
¦ ³ £¡ ¢¡ ÂÃ
< ! q ° ¦ ¢
[Q Q \ ¢¡ ¤ ¦ ` Å
¢ [ ÁQ¨\ ¤ ¦¢ ¬
£ ¢¡ ¢ ¦ ¤ ¦°
£ [À<\ ¡ ¬ ¡ ¢
¦ < ! ¡¤ < ³ ¢ ¢
Q ÁQ¨ ¦ ¢¡ ³ ¡ ¤ ¬£ ³¤ ¢
¬® ¢ £¤ ¤ ¢°¤ ¢ ¡ ¢ ¢¡ <
¤ ¢ ³ - [Ê\ ª
¦ ¤¢ ¢ ³£ £ ® ¤ ° ¡
¢ ¢ ® ¡ ¢¬ ¡ ¦ ¢
¢¡¤ < Q ÁQ¨ ¢ £¤ ³ ® ¢ ¬
Æ? ¦ ¦° ¢ 0 ¬ q ³¢ ¦
³ ³¤ ¤ ¢ ¤¢ <
¬ ¬® ¢ ?ÀÁ' ¦ ?ÀÁ' ¤ ¤
Â6Ã ~ ° ¦ ¡£ ¢ ¤¢
¦ ¡ ¬® ¡ ¦ ¤ ¤ ¬
¦ ³ ¢ ¤
£ £ ?ÀÁ' ¤ ¢ ¬® ¡ ¬ ¤
¢ ¦ [6Ï - ° ¢¤ ¡
Ï - +Í*6\ ?ÀÁ' ¢ ¡
~ ¦ ¬ ¡ ³ ¦¡
¢¡¤ < ³ ¢ ¤ ¬
¤ ¬ ¢ ?ÀÁ'
?ÀÁ' ¢
¢ ]
k_oaZ[Y_
¡ ¦ ³ ¢ ¦ ¤
¤ ³ ¤¬ ¢ ¡ ¡ ¢¡¤
¢ ¢ ?ÀÁ' ³ ¤
¦ QÎ¨ <5% $ [0\ ¤ ¬ ¢
¡ ¬ ¤ ¢ ¤¢ ?ÀÁ' ¤ ¤ ³
¢ ¢ - ¬£®¤ ¢ ³
¢ ¦¬ ¤ ¢ ¤ ¡
¦ ¤ ¢¤ ¤ ¬ [Ê\ ¦ ®
¬ ¦ ¢ [Ê\
~ ¢ eaWaoX[Waa ¦ ¢
¤ ¬££¡ ! ®
< ¦ ¢ ¤¢ ¢ ³ ! " !-
£ °£
'3'4 nGHBJ"H=J"
1. Ahmed S, Zimba O, Gasparyan AY. (2020). Thrombosis 4.
{x`q`_ < xq_`_ < xx_ jq x{| ;}~}~A|
in Coronavirus disease 2019 (COVID-19) through the Sepsis and Microcirculation Dysfunction. Frontiers
prism of Virchow’s triad. Clin. Rheumatol. 39: 2529–2543. in Physiology. 11: 747. doi: 10.3389/fphys.2020.00747.
doi: 10.1007/s10067-020-05275-1. 5. `^ < < jq x{| ;}~}~A| E_j_{^_x{
2. Bikdeli B, Madhavan MV, Jimenez D, Chuich T, Dreyfus I, Drig- characteristics of 2143 pediatric patients with 2019 coronavi-
^_Èjqx{|;}~}~A|x`qq_qj- rus disease in China. Pediatrics. URL: https://www.acceso-
bolic disease: implications for prevention, antithrombotic ther- covid.com/blog-posts-english/epidemiological-character-
apy, and follow-up. J Am Coll Cardiol. 75: 2950–2973. istics-of-2143-pediatric-patients-with-2019-coronavirus-
3. Centers for Disease Control and Prevention. (2023). Health disease-in-china.
jxqj`qjqj xj {q_qj `xxq 6. E_j`x{ < q < x jq x{| ;}~ A| _{xq_`^
Syndrome in Children (MIS-C) in the United States. URL: {j¡j{ j{jq_` x` Ej{jq_` j{xqj q x_¡x{x
https://covid.cdc.gov/covid-data-tracker/#mis-national-sur- magnetic resonance-derived aortic characteristics in young
veillance. adults from the general population, a cross-sectional study.
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 15

J Cardiovasc Magn Reson. 20: 54. https://doi.org/10.1186/ Trauma Acute Care Surg. 86 (4): 583–591. doi: 10.1097/
s12968-018-0473-8. TA.0000000000002166.
7. E_¢x_£x`jqx{|;}~}¤A|_xq_`¥_q 18. ª_` < {{_` < ½x < x`jx E< qj E|
short- and long-term risk of cardiovascular disease and mor- (2020). Coronavirus disease 2019 infection in children with
tality: a prospective cohort in UK Biobank, Cardiovascular jj¬_q_`^ jxq _jxj| ® j_xq| }}J° ¤~}¤~J|j}|
Research. 195; 8: 1718–1727. https://doi.org/10.1093/cvr/ doi: 10.1016/j.jpeds.2020.07.069.
cvac195. 19. Smadja DM, Guerin CL, Chocron R, Yatim N, Boussier J et al.
8. §< ¢x` < j` < £ < ¨x`^ < j § jq x{| ;}~}~A| (2020). Angiopoietin-2 as a marker of endothelial activation
Cardiovascular Implications of Fatal Outcomes of Patients with is a good predictor factor for intensive care unit admission
Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. 5: 1–8. of COVID-19 patients. Angiogenesis. 23 (4): 611–620. doi:
https://doi.org/10.1001/jamacardio.2020.1017. 10.1007/s10456-020-09730-0.
9. qx<xx¡x`<ªj^x{«jqx{|;}~}~A|E¬qx{`x 20. ª_q £| ;}~~ A| j_` {j{j x` jjq| ®
manifestations of COVID-19. Nat Med. 26: 1017–1032. https:// Allergy Clin Immunol. 121 (2): S375–S379: quiz S414. doi:
doi.org/10.1038/s41591-020-0968-3. 10.1016/j.jaci.2007.07.030.
10. Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K, 21. Son MB, Friedman K, Fulton DR, Kaplan SL,
et al. (2020). COVID-19 and the cardiovascular system: ª`j{jqx{|;}~}¤A|°{q_qj_`xxq
implications for risk assessment, diagnosis, and treatment syndrome in children (MIS-C) clinical features, evaluation,
options. Cardiovasc Res. 116 (10): 1666–1687. doi: 10.1093/ and diagnosis. UptoDate. URL: https://www.uptodate.com/
cvr/cvaa106. contents/covid-19-multisystem-inflammatory-syndrome-
11. x`^ < E`_{xjj | ;}~}A| ªjx qj in-children-mis-c-clinical-features-evaluation-and-
{xq_` _`j Ej{jq_` j¬j_` diagnosis#disclaimerContent.
in human endothelial cells. PLoS One. 7 (2): e31874. 22. Sundd P, Pospieszalska MK, Cheung LS, Konstantopoulos K,
doi: 10.1371/journal.pone.0031874. Ley K. (2011). Biomechanics of leukocyte rolling. Biorheology.
12. «xx`j{ «< xj_x` ®< ` < £x`^ ®< 48 (1): 1–35. doi: 10.3233/BIR-2011-0579.
`^ E®| ;}~JA| §x^jq_`^ j{{ xj_` {j{j ¥_q 23. x^x ¨< ¢{xj ®< ªqj_^j jq x{| ;}~}~A| E`qj{_x{
`x`xq_{j_`^_`¡_¡x`¥xj_`¡_qj{ cell infection and endotheliitis in COVID-19. The Lancet. 395
xqj{j_|E¬_{j;x¥A|}¯}; A°J }| (10234): 1417–1418. doi: 10.1016/S0140-6736(20)30937-5.
doi: 10.1177/1535370217693116. 24. x_{_<«j_`_<®xx¼E<x{{<_{jq
13. Khodak LA, Ohiyenko VI, Bilokonova LA, Deyneka NH. (2020). x{|;}~}A|}¤¿__`j¡j{E`qj{_x{_xj
Osoblyvosti novoyi koronavirusnoyi infektsiyi COVID-19 as Predictors of Mortality in Critically Ill COVID-19 Patients.
_qj| `jq_`_ ¡| ¯ ;~}A° ¯¯J| ±² * ³´< Cells. 10 (1): 186. doi: 10.3390/cells10010186.
µ+H!* ¶'< ·*!% ³´< @!* ¸| ;}~}~A| µ#- 25. Voronkov LH, Ryabenko DV. (2021). Urazhennya sertsya,
L %# !%& *! %#!& !G*$& pov’yazani z COVID-19: diahnostyka ta likuvannya. Zdorov’ya
| '!G*$! =%L | ¯ ;~}A° ¯¯J¹| _° ¿x_`²²'q_x|J;>~~A°¤¯|±¶!*%³<"-
10.11603/1681-2727.2020.4.11895. L!* @¶| ;}~}A| À !!" #$"< %Á" ! °
14. Lakkireddy DR, Chung MK, Gopinathannair R, Patton KK, +!# * *% !!"|Â%Á"À* &! ²²'# 88"|J
Gluckman TJ et al. (2020). Guidance for cardiac electrophys- ;>~~A°¤¯¹|
iology during the coronavirus (COVID-19) pandemic from the 26. £xqx` < ª< E{{x{ jq x{| ;}~}}A| E¡x{xq_`
jxqqª_jq§x¢jºE{jq_{- x__` {j¡j{ < E x` j{jq_` x j_q
ogy Section of the American College of Cardiology; and the q__`_qx{_Ãjxq_j`q|{_È¬j|
E{jqx_^xx`q_x_qqjjqj`- 22: 567–575. https://doi.org/10.1007/s10238-021-00787-9.
cil on Clinical Cardiology, American Heart Association. Heart 27. £_qqxjE<x<«j``®<«x<®`jEjqx{|
Rhythm. S1547–5271: 30289-30297. ;}~}~A| ª§ª ªq x` E¿ª x` E¢
15. {_¡x<xÈ<{x_{<j`^j{_<x`j{{_¢jqx{| Consortia. Clinical characteristics of 58 children with a
;}~}A|{jªjEªj{jq_`xx_xj`jq_` j_xq_ _`xxq {q_qj `j qjx{{
Severity in Coronavirus Disease 2019. J Clin Med. 10 (17): associated with SARS-CoV-2. JAMA. 324: 259–269. doi:
4018. doi: 10.3390/jcm10174018. 10.1001/jama.2020.10369.
16. Rodriguez–Gonzalez M, Castellano–Martinez A, Cascales– 28. £{ jx{q ^x`_Ãxq_`| ;}~}¤A| £ `x¡_
Poyatos HM, Perez–Reviriego AA. (2020). Cardiovascular (COVID-19) Dashboard. URL: https://covid19.who.int/.
impact of COVID-19 with a focus on children: a systematic 29. xxx ®< £xqx`xj «< §xx^_ < ª_q ½< «` §|
j¡_j¥|£{®{_`xj| °>}>~>} ¤|_°~|} »¥¼| ;}~}A| x` {q_qj _`xxq `j
v8.i21.5250. in children: a systematic review and meta-analysis. Pediatr
17. Schutzman LM, Rigor RR, Khosravi N, Galante JM, Pulmonol. 56: 837–848. doi: 10.1002/ppul.25245.
¥` E| ;}~A| j{jq_` _ _q_x{ j `¡ {- 30. jÄ<£x`^<x®|;}~}~A|§jxq^j`j_x`qjxqj`q
nary arterial thrombosis following blunt thoracic trauma. J of the ‘Cytokine Storm’ in COVID-19. J Infect. 80: 607–613.
kedZsZoê \]Z W[^Z]e[;

p + v { %Æ # # ! * G| "8 =!G*$! ==%L¸ÇÀ!µ|µ|·+$"|´# °| &%<%|@+ "%#* <}¤º
|;~¯¯A¯ ¤J¯È}|~~~~~~~}}J¤È> ¯|
_ , # p '^ Æ||!|<G|* G| "8 =!G*$! ==%L¸ÇÀ!µ|µ|·+$"|´# °| &%<%|@+ "%#* <}¤º
|;~¯¯A¯ ¤J¯È}|~~~~~~~¤}ÈÈ¯¯|
|h + Æ*||!|<$|* G| "8 =!G*$! ==%L¸ÇÀ!µ|µ|·+$"|´# °| &%<%|@+ "%#* <}¤º
|;~¯¯A¯ ¤J¯È}|~~~~~~~}ÈÈ~ ¤¯|
_ /+q+p '%Æ*||!|< # # ! * G| "8 =!G*$! ==%L¸ÇÀ!µ|µ|·+$"|´# °| &%<%|@+ "%#* <}¤º
|;~¯¯A¯ ¤J¯È}|~~~~~~È>~J~}}|
} ^ ' Æ*||!|<$|* G| "8 =!G*$! ==%L¸ÇÀ!µ|µ|·+$"|´# °| &%<%|@+ "%#* <}¤º
|;~¯¯A¯ ¤J¯È}|~~~~~~}} ¯ ¯|
^ ^ Æ*||!|<$|* G| "8 =!G*$! ==%L¸ÇÀ!µ|µ|·+$"|´# °| &%<%|@+ "%#* <}¤º
|;~¯¯A¯ ¤J¯È}|~~~~~~¤¤È¤J>È|
} v , Æ*||!|<$|* G| "8 =!G*$! ==%L¸ÇÀ!µ|µ|·+$"|´# °| &%<%|@+ "%#* <}¤º
|;~¯¯A¯ ¤J¯È}|~~~~~~È¤J>}¤¯|
y ,^ Æ*||!|<$|* G| "8 =!G*$! ==%L¸ÇÀ!µ|µ|·+$"|´# °| &%<%|@+ "%#* <}¤º
|;~¯¯A¯ ¤J¯È}|~~~~~~~J >~ |
_ y ,l ,Æ* ¸BÉ &%#* #* "8 *!8! !G*$! * !"Ê|´# °| &%<%|@+ "%#* <}¤º |;~¯¯A¯ ¤~~ J|
~,- (V %Æ* ¸BÉ &%#* #* "8 *!8! !G*$! * !"Ê|´# °| &%<%|@+ "%#* <}¤º
|;~¯¯A¯ ¤~~ J|
"! R *$&>|~È|}~}¤|< !" *~|~|}~}¤|

UDC 575.1/.2:613.25:616-008.9-074-053.2:57.088.7
A. Nikulina
Significance of the rs754635 variant
of the cholecystokinin gene in the development
of obesity in children
Dnipro State Medical University, Ukraine
For citation: Nikulina A. (2023). Significance of the rs754635 variant of the cholecystokinin gene in the development of obesity in
children. Modern Pediatrics. Ukraine. 5(133): 17-23. doi 10.15574/SP.2023.133.17.
So far, the possible influence of single nucleotide variants (SNV) of the cholecystokinin (CCK) gene on the likelihood of developing obesity
and metabolic disorders in children has not been demonstrated.
The aim of the study SNV associations of the CCK gene to predict the probability of obesity and personalize the development trajectory
of various metabolic disorders associated with obesity in children.
Materials and methods. 252 obese children aged 6–18 years were examined. The main group (n=152) was represented by children
with metabolically unhealthy obesity (MUO). The control group (n=100) consolidated of children with metabolically healthy obesity (MHO).
Whole genome sequencing (CeGat, Germany) was performed in 31 children of the main and 21 children of the control group. Serum levels
of interleukin-1E were measured using a chemiluminescent immunoassay (CLIA) method, interleukin-6 — by enzyme-linked immunosorbent
assay (ELISA), Synevo, Ukraine.
Results. The G allele of SNV rs754635 of the CCK gene was significantly more frequent among children with both MHO (t=10.93; p<0.05)
and MUO (t=12.96; p<0.05) compared to healthy individuals. The G allele of SNV rs754635 of the CCK gene was associated with basal
hyperglycemia (r=0.44) and impaired carbohydrate tolerance (r=0.33) in the MHO phenotype and with the atherogenicity index of the lipid
spectrum (r=0.40) and was inversely correlated with the level of high-density lipoproteins (HDL) (r=-0.58) in children with MUO phenotype,
p<0.05.
Conclusions. The G allele SNV rs754635 of the CCK gene is associated with obesity and the development of metabolic disorders.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local
Ethics Committee of the institution mentioned in the work. Informed consent of parents or their guardians was obtained for conducting research.
No conflict of interests was declared by the author.
Keywords: cholecystokinin, analysis of single nucleotide gene variants, children, metabolically unhealthy obesity, metabolically healthy
obesity.
L + 9>MNO' ! / . +

$ "
. 2 )R
0 2 6 >EDdaGLdlFGLHBDfLPCKDCdBEAc"@ 6 >FkHGLFhEBHjDdDd
CCK@ 2 * '
V Ac" , 6 *6
)] 6 '
V , 05* :Q: <·%+'5 >dX%Q:@ *
>bLBCoHGDFCGGhldkLCGBkhHoLEDBh¸g5@'/ 2 >dX%SS@ *
>bLBCoHGDFCGGhkLCGBkhHoLEDBh¸m5@'( >1LsCB4)0 @Y% :%
2 '¹2 %E 6- ) <
3 )1AhdLPH4)R '
l .#0 s 2 Ac" KEUQ9<YQ CCK 8 em! >BX%S)&Y; W[S)SQ@) eg!
>BX%:)&<;W[S)SQ@ * 's 2Ac"KEUQ9<YQ CCK - * 2- ,->KXS)99@
8 >KXS)YY@3 em! >KXS)9S@*
- 2 >KXS)Q+@ 3 ¸g!)[S)SQ'
0_2sAc"KEUQ9<YQ CCK -, 2 *682'
. ?2 2 '(
2 * '0 3 * 2 * *)6 -- 2'
_ , 23 '
_ e6 ) ) ) * ) * -
'
Introduction to the predominance of orexigenic over anorexigenic

factors [37]. Cholecystokinin (cholecystokinin —
O
besity in children is a disease, the 1\ %% % 2
development of which depends on signal molecule that suppresses appetite activity
a variety of exogenous and endogenous ÂÃ 1 Ò %% #2 Q Á32 < ?$%#
factors. An increase in appetite, which leads to an [19] in 1928 in extracts of the jejunum as «highly
excess intake of calories in the human body, is due +"% W [$2 +"% ¿ Ñ!Z\
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 17

inducing gallbladder contraction. Cholecystokinin stimulate the secretion of calcitonin, glucagon, and
is a member of a family of regulatory peptides in the kidneys can act as natriuretic peptides
with a conserved C-terminal amino acid sequence Â6Ã 1 ++% 3 %@ + 29
7¨Q +! Â6Ã 7 CCK gene is located $ @ %"% #2 10
on the short arm of chromosome 3 (3p22.1) [6]. approximately 10 times greater than that induced
The primary translation product of the CCK gene by CCK-33 [5].
is preprochocystokinin, the molecule of which ¨ % $ + ++%
consists of 115 amino acid residues. After the signal â" %" ã2 1 ++%
peptide is truncated from preprocholecystokinin, + Ò + ã2
procholecystokinin is formed. As a result binding and, as a result, prevents the development
of protranslational transformations, CCK peptides # $ $ @ Æ%"% 32
of various lengths are formed from prochocystokinin: CCK-induced excitation contributes to the
in endocrine cells — CCK-58, CCK-33, CCK-22, development of obesity [5].
CCK-8 CCK-5; in neurons — CCK-8 and Á # #$ % $ "$ %
CCK-5. Thus, cholecystokinin is represented 3 [ $ "$ % 3 ¿ Z^À\
by several molecular forms, which are united by the CCKAR receptor gene are associated with the risk of
presence of a C-terminal heptapeptide sequence. %3$ + # 2 Â*Ã Ñ Ò3 + #$ @
The predominant form of CCK in the human body of CCK Z^À $5$ % %3$ +
is CCK-33 [42]. CCK peptides are predominantly obesity and metabolic disorders in children has not
% #2 2+ Á " % $$ $$ yet been demonstrated.
intestinal mucosa and brain neurons. Also, CCK The aim ¿ "%2 Z^À
is expressed in the cells of some endocrine glands Z1 +%
(corticotrophs and melanotrophs of the pituitary the probability of obesity and personalize
gland, C-cells of the thyroid gland, adrenal brain the development trajectory of various metabolic
cells, pancreatic cells), in peripheral nerves; cortical disorders associated with obesity in children.
and medullary cells of the kidneys, cardiomyocytes
and immunocytes [11,40].
Materials and methods of the research
The main stimulus for CCK production is food, Study design: observational, analytical,
especially food rich in proteins (L-amino acids) longitudinal, cohort study [27].
and fats. CCK peptides realize their biological Q $% <% $ 2 '+
action through the activation of cholecystokinin " $ ^ + <+ J'+
Q- + [1QÆ 1Æ\ @ 2 $ $ Ñ + $ ^ W '+ 2
neurons of the vagus nerve of the intestine; and B/2 Council, 252 children of the Caucasian group
(CCK B/2 receptor — CCKBR, CCK2R) neurons aged 6-18 years with a diagnosis of obesity were
of the central nervous system. CCK peptides, by 8 % 7 3 2 % $
3 1Æ @ " 3 " of obesity recommended in clinical practice
nerve of the intestine, transmit satiety signals to the Ò " %9 ?% ¨ 2 Ñ $
hypothalamus, which leads to appetite suppression. 45 ^ 6 6 J! $
Thus, CCK, acting as a satiety signal, activates + 3 % $ # $%W %
the anorexigenic signaling pathway, preventing ?% ¨ 2 Ñ $ 45
the development of obesity [6,39]. ^ * 6 Q# " ++ 3 $
Activation of CCK1R also stimulates gallbladder Z % % % $ J?# 2
contraction, pancreatic exocrine secretion, $%W
and insulin secretion from pancreatic E-cells of The main group (n=152) was represented by
the islets of Langerhans; inhibits the secretion children with metabolically unhealthy obesity
of gastric juice and suppresses gastric emptying. (MUO), the control group (n=100) was formed
By activating CCK2R in the central nervous from patients with metabolically healthy obesity
system, CCK peptides modulate the activity [¨Ñ?\
of the dopamine system, slow down the release Criteria for inclusion in the main group: the
of gamma-aminobutyric acid, increase the rate presence of abdominal obesity [3] and two
of neuronal excitation, predetermining various of the following criteria (hyperglycemia and/or
behavioral functions, including satiety, anxiety hyperinsulinemia; dyslipidemia; systolic blood
and phobia levels [30,33,35,42]. CCK peptides also + " [ZÇ!\ % % $ #$ % + "

['Ç!\ # 3 th percentile for a given age, Ð $-Î
gender and height [14]. 90th percentile of the age norm [13].
Anthropometric data were measured by Molecular and immunological examination. To
a nurse in the admission department, the child was "%2 $ + ë 2 5
"%Ò % Ò " Ñ [\ Ò %3$ + ë # 2
"% " Ñ ' $ Z % ® $% $3$ ÁÎE ÁÎ #$ % "
to the nearest 0.01 m. Weight (kg) was measured Ò %% % Z23 $ # 2
using Tefal Bodysignal body composition ['+ 45 \ Á$"5E was investigated
analyzer (France). Waist circumference (WC), by immunochemical method with chemiluminescent
+ " [Ñ\ Ò "% " % [ÎÁQ\ Q $2ç % 2 9
a standardized anthropometric tape, measuring the Á"$ [Z QÖ\ Ö 2 7
circumference at the midpoint between the top of 3 $" Ò %% $3$ ÁÎE 0–5 pg/ml.
the iliac crest and the lower part of the lateral rib Á$"5 Ò %% #2 ç2$5%
Ç %2 ¨ Á%8 [Ç¨Á\ " # 2 [<ÎÁZQ\ " # -
Ò 3% % % % Ç¨Á [Ç¨Á Z'Z\ #2 Cobas 8000 kit provided by Roche Diagnostics
" Ó $% Ñ $ ? ç [ZÒç$ %\ 7 3 $" Ò %%
[ÓÑ?\ Ò Â*6Ã $3$ ÁÎ Å +-$
ZÇ! % 'Ç! Ò "% " % $ Molecular genetic testing. To study the
$$ %3 ' + ! [Ö< contribution of $$% Z^À 3
Ñ $ \ of MUO, a molecular genetic examination
Inclusion criteria: children with polygenic was carried out using the method of new generation
# 2 [Ç¨Á Ðth percentiles) 6–18 years old. Ò $ â" [^ÖZ\ %
Exclusion criteria: monogenic and secondary to the recommendations of The American College
forms of obesity; hereditary syndromes ¨% $ Ö % Ö [Q¨Ö\ ÂÃ
accompanied by obesity; diseases, the treatment of in 52 patients (31 children from the main group
Ò â" " % @ and 21 controls) with venous blood sampling in a
metabolism of carbohydrates and lipids; pregnancy. % Ö $ # 2 [7"# Ö 2\
Immunochemical examination. The studies " Á$$" Z! ì % 3
Ò % " % Z23 $ # 2 provider platform.
(Dnipro, Ukraine). The material for the study was Q3 " '^Q [í\ +$ ¿
venous blood. 0 Î# 2 !+ 9 Ë" 2 " %
To study carbohydrate metabolism disorders, Î# 2 !+ 19 7Ò Ñ"
the level of basal glycemia and insulinemia <8 +$" 1 [7Ò Ç \ Zâ"
was determined by immunochemical testing with + 9 ^ 3 Zâ È Ô #+ Ë 3 $"
$ $" % [<ÎÁQ\ â" Ë* 3 $"9 Ä
Obese children were included in the main group Bioinformatics analysis. Bioinformatic analysis —
with a glycemic level equal to or greater than demultiplexing of the sequencing reads was
5.6 mmol/L and/or they had an increase in + % Ò Á$$" #$ â [3 \
insulinemia >90th percentile according to the Q% + Ò % Ò Z5Ò 3
+$ "3 %% #2 Á% Â0Ã '^QZâ9 7% Ò % Ò $%
and prevention of Dietary — and lifestyle-induced to the human reference genome (hg19-cegat)
$ <> Á $% % Z [Á'<>ÁZ\ using the Burrows–Wheeler Aligner, BWA —
" <" + + +"$ % mem version 0.7.17-cegat [17,25,26,28]. ABRA,
to age and gender of the child [12,36]. 3 0 % Ö 2+Ñ ç 36
To study lipid metabolism disorders, the level were used for local restructuring of readings in
% 2 $+ + [Ñ'Î\ $ Ò target regions to improve more accurate detection
density lipoproteins (LDL-C) and triglycerides of indels in the genome during mutagenesis [8,32].
[7Ö\ Ò %% #2 ç2 Æ â" # % ^ $
colorimetric method using kits from Ç $ 2 Á Æ Zâ
Æ ' [ZÒç$ %\ $2ç database [41].
Cobas 6000. Obese children were included Statistical analysis. Z $ $2
"+ Ò Ñ'Îê* $-Î of the obtained results was carried out using
or less than 10th percentile of the age norm or + 5 ++$ + Z
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 19

Table 1
Characteristics of SNV types of the CCK gene
Clinical
SNV, GnomAD Ref Alt Base
Position _maxPOP Consequence pj66 RawScore >;FG;Q?8G>D
ID Change (ClinVar)
rs754635 42305131 NFE C G 5_prime_UTR_intronic c*.-9G>C 3.98 0.08 No data
sdHbt$¿bCrÀ!À BkL IKLwlLdFh fDEBKDolBDHd HI ÁÁi blBCBDHdE' cÂM KLWKLELdB cHdÂDddDEk MlKHWLCd; OLI KLILKLdFL CGGLGL; tGB CGBLKdCBDPL
allele; Consequence — functional consequence of the variation in relation to the transcript. The nucleotide change and position relative to the coding sequence
HIBkLCÃLFBLfBKCdEFKDWBDdms"AdHbLdFGCBlKL7F'$AÀHEDBDHdOLILKLdFL`CELÄaB;tGBLKdCBDPL`CEL'MrCbWGL7F'::YtÅp>F'ÆDdBLKWKLBCBDHdIHK$ctFHfDda
ELwlLdFL@Ç9%È'pkDEFHGlbdDELbWBhDIBkLPCKDCdBDEDdBLKaLdDF;Át$$FHboDdLfCddHBCBDHdfLWLdfLdBfLWGLBDHd'
Table 2
The frequency of occurrence of major and minor variants of SNV rs754635
of the CCK gene in children with different obesity phenotypes
The frequency
of occurrence of The frequency of occurrence The value of Student’s t-test
major and minor of major and minor variants in Welch’s
SNV options in healthy in patients with obesity (%) E<:;Q?8C;<G
individuals (%) [22]
Allele MHO MUO t1 t2 t3
Allele C G Allele C Allele G Allele C Allele G Allele G
rs754635 76.9 23.1 10 90 16 84 12.96* 10.93* 1.27
Notes:ÆKDBDFCGPCGlLHIABlfLdB]EBBLEBbHfDÉLfohnLGFkÅ%'&U)CBJkDFkBkLfDÃLKLdFLEDdBkLFHbWCKLfaKHlWECKLEDadDÉFCdB)W[S'SQ;B1ABlfLdB]EBLEBHI
EDadDÉFCdFLohCGGLGLs)bHfDÉLfohnLGFkDdBkLFHbWCKDEHdaKHlWEem!CdfkLCGBkhDdfDPDflCGE;B2ABlfLdB]EBLEBHIEDadDÉFCdFLohCGGLGLs)bHfDÉLfohnLGFk
in the comparison groups MUO and healthy individuals; t3ABlfLdB]EBLEBHIEDadDÉFCdFLohCGGLGLs)bHfDÉLfohnLGFkDdBkLeg!Cdfem!FHbWCKDEHdaKHlWE'
[^ QÖQÆ<60>Q\ Ò $+ + $ Associations of SNV rs754635 CCK gene with
+" # % Á$ + !" 6 obesity phenotypes in children. The frequency
Depending on the test result, parametric and " Z^À 6* CCK gene
nonparametric statistical methods were used. $% Ò %@ # 2 + 2+
Correlation analysis was used to analyze 100 presented in Table 2.
indicators of clinical, laboratory-instrumental and According to the data obtained, obese children
molecular genetic examinations in 252 children. 3 $2 â"2 Ö $$$
To assess the relationship between quantitative compared to individuals with physiological body
traits, correlation analysis was used according to the weight.
! % % #Ò â" $ 3 Á $% Ò ¨Ñ? + 2+
non-parametric ranking method was used according â"2 " % Ö $$$ Z^À
Z+ $2 [\ ?$2 $ Ò rs754635 of the CCK Ò $2
taken into account connections (p<0.05). (t=12.96; p<0.05), as in children with the MUO
Ethical approval. ! + + 3%% Ò phenotype (t=10.93; p<0.05), than the frequency
informed consent, and research protocols and of this polymorphism among healthy persons.
procedures were approved according to the ethical According to the analysis, the frequency of
% % Ñ$ 5 '$ * % #2 Ö $$$ Z^À 6* CCK gene in
Ñ" Æ < [ $ children with the studied obesity phenotypes was
++ 3 $ 'Z¨4-<--\ 7 % $$2 [Í +Ê\
collection: January 2020 — February 2023. Associations of CCK gene SNV rs754635
Informed consent: Á % Ò J L QWW X Y X, According to
obtained from all individual participants included the results of correlation analysis, the level
in the study. + %" + ë 2 2 5
# $% %% %+% Z^À 6*
Results of the research genotype of the CCK gene.
As a result of complete genome sequencing in Associations of SNV rs754635 of the CCK
$% Ò # 2 Ò %% $2 Z^À gene with disorders of carbohydrate metabolism.
of the CCK 6* [ÁÀZÌÖ\ 7 Correlation analysis showed the presence of a
Z^À $ % -8 # % $ + #Ò Z^À 6* CCK
the CCK gene, which may lead to a change in the gene and indicators of carbohydrate metabolism
splicing mechanism [22]. + Ò # 2 ¨Ñ? + 2+ Á
7 $"$ ç Z^À Ò "% + Ö $$$ Ò
rs754635 of the CCK gene is presented in Table 1. moderately associated with fasting hyperglycemia

(r=0.44) and impaired carbohydrate tolerance of the blood serum lipid spectrum is characteristic.
(r=0.33). Aditya J Desai et al. [11] demonstrated that
Associations of SNV rs754635 of the CCK gene a decrease in the activity of CCK-associated
with lipid metabolism disorders. We have found signaling pathways correlates with elevated serum
Ö Z^À 6* $$$ CCK gene triglyceride levels in individuals with normal
$% Ò ¨Ñ? + 2+ 3 $2 # %2 Ò % $ Ò Ñ'Î
$ % $3$ Ñ'Î #$ % " in patients with obesity and diabetes mellitus.
(r=-0.58) and directly proportional to the 7 " " @ %"
atherogenic index of the lipid spectrum (r=0.40) in decrease in CCK1R sensitivity due to an increase
children with the MUO phenotype. in the level of cholesterol in the cell membrane in
obese patients. On the other hand, it has been shown
Discussion
that CCK in experimental animals contributes
According to the results of complete genome to hypercholesterolemia, hypertriglyceridemia as
sequencing, obese children, regardless of the obesity a result of increased lipid reabsorption from the
phenotype, have a high frequency of occurrence intestinal lumen. The authors believe that CCK
Z^À 6* CCK gene. Mariaelisa stimulates the secretion of bile from the gallbladder
Ö @ $ ÂÃ "% Z^À into the small intestine and the secretion of
rs754635 of the CCK Ò Ç¨Á %"$ lipases by the pancreas. Bile salts, by forming
According to the results of complete genome amphipathic micelles, emulsify fats, allowing
sequencing, obese children, regardless of the obesity pancreatic lipases to gain access to cholesterol
phenotype, have a high frequency of occurrence of $"$ Ñ2% $2 $ $
Z^À 6* CCK ¨ $ Ö @ by lipases leads to the formation of free cholesterol
$ ÂÃ "% Z^À 6* and fatty acids, which are absorbed by enterocytes
the CCK Ò Ç¨Á %"$ and transported to the peripheral bloodstream
? + Ò ¨Ñ? [44,45]. Also, CCK stimulates the CD36 fatty
have higher serum levels of CCK and insulin acid translocase, promoting fatty acid uptake by
than those with the MUO phenotype [29]. duodenal enterocytes [10]. CCK gene knockout
Á $$ $5$ % $ 5 8 1 (CCK-KO) mice show decreased activity of
associated signaling pathways is associated with Apo B48 chylomicron secretion, lipid transport to
the development of metabolic disorders. We the lymphatic system, and triglyceride uptake in
3 Ò response to intraduodenal lipid administration [21].
Z^À 6* CCK gene with metabolic The contradiction of the results of the study of the
disorders in obese children. Thus, carriers of the @ 1 $+% +" ++ $
Ö $$$ Z^À 6* CCK gene with the #$ % + # #$2 %" %@
¨Ñ? + 2+ ç% #2 % @ 1 # + $+%
tendency to fasting hyperglycemia and impaired the intestinal lumen and the process of absorption
# 2% $ Á 5 Ò $+% #2 %+ 2 %+ " Á 5 Ò
increase in the production of the biologically active that when entering the bloodstream, chylomicron
form of CCK-8 in the duodenum reduces the level triglycerides are hydrolyzed to free fatty acids by
of glucose secretion, regardless of the level of the action of lipoprotein lipase. Most of the released
insulin, the reduction of CCK-induced excitation fatty acids and all monoacylglycerols are directly
%" 1 %2 $2 5 transported to the adipose tissue cells. Adrián
resistance may contribute to the occurrence !$ ç $ Â*0Ã Ò% 10 %"
2+$2 Â6Ã Á %" 1 level of angiopoietin-like protein-4 (angiopoietin-
experimental animals reduces the level of glycemia, $5 + 6 ¿ Q^Ö7!Î6\ +
stimulates proliferation and prevents apoptosis 8+ Q^Ö!7Î6 Ò %+ "
of E-cells of the islets of Langerhans of the pancreas and simultaneously increases the activity of
[20,23,24]. lipoprotein lipase, which promotes the release of
Also, we have shown that in carriers of the fatty acids and their absorption by target cells, in
Ö $$$ Z^À 6* CCK gene with the + "$ %+ 2 Á " +
¨Ñ? + 2+ % Ö $$$ Z^À 6* + # #$2 3 $ 5
Ñ'Î # 3% % Ò ¨4? of biological activity of CCK peptides, which can
phenotype, a higher level of atherogenicity prevent both lipid reabsorption from the intestinal
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 21

$" % $+% ""$ %+ " Á personalize the development trajectory of various
is possible that CCK peptides in individuals with metabolic disorders associated with obesity in
Ö $$$ Z^À 6* #" children.
the reabsorption of lipids from the intestinal lumen "& 0 The author expresses his
than to the absorption of lipids by adipocytes, "% "$ %
which leads to a violation of the lipid spectrum in '+ !% % ¨% $
the blood serum. Ö ' ¨% $ Z Ñ %
Ó 5 Z % 7 $ 2 45
Conclusions ! Q$5 % Q# " 3
7 + Ö $$$ Z^À 6* 3 0 The work is a fragment of the research
the CCK gene in children is associated with the Ò 5 '+ !% %
development of obesity and metabolic disorders ¨% $ Ö '+ Z ¨% $
induced by obesity. 43 2 J!% %3$ +
7 + $$$ Z^À 6* $% % % % Ò 3$ç W
the CCK gene prevents the formation of metabolic [^ 4*6\ 7 "%2 Ò % "
disorders in children. according to the budget program of the Code of
The rs754635 variants of the CCK gene are + $ 8+ % %
associated with certain features of carbohydrate * JZ % % $
and lipid metabolism in obese children. Children 3 $% $ W "%% #2
Ò Ö-ÖÖ Z^À 6* 2+ % ¨ 2 Ñ $ 45
¨Ñ? + 2+ ç% #2 budget. The funders had no role in study design,
level of basal hyperglycemia, fasting hyperglycemia data collection and analysis, decision to publish, or
and impaired carbohydrate tolerance, and those preparation of the manuscript.
with the MUO phenotype have a high level of # The datasets used
atherogenicity. and/or analyzed during the current study
' Z^À 6* are open from the corresponding author on
type of the CCK gene will make it possible reasonable request.
to predict the likelihood of obesity and to &'(')*+(,'/+),0304,456470(863079;,<06=,<'3>
'3'4 nGHBJ"H=J"
1. Abaturov A, Nikulina A. (2019). Genotype C/C 13910 of the 8. Deelen P, Bonder MJ, van der Velde KJ et al. (2014). Genotype
Lactase Gene as a Risk Factor for the Formation of Insulin- harmonizer: automatic strand alignment and format conversion
Resistant Obesity in Children. Acta Medica (Hradec Kralove). for genotype data integration. BMC Res Notes. 7: 901. doi:
62 (4): 150–155. doi: 10.14712/18059694.2020.4. 10.1186/1756-0500-7-901
2. Abaturov A, Nikulina A. (2021). Obesity in Children with 9. Deignan JL, Chung WK, Kearney HM et al. (2019). Points to
Leptin Receptor Gene Polymorphisms. Acta Medica (Hradec consider in the reevaluation and reanalysis of genomic test
Kralove). 64 (3): 158–164. doi: 10.14712/18059694.2021.27. results: a statement of the American College of Medical
3. Alberti KG, Zimmet P, Kaufman F et al. (2007). The metabolic Genetics and Genomics (ACMG). Genet Med. 21 (6): 1267–
syndrome in children and adolescents — an IDF consensus 1270. doi: 10.1038/s41436-019-0478-1.
report. Pediatr Diabetes. 8 (5): 299–306. doi:10.1111/j.1399- 10. Demenis C, McLaughlin J, Smith CP. (2017, Sep 1). Sulfated
5448.2007.00271.x. Cholecystokinin-8 Promotes CD36-Mediated Fatty Acid
4. Breen DM, Yue JT, Rasmussen BA et al. (2011, Dec). Duodenal Uptake into Primary Mouse Duodenal Enterocytes. Front
«Í x` {jq_`_` _^`x{_`^ x¬_ j^{xqj ^{j Physiol. 8: 660. doi: 10.3389/fphys.2017.00660.
production. Diabetes. 60 (12): 3148–3153. doi: 10.2337/db11- 11. Desai AJ, Dong M, Langlais BT et al. (2017, Aug).
0852. Cholecystokinin responsiveness varies across the population
5. Cawthon CR, de La Serre CB. (2021, Apr). The critical role dependent on metabolic phenotype. Am J Clin Nutr. 106 (2):
of CCK in the regulation of food intake and diet-induced obesity. 447–456. doi: 10.3945/ajcn.117.156943.
Peptides. 138: 170492. doi: 10.1016/j.peptides.2020.170492. 12. Draznin B, Aroda VR, Bakris G et al. (2022). American Diabetes
6. Chauhan W, Fatma R, Wahab A et al. (2022). Cataloging Association Professional Practice Committee. 6. Glycemic
the potential SNPs (single nucleotide polymorphisms) targets: Standards of Medical Care in Diabetes — 2022.
associated with quantitative traits, viz. BMI (body mass index), Diabetes Care. 45 (1): 83–96. doi: 10.2337/dc22-S006.
IQ (intelligence quotient) and BP (blood pressure): an updated 13. Elkins C, Fruh Sh, Jones L et al. (2019). Clinical Practice
review. Egyptian J Med Hum Gen. 23: 57. doi: 10.1186/s43042- Recommendations for Pediatric Dyslipidemia. Journal of
022-00266-0. Pediatric Health Care. 33 (4): 494–504. doi: 10.1016/j.
7. Cheung GW, Kokorovic A, Lam CK et al. (2009, Aug). Intestinal pedhc.2019.02.009.
cholecystokinin controls glucose production through a 14. Flynn JT, Kaelber DC, Baker–Smith CM et al. (2017, Sep).
neuronal network. Cell Metab. 10 (2): 99–109. doi: 10.1016/j. Subcommittee on screening and management of high blood
cmet.2009.07.005. pressure in children. Clinical Practice Guideline for Screening

and Management of High Blood Pressure in Children and Potential Therapeutics. Front Endocrinol (Lausanne). 12:
and Adolescents. Pediatrics. 140 (3): e20171904. doi: 10.1542/ 684656. doi: 10.3389/fendo.2021.684656.
peds.2017–1904. 31. Miyasaka K, Takiguchi S, Funakoshi A. (2007). Cholecystokinin
15. Gibbs J, Young RC, Smith GP. (1973, Oct 12). Cholecystokinin 1A receptor polymorphisms. Curr Top Med Chem. 7 (12):
j{__q xq_jq _` xq ¥_q j` ^xq_ Ñq{x| ½xqj| }¯> 1205–1210. doi: 10.2174/156802607780960465.
(5424): 323–325. doi: 10.1038/245323a0. 32. Mose LE, Wilkerson MD, Hayes DN et al. (2014). ABRA:
16. xÒ < ªqq < ®q_j E jq x{| ;}~JA| j`j¥_j improved coding indel detection via assembly-based
physical activity interactions in adiposity – A meta-analysis of realignment. Bioinformatics. 30 (19): 2813–2815. doi: 10.1093/
200,452 adults [published correction appears in PLoS Genet. bioinformatics/btu376.
2017 Aug 23; 13 (8): e1006972]. PLoS Genet. 13 (4): e1006528. 33. Onis M, Onyango AW, Borghi E, Siyam A, Nishida C,
17. Gunning AC, Fryer V, Fasham J et al. (2021, Aug). Assessing Siekmann J. (2007). The WHO reference for children aged
performance of pathogenicity predictors using clinically 5–19 years is: de Onis M, Onyango A.W., Borghi E., Siyam A.,
relevant variant datasets. J Med Genet. 58 (8): 547–555. doi: Nishida C., Siekmann J. Development of a WHO growth reference
10.1136/jmedgenet-2020-107003. for school-aged children and adolescents. Bulletin of the
18. Hongshan J, Rong L, Shou–Wei D et al. (2014). Skewer: a fast World Health Organization. 85: 660–667. URL:
and accurate adapter trimmer for next-generation sequencing http://www.who.int/growthref/growthref_who_bull/en/index.
paired-end reads. In BMC Bioinformatics. 15: 182. doi: html. Accessed 18 May 2023.
10.1186/1471-2105-15-182. 34. Pathak V, Flatt PR, Irwin N. (2018, Feb). Cholecystokinin
19. Ivy AC, Oldberg E. (1928). Hormone mechanism for gallbladder (CCK) and related adjunct peptide therapies for the treatment
contraction and evacuation. Am J Physiol. 86: 599–613. doi: of obesity and type 2 diabetes. Peptides. 100: 229–235. doi:
10.1152/ajplegacy.1928.86.3.599. 10.1016/j.peptides.2017.09.007.
20. Kim HT, Desouza AH, Umhoefer H et al. (2022, May). 35. Peplies J, Börnhorst C, Günther K et al. (2016, Sep 2).
{jq_`_` xqqj`xqj j{{ xq_ _` q j IDEFICS consortium. Longitudinal associations of lifestyle
and human islets. Transl Res. 243: 1–13. doi: 10.1016/j. factors and weight status with insulin resistance (HOMA-IR)
trsl.2021.10.005. in preadolescent children: the large prospective cohort study
21. King A, Yang Q, Huesman S et al. (2015, Nov 1). Lipid transport IDEFICS. Int J Behav Nutr Phys Act. 13 (1): 97. doi: 10.1186/
in cholecystokinin knockout mice. Physiol Behav. 151: s12966-016-0424-4.
198–206. doi: 10.1016/j.physbeh.2015.07.009. 36. Phung HM, Jang D, Trinh TA et al. (2022, Jul). Regulation of
22. Koefoed P, Woldbye DP, Hansen TO et al. (2010, Apr). appetite-related neuropeptides by Panax ginseng: A novel
Gene variations in the cholecystokinin system in patients with approach for obesity treatment. J Ginseng Res. 46 (4): 609–
panic disorder. Psychiatr Genet. 20 (2): 59–64. doi: 10.1097/ 619. doi: 10.1016/j.jgr.2022.03.007.
YPG.0b013e32833511a8. 37. Plaza A, Merino B, Cano V et al. (2018, Mar). Cholecystokinin is
23. Kuntz E, Pinget M, Damgé P. (2004, Nov 10). Cholecystokinin involved in triglyceride fatty acid uptake by rat adipose tissue.
octapeptide: a potential growth factor for pancreatic beta cells J Endocrinol. 236 (3): 137–150. doi: 10.1530/JOE-17-0580.
in diabetic rats. JOP. 5 (6): 464–475. PMID: 15536283. 38. RefSeq. (2023). NCBI Reference Sequence Database. URL:
24. Lavine JA, Kibbe CR, Baan M et al. (2015, Nov 15). https://www.ncbi.nlm.nih.govrefseq. Accessed 18 May 2023.
{jq_`_` j¬j_` _` qj j{{ {jx q _`jxj 39. Rehfeld JF. (2017, Apr 13). Cholecystokinin-From Local
j{{ xjx _` x^j _j x` qjq qjqÃq_` Gut Hormone to Ubiquitous Messenger. Front Endocrinol
induced diabetes and apoptosis. Am J Physiol Endocrinol (Lausanne). 8: 47. doi: 10.3389/fendo.2017.00047.
Metab. 309 (10): E819–28. doi: 10.1152/ajpendo.00159.2015. 40. Rehfeld JF. (2021, Mar). Cholecystokinin and the hormone
25. Li H, Durbin R. (2009). Fast and accurate short read alignment concept. Endocr Connect. 10 (3): R139-R150. doi: 10.1530/
¥_q ¥Õ£jj{j qx`| __`xq_| }> EC-21-0025.
(14): 1754–1760. doi: 10.1093/bioinformatics/btp324. 41. Rehfeld JF. (2021, Sep 17). Cholecystokinin and Panic
26. Little J, Higgins JP, Ioannidis JP et al. (2009, Nov). _j° jjq_` ` qj _q x` ªj ¿`{¡j
STrengthening the REporting of Genetic Association Studies. Questions. Molecules. 26 (18): 5657. doi: 10.3390/
STrengthening the REporting of Genetic Association Studies molecules26185657.
(STREGA): An Extension of the STROBE Statement. Genet 42. Richards S, Aziz N, Bale S et al. (2015, May). ACMG Laboratory
Epidemiol. 33 (7): 581–598. doi: 10.1002/gepi.20410. Quality Assurance Committee. Standards and guidelines for
27. Livesey BJ, Marsh JA. (2020, Jul). Using deep mutational the interpretation of sequence variants: a joint consensus
x``_`^qj`x¡x_x`qjÒjqj_qx`_j`q_ recommendation of the American College of Medical Genetics
disease mutations. Mol Syst Biol. 16 (7): e9380. doi: 10.15252/ and Genomics and the Association for Molecular Pathology.
msb.20199380. Genet Med. 17 (5): 405–424. doi: 10.1038/gim.2015.30.
28. Mahmood K, Jung CH, Philip G et al. (2017, May 16). Variant 43. Steinert RE, Feinle–Bisset C, Asarian L et al. (2017, Jan).
jÒjqj_q_`q{xjj_`^_`jj`j`q<`q_`x{ Ghrelin, CCK, GLP-1, and PYY (3–36): Secretory Controls and
assay-based datasets: implications for discovery and Physiological Roles in Eating and Glycemia in Health, Obesity,
diagnostics. Hum Genomics. 11 (1): 10. doi: 10.1186/s40246- and After RYGB. Physiol Rev. 97 (1): 411–463. doi: 10.1152/
017-0104-8. physrev.00031.2014. Erratum in: Physiol Rev. 2017 Jul 1; 97
29. Mesgari–Abbasi M, Abbasalizad Farhangi M. (2020, Jan– (3): 1229.
Mar). Serum concentrations of cholecystokinin, peptide YY, 44. Zhou L, Yang H, Lin X et al. (2012). Cholecystokinin elevates
ghrelin and high sensitive C-reactive protein in association mouse plasma lipids. PLoS One. 7 (12): e51011. doi: 10.1371/
with metabolic syndrome ingredients in obese individuals. journal.pone.0051011.
Acta Endocrinol (Buchar). 16 (1): 37–42. doi: 10.4183/ 45. Zhou L, Yang H, Okoro EU et al. (2014, May 9). Up-regulation
aeb.2020.37. of cholesterol absorption is a mechanism for cholecystokinin-
30. Miller LJ, Harikumar KG, Wootten D et al. (2021, Jun 2). Roles induced hypercholesterolemia. J Biol Chem. 289 (19): 12989–
of Cholecystokinin in the Nutritional Continuum. Physiology 12999. doi: 10.1074/jbc.M113.534388.

q(^ %*||!|<$|* G| & 8!&+! * @!%#*+@ÇÀ<# %! *¶À³Ø%Ù%#*#$ 8! =#$ # %
;¿|E||ª|AÇ #$ ! !+LÁH! !+* *#! = ! +!# % ! = =%Q% !<|@!<À* &! |´# °|@!<%|¶|¶! #*+<
9. https://orcid.org/0000-0002-8617-9341.
"! R *$&~È|~È|}~}¤|< !" *~È|~|}~}¤|
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 23

~ 6*9*6Ã*
#W X 1 " I 1%Y I1
W%Z" I1$ [X 2

V "/% .' # % , %
..,,-' , %
+ ./ 1". %, %
! ' '
1 % &
2' !( () * + - # &
`<9?;C8C;<Ge§x<«{¡x«<xx½<_{ØÇ<`q`__|;}~}¤A|__{_q_j¡j__xq_``_q
xÚ_j`j`_x_`_{j`x`^j_`{q_xxjq_{x_Ãxq_`xj_{qx{{_`jjx`j
{`xj¬_xq`j`xqj|j`j_xq_|¿x_`j|>;¤¤A°}¯¤~|_~|>>J¯»ª|}~}¤|¤¤|}¯|
(* , * 6 26 6 !"#$%&
* * ) ) * 6- ) 8 6
6 3 6'
V 3 2 2 *
3 6 3
, 3 2 6- 66 6 2686'
V , 0RÊ2* * &+ )66 3 2 6-
) )<9 , )6 -) Y9 ) 3 2 6-
66 6 2686'Z ** 66 8 * '.
6* 2 8 Á '.
2 * 6 2
6 * 6 %·9 > ,) )
@'5 2 '
l .#0 = 66 2 * 2
*6 '(2 6 6 )* 6 - -
3 '\
6 , )66 -'5 6 6
3 - -) &+Ë) 2- 3 -'
0= - 2 * 3
) 3 2 2 6 , )66 3
2 66 '
. ?2 2 '( 6 ^ 2
* '0 2 3 * 2) '
_ - 2 23 '
_ e ))!"#$%&) ) ) '
W<>>;T;A;C;D><R=D9;R;?8C;<G<R?<EE@G;CB18?X@;9D:SGD@E<G;8;G?H;A:9DGTB?H8GFD>
;GE@AC;S898EDC9;?S<A89;Y8C;<G1SH8>DE;?9<>?<SB<RS<AB?9B>C8AA;GDEDET98GD><R
S@AE<G89BDZS;98C<9B?<G:DG>8CD
D8G0/\;*015663C3:034/1F=]/-/:1W%^.C3*:18(E<93<..\;*02
%`ljHPDdDCdABCBLeLfDFCGgdDPLKEDBh)ÌkLKdDPBED)gjKCDdL
2OLaDHdCGolKLClIHKLdEDFLrCbDdCBDHd)kLKdDPBED)gjKCDdL
pkLWKHoGLbHILCKGhfDCadHEDECdfELGLFBDHdHIBCKaLBBKLCBbLdBHIWdLlbHdDCDdFkDGfKLdflKDdaBkLhLCKEHIBkL!"#$%&WCdfLbDFoLFCbL
CFlBL)DdWCKBDFlGCK)JDBkKLaCKfBHWKLfDFBDdaBkLKDEjHIELPLKLfDELCEL)JkDFkWKHbWBLfBkLELCKFkIHKdLJdHdDdPCEDPLfDCadHEBDFbLBkHfEIHK
PLKDIhDdaDdIGCbbCBDHdHIBkLGldaWCKLdFkhbC'
W@9S<>DBHDdFKLCELBkLLIILFBDPLdLEEHIBkLfDCadHEDEHIFHbbldDBhCFwlDKLfWdLlbHdDCDdFkDGfKLdoCELfHdBkLCdCGhEDEHIBkLfDCadHEBDF
PCGlL HI BkL bLBkHf HI blGBDWCKCbLBLK WHGCKDqCBDHdWkCEL bDFKHEFHWh HI WHGhFKhEBCGGDdL bLboKCdLE HI WlGbHdCKh LrWDKCBHKh FHdfLdECBL
DdBkLCEWLFBHIfDIILKLdBDCGfDCadHEDEDdKLGCBDHdBHWCBDLdBEJDBkDdILFBDHlEDdIGCbbCBHKhfDELCELEHIBkLlWWLKKLEWDKCBHKhBKCFB'
m8CD9;8A>8G:EDCH<:>0#dBkLkLKdDPBEDOLaDHdCGÀLfDCBKDFmHEWDBCG)&+FkDGfKLdJDBkDdILFBDHlEDdIGCbbCBHKhKLEWDKCBHKhfDELCELEJLKL
LrCbDdLf)DdWCKBDFlGCK)<9WCBDLdBEJDBkWdLlbHdDCCdfY9FkDGfKLdElIILKDdaIKHbDdILFBDHlECdfDdIGCbbCBHKhfDELCELEHIBkLlWWLKKLEWDKCBHKh
BKCFB' `DHGHaDFCG bCBLKDCG JCE FHGGLFBLf IKHb WCBDLdBE Hd BkL IDKEB fCh HI kHEWDBCGDqCBDHd' pkL DdPLEBDaCBDHd HI BkL GCELKWHGCKDbLBKDF DbCaLE
EBKlFBlKLHIWlGbHdCKhLrWDKCBHKhFHdfLdECBLJCEFCKKDLfHlBDdBkLBKCfDBDHdCGCKKCdaLbLdBHIBkLABHjLEWHGCKDbLBLK'tldDPLKECGCdCGhBDFCG
EBCBDEBDFCG CWWKHCFk JCE lELf IHK LCFk BJHfDbLdEDHdCG fDEBKDolBDHd HI BkL WHGCKDqCBDHd CqDblBk PCGlLE HI BkL WHGhFKhEBCGGDdL bLboKCdLE
HI WlGbHdCKh LrWDKCBHKh FHdfLdECBL) dCbLGh) BkL fLBLKbDdCBDHd HI C ELB HI EBCBDEBDFCG bHbLdBE HI BkL %EB BH 9Bk HKfLKE >bLCd) PCKDCdFL)
EjLJdLEECdfjlKBHEDE@'pkLHoBCDdLfKLElGBEJLKLCdCGhqLflEDdabLBkHfEHIFGDdDFCGLWDfLbDHGHah'

fD>@AC>0ÀHGCKDqCBDHdCqDblBkDdfLrLECdfkDEBHaKCbEHIBkLDKPCGlLEJLKLfLBLKbDdLfIHKDbCaLEHIWlGbHdCKhLrWDKCBHKhECbWGLEHIoHBk
aKHlWEHIFkDGfKLd'pkLFHbWCKCBDPLCdCGhEDEHIBkLHoBCDdLffCBCFHdIDKbLfBkCBoHBkECbWGLECKLFkCKCFBLKDqLfohHWBDFCGkLBLKHaLdLDBhCECd
DdFKLCELDdBkLELdEDBDPDBhHIWHGCKDqCBDHdbCWWDdaHIGldaLrWDKCBHKhECbWGLE'tdDdFKLCELDdBkLHWBDFCGCdDEHBKHWhHIWHGhFKhEBCGGDdLbLboKCdLE
HIGldaLrWDKCBHKhFHdfLdECBLIKHbWCBDLdBEJDBkWdLlbHdDCJCECGEHKLPLCGLf'pkLHoBCDdLfDdfLrLEHICGGEBCBDEBDFCGbHbLdBEIHKBkLWlKWHEL
HIWdLlbHdDCPLKDIhDdakCfkDakELdEDBDPDBhLrFLLfDda&+ËCdfElIIDFDLdBEWLFDIDFDBh'
2<G?A@>;<G>0AlIIDFDLdBfDCadHEBDFPCGlLHIBkLbLBkHfHIblGBDWCKCbLBLKWHGCKDqCBDHdWkCELbDFKHEFHWhHIWlGbHdCKhLrWDKCBHKhCDK)JkDFk
FCdoLlELfDdBkLPLKDIDFCBDHdHIDdIGCbbCBDHdHIBkLWlGbHdCKhWCKLdFkhbCDdFkDGfKLdKLGCBDPLBHWCBDLdBEJDBkDdILFBDHlEDdIGCbbCBHKhfDELCELE
HIBkLlWWLKKLEWDKCBHKhBKCFB)kCEoLLdLEBCoGDEkLf'
HbbDBBLLHIWCKBDFDWCBDdaDdEBDBlBDHd'pkLDdIHKbLfFHdELdBHIBkLWCBDLdBJCEHoBCDdLfIHKFHdflFBDdaBkLEBlfDLE'
gDBI<9:>eFkDGfKLd)WdLlbHdDC)!"#$%&)fDCadHEDE)GCELKWHGCKDbLBKh)WlGbHdCKhLrWDKCBHKhFHdfLdECBL'
ko^X\ ¢

¢ ®£
j
¬ ¢ £¤ ° Ä ¦
¤ £ ¢ ¬ ¢ ¦° ~ ¤
¢ £ ¢ q®£ ¤
¢ ¡ ¤ ® ® ¬ ¤
® ¤ ¤ ¢ ¢ ÂÃ
¡ ¢®¤ ¡
¬®£ ¢¤ ¢ £ ¬ ¢ ZQÆZ À ¤
®¤ ¢ ¦° ¤
¤ ¢°®¤ £ ¡ ?ÀÁ' Â6Ã
¬£ ¦£ ¤ ~ ¦ ®¡ ¦
ÂÃ ¢ ¢ ¢
¢¬ ¢ ¤ [qq\ ³¡ ¢ ¦
®®¤ ¦¢ ¦ ® ®£ ¢
¢ ¦ ¡ ¤¡
¤ ®¤ ¦¢ ~ ¢ ³
¢ ° ¤ *6Å6 ¤£® ¬ ¤¡
¢ ° ¢®¤ °£ ÂÃ q¦ ¬¤ ¦
° ¬ [ ®¤ ¤
\ ¬ [ ¢¤ ¤
\ ¿ ¢¤ ¢ ¤ ¦
¤ ® £ ¡£ ` ® ° ¢
¤¡ ³ ¢£¤ ¢ ³
_ ¡ ® *Ä ¬ ¢ ¢ ¢ £
£ ¤ ¬ ¤ ®
Ä ¢ ¡
_¢£¡ ¡ ¦¡ ¢ ¤
¤ ¤ ¦ ¦¡ ¤¢¬
¢°®¤ ¡°£ ¡£ ¢ Â*Ã ¢¡
¬ ¢ £ ¤ ³ ¡¤ ¤³ ¢¤¤ ¦¡
¢¦® 0 ÂÃ £
` ¡ ¢ ¢ ° ¢®¢ ¤¢
¢ ¤ ~ ¬ ¢¤ ¢
¢ £ Å £ ¦¡ ¤
£ 6 ¢¬¢ ¡
¤¡ ¤ © ¿ ¢¦ _ ¬ £¤
00 qq ¦ ® ¦° ¡ ¢¡¤
¤ ¡ 0 ¢¤
³ z
Ä ¤¡ £ ¡£ ¡£
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 25

³ ® £ rW^c]eWg_ ^W sc^Zd_ dZogedfcaa

¦¡ ¤ £
¤ ¡ ¤ ¤ ¤ ¦¢ ¬
£ ¦¢ ¢ ¦ ¤ q¦ ¦
¤ ¢ ÂÃ ® J¥¬ ¦
® ¢ ¢ ¤¡ ¡ ¤W
¦ ¢ ¡ ¦ ¢ £ JW
¬ ¤ ¦ 0 ¢ £
¬ ¡ ¿ ¬£ £ ®£ ¡£
¡£ ¦¡£ £ £ ZQÆZ À ¢ 6 [j ¡
¢ °¤ \ ¢ ¢£ ®£
© ¦ £ *6 [jj ¡ \ ¢ £
¬®£ °¤ ¬£
¬ ¡ ¡ ¢¤
¬ ¢ £ ¢
¦ ¢ ¬£ ¬ ¢ ¢£ ¢£
¤ ¢ [¦ ?ÀÁ' J¨"$+$8 Æ7!ÆW
¦ ¡ ¡ ¡ JÎ # 2 ' ?2W\
¦ ¢ £¤ ¢ ¢ -¦
¬£ ¦¢ ÂÃ
Â0Ã ¡
¡ ¢ ¦¤ ¦ ¢
£¤ ¬ j ¡ 0Ï6
¤ ¢ ¢¡¤ ¬® jj ¡ ¿ *Ï
°¤ ¦ ¡ [Ê\ ¥ ¡ j ¡
¢ ¬ ¤¤ ³ ¦°£ [Ä\
¤ ¡ ¡ jj ¡ [66Ä MÊ\ ¥
¤ [¤ ¬ ¤¤ ³
¿ Å \ ¡ ¦°£ ¦ ¡ [0Ä Ä
¤ ¡ £¡® j jj ¡ MÊ\
¤ ¦¡ ¦ ¡
¡ ¿ ¢¦ ¤
® £¡ ¢ ¤
£ ¡ ÂÃ q¡ ¤
¢ ¿ ¢ ¢¢
¢ ¢ ³ Â0Ã q ¦ ¤¬ ¥
¦ ¡ ¢ ¤ ¦£¤ ¬ ¬
¦£¤ µ ²¡ [¢¡ ¿
³ ® q ~°\ ¤ ¡ ¢ ¡
¦¢¡ ¦ ¦¦ ¢ ¤¢¬
¤¡ ¢¦ ¢ £
¬ ¢¡
@ ¤ ¿ ¢ ¤ ¤¡
¡ ¬ ¦ ¤ ¡
¡ ¤¢¬¢ °¤ ¤ ¡
¦¡ ° °¤ ¡ ³£ ~
¢ ¢ ¢ ¢¡ °¤ ¢
¢ ¤¢¬ ¢¦ ¡ [ÍÅ*Õ\
¡
¬ ¢ ¢ ¢¤ ¤
¬® ¢ ¤¤® ¦£ ¢ ¬¤
¬¢ ¢ £¤ ¢¤ ¦ ¡
°¤ ¡

alfa(x,y) х104
8
40
20 6
0 4
<20 2
<40
0
-40 -30 -20 -10 0 10 20 30 40
#IJÇ ;% A+# + ;# % A &=!&% 8 ! $ G%+*#*8!+L !!"* # 8-
!&%* +!%+*!!# $H! '*!8!&+
alfa(x,y) х104
8
40
20 6
0 4
<20
2
<40
0
-40 -30 -20 -10 0 10 20 30 40
#IKÇ ;% A+# + ;# % A &=!&% 8 ! $ G%+*#*8!+L !!"* # 8-
!&%* +!%+*!!# $H! ''*!8!&+
¤¢ ¢ £¤ ¢ ¿ ¢¡¤ ¦ ¡

®¤ ¤¢¬ Å6 ¤ [® ¤
¢ ¡ ¢¦¤ ¿ ¤ ¬\ ¤ ¢£
¢ ¡ ¢ [¬¤ ¢ [¡ \
¢¤\ ¤¢¬ ¡ ¬
q ¡ ¡ ¢¦ ¢
¢ ¤ ¡ ¢¤ ¦¤
¬ ¢¦ ¢¢ ¢ °£
¤ ÂÃ ~ ¡£ ¦¦£ ¤ ¢
¡ [ñ Í 8*P\ Ñ^ ¢ [OÍ*0P\ ¡ ¢ ¡
¢¦¤ ¦ ¢ ¦ ¢¢ ¢
¤ ¤ £ ¤ J¨ Î #W
£ ¢ ¤
¬ ¡ ¢¦ ¬ ¬
¢££¡ ¡ ¤ z
³ ¢¦¢¡ ¤ ¦ ¡ _ ¤
¡ ¡ ¢ ¦
¤ ¡
¦ ¤¢¬
¤ ¢ ¢
JcyXgw^W^_ dZogedfcaa ^W ZqZ[Z]caa
¡ ¢ ¤¢¬ ¢¦¤ ¦ ¦¡
¡ ° ¦ ¢¬ ¡
¤ ¦ ®¢¬ ³ *Å6
¡ ¡ ¦ ¢ £¤
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 27


p, , »N1' + *k ! .# .
., + ./%, ' . - + ! ' '
V ., + ./%
,
v' vv'
Á ,)Ae% S)9UQTS)SS+ S)Y<<:<%TS)SSQ ÍS)SQ
. )Ae2 S)Y&YU+<TS)SS9 S):9&+:<TS)SSY ÍS)SQ
_ )AeY S)&Q9Y&YTS)S%Y %)Q9Q9YQTS)S:% ÍS)SS%
)Ae9 %)%<:UQSTS)S:S :)%%+:<%TS)S:S ÍS)SS%
q ¤¢¬ ¢¡ [¢\ ¦¡£¤ ¢

¢¦ ¡ Â*Ã
¬ ¢ £ ¦¡¤ ¤ ¢
¦ ¡ Å6 ¤ ¡ ¬ ¤¢¬¢
¤ ¢£ ¢ ¡ ¢¦ ¢
¤¢¬ ¢¡ ¦ ¡
¤¢¬ ¢ ¢£ ¢
¢¡ ¢ ¤¢¬ ¡ ¢ ¢ [¦ \
¡ ¢¦¤ ¡ ¦¬ ¡
¤ ¡
¤¤¤ ¢°
¤ ¢ ¢ ¢¡ ¢
¤ ¢ ¤¢¬ ¤¢¬ ¡ ¡
¤ ¡ ¡¢ ³ ¤ [¤ ¬\
~ ¤¢¬¢ ¢ ¡ ¢
¡ ¢¦ ¡ ¢ ¡
¦ ¬® ¢ ¤¢¬
¢¤ £ ¡ [ê\ ¡
£ ¡£ £ ¡
¦ ¢¢ ¢¤ ¡ ¢ ¤¢¬
¡£ £ ³ ¡
¤ ¢¤ ¡ ¤¢¬ ¬® ¢
¤ ¡ ¤¤ ¤ ¢¡ Z¨* Z¨6 ³
°¤ ¤ ¦° ¡ ¦°
¡ ¤ °¦ ¤ ¢£ ¡
¢££¡ ¡ * 6 ¤ ¢
¤ ¢¡ ¢ ¤¢¬ _
¤ ¢ ¢ ¤ ¬
¤ ¢¤ ¡ ¢ ¢ ¢ ¡ ¬
¡ ¡ ¬ ¢
¬® £ _ ¬ ¢ ¤ ¢
¢ ¢ ¢¡ ¢ ¤¢¬ ¬ ¢ £¤
¢ ¬ °¤ [¦ \
[ \ ³ ¢ q ¢ ¢¡
¤ ¢ ¬ ¡ ¬¡ ¦
¡ ¤ ¡ ¤¢¬¢
¦£ ³ ¤¢¬ ¢ ¦¡ °
£¤ ¢® ¤ ¢
¤ ¢ ¢¡ ¢¢¡ ¡ ¤
¬ [¡ ¢\ ¢ ¬ ¢ £¤
¦¡ ¦ ¬ ¡ °¤ ¡
Å6 ¤ [Z¨ ¿ ® Z¨ ¿ ¡ ¢ ¢
¤ Z¨* ¿ ¤ Z¨6 ¿ ¬\ ¤ £ £ ¤¤ ¦°£ 0Ä ¢
¢ ¢ ¬¡ ¦ ³ ¡


z' /#!, , "/% .' # % , %
L + . q '
¼1 p /1 ' '
#*s "#*s
. /#*s /#*s
Ae%ÅS)9 ' &+): &%)U &<)Q &Q)<
&QË.Î &S)9·&&)& UY)S·&+)& +U)&·&&)< U+·&&)+
Ae:ÅS):U ' &+): &Q &+): &Q
&QË.Î &S)9·&&)& UQ)%·&&)+ &S)9·&&)& UQ)%·&&)+
AeY[%)9Q &+): +:)< &Y): &Q)S
&QË.Î &S)9·&&)& <%):·&Q)% +Y)Q·&+)% UQ)%·&&)+
Ae9[:)S ' &+): +<)& &9)+ &Q):
&QË.Î &S)9·&&)& <<)9·&U): +Q)<·&+)& U<)%·&&)+
?
' /#!, , "/% .' # % , %
L + h + 1 h + 1

( - - . 1 - ' '
. .
. ' .# .#
Ae%ÅS)9 ' ::): S)&: 9)+ S)S%
&QË.Î Q)&·+Y)<
Ae2ÅS):Q ' %9)U S)+Q %Y)& S):

&QË.Î <)+·Y%)Y
Ae2ÅS):U ' %&)< S&Y Y+ S)+Q

&QË.Î :)&·Y:)U
AeY[%)9Q %+)< S)++ Q)< S)S:

&QË.Î U)<·9Q)Q
Ae9[:)S ' %&)& S)& U)Q S)S:
&QË.Î <)&·QU):
£ ¡£ ¬£ k_oaZ[Y_

¤ ¡ ¬
¡ ¢ q¦ò ¡
¢ ¡ ¬ ¡ ¢ ¢¬
¤ ³ Ä ¤ ¡ ¢¢
°¤ ¦ ¢ ¬ ¤
¢ ¢ ¤ ¬
¢ ¢ ¢¡¤ ¦ ®
¤ ¢ ¬ ¢ £¤ ¢ ¡ ¦¦
¢ ¢ ¢ ¡ ¢ ¡
¡ ¦ ¢ ¤¢¬ ¢ ¢ ¢
¡³ [¦ *\ ¦
q ¦ ¦ _ ¦ ¢
¡ ¤¢¬¢ ¢ ¢ ¡ ¬
¬ ¡ ¢¦¤
¬® ¬ ¡
°¤ ® ¡ ¢£¤ £ ¡£
¬¡ ³ ® ¡¢£ £
¡ ¬ ³
° ®9 ¡ ¤ ³¤ ¡ ¤¢¬
¦¡ ¢ ¤ ¤ ¡
¦¡ ³ ¡ ¢
¤¬ ¢ ®£
¢ ¢ ¢ £ ¢ ¢ ¤¢¬
¦ ° ³ ¦ ¢ ¡ ¢¦¤ ¡
° ¬ ¡ ¢ ¢¡¤
¢¤ ¡ Å6 ¤ ³
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 29

¢£ ¤¢¬ ¢¦ °¤ ¢£¤ £ ¬¡

¢¢ £ [Ì0Ä\ ¡£ [Ì0Ä\
¢¤£¤ £ @ D ! -
¬£ °¤ ` ® ¢ ! @ F
¬ G H J >
¢¤ eaWaoX[Waa ] ¢¤¤£ ³
¡ Å6 ¤ ¢ ¤ ¢ ¦¤
¡ ¬ ¡ ¤
¬ ¢ ¦ ¦ ¡ ¤ ¬
¬ ¢ £
'3'4 nGHBJ"H=J"
1.
x`_ §< x`{x x< ª¡¡x ª< È| _`_q jx{q ¿x_`j| ;}~}~A| ¡__`^ j_x{
xxÃ ª< x{_¡x | ;}~>A| jq qj j x_qx`jqjqjxqj`q`x¡__jxj;A|
{xj{x_jq_jqqjq_q_jx` j qj _`_q jx{q ¿x_`j ½| JÈ} xqj
j`¡_`j`q qj x` | E¬j_j`qx{ j__`j ~}|~}|}~}~`qjx¡x{qjq{¥_qx`^jx`
x` {^| qx{ {j j` j__`jQ >º x_q_`|±ÇµÂÀ* &! |;}~}~A|¸ !!" 8!&-
¤;>Aºxq}°¤ |±· 8 !#* ¶Ø<¶ !8"*µÛ< - + "*% !!"*! %#!&=%L ;A|¸ *
%*%#* ´¶< Q* Ç< B % µ| ;}~>A| ÇµÂ À* &! áJÈ} % ~}|~}|}~}~ | %!!"
B#* % % * # !!" ! = " 8! = *! %!!!" ¹|¿°
% #!!" L * ! ! #% F + !- 7. ½jqj¡x|;}~}A|jj`xq_`_x^`_x`
Q ! | *# ! ! $ ! G- qjxqj`q `j`_x _` _{j`| É{__`^ j
+"| ´* ! L #8 #!& $ ! | >º ¤ ;>Aº Éjx{q¿x_`j|j_x{{_xq_`Ê|j_xq_|;>JA°
Ü }° ¤ | ¿° Ñ{j°»»»¿j»x`qx»¥`{x» }¤| ±¸# %#* µ| ;}~}A| *! $& F +!#-
xÝ}~>Ý>Ý¤;}AÝÝ¯>|. * *% !!"!%!& |Øµ¶É¶ %! 8
2. _x` ¿< {q CC, West jq x{| ;}~A| _`xq_` ÉÂ%Á"À* &! |Ç 8!% !!"ÊB "|;>JA°}¤¹|
{_`_x{ q x` { _xj x` _¡j ¿° qq°»»jx{qx|»xq_{j»È¯¤}jj`xq
___`xq_`jq¥jj`xqj_x{¡_x{`_qxÚ_j x^`q__qx{¡x``x`j¡`qj¼|
`j`_x _` _{j`| {`x j__`j| ° | ª_`xj` < j{xj¡x < {_j¡x § jq x{| ;}~}A|
71. qq°»»_|^»~| È»} ~~~ ¤>>. {_`_x{xq^j`jq_ _^`_Ñx`j {j{j x¡jx^j
3. ¡¡x < j¡xqj < {xÃ¡ < ¿j` < x _Òjj`q xq_` _` {`x j¬_xq x_
¿j`<¡jqx{|;}~ A|{jj`qxx`x{_ xq_j`q ¥_q jxq_ xq_q_| §j{_< {`^
j{{jxq_¬_x^jq_x{{x`_q__^{xqqj- _jxj<_`jq_`|;¯¯A°È~ÈÈ|± !"8!*µ¶<Ù-
_`^_{^_x{q_j|®`x{qjEjx`q_x{ª_- H% Ç¶< ´H% Øâ !R| ;}~}A| !* +!-
jq| ¯ ;A° }~° | ¿° qq°»»¼j|_`^jj`|» 8! ! 8!!" * #!& # ! = G *$
xq_{j»~| È»¯¯JÈ~ ~~ >. +!% = *# = =% = ! % &! |
4. ÞqÃ_`^j ¢< ªx`q_x^xßx < ½^jx®{_à` jq x{| ØL*< +!% =%L < ¶'³!G*$"| ;¯¯A°
;}~}~< ®` }>A| _` _{j` x` x{jj`q È~ÈÈ¹| ªª½ }}}~>~J ;_`qA< ªª½ }>}}~¯ ;`{_`jA|
_` Ej° x {q_`xq_`x{< {q_j`qj q q| x`jq https°»»_|^»~|¤~J »§}~}È~.
_{ {j jx{q| ¯° >¤È| qq°»»_|^»~|~È» | {¡jq < {q «< xq¡ E jq x{| ;}~}~A|
ª}¤>}¯È¯};}~A¤~JJ}. §j`x_x`^j_`qj_`_j`jxqj`j`_x
5. _`_qjq¡ Ã¡q j`_< q_¡{_ qx _{ - _` _{j` ¿x_`j ¡j qj xq }~ jx| j_x{
xq¡x¿x_`|;}~}~A|xqj`q`x`j{| jjq_¡j| }>º ¯° J¯ | ±¶#%$ µB< ·L
±Ç!# # % % * *!* < +% ##*+ â <´L %µÙ !R|;}~}~A|@ ! * ! * ! *
+# # % À* &! |;}~}~A|µ # ! ! * #! =%Q% !# ! !%!Q À* &! # !!}~
¹| ¿° qq°»»_x|»_`¡»»¼^j *%| Ç 8! #* % | }>º ¯° J¯ ¹| https://doi.
j_q_`|. ^»~|}ÈÈ¯»}¤~J~¯~¯|}~}~|¯|}}È ~|

nl ,# Æ # ! * G| & "8 =!G*$! ==%L·*% !#*+@ÇÀ|´# °|Ü!%$<F Ø ! <}|
qq°»»_|^»~~~~~~~}ÈJ>¤}¤È>|
_ ^ _ +Æ||!|<G|< %|* G| & "8 =!G*$! ==%L·*% !#*+@ÇÀ|´# °|Ü!%$<F Ø ! <}|
qq°»»_|^»~~~~~~~}¯¯~} J>È|
a V q Æ*||!|<$|* G| & "8 =!G*$! ==%L·*% !#*+@ÇÀ|´# °|Ü!%$<F Ø ! <}|
qq°»»_|^»~~~~~~~J¤~¯}~~|
) n +V!Æ||!|<$|* G| & "8 =!G*$! ==%L·*% !#*+@ÇÀ|´# °|Ü!%$<F Ø ! <}|
qq°»»_|^»~~~~~~~}¯È¯~|
( +vÆ* #% 8! *# +# + ÇÀÉµL #!LQ#% 8!&*# Ê|´# °|Ü!%$<%| R !%#* <}|
qq°»»_|^»~~~~~~~}~ÈJÈ¤È~|
"! R *$&~¯|~¯|}~}¤|< !" *~È|~|}~}¤|

UDC 616.248-053.2-005.1-036-078
N.I. Makieieva, V.V. Andrushchenko

The von Willebrand factor as a marker of partially
controlled asthma severity in children
Kharkiv National Medical University, Ukraine
For citation: Makieieva NI, Andrushchenko VV. (2023). The von Willebrand factor as a marker of partially controlled asthma severity
in children. Modern Pediatrics. Ukraine. 5(133): 31-38. doi 10.15574/SP.2023.133.31.
Asthma is one of the most common chronic non-communicable diseases among adults and children. Recent studies have paid special
attention to endothelial dysfunction in the mechanism of development and progression of asthma, on the one hand, and the occurrence
of long-term consequences of endothelial damage, on the other hand. Endothelial dysfunction in the modern sense is not only a pathology
of the vascular wall but also a deep, complexly organized system of disorders and compensatory and adaptive reactions that originates at the
molecular genetic level.
Purpose — to improve the knowledge of assessing the levels of von Willebrand factor (VWF) as a marker of endothelial dysfunction in the blood
of children with partially controlled asthma.
Materials and methods. 94 children participated in the study. Patients were divided into 4 groups: the Group 1 — children with mild
persistent asthma (n=59), the Group 2 — moderately severe persistent asthma (n=10), the Group 3 — severe persistent asthma (n=12), and the
Group 4 — control group (n=13).
The study of VWF was carried out by a standard enzyme-linked immunosorbent assay (ELISA) using the Human VWF ELISA Kit. Data were
analyzed using Statsoft Statistica version 8 (Tulsa, OK) and MedCalc statistical software version 17.2.
Results. It was found that children with asthma had significantly increased levels of VWF in the blood serum compared to the control group.
The highest levels of serum VWF were found in patients with severe asthma.
Conclusions. Elevated levels of VWF indicate the presence of endothelial dysfunction. Increased levels of VWF depending on the severity
of asthma indicate more severe endothelial damage in children with severe asthma.
No conflict of interests was declared by the authors.
Keywords: asthma, children, endothelial dysfunction, von Willebrand factor.
[ - +, + # %

- !# %,
% gg $j
x 2 2 )R
Ò6 2 >Ò_@ 886 66 36 6- 2 6 ' . -
6 - 2 * 2 3 6 Ò_) *)
- 6 8 -) 8 ' 2 3
2 ) * ) 82 26 )
* '
V * 3 =* 2 3 -
2 -Ò_'
V , 0R 2&9 '( , 9 7%8 - --
-Ò_>dXQ&@;: 2 - --Ò_>dX%S@;Y - --Ò_>dX%:@;9
->dX%Y@'
. 3 =* 3 * 1mlbCd "nÂ
>"HdnDGGLoKCdfÂCFBHK@Mv#AtiDB4'( 6 -1ABCBEHIBABCBDEBDFC4 +>1plGEC4)5/@ -
1eLfCGF4 %U':'
l .#0= ) Ò_ 3 =* --
-'0 3 =* , -Ò_'
0 ( 2 3 =* 2 2 2 3' Z*28 3
=* Ò_ , *28 8 - -Ò_'
. ?2 2 '( 6 ^ 2 -
* '0 2 3 )* 2'
_ - 2 23 '
_ e*6 2 ) ) 2 3)3 =* '
Introduction 7 +3 $ Ò

% 3 $$ %
T
ÓÑ? Æ $ ?ã <" + $"% $% " -
Ò Ò 5 Ñ $ + %
Q$$ 2 $ % $$ # %3$ + Ò %
% 5 +"#$ $ +3 + $ % Â00Ã
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 31

Q ë 2 Ò 2 Q % $ " + ë -
% $ % Ò 2 # " Ò 2 % ë 2 2 5 3
# + $$2 3 #$ Ò % + 5 % $ $ %2 " ÂÃ
Ò 2 %$ Â0Ã ? " 5 3 Ó$$# %
ë @ 3 "$ - [ÀÓ>\ ÂÃ 7 +$ $2 + ÀÓ>
% $" #$ % "$ 2 +$ 2 ç% $2 < 5 2 2 %
2 % ÂÃ " 7 Ò2 2
7 % $" +2 $ # - 3 "$ % $"
#Ò #$ % % 3 " 7 % #2 "
% $" 3$2 3 $3% # $ + - ÀÓ> #$ % +$ Â*Ã
% +$ 2 52 $ % " - The purpose "%2 ¿ " ÀÓ>
# $ % + % 3% % $ $ 3 $%
$ ë $"5 2 - Ò %@ % " $$%
+ 3 "$ % % $$ ÂÃ
Q + + 2 + $
$2 % $ $ %2 " 7 Ò "%2 7 "%2 $"%%
%3$ + % + $% % 2 Ò $ %2 #-
% $"% #" $ $ % % $$ [Á<%+%
" $ â" % - Á<%+%\ + $% %
$ $ % 3 [Å6 32\ + $$2 $$%
Á 3 3 " + $ $ % + % 8 # <8 # Ò $%
[% -ë \ % $" % 32
â"5$2 + #" + $ ! Ò "% +"$ $ 2
% %$$ 3 "$ Ò $$ Ò %+ $% + $
" + + ?" * $% %% + $
% 3 "$ % %" + % 0 $% Ò $% 7
<% $ $ %2 " # + 3 % + + "%2 Ò
3 " % $"% $ - +$ Ò $" % 8$"
$ 2+ 2+ $ $ Inclusion criteria: $% % 2
$" % # $$" " % Ò % + $% %
% 3 % % Ò 3 [Å6 32\ + $$2 $$%
" % 3 "$ +$ + % 8 # È Å % 2 8
<% $ $ $$ [< \ +$ 2 + $ # È $% Ò % #
# +"$ 2 2 7 +"$ - + % 6 2 + -
2 3 "$ #% $ 3 "$ #% $3
" # %2 % +"$ 2 < + - Exclusion criteria: $% "% 2
+ 8 ++ " $3 $ Â6Ã 3 2 È $% "% 2
Á Ò$$ 5 Ò + Ò % Ò + [ + \ %% 3
% 3 Ò " $$% Ò "%2È + % 6 2
+ % #2 2+ 8 Ò # % $% Ò " Ò "%2È + -
+ 3 3 Â6*Ã 2+ 8 $ % Ò " # +$ " # "3
$2 Ò 2 %$ % % # +" È +
$" % $" #" $ %2 " % % Ò % $$%
% 2 ÂÃ Ñ2+ 8 $2 È + Ò $ % -
% " %2 " % +"$ 2 " $ $ % È % 2
" 2 $ +$ 2 + $ Ò % $ % "
+ 2 8 # + 2 $"% 2 # È + 3 -
#" %2 + % " %2È + Ò 3 %-
# +"$ 2 2 3" $$2 $ % % % + 3 $ " È " +-
+ $ 2 # %2 2 % % $ % È +
7 5 " $$ # 3 " $ Ò +$ 2 $
" % % $ $ ! + 3% + 3 -
% # " % % + "%2

7 "%2 Ò + % Ò $ + 2 $ "# Ò " $$ Ò " % "
$ % + + # " Ò + % Å +
7 $ "+ % * $2 Å " Q " -
$% [ $ - 8\ Ò " 2 $ Ò % #"% % + #$ "# "
" $$ %" +3 " $ ++ % % Õ Q$â" -
Ò Ò % $ - +$ Ò $2ç% Ò " + % ç
% $ 3 ! $ Ò 2$
"+ $% Ò % # " #×3 7 "%2 ÀÓ> Ò % " #2
"%2 % % Ò % % % ç2$5% " # 2
# $ [<ÎÁZQ\ " Ñ" ÀÓ> <ÎÁZQ 1
Q$$ + Ò Ò % % #2 7 8 $ + 2 "-
+% + 2 + $ [+"$ $ $% Ò + % " Z+
$$ \ 7 % % 8 Ò QÁ^6* Á + + +$8 Á Ò
#2 + $ $% Ò " "% #2 ^ $ Q + 43 -
^ 00 0* J? Q++ 3 $ % 2 J1 53 Q + Á "W [J1QÁW\ Z-
Á+$ ¨% $ % 7 $ $ % 7 $ 2 <$ ¨%-
' " Z % % ¨% $ $ '3 % 7 $ J1QÁÅ¨% W
Ç $ Q W 7 Ö$ # $ Á 3 1 53 45 [74 4**Å Å\
Q [ÖÁ^Q\ % Ò $ 7 "%2 Ò %"% % -
5 " % % % + +2 7 + %
7 8 Ò % " + Ò 3 " "
% 2 8 # $2 + Ò ++ "%2 % % -
%2 + " % Òç % # + +2 Ò 8+$ % 7 + %%
# +2 " # "%2 2
! 3% # #2 +2 $ 32 Ò %"% " #
+% ÖÁ^Q "%$ Â0Ã "%2 [ 5 # + \ + $
7 $ Ò " % % 5- Ò $ % %% % #% -
" $% 7 $ 3 % $% % Ò % -
$% % 6Å 2 % 2 % "% " # + 2
% $ Â060Ã Q % "$ 7 +$ % $ $ $ Ò %"%
% ÖÁ^Q + $$2 $$% Ò # ++ 3 $ < % Ç
+ [ Ò + 3\ 1 53 ^ $ ¨% $
Q$$ + "%Ò +2 $ % $ # - 43 2 ? # + $ ^ %
2 8 Q " "%2 Ò %"% #2 ++$ '$
% Ò % " $29 % Ñ$ 5 %% ? # *
%" % #"%% $2 Methods of statistical analysis. 7 -
2 $$ % [ 2 % + $$2 $ + "%2 "$ Ò + %
\ " $ + 5 <ó<ÎÎ >?Æ
! Ò %3%% "+ %+% ÓÁ^'?ÓZ Z Z Z7Q7ÁZ7ÁQ À
% 7 Ö "+ $"%% [7"$ ?1\ % ¨% $ Z $ Z Ò
$% Ò $% + [Í\ [3 \ 7 Z + ÅÓ$5 % -
Ö "+ ¿ % % + [Í\ % ââ +$ Ò " % $2
Ö "+ * ¿ % 3 + [Í\ Z +$ % #" %@%
% Ö "+ 6 Ò $ "+ [Í*\ $ % [¨\ % â" $
Methods for assessing the state of the endothe- [Îâ ¿ $ Ò â" $È 4â ¿ "++ â" -
lial component. Z" +$ Ò 5 %" $\ Ò %% > "$+$ +
" 8 $% # +2 [ "%2 $"%% 6 "+ \ + -
Ç$ % +$ Ò % Ò #2 % 1" 5 $ÅÓ $$ Ò " % '@ Ò
+% +$# " Ç$ % Ò $$% %% Ò Ç -
+2 #2 3+"- 7 + ¨ ÅÓ2 Ò
" Ç$ % +$ Ò +%% #2 " " % % %@ #Ò "+
+2 $ % $ 7 $ Ò 7 %@ #Ò Ò + Ò -
$$% + $ "# > " $$ %% $$2 +Ê 7 -
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 33

Table
Clinical and laboratory data
Group 2 Group 3
Group 1 Group 4
Sign (Moderate (Severe
(Mild asthma) (Control)
asthma) asthma)
Number 59 10 12 13
P1<0.05
Gender, M/F 23/36 4/6 6/6 7/6 P2,3,C>0.05
p1–2 – 0.798
Age, years %%'S>U'S;%Q'S@ %S'S>%S'S;%%'S@ %:'Q>%%'S;%9'S@ +'S><'S;%S'S@ p1–3 – 0.253
eL>vw;gw@ p2–3 – 0.129
p1–2 – 0.213
Disease duration :'S>%'S;<'S@ Y'S>:'S;9'S@ <'Q>Y'Q;%S'S@ p1–3 – 0.002
eL>vw;gw@
p 2–3 – 0.075
p1–2 – 0.707
Allergic diseases in the 52.5% (31/59) 60% (6/10) 66.7% (8/12) p1–3 – 0.442
family p2–3 – 0.791
p1–2 – 0.651
Asthma in the family 39.0% (23/59) 30.0% (3/10) 58.3 (7/12) p1–3 – 0.293
p2–3 – 0.262
p1–2 – 0.034
#aMDdFKLCEL)#gVbG 74.5% (44/59) 100.0% (10/10) 91.6% (11/12) p1–3 – 0.003
>bHKLBkCdQS#gVbG@ p2–3 – 0.391
p1–2 – 0.246
CRP, mg/l 16.9% (10/59) 40.0% (4/10) 66.7% (8/12) p1–3 – 0.007
p2–3 – 0.291
p1–2<0.001
FEV1 %SQ'S>%S:'S;%:<'S@ &&'S>&S'S;%SY'S@ UU'Q>U9'S;U&'S@ p1–3<0.001
p2–3<0.001
p1–2<0.001
FEV1/FVC %SU'S>%SQ'S;%S+'S@ %S%'S>&Q'S;%SY'S@ &9'S>+&'S;&U'S@ p1–3<0.001
p2–3 – 0.010
p1–2=0.036
PEF %SU'S>%SQ'S;%:S'S@ %S%'Q>+&'S;%S+'S@ <Y'Q>Q+'Q;<+'S@ p1–3<0.001
p2–3<0.001
$ #Ò + Ò %% Results of the research and discussion
#2 Z+ 5 $ $2 [\È +Ê
Ò %% $$2 %@ 7 "%2 3 $3% 0 $% Ò
7 5 # $ $ ã [ #\ ^ $ %@ Ò "%
# " % % " $ % 3- #Ò "+ Ò 5 % $ -
" 5 [ % $\ 7 + Ò # $ - 2 7 % $% %
$ ã " + +2 $ $ 3 [ %-
$ + #Ò Ò 3 #$ $ 3 \ [ + % $$
: Ò % + - $$ % $2 $2\
3 $ + % : % + + - '@ Ò "% Ò
3 $ + Æ3 + % 9 # 2 $$2 +% %
[Æ?\ "3 Ò "% 3 #$ $% "+ %
% + $ " @ 3 $" +- %@ % %" %
% %+ 7 %+ "%2 + Ò 3 Ò $$2
% $ $ %2 " $- Á $ # 2 8 -
% Ò + $$2 $$% 7 " @ $$2 Á< % -
+ 3 #$ % 32 + 3 + [Æ!\ $3$ Ò "% +
2 + 3 $5$ % [:ÎÆ\ % 3 Ò 3 + % Ò $%
$5$ % [ÎÆ\ " @ + Ò Æ "$ $" " 9 ><À [> % <8+ -
# % " ô"% %8 7 % 2 À $" %\ 7@ ¿ ><À-
$ #$ $ " 3 - >À [> % À $ + 2\ !<> [! 5 <8+-
#$ + Ò + 3 #$ Ò 2 >$ Ò\ Ò + % " 1" 5 $Å
+ % #2 % %@ #Ò Ó $$ 7 Ò $2 9
"% "3 " Ñ $2 % Ñ ><À Í *0È +Ê Ñ ><À->À Í
¨^$ % 6È +Ê

Ñ !<> Í **6È +Ê 7 Ò $ -

$$2 % $" "
+ Ò 3 + % Ò $%
[7 #$\
The level of VWF in the blood serum of
children with asthma
Z $ + " 1" 5 $ÅÓ $$
3 $% + $2
Ñ Ò $$ Ò% " $"%
$3$ ÀÓ> 3 %@
"+ % 3 % #" "+
Ò % " %+% 32 -
# "% $3$ ÀÓ> %-
+% 32 Ó $"$ %@
#Ò "+ " ¨ ÅÓ2 Fig. 1. Statistical indices of the Von Willebrand Factor, (Me (Lq; Uq))
% $3$ ÀÓ> Ò "% $-

% Ò $$ "+ Ò $3$ Ò # 3% + Ò
$3$ $% Ò 3 [>" \ 8 3 $ $ ÂÃ Á %
Q 3 $ Ò "% #Ò $3$ ÀÓ> 3 $ # + % #2
$3$ ÀÓ> $% " % "%2 %"$ ÂÃ
><À Í* +ÊÈ ><À->À Í0 Á 5 Ò Ò +
+ÊÈ !<> Í* +Ê % " ÀÓ> %
7 # $ $ Ò " % " â" % $ $ %2 -
$ + #Ò $3$ ÀÓ> % " #" $3$ %$2
+ $$ % $2 - %$2 $ % + $ -
2 7 8 $ + Ò %- $ + ÂÃ
%9 #Í +Ê 7Í6 Z $ + ÀÓ> $3$ "
7 # $ $ Ò $ " % - 1" 5 $ÅÓ $$ 3 $% % -
$ + #Ò ÀÓ> $3$ % "+ % 3 "+
Æ! $3 #$ % 7 8 Ò %3%% % 32
$ + Ò %%9 #Í0 # "% ÀÓ> $3$ %+%
+Ê 7Í6 32 7 3 $" ÀÓ>
7 3 "$ % $" +$ 2 " "%2 + % 3
+ + 3 $ # %2 #" Z "%2 5 3 " -
3 % ë % $" # # $ %"$ + Ò #$ -
â"5$2 $ 3 2 # $ $$2 [$% 3 % +% \ "%
3 "# Â*Ã 7 " % - ÀÓ> $3$ Ò 3
$ $ %2 " % 2 ÂÃ
Z $2 ?" "%2 3 $% 3 $
5 % $ $ %2 " % $- #Ò ÀÓ> % % 8 $ + -
%2 %% ÀÓ> Ò % 2 " 7 $3$ ÀÓ> Ò -
Ó#$Å! $ % # % +"$ 2 3 "$ % Ò %"% $" "
% $" % $ % < + 7 % +
% ÂÃ 3 % " $$%
Á " "%2 Ò "% $3 % $3$ ÀÓ> + $2 $$% 2+ 8
$$ $% Ò %@ % + $$2 7 5 " $" < +
$$% $ $ - + $3 $ 8 +-
7 % % + % - + " % " Ò $ 5
$ $ %2 " 82 Â6*Ã
Z$ % Ò ë% + + Q "+ Ò "%%
Ò #× "%2 Ò $% % %"$ % 0Å 2 Ò #$ "%
8 # % Ç % Ò 3 $ #Ò % $ $ %
+ % #2 ÀÓ> $3$ #" % 8 $ # " Ò -
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 35

ÂÃ 7 "%-

3 % + #$ %2
ÀÓ> $3$ $ $ -
% "$+$ # $ # "
$% % + % " % 8 # -

7 $ ÀÓ> $$
"$$2 "% % #" " % %
"$ % "$ 2
Ò $ ÀÓ> Ò$$ 5 Ò 3 "
ë 2 + + 2
# + 3 #2 % Z" %
Ò # % "% $% % %"$
Ò " + 2 % 2%
Fig. 2. ROC curves for von Willebrand factor as a biomarker of the severity # "3 +"$ 2 % +"$ 2 #
asthma in children
% +" Â*Ã
7 " # " %
Ò " % #" 2 " % # $ 2 + $ $ % $ % % $ $
%$ % % % %2 "
5 5 % $ $ % ÂÃ 7 Æ? $2 % + #$ %
72 $ 3 $ #Ò " @ 3 $" ÀÓ>
8 $ # " % % 8- #$ % " Ò + $$2
$ + 2 " Ò "% #2 32 Á Ò "%
ÂÃ ÀÓ>Ì6 -$ % +
Z %" $% 32 $% Ò
Ò + % % " Òç "% [>" \
$ $" " % 3 7 $ "%2 +
[Å 2 \ % $2 3 - $$ + $ 2 + 9
+ "# # " #" $ + % [6Ä\ $$ [Ä\
" + ÂÃ # [Ä\ 7 #%
7 + ë 2 + " $ @ " ÀÓ> $3$ ÂÃ
"%2 "++ % #2 % $3 % Æ!
$3$ $% Ò 3 Q + 3
Conclusions
$ + #Ò ÀÓ> % Æ! + Á $$ + Ò %" + %
Ò 3 Ò # 3% # $ $ $ $3$ ÀÓ>
$ $"$ $3 % % % $ $ %2 "
Z $$ Æ! 5 2- 7 $3$ ÀÓ> #$ % "
ë ÂÃ Z "%2 % Ò 3 % -
3 Æ! % ë - 2 % $ $ %
3 " % $"% + $ 7 + 3 $ -
# +"$ 2 2 ÂÃ 7 % - #Ò ÀÓ> % % 8-
% 3 + 5 $ + 2 " %+%
ë 2 + #" 2 $ 3 $3 % 32 %
$3$ Ò $ $ "# % 7 + 3 $ #Ò ÀÓ>
Á 3 " ë % %" % +
" "%2 # % $$ Ò % 9 $5 Ò % Æ! $3$
"% #Ò %" % % ÀÓ> 3 $3% ë
32 % + 3 $ Ò 7 ÀÓ> #$ % "
"% #Ò $3$ ÀÓ> % %" $% Ò # 3 ÀÓ>Ì6 -$
% # %% %% $ 5 32
¨ % "% Ò $5 #Ò $3 % 7 "$ " "%2 Ò$$ + # #$2 # #$
$3$ ÀÓ> % - ë" " 8 %
ë $% Ò % % % + Ò

Gratitude. Ó 5 $$ + % - 7 $ + Ò 5

$ + + " "%2 Ñ $ '+ !% ^ Ò $
8+ "% $$ + - "++ 1 53 ^ $ ¨% $ 43 2
+ Ò + #" &' (')*+(, '/ +),0304,4 564 70(86307 9; ,<0
"%2 6=,<'34>
'3'4 nGHBJ"H=J"
1. Agostini S, Lionetti V. (2017). New insights into the 13. Mojzisch A, Brehm MA. (2021, Sep 8). The Manifold Cellular
non-hemostatic role of von Willebrand factor in endothelial Functions of von Willebrand Factor. Cells. 10 (9): 2351.
protection. The IACS 4th Cardiovascular Forum for Promoting doi: 10.3390/cells10092351.
Centers of Excellence and Young Investigators, Quebec, 14. Ochoa CD, Wu S, Stevens T. (2010, Apr). New developments
Canada, September 2016. Can J Physiol Pharmacol. in lung endothelial heterogeneity: Von Willebrand factor,
95: 1183–1189. P-selectin, and the Weibel-Palade body. Semin Thromb
2. Eelen G, de Zeeuw P, Simons M, Carmeliet P. (2015). Endothelial Hemost. 36 (3): 301–308. Epub 2010 May 20. doi: 10.1055/s-
cell metabolism in normal and diseased vasculature. Circ Res. 0030-1253452.
116: 1231–1244. doi: 10.1161/CIRCRESAHA.116.302855. 15. x{Ãxxj¼ < «Ã_jÃ < ¥x`_j §< ¨xåx <
3. El Basset Abo El Ezz AA, Abd El Hafez MA, El Amrousy DM Zarychta J, Walocha JA et al. (2021, Oct 25). Endothelial Dys-
et al. (2017). The predictive value of Von Willebrand factor function and Pentraxin-3 in Clinically Stable Adult Asthma
antigen plasma levels in children with acute lung injury. Pediatr Patients. J Investig Allergol Clin Immunol. 31 (5): 417–425.
Pulmonol. 52: 91–97. Epub 2020 May 6. doi: 10.18176/jiaci.0563.
4. Gheware A, Panda L, Khanna K et al. (2021, May 1). 16. Pi X, Xie L, Patterson C. (2018). Emerging roles of vascular
Adhatoda vasica rescues the hypoxia-dependent severe asth- endothelium in metabolic homeostasis. Circ Res. 123:
ma symptoms and mitochondrial dysfunction. Am J Physiol 477–494. doi: 10.1161/CIRCRESAHA.118.313237.
Lung Cell Mol Physiol. 320 (5): L757–L769. Epub 2021 Feb 10. 17. Poredos P, Poredos AV, Gregoric I. (2021). Endothelial
doi: 10.1152/ajplung.00511.2020. Dysfunction and Its Clinical Implications. Angiology. 72 (7):
5. Goncharova EA, Chan SY, Ventetuolo CE, Weissmann N, 604–615. doi: 10.1177/0003319720987752.
Schermuly RT, Mullin CJ, Gladwin MT. (2020). Update in 18. Reddel HK, Bacharier LB, Bateman ED, Brightling CE,
pulmonary vascular diseases and right ventricular dysfunction j{{j < { < Ã < æq < xÃj` ®< ¢_qÃj-
2019. Am J Respir Crit Care Med. 202: 22–28. doi: 10.1164/ rald JM, Fleming LJ, Inoue H, Ko FW, Krishnan JA, Levy ML,
rccm.202003-0576UP. Lin J, Mortimer K, Pitrez PM, Sheikh A, Yorgancioglu AA, Bou-
6. Green CE, Turner AM. (2017). The role of the endothelium let LP. (2021). The Global Initiative for Asthma Strategy 2021:
in asthma and chronic obstructive pulmonary disease [COPD]. executive summary and rationale for key changes. Eur Respir
Respir Res. 18: 20. doi: 10.1186/s12931-017-0505-1. J. 59 (1): 2102730. doi: 10.1183/13993003.02730-2021.
7. Guo L, Lv H, Wang J, Zhang B, Zhu Y, Zhang X et al. (2023, 19. Satta E, Alfarone C, De Maio A et al. (2022, Jan 18). Kidney
Apr 20). Predictive value of high sensitivity C-reactive protein in and lung in pathology: mechanisms and clinical implications.
three-vessel disease patients with and without type 2 diabetes. Multidiscip Respir Med. 17 (2): 819. doi: 10.4081/
Cardiovasc Diabetol. 22 (1): 91. doi: 10.1186/s12933-023- mrm.2022.819.
01830-7. PMID: 37081535; PMCID: PMC10120230. 20. ª`jjj ª< x¼ ®< j «_j¡_q < jæj ®<
8. Hashmi MF, Tariq M, Cataletto ME. (2023). Asthma. van der Poll T, Kamphuisen PW, Bel EH. (2016, Jun).
StatPearls. Treasure Island (FL). PMID: 28613651 Bookshelf Prothrombotic state in patients with severe and prednisolone-
ID: NBK430901 Free Books & Documents. dependent asthma. J Allergy Clin Immunol. 137 (6):
9. Makieieva N, Butov D, Vasylchenko Y, Biriukova M, 1727–1732. Epub 2015 Dec 20. doi: 10.1016/j.jaci.2015.10.038.
Serhiienko K, Morozov O. (2019). Endothelial Dysfunction PMID: 26714414.
in Children with Clinically Stable and Exacerbated Asthma. 21. Soh JE, Kim KM, Kwon JW, Kim HY, Seo JH, Kim HB et al.
Advances in Respiratory Medicine. 87 (1): 7–13. https:// (2017, Oct 8). Recurrent wheeze and its relationship with
doi.org/10.5603/ARM.a2019.0002. {`^`q_`x`x_¥x_`xxq_`_`j{_{j`°
10. Makieieva N, Malakhova V, Vasylchenko Y, Biriukova M. (2020). a cross-sectional study in South Korea. BMJ Open. 7 (10):
¥_{{jx` xq _`_xq_¡j `_ _`xxq_` _` e018010. doi: 10.1136/bmjopen-2017-018010.
children with asthma? Turk Thorac J. 21 (6): 362–366. 22. Sottile PD, Albers D, Moss MM. (2018). Neuromuscular block-
11. Manuyakorn W, Mairiang D, Sirachainan N, Kadegasem P, ade is associated with the attenuation of biomarkers of epi-
Kamchaisatian W, Benjaponpitak S, Chuansumrit A. (2016). thelial and endothelial injury in patients with moderate-to-se-
Blood Coagulation and Asthma Exacerbation in Children. Int vere acute respiratory distress syndrome. Crit Care. 22: 63.
Arch Allergy Immunol. 170 (2): 75–83. Epub 2016 Jul 26. doi: doi: 10.1186/ s13054-018-1974-4.
10.1159/000446775. PMID: 27454316. 23. Taytard J, Lacin F, Nguyen TLT, Boizeau P, Alberti C, Beydon N.
12. Manz XD, Bogaard HJ, Aman J. (2022, Nov). Regulation of ;}~}~<®À|_{j`¥_q``q{{jxqxx`_^`_Ñx`q
£¢ ;` £_{{jx` ¢xqA _` `xxq §_| reversibility might show hypoxaemia. Eur J Pediatr. 179 (6):
Arterioscler Thromb Vasc Biol. 42 (11): 1307–1320. Epub 2022 999–1005. Epub 2020 Feb 4. doi: 10.1007/s00431-020-
Sep 29. doi: 10.1161/ATVBAHA.122.318179. 03600-z. PMID: 32020332.
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 37

24. Tinschert P, Rassouli F, Barata F et al. (2019, Jan 7). Prevalence !# !!" $*% L } | ª_j`j-
of nocturnal cough in asthma and its potential as a marker for Rise: Medical Science. 7 (27): 35–28]. doi: 10.15587/2519-
asthma control (MAC) in combination with sleep quality: pro- 4798.2018.148972.
tocol of a smartphone-based, multicentre, longitudinal obser- 27. Zhang F, Yang XC, Jia XW et al. (2017). Von Willebrand factor
vational study with two stages. BMJ Open. 9 (1): e026323. doi: and ADAMTS13 plasma in older patients with high CHA2DS2-
10.1136/bmjopen-2018-026323. ª ªj ¥_q x` ¥_qq xq_x{ Ñ_{{xq_`| E j¡ j
25. Yang X, Chang Y, Wei W. (2016). Endothelial Dysfunction Pharmacol Sci. 21: 4907–4912.
x` `xxq_`° `_q _` jxq_ q_q_| 28. Zhang J, Zhao L, Zhao D et al. (2019, Aug 26). Reliability
j_xq `x° È ¤~È| E }~È x ¤~| and validity of the Chinese version of the Test for
doi: 10.1155/2016/6813016. Respiratory and Asthma Control in Kids (TRACK)
26. Yeromenko GV, Ospanova TS, Bezditko TV. (2018). in preschool children with asthma: a prospective
¢jxqjÑq_xjx`j`qj{_x{_Ò_`_`x- validation study. BMJ Open. 9 (8): e025378.
tients with bronchial asthma and comebidity with obesity and doi: 10.1136/bmjopen-2018-025378.
type 2 sugar diabetes. ScienceRise: Medical Science. 7 (27): 29. Zinter MS, Delucchi KL, Kong MY et al. (2019). Early plasma
¤>} |±Ù!*¶<µ# !% Ø<· *Ø¶|;}~ A| xq_¬jqx{{qj_`xjÑ{j|`¡j{xq¥x_`j_xq-
µ#L %# GL 8! = *% ! !& ric acute respiratory distress syndrome. Am J Respir Crit Care
#G!*$& =% = ! L!= ! # % *L- Med. 199: 181–189.

Vddq+vÆ||!|<G|< %|* G| &á}² *%#*+¸ÇÀ|´# °|² *%<#|¸ * <¯|qq°»»_|^»~~~~~~~¤¤¯È}J ~ |
( k %Æ # ! * G| &á}² *%#*+¸ÇÀ|´# °|² *%<#|¸ * <¯|qq°»»_|^»~~~~~~~}>}>¯}>~|
"! R *$&¤|~È|}~}¤|< !" *~È|~|}~}¤|

~ **9*:06
# 1 qt 1,2$j 1,3
[.#
, ! /# ' -, +
1. !/ 0 -3 + 4' # 5
25 6 -
35
`<9?;C8C;<GeRak LI, Kashina-Yarmak VL, Yeshchenko AV. (2023). Physical activity of teenagers in conditions of social restriction.
Modern Pediatrics. Ukraine. 5(133): 39-46. doi 10.15574/SP.2023.133.39.
Z8 6 , - * 26 6- 2 - ' Ò28 2 8 R >US)<Ë 6
+Y)SË ) :S%< '@ 3 >Õ_@' Z ] ,-
!"#$%&Õ_ * 2* 26 6 '( 6 , 6 *3
66*82 *'
V Õ_ 6 6*2] ,-!"#$%&; 2 )
*- 2 - 26 2; 86 Õ_ '
V , 0 ( %Y+ %S·%+ ><+ US 6@)
:S:S- :S::'Õ_ -¸ 2 3 '= 6
Õ_ > ) ) )8 ) 3 6 @ )
'Z 2 U* 2Õ_) U +)&)*28& Õ_'
l .#0QS)%Ë 6 2-Õ_)::)9Ë 2-):U)QË -'R 2-Õ_
8 6 )<:Ë6 32 %+Ë
-'. 2-Õ_YQË -)+9Ë 32 ) *
'= Õ_ , 2 >+:Ë@32 >+UË@) 6 ><<Ë@
><+Ë@'¸ Õ_ 8 ) 2 2-Õ_6 2
YS6'Z 2 Õ_ 2 *28 * 9S6'
00 8 )* 2) , 32
8 6 ) 6 26*2'. 2Õ_ - 2
) 6 2'
. ?2 2 '( 6 ^ 2 -
* '0 2 3 * 2) '
_ - 2 23 '
_ e )3 2) 2*) ) !"#$%&) )3
366*'
WHB>;?8A8?C;=;CB<RCDDG8FD9>;G?<G:;C;<G><R><?;8A9D>C9;?C;<G
A(D/018A6/:;.</q)/-7/01,2E8),:;\;,<031,3
%A#1#dEBDBlBLIHKkDGfKLdCdftfHGLEFLdBEmLCGBkCKLHIBkLcteAHIgjKCDdL4)ikCKjDP
:"'c'iCKCqDdikCKjDPcCBDHdCGgdDPLKEDBh)gjKCDdL
YikCKjDPcCBDHdCGeLfDFCGgdDPLKEDBh)gjKCDdL
t fLFKLCEL Dd CFBDPL bHPLbLdB DE BkL FClEL HI bCdh fDELCELE HI bHfLKd bCd' pkL bCuHKDBh HI EFkHHGFkDGfKLd Dd gjKCDdL >US'<Ë HI oHhE
Cdf+Y'SËHIaDKGE):S%<@fDfdHBIHGGHJKLFHbbLdfCBDHdEIHKWkhEDFCGCFBDPDBh>Àt@'$lKDdaBkLwlCKCdBDdLflLBHBkL!"#$%&WCdfLbDF)
FkDGfKLd]E Àt JCE GDbDBLf Dd bCdh FHldBKDLE HI BkL JHKGf' #dFKLCEDda bHBHK CFBDPDBh DE HdL HI BkL WHJLKIlG bLCdE HI WKLPLdBDda C dlboLK
HIFCKfDHPCEFlGCKfDELCELECdfbLBCoHGDFfDEHKfLKE'
W@9S<>DBHfLBLKbDdLBkLGLPLGEHIÀtHICfHGLEFLdBEDdBkLFHdfDBDHdEHIwlCKCdBDdLKLEBKDFBDHdEDdFHddLFBDHdJDBkBkL!"#$%&WCdfLbDF;
BHLEBCoGDEkBkLBhWLEHICFBDPDBDLEBkCBLdElKLElIIDFDLdBCdfGHJbHBHKCFBDPDBh;BHDdfDFCBLJChEHIDdFKLCEDdaDBDdCfHGLEFLdFL'
m8CD9;8A>8G:EDCH<:>0pkLCdCGhEDEHI%Y+wlLEBDHddCDKLEHIBLLdCaLKECaLf%S·%+IKHbEWKDda:S:SBHÂLoKlCKh:S::JCEFCKKDLfHlB7
<+aDKGECdfUSoHhE'ÀtHICfHGLEFLdBEJCECEELEELflEDdaBkL#dBLKdCBDHdCGtfCWBLfÀkhEDFCGtFBDPDBhÖlLEBDHddCDKL'tGGBhWLEHI¹tflKDdaBkL
JLLj>EWHKBEELFBDHdE)CFBDPLaCbLE)bHKdDdaLrLKFDEL)kDjDda)WkhEDFCGLflFCBDHdFGCEELE@CdfBkLBDbLEWLdBHdLCFkBhWLJLKLBCjLdDdBH
CFFHldB'tBHBCGEFHKLHIlWBHUWHDdBEFHKKLEWHdfLfBHGHJ¹t)IKHbUBH+'&BHbHfLKCBL)bHKLBkCd&BHkDak¹t'
fD>@AC>0QS'%ËHIBLLdCaLKEkCfGHJÂt)::'9ËbDffGL)Cdf:U'QËkDak'#dBkLaKHlWHIBLLdCaLKEJDBkGHJ¹t)HdGhCBkDKfkCfbHBHKaCbLE
DdBkLIKLEkCDKCdfbHKdDdaLrLKFDELE)<:ËHIBkLbCBBLdfLfWkhEDFCGLflFCBDHdFGCEELECdf%+ËCEWHKBEELFBDHd'kDGfKLdJDBkCPLKCaL¹t
DdYQËHIFCELECBBLdfLfBkLELFBDHd)+9ËWkhEDFCGLflFCBDHdFGCEELE)CdfLPLKhELFHdfHdLfDfbHKdDdaLrLKFDELECdfkCfCFBDPLaCbLE'
mDak¹tFHdEDEBLfHICFHboDdCBDHdHIEWHKBE>+:Ë@CdfWkhEDFCGLflFCBDHdGLEEHdE>+UË@)CFBDPLaCbLE><<Ë@CdfbHKdDdaLrLKFDELE><+Ë@'
tGbHEBCGGBLLdCaLKE)KLaCKfGLEEHIBkLGLPLGHI¹t)kCfJCGjE)olBIHKLPLKhBkDKfWLKEHdJDBkGHJ¹t)BkLDKflKCBDHdfDfdHBLrFLLfYSbDdlBLE'
nDBkCPLKCaLCdfkDak¹t)BkLflKCBDHdHIJCGjEDdbHEBWLHWGLJCEbHKLBkCd9SbDdlBLE'
2<G?A@>;<G>0 t bHKL DbWHKBCdB BCEj IHK LflFCBHKE) WCKLdBE) fHFBHKE Cdf BkL EBCBL CE C JkHGL DE BH DdFKLCEL BkL bHBDPCBDHd HI BLLdCaLKE
BHWkhEDFCGFlGBlKLCdfLrWCdfkLCGBkCdfEWHKBECKLCE)BkLDKCfCWBCBDHdDdWLKDHfEHIEHFDCGKLEBKDFBDHdE'pHCFkDLPLHWBDbCG¹_)oHBkBkLPCKDLBh
HIBhWLEHICFBDPDBhCdfBkLDKflKCBDHdCKLDbWHKBCdB'
cHFHdIGDFBHIDdBLKLEBJCEfLFGCKLfohBkLClBkHKE'
gDBI<9:>eBLLdCaLKE)WkhEDFCGCFBDPDBh)EHFDCGKLEBKDFBDHdE)wlCKCdBDdL)!"#$%&WCdfLbDF)EWHKBECFBDPDBDLE)WKLPLdBDHdHIdHdFHbbldDFCoGL
fDELCELE'
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 39

_
¡ ¢ ¦¡ ¢ £ ¤ ¢¤
¡ ¬ ¬¢ £ ¡£
¤ £ ® ¤ ¢¤ ¤
¤ ¿ ® ¢¡ ®¤ qq ®
¤ ¿ £ ¦£ ¤ £
¦ ¡ £ °¤ ¬ ³
® ¡£ ¦ ¢ £ ¡ ¬ qq Â6Ã
£ ¢£® ¤ ¢ ¤ ¤ £
¤¡ ¬ £® ¤9
¡ ¤ ¢°¤ J¤ ¬ Å
¤ ®¤9
¦ ¤ ¤ ¢¡
¢¬ ¢ ¤ [qq\ °
Å 6 ¤ ¤
Ä ¢ ¦ ¤
£ ¢¡ [²]\ ¤ * ¢ ¤
¢¤ ¡ ¦ ¢¡
Å ~ ~ Ä ¬ ¤ ¢
0*Ä ¡ ¬ ¬££ ¤¢
³ ²] ¦ * ¦ ¡ ³ ¤
® ~ ¡ ¤¡ ¦ ¡ ¦
¬¤ ³ ° ] ¢ ¬¤ W Â*Ã
¤ ²] ¤ Ä ¦ ¤ ¦
j ¿ *Ä ¿ ¦¢ [?ÀÁ'\ ¢ ¦ ¤ ¢
6Ä ¡ ¤ ¢°¤
¤ ¡ ¤¤ ° ¡ ¢¡ ¦ ¤ ¢ ¬
¢ ¬ ÂÃ _¦° ¢¬¤ ¢ ¢ ¤
¤ ] j ¤ ¤ ¤ ¤
¢¡ ¦ ¢
6Ä ¬ 0Ä ¡ *Ä ¬ ¦ ¤¡ ¤£ ²]
0Ä ¡ ÂÃ ¡
_¬¤ ³ 6 ¤
¢¡ ¢ ¤ ¢¤ ¢¦°
¢¦¢¡¤ ¢¡ ¬ ¤ ¡ ³ ¤ ¢ ¤ ¢
¢ ° Â0Ã ª ÂÃ ~ ¤ ¢¢¤ ¢
° ¦ Å6 ¢ ²] Â*Ã _¡¡
[ ¦ ¦ ¢¦°¤ ¤ ²] ³ ¢
¢¤¤ ³\ ¦ ¢ ¢¦°¤ ²]
*Å60 ¦ ] ¢ ÂÃ
° ¦¢ ÅÄ ¡ ¢ ¡ ¢¦¤
£¤ ¢¡£ £ ¤£ ¢ ¡ [Ä\ ¤
Â0Ã § ¦£ ¢ ¡¤ ° Å0Ä ¦ ¬ qq ³ ²] ÂÃ
¢¤ ¢¡£ £ @ ¤ ¿ ¢¡ ²]
¡ ¢ ¦
® ¬ ³ ¢¦ ¢ ¤¢ ¢ ®£ ?ÀÁ'È
¤ °¤ ¢ ¤ ¢ ¤ ³ ¢¦¢¡£ £
¢¦°¤ ¢ È ¢¡ °¤
~ 0 ¤ ¦¤ ¢ ³¤ ²] ¬
¤ ¢ ¢
0Å* £ ¤
® ¢¤ ¦ ¤ ²] ¢¡ ¢ £
Ä ÂÃ ` ¤ ¤ ¢ ¤
¬ ¤ ¬ ¢¡


¼ + .! ,. ., ,". % sxE
l #[(

.#*GtO +*Gt *Gt
= %+)+T9)U%): YQ)9T+)<: +%)<T<)Y
_ YS)9TQ)Q%): Q%)<T&)S <Q)+TU)U
¹ Y9)+TQ)U: Q%)<T&)S <+)9TU)Q
( &U)%T:)S &<)+TY): %SS
= 3 6 <:)YTQ)+%)Y +Y)&T<)< +<)+TQ)Q
% [S)SQ 2- Õ_; : [S)S% - Õ_; Y [S)SQ
-Õ_'
¿ ]q²] [¢ ¬ ¡ ¦¦ ¢

q ¢ q] © q ¥ ] ¢ £ ¤
¯ 6 J¦ ¬ ¢¡ ²° ¢¦ ¤ ¡
W Â*Ã ¡ ¢¤ ¢¡³ ¢ Ä ³ [Ê\
£ ²] ¤ ¤ ¤
¤ ¡ ¡¤ ¢¡
¡ ~ ¤ 9 ¢ ¦
¤ ¬ ²]9
¢¤ ¡ ¤ 6Ä Ä ³ ¢ ®
¤ ¢¡ ¤ [ ¢ ³ ¤ ²] °¤ °
¤ ¬ ¬ ¡ ÂÃ
¤ ¢¡ ¤ ¢¡ °¤ ¡ ¬ £
¤ ¡\ ²] ® ¬ ¡ ¢ ¢£ £
¢ ¡ ¡9 ¿ ²] 9*0 ¿ ¢ £ ²]
° ¬¤ ¤ ®¤ ¦ Å ¢ ¢ ¦
¿ ¬¤ ¦ Å* Å *¤ ¢¬ ¢ 9
¬¤ * ¦ 6Å ¿ 6 ¬¤ ¢ ¢£ ²] ¡
6 ¦ ¿ ¬¤ ¦ 6Ï* ¦ ¬ ¿ Ï ¦È ¢
¢ ¤ ¢ £ ²] ¿ 0Ï* ¦ 0Ï ¦È
¦ ¢ £ ²] ¿ Ï** ¦
¢ ¦ ¢ ²]9 ¦ ¿ ¢ *Ï6* ¦
0 ¦ ¿ ¦ ¿ ~ ¢ ¢£ ²] ¡ ¤
¤
]¤ ¢ ¡ ¦
£ ¢ *0 ¡£ ¤ ¢ ¢ £ ²]
Å0 0 ¡ [ ¦ ¢ ¤ ¬
¿ 6 0 ¤¬ Ï ¤¬\ ¢¤
¬ [ ¿ 6 [¦ \ ¢ ¢£ ²] ¢
¤¬ Ï ¤¬\ _¢ ²] Ä £ MÊ ° ¢¤¤
£ ¿ 6Ä ¿ Ä ¢¡ ¤
¡ ¢ ²] ®¤ _¦° ¬ ¢¤ ¢¡¤
Ä ¤ ¿ Ä ¿ 6Ä ¢¬ ¢ ¢£ £
~ ¬ ¢ ¢ ¤ ²] ¦ ²] ¤ ¦ò¤ ¢°
¦9 60Ä ¢ Ä ¿ ¤ ²] ¦¬ ¡
£ ¤ ¤ ¬
¤ ¤ ¢¡ ¤
¬ ¬ ¢ ¢ ²] ¦ °£ ¤
¤ z ¡ ¢ £ ¢ ²]
¢¢¡ ¦ ¢¬¤ ¢ ¡£ ¢¤ ¤
¦ 6 Í ¦ ³
¢ ³ ¡ ¤ ¤
® ¢ ° ¤
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 41


¼ + .! ,
. , ,". % . sxE
[(

*Gt ! /*Gt
= +Q)ST+): UU)+T%S)%
_ <Q)ST%S)& <<)UT%%)9
¹ US)ST%S)Q <<)UT%%)9
( %SS %SS
= 3 6 +Q)ST+): ++)&TU)+
?
¼ + .! ,..#,
, ,". % . sxE
l #[(
.# +
*Gt ! /*GtN *Gt ! /*Gt
= :S)ST<)+ %U)<T<)Q YS)+T%Y)Y Y+)&T%%)+
_ ::)YTU)S Y+):T+)Y Y+)QT%9)S <%)%T%%)+
¹ 9S)ST+)Y :&)9TU)+ <%)QT%9)S 99)9T%:)%
( %SS &9)%T9)S %SS &9)9TQ)<
= Q9)YT+)9 US)<TU)+ <%)QT%9)SÆ %SS
3 6
Æ[S)SQ 6'
® ¢ ¤ ¦ ® ¢
¤ ²] ¤
¤ ¢ ¢ ¦°
¢ ¢ £ ¢ £ £ ²] ¤ ¤
²] ¡ ¡ ¦° ³
¡ ¬ ¢ ³ ¬¤ [*Å\
[¦ \ ¢ £ ²] ¦
¡ ¢¡¤ 0Å00Ä ¢ ¤ £
¢ 0Ä ¢
¢ ¢ ²] ¢¡ ¤ 6 ¦° [¬ 6Å\
¤ ¬ ¡ ¢¬¤ ~ ¢ £ ²] ¢
[MÊ\ ° ¦°
¤ ¢¤ ¢¡ ¤ ¢ Ä 0Ä £ 6Ä
²] [¦ *\ ] ¢ ¤ ¬
¦ ¦° ¬ [³ ¬¤È MÊ ¤
[¡ ¢ Ä ¢ ¢ ²] ¢ ³
Å ¢ ¤ ¢ ¡ ¦ ***Ä ¢ ²]\
\ ¢¤ ¢¡ ¤ _ ¢ ¢£ ²]
¡ ¿ ¢¤ [¡ ¤³ ¡
6 ¢ ¤ ¢ ¬¤ ¦ \ Ä ³¤ [¬
_ ¤ ¢ Å\ [MÊ ¤ ¢ ¦ ¢
¡ ¢ £ £ ²]\ *
¤ ¡ ª ¢ ° *0Ä ¢¡
¤ ¬¤ ¤ [* ¬ ¡\ ¢
¢¡ ¤ ¡ £
- ¦ 6Å ³ ³¤9 Ä ¤ ¬
¦ ¢¤¤ ¦° [MÍ
¢ ¦ ¢¬¤ ¤ ¢ ° ¤\
¢ ¬ ¤ ¢ ¢¬ ¡
¤ ³ ¦¢¤ ¢
¢¬ ¡ ¢ ¢£ £

L
¼ '+ . % . ., ,". % s
l #[(
n # '+
.#*GtOM +*Gt *Gt
* %Q)U·%&)%:)
.:S6 6 Q)+·U)Y <)U·U)9 S·Q)U
* %U)%·%&)9)
:S·YS6 %Y)S·%<)U% Y)U·9)S 6 Q)U·+)%
* <9)<·<+)%%) * UU)%·UU)+)
9S6*28 U&)Y·+&)Y
6 +%)+·++)Q 6 &%)&·&9)Y
%M[S)SQ 2-Õ_;:M[S)SQ -Õ_'
²] ¦ ¦° ®£ ¡ ¢ ¤ [¡ \
¢ ¢£ £ ¤ ¦¬ 6
¢ £ ²] ¿ ¬ ¡ ¦ ¤ ¤
¦ ¬¤ ¢¡¤ ¬
¢¤ ¥° ° ¡ ¤
¡ ¢ ¢£ ²] ¦
Å ¦ Å ³ ³ ° ¤
~ ¢ ¢£ ²] ¢¤ [Å \ ¤ ¢ ¦ ¢ £
° ²] ¤ ¤ Å*
¦ ¢ ¤ ¢ ¦°£ ¤ ¢ ¢ £ ²]
£ [Å6 \ ¬ ¢ ¬ ¢ ³¤ ¤
¤ *0Ä _ £¡ ¤ ° ¦ ¢£¡
¢ £ ²] ¡ ¢ ¤ ¢ ¡£ ³
¢¤ ¢ ¤ ¦ ¢ £ ²]
¤ 6ÅÄ [MÍ ¤ ® ¢ ¢¡ ³ ²]
¢ ¢ ¢£ ²]\ ¦° ¢
¤ ¤ Å ~ ¢ ®° ¢¬¤ ¤
£ ²] 0Å*6Ä ¦ ¡ ¤ ¡ ¢ ¢£ ¤
¢¤ ¡ ³¤ ¢ £ ²] ¤ ¤
¤ ¢¤ ¢¤£ ¢ £ ²] ¢
¦° 9 £ Ä ° ¡ ¤
*60Ä ¢ ³ ¦ ¡ ¡ ¢ ¢£ ²] ° ¤
° ¤ ¢ ¦ ¢ ¢£ ²] 0*Ä Ä ¢ [MÊ\
[Ä MÊ\ ³ ¡° ¿ ¤ ¤ [ 6
¢ ¢ £ ²] [ÅÄ\ ¬ 6Å\ ¢ °
® ¢¦ ³ ÅÄ ¡ ¢ ¢£ ²] ¤
¢¤ ¢ ¤ ²] ¢ ÅÄ ¢ ²]
¦ ¬ q ¢ ¡
¬ ³ ¢¤ ¢
° 6Å ¢ ®¤ ¬¤ ¢¤ ²]
® ¢¦°¤ ¡
³ ¬ ¢ ³ ¦¢¢¡
¤ ® ¢¡ ¢
¢ ¢ ²] ¤ ¡ ¬ ¢ £
6 ¦° °¤ ¡ ¡ ¡
¦ ¢ ¢£ ²] ³ ¦ ° ¤ ¢ °¤
¢ £ [MÊ\ £ £ ® ¤ ¢ ¤
²] [MÍ0\ [¦ 6\ ¡ ° ~ ¤ ¢
¤ ¢ ¢£ ²] ° °¤ ¢ ¤ £¡
° ¦ ¬ [ ¿ ¤ ¢¡¤ ¦°
¢ ¢£ ²] ¿ ¢ £ ²]\ ¢ ³¤ ¤ ²] ¢
³ ¢ ¬
Ä ~ ¢ ¤¢ ¢ ¤£ ¤ ¢ ¢¡ ¤ £¡®
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 43

¤ ¢¡ ¢ ¢ [ ¢ \
¤ ¤ ²] ¡ ¢ ¢ ° ¡
¦ ¤ ¤ ¢¢¡®¤ ¢¤
£® ³¤ ¬ ¤¢ ¢ ¢ ¤ ¤ ¤
¬ ¢¤
® ¦ ¢ ¢° ¤
¬£ ¢¦°¤ Â6Ã
¤ _ ¢¤ ®
¡ _¤ ¡ ¢¡¤ ¤ ¤¤ ²]
¢¡ ¤ ® ¢¡ ¤ ` ¤ ¤¡
¤ ¤ ¤ ¡¤ ¢¡³ ²] ¦ ¤
®¤ ¢ ¦ ¢ ¤ ³ ¢¡
°®¤ ¤ ¡ ® ° ¢
¤ ¢¡ Â6Ã
~ Å ¤ ¤ ] £¡
¢¤ ¡¢ ¢ ® ¢
¬ ¦¤ ¢ ¢¤ °
¬ -¢¤ }¤
¡ ¬ ¢ ¦ ¤ ¢¬ ° ®¤
°¤ ¢ ¢
£ ¡ ²] ¦ ¡ ¢¤ ¤
ÂÃ Å ¿ Å
_ ® ¢¤ ¤ ²] °¤ ³ q ¡ ¢
¤ ¢£ ¤ ¦ ²]
¢ ¢® ¢ ¤®¤ ¢¡ ¢
¡ ¤ - ¢¡ £¤ ¢ ¬
[ ¦\ *Å*Ä - ¦¡ ¬
¢¡ Å0Ä
] ¦ ¢¢¡® ³
k_oaZ[Y_
¢£¡ ¦¤ ¦¤
¡ ¬ ³ ²Q ?ÀÁ' ¢¢
¢¤¬ ¤ £ £
¡ ¢¤¬ ÂÃ ¦ ¤¢ ²] ¢
¢¤ ²] ¢ ¢¦°¤ ¡ ³ ²] ¢¦¢
¡ ¢ ¡®¤ ®¤ ¢ ¡
¢¡ ¢ ¢ ³ ¤ ¢ [ ¢¡
²] ® ¤ ¬ ¤ ° £ ° 6
¬ ¡ ¤ ¬ ¦ ¬£
¦ ¡ ¢¡ \ ¦ [
¬®£ ¦¢ ¤
¦ ¡ ¢ ¢¤\ ¢¡¤ ® ¤
ÂÃ _° ¢¤
¤ ¢ ¦£ ¦°
¤ ® ¢ ¡ ¢ ¢¡³ ¦
£ £ ²] ¤ ¢ ¤ ¬
ÂÃ °¤
q ¤ ¤ ¦
¢¤ ¢¡ ¤ ¬ ²] £¡ ¤ ¦
¬ ¡¤ ¦ ® ¢¤
` £ ³ ¢ ¦ ¬ ³
¡³ ¬ ³¤ ¬ ¤ ¤
¢¦¢¡ ²] ~ ¢¦ ¢¡
¢¤¬ ¢¤ ° ³®¤ ¡¤ ¢¡

¤ [¢ ¦ \ ¬ ¢ £ ¦ ¦¡

¢¡ ¬ ¢¡¤
¤ ¢ ¤ ¬ ° ³ ¡¤£
¬ ¤ © ¢ ¡ ¢ ¢
¦ ¡ ¡ £ ¤ ¦ ¢
¢¤ ¤ ¤ ¢ ¬ ¦ ¤ ¢¦¤ ¢
¦ ³¤ ¤ ¦ ® ¢¤ ¦ ²]
¤- ¡ ³ ¢¦°¤ ²]
¢¤ ° ¤ £ ¢ ¢°¤ ¦ ¤
¤ ¡ ¢ °¤ ¡ £¡
¢ ²] ¡ ¤ £ ¤
¦ ¢ ¤¢ ¢ ®£ ?ÀÁ'
³ ¢ ! " !
¢¦°¤ ¢ ¦ >
'3'4 nGHBJ"H=J"
1. Braksiek M, Lindemann U, Pahmeier I. (2022). Physical *%| %! $ ! | ° ¤È¯~¹| _° ~|¤}È>}»
Activity and Stress of Children and Adolescents during j|}~¯||¤È¯~|
the COVID-19 Pandemic in Germany — A Cross-Sectional 9. Konstabel K, Verbestel V, Veidebaum T et al. (2014).
Study in Rural Areas. Int. J. Environ. Res. Public Health. 19: ¼jq_¡j{ jxj _x{ xq_¡_q _` Ejx` _{j`°
}J¯|_°~|¤¤~»æj¯ }J¯|°¤> È}È|° §jE¢ªq|`q|®|j|¤ °ª¤>ª¯¤|_°~|~¤ »
PMC9321660. æ|}~¯|¯¯|°}>¤JÈ}>|
2. `_¥x < «ÃÃqÃj ®< çxqx < ¥_Ãx < 10. Kovacs VA, Starc G, Brandes M et al. (2021). Physical activity,
{qx|;}~}A|x_`_x{q_¡_qj¡j{_`q jj` q_j x` qj { {j _` Ej Æ
before and during a Pandemic Lockdown. Int. J. Environ. Res. `j¡xq_`x{q_`~`q_j|E|®|ªqª_|¤J¤°
{_ jx{q| ° >¤| _° ~|¤¤~»æj ~>¤| ° 1–10. doi: 10.1080/17461391.2021.1897166. PMID: 33641633.
3406620. PMCID: PMC8151114. 11. íjÃx{j`_x`<ªàjÃ^{j_x<ªx`jÃxqx<
3. Chambonniere C, Lambert C, Fearnbach N et al. (2021). à`|;}~}A|xqx`j_`¿`_¡j_q
EÒjq qj {¥` ` _x{ xq_¡_q x` Students’ Physical Activity Levels: An Early Systematic Review.
sedentary behaviors in French children and adolescents: ¢`q|{|°È}¯>ÈJ|_°~|¤¤ »^|}~}~|È}¯>ÈJ|
New results from the ONAPS national survey. Eur. J. Integr. PMID: 33519653. PMCID: PMC7845570.
j| ¯¤° ~¤~ | _° ~|~È»¼|j¼_|}~}|~¤~ | ° 12. Malta DC, Gomes CS, Barros MBDA et al. (2021).
33584872. PMCID: PMC7871771. §j x`j_ x` x`^j _` qj {_jq{j
4. xq ®< £_{{j` ®< {{ ¢< < Ej{` ¿< xÃ_{_x` x{jj`q| j¡| x| E_j_{| }¯° j}~~}|
¢_q®jqx{|;}~}~A|}~}~£^_j{_`j`_x{xq_¡_q doi: 10.1590/1980-549720210012. PMID: 34105593.
and sedentary behaviour for children and adolescents aged 13. Ã¡ < j E| ;}~¤A| jj`q _x{
5–17 years: Summary of the evidence. Int. J. Behav. Nutr. activity in healthy and diabetic children and adolescents
|q|J°¯|_°~| È»}ÈÈ~}~~~¤JÃ|° (review and own results). Problems of Endocrine Pathology. 4:
33239009. PMCID: PMC7691077. J J|±Ç%µ¶<·*µ´|;}~¤A|µ$!* G 8!&
5. E{`x^^x «< {Úxqx`_ < x £ª< E{¢xxx` ª| * %!# % = =% =! $*% L
(2020). Physical Activity in Adolescents During the Social *%;+" % #! !A|BL !-
Distancing Policies of the COVID-19 Pandemic. Asia Pac. J. * !!& +&|¯°J J¹|_°~|} >È»¼E|}~¤|¯|~|
{_jx{q|¤}°¯¯¯|_°~|JJ»~~>¤>}~È¤>È¯| 14. Morres I, Galanis E, Hatzigeorgiadis A,
PMID: 33016086. Androutsos O, Theodorakis Y. (2021). Physical
6. ¢Þj{ «< è < x{x < êxàë < _qàì ®| ;}~}}A| q_¡_q< ªjj`qx_`j< Exq_`^ jx¡_ x` £j{{j_`^
§j xq _qx`j Exq_` _`^ qj during a COVID-19 Lockdown Period in Greek Adolescents.
x`j_ ` _x{ q_¡_q x` £j{{j_`^ Ãj x` Nutrients. 13: 1449. doi: 10.3390/nu13051449. PMID:
{_{jj`q|®|ª|jx{q|}°¤J¯J|_°~|» 33923341. PMCID: PMC8147023.
¼|¤}¤}|°¤>È}|°>¤}~>| 15. ½^«<j®<x{j¢<{_Ò®<£|;}~}~A|x_j
7. Guthold R, Stevens GA, Riley LM, Bull FC. (2020). x` x_{_qxq q x`^j _` x{jj`q _x{ xq_¡_q
{x{ qj` _` _`è_j`q _x{ xq_¡_q x`^ _`^|®j`ªqE¬j|j|È°j~~~|
x{jj`q° {j x`x{_ } {xq_`xj _° ~|¤È»¼j}~}~~~~| ° ¤¤}È} ¤|
¡j ¥_q |È _{{_` xq__x`q| x`jq _{ {j| PMCID: PMC7673110.
jx{q| ¯° }¤¤>| _° ~|~È»ª}¤>}¯È¯};A¤~¤}¤}| 16. O’Kane SM, Lahart IM, Gallagher AM, Carlin A, Faulkner M,
PMID: 31761562. PMCID: PMC6919336. ®x^ < | ;}~}A| x`^j _` _x{ q_¡_q<
8. «x{_`_j` '| ;}~¯A| ^_j`_ xjj`q x_{ ª{jj<j`qx{jx{q<x`ª_x{j_x¿j_`^
q xq_¡_q _{j` JJ jx {| ªq j ¥``^{jj`q_{°_¬jjqªq|
__`j| ° ¤È¯~| ± ! 8!* 'µ| ;}~¯A| +H!8! ®| | q| jx{q| ° ÈJJÈ >| _° ~|}¤»¼x|}~}~
$!* L%& =%& * %!# JJ - 0649. PMID: 33979779.
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 45

17. x < ªqx «| ;}~A| _x{ xq_¡_q x` _x{ 21. Ten Velde G, Lubrecht J, Arayess L, van Loo C,
j¡j{j`q { x^j _{j`| j` j_xq_| jj{_` < jæ`j < j^j`_{ | ;}~}A|
¿x_`j| > ;~A° ¯¤¯ | ± * ³'< î = ¶| ;}~A| ï 8- Physical activity behaviour and screen time
! * %!# G 8! % * R*!+ %*| _` q _{j` _`^ qj x`j_° j<
8 #! "|À* &! |>;~A°¯¤¯ ¹|_°~|>>J¯» _`^ x` q{ {j| j_xq| j| È°
SP.2019.101.43. j}JJ| _° ~|»æ}JJ| ° ¤¤È}¯¯¯¤|
18. Eª| ;}~}}A| {x{ qxq jq ` _x{ xq_¡_q PMCID: PMC7995017.
}~}}| ¿° qq°»»jj|j{x|^»»jj» 22. §{_`¢x`_ «< ªqj¡j` £®< < ¨x`^ §< jq <
^{x{qxqjq`_x{xq_¡_q}~}}»| «j{{j ® jq x{| ;}~}A| §j _xq qj `x¡_ _jxj
19. Rossi L, Behme N, Breuer|;}~}<q¤~A|_x{q_¡_q }~x`j_`_x{xq_¡_q_`¿|ª|_{j`|®|ªq
Children and Adolescents during the COVID-19 Pandemic — jx{q ª_| ~° ¤}¤¤¤}| _° ~|~È»¼|¼|}~}|~}|~~>|
ª_`^ j¡_j¥| `q ® E`¡_` j {_ jx{q| ;}A° PMID: 33657464. PMCID: PMC8167336.
¯¯~|_°~|¤¤~»æj }¯¯~|° > ¤¤~J| 23. £| ;}~}¤A| _x{ q_¡_q| ¿° qq°»»¥¥¥|¥|_`q»
PMID: 34769956. `j¥»xqjjq»jqx_{»_x{xq_¡_q|
20. Schmidt SCE, Anedda B, Burchartz A, Eichsteller A, 24. ¨x`^ < ¨ £< «x`^ ª< Ä_ < ¨< ª` | ;}~}~A|
Kolb S, Nigg C et al. (2020). Physical activity and screen time Association between Physical Activity and Mood
of children and adolescents before and during the COVID-19 States of Children and Adolescents in Social Isolation during
{¥` _` jx`° `xqx{ j¬j_j`q| ª_| j| ~° qj E_j_| `q| ®| E`¡_`| j| {_ jx{q|
1–12. doi: 10.1038/s41598-020-78438-4. PMID: 33311526. J° JÈÈÈ| _° ~|¤¤~»æjJ}~JÈÈÈ| ° ¤¤~ÈÈ>|
PMCID: PMC7733438. PMCID: PMC7589310.

ly vÆ||!|<# |!|#|< %|%!!" & L $&@ÀÉ'!# =! %Á" *%¸´Ç¸À* &! Ê|
´# °|² *%<|â%! <>} |jjxj£jª_j`j°¢~~} }~}}ºqq°»»_|^»~~~~~~~>>}È¤ |
_h1½ , +y Æ*||!|<# |!|#|<$|* G| &² *%#*+! $! !+!%# !¶|¸| ! |
´# °|² *%< !%L <¯| |!|#|%!!" & L $&@ÀÉ'!# =! %Á" *%¸´Ç¸À* &! Ê|
´# °|² *%<|â%! <>} |qq°»»_|^»~~~~~~~ >>} ÈÈ|
|k ( Æ*||!|<$|<$|* G| &á¤ !! +&² *%#*+¸ÇÀ|´# °|² *%<|¸ * <¯| |!|#|%!!" &
L $&@ÀÉ'!# =! %Á" *%¸´Ç¸À* &! Ê|´# °|² *%<|â%! <>} |jjxj°§}È¯J}~}¤º
qq°»»_|^»~~~~~~~} >¤ÈÈ¯¤|
"! R *$&}}|~È|}~}¤|< !" *~È|~|}~}¤|

~ ***99
W X $$ X
L ++ %, % ' .%1

-22O - ! # '
6 '/
For citation: Tokarchuk NI, Overchuk AA. (2023). Value of vascular cell adhesion molecule-1 and CC16 protein in bronchiolitis
in young children. Modern Pediatrics. Ukraine. 5(133): 47-51. doi 10.15574/SP.2023.133.47.
= 6- 2 * *6 2 ) * * ) 2
,8* 2 6- '
V *× 2 2 "te% %< *6 2 '
V , 05 Y9 )6 *6 ** '.
8YY )6 *6 * '/ 2
:Q 6 '/ * * "te% %<
- 3 '
l .#0¹2"te% QQ)QT%)%: V)
, >%<9)&T%)% V@2 *Y >_5OXY;&QË.#7%)9+·<)%:;W[S)SQ@'R 2
2"te% 9%)<T%)Y: V'_ 2 * ÁÁ%<
>9%):T%):9 V@ >::)+T%)<9 V@
>t!OX%)<;&QË.Î7S)+·Y):;W[S)SQ@'R 2 , * %<* 63 6 2
>%<):T:)9Y V@'
0R 2 )66 *6 ) 2, * ÁÁ%< "te% '=
)2* ÁÁ%< *
** '0 2 "te% )
*28 * '
. ?2 2 '( 6 ^ 2
* '0 2 3 * 2 '
_ - 2 23 '
_ e*6 ) ) ) ) %)*ÁÁ%<'
48A@D<R=8>?@A89?DAA8:HD>;<GE<AD?@AD18G:22OS9<CD;G;GT9<G?H;<A;C;>
;GB<@GF?H;A:9DG
=(G30/-\;*0EE54,-\;*0
cCBDHdCGÀDKHaHPeLbHKDCGeLfDFCGgdDPLKEDBh)"DddhBEhC)gjKCDdL
sDPLdBkLELPLKDBhHIBkLFHlKELHIoKHdFkDHGDBDEDdhHldaFkDGfKLd)LEWLFDCGGhJDBkColKfLdLfCGGLKaDFkDEBHKh)BkLELCKFkIHKoDHbCKjLKEIHKLCKGh
fDCadHEDECdfWKHadHEDEHIBkLfDELCELDElKaLdB'
W@9S<>DBHEloEBCdBDCBLBkLLrWLfDLdFhHIfLBLKbDdDdaBkLGLPLGEHI"te%Cdf%<DdoGHHfELKlbDdoKHdFkDHGDBDEDdhHldaFkDGfKLd'
m8CD9;8A 8G: EDCH<:>0 pkL bCDd aKHlW FHdEDEBLf HI Y9 FkDGfKLd JDBk oKHdFkDHGDBDE JDBkHlB C ELKDHlE CGGLKaDF kDEBHKh' pkL FHbWCKDEHd
aKHlWDdFGlfLfYYFkDGfKLdJkHElIILKLfIKHboKHdFkDHGDBDECdfkCfCELPLKLCGGLKaDFkDEBHKh'pkLFHdBKHGaKHlWFHdEDEBLfHI:QFHdfDBDHdCG
GhkLCGBkhFkDGfKLd'pkLFGDdDFCGCdfGCoHKCBHKhLrCbDdCBDHdFHdEDEBLfDdfLBLKbDdDdaBkLGLPLGEHI"te%Cdf%<DdoGHHfELKlblEDda
BkLDbbldHLdqhbCBDFbLBkHf'
fD>@AC>0pkLGLPLGHI"te%DdoGHHfELKlbJCELEBCoGDEkLf>QQ'QT%'%:daVbG@DdBkLFkDGfKLdHIBkLbCDdaKHlW)JkDGLDdBkLFkDGfKLdHIBkL
FHbWCKDEHdaKHlWBkLCPLKCaLPCGlL>%<9'&T%'%daVbG@HIBkDEDdfDFCBHKJCEYBDbLEkDakLK)>t!OXY;&QË#7%'9+·<'%:;W[S'SQ@'#dFkDGfKLd
HIBkLFHdBKHGaKHlW)BkLCPLKCaLGLPLGHI"te%DdoGHHfELKlbJCE>9%'<T%'Y:daVbG@'tdCGhEDEHIBkLCPLKCaLGLPLGHI%<WKHBLDdDdoGHHf
ELKlbKLPLCGLfDBEEDadDIDFCdBDdFKLCELDdFkDGfKLdHIBkLbCDdaKHlW>9%':T%':9daVbG@FHbWCKLfBHBkLDdfDFCBHKHIFkDGfKLdJDBkoKHdFkDHGDBDE
JDBkCELPLKLCGGLKaDFkDEBHKh>::'+T%'<9daVbGbG@)>t!OX%'<;&QË#7S'+·Y':;W[S'SQ@'#dFkDGfKLdHIBkLFHdBKHGaKHlW)BkLCPLKCaLPCGlL
HIBkL%<WKHBLDdJCEJDBkDdBkLKLILKLdFLPCGlLE>%<':T:'9YdaVbG@'
2<G?A@>;<G>0 #d hHlda FkDGfKLd JDBk oKHdFkDHGDBDE) DB DE CfPDECoGL BH fLBLKbDdL BkL GLPLG HI %< Cdf "te% WKHBLDd Dd oGHHf ELKlb'
#BJCEIHldfBkCBBkLGLPLGHIAA%<WKHBLDdDdoGHHfELKlbJCEEDadDIDFCdBGhGHJLKDdFkDGfKLdJDBkCELPLKLCGGLKaDFkDEBHKhFHbWCKLfBHFkDG
fKLdJDBkHlBCELPLKLCGGLKaDFkDEBHKh'!dBkLHBkLKkCdf)KLaCKfDdaBkLGLPLGHI"te%DdoGHHfELKlb)DBEPCGlLJCEEDadDIDFCdBGhDdFKLCELf
DdBkLbCuHKDBhHIFkDGfKLdJDBkELPLKLCGGLKaDFkDEBHKh'
HbbDBBLLHICGGWCKBDFDWCBDdaDdEBDBlBDHdE'pkLDdIHKbLfFHdELdBHIBkLWCBDLdBJCEHoBCDdLfIHKFHdflFBDdaBkLEBlfDLE'
gDBI<9:>e`KHdFkDHGDBDE)FkDGfKLd)LCKGhCaL)CGGLKaDFkDEBHKh)PCEFlGCKFLGGCfkLEDHdbHGLFlGL%)%<WKHBLDd'
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 47

ko^X\ ¬¤ ¦ ® ¤¬¤

¢ £ °¤
©
¢ ¤ ÂÃ _
® ®£ ¢ ¡° ¡ ¢ ¦ ¢¦¢¡
¤ ¡ ÂÃ ¢ ¢
¤ ¦££ ¤ ¡
¦ ¦ ¬ ÂÃ ¢ ¦
¦ ¦¬ ¢¦¢¡®¤
££¤ ¡ ¤ ¡ ¢
¢ ¤ ¡ ¢ £ ÂÃ ¢ Q [ !ÎQ\
£¡ ¤ ¦ ¦ °¤ ¢ ¤¢¤ ¢ ÂÃ
¦ ¢ ¦¤ ¢¡¤ ¤ ¬
¡ ¢ ° ¢ ®¤ ¤ ¤¤ °¤
¢ ¬ ° $"# ¢ ¦
¦ ¤ £ ¢°®¤ ¢ ¤
¢ ¢ £¤ ¦£® ® ¡ ¢ £ ³ ¢¡® ¬
¡¤ Â0Ã ¤
_ ®¤ @ ¤ ¿ ¦ò ¬
¡¤ ¡ ¢®¢ ¤¢ ¢¡¤ ÀQ¨
¢¡ ¢ ¦ ¬ ¢ ¦
¢ ¦ ¢
¬ £®¤
¤ ¦ ¤
¡ ¢ ¤ ®
¢ ¤ ¦ Jq¢¬¤
® ¤ ¢ ¤ ¡ W
[ÀQ¨\ q£ ¤ ¢ ¯ ¬ ¬
®¤ ¢ ¡ j
¢ ¬ ¢ ¢ ¡ ¦¤ ¢¡
¡¤ ÀQ¨ ¤ ® ¤ q
° ¢ ¬ *6 ¦ ¦¢ ¦¤
¬ ÂÃ ÀQ¨ ¢¦¢ ¡ ¢ ¤¤
¡® ¢£ ¬ ¬ ¢ ° ** ¤ ¦
£ ¢ ° ¢ ¦¤ ¡ ¢
¡ ¢¤ Â*Ã ¢
ÀQ¨ ¬ ¤
¬® ¢ £ 06Ï ¤¤ ¿ Ï6
¦ £ £ ¤ ¬ ¿ 6Ï
³ ¦ò® ¬ ¤ ¢¡¤ ¤ ¦
¤ ÀQ¨ ¤ ¦ °
¬ Â6Ã ¤¬ ¢
_¢£¡ ¡ ¤ ³ ¦-¢
¢¡¤ ÀQ¨ ¢ ¤ ¡ ¤ ¡¤ ¢
¢ ¦¡ ¤ ¤ ¦ ¢
¤ ¬ ¢ ¦ ¢ ¦ ¬
£ ¢ ¦ £
~° ¦ ¢ ¢®£ ¢££
¡ $"# £ ³ ¦£ ¡ ¤
¡ ¬ ¡ ¡ ¦ ¦
¤ ¤£¤ Â6Ã © ¤ ¤ ¢¡ ÀQ¨
³ ®¤ $"# ® ¦° ¬ ¢ £ ¦
° ¬¡ JÑ" ÀQ¨ <ÎÁZQ 1W JÑ"
°¤ q <ÎÁZQ 1W


(. +42jm1 / . ' - +-0*s
^ ' a ++ _ #'
GtN Gt Gt
a # # #
-0s 42jm1 -0s 42jm1 -0s 42jm1
'¾, '¾, '¾,
. &>:<)QTY):9@ U<)+T:)9+ :<>U+)UT:)UY@ :9U)UT%)+: · ·
"te%
. 3 :Q>UY)QT%)<+@ 9<):T:)Y9 U>:%)YT9)9<@ Q+):T:)%: 9%)<T%)Y: :Q>%SS@
"te%
8 3 "te% 6 2 R '
¡ ¦¦ ¢ ¡¤ [6Ï -\ ¬ ¢ ¦
¤ £ * ¢ ³ []qÆÍ*È Ä Á9 60ÅÈ
¢ £ +Ê\
ÁÇ¨ Z!ZZ JZ7Q7ÁZ7ÁQ W Z Z Á ~° ¢¡ ÀQ¨
J<8$ *W ¤ JÓ% Ò W ¢ ¬
¤ ¡ ¡ 6Ï [6Ï* -\
¦¡¤ q¬ ¤ ³ ¦° [ÍÈ
¢ ¢ £ ¢¡¤ *Ï0Ä\ ÀQ¨
¬® °¤ ° ¬ ¦
[Q?Æ\ ¢ ¡ [Á\ ¢¡ ¢ ¢ 6Ï*6
Ä - ¤ ° [Ï*6Ä\ ¦
¤ ¤ ³ ÀQ¨ ¬
®£ ¬ ¬ ¡ ¢ ¢¡¤ 0Ï60 -
j ¢ [Q?ÆÍÈ Ä j9 0Å**È +Ê\
¦¡ ³ ¤ _ ¦° [ÍÈ 0Ï*Ä\
¤ ¡ ¤¤ ÀQ¨
~ ¦-¢ ¬ ¦ ³ ¢
¬® ¢¡¤ 6Ï0 - ¤ °
¬ ¬ ~ [*Ï66Ä\ ¦ ¬®
¦-¢ ¬® ÀQ¨ ¦ ¢¡ ¢
¤ ¤¬ 0Ï - [Q?ÆÍ6È
¢ ¡ Ä j9 Å*0È +Ê\ ¢¢¡ ³
³ ¤ ¡ ¤¤
¦¡ £ ¢¡¤ ÀQ¨ ¦
¬ Ö! [\ ³ [Q?ÆÍ*È
¬ § ¢ £ ¦ Ä j9 6Å*0È +Ê\ [¦ \
¬ [66\ ¬ ¢¡
¡ ¬¬ ¢ ¡ ¢ ³ ¢¡¤ ¦
¤ ¢ ¡£ £ [6Å0\ ¢ ¤ Â*Ã q
¢ ¢ ¤ ¢ ¢ ¦
~ * ¯ [¢ ¢ £ ¬ ¢
¢ ¢ ¢ ¡ ¬ ¦
¢ ¤ ~ ¯ *\ [¦ \
[6Ï6 -\ ¦
³ ¤¤ ¿
~ 0Ï6 - [Q?ÆÍÈ Ä j9 0Å*È
¢¬£ ¢ +Ê\ ~ ® ¢
¤ ÀQ¨ ¬ ¡¤ ¦ ¦
[¦ \ ¢ ¿ Ï6* -
ÀQ¨ Ï - ¢¢¡ ³ ¦° [Í*È
¤ ¤¤ ® ¢ 6Ï*0Ä\
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 49


(. +-ppO / . ' - +-0*s
^ ' a ++ _ #'

GtN Gt Gt
a # # #
-0 -0 -0
ppO ppO ppO
s s s
'¾, '¾, '¾,
. ÁÁ%< :Y><U)9TY)+<@ Q9)QT9)9+ · · · ·
. ÁÁ%< · · :9>U:)UT:)+:@ &)9:T%)Q9 · ·
. 3 %%>Q9)QT9)9+@ %+):T:)9: &>:U)YT9)Y: %%)<T:)%: :Q>%SS@ %<):T:)9Y
ÁÁ%<
³¤ ¤ ® ¢¡¤ ³¤ ¤ ¦ ¬£
¤ 6Ï660 - ¤ ° ¤ ¢ ÂÃ
[6Ï660Ä\ ¦ ¬® ¡ ³ ¦
¦ ¢ ¬ ® ¡ ¢
¢ ¢¡¤ 0Ï6 - ¦¤ ¡ ¢ ¤
[Q?ÆÍÈ Ä j9 6Å*0È +Ê\ ¢ ¢ ¦¢ ¦¤
_¢ ¦° [Í6 Ï0Ä\ ¡ ¢ ³ ¢®¤ ¢
¤¤ ¦ ¢ Â00Ã
¢ ¢¡¤ 6Ï6 - _ ³ ¤ ÀQ¨ ¬
¤ ° [*Ï6*Ä\ ¬® ¢¡¤ ³
¦ ¢¡ ¦° ¢ ¦¤ ¡
¢ ¢ Ï - ¢ ³ ¢®¤ ¢
[Q?ÆÍÈ Ä j9 0Å0È +Ê\ ÂÃ
¢¢¡ ³ ¦ ° ®
[Ï -\ ¤ ¡¤ ¤ ¢ ¤¢ ¦
¤ ¦ ¡ ¤ ¢ ¢ ¬ ¤
[Q?ÆÍ*È Ä j9 ¡ ¢ £¤
6Å*0È +Ê\
¤ ¡
k_oaZ[Y_
¦° ¤®¤ ¡£ ~ ¦
¢¡ ¢ ¦ ¢ ¬ ® ¢¡¤ ¤ ¦
¦ ¢¡¤ ¢ ¢ ÀQ¨ ¬ ³
¤ £ ¬¤ £ ¦ ¬
¢¤ ¬ ÂÃ ³ ¡ ¢ ¦¤ ¡
¢ ¬ £® ¢ ¤ ¢ ¢ ¦¢ ¦
¤ ¢ £¡£¡ ¤ ¡ ¢ _
ÀQ¨ ÂÃ ³ ¤ ÀQ¨ ¬
£¡ ¢ ¢¡¤ ³ ¦°
¤ ¤ ¦ ¬ ¢ ¦¤ ¡ ¢
¡ @c]o\cY^_[_ \ZdWgwm_ dZogedfcaw;
¡ ¤ ¤£¤ ¦¤ ¤ £® ¡
¡ ££¤ ¡ ¦ ¢°®¤
¬ ¤ ¤ ¢¡¤ ¢ ¤¢ ¤ ¦
¤ ¤¤ ° ¬ ¤
°¤ ¡ ¢ £¤
¦ ÂÃ _ ³ Ffc]cgW ieaWaoX[Waa; ¤
¤ ¤ ¬ ! " !-
¦ >

'3'4 nGHBJ"H=J"
1. Almuntashiri S, Zhu Y, Han Y, Wang X, Somanath PR, ERJ open research. 6 (1): 00268–2019. https://doi.
Zhang D. (2020). Club Cell Secreted Protein CC16: org/10.1183/23120541.00268-2019.
Potential Applications in Prognosis and Therapy for 10. Kou M, Hwang V, Ramkellawan N. (2018). Bronchiolitis:
Pulmonary Diseases. Journal of clinical medicine. From practice guideline to clinical practice. Emergency
9 (12): 4039. https://doi.org/10.3390/jcm9124039. Medicine Clinics. 36 (2): 275–286. https://doi.org/10.1016/j.
2. Birnhuber A, Fliesser E, Gorkiewicz G, Zacharias M, emc.2017.12.006.
ªjj{_^j < x¡_ ª jq x{| ;}~}A| jq¥jj` _`xxq_` 11. Li G, Jiang X, Liang X, Hou Y, Zang J, Zhu B et al. (2023). BAP31
and thrombosis: endothelial cells in COVID-19. j^{xqjqjj¬j_`»¡_x »½¢
European Respiratory Journal. 58 (3): 2100377. ò xq¥x _` xqj {`^ _`¼ _j j{| _j ª_j`j|
doi: 10.1183/13993003.00377-2021. 313: 121310. https://doi.org/10.1016/j.lfs.2022.121310.
3. Cui A, Xiang M, Xu M, Lu P, Wang S, Zou Y et al. (2019). 12. Li Y, Huang X, Guo F, Lei T, Li S, Monaghan–Nichols P et al.
j_xqj `jq_{ _`Ñ{qxq_` j¬xjxqj (2020). TRIM65 E3 ligase targets VCAM-1 degradation to
x_j`q Ñ`j xq_{j_`j {`^ _`¼| §¬_{^ {__q ª_`j {`^ _`xxq_`| ®`x{ {j{x
Letters. 302: 60–74. cell biology. 12 (3): 190–201. https://doi.org/10.1093/jmcb/
4. ¢q ®< ª`xxx¼x` < j`^ ®< ¬ < xj` mjz077.
drasah S, Muthavarapu N et al. (2016). The role of club cell 13. Liu M, Lu J, Zhang Q, Zhang Y, Guo Z. (2021). Clara cell 16 KDa
phenoconversion and migration in idiopathic pulmonary qj_`_q_^xqjjq_qj_`jx_¥x_`xxq_`
Ñ_| ^_`^| ° ¤~¤~| qq°»»_|^»~| È¤}» and damage via regulating airway epithelial cell apoptosis in a
aging.101115. manner dependent on HMGB1-mediated signaling inhibition.
5. Genies MC, Kim JM, Pyclik K, Rossi S, Spicyn N, Molecular medicine (Cambridge, Mass.). 27 (1): 11. https://
Serwint JR. (2018). Impact of an educational intervention to doi.org/10.1186/s10020-021-00277-4.
improve physician adherence to bronchiolitis clinical practice 14. Perkins TN, Oczypok EA, Milutinovic PS, Dutz RE, Oury TD.
guidelines: a pre-post intervention study. Clinical pediatrics. ;}~A| Ejj`j`q j¬j_` _` qj {`^
57 (3): 253–258. https://doi.org/10.24061/2413-4260. endothelium mediates IL-33-induced allergic airway
XII.1.43.2022.6. _`xxq_`|{{j^|J¯;A° |qq°»»_|^»~|»
6. Guerra S, Vasquez MM, Spangenberg A, Halonen M, all.13500.
Martin RJ. (2016). Club cell secretory protein in serum and 15. __ £< £¼qxx ®< ôj{¼æ{_ | ;}~ÈA| §j {j x`
bronchoalveolar lavage of patients with asthma. J. Allergy importance of club cells (Clara cells) in the pathogenesis
Clin. Immunol. 138: 932–934.e1. https://doi.org/10.1016/j. of some respiratory diseases. Pol. J. Cardio-Thoracic Surg.
jaci.2016.03.047. 1: 26–30. https://doi.org/10.5114/kitp.2016.58961.
7. Guzmán–Bárcenas J, Calderón–Moore A, Baptista–González H, 16. Sonntag H-J, Filippi S, Pipis S, Custovic A. (2019).
{j|;}~JA|{xxj{{qj_È¬j_`_`jx`_x{{ Blood Biomarkers of Sensitization and Asthma. Front.
Ventilated Term and Preterm Infants with Respiratory Pediatr. 7: 251. https://doi.org/10.3389/fped.2019.00251.
Distress Syndrome and at Risk of Bronchopulmonary 17. Spella M, Lilis I, Stathopoulos GT. (2017). Shared epithelial
Dysplasia: A Pilot Study. Can. Respir. J: 1–5. https://doi. pathways to lung repair and disease. Eur. Respir. Rev.
org/10.1155%2F2017%2F8074678. 26: 170048. https://doi.org/10.1183/16000617.0048-2017.
8. Hong EY, Ahn YM, Hong G, Ro JY. (2019). A role of mast cells 18. §x ½< ¡j | ;}~}}A| §j _^`_Ñx`j È
in ovalbumin-induced mouse allergic asthma responses protein in bronchiolitis in young children. Neonatology,
jj `xqx{ q _¬qj ;¥x`^x`Â| surgery and perinatal medicine. 12; 2 (44): 34–37. https://doi.
Journal of Allergy and Clinical Immunology. 143 (2): AB74. org/10.24061/2413-4260.XII.2.44.2022.6.
https://doi.org/10.1016/j.jaci.2018.12.230. 19. Tokarchuk N, Overchuk A. (2022). Diagnostic value of markers
9. Hunderi J, Rolfsjord LB, Carlsen K, Holst R, Bakkeheim E, x{{j^__`xxq_`_``_{_q__`_`x`q|½j`xq{-
Berents TL et al. (2020). Virus, allergic sensitisation and gy, surgery and perinatal medicine. 12; 1 (43): 31–36. https://
cortisol in infant bronchiolitis and risk of early asthma. doi.org/10.24061/2413-4260.XII.1.43.2022.6.

n q +vÆ||!|<G|* G| &á¶!! $*+¸ÇÀ!Ç|'|B +% |´# °|¶!! $"<%|²! $*R#<~ |
Resercher ID: http://www.researcherid.com/rid/U-4036-2017; https://orcid.org/0000-0001-6868-6596.
^ (+( %Æ # ! * G| &á¶!! $*+¸ÇÀ!Ç|'|B +% |´# °|¶!! $"<%|²! $*R#<~ |
Scopus Author ID: 57842848800; http://orcid.org/0000-0002-7797-4458.
"! R *$&¤~|~È|}~}¤|< !" *~È|~|}~}¤|
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 51

UDC 616.98:578.834]-036.1-07-092-053.66
N.V. Drutsul–Melnyk1, L.A. Ivanova1,

I.B. Horbatiuk1, A.O. Shkilniuk2
Features of COVID-19 in teenagers. Clinical cases

1Bukovinian State Medical University, Chernivtsi, Ukraine
2Regional Children’s Clinical Hospital, Chernivtsi, Ukraine
For citation: Drutsul-Melnyk NV, Ivanova LA, Horbatiuk IB, Shkilniuk AO. (2023). Features of COVID-19 in teenagers. Clinical cases.
Coronavirus infection in childhood is a common disease and has a number of features of the clinical course. There remain quite a lot
HIWKHoGLbEKLGCBLfBHBkLPCKDLBhHIFGDdDFCGEhbWBHbE)BkLELPLKDBhHIBkLFHlKELCdfBKLCBbLdBBCFBDFEDdfDÃLKLdBCaLFCBLaHKDLE'
PurposeBHEBlfhBkLLWDfLbDHGHaDFCGCdfFGDdDFCGILCBlKLEHIBkLFHKHdCPDKlEfDELCEL!"#$%&DdCfHGLEFLdBEFHbWCKLfBHBkLhHldaLK
CaLaKHlWDdHKfLKBHWKLfDFBBkLELPLKDBhHIBkLFHlKELCdffLBLKbDdLBKLCBbLdBBCFBDFE'
Materials and methods. tEDdaGLFLdBLKKLBKHEWLFBDPLHWLdFHkHKBEBlfhHI%++WCBDLdBEldfLKBkLCaLHI%+kHEWDBCGDqLfDdBkLDdILFBDHlE
fDELCEL fLWCKBbLdB HI BkL kLKdDPBED OLaDHdCG kDGfKLd]E GDdDFCG mHEWDBCG JDBk C FHdÉKbLf KLEWDKCBHKh DdILFBDHd FClELf oh AtOA":
JCEFHdflFBLf'pkDEFHkHKBHIWCBDLdBEDEfDPDfLfDdBH:FGDdDFCGaKHlWE'pkLsKHlW#FHdEDEBLfHIFkDGfKLdCaLf%:BH%+hLCKE>9YFkDGfKLd@)
BkLsKHlW##DdFGlfLfFkDGfKLdCaLfSBH%%hLCKE>%9QWCBDLdBE@'
Results. MWDfLbDHGHaDFCGGh)LrBKCICbDGDCGEHlKFLEHIDdILFBDHdWKLPCDGDdCfHGLEFLdFLDdBkLKCdaLHI99':Ë>dX%&@)JkDFkDELrWGCDdLfohaKLCBLK
EHFDCGCFBDPDBhFHbWCKLfBHFkDGfKLdIKHboDKBkBH%%hLCKEHICaL'ÂHKBkL%stHoELKPCBDHdaKHlW)EhbWBHbEHIfCbCaLBHBkLGHJLKKLEWDKCBHKh
BKCFBCKLbHKLFkCKCFBLKDEBDF)DdWCKBDFlGCK)FHlak+%'9Ë>dX:Y@)EkHKBdLEEHIoKLCBkQ%'%Ë>dX::@)khWHrLbDC%9':Ë>dX<@CdfEhbWBHbE
HICEEHFDCBLfJDBkDdBHrDFCBDHdEhdfKHbL>aLdLKCGJLCjdLEE)CEBkLdDC&U'<Ë>dX9:@)fLFKLCELfCWWLBDBL)KLIlECGBHLCBU9'9Ë>dXY:@)bhCGaDC
%%'<Ë>dXQ@)kLCfCFkL%9):Ë>dX<@@'pkLELPLKDBhHIBkLFHlKELHIBkLFHKHdCPDKlEDdILFBDHdDdCfHGLEFLdFLDEflLBHBkLfHbDdCdFLHIGHJLK
KLEWDKCBHKhBKCFBGLEDHdEJDBkBkLfLPLGHWbLdBHIWdLlbHdDCDdQ+':Ë>dX:Q@HIFCELE)JkDFkKLwlDKLfGHdaLKCdfbHKLDdBLdEDPLBKLCBbLdB'
Conclusions.pkLEkCKLHICfHGLEFLdBEkHEWDBCGDqLfflLBH!"#$%&JCE::'&Ë>dX9Y@)CbHdaBkLbJDBkCELPLKLfLaKLLHIDbWCDKbLdB
HIBkLaLdLKCGFHdfDBDHd%<'9Ë>dXU@)JkDFkDEflLBHBkLWKLfHbDdCdFLHIfCbCaLBHBkLGHJLKKLEWDKCBHKhBKCFBJDBkBkLfLPLGHWbLdB
HIWdLlbHdDCDdQ+':Ë>dX:Q@HIFCELE'pkDEFHkHKBHIWCBDLdBEDEFkCKCFBLKDqLfohCGHdaLKDdBHrDFCBDHdEhdfKHbL)BkLLWDfLbDHGHaDFCGKHGL
HIICbDGhFHdBCFBEJDBkKLaCKfBH!"#$%&fLFKLCELE)CdfBkLPCGlLHIldDfLdBDÉLfdHdICbDGDCGEHlKFLEHIDdILFBDHdDdFKLCELE99':Ë>dX%&@'
pkLKLELCKFkJCEFCKKDLfHlBDdCFFHKfCdFLJDBkBkLWKDdFDWGLEHIBkL$LFGCKCBDHdHImLGEDdjD'pkLKLELCKFkWKHBHFHGJCECWWKHPLfohBkLvHFCG
MBkDFEHbbDBBLLHIBkLDdEBDBlBDHdbLdBDHdLfDdBkLJHKj'#dIHKbLfFHdELdBHIWCKLdBEHKBkLDKalCKfDCdEJCEHoBCDdLfIHKFHdflFBDdaKLELCKFk'
cHFHdØDFBHIDdBLKLEBEJCEfLFGCKLfohBkLClBkHKE'
Keywords: AtOA":)LWDfLbDHGHaDFCG)FGDdDFCGILCBlKLE)CfHGLEFLdBE)FkDGfKLd'
^ - -'234561 0_

"q%" 1 $ 1ZY ' 1$ " 2
%Ò 2 )'Ê)R
:5* )'Ê)R
/ 3 ,8 6- , * * 'Z 8 , 2
* *) ] 6 6 ) - * 2- - 6 6
6'
V * !"#$%& 8-- -
* '
V , 0( %++ , %+)
6 36 2 Ê2 * - - 3
,-)-AtOAH":'Ù- , '?Î %: %+
>9Y @) ÎÎ S %%>%9Q , @'
l .#0= 8 3 - 2 699):Ë>dX%&@)
-, 2 *28- 2- - 2 %%'. Î*286
6 6 2686) ) 82+%)9Ë>dX:Y@) 8 Q%)%Ë>dX::@) %9):Ë>dX<@)
)] > 2 * 2) &U)<Ë>dX9:@) )
U9)9Ë >dXY:@) %%)<Ë >dXQ@) *2 %9):Ë >dX<@@' \ 2 * 3
* 6 6 26 86 Q+):Ë >dX:Q@ ) *
*28 '
0Ê 6 Á!"#$%& ::)&Ë>dX9Y@) 6 8
2 %<)9Ë>dXU@) 6 6 2686 Q+):Ë
>dX:Q@ '., , 6 *28 )8, 2 2
6 Á!"#$%& , 6 6 399):Ë>dX%&@'
. ?2 2 ' ( 6 ^ 2
* '0 2 3 )* 2'
_ - 2 23 '
_ eAtOAH":) ) * ) ) '

A
% ã $ +% 32 " % %
ô " 2 0 * *
3" % " % #2 ZQÆZ
À Ò % 3
Materials and methods of the study
$"% 6*00 $% + +"$ Á % Ò ++$ #
% ã $$2 %$ % $ +3 + "%2
+ % 45 '" +% + % Ò %"% Ò $"%% + "%
*66 % Ò % 0 + $ç% " %
"$ " $$% %- +$ % %+ ¨"+ $ + -
" ?ÀÁ' + "$ $% + J3 Æ $ $% $ $
%% 7 $ "# % Ñ + $W Ò % + 2
% $% Ò "% "+ " % #2 ZQÆZ À Ç2 $2ç 00 %
Å 2 ¿ *Ä % +$ ¿ + # % %@
$% % Å 2 ¿ Ä % % # 3 "+ Ò % 7 Ö "+ Á
Ò $2 % $% % % $% % 0 2
Å 2 ¿ Ä ÂÃ Q "$% [6* $%\ Ö "+ ÁÁ $"%% $% %
# % " " % 2 [6 + \ 7" +
$% % % # 3 $ç% + % Ä
2 %3$ + $ $ 7 ?ÀÁ' Ò 3% #
% $% % + 3 "$ $"$ + $2
ÅÄ $% % 3 " [!Æ\ "%2 Ò %
% # 3% ZQÆZ À $% ¨ $
% $% Ò + 2 + 2 $ % + 2 $ Ò # Ò " %
+ $ 2 ÂÃ Q$ Ò % % ZQÆZ À Q +$8
+ " ?ÀÁ' $ $ $ # 2 % " $ 5
% $ "% " # â" $% " " % #2 ?ÀÁ'
7 % 2 5 Ò % " % Ò %% + $ç% $%
#2 ZQÆZÀ + 7 $2 "$ Ò %
% % 3 + % " " +" + 5 Z
2 " $% Â*ÅÃ <3 # Z Z Á <8$$ ó! Ó% Ò + $
#% +" Ò 2+ 8 +" " + % +
% 2+ë $ % #% $"$ % 7 % 3 $"
%"$ " % $ $ $ % + $ $ "$ Ò "%% # %
^3$ 3% $ $ 32 [Z\ +2 [Z+\ 7 5
" ?ÀÁ' +" % $ 3 $ç Ò "%% 5 "
$ 3 % + # #"3 [QÆ\ $ 3 5 [ÆÆ\ % %%
%"$ ÂÅÃ [?Æ\ 3 Ò %
Á $2 $3 % $3$ ë Ä % 3 $ [Ä Á\
2 5 + $ % $"% 7 Ò % " %
3 + '% % Ò ++$ '$ Ñ$ 5
Ò $ % Ò " 5 32 7 + $ Ò ++ 3% #2 Î $
" $ + $ 2 % %" < " %
+ 2 "++ ÂÃ Ñ + $ç Ò 5 Á % $%
3 " % Ò + " % Ò # %
% Ò $ Ò $3$ $"5 2 %"
% +$ $ % $3$ 3
Results of the study and discussion
+ Â*Å6Ã 7 % $$ Ò
$2 % % $ Ò 5 Ó "%2 +% $ $ "
3 ?ÀÁ' 3" $%
7 purpose Ò 5 ¿ "%2 3 Ò #$ % + 3
+% $ $ % $ $ " +% $ $ "% $
3" % ?ÀÁ' % $ Ò +3 $ +% $ $$2
+ % 2 " "+ % $2 7 Ò
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 53

Table 1
Features of the course of COVID-19 in children at the hospital stage (%)
Symptoms Group I (n=43) Group II (n=145)

sLdLKCGJLCjdLEE)CEBkLdDC 97.6 +<'U
ÂLPLK U&'% 88.9
$LFKLCELfCWWLBDBLVKLIlECGBHLCB 77.4 <<'9
ÀkCKhdaDBDE <+'% <Q'%
cCECGFHdaLEBDHd Y9'& 46.8
Rhinorrhea %Y'& 21.3
ehCGaDC 11.6 Q'+
mhWHrLbDC 14.2 Y'<
mLCfCFkL 14.2 Y'Q
MrCdBkLbC :'Y :'+
$DCKKkLC :'Y 5.8
ç% $% "+ [Í\ % 2+ 8 [Í\ Ò %
Ò 8+$ % #2 + % × 2 Á + â"2
+ #$ 3 %" 3 â" " #
" Ó $ 32 % 2+ 8 Á % ÁÁ $ $ "+ Ò
$% % % $ +% $ $ 069606Ä 90Ä % 69*Ä +3$2
$ $2 % % Q$ % $ % 2+
"%% 8 $ $ " % Ò 8 2% [ $
Á + "$ % $ Ò 5 Ä [Í6\ % %
$% Ò %% 3 "5 Ò ++ " $ 66Ä [Í*\ 2 $
" Ò Ò 66Ä [Í\ % 6Ä [Í\ Ò + # #$2
Q $2 $ $ %" 3# $ " + #$
" 3" % $% $% 2 ? %
% + #$ % " $ % + "+ 2+ %
" @% â"2 "++ + 2 % %
2+ $% $ $ "+ + "$ $ 60Ä [Í0\
[7 #$ \ 7" 2+ % *Ä [Í*\ % 3 00Ä [Í\
$ Ò + 2 +3 $% % $ % % 0Ä [Í0\ Ò â"$2
+ "$ " [Í*\ # %
Q %" $
$$ 2+ % Ò %
9
8.2 $$ $ $% Ö "+ Á 8+
8
% Ò % +
7
5.9
6.4 + + Ò + # #$2 # 3%
6
5.1 5.3 5.5 $ $% Å 2 $% Ò
5 4.7 4.7
days
4.4
4 3.7 3.8
4.3 4.34.1 4.4 + # #$2 # " % #2 "#×32
4
3 #2 + $% % "+ %
3
2
2.3
1.9 + #$2 $ Ò
1
1 % #2 × 2 + 3
0
+ "+ 7" % 2
+ $ " $ $ 2+
$ Ò 5 " + + 2
Group I Group II
% 8 + % % $ Ò
Ò % $ "+ #"
Fig. 1. Duration of clinical symptoms (days)
+ % $ [> \

7 " ?ÀÁ' 6Ä [Í\ 70
+ Ö "+ Á Ò + % 58.1

60
#2 3 % "# $ %
Ò$ + Ö "+ Áj 3 50
41.4
" % Ò % $2 40 37.2
Ä [Í\ 7 +% 32
%
30
" % $ # 8+$ % #2 18.6 18.6
20
% × 2 + 15.1 13.9
9.3
"+ $ $ Ò + 2 10 6.9
% %3$ + +" 0Ä 0

0.4
[Í\ + Ò +

Ö "+ ÁÁ Ò â"2
+" %% 8% *Ä [Í*6\ $ $
+% $ $ $2 Ò% 32 Group I Group II
" ?ÀÁ' Ò %
Fig. 2. Treatment for COVID-19 in children
% $ $$ Ò 9 Z ¿ 6Ä [Ä Á9
0Å\È Z! ¿ *Ä [ÄÁ9 0Å\È
?Æ ¿ [ÄÁ9 Å6\È ÆÆ ¿ 6 [Ä % %" ?ÀÁ'
Á9 Å6\ QÆ ¿ Á $ Ò + $% # +
+ % + Ö "+ ÁÁ "+ Ò 7 #$ % >
Ö "+ Á % % 5 % > 3 " $ % $ $
$ Ò + 2 "$ + 2 " " ?ÀÁ'
" % #2 ZQÆZ?À9 ?Æ ¿ Ò +
66* [Ä Á9 6Å 0\È ÆÆ ¿ [Ä Á9 Clinical case 1
*Å\ QÆ ¿ * Boy O. 2 $% Ò + $ç%
7 $ 3$2 3 " ?ÀÁ' 3 " % 2
% $ + Ò +% % Ò +$
%2 3 $3 $ Ò + 2 # %2 + " *Õ "
ë 2 + Ò $ ë% # 5 > 9
3 %" + % 2 ¿ " % Ò
+ %@ 7" # %2 + " *Õ "È
3 $ 2 + #% Å*rd % 2 ¿ # %2 + "
$% Ö "+ ÁÁ Ò 0 % 2 + % "+ *Õ " # È
Ö "+ Á ¿ % 2 6 % 2 ¿ ++ % $$ 3 # %2
7 3 " ?ÀÁ' # %2 + " *Õ "
Ò $ ë% # È % 2 ¿ + $ç
"+ Á + "$ % $ + 3 " 3 Æ $
+ # #$2 3% 2 $" % $% $ $ Ñ + $ Ò " +
[ÖZ\ Ï6 % 2 $ + % % #$ $ +" + 2 "ã2
â"% 82 "++$ ¿ Ï* % 2 ÁÅÁÁ % 2+ 2%
Ò$$ 3% # Z" +% ?ÀÁ'õ <+% $ $
+2 ¿ 0Ä [Í\ % â"% " % '" #×3 8
+2 [Á7\ ¿ *Ä [Í\ Ò $" + $ç Z ?2 ¿ 6Ä # %2
$ $" % % " % + " ¿ *0ÕÈ + 2 ¿ 0-
"$ ¿ *Ä [Í\ > " 7 $ % 3 Ò %"
Table 2
Duration of treatment for COVID-19 in children (days)
Group Oxygen subsidy Antibiotics Infusion therapy Glucocorticosteroids

# <'STY'Q %:'QTS'+ :'&TS'&U <'%T%'<9
## %'9TS':: +'%TS'9U :'YTS'<< :'QTS'Y9
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 55

+ # # " ÁÁ % % Ò +$
2+ 8 2% 7 # %2 + " *0Õ
2+ Ò $ # %2 2 " $$ 3 # %2 >
3 " ç 9 nd % 2 ¿ # %2
ÁÅÁÁ % Q" "$ 2 # 3 + " *0ÕÈ *rd % 2 ¿
$" Ò 5% # % Ò 3 "$ # %2 + " *Õ $$ 3
$ ' 9 ?" + $ # %2 Q + #% #2 % 5
3 $# $ #$ $ $ +" >$ 8 ^" È ? 6 % 2 ¿ 2
+$ % ÁÁ % # # " "$% +% % Ò + $ç%
ÁÅÁÁ % + 2 $" ?ÀÁ' # % 3 Æ $
% #2 + $2 [!ÎÆ\ $% $ $ Ñ + $ ' "+
Á $ #$ % $2 %2 $9 Z" + ?ÀÁ' <+% $ $
# 2 [6Ô10\ % % '" #×3 8
" +$ [ %"$ ¿ * "$ ¿ + $ç Z ?2 Ò 0Ä
6\ # 3% Q "$ %% $ # %2 + " Ò *Õ % + 2
% % Ò Ò 6- Ö $ % %"
$% 3 + [6 -$\ 32 %" 2+ 8
% '% [0 -$\ 2% "++ + 2
$3$ + $ [6 -$\ Q + 3 "$ ? 5 "5 $ Ò % "++ $#
+ $2 Ò # + %+ +"$ 2+ # 5 "%
- ZQÆZ À Ò # % + " % ' 9 "
% 2 % 3 3 $ "++ + 2
% 2 % "$+$ $ $ç %" 3 "
ó 2 8 3 $% #$ $ ?ÀÁ'Q" + 2 % Á $
+ $2 $ +" '" 2 #$ % $2 $"5 2 Ò " +$
+ $ + % # %2 %2 # 2 % Q
+ " $3$ #$ 3 $" 6 % 2 "$ %% $ %
7 + "%Ò 82 +2 ¿ * % 2 % Ò $% 3
# $ +2 [$3 ë 8 : +\ ¿ + [6 -$\ % '% [6 -$\
% 2 Ò #% ¿ % 2 $3$ + $ Ò $
< 8+ %" " " $ #"$ [0 -$\ Q + 3 "$ + $2
% %8 Ò $ " % ? 6 % 2 Ò # -
2 3 " $% ZQÆZ À Ò # % Ò [
% + 3% $2 $% Ò *rd % 0 % 2
% " %+ % \ '" "$ "% 8
# ? % 2 #% $ 32
% ++ % Q% $ %2 % 2 ç +$ Ò 3 $% '"
+ $ 3 "$ 2 + $ # %2 + "
+ $2 $% Ò 5+ Ò $ $ 7 + Ò
Ò % % 2 % % Ò 8 # $ +2
7 +"$ 2 $ $ + % 2 "$ %
#$ $ $ +" + # #$2 $" % Ò % % ? 0
3 $# $ # % 2 $$ % ++ %
+ $ 2 Ò 2+ 8 Ò â"% ? % 2 $% Ò % %
3 " Ò 82 2 %
"++$ È % ë 2 7" $ $ % " % #2
+ Ò #$ % "$ % % 7" + + $2 + $%
# "% % + % $ $2 ë" " Ò $
%"$ #" Ò 3 #$ " + # #$2 %" 3 "$ # 5 "%
$3 % # %2 + " % $
Clinical case 2 "++ + 2 #" Ò
Boy H. 2 $% Ò + $ç% $3$ % ë 2 5
" %+ 6 % 2 % 2+ "$

Conclusions 7 32 % %"

?ÀÁ' $%
Q +% + + $ç% Ö "+ Á 6Ä [Í\ + %
?ÀÁ' % $ Ò Ä Ö "+ ÁÁ [Ä [Í\ Ò %"
[Í6*\ +% $ Ò + 2
Á % $ +% $ $ $ $ Ò %3$ + +"
$2 Ò % ?ÀÁ' 0Ä [Í\ Q% $
% % 3 $" "%% + 3 "
$ $ " ¿ 66Ä ?ÀÁ' % $$ Ò 3 $"9 Z ¿
[Í\ 6Ä [Ä Á9 0Å\È Z! ¿ *Ä
7 $ $ " 3" % [ÄÁ9 0Å\È ?Æ ¿ [ÄÁ9
% $ + ç% #2 $ Å6\È ÆÆ ¿ 6 [Ä Á9 Å6\ QÆ ¿
8 2% % 2+ % &' (')*+(, '/ +),0304,4 564 70(86307 9; ,<0
$ Ò + 2 6=,<'34>
'3'4 nGHBJ"H=J"
1. Alsohime F, Temsah MH, Al-Nemri AM, Somily AM, 8. Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, Zhang W, Wang Y,
Al-Subaiea S. (2020). COVID-19 infection prevalence Bao S. (2020). SARS-CoV-2 infection in children.
in pediatric population: Etiology, clinical presentation, N Engl J Med. 382: 1663–1665.
and outcome. J Inf Public Health. 13 (12): 1791–1796. 9. Ludvigsson JF. (2020). Systematic review of COVID-19 in chil-
2. Cai J, Xu J, Lin D, Yang Z, Xu L, Qu Z et al. (2020). A Case Series dren shows milder cases and a better prognosis than adults.
of children with 2019 novel coronavirus infection: clinical and Acta Paediatr. 109: 1088–1095. doi: 10.1111/apa.15270.
epidemiological features. Clin Infect Dis. 28: 28. 10. MOZ Ukrainy. (2022). Chernivetskyi oblasnyi tsentr kontroliu
3. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y et al. (2020). qxÑ{xq¡¨¿x_`|±ÇµÂÀ* &! |;}~}}A|
Epidemiological and clinical characteristics of 99 cases Ü!%$* L #! $! *! Q G * *
of 2019 novel coronavirus pneumonia in Wuhan, China: =%LÇµÂÀ* &! ¹|¿°qq°»»¥¥¥|^j`j|^¡|x|
a descriptive study. Lancet. 395: 507–513. 11. Ong SWX, Tan YK, Chia PY, Lee TH, Ng OT, Wong MSY,
4. Cui X, Zhao Z, Zhang T, Guo W, Guo W, Zheng J et al. Marimuthu K. (2020). Air, surface environmental,
(2021). A systematic review and metaanalysis of children and personal protective equipment contamination by severe
with coronavirus disease 2019 (COVID-19). J Med Virol. acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from
93 (2): 1057–1069. a symptomatic patient. JAMA. 323 (16): 1610–1612.
5. Cui Y, Tian M, Huang D, Wang X, Huang Y, Fan L et al. (2020). A 12. Wardell H, Campbell JI, Vander–Pluym C, Dixit A. (2020).
55-Day-Old Female Infant infected with COVID 19: presenting with Severe Acute Respiratory Syndrome Coronavirus 2 Infection
pneumonia, liver injury, and heart damage. J Infect Dis. 17: 17. in Febrile Neonates. J Pediatric Infect Dis Soc. 9 (5): 630–635.
6. Dadgar S, Mahmoudinia M, Akbari A et al. (2022). Placental 13. Young BE, Ong SWX, Kalimuddin S. (2020). Epidemiologic
infection with SARS-CoV-2, analysis of 16 cases and features and clinical course of patients infected with SARS-
literature review. Arch Gynecol Obstet. 305: 1359–1367 CoV-2 in Singapore. JAMA. 323 (15): 1488–1494.
https://doi.org/10.1007/s00404-021-06372-5. 14. Zhao S, Ling K, Yan H, Zhong L, Peng X, Yao S, Huang J,
7. Huang C, Wang Y, Li X, Ren L, Zhao J. (2020). Clinical features Chen X. (2020). Anesthetic Management of Patients
of patients infected with 2019 novel coronavirus in Wuhan, with COVID 19 Infections during Emergency Procedures.
China. Lancet. 395: 497–506. J Cardiothorac Vasc Anesth. 34 (5): 1125–1131.

z /»V #q+Æ # ! * G| & "8 =!G*$! ==%L·*% !#*+@ÇÀ|´# °|Ü!%$<%|#* <}~J´º
|;~¤J}A>J>ÈÈ~|
v y (,Æ||!|<G|* G| & "8 =!G*$! ==%L·*% !#*+@ÇÀ|´# °|Ü!%$<%|#* <}~J´º
|;~¤J}A>J>ÈÈ~|qq°»»_|^»~~~~~~~}È¯ÈÈ |
a -v) Æ*||!|<$|* G| & "8 =!G*$! ==%L·*% !#*+@ÇÀ|´# °|Ü!%$<%|#* <}~J´|º
|;~¤J}A>J>ÈÈ~|qq°»»_|^»~~~~~~~}J >¤~|
}#(^ 'Æ* G!*$! !& +!# * µ ¸BÉµL #! "8 *!8! * !"Ê|´# °|Ü!%$<%|#* <}~J´|
"! R *$&}|~}|}~}¤|< !" *~È|~|}~}¤|
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 57

~ 09Â09*Ã
! [X 1WX 1%2W X[1

a , ., - + /
" /* b+.!. +,, % , '*
!
18 . 9
2 ++ : 8 ( !8 ( !5'4;.<;#
`<9?;C8C;<GeKorniychuk OP, Tymchuk IV, Ferents NM, Konechnyi YT. (2023). Gram-positive microbiota as potential factors of
healthcare-associated infections in children and adults. Modern Pediatrics. Ukraine. 5(133): 58-64. doi 10.15574/SP.2023.133.58.
R ^2 2 * 3) ] 6 >Î(0¸.@) - 2 )
, - 2 'Z :S%&·:S:%' , '
V 6* Î(0¸. 6 6'^2 '
V , 0 ¸ * 6 * 6 8) *
6 ^2 'Î 3 - - *1e#iO!vtpMAp4* 1MKoCvCFkLbC4'
_ * 2 MgtAp'
Á ** 6 - 1eDFKHEHIBMrFLG:SSU4'
l .#0Á * ) , Î(0¸.) 6 8
>YS)+Ë@) > S %U@YQ)9Ë ' 2 3 , )*
) :%)QË) 6:U):Ë'Z ><Y)<Ë@ 2 S. aureus) 6
)* - > 6Q<)QË@)3 >Q9)QË@ 3 >9Q)9Ë@'Á 6
, * 6 68 3 ><Q):Ë@)3 >Q:):Ë@)3>+U)SË@
&)%Ë) %+):Ë Y<)9Ë) ' Ú
* 3 9Q)QË*3 '
00 - 22, Î(0¸. )* ,'/2 2 68 *28, 2
'_ * 28 ) 6 6) 2 ) 2 2* ,'
¹2 * , - 3 3 -
* 6 66 ]'
. * )6 ^0¸R. ? 2 '0
2 3 , >* 2 *66@'
_ - 2 23 '
_ e3)] ) * ) 2 3)
) '
c98E1S<>;C;=DE;?9<T;<C88>S<CDGC;8AR8?C<9>
<RHD8ACH?89D18>><?;8CD:;GRD?C;<G>;G?H;A:9DG8G:8:@AC>
5B63-<.>\;*01(8G>7\;*01=F,-,<9:2)G63<,\;<>.1
%$CdhGHmCGhBEjhvPDPcCBDHdCGeLfDFCGgdDPLKEDBh)gjKCDdL
:HbbldCGcHdFHbbLKFDCGMdBLKWKDELHIvPDPOLaDHdCGHldFDG1vPDPOLaDHdCGkDGfKLd]EGDdDFCGmHEWDBCG1!metp$Ûp4)gjKCDdL
#d BkL vPDP KLaDHd) FCELE HI kLCGBkFCKLCEEHFDCBLf DdILFBDHdE >mt#E@ Dd FkDGfKLd HFFlK) olB CKL WKCFBDFCGGh dHB KLaDEBLKLf' ÂHK BkL WLKDHf
:S%&·:S:%)dHBCEDdaGLFCELJCEKLaDEBLKLf'
W@9S<>DBHDfLdBDIhCdfFHbWCKLBkLEWLFDLEFHbWHEDBDHdHIWHBLdBDCGmt#EWCBkHaLdEDdFkDGfKLdCdfCflGBEDdvPDPkHEWDBCGE'
m8CD9;8A>8G:EDCH<:>0eCBLKDCGIHKBkLEBlfhJCEFHGGLFBLfIKHbFkDGfKLdIKHbPCKDHlEoDHGHaDFCGdDFkLEJkHJLKLldfLKaHDdaDdWCBDLdB
BKLCBbLdBDdvPDPkHEWDBCGE'#fLdBDIDFCBDHdJCEFCKKDLfHlBlEDdae#iO!vtpMApjDBEbCdlICFBlKLfohMKoCvCFkLbC'tdBDoDHBDFElEFLWBDoDGDBh
JCEfLBLKbDdLfCFFHKfDdaBHMgtApKLFHbbLdfCBDHdE'
fD>@AC>0tbHdaBkLDEHGCBLfaKCbWHEDBDPLbDFKHoDHBCBkCBbLLBEBkLFKDBLKDCHImt#E)LdBLKHFHFFDJLKLbHEBHIBLdfLBLFBLfDdCflGBE>YS)+Ë@)
CbHda FkDGfKLd >IKHb S BH %U hLCKE@ Dd YQ)9Ë HI FCELE' ABCWkhGHFHFFlE LWDfLKbDfDE JCE fLBLFBLf Dd :%)QË IKHb FkDGfKLdÜE WCBDLdBE)
CEBkLFClECBDPLCaLdBHIBkLWlKlGLdBELWBDFWKHFLEE)JkDGLDdCflGBE·:U):Ë'tEDadDIDFCdBWCKBHIS. aureusFlGBlKLE><Y)<Ë@DEHGCBLfIKHbFkDG
fKLdJCEKLEDEBCdBBHCbHrDFDGGDd>CbHdaCflGBEQ<)QË@)FLIBCqDfDbL>Q9)QË@CdfFLIlKHrDbL>9Q)9Ë@'tbHdaCflGBWCBDLdBE)BkLWLKFLdBCaL
HIDEHGCBLfKLEDEBCdBEBKCDdEBHFLIBKDCrHdL><Q):Ë@)FLIHBCrDbL>Q:):Ë@)FLILWDbL>+U)SË@JCEEDadDIDFCdBGhkDakLKFHbWCKLfBHElFkDdfDFCBHKE
DdFkDGfKLd·&)%Ë)%+):ËCdfY<)9Ë'pkLCdBDoDHBDFFLIBDqHrDbL)JDfLGhlELfDdKLFLdBhLCKEDdBkLBKLCBbLdBHIFkDGfKLd)JCEdHBLIILFBDPLDd
9Q)QËHIFCELE'
2<G?A@>;<G>0 $LEWDBL BkL GHJ GLPLG HI KLaDEBKCBDHd HI mt#E Dd FkDGfKLd) BkDE WKHoGLb LrDEBE' pkL dlboLK HI KLEDEBCdB EBKCDdE DE DdFKLCEDda'
pkLELdEDBDPDBhHIEBKCDdEBHCdBDoDHBDFEDEHGCBLfDdFkDGfKLdCdfCflGBEfDIILKEEDadDIDFCdBGh)EHaLdLKCGKLFHbbLdfCBDHdEbChdHBoLLIILFBDPL'
pkL KHGL HI BkL FGDdDFCG bDFKHoDHGHaDEB Cdf LWDfLbDHGHaDEB DE LrBKLbLGh DbWHKBCdB IHK LIILFBDPL DdILFBDHd FHdBKHG Cdf wlCGDBh LbWDKDF CdBDoDHBDF
BkLKCWhDdDdfDPDflCGkLCGBkFCKLELBBDdaE'
pkLKLELCKFkJCEFCKKDLfHlBDdCFFHKfCdFLJDBkBkLEBCdfCKBEHIoDHLBkDFE)CWWKHPLfohBkLLBkDFEFHbbDBBLLHIBkL$CdhGHmCGhBEjhDvceg'
pkLDdIHKbLfFHdELdBHIBkLFkDGfÜEWCKLdBECdfBkLWCBDLdBJCEHoBCDdLfIHKBkLfLEFKDWBDHdHIBkLFGDdDFCGFCEL'
gDBI<9:>emt#E)aKCbWHEDBDPLbDFKHoDHBC)kHEWDBCGDdILFBDHd)FkDGfKLd]EkHEWDBCG'

ko^X\ ¤ ¬ £

¤ ¢ ¡
~
¢
¡ ¦ @ ¤ ¿ ¤
¡¢ ¤ ¡ ¤¢ ¤ ¬ ¢¦ j_
¢ ®£ ¬®£ - ¬ z ¢
¤ ¢ ¢ Å
³ ¤ ³ ¢-
¤ ¢ ¤ ¤¢ ¢ ¢¦¤
¤ ¢ ¤ £ ® ¦ ¤ ¤ ¢¦ -
¤ ° ¤ - ¢ ¢ ¦¡ ° ¤ ¦
¢ ¤ ~ ¬ - ¬
¢ ¤ ® ¦ ¬ ® z ¦-
¤ ® - Jz ¦ ¤¡ ¡
¤ ¢ ¬ - ¤ Jq]|W ¬®
£ ¤ ³ ® ¦ ¬ ®
¤ ° ¤ z ¦ Jz ¦
¤ ¡ ¤ ¡ ¤W ¤ ¢¡
¢ ¦¢ ¦¢ ¬ * ¬® [0Å06 \
¢ £ ¦ ¢ [Å \ ¡ 6 £ [Å ¤-
¬ ¤¢ ¢ ¤ ¡ - ¬\ ¢ ¢£ ¤ j_
[j_\ ¢¦ -
¢ £¤ ¢ ¢¤ ÑÆ?¨Á' S. aureus <$ ¿
¢ j_ ¡¢ ° ¡ # ¨ö"8 ¤
¤¢ ¢ ¤¡ ¤£ ¦ ¦ ¤ -
¢ ¡¤È ¢°- j¬£ ¢ -
¡ ¤ ¬¤¬¤ ¤ £ ¦ J¨Á1Æ?ÎQ7<Z7W ¦¬
³ ¦¢ - J<# Î W ]¦¡ ¢-
¢ ¤ ¢ ¡ ¦¿© ¢ ¢ -
¤ ¬ ¢ - ¬¤ <4QZ7 ¢ Q
¡ ¤¬¤ ¡ S. aureus ¢¡ ¢-
° ÂÃ j_ ¢£¤ ¬£ ¬
¦¢ Ä ¡ ¬® j_ ¤ -
¢ ¢ ¤ ¤ ¬ ` ¢ ¤ ~ ÂÃ
_¦° ¦ ¤ ¢ ¢ ¤ ~-
[0Ä\ ¬ ¡ ÂÃ £¡ ¤ ¡ ¡
°¤ [*Ä\ ¬® ¢ j_ - ¢ ¢ ¦¡
¤ ¢¡ °¤ ¢
¢ ¤ [Ä\ ¦ - ¡ ¦¦ ¢
¢ [*0Ä\ ¿ ¢ £ J¨ <8$ W
¡ ¦ ¤¢ ¤ -
¢ ³¤ ¤ ¬® ¢ ¦ ¡
S. aureus ^Z Enterobacter spp., z ¬ ¡ -
P. aeruginosa, K. pneumoniae E. coli ÂÃ ¬ _ -
~ ³ ~ ®®- ¤ ¢
¤ Ï60 j_ ¢- ¬® [¦ ¦ \
~ z ¦ j_
¢¡£¤ ¡ ®-
£¤ Å ¢® ¢ ¦¡
ÂÃ _ ¬ ¤¢ [¦ \ ¦ ¢¦-
¢ £ ¬ £ ¤ ¬ ¬ ³ £
¦¤¢£ ¢ ¤ j_ ¤
j_ _¬ ~ ¡- ¦ ¬ -
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 59


p , '.,Â /!" /! / *
b+.!. +,, % , '* !
' + /d

a , '., ,+/+
-0 % -0 % -0 %
? * %SY YQ)9 :+ 99)9 %< 9U)%
? * %9& Q%): Y% 9&): %U QS
?* Y& %Y)9 9 <)9 % :)&
R 2 8 :&% <Y Y9
£ - [ ¢ \ [£
¦ [6Ä 666Ä ¢ ¤¬¤\
¦\ ¤ j_ q ¡ ¢
¢ ¦ ¬ ¬ ¬ -
*6Ä ¦ ¦ - ¤ ¢°£¤ ¢¡ -
¤¤¤ 6Ä ¿ *6Ä ¢ ¦ ¤ ¡-
~ £ ¤¬¤ £ ¤£ ¡ ¢
¦ ¢
¢¡³ ® ¦° £ ¬® -
q ¢ ¢£ ¦£ ¤¡ ¤ ¢¦ ¡
¤¢ ¬ ¡- ¬ ¡¤ ¢ Ä ¤
¢ ¿ Ä ] £ -
¦° ¡ ¢ ¤¬¤ S. epidermidis ¡¤ ¬
¦ ¦ ¿ - ¬ Ä ³ ¤¢ £ £ ¢
Staphylococcus spp j¬ ¬ ¤
¢ ¢£¤ ¢ S. epidermidis. ¢
° ¬ ° ¢ ¤® *06Ä -
¬ ° ¢ ¤ ÂÃ q¦ ¦ ¤ -
¦ °¤ ¬ ¢ ¢- ¢ ¢£ £ ¤
¦ - S. epidermidis ¤® 60Ä
¤ £ ° ¢ Â6Ã ¡ U> V+703W+7+4 ®¤ -
¢ £¤ ¢ ¤¤ ¤ ¢ ¦ ¢ ¡
¤ ¤ ° ¬ ¤ [¡¢ £ ÁZ\
- ¢ ¦¤ ¦ ¡
¢ ¦ ¡° ®¤ ® ¢ ¢ -
° °¡ £ ¬ ¢¦ j_
¡£ ¤ ¢- ÂÃ ¢
¦ ¿ ¡ j_ ® £ ³
¢ ¦ ® ¡¤® ¬ ¢ ¤ ¢ -
¤¤ £ ¤ ¡ ¢-
¡ ¡ j_ ¤ Ä ¬®
¤ ³ ¢ ¡- ¤¡ °
£ ¤ ³ ¢ S. aureus ¦ ¡£ ¬-
[*0Ä\ - ¬ Ä
¤¡ [ \ ¤- £ [Ä\ ¡£
¤¤ ³ ¡° ¿ *6Ä £ ¿ ¤¤£ S. haemolyticus ¢¤
*0Ä [¦ \ © ¢ ¤£ ¿
Enterococcus ¢ ¦° ¢ ¤¤¤ 6Ä 6Ä [ ¢ ¢-
¢ ¤ ¢ £\
¦ ¢ ¢ - S. haemolyticus ¤¢£ ¢ ¬¤ °
¤ ¤ ¤ ¢ ° -
Streptococcus. ¤ - S. haemolyticus ¡° ¢®
0 [ ¬®\ 0 °¡ [*Ä 0ÄÈ !Ê\ °


. ! ! ' , . %, -
q
z z
,+/+
-0 % -0 % -0 %
Staphylococcus epidermidis QY :U): %9 :%)Q Q ::)U
Staphylococcus aureus :Y %%)+ %% %<)& 9 %+):
Staphylococcus hominis + 9)% Y 9)< % 9)Q
Staphylococcus haemolyticus %: <)% Y 9)< % 9)Q
Staphylococcus lugdunensis Q :)Q : Y)% % 9)Q
Staphylococcus xylosus : % S S S S
Staphylococcus warneri : % S S S S
Staphylococcus saprophyticus Q :)Q % %)Q % 9)Q
Staphylococcus lentus Y %)Q % %)Q S S
Staphylococcus simulans % S)Q S S S S
Enterococcus spp. <S YS)+ :Y YQ)9 U Y%)+
Streptococcus spp. :% %S)+ U %S)+ : &)%
%&Q <Q ::
[Ä 0ÄÈ ! Ê\ ° - ¡ ¢ ¢ ³ -
[Ä *00Ä\ ÂÃ ¬ ¡ ¦
S. lugdunensis ¢ ¤£ ¬® _¦° ° ¢-
¤ ¢ ° ¦
¢£ £ ¡- ¡ ¬¢ [6Ä\ ¬-
£ ¢ ° Â0Ã [66Ä\ ° ¢-
¢ ° ¢ ¬® ¢¡ ³ ¦
¤¤ ° ³ ¢ ° ¬-
*Ä ¬ ¿ Ä Ä -
° [6Ä\ ¤ ¢ ¢ ¿
£ [Ä\ Ä 0Ä ¡ ¦° ¢ -
¢¦ j_ ¦ S. saprophyticus, - ¤¤ ³
¬® ¿ [Ä\ ¦ ¬ ¿ 0Ä *6Ä -
¬® ¦° ° ¦-
S. lentus. ¡- ¬¢ 6Ä ® ¡¢
¢ ¬ ¦ ° j
S. simulans ¢¦ - ¬¢ ® ¢¡£
¢ ¦ ¤ ¬ ® ¢¤
¡ ¢ ¡£ ¤ ¢ ¡ - ¦¢ ³ -
¬ ¬ £ ¢ ° ¬ ¦
S. epidermidis ¢ ¦° ¢- ³® Ä ¥¢ ³ ¦
¡³ S. aureus ¤ ¦° ° £¤ ¤ ¤
¦°£ £ ® ¦¢¡ ¤ ¤¡ - ¡ ¤ ° ¤-
¢ q¦ ¦ ¢ ® ¢¤ ¢¡ ° ¿
¦¤ ¢ ¦ *Ä ³ ° Ä ¿ ³ -
¡ ¢¦¢¡£ ]¡ ¢
° ¡ - ¢ ° ¡ -
¡ ¡ ¬ ¬® ® ¦°£
¤¤ ¢ - ° -
¦ ¢¤ S. aureus ¢ - ° ¬¬ -
¢ ¦¡ - Ä ³ ¢¤
¢ ¡ ¬ ¬® 0Ä ³ ¢¤
¤¡ ¤ ¢ ¢ ¤ -
¦¬ * ¢¡ [*Ä\ ¡ ¦ ¤ ¢°®¤ -
¤¤ - ¢¤ ¢¤
£ ¬ [ ¿ Ä\ ¢ ¡ ® ¢¡-
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 61

? ³£ q ¢¡ ¡°

!h,+/*-,*:* . !
- * ! £ ° ¢¬-
¢ ° -
(- z z ¢ ¢¤ *Ä
Ò %SS · ¡ ¡¤ ¦¡
5 U+): · ¢¤ ¦
¤ ¢ ¤ _ ¤¤ ¨Q
_ <Q): ·
° S. aureus z° -
_ Q<)Q <Y)<
¤ ³ ¢¡® ¢-
_ V Q:): · ¢ ¬¢ ¤¢£¡ ¦
( YS)9 · [©\ ³ ¨Q
Ù3 +U %+): ¦ ¡ -
Ù3 · Q9)Q J W
Ù3 <Q): 9Q)9
® ¦£ ¢£
q
Ù3 <Q): &)%
¢¦ ¢ ¬
Ù3 VÁ2* <Q): · ³ ¢£¤ ¤ ¢
Ù3 Q:): %+): ¬®
Ù3 +U)S Y<)9 ¢ ¡ ¢¦ ¢ ¦-
Ù3 · Y<)9 °£ ¡£ £¤ -
Ù3 V * · %+):
¢ ¦ Staphylococcus spp.,
Enterococcus spp, Streptococcus spp. ª ¦°£
Ù3 · 9Q)Q
¡£ ¤ ® ¢ -
Á2 · &)% ¦ ® ¡ ¡ ¬
Ù3 · Q9)Q ¬ £ ¤¬¤ ` ¤-
Î YS)9 :U)Y ¢ ¤ ¢ ¦¤ ¢ -
¸ YS)9 &)% ¢ ¡ ¢-
^ S %+): ¬ ¬
¡¤®¤ ¢
= S S
¬ ¦¢ ° ¦
Ò U+): ·
¢ ¦ ³ ¡
Ù3 <Q): %+): ¬ ¢
53 <Q): &)% ³ ¤ ¦ -
^3 <Q): Y<)9 ¦¤ ¦ Ä -
? 3 9Y)Q &)% ¤ ° ¢ ¦ ¢
6Ä ¤ ¢
¸ 3 Q:): ·
¦ -
? U+): &)%
°¡ [ Å* ¬ ¢ ¢®-
0 Q:): · ¤ Ä\ ` ¢®¤ ¢-
\* YS)9 %+): ¦¢ ~
Á Q:): · ¢¤ £ Å* ¤ -
_ 9Y)Q S ¤ ¦®¤ ¬¤
_ 9Y)Q :U)Y
¡ £ ® -
°¤ °
9Y)Q S
¬¤ ¢ ¦®¤
/ <Q): · ¢ ¤
/ YS)9 · ¥ ¦ ¬ ¡-
Õ S · ¤® Ä Â*Ã
\ Q:): · ¢ ° -
\ · S
¡° ¢¦ ¬¢ -
¬ ¢ ¦ ¢
¹3 :%)U ·
¢ S. epidermidis, ¤ ® -
14 '
¢¦ ¢

¤ ¢ ¢£ £ - ]¢ ¦¢

Â*Ã ¤ ¤ ¢¦¢¡- ¤ ¤
¤ ° ® ¤¡ ¢ ¿ S. aureus, ¡
¬ ¡¤® ¤ ³ ° ¢-
S. epidermidis ¢ ° ÂÃ ° ¦ ¦-
¡ ¢ ¡£ ¤¤ ¤ ¬ ¬ ¬¢-
® ° ¬ ¤- ¬¢ ¬ ¬¢
¢ ¦ ¡ ¬ ¬ ¢¬
¬ ¦° ¦¢ ¤ - ]¦£ ¡ ¡ ¢¤
¤¡ ¢ ¦ - ¢ ¢¦®¤ -
S. aureus S. aureus £ ¬
¦£ ¡£ * _¢£¡ £¤ ¢¦
¦ ¤¢ ¢ ÂÃ ¢ ¬ -
¤ ¢¬¤ ¢ ¤ S. epidermidis, ¦° ¦
S. aureus J W S. aureus ¤ ¡ ¤-
©° ¢¤ ¥¢ ¢¡ -
S. aureus ¤¡ ¢ ¦ °¤ ¢ ¢
¤¢ ¢ £ ¢ ¦ ¤ ¬ ¬ ò-
¤ £ ¦¦ - ¤ ¢ ¦-
¦¬¢ ¦® ° ¬ ¡ ¦ ¢¤ ¤
¤ ¦ ¢ ¢ ¢ ¦
¤ ¢
S. aureus, [ ¡
\
k_oaZ[Y_
S. haemolyticus. ¢ ® - _¢£¡ ¢ ®¬
¡£ ¢ ¢ ¡ j_ ¬¤ ¦ ®
¡ ¡ ® ¢- ¢ ° ¢¦°®¤ ]¦-
© ¤ ¤ - ¡ °
¡ ¢ ¤ ¦° ¦- ¢¡ ¢¤ ¢ -
~ ¤ ¬ ¦ ® ¡-
S. hominis. ¦ ® ¢¡-
q ¢°¤ - £ ¤ ¬
¢¤ j_ ¢ £ ¤ ¡ ¦-
° ¤ ¤ ¢ ¢ ¤
£ ¢ - ! " !-
¤ S. lugdunensis, ¢- >
¤ ¤¤¤ eaWaoX[Waa. ¤ -
¡ £ [¦¢ Ä\ ¤ ³ ¢ ¤ ~
¢® ¢ ¡¤ Â*4*Ã _¬
¡ ¬ ~ ¢ ®9 -*
¡ ¬ - @ZdY_. ] ¤¡ ¦
¬ ³ ¢£¤ ¬ ~ ¢ ¢¤ -
¬® ® ³ ¦° °° £ ¤£ ¡ £®
³ ¦°£ £ ¤¢ ¢ ¡ ¤ ¬ JW
¤ ¦°£ £ - [+ 9--8+$ " -" -\ ¢ -
¡ ¢ ¤¡
'3'4 nGHBJ"H=J"
1. Akinkugbe O, Cooke FJ, Pathan N. (2020). Healthcare- context of catheter-associated bloodstream infections:
Associated Bacterial Infections in the Paediatric ICU. JAC- the role of microbiological monitoring in a medical and
Antimicrobial Resist: 2. doi: 10.1093/jacamr/dlaa066. preventive institution Current issues of dermatology, vere-
2. Berezhna AV, Chumachenko TO. (2020). Sources {^ x` »ª _`jq_`| xqj_x{ qj _j`q_Ñ
of infection of Staphylococcus aureus isolates in the conference dedicated to the 160th Anniversary of Profes-
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 63

|| §qj¡x° }~}¯| ±·! ´¶< Ü 8!* Øµ| Aortic Thrombus in a Preterm Infant. Children. 9: 46.
;}~}~A|@ !G*$&" %ªqx{xj doi: 10.3390/children9010046.
*! *# * #$% ! = !G*$ *% *° 9. Ministerstvo okhorony zdorovya Ukrayiny. (2021). On the
*L+8!+ ! !+ % *% !G * 8- approval of changes to the criteria for determining cases
! * ´* ! !!" +&<%+& of infectious and parasitic diseases that are subject to
¶'³»¸'@!G*$&|Ç ! *%&*!G!$& - registration. Order of Ministry of Health of Ukraine 15.07.2021
#%"8!&È~88QG# Ç|¶|Ø $% °}~}¯¹| ÷ ¯¯J| ±Ç!# # % =! %Á" À* &! ;}~}A|
3. Berezhny VV, Mamenko ME. (2016). Intestinal Micro- B %!!" ! * &%< "* % ! 8 -
biota of a Newborn Child: Impact on Health, Physiological Q #"% * !G*$! = ! = =%Q% !<
Approaches to Correction of Disorders. Pediatrician. "*"+ Q H# $&|¸ * Ç!# # % =! -
¤°¯}~|±·! ¶¶<Ç !*ÇÙ|;}~ÈA|Ç*L %Á" À* &! á ¯¯J % >|~J|}~}¹ ¿° qq°»»Ãx`|
* R8! * !%! !& ! ° % % ! # ! - rada.gov.ua/laws/show/z1214-21#Text
%Á" G+8!= **$&R!|@ "- 10. Ministry of Health of Ukraine. (2021). On the organization of
8 * |¤°¯}~¹| infection prevention and infection control in health care insti-
4. Dong Y, Speer CP, Glaser K. (2018). Beyond Sepsis: tutions and institutions/institutions providing social services/
Staphylococcus Epidermidis Is an Underestimated social protection of the population. Order of Ministry of Health
q ª_^`_Ñx`q `q_q q ½j`xqx{ __q| _{j`j| ¿x_`j ~¤|~ |}~} ½| È¯| ±Ç!# # % =!
9: 621–633. doi: 10.1080/21505594.2017.1419117. %Á" À* &! | ;}~}A| B + ! $Q G * *
5. Dong Y, Speer CP. (2014). The Role of Staphylococcus !G*$ !G*$!+ *! Q % * = =!
Epidermidis in Neonatal Sepsis: Guarding Angel or Pathogenic %Á" # !% =» * = ! !!" #$ ! = -
Devil? Int. J. Med. Microbiol. 304: 513–520. doi: 10.1016/j. #+»#$ !+ = # ! #!!"| ¸ * Ç!# # %
æ|}~¯|~¯|~¤| =! %Á" À* &! á È¯ % ~¤|~ |}~}¹| ¿°
6. Korniychuk O, Tymchuk I, Pavliy S, Konechnyi Y. (2023). https://zakon.rada.gov.ua/laws/show/z1318-21#Text.
Healthcare-associated infections in children in Ukraine during 11. Murni IK, Duke T, Kinney S, Daley AJ, Wirawan MT, Soenarto Y.
2009–2021. CHILD`S HEALTH. 18 (3): 214–218. https://doi. (2022). Risk Factors for Healthcare-Associated Infection
org/10.22141/2224-0551.18.3.2023.1588. among Children in a Low-and Middle-Income Country. BMC
7. Linz MS, Mattappallil A, Finkel D, Parker D. (2023). Clinical Impact Infect. Dis. 22: 406. doi: 10.1186/s12879-022-07387-2.
of Staphylococcus Aureus Skin and Soft Tissue Infections. 12. Westberg R, Stegger M, Söderquist B. (2022). Molecular Ep-
Antibiotics. 12: 557. doi: 10.3390/antibiotics12030557. idemiology of Neonatal-Associated Staphylococcus Haemo-
8. Mani S, Chandrasekharan P. (2022). Staphylo- lyticus Reveals Endemic Outbreak. Microbiol. Spectr: 10. doi:
coccus Lugdunensis Bacteremia with an Infected 10.1128/spectrum.02452-22.

_ ^ Æ||!|<G|< %|* G|*L+&³%%#*+¸ÇÀ!@| $*+|´# °|³%%<%|B* #* <Èº
|;~¤}A}JÈ} ¤È|qq°»»_|^»~~~~~~~¤¯ >~>}>|
n,v Æ*||!|<$|* G|*L+&³%%#*+¸ÇÀ!@| $*+|´# °|³%%<%|B* #* <Èº |;~¤}A}JÈ} ¤È|
https://orcid.org/0000-0002-9290-2954.
_ {n Æ|G#|< # # ! * G|*L+&³%%#*+¸ÇÀ!@| $*+|´# °|³%%<%|B* #* <Èº
|;~¤}A}JÈ} ¤È<qq°»»_|^»~~~~~~~¤¯J ÈJ>|
[ /q+V!Æ* L * + ¸B³µ³%%#*&L #!& "8&*!8!&* !Éµ²Ç´Ø@øØÊ|´# °|³%%<
%|³ #!* |¤|
"! R *$&}|~J|}~}¤|< !" *~È|~|}~}¤|

UDC 618.36-056(477.411+477):303.44
V.O. Berestovyi1,2, O.V. Zelinska2, N.V. Gerevich1,2, D.O. Govsieiev1,2

Risk factors for placenta previa among pregnant women
of Kyiv, Ukraine: a retrospective cohort study
1Bogomolets National Medical University, Kyiv, Ukraine
2Kyiv City Maternity Hospital No.5, Ukraine
For citation: Berestovyi VO, Zelinska OV, Gerevich NV, Govsieiev DO. (2023). Risk factors for placenta previa among pregnant women
of Kyiv, Ukraine: a retrospective cohort study. Modern Pediatrics. Ukraine. 5(133): 65-71. doi 10.15574/SP.2023.133.65.
Placenta previa is a significant obstetric problem with elevated morbidity and mortality rates for both mother and fetus. The risks associated with
placenta previa underscore the necessity for comprehensive treatment and timely intervention to mitigate adverse outcomes.
Purpose — to conduct a retrospective analysis of the impact of obstetric-gynecological factors on the prediction of placenta previa occur-
rence and its influence on perinatal outcomes.
Materials and methods. A retrospective cohort study was conducted on cases of placenta previa between 2018 and 2022. The study includ-
ed 22491 deliveries, of which 65 (0.29%) cases were registered as placenta previa. Data from delivery records of 374 patients without placenta
previa were used for comparison. The following variables were evaluated for all patients: maternal age, characteristics of the menstrual cycle,
gravidity, parity, history of cesarean sections, gestational age at delivery, method of delivery, blood loss during delivery, length of postpartum
hospitalization, birth weight, gender of the newborn, Apgar scores at 1 and 5 minutes. Gynecological intervention histories, including curettage/
hysteroscopy, laparoscopy, and cervical treatment, as well as obstetric pathologies, such as cesarean section, ectopic pregnancy, instrumental
abortions, missed pregnancies, and assisted reproductive technologies in the last pregnancy, were examined.
Results. Multifactorial analysis revealed four significant risk factors. The risk of placenta previa was found to increase with advanced maternal
age (p<0.001), OR=1.14 (95% CI 1.07–1.20), and the presence of previous cesarean sections (p<0.001), OR=5.51 (95% CI 2.73–11.1), while
a history of previous deliveries reduced the risk (p<0.001), OR=0.24 (95% CI 0.15–0.40). Instrumental abortions increased the risk of placenta
previa (p=0.001), OR=2.14 (95% CI 1.20–3.81). Newborns in the placenta previa group had lower Apgar scores at 1 and 5 minutes and lower
birth weight.
Conclusions. The obtained results emphasize the importance of considering risk factors in assessing placenta previa occurrence
during antenatal monitoring and can contribute to improving obstetric and perinatal care for women. However, the morphological and functional
basis of placenta previa remains unknown and requires further study.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics
Committee of participating institution. No conflict of interests was declared by the authors.
Keywords: women, placentation, placenta previa, cesarean section, curettage, instrumental abortion, assisted reproductive technologies,
obstetric hemorrhage, preterm delivery.
[ . + + / '!_d*$ %e

' +
ZI [1,2"I 2Y X1,2Y Igg 1,2
10 2 5'5'Ò 2)'/)R
2/0(1/ 2 2 * ÝÌQ4)R
( , - 8 2-*-)6 , 2 6-
'¹)] )8-- 2 ) ) -,-
*6 2 , ]8 6 '
V 3 8 2
) 2 '
V , 0 ( :S%+·:S:: '
. 6-,::Ì9&% )6 , <Q>S):&Ë@ '.
YU9 , * '= 6 , 7 )6 2
) ) )2 2 6 ) ) )
)2 2 * ) ) 2 ) 8 -_ %Q6 6'
= 6 27 - V ) ) 8 ' . -
8 2 7 2 ) ) 26 * ) 6 )
6 6 6 '
l .#0 Ò 3 *28 3 ' = -
>W[S)SS%@)=ÚX%)%9>&QË.Î7%)SU·%):S@ 6 >W[S)SS%@)
=ÚXQ)Q%>&QË.Î7:)UY·%%)%@) 2 >W[S)SS%@)=ÚXS):9>&QË=ÎS)%Q·S)9S@'Î -
2 * *28 >WXS)SS%@)=ÚX:)%9>&QË.Î7%):S·Y)+%@'= )
* 8 -_ % Q6 6 '
0 5 2 -- 2 2 6 3 - -
2 2 8 8 2 2
' 5 2 8 - 2 3 3 2 )
*- 2 28 '
. ?2 2 '( 6 ^ 2 -
* '_ - 2 23 '
_ e ) ) ) ) 8* ) 2 * )
6 ) 8 2 ) '
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 65

Introduction For comparative analysis, data from the

delivery histories of 374 patients without PP
P
lacenta previa (PP) is a condition charac- (non-PP group) were utilized for the same period.
terized by abnormal placental attachment, Exclusion criteria included multiple pregnan-
resulting in partial or complete coverage cies, fetal anomalies, absence of records in medical
of the cervical os by the placenta [9]. PP occurs documentation, and PP.
in 0.3–1.5% of pregnancies, potentially leading The following clinical characteristics were eva-
to severe maternal morbidity and mortality [10]. luated in all patients: maternal age, characteristics
¨ !! %% " $2 of the menstrual cycle, gravidity, parity, number of
ultrasound examinations (USE), while others may previous cesarean sections, gestational age at deli-
manifest as asymptomatic vaginal bleeding during very, method of delivery, blood loss at birth, length of
the second or third trimester of pregnancy [3]. postpartum hospitalization, newborn weight, new-
PP also increases the likelihood of «deep» inva- born sex, Apgar score at 1 and 5 minutes. The pre-
sion, namely the development of placenta accreta, sence of gynecological interventions (GI) in the his-
increta, and percreta [21]. Such conditions esca- tory was assessed, including curettage/hysteroscopy,
late maternal risks, as PP precludes vaginal deliv- laparoscopy, cervical treatment, and the cumulative
ery, necessitating cesarean section. Uncontrolled number of GI-related factors. The presence of obstet-
postpartum hemorrhage from placental invasion ric pathology in the history requiring intervention
can result in blood transfusion, hysterectomy, in- (OI) was also examined, including previous cesarean
fertility, intensive care unit admission, or even section, ectopic pregnancy, instrumental abortions,
death [4]. Additionally, PP is associated with missed miscarriages, and the use of assisted reproduc-
unfavorable neonatal outcomes, including preterm tive technologies (ART) in the last pregnancy, along
birth, low birth weight, and perinatal mortality with the cumulative number of OI-related factors
[16]. Understanding the impact of obstetric-gyne- and the combination of OI with ART.
cological history on the occurrence of PP is crucial Statistical Analysis. Categorical data were pre-
for providing appropriate counseling to pregnant sented as frequencies and percentages (%), while
women. descriptive statistics were reported as mean (M)
The purpose of the study — to retrospective- Ï % % %3 [Z'\ % 3 $
$2 8 ë" # 2 $ (CI) of 95% or interquartile range were calculated,
gical history factors on predicting PP occurrence %% [?Æ\ '@ $ 3 -
and the impact of PP on perinatal outcomes. ables were assessed using the chi-square or Fisher’s
The research was carried out in accordance with 8 Ò$ %@ " " 3 #$
the principles of the Helsinki Declaration. The were evaluated using the Mann–Whitney U test
study protocol was approved by the Local Ethics or t-test. Data analysis was performed using R
Committee of participating institution. (3.4.1). A two-sided P-value less than 0.05 was
%% $$2
Ethical Approval and Informed Consent. The
A retrospective cohort study of PP cases Bioethics Committee of Bogomolets National
was conducted for 2018–2022. The study was ¨% $ 43 2 ã$ % Ò '+ -
conducted at Maternity Hospital No. 5, which ment of Obstetrics, Gynecology, and Neonatology
serves as the clinical base of the Department of the Postgraduate Education, authorized the
of Obstetrics, Gynecology, and Neonatology of study, based at Maternity Hospital No. 5 in Kyiv.
the Postgraduate Education of O.O. Bogomolets Patients’ data was protected by excluding names,
National Medical University. The study encom- + "# %% % %-
passed 22491 deliveries, with 65 cases of PP regis- tial information. Since the study was based on
tered (PP group). electronic medical records and all information
The analysis involved a retrospective review was anonymized, informed consent was waived.
of electronic medical records, cesarean section The study adhered to the principles of the Helsinki
protocols, and neonatal records. The diagnosis of Declaration.
!! Ò % #2 8+ # "
transabdominal ultrasound scans or Magnetic Res-
Results of the research
onance Imaging (MRI), and the diagnosis was ver- The total number of deliveries during the study
% %" %$32 period were 22491, with 65 cases of PP, resulting

Table 1
Comparative characteristics of patients
Non-PP group PP group P;FG;Q?8G?D
Indicator (n=374) (n=65) of the difference, P
Age, years 30 (26–34) 34 (30–37) <0.001
Menarche, years 13 (12–14) 13 (12–14) 0.829
Menstruation, days 5 (5–5) 5 (5–5) 0.906
Menstrual cycle, days 28 (28–28) 28 (28–30) 0.073
Gravidity 2 (1–2) 2 (2–3) <0.001
Number of cesarean sections (1 or 2) 22 (5.9%) 14 (21.5%) <0.001
Parity 1 (1–2) 1 (0–1) <0.001
Blood loss, ml 250 (250–400) 777 (600–912.5) <0.001
Duration of hospitalization, days 3 (3–4) 5 (3.75–8) <0.001
Note: The Mann–Whitney U test is used for the comparison.
Table 2
The analysis of gynecological interventions
Non-PP group PP group P;FG;Q?8G?D<RCHD
Indicator (n=374) (n=65) difference, P
0 346 (92.5) 61 (93.8)
Hysteroscopy and/or dilation and curettage 1 27 (7.2) 4 (6.2) 0.872
2 1 (0.3) 0 (0)
0 332 (88.8) 54 (83.1)
Laparoscopy 0.215
1 42 (11.2) 11 (16.9)
0 319 (85.3) 54 (83.1)
Cervical treatment 0.707
1 55 (14.7) 11 (16.9)
0 269 (71.9) 40 (61.5)
The sum of gynecological interventions 0.105
1 105 (28.1) 25 (38.5)
Notes: pkLFkDEwlCKLBLEBHKÂDEkLK]ELrCFBBLEBJCElELfBHWLKIHKbBkLFHbWCKDEHd'pkLElbHIahdLFHGHaDFCGDdBLKPLdBDHdE#ICBGLCEBHdLLWDEHfLHIDdBLK-
vention was present, the patient received a mark; however, combinations of factor features were not considered when calculating the sum.
in a prevalence rate of placenta previa among pa- Analysis of pregnancy-related interventions

tients in the maternity hospital of 0.29%. In the among patients in the two groups included a his-
non-PP group, there were 117 (31.3%) out of 374 tory of cesarean section, ectopic pregnancy, instru-
deliveries, while in the placenta previa group, all mental abortions, pregnancy loss and ART. The
65 (100%) deliveries were performed by cesarean analysis of pregnancy-related interventions is pre-
section, P<0.001. When evaluating background of sented in Table 3.
PP occurrence, it’s crucial to consider the interplay Among the newborns in the PP group,
between risk factors. Furthermore, making a com- 41 (63.1%) were male and 24 (36.9%) were
prehensive assessment of these factors essential in female, while in the non-PP group, 202 (54%) were
providing optimal prenatal care and minimizing male and 172 (46%) were female, with a P-value
potential complications associated with PP. of 0.180. Massive obstetric hemorrhage (>1000
A comparative assessment of age, menstrual his- ml) occurred in 3 (0.8%) cases out of 374 cases
tory, gravidity, parity, number of previous cesarean in the non-PP group, whereas in the PP group,
sections, blood loss at birth, and duration of hos- it occurred in 15 (23.1%) cases, with a P-value
pitalization was conducted among patients in the of <0.001. A comparative analysis of perinatal
two groups. The comparative characteristics are outcomes between the patients in the two groups
presented in Table 1. was conducted, which included gestational age at
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 67

Table 3
Analysis of pregnancy-related interventions
0 348 (93) 51 (78.5)
History of Cesarean section <0.001
1 26 (7) 14 (21.5)
0 365 (97.6) 64 (98.5)
Ectopic pregnancy 1 6 (1.5) 1 (1.5) 0.768
2 3 (0.9) 0 (0)
0 331 (88.5) 53 (81.5)
1 38 (10.2) 6 (9.2)
Instrumental abortions <0.001
2 5 (1.3) 3 (4.6)
3 0 (0) 2 (3.1)
0 310 (82.9) 53 (81.5)
1 57 (15.2) 10 (15.4)
Pregnancy loss 0.839
2 6 (1.6) 2 (3.1)
3 1 (0.3) 0 (0)
0 361 (96.5) 49 (75.4)
Assisted reproductive technologies <0.001
1 13 (3.5) 16 (24.6)
0 255 (68.2) 34 (52.3)
Obstetric sum 0.016
1 119 (31.8) 31 (47.7)
Obstetric and Assisted reproductive 0 183 (48.9) 19 (29.2)
0.004
technologies sum 1 191 (51.1) 46 (70.8)
Notes: ÂDEkLK]ELrCFBBLEBJCElELfIHKBkLFHbWCKDEHd'!oEBLBKDFElb#ICBGLCEBHdLLWDEHfLHIDdBLKPLdBDHdJCEWKLELdB)BkLWCBDLdBKLFLDPLfCbCKj;kHJLPLK)
combinations of factor features were not considered when calculating the sum. Obstetric and assisted reproductive technologies sum — the cumulative assessment
of interventions related to pregnancy and assisted reproductive technologies.
Table 4
Analysis of perinatal results of childbirth
Gestational age, weeks 39 (39–40) 37 (36–37) <0.001
Newborn weight, gram 3460 (3220–3740) 2960 (2577.5–3250) <0.001
Apgar 1 7 (7–8) 7 (6.75–7) <0.001
Apgar 5 8 (8–9) 8 (7–8) <0.001
Note: The Mann–Whitney test was used for comparison.
Table 5
2<DRQ?;DGC><RCHDN1R8?C<9A<F;>C;?9DF9D>>;<GE<:DAR<9S9D:;?C;GFCHD9;>K<RSA8?DGC8S9D=;8
Non-PP group PP group P;FG;Q?8G?D<RCHD:;RRD9-
Factorial sign (n=374) (n=65) ence, p
Age 0.13±0.02 <0.001 1.14 (1.07–1.20)
Number of cesarean sections 1.71±0.36 <0.001 5.51 (2.73–11.1)
Parity -1.42±0.25 <0.001 0.24 (0.15–0.40)
Instrumental abortion 0.76±0.29 0.001 2.14 (1.20–3.81)
birth, newborn weight, and Apgar scores at 1 and sarean section, ectopic pregnancy, instrumental
5 minutes. The respective data are presented abortion, pregnancy loss, obstetric sum, obstetric
in Table 4. interventions and ART sum, sex of the newborn.
Risk assessment of PP. The logistic regres- The stepwise inclusion/exclusion method (inclu-
sion model construction was employed to ana- sion threshold p<0.05, exclusion threshold p>0.1)
lyze the factor features associated with the risk Ò "$ç% $ "
of pathology. The analysis was conducted for '" $ + " 5
17 risk factors: age, menarche, duration of men- Ò %%9 "# -
struation, menstrual cycle, number of cesarean an sections, parity, and instrumental abortion.
sections, parity, hysteroscopy and D&C, laparo- A four-factor logistic regression model for predict-
scopy, cervical treatment, gynecological sum, ce- ing the risk of pathology was constructed based on

the selected features. Table 5 presents the charac-

teristics of the model.
An increase in the risk of pathology with ma- 100
ternal age was established (p<0.001), OR=1.14
(95% CI 1.07–1.20) per year (considering the in- 80
ë" 5 \ 7 5 + $ 2 Sensitivity: 75.4
increases (p<0.001) with a history of cesarean sec- Specificity: 77.8
Criterion: >0.1574
tions, OR=5.51 (95% CI 2.73–11.1) per operation 60
[ " ë" 5 \
A decrease in the risk of pathology was found with a
history of previous deliveries (p<0.001), OR=0.24 40
(95% CI 0.15–0.40) per delivery (considering the
ë" 5 \ Á + 20
instrumental abortions in the medical history, the
AUC = 0.790
risk of pathology increases (p=0.001), OR=2.14 P<0.001
(95% CI 1.20–3.81) per instrumental abortion 0
[ " ë" 5 \ 0 20 40 60 80 100
Figure 1 presents the receiver operating characte- 100-Specificity
ristic curve of the model.
The area under the curve (AUC) of the Fig. ROC-curve of the 4-factor logistic regression model for predicting the
_xq{^
model’s receiver operating characteristic is
[Ä Á Å0*\ % % is consistent with the studies conducted by
of the model and a moderate level of association L. Tuzovic et al., as well as M. Kollmann et al., who
between the risk of PP and age, number of cesa- reported an increased risk of PP with higher parity,
rean sections, parity, instrumental abortions. When possibly due to endometrial scarring and reduced
selecting the optimal decision threshold based on " +$ $ #$ % ë Ò %" $
the Youden Index, the model demonstrated a sen- changes in blood vessels [11,22]. However, our
sitivity of 75% (95% CI 65.1–85.2%) and a speci- study revealed a reduced risk of PP in patients with
2 0Ä [Ä Á **Å0Ä\ 7 + 3 a history of previous deliveries, OR=0.24 (95%
predictive value was 36.3% (95% CI 31.1–41.8%), CI 0.15–0.40), which the distribution of patients
while the negative predictive value was 94.7% 8+$ % 5 @
(95% CI 92.1–96.5%). occurrence of PP.
Previous cesarean deliveries are a well-
Discussion known risk factor for PP, as demonstrated in this
Placenta previa is a common and severe "%2 % % #2 $2
complication of pregnancy that can lead of 170,640 pregnant women [20]. A cohort
to complications such as postpartum hemorrhage study conducted at the National Health Service
% ë"% # $ ÂÃ >" Hospital in the United Kingdom also found
studies have shown that the frequency of preterm that PP occurred in 32.9‰ out of 1000 women
%$32 % $ Ò # Ò $2 with a planned cesarean section [13]. Thus,
higher in women with PP than those with a normal H.S. Abduljabbar et al. concluded in their
placental position [2,5], indicating an increased meta-analysis that 359 cesarean sections are
risk of adverse neonatal outcomes. Therefore, %% %" %$3 # %%
investigating the risk factors associated with PP is tional case of PP in subsequent pregnancies [1].
crucial for reducing the likelihood of unfavorable The increased risk may be a result of prolonged
consequences for both the mother and the child. damage to the myometrium and endometrium
In order to elucidate the etiology of PP in pregnant due to surgical disruption of the uterine cavity,
women, we conducted a retrospective analysis leading to hypoxia, incomplete decidualization,
of 65 records of obstetric histories of women and abnormal trophoblast invasion, which can
with PP. cause placental adhesion [24]. The data above
The study found that advanced maternal age, are consistent with our study, as patients with a
%% Ð*6 2 5 history of cesarean section had a 5-fold higher risk
!! Ò 8 $% % 5 7 % of developing PP, OR=5.51 (95% CI 2.73–11.1).
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 69

Another well-known fact is a history of newborns, and increased neonatal mortality [25].
instrumental abortions, a risk factor for PP. This conclusion aligns with a study conducted
In the study by L. Tuzovic et al., abortions increased by J.M. Crane et al., where newborns delivered
the risk of PP by 2.75 times. The mechanism #2 Ò Ò !! % 3 $% % 5
of this association may be attributed to the of developing respiratory distress syndrome [7].
damage to the endometrium during repeated Similar results were obtained in our study. It was
abortions, leading to impaired successful placental determined that newborns in the PP group had
implantation [22]. The data obtained in this study lower Apgar scores at 1 and 5 minutes and lower
$ + " $ birth weight.
# 5 %3$ + !! + $$2 Maternal mortality and antenatal hemorrhage
an OR of 2.14 (95% CI 1.20–3.81). are among the most severe complications during
ART has drawn attention due to its wide pregnancy. In patients with PP, the risk of
application in clinical practice, particularly among antepartum hemorrhage is nine times higher than in
older patients with a history of endometriosis patients with customarily located placenta [19]. It
and chronic salpingitis [14]. Furthermore, has been reported that the frequency of antepartum
ART often involves the use of ovulation- hemorrhage in women with PP is approximately
stimulating drugs, which can disrupt the regulation 51.6% [8], underscoring the critical nature of this
or uncontrolled expression of genes associated condition and the necessity for careful monitoring
with endometrial growth, leading to asynchrony and treatment during pregnancy. Similar to the
between endometrial and embryonic development % É " $ ÂÃ "$ # %
and ultimately resulting in PP formation [12,17]. from the study indicate that the frequency of
Additionally, the mechanical implantation postpartum hemorrhage and the duration of
of embryos using a transfer catheter can cause the + $ 2 Ò $2 !!
release of prostaglandins during passage through the group compared to the non-PP group.
cervical canal, leading to uterine contractions and
an increased likelihood of placental implantation
Conclusions
$ Ò " ÂÃ 7 % 7 "%2 %% #Ò
"%2 % %@ "# the risk of PP and maternal age, parity, previous
of patients who conceived through ART, although cesarean section, and history of instrumental
the sample size is not representative for analysis. abortions. The risk of developing the pathology
!$ +3 $ + increased with advancing maternal age and
neonates. A cohort study of 3,550,842 deliveries the presence of a history of cesarean section or
revealed that PP after 37 weeks of gestation is instrumental abortions, while the risk decreased
an independent risk factor for adverse neonatal with prior deliveries. PP increases the risk of
outcomes [18]. The risk of preterm birth is 14 giving birth to newborns with lower Apgar
times higher in women with PP [22]. A systematic scores than pregnant women without PP. These
3Ò Â*Ã %% Ä %$3 % + ç + %
in women with PP occur prematurely, whereas, these factors when assessing the risk of PP
in another study, this rate was 52% compared to during antenatal surveillance, which can help
8% for preterm births in women without PP [6]. improve obstetric care for women. However,
C. Zhou et al., in a study on the impact of PP on the morphological and functional basis for the
neonatal outcomes, found that the PP group had occurrence of PP remains unknown and requires
lower birth weight and lower Apgar scores at 1 and further investigation.
5 minutes, leading to an increased risk of delivery &' (')*+(, '/ +),0304,4 564 70(86307 9; ,<0
complications, respiratory distress syndrome in 6=,<'34>

'3'4 nGHBJ"H=J"
1. Abduljabbar HS, Bahkali NM, Al-Basri SF, Al Hachim E, Templeton A, van der Meulen JH. (2011). Maternal morbidity
Shoudary IH, Dause WR et al. (2016). Placenta previa: A 13 associated with placenta praevia among women who had
years experience at a tertiary care center in Western Saudi elective caesarean section. European Journal of Obstetrics &
Arabia. Saudi Medical Journal. 37 (7): 762. Gynecology and Reproductive Biology. 159 (1): 62–66.
2. Adnan WFW, Shamsudin F, Zon EM. (2021). Uterine torsion 14. Petersen SH, Bergh C, Gissler M, Åsvold BO, Romundstad
in patient with major placenta previa. European Journal of LB, Tiitinen A et al. (2020). Time trends in placenta-mediated
Obstetrics and Gynecology and Reproductive Biology. 258: pregnancy complications after assisted reproductive
467–469. technology in the Nordic countries. American journal of
3. Ahmed SR, Aitallah A, Abdelghafar HM, Alsammani MA. obstetrics and gynecology. 223 (2): 226. e221–226. e219.
(2015). Major placenta previa: rate, maternal and neonatal 15. Qin JB, Wang H, Sheng X, Xie Q, Gao S. (2016). Assisted
outcomes experience at a tertiary maternity hospital, sohag, reproductive technology and risk of adverse obstetric
Egypt: a prospective study. Journal of clinical and diagnostic outcomes in dichorionic twin pregnancies: a systematic review
research: JCDR. 9 (11): QC17. and meta-analysis. Fertility and sterility. 105 (5): 1180–1192.
4. Anderson–Bagga FM, Sze A. (2023, Jun). Placenta Previa. 16. Rao J, Fan D, Zhou Z, Luo X, Ma H, Wan Y et al. (2021, Jul 6).
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Maternal and neonatal outcomes of placenta Previa with and
Publishing. URL: https://www.ncbi.nlm.nih.gov/books/ without coverage of a uterine scar: a retrospective cohort
NBK539818/. study in a tertiary hospital. International Journal of Women’s
5. Balayla J, Desilets J, Shrem G. (2019). Placenta previa and Health. 13: 671–681.
the risk of intrauterine growth restriction (IUGR): a systematic 17. Sakai Y, Ono M, Iizuka T, Kagami K, Masumoto S, Nakayama
review and meta-analysis. Journal of perinatal medicine. 47 M et al. (2019). Embryo transfer associated with hormone
(6): 577–584. replacement therapy cycles using assisted reproductive
6. Baumfeld Y, Herskovitz R, Niv ZB, Mastrolia SA, Weintraub AY. technology increases placenta accreta spectrum. Journal of
(2017). Placenta associated pregnancy complications in Obstetrics and Gynaecology Research. 45 (12): 2394–2399.
pregnancies complicated with placenta previa. Taiwanese 18. Schneiderman M, Balayla J. (2013). A comparative study of
Journal of Obstetrics and Gynecology. 56 (3): 331–335. neonatal outcomes in placenta previa versus cesarean for
7. Crane JM, Van den Hof MC, Dodds L, Armson BA, Liston R. other indication at term. The Journal of Maternal-Fetal &
(1999). Neonatal outcomes with placenta previa. Obstetrics & Neonatal Medicine. 26 (11): 1121–1127.
Gynecology. 93 (4): 541–544. 19. Senkoro EE, Mwanamsangu AH, Chuwa FS, Msuya SE, Mnali
8. Fan D, Wu S, Liu L, Xia Q, Wang W, Guo X et al. (2017). Prevalence OP, Brown BG et al. (2017). Frequency, risk factors, and
of antepartum hemorrhage in women with placenta previa: a adverse fetomaternal outcomes of placenta previa in Northern
qjxq_j¡_j¥x`jqxx`x{_|ª_j`q_Ñjq|J;A° Tanzania. Journal of pregnancy. 2017: 5936309.
1–9. 20. Sheiner E, Shoham–Vardi I, Hallak M, Hershkowitz R,
9. Jain V, Bos H, Bujold E. (2020). Guideline No. 402: diagnosis Katz M, Mazor M. (2001). Placenta previa: obstetric risk factors
and management of placenta previa. Journal of Obstetrics and and pregnancy outcome. Journal of Maternal-Fetal Medicine.
Gynaecology Canada. 42 (7): 906–917. e901. 10 (6): 414–419.
10. ®x`_x¬E<{Ñj¡_¨<_j<j{q<q`<{{_`ª 21. Silver RM, Branch DW. (2018). Placenta accreta spectrum.
et al. (2018). Placenta praevia and placenta accreta: diagnosis New England Journal of Medicine. 378 (16): 1529–1536.
and management: green-top guideline no. 27a. Bjog. 126 (1): 22. §Ã¡_ < ¼j{_ ®< {æ_ | ;}~~¤A| qjq_ _ xq
e1–e48. associated with placenta previa development: case-control
11. Kollmann M, Gaulhofer J, Lang U, Klaritsch P. (2016). Placenta study. Croat Med J. 44 (6): 728–733.
praevia: incidence, risk factors and outcome. The Journal of 23. Vahanian SA, Lavery JA, Ananth CV, Vintzileos A. (2015).
Maternal-Fetal & Neonatal Medicine. 29 (9): 1395–1398. Placental implantation abnormalities and risk of preterm
12. Makarenko M, Govsieiev D, Martynova L, Berestovoy V, Vorona delivery: a systematic review and metaanalysis. American
R. (2016). Assisted reproductive technology and intrauterine journal of obstetrics and gynecology. 213 (4): S78–S90.
pathology as the risk factors of placenta praevia. Health of 24. Wortman AC, Alexander JM. (2013). Placenta accreta, increta,
¥x`|~;ÈA°¯~¯}|±Ç * !*Ç<%#HH%@<Ç - and percreta. Obstetrics and Gynecology Clinics. 40 (1): 137–
!% ³<·# % ¶<¶! |;}~ÈA|@!- 154.
* %! =!+& %! R! *% +""* 25. Zhou C, Zhao Y, Li Y. (2022). Clinical Analysis of Factors
G * * !!" $! | Â% !- `j`_`^qjj¡j{j`q{xj`qxxj¡_xx`j_`xqx{
F !ù|~;ÈA°¯~¯}¹| Outcomes in First-Time Pregnant Patients. Frontiers in
13. Onwere C, Gurol–Urganci I, Cromwell DA, Mahmood TA, Surgery. 9: 862655.

) ^ ' Â< # # ! * G| *R# % <+!*+& !! +&#" !&#% ¸ÇÀ!µ|µ|·+$"º
* *R+!*+ ¸BÉ &%#* #* +% L !*á>Ê|´# °| &%<#|¶|³L !%#*+<}|qq°»»_|^»~~~~~~~}> ~JJ~|
L #^#' Â* *R+!*+ ¸BÉ &%#* #* +% L !*á>Ê|´# °| &%<#|¶|³L !%#*+<}|
https://orcid.org/0009-0006-0362-1031.
a q +Â*||!|< # # ! * G| *R# % <+!*+& !! +&#" !&#% ¸ÇÀ!µ|µ|·+$"º
* *R+!*+ ¸BÉ &%#* #* +% L !*á>Ê|´# °| &%<#|¶|³L !%#*+<}||qq°»»_|^»~~~~~~~}J>~¤>|
a ddz, ^ Â||!|<G|< %|* G| *R# % <+!*+& !! +&#" !&#% ¸ÇÀ!µ|µ|·+$"º
* ¸BÉ &%#* #* +% L !*á>Ê|´# °| &%<#|¶|³L !%#*+<}|qq°»»_|^»~~~~~~~ÈÈ~} |
"! R *$&}È|~>|}~}¤|< !" *~È|~|}~}¤|
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 71

~ 60*9**-
" I 1W I 1!Z qY" 1
1%!" qtj 2
_ 1 , #*/ '

", , , , '
!#!h+!! !- !#,
1 % &
2 !& ( #
`<9?;C8C;<Ge«{¡x«<§x`x¡xª<`{¡x <ªx¡x<q{xj`|;}~}¤A|{_`_x{_`qj`qx{<
q{^_x{x`_`{xxqxjx_¥xjj{_`^_`_{j`¥_q`_x{xqx|j`j_xq_|¿x_`j|>;¤¤A°
72-79. doi 10.15574/SP.2023.133.72.
V 2) 3 6 6- 66 *6 2
6 &>¸¸¹&@ ,
* *6'
V , 0= 62 5/0(1Ê2 * 4
** &&66 Ò_'=
) *6 62 *
) * 3 '
Á3 '. Î 8QQ , )6 ¸¸¹&
Q)9 V) ÎÎ 3 996 ¸¸¹&àQ)9 V'Z 6
* '
l .#0= ) ¸¸¹& ,*28
* 6- > %)9) 8 8 :)S@ * ,
Q * '( )66ÎÎ ÂLc!*28::)S2V , 2 8)
Î >WM[S)SQ@) * , - 6 2686 62 '¹2
*6 * 2
) , *6)8 - 2 ¸¸¹& 7
:U)U ) 8*],3 6 %8 >5Õ=%@ :SË
6 >(/:S?@>5Õ=%@[Y)U V 9+)+ >(.:S?@>5Õ=%@[S)+ '
0( ¸¸¹& - * 2*6 2
) * ) 8
*6'
. ?2 2 '( 6 ^ 2
* '0 2 3 * 2) '
_ - 2 23 '
_ e*6 2 ) ) ) 2*6) &'
2A;G;?8A1;G>C9@EDGC8A*?BC<A<F;?8A8G:;GRA8EE8C<9BE89KD9><R8;9I8B9DE<:DA;GF
;G?H;A:9DGI;CHT9<G?H;8A8>CHE8
5663C3:034/1+(G/-</4:0/1B^*-><*0qC34/0155+;/0;34/1F5B>9C>0q)/:;\;,<032
%`ljHPDdDCdABCBLeLfDFCGgdDPLKEDBh)kLKdDPBED)gjKCDdL
:OeM1kLKdDPBEDOLaDHdCGkDGfKLd]EGDdDFCGmHEWDBCG4)gjKCDdL
W@9S<>D BH DdPLEBDaCBL BkL FGDdDFCGDdEBKlbLdBCG) FhBHGHaDFCG Cdf DdIGCbbCBHKh FkCKCFBLKDEBDFE HI BkL fDELCEL Dd FkDGfKLd JDBk oKHdFkDCG
CEBkbC)BCjDdaDdBHCFFHldBBkLFHdBLdBHIBkLKLbHfLGDdabCKjLKbCBKDrbLBCGGHWKHBLDdCEL&>eeÀ&@DdBkLEWlBlbBHHWBDbDqLBkLBDbLGh
fLBLFBDHdHIEBKlFBlKCGKLbHfLGDdaHIBkLoKHdFkD'
m8CD9;8A>8G:EDCH<:>0tFHkHKBHI&&FkDGfKLdJDBk`tJCELrCbDdLfohBkLbLBkHfHIKCdfHbECbWGDdaDdBkLFHdfDBDHdEHIBkLÀlGbHdCKh
tGGLKaHGHah$LWCKBbLdBHIBkLOeMOm'
tGG FkDGfKLd ldfLKJLdB C FHbWGLr FGDdDFCG Cdf WCKCFGDdDFCG LrCbDdCBDHd JDBk BkL fLBLKbDdCBDHd HI BkL FhBHGHaDFCG FHbWHEDBDHd HI EWlBlb)
BkLfLBLKbDdCBDHdHIoKHdFkDCGkhWLKKLCFBDPDBhCdfBkLDKkhWLKELdEDBDPDBhDdCECbWGLJDBkELKDCGfDGlBDHdHIkDEBCbDdL)BkLEBlfhHIBkLFHdFLdBKC
BDHdHIbLBCoHGDBLEHIdDBKHaLdbHdHrDfLDdWLKDWkLKCGoGHHfCdfFHdfLdECBLHIWlGbHdCKhLrWDKCBHKhCDK'
pJHFGDdDFCGaKHlWEJLKLIHKbLf'pkLsKHlW#DdFGlfLfQQWCBDLdBEDdJkHbBkLFHdBLdBHIeeÀ&DdBkLEWlBlbElWLKdCBCdBfDfdHBKLCFkBkL
GLPLGHIQ'9daVbG)CdfBkL##aKHlWJCEIHKbLfoh99WCBDLdBEJDBkeeÀ&FHdBLdBàQ'9daVbG'pkLbCDdFGDdDFCGFkCKCFBLKDEBDFEHIBkLHoELK
PCBDHdaKHlWEJLKLFHbWCKCoGL'
fD>@AC>0#BJCELEBCoGDEkLfBkCBBkLKDEjHICFGDdDFCGGhbHKLELPLKLLrCFLKoCBDHdHIBkLfDELCELDEBJDFLCEkDakDdFkDGfKLdJDBkCdDdFKLCELf
FHdBLdBHIeeÀ&DdBkLEWlBlb>KLGCBDPLKDEj%'9)HffEKCBDH:'S@JDBkBkLWKLELKPCBDHdHIBkDEBKLdfflKDdaQfChEHIDdWCBDLdBBKLCBbLdB'
pkLJHKjCGEHEkHJEBkCBDdWCBDLdBEJDBkCdDdFKLCELfFHdBLdBHIeeÀ&DdEWlBlb)BkLFHdFLdBKCBDHdHIÂLc!bHKLBkCd::'SábHGVGHFFlKE
BJDFLCEHIBLdCEDdBkLIDKEBFGDdDFCGaKHlW>WM[S'SQ@'pkDEIDdfDdaKLIGLFBEBkLCEEHFDCBDHdHIBkLWKHFLEELEHICGGLKaDFDdIGCbbCBDHdHIBkLKLEWDKC
BHKhBKCFBCdfBkLDKKLbHfLGDda'pkLKLElGBEHIBkLÀ:SmoKHdFkHWKHPHFCBDHdBLEBDdfDFCBLEBCBDEBDFCGGhEDadDIDFCdBGhGHJLKGLPLGEHIBkLWKHPHFCBDHd
fHELCdfWKHPHFCBDHdFHdFLdBKCBDHdHIkDEBCbDdL)JkDFkFHKKLEWHdfEBHEDadDIDFCdBoKHdFkDCGkhWLKELdEDBDPDBh)BkLFkCdFLEHIJkDFkDdFKLCEL
CaCDdEBBkLoCFjaKHldfHIBkLCFFlblGCBDHdHIeeÀ&DdEWlBlb7:U'UBDbLEIHKÀ:Sm>ÂM"%@[Y'UbaVbGCdf9+'+BDbLEIHKÀ$:Sm>ÂM"%@
[S'+ba'
2<G?A@>;<G>0tdDdFKLCELDdBkLFHdBLdBHIeeÀ&DdBkLElWLKdCBCdBIGlDfHIEWlBlbJCECEEHFDCBLfJDBkCbHKLELPLKLFHlKELHILrCFLKoC
BDHdEHIoKHdFkDCGCEBkbCDdFkDGfKLd)CdDdFKLCELDdBkLFHdBLdBHIbLBCoHGDBLEHIdDBKHaLdbHdHrDfLDdBkLoGHHfCdfGldaLrWDKCBHKhCDK)bHKL
WKHdHldFLfEDadEHIoKHdFkDCGkhWLKELdEDBDPDBh'
gDBI<9:>eoKHdFkDCGCEBkbC)FkDGfKLd)KLbHfLGDda)oKHdFkDCGkhWLKKLCFBDPDBh)bLBCGGHWKHBLDdCEL&'

ko^X\ ° ¦¡ ¢¤

³ ¢££ ¡¢ ¤
©
¿ ¬ ° ÂÃ
¡ ¢ ¢ £¤ _¢ ¢¤ ® °
¢ ¤ ¤ ¢¡ © ¤¡
® ¦ [©\ ÂÃ J¢W ¿ ¦¤
¤ ¤ ¬ ¦ ¿ ® ¦ ¡¢
¤¢ °¤ ³ ¢ Â*Ã ¢
¤ ¬ ¢ ¬¬¤ ¡
¢¤ ¦¦ ¬ ¢ [\
¦ ÂÃ ¢ ³ ¤ ¤ Â6Ã ~ ¢ ¢ ¤¢ ¦
- ¡ ¢ ³¤ ¬¬
¬ °¤ ¬ ÂÃ ¤
¤ ¦ ¤ ¢ © ÂÃ ¤ ¤
°¤ ¦
¡ ¢¤ ¦ ® @ ¦ ¿ ¦
¤ ¡ ¤
¢ £¡ ¢¤ ¬ ¬¡ ¡
¦£¤ ¢ £ ¢ £¤ ¢ ¤
¤ ¦¢ ¦ ¤
¦ ¢ ¢¬ ®¡ ¤¤
¢¢ ¢ ³®¤ ¤ ¦ ¦
°¤
¢ ¬® ¢ £ £ ¿
Å*Ä ¢ ¤£ £ ¿ ÅÄ ¡ ¤
ÂÃ ¤ ¤£ ¤ q_ J¥¬ ¦ ¤¡ ¡
© ¦£ ³ ¡ ¤ ¢ ¤W Å
£¤ Â0Ã ¢ ¦ ¦ ¢
¤ ¢ ¬ ¦ ¤ ¢
©° ¢ ³ ¢ ¢ ¦ ¢¡
¢¦ ¤ ¢¢¡ ¢£¤ ¤ q
¤ ¤ £ ¢¡ ¦ ¦¤ ¦¡ ¢
£ ¦ © ÂÃ ¢ ¤ ~ 0*
¤ ¦ ¢® ¯ 00 J ¢¤ ~
¤¢ ¢9 ¢¤ ¡
°¤ ÂÃ [¬¢\ ¡ J©
¤ ¢®¢ ¤¢ W ¢
£ ¬¬£ ¢ ¡ ¦ ¢¡
¤ ¢ £¤ ¡ ¡ ¤ ¤ ¢¡¤
_¢£¡ ³ ¢¤ ¬ © ¢ ¦
°¤ £ ¤ ¢
¢ ¤¢ £¤ ¢ £ ¬® 6Ï - ¢
¢ £ ¬® ¡ ¡
¢ ¤¤
¡¤ ¦ j ° ¬®
¢£® ¡ ¤
°¤ ³ © £® ¢ ¤ Ê6 - jj
¤¢ ° 66 ¢ Ð6 -
[ ¦¦
\ ÂÃ £¡ ¦¬
¢ ¤£ £¡ ¦ ¢
£ ¢ ¡
¢ ¢ ¦ ¡ ¦ ¢¦ ¢
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 73


L'#! ' +
p * ¼ V h/ p + #
a ! *s ,*s .! +*
Î %%)<TS)9 <U)Y 9&)% 9)YTS)<
>dXQQ;¸¸¹&[Q)9Ì V@
ÎÎ %:)%TS)Q <Y)< Y%)+ Q):TS)<
>dX99;¸¸¹&àQ)9Ì V@
W ÅS)SQ ÅS)SQ ÅS)SQ ÅS)SQ
¡ ¢ ¤ ¡ ¤

¢ £¤ ¦£ ¤ ¢ ¢ ¤
¦ ¦ ¦ ¢¡ °¤ ¬
¢ ¦£ ¦ ¬ ¢ ¦ ¤¬£
¬® ¤¤ ¦¬ ¦ ¢ ¦¡¤ ¦
q ¢ ¦° ¢¡³ ¡ ¢ ¦ ¬
¢ ¤ ¢ ¢ ¦ ¦ ¤
¤ ¡ ¢¦ ¬¡ ¤ ¦
¡ ¤¤ ¤ ¤ ¦ ¢ ¡
¡ ¦ ¢ £ ¤¬ ¡
¤ ¢¡ ¦¡ ¬ ¢ ¢¤
¬¡ ¤ ¢¡¤ ¢ ¤ ¬ ³
¦ ¡ ¢¬ ¤ Â0Ã
¦ ¢ ¢¤ ¬¬£ [\ ¢ [\
¤ ¬¬ ¦ ¤ ¢°¤ ¦ ®
¡ [^?\ ¢ ° [q²\
[>^?\ Ä ¢
_£¡ ¢ ¡ ¢ ¤ ¢¡¤ ¡
¢ ¢¡ °¤ ¢ ¤ ³
¢ ¡ ³£ ® ¡ ¦
¢ >^? z ° ® ¬ ¢ ¦
¢ £ ¢ £ ¦® J¢¢ W ¢
¤¡ ¢ ¬ ÂÃ ¤ ¢ ¢ J¦ ®W ¡
¡ ^? ¢ _z §¡ ¬ ¤¬ ¦ ¢ Â6Ã
]j ¬® ¢ q ¢ ¤
¢ £¤ ¬ ¢ ¢ £ £
¡ ¢ ¤ JZ7Q7ÁZ7ÁQW Z Z Á J<8$$ ó! ¤
¬ ¢ ¤ ¢ Ó% Ò £ ¢
¡ ¢¡ [*Ä Ä Ä\ ¤ ¡ ¡
£ ¢ ¢ ¢ Á ! ¦¡¤ ¡ ¬
¬ Á' ! 3 % ¢¡ ¢ ¤ ¡
¨¨ !çç ÂÃ ¬¡
¤ ¨¨! ¢ ¢ [:\ ®
¤ J [\ ¢
¡W<ÎÁZQ [ JQ@28 Ç ¢ ¢¬ ¬ ¢ ¤
W Ç¨Z -- Ç¨Z-7<^ [JÇ% ¡ [\ ¦
¨%Z2 W JÖ#ÑW ]¤\ []\ ¢ °¤ °

l . /d' ++. -- !# %,
z -.! +*s
a
O O
Î >dXQQ@ :U)Y :S Q:)U
ÎÎ >dX99@ Y%)+ ::)U 9Q)Q
M ÅS)SQ ÅS)SQ ÅS)SQ

[\ ¢ ¢¡¤ ¡ 16

15
14
[Ä j\ 11,8
13,1
12
¤ 10
10,6
9,8
8,9
¬ ¬ 7,6
Бали
8 7,1
5,4 5,7
¤ z ¡ 6
4,2 4,6 3,5 3,4
¢¢¡ ¦ _ ¤ 4
2
¢ ¦ 0
1-й день 2-й день 3-й день 4-й день 5-й день 6-й день 7-й день
JcyXgw^W^_ dZogedfcaa ^W ZqZ[Z]caa І група

ІІ група
11,8
15
10,6
13,1
8,9
9,8
7,1
7,6
5,4
5,7
4,2
4,6
3,5
3,4
День госпіталізації
s¡ ¢ ® £ І група ІІ група
¡ © #IJ@ ! 8! $!* "*# +# !!"L!= !& # % -
$H! %+%!"!!"%%R+ !"+# $&;L =A
¡®¤ ³ ¢ ¤
¢ £¤ ¢¤ ¦
q¬£¤ ¤ ¦ ¢ £ ¢ ³ jj ¡ ³¤
¤ ¢ ³ £¡ ¢ ¬ ¤ ¦
¦ ¤ ¢¬ ¬9 ] ¿ Ä
¤ ¦ ¦ ¿ 6 [Ä j9 0Å\ ¿ [Ä
¡¤ 6Ä Ä *Ä 6Ä ¬® j9 Å6\ q ¢£¡
j ¡ jj ¬ ¢ ¢¦ ¢ ¦£ ¬£
¤ 0Ä [MÌ\ ¡ ¢ ¢¤
Ä [MÌ\ *6Ä [MÌ\ *Ä ³
[MÌ\ ®¤ ¤¡ ¦
¤ ³ ©¡ ³
¬ ¬¬ © ¿
¤ ¢ ¢¤ ¦ ¡ ¢¤ ¦ ¿ >^?
¬ ¤ ¦ ÂÃ ¤
¢¤ ¢ ¢¤ ¦ ¦¬ ¢ ¦ ¬¬ ¦
¢ zq ©¢ Â*Ã ¢ ^? ¬ >^? ¢
© _ ¤ q
¦ ¬ ¤ ¢ ³ ¡ ¡ ¦ ¢¤
¤ ¤¤ jj ¡ ¡
¤ ¬ ¤ ¤ ¦¤
¬ ¦ ¦³
¤ ¬ ¤ ¦ ¡ ¤¤ [¦ *\
¡ ³£ jj ¡ °
¡ ° ¬£ ¡¤ ¦ ^?
¤ ¢¦¤ ¬¤ ¦¡ ¢
¢° ¤ ¦ ¢¤ ³£ ¬¬®£
¢ ³ ¡
¤ ` ¢¦® ¤ ¡ ¢ ³ ¡
¤ ¢ ³ ¬¬ ¤ ^? Ì -
¢ ¤£ ¦ ¬® j ¤ 00Ä
¬® ¢ jj ¿ *Ä [+MÊ\È
¬¬¤ ¬ © jj ¡ >^? Ì -
ÂÃ q ¡¤ Ä j ¡ ¿
³ ¬¬¤ *Ä [+MÊ\ ¦
¬£® ¢ ¢°£ ¤£ ¢ ¢
?
.,, ' - k!!' ++
_' ,r3 / *,, #¾ `Dr3*,, #¾
Î %+)QTS)& 9Y)+TY)%
ÎÎ ::)ST:)< 9&)QT&)%
ÅS)SQ ÅS)SQ
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 75

L
_ 1 , ' . .h ' . # ' / , '- !
/dvv %' + .! ,v %'
. .
.
(l*s lszv }szv
c!Å::)S2V :Y)% %)Q>%)S·:)Q@ :)<>%)9·9)&@
ÂLc!ÅQS2V :U)< %)U>%):·:)9@ Y)%>%)U·Q)<@
[
~ ' , + /d' ++
~ ' , +*s

a
. " " , "' ," /
Î :)9 <9)% %+)Q 9)+ %S):
ÎÎ %Y)S Y&): %+)+ Q): :Y)+
M [S)SQ [S)SQ ÅS)SQ ÅS)SQ [S)SQ
^? ¦ ¬ ° ¢ ¬ °¤ [
¬£ ¬ ¡ ¢¤ ^? Ì -\9
°¤ © ¢¤£¡ ¡¤ ¡ ¿ *Ä ¬¡ ¿
¦ ¦³ 0Ä [:\ ¿ Ä
¤ ¢ ¢ [\ ¿ 6*6Ä ¤ ¢
¬ Â*Ã ¢ ¬¬£ ¢ ¤ ¤ ¦® >^? Ì -
¬ © ¤ ® ¬ ³ ¬¬¤ [Ð6 -\
¬¤ ³ ¢®¤ ¢¤ £
¢ ¢ ° £ [:\ Ä £
ÂÃ q ¬® jj ¡ £ [\ *6Ä
¢¡ ¢ £¡ ¢ ¤
¡ ¢ ¢° ¢ ¡ ¢
¬ °¤ ¤ ¢ ¤ ¦ ÂÃ
j ¡ [¦ 6\ ¤ ¬ ¬¡
q ¢ ³£ ¤ ¢
¬¬®£ ¡ ³ [¦ \
® ° ¢° ¢ ¬ ¡ ¦
¢ ¡¤ ^? ¬ ¢
¬ ¡¤ [Ð6 -\
Ð6 - ® °¤ ¬ ¢° ¢
£ ¬¡£ ³ ¤ ¢ ¢ ¬ ³ ¢®¤
¢ ÂÃ ¥ ¢
4
³¤ *Ä ¢
3,7
3,5
j ***Ä
3 jj ¿ Ä ¢ ¢ ¤
2,5 *Ä ¢
2 ¬® jj j 9
мг
1,5 ] ¿ Ä ¿ 6 [Ä j9 Å\ ¿

1 0,8 0,8 [Ä j9 Å*\ ¡ ¢ ¦£
0,5
0,2 ¬ ¬
0
ПК20Г, мг/мл ПД 20Г, мг ¡ ¡ ¢¡³
І група 3,7 0,8
ІІ група 0,8 0,2 ¤¤
І група ІІ група j
#IKB* ! * 8 %# L!=%+# !% *!8! =+ ¢ £ 0ÏÄ ¦
%!"!!"
£ ¢ ¡ ¿ 6*Ï6

\
_ 1 , ' .' - ! , '- !
/dvv %' + .! ,v %'
. .
.
(l*s lszv p}szv
(/:S?>5Õ=%@[Y)U V <9)9 +)%><)%·%S)<@ :U)U>%%)9·<U)9@
(.:S?>5Õ=%@[S)+ U:)+ %S):>U)S·%9)+@ 9+)+>%&)Q·%:%)+@
-* ¡ ¬® jj ¡ ¡ ¢ ¢°

¿ ÏÄ [Ì\ 66**Ï* -* ¤ ¦ ¦ ¬
[Ì\ ¡ ¦ ¢
³ ¡ ¬ ¦ ¢ ¬¬
¤ ¡¤ ¬ ¬ ¤
¦ [¦ \
³ ¦® ¬¬£ ¢ q ¢ ³
¢¤ ¢ © ` ® ¤ ¢
¬ ¬ ³ ® ¢ ¢¡ ¦
¡ ¢¤ ¤ ®£ ¡ ¦ ¬ ¡ ¢
£ ¤® £ ¤ ¦ ¢
¦ ¢° ¡ ¢ ¦ * ÂÃ
¢ ¦¢
¢ ¢ £ ¤ ¡ ¡¤ ¤
¤ ÂÃ ¤ £ ³ ¢ ¢¤ °¤
¡ ¤¬ ¢ ® ¢ ¡ ¢¤ ¬
¦ ¤ ¢ ¬ ¢¤ ¤
¤ ¡ ³¦ ¢ ¢ `
¤¡ ° ¤ £® ¢®¢ ¤¢ ¡
q ® ° ¦ ¤¬¤ £¡ ¡ ¢
¦ ¤ 9 ¡ ¦
£
°¤ >^?
k_oaZ[Y_
¤ ¤ £¡ ¡
¦ ¢ ¤£ ¤ ¦
¡ ¦¡¡¤ ¤¬ ¢ ³
¦ ¬ ¦ ¢ ¢ ¡ ³ ¢ ¡ ¤¡
¤ [_\ ¤ ¢¡¤ ¦ ¢¤ ¢ £¤ ¢ ¢¦
¢®¢ ¤¢ ¢ © ¦ ¤ ¬ ¬
_ ¢ ¦ ¤
¬ ¦ ¢ ¤ ~ ¢
¬ ¢ [\ ¬ ³ ¬
¬¬ [\ ¤ ¢¤ ¬¤ >^? Ì - ¡®¤ ¡
¢¤ q² Ä ¡° j ¡ [+MÊ\
® ¡ >^? Ì - ¢¡®¤ Ä
³ ¦ *Ä [+MÊ\
¬£ ¢ ] ¬ ¦® ¬¬£ ¬ ¡
¢ ¢¤ °¤
© [ Ð6 -\ ®¤ ¡
~ ° ¦ ¤ Â6Ã ¢¡³ ¢ ¡
¬¬ ¢ ¡ ¬
¤ q¦¤ ¢ ¬
° © ¢ ¬¡ ¬ ¤ ®
¢ ¢ ¢ ¢ ³
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 77

³£ ¬¬®£ ¢ ° ¤ ¢£ ¡¤
¡ ¬¬ 9 ¢ ¤
¢ ¬ ¦ ¬¬ ¤
®¤ ¢°¤ q² Ä
¢ ¦ ¬ ¦ [\ [q²Ê* -\
¢ ¡ ¡ 600 ¢ ¤ ¢ [\
¡ ¬ ¢ [q²Ê0 \
¬ ¬¬ ³ ! " !-
® ¢¡ ¤ ¦ >
'3'4 nGHBJ"H=J"
1. {{xª< £xj`<§xx ª< {x ª< £j`j` ª< j¼{j | 11.
< §_x` < x`^ Ä< _ < £x`^ < x_ ® jq x{|
;}~}¤A|½xxqxqxx`q_xqxq_jÒjqx_xqj¥_q ;}~}A| §x^jqj _`__q_` xqj`_` x{{j¡_xqj x_¥x
jj _`xxq ^j`j j¬j_`< j_`_{ _`xxq_` x` jj{_`^ _` xqx ¡_x {xq_`^ qj
_`Ñ{qxq_` x` x_¥x jjxq_¡_q| ¢`q `{| Ñq_ x` x`q__`xxq xq_` qx`_`^
¯°¤ÈJ ~|_°~|¤¤ »Ñ|}~}¤|¤ÈJ ~| ^¥q xq1| §j ¡ j_ _| >° J> | _°
2. xx < ªx`j¡j{{ < x{{x_` < ªx{j` ¢< 10.1177/1753466620981858.
xj`_x < xx^`x` E| ;}~¯A| E¬x{j xq_¬ 12. ®x`{x_qqj < ®x`j¡__ < «x{_`xx_qj¨xj <
jqx{{qj_`xj ;A _` _Òjj`q _{^_x{ x{x_`qj®<x{xxx«|;}~}A|qxq_E_`_{
j`qj xqx| E ® `qj` j| }> ;A° }È| qj`qxq_{_qx`_^xq_`_¥xªq{j
_°~|~È»¼|j¼_|}~¤|~ |J~>| j{{x`{`x¢_{xq`_q|j{{|~;ÈA°¤ |
3. jÃ¡ < ½j_qx¼{ ½< jj¡ ª| _ | ; A| doi: 10.3390/cells10061389.
_x^`q_x_{jj`_jq`j¡`æ_<{Ã`j`` 13. ®jÒj «< x_q_`j` < j`^j | ;}~~~A| _ xj
ªjqj¼x``j^¡Ãxqx|j`¡°}¤|±·*%³´< x_¥x_`xxq_`x`jj{{_`^|j_j|¯ºª{
¸8 â¸<Ü%*´ |; A|@ +!# * - ¢°>|_°~|~È»~>¯È;~~A~}JÈ|
8! # ù=!%! µ¶ø<#!!!ù=·µ- 14. ®`_j E¢< q £< x^jx¡j ¢E| ;¯A| _qx_`j
!!+% # |Ü!%$ù°}¤¹| x`jqx{_`j_`x{xq_`qjq`<ª¥jj`°>|
4. ^x{q < §j{ ®< {jq | ;}~}}A| ªj x` q 15. «xx < j{j` < _{xÃ < {q_`qx ¿< «j`_{_ ª|
»§ _` ¥_`qj q xq{jqj x` ¥_j° ;}~}A| E¬x{j jxq `j`xqj {j¡j{ x` _q
j{xq_`_ ¥_q x_¥x `q_`| _xj| }J ;}A° j{xq_`_ ¥ûq xqx j¡j_q x` _`qj{j_`¯»~ {j¡j{
}J¤J|_°~|~ ~»¤>¯J>~|}~}|}~}~~}| _` _{j`| `` {{j^ qx `{| ~ ;>A° ¤~~¤~¯|
5. _`<«{j_ª<xx<x_j<x^x`_`¢<x< _°~|~È»¼|x`x_|}~}|~}|~|
x`jÃ|;}~}A|__qjqqjqj_j`_¡j`j_ 16. «{¡x «< _{ < x ¿< §x`x¡x ª| ;}~}}A|
x_xqj¥_qq_j`_`^`_x{xjj`qjx`j {_`_x{ jxqj `_x{ xqx j_qj`j _` _{j`
_` j¡jj xqx| jq| ¯ ;ÈA° >~¯>| _° ~|¤J » ¥_q x{qj`xq_¡j `qj`q j_xq qxq jj{_`^
jq|~}¤}| xj| j` j_xq_| ¿x_`j| ;} A° }>¤| ± -
6. {{`j < x¡_j ®| ;}~}~A| §j jÚ_`j xqx j{ #*% µ < · * ´< Ø ! %#* '< Ç # * À'| ;}~}}A|
x_¥xjj{_`^°x¡jqj_`xqxx`jjq_¡j| !8! #L %# # # % !!" L!= !& #
j{{§_jj|¤ ~;}A°}}¤}¤È|_°~|~~J»~~¯¯~ % ! %!+ %# *% !+
03117-4. % = ! = R"= =| 8 #! "| À* &! | ;} A°
7. xjqq_jx < j ¢| ;}~}A| _¥x q }>¤¹|_°~|>>J¯»ª|}~}}|} |}>|
{j xq_{^ _` xqx| ® {{j^ {_` `{| 17. j`^§¢<«¢£<£`^£|;}~¤A|jj`qx¡x`j_`xqx
¯J;ÈA° ¤>|_°~|~È»¼|¼x_|}~}|~¤|~¤>| _xjjjx|§j¡j__|J;>A°}J¤~ |_°
8. x < xx_ < xqj < E`_^q < x` 10.1177/1753465813496863.
_`` ®< ¡_` < x`qj ½< «x §< £x`^j ®ª< 18. x`j½<^j<j{qE<x`_<`qx{{_««<<
`j` ª< q £< ¢_ ®E< ªqj ®| ;}~~~A| ®jÒj«|;}~~¤A|Ex{q_j`_`^qjjq_{xxjj`q
_j{_`j jqx{_`j x` j¬j_j x{{j`^j qjq_`^ jx`j _` _{j` ¥_q _è{q xqx| ® j_ _q
||®|j_|_q|xjj|È°~¤}| xjj|ÈJ;A°J }|_°~|È¯»|}~~}~>¯¯|
9. _` < j` < §x | ;}~~~A| ½`_`¡x_¡j 19. _ < ```_ < ¢jj_x ª< x ª_{¡x ¢< xx §|
xjj`q x_¥x _`xxq_` _` _{j`° _`j ;}~A| ªqqx{ x{qjxq_` x` xj j`qj{_x{
q< j¬x{j `_q_ ¬_j< x` jxq `j`xqj| E xq_¡xq_`_`{`xx``_x{xqj_j_`xqx{xqx|
j_®|È°~~ ~>| {{j^qx{_``{|} °>>~|_°~| È»¤}}¤
10. `^ ¨< _` < Ä_` < j`^ ®| ;}~}A| ªj _ 019-0363-0.
j{j¡xqj _` _{j` ¥_q xqx| { j j| > ;}A° ¯È} 20. ªx^{x`_ ª< { | ;}~>A| ½¡j{ `jq _` x_¥x _`-
¯È¯|_°~|¤ }»|}~|È>È| xxq_`x`jj{{_`^_`xqx|Ejx`j_xq

®`x{| ¯È ;ÈA° JÈ ~¯| _° ~| ¤»¤¤~~¤|~È q x` _^j{q_` qj q^x
2014. _` xqx x` | E j_ ®| }¯ ;ÈA° ~J|
21. ªxx¡_xx`{ < x`xj < x¡x{ | ;}~~¤A| doi: 10.1183/09031936.04.00032603.
x_`qjjjq_Òjj`q_x{j{{`q_`_`- 25. £ª<_E<x_<¨x`^Ä<®|;}~}A|_¥xjj{_`^
jq|jq|}¯°~È~~ÈÈ| xjj_^j{q_`qjq^x_`xq_j`q
22. ªqj ®< ¢x_ < Äx`¼j < q £| ;¤A| ¥_q xqx° j{xq_`_ q _{^_x{ xj _` _`j
ªqx`xq_Ãj x{{j`^j qjq_`^ ¥_q xx{^_x{< - q|¨`^x®_jjj_¨x¨_|¤>;}A° } È|
_x{ x` j`_q_Ã_`^ q_{_ _` x{q| jq £_`^ xq 26. _`¢<¨x<_¨<ª`^<ª_|;}~~JA|jqx{{qj_`xj»
ªqx`x_Ãxq_` `^ ¢`q_` §jq| Ejx` - q_j _`__q jqx{{qj_`xj _` _`j q
`_q ªqjj{ x` x{| è_x{ _q_` qj Ejx` _` xq_j`q ¥_q xqx x` `_ qq_¡j {`x
j_xqª_jq|E|j_|®|È;ÈA°>¤ ¤| _jxj x` qj_ j{xq_`_ q x_¥x _`xxq_` x`
23. §j`j < ¨xÒx`j{{ < _xÃÃx < _xj`q_`_ | ;}~ A| x_¥ {__qxq_`| ¨`^x ®_j j j _ ¨x ¨_| ¤~ ;¤A°
jx_`^ _¥x `xxq_` _` qxq_ _{j`| ¢`q }È|
j_xq|È;ÈA°È}~¯|_°~|¤¤ »j|}~ |~~È| 27. ¨x`^®<`^|;}~}~A|ªqxqx`jq°j`x{_Ãj
24. _^`{x < x^x`_` ¢< x_j < ª__{`j ½< j{{_x < qjxqj`q x` _xj x_¥x jj{_`^ _` xqx|
xxj{ jq x{| ;}~~¯A| _¥x jj{{_`^ xjj ®§x_|};~A°È~~È~|_°~|}~¤J»¼q}~~}¯|

_ ^ _ +Æ||!|<G|< %|* G| & "8 =!G*$! ==%L·*% !#*+@ÇÀ|´# °|Ü!%$<
%|#* <}~J´|qq°»»_|^»~~~~~~~} J J~¯|
n #pvÆ*||!|<$|* G| & "8 =!G*$! ==%L·*% !#*+@ÇÀ|´# °|Ü!%$<%|#* <}~J´|
qq°»»_|^»~~~~~~~¤~¯È È|
) »a b+Ã Æ*||!|< # # ! * G| & "8 =!G*$! ==%L·*% !#*+@ÇÀ|´# °|Ü!%$<
%|#* <}~J´|qq°»»_|^»~~~~~~~¤¯}>¤~J¤|
}! ^#'^ Æ*||!|<$|* G| & "8 =!G*$! ==%L·*% !#*+@ÇÀ|´# °|Ü!%$<
%|#* <}~J´|qq°»»_|^»~~~~~~~}È¯}~>¤È|
»½k V ^ Æ* ++ "8 % F&* +&µ ¸BÉÜ!%$* L #! "8 *!8! * !"Ê|
´# °|Ü!%$<%|#* <}~J´|
"! R *$&}|~>|}~}¤|< !" *~È|~|}~}¤|
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 79

UDC 616.323-089-616.212-089
K.V. Liakh1,2, A.L. Kosakovskyi1, Ya.V. Shkorbotun1,2

Assessment the Impact of the Torus Tubarius Correction
by Power-Assisted Technique on the Equipressor
Eustachian Tube Function
1Shupyk National Healthcare University of Ukraine, Kyiv
2StateInstitution of Science «Research and Practical Center of Preventive
and Clinical Medicine» State Administration Department, Kyiv, Ukraine
For citation: Liakh KV, Kosakovskyi AL, Shkorbotun YaV. (2023). Assessment the Impact of the Torus Tubarius Correction
by Power-Assisted Technique on the Equipressor Eustachian Tube Function. Modern Pediatrics. Ukraine. 5(133): 80-84.
doi 10.15574/SP.2023.133.80.
Purpose of the research is to evaluate the impact of the torus tubarius correction by microdebrider technique on the eustachian tube
function in children without middle ear pathology.
Materials and methods. 115 children aged 3 to 12 years participated in the study. All children underwent endoscopic modified microdebride-
ment adenotomy for the first time, which, in the case of tubal hypertrophy (we analyzed the frequency of this phenomenon), was combined with
its correction by the microdebridement method. For the next stage of the research, we selected 19 children, who had preoperative intratym-
panic pressure monitoring results more than —100 daPa and who hadn’t concomitant tonsil hypertrophy (19 children). Control measurement
was done on days 1 and 8–10 after the intervention. Depending on the presence/absence of concomitant hypertrophy of the torus tubarius,
patients were divided into the main (11 patients) and control (8 patients) groups. The analysis was carried out using the STATISTICA program.
Results. 36 patients were diagnosed with torus tubarius hypertrophy. When comparing intratympanic pressure on the 1st day after the
intervention in patients of the main and control groups, a significant difference in values was found (-144.37±41.09/-95.00±27.90 daPa).
On day 8–10, the intratympanic pressure data in patients of both groups did not differ from each other (-39.15±14.85 daPa in the main
and -33.87±19.57 daPa in the control groups) and preoperative values in both groups.
Conclusions. Hypertrophy of the torus tubarius is noted in 31.3% of patients with primary adenotomy. The microdebrider technique method
of torus tubarius correction is safe in view of the equipressor function of the auditory tube.
Keywords: children, torus tubarius, adenoidectomy, upper respiratory tract, pharyngeal tonsil hypertrophy, adenoid vegetations, microde-
bridger, tympanometry, endoscopic rhinosurgery.
^/ /% - ' , - ,, ,

"/! % -
1,2$ I I [1t ' 1,2
10 2 6 ]R ('^'Ú )'/
2. 10 3 4
. )'/)R
V 3 * * 3- 6 *'
V , 0 . %%Q Y %: ' R 8 -
3 * -) 3 * , ,- *-
*'. * %& )6 82* * -
%SS ( 6 2 3 >%& @'/ 2-
% +–%S * 'Z V 2 3BHKlEBloCKDlE66
>%%66@ 2>+66@ 'Á ** 6 - 1Aptp#Ap#t4'
l .#0RY< * 3- *6 'Z 2 %8 *
, 2 - 2>%99)YUT9%)S&V&Q)SST:U)&S ( ;W[S)SQ@'0 +%S
* 2 , *6 *->Y&)%QT%9)+Q ( YY)+UT%&)QU (
2 6@ *6 6'
0 ? 3 *6 , 2 Y%)YË , ' ¸ * *
*6 ,* 3- 6 *'
. ?2 2 '( 6 ^ 2 -
* '0 2 3 * 2'
_ - 2 23 '
_ e ) * ) ) 6 6 2 86) 3 ) )
* ) ) 6 '

A
mong the structures of the Walderyer’s @ % $$2 "
ring, which are located in the Eustachian tube was found.
nasopharynx, the pharyngeal tonsil is The purpose of the study — to assess the impact
the most frequent subject of study in pediatric of the torus tubarius correction by microdebrid-
otolaryngology. Other structures of the ring, er technique on the equipressor Eustachian tube
namely the tubal tonsils, are often disregarded function in children without middle ear pathology.
by doctors due to their localization [6]. The
anatomical description of the pharyngeal tonsil
was recorded much earlier by Schneider (1661) 7 "%2 3 $3% $% [6 # 2 %
(Ruben, 2017), in comparison with the description 6 $ \ % *Å 2 Ò Ò %
of the accumulation of lymphoid tissue around the adenoid vegetations at children’s hospital of the
pharyngeal ostium of the eustachian tube (tubal Z Z Á " üZ % ! -
tonsil) — R&dinger (1872) and Gerlach (1875), $ !33 % $ $ ¨%
and the accumulation of lymphoid tissue in the of the State Administration. The study was con-
pharyngeal recess were described by Eggstone and %"% + Ò 5 '-
Ó $@ $2 6 Â*Ã Ç 5 6 4 Q + !% ? $ 2 $ 2
distinguished between them, noting that the Z"+25 ^ $ Ñ $ 43 2
lymphoid tissue of the pharyngeal recess can never 45 % Ò 5 '+ -
extend to the ostium of the eustachian tube [3]. ¨ $$2 Á3 3 Z"2 Z
Ñ Ò3 % 2 " 5 %@ + Z Á " üZ % ! $ -
of view on the relationship between these lymphoid !33 % $ $ ¨%
formations, describing them both as one tonsil with State Administration. The study was conducted
the spread of the tubal tonsil to the torus tubarius % Ò ++$ Ñ$ 5
[1,10,15,21] and as separate formations [23]. '$ < $ ++ 3 $ ^
The tubal tonsil and the lymphoid tissue of the < Z"+25 ^
torus tubarius (LTTT) in recent decades is in- $ Ñ $ 43 2 45 Ò # %
creasingly becoming the focus of studies and the to carry out the research. Informed consent for the
+ ë" %%$ + $ 2 Â6Ã research was obtained from the parents.
The widespread introduction of new safe methods All patients underwent endoscopic power-
of surgical intervention, such as shaver, radiowave, assisted adenoidectomy. The method involved
electrothermadhesion, coblation, laser technolo- removing the main mass of the pharyngeal tonsil
Â6*Ã + % "% % $ Ò % %%$ + Ò Ç5
+ $ Ò$$ $$ Ò @3 % adenotome (biopsy sample collection) followed by
of LTTT and tubal tonsil. accurate removal of lymphoid tissue in the pericho-
Changes in torus tubarius and LTTT can also anal and peritubal regions using a microdebrider.
lead to the development of symptoms unrelated During the intervention, the condition of the torus
to middle ear diseases, such as snoring and apnea tubarius was assessed. Its size and shape (uniform
Â*Ã 5 2+ % % 3 5 $ $ 5 + %% $
Ò % % 2 @3 ÂÃ particles) and the prolapse of lymphoid tissue into
Á %% Î777 # $ # $ Ò 5 "
that spread from the pharyngeal tonsil and act as a In case of the torus tubarius hypertrophy
reservoir of infection in the pathogenesis of recur- (TTH) after adenoidectomy, its correction was per-
ë 2 % "++ + 2 formed with tangential movements to the surface
tract in children [13]. " "# " # " 5
7 $ " + "- of the tissue above the cartilage, without reaching
ber of studies that prove the precision, accuracy the level of the perichondrium. Correction was
and tissue preservation of the microdebrider ade- performed on the front part of the medial surface
noidectomy [11,18], which has transient [5] and of the torus tubarius without resection in the depth
$ + "% @ <" "# of the Rosenmüller fossa to avoid further contact
" + % % $ % Â6Ã of the wound surfaces (torus tubarius and
However, since the correction was most often per- peritubal region of the pharyngeal tonsil). A 60° mi-
formed in patients with middle ear pathology (in- %#% + Ò Ò 5 Ò% Ò %
cluding the Eustachian tube), no data on the di- towards the intervention was used for this purpose.
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 81

Table 1
Distribution of patients into groups by age and gender
Characteristics Main group, (n=11), M±m Control group, (n=8), M±m l
Mean age, years 5.63±2.69 6.37±3.62 >0.051
Gender, male/female 5/6 4/4 >0.052
Notes: %CFFHKfDdaBHBkLeCddnkDBdLhBLEB;:CFFHKfDdaBHBkLÂDEkLK]EBLEB'
After primary hemostasis, point coagulation of dysfunction (pressure in the tympanic cavity
bleeding sites was performed over the entire sur- % ! % $ ÂÃ\ $"% "$ $
face of the nasopharynx. hypertrophy of the palatine tonsils and refusal
For the second phase of the study, patients were to undergo a control tympanometry.
selected according to the criteria outlined below. Q "$ $% 5 + %
Inclusion criteria was the presence of indica- phase of the study. These patients were assigned
tions for adenoidectomy: nasal breathing disorder, to the main group — 11 children (with TTH),
snoring, apnea, chronic nasopharyngitis, as well and 8 remaining children — to the control group
as combination of hypertrophy of the pharynge- (Table 1). The distribution of patients into
al tonsil with accompanying pathology, such as "+ #2 % % %% %@ +
recurrent acute and chronic rhinosinusitis in the sented groups.
anamnesis. Exclusion criteria were the presence of Impedancemetry (tympanometry) was used
concomitant pathology of the maxillofacial area, to assess the invasiveness of the performed
injuries or operative interventions of the maxil- intervention in relation to the tissues
lofacial area in past medical history, the presence of the peritubal regions of the nasopharynx and
of concomitant secretory otitis media, vasomotor " "# " Á Ò$$ 5 Ò "$
rhinitis, recurrent acute otitis media and previ- obtained with the help of this research method
ous interventions on the pharyngeal lymphoid correlate with the severity of nasopharyngeal
ring in the anamnesis, presence of eustachian tube edema [20], therefore it is used by various
" $ "% Â6Ã Q$$ +
Ò 8 % # "2 % 2
[0Å " 3 \ %
to the tenth day after the intervention.
Depending on the type of data obtained,
statistical processing was carried out
by determining the main statistical indicators,
+ % %+% [¨ ¿
Whitney test) and dependent (Wilcoxon test)
groups, as well as qualitative indicators (Fisher’s
exact test) using the STATISTICA program.
Fig. 1. Hypertrophy of the torus tubarius in the form of uniform thickening. Results of the research and discussion
Intraoperative view of the nasopharynx after removal of the pharyngeal
tonsil As a result of the intraoperative assessment
of the torus tubarius, its hypertrophy was de-
tected in 36 patients. The changes revealed were
$$ Ò 9 " 5 ¿ 0 [Ä\ + -
È + %% $ $% ¿ [*Ä\ +
tients; an additional particle in the upper part
of the torus tubarius, protruding into the choana —
[Ä\ + Á * [0*Ä\ $% #-
nation of 2 types of increase was noted. In all cases,
the changes were bilateral, but in 2 patients they
were asymmetric (Fig. 1, 2).
Á $ " %@ 2+ 77Ñ
described, from a slight increase to the state
Fig. 2. Hypertrophy of the torus tubarius on both sides in the form of an
additional lobe. Intraoperative view of the nasopharynx after removal of the
J5 $ W $ +$$2 # "
pharyngeal tonsil the lumen of the nasopharynx [12,22]. In a small

Table 2
Results of tympanometry in patients of the main and control groups
Intratympanic pressure (daPa) Statistical

>;FG;Q?8G?D
Groups
Before surgery On day 1 On day 8–10 (according to the
M±m M±m M±m Wilcoxon test)
P1–2[S'SQ;
Main group (11 patients) n=22 ears -43.57±27.13 -144.37±41.09 -39.15±14.85 P2–3[S'SQ;
P1–3>0.05
P1–2[S'SQ;
Control group (8 patients) n=16 ears -33.92±24.82 -95.00±27.90 -33.87±19.57 P2–3[S'SQ;
P1–3>0.05
$DÃLKLdFLoLBJLLdaKHlWE p>0.05 W[S'SQ p>0.05
(Mann–Whitney criterion)
Notes: AloEFKDWBE7%#dBKCBhbWCdDFWKLEElKL>fCÀC@oLIHKLElKaLKh;:#dBKCBhbWCdDFWKLEElKL>fCÀC@HdfCh%;Y#dBKCBhbWCdDFWKLEElKL>fCÀC@HdfCh+·%S'
"# +"#$ " indicators obtained during the second examination
of TTH without middle ear pathology mostly "2 Ò $2 %@
% # "ã $ $ @3 those in the early postoperative period (p<0.05),
of primary adenoidectomy, when the correction they reached the preoperative level (p>0.05)
of torus tubarius was carried out during a revision in both groups and corresponded to normal limits.
intervention [12,23]. Some authors consider Among the patients of both groups, there were no
LTTT hypertrophy to be a compensatory reaction cases of complaints of ear congestion or hearing
to the removal of the pharyngeal tonsil, emphasizing loss in the pre- and postoperative period.
that this situation was most common in children Changes in intratympanic pressure on the
after adenoidectomy performed at an early age % 2 % % 2 Ò $ %%
(at the age of 3 years and younger) [10,12]. However, by other researchers, including cases after
the authors do not indicate the anamnestic data + Ò % % % 2 Â60Ã Ò
why these patients needed early adenoidectomy were explained by postoperative swelling of
# $ + 5 [*Å 2 \ ÂÃ the nasopharyngeal tissues and possible
The above-described changes in the torus #$ 5 " "
tubarius were found in patients during the initial tube by blood clots [20]. In all these studies,
3 Ò % + #$2 %@ the authors noted the normalization
genesis, and the symmetry of the changes suggests of intratympanic pressure on the seventh day after
a systemic cause. 3 Â6Ã Ò + %
The data obtained during tympanometry of pa- data obtained in patients of both studied groups,
tients of the main and control groups are presented regardless of the fact that in the main group, torus
in Table 2. tubarius correction was additionally performed.
According to the data presented in Table 2, Since the proposed method of the torus tubarius
intratympanic pressure in patients before the 3 @ "
3 Ò $2 %@ tube function, it can be recommended for use in
% Ò 6*Ï* % ! $% clinical practice if reduction of the torus tubarius
"+ % **Ï60 % ! tissue is necessary.
of the control group. Study limitations and prospect of further
Q $$2 % research. The obtained data on the spread of
2+ + " Ò # 3% Å0 " LTTT hypertrophy are described only in patients
after adenoidectomy in patients of both groups Ò $ $$2
compared to the preoperative period, while the hypertrophy of the pharyngeal tonsil and without
changes were more pronounced in patients of the middle ear pathology, so they cannot be considered
"+ [66*Ï6 % ! \ $ an indicator of the spread of this phenomenon
$ "+ [Ï % ! \ in this age group.
(p<0.05). The data obtained during the A small sample did not allow for a detailed
second measurement in the postoperative analysis of the prevalence of LTTT hypertrophy and
+ % [0Å % 2 % % 2\ the result of its correction in various concomitant
Ò $$ Ò 9 *Ï60 % ! pathologies of the middle ear and sinuses, as well
"+ % **0Ï % ! as probable systemic causes (presence of allergies,
the control group. It should be noted that the viral load, etc.) and requires further study.
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 83

Conclusions + % [ % 2\ Ò % Ò

8 % % 2 %@
'" + 2 % % 2 **Ä pressure in relation to the initial level and between
patients have TTH. groups is not detected.
Torus tubarius correction during endoscopic ¨ %#% â"
power-assisted adenoidectomy leads to a more 77Ñ @3 % % # %%
pronounced decrease in intratympanic pressure for implementation in health care practice.
[#2 % ! +Ê\ $2 + + 3 &'(')*+(,'/+),0304,456470(863079;,<06=,<'34>
'3'4 nGHBJ"H=J"
1. Acar G. (2021). Surgical anatomy of the Tonsils. In Oral # *%#* ´³< % !* â¶| ;}~¯A| 8 #! =
and Maxillofacial Surgery. London: 30 *% !!" +# + =!8!+ !& % |
2. Alimova NP. (2021). Comparative characteristics of the anthro- À* &!#* 8! 8 # #|};~~A°JJÈ¹|
pometric parameters of the head and maxillofacial region in 14. «x_¡x|;}~JA|{_xq_`j{jqqjxj_`
children with Adenoids. New Day in Medicine. 1 (33): 203–208. in surgical intervention for the diseases of lymphatic pha-
3. Aschan G. (1954). The Eustachian Tube: Histological Findings ryngeal ring in children. Klinicheskaia Khirugiia. 2: 31–33.
under Normal Conditions and in Otosalpingitis. Acta Oto-Lar- ± # *%#* '´| ;}~JA| ¶ * # !!" * +&
yngologica. 44 (4): 295–311. =+8! = % 8 !!"= % =%Q% !
4. q_{{x<«xqjÃª«<«j__<xýq_ª<§`jª|;}~}~A| G 8!+ *$" + * | !8! =+"| }°
Comparison between curettage adenoidectomy and endo- ¤¤¤¹|
scopic-assisted microdebrider adenoidectomy in terms of 15. Mansour S, Magnan J, Ahmad HH, Nicolas K, Louryan S.
Eustachian tube dysfunction. Braz J Otorhinolaryngol. 86 (1): (2019). The Eustachian Tube. In: Comprehensive and Clinical
38–43. Epub 2018 Sep 25. doi: 10.1016/j.bjorl.2018.08.004. Anatomy of the Middle Ear. Springer, Cham. https://doi.
PMID: 30322828; PMCID: PMC9422505. org/10.1007/978-3-030-15363-2_7.
5. ¥x{_<_|;}~JA|§jj_xqjEÒjq¥- 16. McCoul ED, Lucente FE, Anand VK. (2011). Evolution of
er Assisted Endoscopic Adeno with Microdebrider on Eusta- Eustachian tube surgery. Laryngoscope. 121 (3): 661–666.
chian Tube Function in Children. Otolaryngology online jour- Epub 2011 Feb 8. doi: 10.1002/lary.21453. PMID: 21305559.
nal. 7 (3): 162. 17. Metson R, Pletcher SD, Poe DS. (2007). Microdebrider
6. Botev I, Karchev T, Botev B, Tsenova V. (2011). Tubal tonsil – eustachian tuboplasty: A preliminary report. Otolaryngol
j¡_j¥| q{x`^{^| }° ¯| ±· % ø< 8% Ø< Head Neck Surg. 136 (3): 422–427. doi: 10.1016/j.
· % ·< þ!% ¶| ;}~A| ØL ! ! L| Ç· otohns.2006.10.031. PMID: 17321871.
! !++ "|}°¯¹| 18. Rajan N, Saxena SK, Parida PK, Alexander A, Ganesan S. (2020).
7. Dange PS, Bhat VK, Yadav M. (2022). Adenoid Morphology Comparison of middle ear function and hearing thresholds in
x` qj ^`q_ ¢xq q_q_ j_x ¥_q EÒ_` children with adenoid hypertrophy after microdebrider and
in School Children. Indian J Otolaryngol Head Neck Surg. conventional adenoidectomy: a randomised controlled trial.
74 (3): 3649–3653. Epub 2021 Jan 7. doi: 10.1007/s12070– Eur Arch Otorhinolaryngol. 277 (11): 3195–3203. Epub 2020
020-02332-8. PMID: 36742487; PMCID: PMC9895436. Jul 14. doi: 10.1007/s00405-020-06197-z. PMID: 32666291.
8. ÿ{ýj`ª<___ª|;}~}~A|x_È`j- 19. Ruben RJ. (2017). The adenoid: Its history and a cautionary
sisted Coblation Adenoidectomy to Conventional Curettage tale. Laryngoscope. 127; 2: 13–28. doi: 10.1002/lary.26634.
Adenoidectomy in Terms of Postoperative Eustachian Tube PMID: 28543437.
Function. J Craniofac Surg. 31 (4): 919–923. doi: 10.1097/ 20. Unlu I, Unlu EN, Kesici GG, Guclu E, Yaman H, Ilhan E et al.
SCS.0000000000006039. PMID: 31764564. (2015). Evaluation of middle ear pressure in the early period af-
9. x¡<¨j{q¡<«_`|;}~ÈA|xxq_¡jjÒj- ter adenoidectomy in children with adenoid hypertrophy with-
tiveness of the methods adenoidectomy in children with exu- qq_q_j_x¥_qjÒ_`|®q{x`^{|¤È;¤A°¤JJ
dative otitis media. Sovremennaya pediatriya. 2 (74): 151–154. 381. Epub 2015 Jan 13. doi: 10.1016/j.amjoto.2015.01.005.
±# *%´@< %´Û< ** !@¸|;}~ÈA| %! - PMID: 25766622.
! "GG* %!# %= + 8#*+8! " - 21. Varadharajan R, Thingujam S. (2020). Prevalence of Gerlach
! !ù= %+ $ # *## %!ù #! tonsil: a mucosa associated lymphoid tissue aggregation
|%!! " "|};J¯A°>>¯¹| in the nasopharynx. International Journal of
10. Hong SC, Min HJ, Kim KS. (2017). Refractory sleep apnea Otorhinolaryngology and Head and Neck Surgery. 7; 1.
caused by tubal tonsillar hypertrophy. Int J Pediatr Otorhi- _°~| }~¤»_`|}¯>¯>}|æ`}~}~>¤|
nolaryngol. 95: 84–86. Epub 2017 Feb 11. doi: 10.1016/j. 22. Yanagisawa E, Joe JK. (1999). Endoscopic view of the torus
æ{|}~J|~}|~~|°} >JÈ>¯~| tubarius. ENT-Ear, Nose & Throat Journal. 6: 404–406.
11. Juneja R, Meher R, Raj A, Rathore P, Wadhwa V, Arora N. 23. Yang SZ, Zhou CY, Wang ZL et al. (2022). Preliminary experience
(2019). Endoscopic assisted powered adenoidectomy versus of surgical treatment for torus tubarius hypertrophy in children.
conventional adenoidectomy – a randomised controlled trial. Zhonghua er bi yan hou tou Jing wai ke za zhi = Chinese
J Laryngol Otol. 133: 289–293. https://doi.org/10.1017/ Journal of Otorhinolaryngology Head and Neck Surgery. 57
S0022215119000550. (4): 505–509. doi: 10.3760/cma.j.cn115330-20210412-00196.
12. Kim JW, Rhee CS, Jung HJ. (2020). Partial resection of hy- PMID: 35527449.
pertrophic torus tubarius for recurred snoring: Case se- 24. Zheltov AYa. (2019). Diagnosis and treatment of the diseas-
ries. Medicine (Baltimore). 99 (10): e19329. doi: 10.1097/ es of nasopharyngeal lymphoid tissue in children with exu-
MD.0000000000019329. PMID: 32150069; PMCID: xq_¡jq_q_j_x|Äx{_Ñxq_`_j`q_Ñ¥`qj_^q
PMC7478779. qj x`_q| ¨x_ÃÃ_x° J>| ± % ´Û| ;}~A|
13. Kosakovskyi AL, Gavrilenko YV. (2014). Modern approach to @ +!# * *% !!" =%Q% !G&!& * ! !
the treatment of acute and chronic adenoiditis in children. !#+ * *# %! #! |@ #-
¿x_`Á j` x| } ;~~A° JJÈ| ± - $"! L|* !|! *|Â "°J>¹|

_ #( yb+ Æ||!|<G|< %|* G| "8& ! !++& +& G! &¸ÀµÂÀ* &! !B|³|î * |
´# °| &%<%|@+ $* <º |¤ ;~¯¯A}~>¯¯È|qq°»»_|^»~~~~~~~J¯¯}~|
y+!_ , Æ # ! * G| "8& ! !++& +& G! &¸ÀµÂÀ* &! ! B|³|î * |
´# °| &%<%|@+ $* <|qq°»»_|^»~~~~~~~¤¯ È¤¯ |
} - ½ , Æ*||!|<$|* G| ! !++&¸ÀµÂÀ* &! !B|³|î * |´# °| &%<%|@+ $* <º
|¤ ;~¯¯A}~>¯¯È|Â %| !++8!+%!!"@¸ÀÉ¸ *% * 8! $! G * 8!& *!8!& $ ! Ê@À|
´# °| &%<%|¶=!"<>º |¤ ;~¯¯A} ¯J~}|qq°»»_|^»~~~~~~~}¤~¤J¯|
"! R *$&¯|~È|}~}¤|< !" *~È|~|}~}¤|

~ *9*-*Ã06
$%! X1,2$Z 3
^-.#,-!-#k //%
1 0 -3 8 ?+
2'@ !.( #
3'% :+
`<9?;C8C;<GePugach AM, Bondarenko AV. (2023). Awareness of future parents about vaccination. Modern Pediatrics. Ukraine.
5(133): 85-89. doi 10.15574/SP.2023.133.85.
V 6 6 26 66 * 6 ; 3 )
- 2 8'
V , 0¹* 3:S '. ) )
'( 3 ) 3 ) 2 2 6
> ) - 2 * * - 2 @'
l .#0Z 2%9Q )6U&)QË6 ] :S)QË 6 'Ò2
8 2 6 ) %+ YS'Z )UU):Ë - 2*
8 3 6- 2 ) +Ë - 2 2 6-
) ) %9Ë 2 - -'. +%Ë 6 - 2
;%<Ë ) :Ë 2 ) %Ë - 2 'Z
6 * 6 6 ] 2 6* 2 26 71* 4
QUË ) - 2 6 * 6 R ) 9Y)&Ë
1* 4 * 2 8 *] ; +)+Ë ) 6 8 :Ë 1 4
6 ' (8 6 , 6 *6 26
2; * ) , ' 0
) 2 * 2 *28 6 2
6 7 +U)UË; Q<)%Ë) 9<)QË'
0 ¹2 * 2' ¹ ,'
. 2 6 63 - 23 2 * 2
* 'ã*8 2 8 )
8 V ) * 2 * 3
6- 2 2 8 'Ò
- 26 2 8 6) 66 '
. ?2 2 '( 6 ^ 2
* '
_ - 2 23 '
_ e ) ) 2 )62 2) )*
,-) * * 2) ) 2'
jI89DGD>><RR@C@9DS89DGC>8T<@C=8??;G8C;<G
EFB*/\;JKE8^3<?/-,<033
%AklWhjcCBDHdCGgdDPLKEDBhHImLCGBkCKLHIgjKCDdL)ihDP
:eLfDFCGLdBKL1$HoKHfDh4)ihDP)gjKCDdL
Y#dBLKdCBDHdCGMlKHWLCdgdDPLKEDBh)ihDP)gjKCDdL
W@9S<>D — to assess the intentions of students of different universities to vaccinate their future children and the factors that influence their
fLFDEDHd'
m8CD9;8A> 8G: EDCH<:>0 t sHHaGL IHKb JDBk :S wlLEBDHdE JCE fLPLGHWLf' pkL fCBC JLKL HoBCDdLf IKHb Cd HdGDdL ElKPLh FHdflFBLf
CbHdaEBlfLdBEJkHkCPLdHBhLBkCfFkDGfKLd'pkLwlLEBDHdEFHdFLKdLfBkLCBBDBlfLBHDbbldHWKHWkhGCrDE)CEJLGGCEDdIHKbCBDHdCoHlBBkL
CaL)aLdfLKCdfHFFlWCBDHdHIBkLKLEWHdfLdBE>HIWCKBDFlGCKDdBLKLEBCKLBkHELJkHkCPLHKCKLHoBCDdDdaCbLfDFCGLflFCBDHd@'
fD>@AC>0tBHBCGHI%9QEBlfLdBEBHHjWCKBDdBkLElKPLh)DdFGlfDdaU&'QËIKHbkLCGBkFCKLCdf:S'QËIKHbdHdkLCGBkFCKLELFBHKE'pkLbCuHKDBh
HIBkHELJkHBHHjWCKBDdBkLElKPLhJLKLILbCGL)CaLf%+BHYS'tFFHKfDdaBHBkLfCBC)CIBLKaDPDdaoDKBkBHFkDGfKLd)UU':ËHIKLEWHdfLdBE
LrWKLEELfCfLEDKLBHDdPLEBDdfDELCELWKLPLdBDHdCdfLduHhCIlGGGDIL)JkDGLCGbHEB+ËFHdEDfLKDBCWWKHWKDCBLBHBKLCBfDELCELEBkCBkCPLCGKLCfh
HFFlKKLf)CdfbHKLBkCd%9ËCKLldfLFDfLfCoHlBbLfDFCGBCFBDFE'#daLdLKCG)+%ËkCPLCWHEDBDPLCBBDBlfLBHJCKfEPCFFDdCBDHd;%<ËkCPLC
KLELKPCBDHd)bHKLBkCd:ËCKLldfLFDfLf)CdfCGbHEB%ËkCPLCdLaCBDPLCBBDBlfL'tFFHKfDdaBHBkLCBBDBlfLBHJCKfEPCFFDdCBDHdHIBkLDKIlBlKL
FkDGfKLd)IDPLfDEBDdFBWCKLdBCGaKHlWEJLKLDfLdBDIDLfCbHdaBkLKLEWHdfLdBE71ldwlLEBDHdDdaCFFLWBHKE4QUËHIKLEWHdfLdBEDdfDFCBLfBkCB
BkLhDdBLdfBHPCFFDdCBLBkLDKIlBlKLFkDGfKLdJDBkCGGPCFFDdLECPCDGCoGLDdgjKCDdL)9Y'&Ë1FClBDHlECFFLWBHKE4JDGGFkHHELHdGhbCdfCBHKh
PCFFDdCBDHdE;+'+ËCKLldfLFDfLfCdfEGDakBGhGLEEBkCd:ËCKL1KLIlELKE4IKHbCGGPCFFDdLE'pkLIDKEBWGCFLCbHdaBkLbCDdKLCEHdEIHKKLIlEDda
BH PCFFDdCBL FkDGfKLd DE BkL ILCK HI CfPLKEL KLCFBDHdE Cdf WHEBPCFFDdCBDHd FHbWGDFCBDHdE; BkL ELFHdf WGCFL DE fDEBKlEB HI BkL bCdlICFBlKLK
CdfBkLBkDKfDEFClBDHdoLFClELHIEHFCGGLfFHdBKCDdfDFCBDHdE'pkLElKPLhCGEHIHldfBkCBJkLdfLBLKbDdDdaFHdBKCDdfDFCBDHdEBHPCFFDdCBDda
Cd ldoHKd FkDGf) KLEWHdfLdBE JHlGf bHEB GDjLGh GDEBLd BH BkL HWDdDHd HI BkL IHGGHJDda EWLFDCGDEBE7 WLfDCBKDFDCd +U'UË; DbbldHGHaDEB
Q<'%Ë;ICbDGhfHFBHK9<'QË'
2<G?A@>;<G>0pkLGLPLGHICJCKLdLEEHIPCFFDdCBDHdCbHdahHldaWLHWGLDEaLdLKCGGhECBDEICFBHKh'pkLKLDEdHfDIILKLdFLoLBJLLdfHFBHKE
CdfdHdWkhEDFDCdE'pHbCrDbDqLWKHBLFBDHdHIFkDGfKLdIKHbPCFFDdLWKLPLdBCoGLDdILFBDHdE)WLfDCBKDFDCdEEkHlGfLIILFBDPLGhFHldELGWCKLdBE
HdBkLoLdLIDBEHIPCFFDdLECdfBkLKDEjEHIfLGChDdaHKKLIlEDdaPCFFDdCBDHd'pHDdFKLCELldfLKEBCdfDdaCdfoLdLIDBHIPCFFDdLECbHdaBkL
aLdLKCGWHWlGCBDHdCdfKLflFLPCFFDdLkLEDBCBDHdVKLIlECG)PCFFDdLLflFCBDHdEkHlGfoLaDdCEWCKBHICkLCGBkhGDILEBhGLCdffDELCELWKLPLdBDHd
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 85

WKHaKCbGHdaoLIHKLldDPLKEDBhCdfFHdBDdlLCIBLKbLfDFCGCdfdHdbLfDFCGBKCDdDda'`CEDFjdHJGLfaLCoHlBPCFFDdLEEkHlGfoLDdFGlfLfDdBkL
FlKKDFlGlbHIdHBHdGhbLfDFCGolBCGEHdHdbLfDFCGldDPLKEDBDLE'
HbbDBBLLHIBkLWCKBDFDWCBDdaDdEBDBlBDHd'
gDBI<9:>e PCFFDdL) DbbldDqCBDHd) WHEBPCFFDdCBDHd KLCFBDHdE) CfkLKLdFL) FHdBKCDdfDFCBDHdE BH PCFFDdCBDHd) WKLPCFFDdCBDHd LrCbDdCBDHd)
LrWLFBCdBWCKLdBE)PCFFDdCBDHd)hHldaWLHWGL'
ko^X\ ¤¤ ¢¤ ¢

j
¢¬¤ ® ¢ ¬ ¤¢ ¢ £
¢ ¤ ¬¬¤ ¤ ¢¦ ¤
¢¤ ¢ ¬ ³ ?ÀÁ'
£ ¤ ¬ ° ¬ ¢ £
¢ £ ÂÃ _°¡ ³ ¬ ³ ¤ ¢¬£ ¢ ¤ ¬
¬ ¤ ¢¡®¤ ¤ ¢ ¤ @ ¤ ¿ ¬
¦ ¬¬ ¢£¡ ¢ ³ ¡ ¢
¤ ® ¦° ¦ ¬ ¦ È ¢
¢®¤ ¤ ¬¬ ¡ ³ £ ¤¤
£¡ ¢ °¤
£ ¬ ®
°¤ ¤ ¬
¦¤¢ ÂÃ ¢¦ ¢ ¤
¬¬¤ ¢ ³® ¬ ¢ ¤
¢¦® ¤ ¦ ¦ ¤ ³
£ ¤ ¤ ¤
¬¤ ¢¬ ³ ¢¬
¢ ¤ ³° Ä £ ¦ ¤ ³ ¦¢ ¬
¬ ¦ ¬ °£¤ ¬¬ ¬£ ¢
¡ ¬¬ ¢
¤ ¢¦ ¦ ° ¦ ¤¢ -¦
¢ £ ¢ ³¤ ¬
¬ ¤ ¢ ¤ ¦¦ ~ ¢¤ [
¤ ¦ ¡®¤ ¤ ¤ £ ¦ ¢¦£
¤ ¬¬ ¡ \ ] ¢£
® ¤ ³¤ ¤ ¤¡ ¦ 0 ¢ ¤
¤ Â*Ã ³ ® ¬ ]¢ ¢ ¦
¤ ¡ ¢ £ ¦ ¢ £ J<8$W
¬ ¬ ² ³ ~
£ ¤ ³¤ £ ¢ ¡¤ *
¡£ ¡ ¤ ¡¢ ¬
¢¦¢¡¤ ¬ ¦¢ ¦ ¡ ¡
³ ¦ ³¦ ¬ ¬
¤ ³ Â*Ã ¦
q¦¢ ¦ ³ ³ ¢¤ ¡ 6 0 *
® ¢ ¦¢ ³ ³ ¢ Ä ¿ ¢ ¢ ¤ Ä ¿
¤ ¢ ¦ ¢ ¡ ~¡ ¤
¡¤ ¤ -¦ ¦ ¦ ¢ ® ¦ £¡
¬¬ ¢ ¡ ¤ ¢ ³ ¦¡£ ¤¤ ¬
¡£ ¬ ¤ ¦° ¤ ¢ ¢ £
¬ ¡ ¢ ¤
¦ ® ¦ ¢ Ê ¤ ¢¡³
£ ¤ ¬ ¤¡ ¤
¤ ¤ ³ ¬ ¬

¤ z ¡ W ¿ ³ £ ¬
¢¢¡ ¦ ¦ ~
¬ [Ä\È J¦ ¬W ¿
JcyXgw^W^_ dZogedfcaa ^W ZqZ[Z]caa ¤ ¦ ° ¦ ¤¢ ³¤
_¦° [6Ä\ ¦ [6*Ä\È ¦ ¤ ¡ ¢¡
0Å 0Ä ¿ ¬ [00Ä\ JW
Å *Ä ¿ Å* ©° ¬ [ ° Ä\ ¤
¬¬ ¦
¢ *
¤ ¬¬ ¢ ¤ 0Ä ¡
¦° 0Ä ¬¬ ¦ ° ¬
£ ¬¬£ ¦ ® ¦¡ ¬ ¬
¦ ¤¢ ¤ È ¬ ¿
¢ ¢ ¤ ¬ ¦ ® ¿ ¡¢ ¢
¬ ¢ ¢¤ ¡
Ä ¤ ¤ ¬¬ ¦
¤¤£ ¦¤ ° 6
¢ £ ¢ ¤
¤ ¬ ¤ ¤ 0Ä ³ ¡ ¤¤ °
£ ¢ ¬ ¢ £¤ ¤ ¬¬ ¦
³ 6Ä ¦° ¤
¢¡¤ ¢ ¡£ £ ¢ ¬9 ¿
¢ ¤ ¬ 0ÄÈ ¿ Ä ¤ ¿
6Ä ¤
¤ ¬¬ ¦° ¤ ¦ ¦
¦ ¢¡ ¤ ¡ ³ ¬¬ ¦
¦ 9 J¦¢¢¡ ¬
90
90 77,2
80,7 80
80 70
70 60
60 50
50 40
40 30
30 20 14
20 15,8 8,8
10
10 2,6
0,9 0
0 Інвестувати кошти Будемо лікувати те, Не можу
Позитивне Негативне Із застереженням Не можу в профілактикузахворювань що вже трапилось визначитись
визначитися і насолоджуватись
повноцінним життям
#IJ ! = # %!!"% *$ ! $& + <? #IK#!! % ! " $ ! <?
60 57
67,3
50 43,9
40 41,8
32,7
30
10,9 9,1 9,1
20
0
8,8
10 Вважаю,
0,9 0,9 1,8 Недовіра Страх
Не бачу
Вважаю, що ризик
Релігійні потреби — Страх
0 до вироб- побічних що краще вакцинації
переко- вакцинація проти-
Обов'язково Оберу тільки До 12 місяців Не буду вак- Не хочу Точно ника реакцій та перехво- більший за
нання малоефек- показань
буду вакци- обов'язкові не буду обтя- цинувати вакцинувати не знаю вакцин ускладнень ріти ризик хво-
нувати всіма щеплення жувати ди- поки не почне взагалі, а за пот- тивна
роби
доступними тину зайвими говорити реби «куплю»
в Україні уколами довідку 41,8 67,3 0 10,9 9,1 9,1 32,7
вакцинами
#IL %!!"% *$ ! $&% #! = L != <? #IM * 8 !%% %% *$ ! $&% #! = L !=
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 87

100
90 60 57
80
70 50
60 41,2
50 40
40
30
30
20 20
10
0 10
0,9 0,9
0
Інтернет Телебачення Друковані Особистий
(сайти, засоби сімейний лікар
форуми, (журнали, чи педіатр
соцмережі) книги,
листівки)
#I N * % %< * "* = ! LR #= - #IO * !G $&#!! %<?
#" L !L *
Ä ¦
£ ¬£ ³ ¬¬ ¢ ¦
¤ 6Ä ¿ ¢ ¤ ¬ ¬ ®
¬ ¤¤ ¬¬
¬ ¢
0Ä £ ¢ ¬ ¢ ¤ ¬¬ ³¦ ¡
¦ ¦ ¦¤ ¢ ¤ °¤ ¬ ¦
¬¬®£ ¢ 6*Ä £ ¬ ¦ ¤¢ _ ¤ ¢ ³ ¤¡
£ £ *Ä ¿ ¦ ® ¤
¦ ° ³ ¬¬ ¦¤
` £ ¦¢¡ ¬ ¢ ¬® ¦ ®
¦ ¬ ¬ ³ °£ ®£ ¡¤ ¬
¢ q ¡
]¢£¡ ¢¦ ³ ¦¢ ¤ ¦¢¡
³ 0 ¦ ¬¬
¦° ¬ ¬
¤¢ ¢ ¦¤ ¡¤ £ ¦ ®
´ ° £ ¢ ¤ j ¬ ¦ ¢
¤ ³ ¦ ¤¢ ¢ ¦ ¡ ¦
°£ ¤£ ¡ ® ¢¬ ¬¬ ¢¡£ £
¦¢ ¤ ¢¬ °¤ £ ³ ³
¡ ¡ ³ q ¦° ¢ ¬ ¦
¡ ¢ ¤ £ ¤ ¦°¤ ¦
¦¢ ¤ ¢¬ ¢ ¡ ¢ ¤ ¦
¤ ¬¬ ¢ _ ¡¤ ¢ ¦¡
¤ ¤³ ¤ ¬¬ ¤ ¢¤
¬ ÂÅ0Ã _ ¡
¤ ® ¡
¢ ¤ ££ ¬£
50
45
³ ò®¤ ¤ ¡
40 ¡ ¤ ¤ °
35
¢¢ ¬
30
25
£¡ ¬£ ¤ ®¤ ¬
20 ¬ ¦ ¤ ¤
15 ¬¬ £ °
10
5
¬£ £ ¢
0 ¢£ £
Так Ні Іноді
¥¢ ¦ò ¢¡¤ ¦
#IPÜ %% H $! L !L# !!"% *-
¦ ¬¬®£ ¦
$ ! $HQ £ ¢ ¬
¢¡ ] ¤- ¬¬ ¡
¦ ¬¬®£ ¦¢ ¬¬ ¤ ¡ ¢
¦ °£ ¦ ¤ ¢ £
¦ ¢ ¦ ¦ ¢ ³ ¡ ¢
® ¢¤ ¢ ®¡£ ¤ ¢°¤ ¡
¬¬®£ ¢¡¤ ¡ ¡¤
¢ ¤ _¡¤ ¦ ®
¤ ¤
k_oaZ[Y_ ¬¬£ ¡
¦¢ ³ ¬¬ ¦ ¤ £¤ ³ ¬¬
¢ ¢ ¢¬ ` ® ¦ ¡¤
® ¬
¤ ¢ ¬ ©¢ ¢¤ ³ ¬ £
¬ £ ¡ ° ¡
¦ ³ ¬ ¡ ³ ¡ ¢
¢ ¤ ¦ ¬¬
ª¦ ° ¢¤ ! " !-
¬ ° ¢ ¢° >
'3'4 nGHBJ"H=J"
1. Abaturov OYe, Siedunova OV, Agafonova OO. (2015). 7. Gjini E, Moramarco S, Carestia MC, Cenko F, Ylli A,
qq_q_jjx{q¥jq_`{x¬_x`jè_x jjq_ jq x{| ;}~}¤< ®x`¢jA| xj`qÁ x`
of their health education activities regarding active xj^_¡jÁ {j q¥x _{ ¡x_`xq_` _` {x`_x°
immunization of the population. Zdorovia Dytyny. 1: 65–68. assessment of predictors of vaccine hesitancy. Ann Ig.
±´L %µÙ<H!% µ¶<´+ G!% µµ|;}~>A| %- 35(1): 75–83. Epub 2022 May 6. doi: 10.7416/ai.2022.2521.
!!" 8! = $%! *%!G * * G*- PMID: 35532052.
%!# %!!"! # ! !#% ! $*&L- 8. ®x_` < æ ®< ªxqxxq < xxx`_ < xq < «x ªª
! * %!&! $&#! #!!"|Â%Á" jq x{| ;}~}< j >A| ¢xq `j`_`^
! |°È>–68]. Vaccination Intentions Among College Students: A Cross-
2. Antonova NA, Eritzian KY, Dubrovskiy RH. (2014). Otkaz Sectional Study in India. Front Public Health. 9: 735902.
q¡xq_`xq__°xjq¡j``_x`x{_Ã_^xÑj__`qj¡| doi: 10.3389/fpubh.2021.735902. PMID: 34976911; PMCID:
Teoriya i praktika obschestvennogo razvitiya. 20: 208–211. PMC8714761.
±´! !% ¸´< $"! â<@L%#* |;}~¯A|¶- 9. OON. (1989). Konventsiia pro prava dytyny. Rezoliutsiia
% % % *$ ! $&° "*#! ! L+ G8! ! %ÁQ| ½ ½| ¯¯»}> ¡_ }~ {qxx | ±µµ¸| ; A|
20: 208–211]. !%!$" % ! |Q$"µµ¸á¯¯»}>%
3. Boyarchuk OR, Mishchanchuk VA. (2020). Evaluation of }~ # *¹| ¿° qq°»»Ãx`|xx|^¡|x»
_`j`jxq`xj`qÁxjj`jqqj_`_Ãxq_`| laws/show/995_021#Text.
Modern Pediatrics. (2020). Ukraine. 5 (109): 19–}¤| ±·" 10. Philip RK, Shapiro M, Paterson P, Glismann S, Van
8* µ< ÇF !8* ¶´| µ$!* G * %< "* % % Q ! Damme P. (2016, Dec). Is It Time for Vaccination to
# %!!" L *% !G * * | 8 #! - É _x{Ê j_xq `jq _ ®| ¤> ;}A° ¤¯¤–1349. doi:
"|À* &! |>;~A°–23]. doi: 10.15574/SP.2020.109.19. 10.1097/INF.0000000000001321. PMID: 27626913.
4. Carrillo–Marquez M, White L. (2013). Current controversies 11. Ukrainian Institute for Strategic Studies of the Ministry
in childhood vaccination. South Dakota Medicine. Spec no: of Health of Ukraine. (2017). Annual report on the state of
46–51. health of the population, the sanitary and epidemiological
5. Chernyshova LI, Lapii FI Volokha AP, Bondarenko AV, situation and the results of the health care system of Ukraine.
Stepanovskyi YuS, Hilfanova AM. (2019). Immunoprophylaxis «_j¡° ¯> | ±À* &!#* !# # +8! = #!
`jq__jxj|«_¡°j`x°¤}~|±Ü! R% ³'< ÇµÂÀ* &! |;}~JA|8! %# !% "
³ ï'<¶= ´B<·! !*´¶< !%#* â< ! #!!"< # ! ! 8! # $Q
G !% ´Ç| ;}~A| '!G * * !G*$! = "!# # # =! %Á"À* &! | &%°¯> ¹|
=%L| &%°Ç $ ! °¤}~¹| 12. £|;}~}A|x_`jjèx<jÒjq_¡j`jx`qjq_`|
6. Delgado–Gallegos JL, Padilla–Rivas GR, Zúñiga–Violante E, ±¶##% !" + ! $" =! %Á"| ;}~}A| G*-
Avilés–Rodríguez G, Arellanos–Soto D, Gastelum–Arias LJ %!# < H%# = # % *$ ! ¹| ¿° qq°»»¥¥¥|
et al. (2021, Nov 26). Determinants of COVID-19 Vaccine ¥|_`q»`j¥»jxqjq_j»jqx_{»¡x_`jjèx
Hesitancy: A Cross-Sectional Study on a Mexican Population jÒjq_¡j`jx`qjq_`|
Using an Online Questionnaire (COV-AHQ). Front Public 13. World Health Organization. (2010). Global recommendations
Health. 9: 728690. doi: 10.3389/fpubh.2021.728690. PMID: on physical activity for health. Geneva. URL: https://www.who.
34900890; PMCID: PMC8661090. int/dietphysicalactivity/global-PA-recs-2010.pdf|G

'(V b+Æ # ! ¸ÀµÂÀ* &! !B|³|î * º+|* ÇþÉ@LÊ|´# °| &%<%|Ù|Ü % < |
https://orcid.org/0000-0001-8125-3031.
) (+ %Æ||!|<G|< %|* G| &<!+&<!G*$! = *#! = =%Q% !
Ç! !+Ù%#*+!%# |´# °| &%<#|´* * R*% <¯}¶|qq°»»_|^»~~~~~~~}J¤J} È |
"! R *$&~|~È|}~}¤|< !" *~È|~|}~}¤|
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 89

ÎÃËßÄÈ
~ 09669Â0900*6?ÀÁ'Ã*
% 1WYj 1$1,

Zt1%% 2
l #,' '.,. % -'

-/% + %" / % '%
234561 , *
1
2 !. EFG JL :#
`<9?;C8C;<Ge Marushko Yu, Hyshchak T, Dmytryshyn O, Dmytryshyn B, Myka M. (2023). Magnesium’s role in a healthy
person’s body, in the course and rehabilitation after infectious respiratory pathology and COVID-19 (literature information, own data).
¸ ) , 2 * 263 6 'R 6
-) , * ) , 2 3 '/ 3 -, 3
2* * 6 6- 2) 'Á,- -)
,8 ) 3 6- )!"#$%&) 8 3 -'R 6
2)8 - 2) -) ) *2 2'= 6-)
2 * 3 *28 3 6 ) 6 )
*) 6 2 -) , 2 ) 6 * ]
3 '
V 2 - - ) * *)
* * 3 !"#$%&) 3 ; 2
6 2'
V , 0= 2> 6 @) * > -
@) )** 3 3 '= 2<S
& %+) 6YQ ) !"#$%&>8 @ :Q ) !"#$%&6> @'
l .#0= ) , - 8 *)
>XS)SSQ@' Î 2 ) Y%)9Ë , 8 ) !"#$%&
9·Q ) 2 !"#$%&) - 2) *2) * 2])8
) ) , '
0. 8 2 !"#$%& 2 - )
* ,- 3 ) ) !"#$%& '.2 *
- ) 3 -) !"#$%&) -
6)* -6 2 ) 3 - 8 6
86 * 3 !"#$%&'
_ - 2 23 '
_ e ) 3 ) ) * ) !"#$%&)) '
m8FGD>;@Eb> 9<AD ;G 8 HD8ACHB SD9><Gb> T<:B* ;G CHD ?<@9>D 8G: 9DH8T;A;C8C;<G 8RCD9
;GRD?C;<@>9D>S;98C<9BS8CH<A<FB8G:234561A;CD98C@9D;GR<9E8C;<G*<IG:8C8
)*F/-*:;031G>:;\;/0157>9->:;><1^7>9->:;><1FF>0/2
%`HaHbHGLBEcCBDHdCGeLfDFCGgdDPLKEDBh)ihDP)gjKCDdL
:ÁcM1kDGfKLdÜEGDdDFCGmHEWDBCGÝÌQHIAPDCBHEkhdfDEBKDFBDdihDP4)gjKCDdL
eCadLEDlbDECbCFKHLGLbLdBBkCBWGChECdDbWHKBCdBKHGLDdBkLKLalGCBDHdHIbCdhWkhEDHGHaDFCGWKHFLEELE'#dBkLFCELHIDdElIIDFDLdBDdBCjL
HIbCadLEDlb)JkDFkfHLEdHBbLLBBkLdLLfEHIBkLFkDGfÜEoHfh)DBEfLIDFDLdFhfLPLGHWE'GDdDFCGbCdDILEBCBDHdEHIbCadLEDlbfLIDFDLdFhCKL
dHdEWLFDIDFCdfbChoLEDbDGCKBHEhbWBHbEHIPCKDHlEfDELCELE)DdFGlfDdaCEBkLdDFEhdfKHbL'#dBlKd)CEBkLdDFEhdfKHbLDEFHbbHdDdFkDG
fKLdJkHkCPLElIILKLfDdILFBDHlEfDELCELE)!"#$%&)DdIGlLdqC)CdfHBkLKCFlBLKLEWDKCBHKhDdILFBDHlEWCBkHGHah'#dElFkFkDGfKLd)LrFLEEDPL
CdrDLBh)KCWDfICBDalL)ElffLdbHHfFkCdaLE)EGLLWfDEHKfLKE)CdfLbHBDHdCGGCoDGDBhFCdoLfLBLFBLf'sDPLdBkCBBkLGLCfDdaKHGLDdLdElKDda
BkLWKHWLKIldFBDHdDdaHIbHEBHIBkLoHfhÜELdqhbLEhEBLbE)BDEElLKLEWDKCBDHd)LdLKahLrFkCdaL)CdfEhdBkLBDFWKHFLEELEoLGHdaEBHbCa
dLEDlb)DBDECEElbLfBkCBBkLfLPLGHWbLdBHIBkLfLEFKDoLfEhbWBHbEbChoLKLGCBLfBHDBEfLIDFDLdFh'
W@9S<>DBHElbbCKDqLGDBLKCBlKLfCBCHdBkLKHGLHIbCadLEDlbDdBkLoHfhHICkLCGBkhWLKEHd)BkLWLFlGDCKDBDLEHIDBEbLBCoHGDEb)DBEDbWHK
BCdFLDdBkLFHlKELCdfKLkCoDGDBCBDHdCIBLKKLEWDKCBHKhDdILFBDHlEWCBkHGHahCdf!"#$%&)EDadEHIfLIDFDLdFh)CdfbLBkHfEHIDBEFHKKLFBDHd;
LPCGlCBLBkLKLElGBEHIHJdKLELCKFk'
m8CD9;8A> 8G: EDCH<:>0 sLdLKCG FGDdDFCG >CdCGhEDE HI CdCbdLEDE fCBC@) GCoHKCBHKh >fLBLKbDdCBDHd HI bCadLEDlb GLPLG Dd oGHHf ELKlb@)
EBCBDEBDFCG)oDoGDHaKCWkDF)CdfDdIHKbCBDHdCdCGhBDFKLELCKFkbLBkHfEJLKLlELf'<SFkDGfKLdCaLf&BH%+BHHjWCKBDdBkLEBlfh)CbHdaBkLb
YQFkDGfKLdJkHkCf!"#$%&>BkLIDKEBaKHlW@Cdf:QFkDGfKLdJkHfDfdHBkCPL!"#$%&>BkLELFHdfaKHlW@'
fD>@AC>0#BJCELEBCoGDEkLfBkCBBkLCPLKCaLPCGlLHIbCadLEDlbGLPLGDdoGHHfELKlbDdFkDGfKLdHIBkLIDKEBaKHlWJCEGHJLKBkCdDdFkDGfKLd
HI BkL ELFHdf aKHlW >WXS'SSQ@' #dfDPDflCG CdCGhEDE EkHJLf BkCB Y%'9Ë HI WCBDLdBE Dd BkL IDKEB aKHlW) JkH kCf C BLKb HI 9·Q bHdBkE CIBLK
!"#$%&)dHBLfBkLWKLELdFLHIWHEB!"#$%&EhbWBHbE)ElFkCELrFLEEDPLICBDalL)kLCfCFkL)blEFGLJLCjdLEE)DbWCDKLfEGLLW)CWWL
BDBL)JkDFkFHDdFDfLEJDBkBkLfCBCHIBkLGDBLKCBlKL'

ÎÃËßÄÈ
2<G?A@>;<G>0pkLfCBCHIHlKEBlfhbChDdfDFCBLBkLLIILFBHIBKCdEILKKLf!"#$%&HdBkLGLPLGHIbCadLEDlbDdBkLoGHHfELKlb)JkDFkbCh
oLHdLHIBkLKLCEHdEIHKDBEfLIDFDLdFhCdf)CFFHKfDdaGh)BkLfLPLGHWbLdBHIWHEB!"#$%&EhbWBHbEDdFkDGfKLd'#BDECfPDECoGLBHFCKKhHlB
GCoHKCBHKhfLBLKbDdCBDHdHIBkLbCadLEDlbGLPLGDdFkDGfKLdJkHkCfCFlBLKLEWDKCBHKhDdILFBDHlEWCBkHGHah)DdFGlfDda!"#$%&)BHLEBCoGDEk
BkLFClELEHIBkLfLPLGHWbLdBHIDdfDPDflCGEhbWBHbEBkCBCaaKCPCBLBkLaLdLKCGJLGGoLDda)WKLPLdBBkLfLPLGHWbLdBHIbCadLEDlbfLIDFDLd
FhCdfIDdfCffDBDHdCGJChEHIKLkCoDGDBCBDHdCIBLKKLEWDKCBHKhDdILFBDHlEWCBkHGHahCdf!"#$%&'
gDBI<9:>ebCadLEDlb)fLIDFDLdFh)CEBkLdDFEhdfKHbL)KLkCoDGDBCBDHd)WHEB!"#$%&)FHKKLFBDHd)FkDGfKLd'

° ¤ ® ° Â6Ã _ ¬
¤ ¬ ¢ ¦ ¤ ¢
¤¡ ¤ _ £ ¦°
?ÀÁ' ¢ ££ ¬
° ¢°£ ¤ ¡ ¦ ¤
¢¦ ¢ ¡ ¬ ¢ ¦¡
¡ ¦ ¬ ¡ ¦¢ ¦
¢®£ ¢ ¢¤ £ ¬
¤ Â*Ã
³ ¢ ¢¦¢¡
®¤ ¢£¤ ¢ ¬¤ ³ ¦ ¡
£ ¡¤ ¡ ¬ ¢ ¤
¢ ¡ ¢ ¡ £
¡ °¤ ³ ` °
¢ ¢ £¤ ¢ ¦ ¬ ³ £®¤
³ Â0Ã ¤ £ ¦°£ £
³ ® ¢¡ ¤
¢ ° ¡¤ ¤ ¢ £ Â*Ã
°¤ ¢ ¤ £ @ ¤ ¿ ¢
¬ ¢ £¤ _ ³ £ ¢ ¢
¢ ³ ¡ £ ¦ ¦¢ ¢
?ÀÁ' ¢ ³ ¡¤ ¦ ¦¬ ¤
°° ¡ ¤ ¬ ¬ ?ÀÁ'
¦ ¢ £ ¿ ¢ ¬ ¬È ¬
¤ [Ä\ [Ä\ ¢ ¢
¿ ¦¢¤ ¤ ¤ q ¬ £ £¡£
[06Ä\ ÂÃ ?ÀÁ' ¦
¢ ¤ ¡ ¢¦¢¡ ¤
® °¿© j ¬ ¦
jj ÀÁ ¬ [_ _\ ¢¦¢¡¤ ¦¡
ÂÃ ¬ ¢ ¢
q ¢ ¢¡®¤ ¤ ÂÃ ¦
¢ ¦¢¡¡£ ¤ ¤ ¦ ¢¢£¡
£ ¬ ¦ ¤ ¤ ®
® ° ¦¤ ¢ []²\
°¤ ¬ ° ¤ ]²¢ [®
£ ³ ]²¢\ ³ ¦ ¡
°¤ ¡ ¤ Â*0Ã ¬ ¦ ÂÃ
¤ ¢ ¢ ¦ ¤
¢ £¡® ¢ ¤ ¬ ¡¢
¡ °¤ ¢ ¦ ¤
¦¡ ® ¤
Â0Ã ¢ ¤ ¡ ¡¤ ¤¢ ¤
¢ ¡ ¬£ ¬ ÂÃ
® ¬ ®¤ ¬ ® ¢
¤ ¤¡ ¢ ¢¡ ¢
¦¡ ¬
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 91

ÎÃËßÄÈ
¤ Â*Ã ¬ ¦ ¤ £¤ °¤ ¢®¤
¡ ¦ ¬ ¡ [¬ ¦ ¢ £
¤ ¢ °¤ ¬ \ Â*Ã
£¡ ¬¤ ~ ¢ ¬ ¤ ³
¢ £ Â*Ã ¢¢¡ ³ ®
¦¢ £ ¢ £ ® ¦ ¢ ¢®¤
¤9 ¢ ¬ £ ¤ ¢ ¤
¡¤ ¦ ¤ ®¡ ¦ ¦¢ ®¤ Ä 6
*ÅÄ £ ®¤ 0Ä Â*Ã ¡
°¡ ° [ÅÄ\ ¬ £ [ **Å6Ä \
¤ ¢ ¥ ¦ ¤ * ÂÃ
¦ ¢® £ ¢¤®¤ ¡ ¢ £ ¡
¦9 ÅÄ £®¤ ¦ ¡ ¤ ° ¢ £
® ¢ ¤ ¦ ¢¬
¢ ¢£ ÂÃ _ ¡ ¡
¬¬®£ ° ¤ ¤¢ [*Ä\ ¤£ ¡
¢ ° ¤ [Å 9
Ä\ Â**Ã z° Ä ¢ £ ® ¢ \ ¢¡9 ¤¢ ¦È ³
*Ä ¬ £ ¬£® £È ° ¤ ¤
¬ ¢ 9 ¢È ¢¤ È
[Ä\ ¤ ® ¦¡ È ¢ ¤¢ \ 9 ¢ ¢
¢ ¦ [*Ä\ ¦ ¢ ° ¬¬ ¢®¤ ¬È °
[Ä\ ÂÃ ¤ ¤ ¤È
£ ¤ ¢¢¡ ³¤ *\ ¬ ¡9 ¬ ¦
¤£ ¢ ¡£ ¦¢ £ ¡ ¢ £È
£ ¬ ¢ ¬ ¢ ¦È
° ¡ ¬ ¬ Â**Ã ¢ ¢¦¤È
q ¢ £ £®¤ ¢ 6\ ¢ Â*0Ã
¡ ¦ ° ¡ ¤ £
¤ £ ¬®£ ® ¦ ¤
¤¬®£ Â**Ã ¢ ¿ ¡ [¦ \
© ¤ £ ¬ ¢¢¡ ³ ¡
®¤ £¤ ® ° ¤
¬ ¤ ¢¬ £ ¬ ¬ ¢ £¤ ¡ ?ÀÁ'
®¤ Â6Ã _ ¬ ®£ °
¡£ ® ¦¢¡ ¢9 ¢ ¬ Â*0Ã ~ ¢ ¤ ® £
¤ ³ ¢£ £® ¢ ¦ ¬£
¦ °£ ¤ £ ³ ¢®¤ ¢ ¢
¢ [ ¦ ¢¡
¦\È ¢¡ ³ ¢¡ ¢
¦£ ¢¦°¤ ¦ £ ¿ ¢ ¡
[¤¡ ¢\È ¦ ¢ ¤¢ ¢ £¡ ¤ ®

++ . "/,' ' ,
+ "/,' ^. ' ,
= - 2 = - 2
. 2 . 2 *
( 2 0 2V 2
¸] * 2 0 ]
= Ò2 6V
= ) =
?*2 ?*2
¹ ¹

ÎÃËßÄÈ
¬¡ ® ¦ ¡ -¦ j® ¦ ³ ®¤
¦ ÂÃ ¤ ¢¡¤ ¤ £ ¢ £
¢ ¢ ¡ ¤¢ ¢ £ ¢
³ ® ¤ ¢ £ £ ³ ° ° Ä ¢
³ ¬¤ ¢ ¤ ÂÃ _ ¢
¦ ¤¢ ¢ ¬ ÂÃ ¡ ¬¬¤ £
?ÀÁ' ¤9 ¢ £ ¡ ¬ £ ¢ ¢
¤ ¢ ¢¤ ¬¬ ¦ °
¬¤ ¬¤ ¦ £ ÂÃ q ¡ ¡
¬¦¤ ¢¢¡ ¢ ¬ ¢¡¤ ¤ £ ¬
¢¤ ¿ ¬ ¬¤ ® ¦°
¡ -¦ ¡ ¦ ° ¬ ®
ÂÃ q ¢°®¤ ¢ ¢ ÂÃ
¢ ¡ ¢¤ ¦ ¤
¢ ¬ ZQÆZ À ¡ ¬ ¬¬ £ ¬
¢ ¬ ®¤ - - ¢
¤ ¬¤ ¬ ¢¡¤ 0 - Â0Ã
¢ Â6Ã ¬ ® ¬ ¢¡®¤ ¢
³¤ ³ ¡ ¢ £ ¬ ° 0 - ÂÃ
¤¢ ¢ °¤ _ ¤
¬ ¤ ¬ ¤ £® £ ¤ ¦ ¤ ¤ £
® ¢ ¢£ ¡£
¡ ¬ ¬ ®£
¢ ¬ ~ ¡
¦¢ £ ¬ °¤ ¢ £
¤¬ ¦¤ ¤ ¡ ¢ ¤¢ ¢ ¢ ¡¤
¦¡ 0 ¢ ¡ ¢ £
¢ ³ ¢¤ ¬¢ ¤ ~ 6Ä ¦ ¡
¢ ° °¤ ¬ ¤ ®£ Ä ¤
¤ Â*0Ã ¢ ¢ ¤ £ ~ ¬ Ä
¢ ¤¢®¤ ¢ ¬ £ ¢ ¤ £
¤ ¢¦¢¡£ ¤ ¡¢ Ä ¿ ¢ °¤ ¤
¢ ]²¢ ¦ ¬£-£ Ê [® ¢¡¤ ¿
¤ ¡ ¬ \ ` ¢ ¢
¢ ÂÃ ¢¦°¤ ¢ ¢ ° ¡
q ¡ ¤ ¬ £ ¢ £ ¤ ¬ ¢
® ¬¡ ¦ ¦ £¤ ¬ ¦
¢ ¢ £ ¤ ¦¡ ÂÃ
£¤ £ ¬®£ ¬ ]¢ ¬¬ ¤ £ ¬
¬ ¢ ¤ ¬ ¢ £ £
¢ ¡ ¬ ¢®£ []\ ¢ ³ ° ¢¡¤
° ÂÃ ¢® ¢ ¦£ ] jj
£¡ ³¢¢¡ ¢¡ ¤ [Ï6 -\ ¤
³ £ ¢¦¢¡ ¢ ¢ ° ] ¤
¡ ¬¤ ¢ £ ³ ¢ ¦£ ] jj ¤
¬ ¦ ¢¡¤ ®¤ ¢¡¤ *Ï*Ä
¤ £ ³ £ ¢ £¤ ¢ ¦£ ] j ¤ ¿
¬ 0ÏÄ ¢ ¦£ ] ¿
¤¢ ¢ £ ¢¡¤ ¡ 0ÏÄ ÂÃ
¢ ¦¤£¡ ¢ ¢ ° ¬
¡¤ ¤ ¢ ¤ *
¬ £ ° °¤ ¤ £
¬ ¤ ¡ ¢ ³ £ ¬
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 93

ÎÃËßÄÈ
¢£ ¦ ¡ ¡ ¬® ° ¤ ¤
[0 - - !Ê6\ ?ÀÁ' 6Å ¤¬ ¡¤
¤ ¢ ¦¢ Â*Ã ?ÀÁ' ¤
¦ ¢ ¢ £ ¦ ¦ ¤¢
³ ¬£ £ ¬ °¤
¢ ¬ q ® ¢¡¤ £
[~\ ³ ¬ ° ¡ ¤
£ ¡ ¢ ¢ ¢¡¤ £
¬ ¦ ¬ ¢ ¢ ³ ¡ £
~ ¦ ¢¡ ¡ ¤ ?ÀÁ' °
[kÍ0 Ñ% ÿ gÍ6 Ä Á Í 00 ¤ ¡ ¤
]Ê\ Â*Ã ¢®¢ ¤¢ ¢ ?ÀÁ'
£ ³ ¬ £ ` ¤ ® £
£ ¢®¢ ¤¢ ¦¢ ¡£ ¦£ ³ ¦® °
£ ' ¢ ³ ® ¡¤
¦ ¤ ¬ ¬ £ £¡£
¦¢ ' ¢¤ ®¡ ¢ £ ®¤
¢ ' ¡ ¢ ¤ ® ° ¤
¤ £ ¢ ¡ ¤ £ ÂÃ q¦
¤ £ ³ ® ³ ¢¤ £ ¤¤
¦ ¢¤ ¤ ¬¤ ¢ ¡¤ [7 ' 2 Æ
' Â*Ã Á 5 'ÆÁ\ ¢¦ £ ¢
_ £ ¬ ¡¤ j ¬ _¬
° ¤ [ Á " ¨% [Á?¨\
¢ ?ÀÁ' [¤ ^ $ Q %2 ¨% [^Q¨\\
¢ ¢ £ ¢ ¬£ £¡£ ¢
¬ [z\ ¢¢ -¦ ° ®¡ [Æ %% ' 2
\ ~ ¢¤ ¡ Q$$ Ò Æ'Q\ ¦¬ ÂÃ
0 ¤ _ ¦¬ ¦
¦ ° ¿ ¤ £ £¡£
* ¤ ?ÀÁ' [ ¢ ¡¤
¤ ?ÀÁ' 6 ¤ ¤ ®¡ ¦ ÂÃ
¬\ ¿ ¤ ?ÀÁ' ¡¤ ¤ ® ¢
¢ ¦ £ ® ¦¢ ¤ [
¢¡ ³ ¢ 0 £ 0 ¤\ [0
¢¤¤ ¤ 0 \ ¡ [ \ ¤
¤ ¢ ® ¢¡ [0 \ °¡ [00
¤ [ \ ¤ [ÏZ'\ \ ° [0 \ ° £ [6
³ ® ¢¡¤ ¤ £ 0 \ [* 0 \ ÂÃ
¬ ° [Í*\ ¤ ¬ ®
£ *Ï0 ¬ ¢£¤ ¢
[Í\ ¿ 0*Ï - [Í ¢ £9 £ £ ¦
® £ ¤ ¢ ¦\ £ £ ¬ £
j ¢ ¢ ³ *6Ä £ £ £

l , - ,,' + . '
Ã z
= < YS YS
U·%: UQ UQ
%·Y +S +S
9·+ %YS %YS
&·%Y :9S :9S
%9·%+ 9%S Y<S

ÎÃËßÄÈ
£ £ £ ¢¡¤ ³

³ ÂÃ q¦£¡ ¤ ¦¬£ £ £ ¤£®
®¡ ¦ ¤ ¬ £ ¬ ¤ ¤¢ ¦£ ¦¢
¢ £ ¦ ¦ ³ ¬ £ ¡
£ £ £ £ ¢ ® °¤
¦¢¡£ ° £ ¦£®
¦ ® ¦¤ ]²¢
¡ ¢¡ ® ¦¤ ® ¢¦°®
£ £ Â**6Ã ¬£ £ ¬¤
® ¦ ¬ £ £
¤ ¦ ® ° ®£ ¦ £
¦ ¤ ® ÂÃ
¢¦¢¡¤ ¬¤ q ¬ £ ® ¢¡
¢ £ ¦ ¢ ¤ ® £ ¦£
¡ ® Â6Ã ¡ ® ¢¡
¤ ® ¢® ¬ ¦ ¦¡
¢ ¤¢ ¤ £ ¢ ¡ ¡ ¬ ¢
¤ ³ ®£ ©° ¡ ¢ £
¡£ ® ¢ °¡ ¡
¦ ¬¤ ¬ £ ¤ £ £
¢ ¢¦°¤ ¢ ¤ ¦£ ¤ ¤ £
¢ ¢ ¤ ¬ ¬
¢ ¢ ¤ ¬£ ¢ ¡£
¡£ £ Â*Ã ¤ ¬ ¬ ®¡ ¢
_¢¡ ¬ £ ¤¤®¤ ¢ ¤ ¢ ¢¦°
£ ¢ [¡¢ ¢¤ £ £ ¢
°¡\ £ ¤¢£ ¦ ¤ £ ¤ ®¡ ¦ ¢ ¤
£ ®¤ ¢®¤ ¢ ® ¢ ¢
®£ £ £¢ ¤¢ ¢ ¦ ¢ £ ¤¢ ¢
¡ ¬ ¤ ¦ ¬ £ ¢ °¤ ¡
¦ ¢ ¡ ¤ ¬¤ ¤ ¦ ¤
®¤ ¦ ¦¢¡£ ¤ £ ¬ ¢ ¢
¤ ¡¢ ¡¤ ¤¢ ! " !-
¬ ¬£ ÂÃ >
'3'4 nGHBJ"H=J"
1. Ahmed F, Mohammed A. (2019). Magnesium: the forgotten 9. Escobedo–Monge MF, Barrado E, Parodi–Román J, Esco-
electrolyte — a review on hypomagnesemia. Medical bedo-Monge MA, Torres–Hinojal MC, Marugán–Miguel-
Sciences. 7 (4): 56. sanz JM. (2022). Magnesium Status and Ca/Mg Ratios in
2. Barna OM, Kalinichenko MA. (2021). Asthenic syndrome: new a Series of Children and Adolescents with Chronic Diseases.
challenges — a new approach. Medicine of Ukraine. 4 (250): Nutrients. 14 (14): 2941.
25–29. 10. Glasdam SM, Glasdam S, Peters GH. (2016). The importance
3. Bhurat R, Premkumar S, Manokaran RK. (2022). Serum of magnesium in the human body: a systematic literature
magnesium levels in children with and without migraine: review. Advances in clinical chemistry. 73: 169–193.
A cross-sectional study. Indian Pediatrics. 59 (8): 623–625. 11. j¢®<xj^|;}~~ A|j`jÑ_x{jÒjqqx_
4. Caronna E, Pozo–Rosich P. (2021). Headache during on human health. Physiologia plantarum. 133 (4): 725–735.
Õ° j` x{{< _{_xq_` qj `qj`xq_`x{ 12. x`^ < « E| ;}~~JA| jx`_ x{j_x
{x_Ñxq_`jxxj_j|jxxj|È;}A°¤ >| _` x^`j_ jÑ_j`| ®`x{ qj j_x` ª_jq
5. Cleveland Clinic. (2023).Magnesium-Rich Food Information. of Nephrology. 18 (10): 2649–2652.
¿° https://my.clevelandclinic.org/health/articles/15650- 13. x`^ < ¨j`^ < _ ®< j`^ ª< j` §< _x`^ jq x{|
magnesium-rich-food. ;}~A|ª_^`_Ñx`q{{¥jjx`x_x^`j_{j¡j{_`
6. Di Nicolantonio JJ, O’Keefe JH, Wilson W. (2018). Subclinical _{j`¥_qxqqj`q_`jÑ_qjxq_¡_q_jqx``q{°
x^`j_ jÑ_j`° x _`_x{ _¡j x_¡x{x A systematic review and meta-analysis. Progress in Neuro-
disease and a public health crisis. Open heart. 5 (1): e000668. Psychopharmacology and Biological Psychiatry. 90: 134–141.
7. Dotan A, David P, Arnheim D, Shoenfeld Y (2022). The autonomic 14. Hyshchak TV, Marushko YuV. (2012). Ctan obminu mahniiu u
aspects of the post-COVID19 syndrome. Autoimmunity ditei shkilnoho viku na tli somatychnoi patolohii. Sovremennaia
Reviews. 21 (5): 103071. jxq_x| °¤~¤¤|± F *Ø¶<Ç R*â¶|;}~}A| !
8. Elin RJ. (1987). Assessment of magnesium status. Clin. Chem. L! +!Q R*!+%*! # 8!& -
33: 1965–1970. +&|%!! " "| °¤~¤¤¹|
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 95

ÎÃËßÄÈ
15. Jahnen–Dechent W, Ketteler M. (2012). Magnesium basics. %+ !Q ! % %!R!+%# +!Q!
Clin. Kidney J. 5: i3–i14. "*# " + # G + !Q GQ*#!Q
16. Kyrytsia N. (2012). Asthenic syndrome in convalescents =%LQ|%!! " "|;JA°}¯¤~¹|
of infectious mononucleosis Epstein–Barr virus etiology. 26. x | ;}~ÈA| { qx _qj jÑqq x`__
¿x_`_x` ª_j`q_Ñ j_x{ q ®`x{| ¤ ;ÈA° ÈÈÈ | v rozvytku vehetosudynnoi dysfunktsii u ditei. Zdorove
± $" ¸| ;}~}A| ´# !8! # ! *!% - jj`x| ¯° ¯¤¯ | ±Ç R* â¶| ;}~ÈA| #$
#$! %!G*$!+!!* R ! · %- G$ +!Q % % * %+ # !!& #G!*$&
#!& +&|À* &!#* ! *% 8! - |Â%L!* |¯°¯¤¯ ¹|
! ! |¤;ÈA°ÈÈÈ ¹| 27. jj < ª_q £| ;E|A| ;}~~JA| _jqx jjj`j
17. jÃj` ª< £j^x`q §< j{ x{{j ½< jj{ intakes research synthesis: workshop summary. National
x`<ªj{¡jx<j{{jjqx{|;}~}}A|`^ xj_jj|¿°
in Children and Adolescents: A Systematic Review and Meta- 28. Nieder R, Benbi DK, Reichl FX. (2018). Microelements and
analyses. Sci Rep. 12 (1): 9950. doi: 10.1038/s41598-022- their role in human health. In Soil Components and Human
13495-5. PMID: 35739136; PMCID: PMC9226045. Health. Springer, Dordrecht: 317–374.
18. Marushko YuV, Hyschak TV. (2014). Systemni mekhanizmy 29. Ohyama T. (2019). New aspects of magnesium function: a key
xxqxq__| ªqj _qj_| `xÑ_x| «_¡° ¤ | regulator in nucleosome self-assembly, chromatin folding and
±Ç R* â¶< F * Ø¶| ;}~¯A| # ! = ! phase separation. International journal of molecular sciences.
$&| # |Ç!+ G"| &%²! $* < 20 (17): 4232.
B % ! * !"ïµB *µ¶|°¤ ¹| 30. Ozmen H, Akarsu S, Polat F, Cukurovali A. (2013). The levels of
19. Marushko YuV, Hyschak TV. (2016). Obgruntuvannia calcium and magnesium, and of selected trace elements, in
zastosuvannia preparativ mahniiu v pediatrychnii praktytsi whole blood and scalp hair of children with growth retardation.
(ohliad literatury). Sovremennaya pedyatriya. 6 (78): 27–32. Iranian Journal of Pediatrics. 23 (2): 125.
±Ç R* â¶< F * Ø¶| ;}~ÈA| µL ! % !!" # #- 31. _j_`^§<x{jj<ª_`^j<j|;}~}A|_^j
% !!" % +!Q% 8! * $;+"- intakes of potassium and magnesium, but not lower sodium,
A|%!! " "|È;J A°}J¤}¹| jjx_¡x{x__`qj¢x_`^xÒ_`^ªq|
20. Marushko YuV, Hyshchak TV, Zlobynets AS. (2012). Nutrients. 13 (1): 269.
Zastosuvannia kombinovanoho preparatu mahniiu ta kaliiu 32. j<E¥x|;}~A|x^`j_{jj`qxq_`_`
u kompleksnii terapii ditei z dyskineziieiu zhovchovyvidnykh ¡_qx_`jÑ_j`|j_x`¼`x{qjxjq_|}È;A°
shliakhiv ta kardiometabolichnymy porushenniamy. e124–e132.
ª¡jj``xx jxq_x| J ;¯JA° È| ±Ç R* â¶< 33. < xx{{j < _` ®< §j «<
F *Ø¶<ÂL !$´|;}~}A|Â # #% !!"*L!% - Ziegler TR. (2014). Modern Nutrition in Health and
!+ +!Q * Q**#! & Disease. 11th j| __`qq £_{{_x £_{_`° x{q_j<
#*!HQ%8% %! =R"=% * L8! - MD, USA: 159–175.
R!!" |%!! " "|J;¯JA°È¹| 34. ªj{ÇÇ<«xÇÇ<¡_`'Ç<ªj{µ<x¡x'ª<
21. Marushko YuV, Hyshchak TV. (2012). Vmist mahniiu, {j` Ç´| ;}~}}A| §j j x {j¬ xj `
kharakterystyka astenichnykh proiaviv ta nichnoho snu v ditei magnesium and potassium (Panzikor) on the course of arterial
iz riznymy formamy pervynnoi arterialnoi hipertenzii. Zdorove hypertension of I–II stage 1–2 degree with hypokalemia.
jj`x|J°¯}|±Ç R*â¶< F *Ø¶|;}~}A|¶# +- j` j_xq_| ¿x_`j| J ;}JA° ¤¯¤| ±Q* ÇÇ<
!Q<= * # * # !8! ="%% !8!+#!%- 8*ÇÇ<³%*!'Ç<Q*µ¶<Û%#* '<B !-
! G % !!& !&+ !- * Ç´| ;}~}}A| Â # #% !!" **# ! #!% +!Q
&|Â%L!* |J°¯}¹| * Q;B !$ *A! L+ !&+ !&'''
22. Marushko YuV, Hyshchak TV. (2013). Efektyvnist zastosuvannia # & }+ # !" +* HHQ| 8 #! "|
Mahne V6 pry astenichnomu syndromi i porushenniakh À* &! |J;}JA°¤¯¤¹|_°~|>>J¯»ª|}~}}|}J|¤¯|
nichnoho snu u ditei. Sovremennaya pedyatriya. 6 (53): 35. ª`^®<ªj®<j`<x`¢|;}~}~A|xqjqjjxx¡x`j
¤J¯¯| ±Ç R* â¶< F * Ø¶| ;}~¤A| G* %!# on magnesium and magnesium alloys worldwide. Journal of
# #% !!" Ç +! ¶È # !8! # ! - Magnesium and Alloys. 8 (1): 1–41.
R!!"= !8!+ #! | %!! " "| 36. ª{<_¨|;}~ÈA|ªqx`xqx_j{jj`q-
È;>¤A°¤J¯¯¹| noho zabezpechennia u khvorykh na tsukrovyi diabet 2 typu
23. Marushko YuV, Hyshchak TV. (2013). Mahnii ta yoho z ozhyrinniam. Zdobutky klinichnoi i eksperymentalnoi me-
znachennia dlia dytiachoho orhanizmu. Dytiachyi likar. 1: 9–13. q`| ;}A° ¯~¯~| ±# * '< ³F* µÂ| ;}~ÈA| !
±Ç R*â¶< F *<Ø¶|;}~¤A|Ç +! +! 8!!" * *! !+ L8!!" =% = !
" "8++ !|@ "8 * |°¤¹| $*% L } !!"| ÂL * *!8!& _
24. Marushko YuV, Kostynska NG, Hyshchak TV, Marushko TV. *# ! !& $ ! |;}A°¯~¯~¹|
(2022). The biological role of chromium and the impact 37. §x`^¢<_`^<®_xÄ<£<«`^|;}~}~A|__{_q
of changes in its content on the course of obesity and of magnesium supplementation for supportive treatment in
hypertension in children (literature review, own research). patients with COVID-19. European Journal of Pharmacology.
j`j_xq_|¿x_`j|¤;}¤A°J¤J|±Ç R*â¶< 886: 173546.
# !#* ¸< F *Ø¶<Ç R*Ø¶|;}~}}A|·+8! 38. `x<«xx<x_`x§|;}~}A|q¡_`_
= % % ! + %# ! L+ !- astenichnyi syndrom u ditei: chy potribna dopomoha?
!" !& + !& % ;+" < ¨¡Áj jj`x| È ;ÈA° ¯}>¯¤¯| ±¶ #8 ! '³<
% #! #!!"A| 8 #! "| À* &! | ¤ ;}¤A° 8*¶¶<ÛR*! Øµ|;}~}A|B# %#! # !8!
J¤J¹|_°~|>>J¯»ª|}~}}|}¤|J¤| # ! °8 L! + Â%Á" ! |
25. x < ´`¡ < x §| ;}~A| { x`__ È;ÈA°¯}>¯¤¯¹|
v orhanizmi liudyny ta vplyv zmenshenoho vmistu mahniiu 39. Weaver CM. (2013). Potassium and health. Advances in
`x x_q Ãqq_x _qj_ _Ã xqjÃxjx{`_ j_`_ Nutrition. 4 (3): 368S–377S.
khvoroboiu. Sovremennaya pedyatriya. 1 (97): 124–130. 40. World Health Organization. (2012). Guideline: potassium
±Ç R*â¶<´#!%< F *§¶|;}~A| +!Q _`qxjx{qx`_{j`|£{jx{q^x`_Ãxq_`|¿°

V h { , Æ||!<G|< %|* G| &#" !&#% ¸ÇÀ!µ|µ|·+$"|´# °| &%<L%|Ø|î%8!* <¤|
https://orcid.org/0000-0001-8066-9369.
akn +%Æ||!<G|* G| &#" !&#% ¸ÇÀ!µ|µ|·+$"|´# °| &%<L%|Ø|î%8!* <¤|
https://orcid.org/0000-0002-7920-7914.
z, h^#'( %Æ # # ! * G| &#" !&#% ¸ÇÀ!µ|µ|·+$"|´# °| &%<L%|Ø|î%8!* <¤|
https://orcid.org/0000-0002-5550-7234.
z, h) ' ½ Æ*||!|<$|* G| &#" !&#% ¸ÇÀ!µ|µ|·+$"|´# °| &%<L%|Ø|î%8!* <¤|
https://orcid.org/0000-0002-2360-6609.
VV { %Æ %| 8! %!!" ¸BÉ@ "8 *!8! * !"á>%" R !#*+ !| H% Ê|
´# °| &%<L%|´* * ¶! #*+<}¤|
"! R *$&~¯|~¯|}~}¤|< !" *~È|~|}~}¤|

ÊË²Í²×ÍÈÉ ÂÈÏÀÄÎÊ
UDC 616-091.8:576.368-089.843
A.M. Hilfanova1, D.V. Zabara2, O.V. Lysytsya3, A.V. Volkova3

Hematopoietic stem cell transplantation in patient
with DOCK8 deficiency: Ukrainian experience
1European Medical School, International European University, Kyiv, Ukraine
2SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O.M. Lukyanova of the NAMS of Ukraine», Kyiv
3National Pediatric Specialized Hospital «OKHMATDYT», Kyiv, Ukraine

For citation: Hilfanova AM, Zabara DV, Lysytsya OV, Volkova AV. (2023). Hematopoietic stem cell transplantation in patient with
DOCK8 deficiency: Ukrainian experience. Modern Pediatrics. Ukraine. 5(133): 97-101. doi 10.15574/SP.2023.133.97.
Dedicator of Cytokinesis 8 (DOCK8) deficiency is a combined immunodeficiency that exemplifies the broad clinical features of primary immu-
nodeficiencies (PIDs), extending beyond recurrent infections including atopy, autoimmunity, and cancer.
Purpose — to describe the natural course of hyper-IgE syndrome (HIES) disease in an 8-year-old boy and his path to diagnosis, as well as
our first local history of conservative treatment for 6 months. In particular, we describe the effectiveness of omalizumab, and the application of
allogeneic hematopoietic stem cell transplantation with follow-up.
Clinical case. The 8-year-old boy presented with severe eczema and an involvement of the whole surface of the body. Infectious syndrome
manifested from the age of 4 months in a form of recurrent respiratory infections. Over the next few years, the child suffered from life-threatening
infections with high serum IgE (>3000 IU/ml). The examination revealed a cushingoid constitution, flat-valgus feet, and dysmorphic features.
Therefore, HIES was suspected.
Genetic studies have confirmed the diagnosis by detecting a pathogenic homozygous mutation in the DOCK8 gene (Deletion Exons 2–46).
We decided to use a humanized monoclonal anti-IgE antibody (off-label) to control the skin syndrome rather than systemic steroids. A signifi-
cant improvement in skin condition, a decrease in eosinophils, and IgE were observed. Allogeneic stem cell transplantation of hematopoietic
cells (HSCT) derived from peripheral blood of an human leukocyte antigen (HLA) — identical sibling donor was performed. The donor had
a pathogenic mutation identical to the recipient in the DOCK8 gene but in a heterozygous state. Our data and treatment approach may be
clinically useful as a diagnostic and treatment approach to HIES.
The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained
for conducting the studies
Keywords: DOCK8 deficiency, primary immunodeficiency, hyper-IgE-syndrome.
n /+' , ! - ! /d

. "/ ,632ge %#
$%Y" 1 ' 2 I 3$ " 3
1ä 2 8 )¸ , 2 )'/)R
2.R1Î ) 8 5'¸'^]0_¸0R 4)'/
30 2 15x¸_\.å\4)'/)R
.3 $!i+> ' 'Dedicator of Cytokinesis 8@* 3 8 6
63) 6 6- 2 '
V * #aM) 3 $!i+)+ 6 86
) 88 2 - < '
Z ) 3 2 * 6 *6 2-
8 '
_ 0+6 -3-) 6 -6- 'Î3
9 6 63'( 626 -
* 3 #aM>ÅYSSS¸5V@'( * 8 -
-) 2 3 ) #aM'
? )8 - $!i+> :·9<@'=8
2 #aM >HIIGCoLG@ - 8 2 6 -
'Á 8 8)82 3 #aM'( -
*6 6 ) 6æ3mvt> ' ' human leukocyte antigen@ -
* '. - $!i+) , ) '
5 6 2* 2 6 #aM'
. ?2 2 '0 2 3 * 2-
'
_ - 2 23 '
_ e 3 $!i+) 3 ) #aM '
Introduction '?10 %2 + " $$ -

" % "33 $ Á + #
A
utosomal recessive (AR) HIES is a pri- innate and adaptive immune responses. Clinically,
2 " %2 '?10 %2 + 3 $$ -
" '?10 ë Ò$$ " +#$2
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 97

" "2 % $ 2 ÂÃ 7 Ñ % # 3 2 $" -
$$2 " 2 Ò 8+ % $ ç 7 "
ÑZ7 Ò 2 # " 3 2% % 6
7 ^ $ Æ ! 2 Á" %- " + 2 Á
45 Ò # " 2 $ Ò + % #2 $ %%
$2 '?10 %2 7 % % [ \ +" [ \
+ 2 $% $ Ò 2 + " #$ $ " %
3 " $ % " #$ Ò [ \ % " 8 + [ \
"%Ò $$ ÑZ7 "$ % ?3 8 Ò 2 $% "@%
% Á $2 Â6Ã Ñ Ò + $ 9 + 1 + ç
+ + Ò 3 $ #$% [6 2 \ +2$ $ +
eczema, atopy, and recurrent skin infections since [ 2 \ 3 #$ $ +" % 3
$ 7 % QÆ + $2 [ 2 \ Q$$ 2+
ÑÁ<Z Ò #$ % Ò + - ç % Ò$$ " "$+$
3 '?10 7 + "%Ò ç % $$ [ Ò $5 +
+ $$ +$ Ò $" $ \ % $ $$
complete remission of various manifestations. Ò " Á< [Ì* Á4-$\ 7
7 purpose + ¿ % # # 2 3% " +$ 2 2
" $ " ÑÁ<Z 02 $% # 2 % 3 " " $ #"$ [ÁÀÁ\
% + % Ò$$ " $ $ ÇÖ 3 [ $2 + -
2 3 3 3%\ %% 3 +$
+ "$ @3 $ç" # % ? 8 +
++$ $$ ÑZ7 Ò $$ Ò"+ " " " ë 3 $" %
%2 + " 9 %2 +$
Case presentation $ $%% " % $ "
Q 02 $% # 2 + % Ò 3 ç 7 3 ç % 2-
% $ 3 $3 # %2 " [> \ Ò $ç % 8
Ñ Ò # % $ + 2 % % % Ä # %2
" " % Ò $2 " ? " +"
#$ 7 + "@% #9 Ò$$- $ # Ò 3 $% Á Ò %ã"$
2$% Ò % Ò Ò5 $% + " # " %-
$ Ò Ò $ + % #2 + % - $ %$5 5 + $ Ç %
% +$ % #2 # $ " $ - + $ Ò + $ %2 +2
%2 %"$$ % # Ò @% #2
Ò 3 $% [>" \
7 $ % $% Ò 3
% @% + 2 $
[ â" 2 32 82 \
% $2 + % â" $2 #$2
3 +$ 2 $ Ò$$ $
[ $ #" " 82 $ $ \
Ç % % #% + 2+ Ò " +%
ÑÁ<Z ?" + % %
$$ ÑÁ<Z 3 ¿ " $ % [ $
%2 + # " \ % " $
3 3 [Ò 1 + ç
% $$2\
7 "$ $$ Ò"+ 8 3 $%
7
ë # 2 $2+ +
[ $$ -v$\ +$ [*Ä $$ -í$\
% % 2 2 %
Fig. 1. The general appearance of the patient and his skin before allogeneic
hematopoietic stem cell transplantation [6 -\ Ò % 7 -

Table 1
fD>@AC><RCHD>C@:B<RABESH<?BCD>@TS<S@A8C;<G>TBi<I?BC<EDC9B8CCHDC;ED
of the initial examination of the patient
Reference Reference values,
Cell population % Cells/μl
values, % (cells/ μl)
Whole blood cells – – 5807 4700–8000
Granulocytes 77.7 – 4511 –
Monocytes 3.63 – 211 –
Lymphocytes 18.68 35–55 1085 1100–5900
T lymphocytes (CD3+) 62.4 60–76 677* 1200–2600
Activated (HLA-DR+) 36.3* <15 246 –
NKT (CD3+CD56+) 1.2 <12 8 –
CD4+CD8+ 1.2 <5 8 –
CD4-CD8- 5.3 <5 36 –
T-helpers (CD3+CD4+) 25.66 31–47 278* 650–1500
Activated (HLA-DR+) 47.81* 3–13 133.10 40–120
T-cytotoxics (CD3+CD8+) 39.47 18–35 428 370–1100
Activated (HLA-DR+) 65.77 6–29 281.61 40–270
CD4+/CD8+ 0.65* 1.0–2.5
B-lymphocytes (CD19+) 21.53 13–27 234* 270–860
-B1A (CD5+) 27.90* <20 65.15
cCBlKCG/DGGLKGhbWkHFhBLE>$Y$%<èQ<è@ 15.76 4–17 171 100–480
Immunoglobulins Reference values
IgA, g/L 5.16* 0.6–2.4
IgM, g/L 0.41 0.5–2.1
IgG, g/L 14.74 5.7–14.1
IgE, IU/ml 16000* –
Note: * — data is outside the normal range.
" $ 3 $" Ò% '6 7 $% Ò % $
$2+ + $ % Ç $2+ 2 % Ò 8 % #2 % $ 32
3 7 $2+ 2 8$2 - Ò5 % 3 $ Ò5 #2 $+
" $ #"$ < % % " $ #"$ 7 Ò $$ Ò 9 3 % -
Q % Ö [7 #$ \ $ [ 5 + % % \ "-
Î # 2 % " $ "% 3 $% tritional support, elimination diet, replacement
%$ 2 +2 $ %3$ + [# 2 \ +2 + "ã2 [+
[%"% "$$5 Ò ç2 \ % 2+ 2 % [Î2 8
[ÁÖ>\ ¿ *0 -$\ 2+ $ -% 2\ %2
2+ + + 2++ 2 % $3 -
% 5 + % ó 29
osteoporosis, consolidated spontaneous fracture
$# Ò # % %"
# $ % 2 Ò 2+ 2 %
>" + "ã2 [
$% 2+ * %" $ $ \
+% # [%"% ++% % "$\ %
2+ $#" [ -$\ Ò % 7 -
# $ $ $2 5 3 $% # -
rial (U>=30=4, ^>03=_+)'46\ % " $ [`6)7+76
689+(6)4@`6)7+76,3'V+(68+4) colonization.
7 "% % %
#2 % + ç2 " " -
'?10 ['$ <8 Å6\
Q $$$ + 3 Î<Z7
[06ÖÌ7 + Ö$"* \ % 3 Ò
"%% + 2 ¨Q!*16
[QÌÖ + Ñ 0Q\ % Æ>ó [0ÖÌQ
Fig. 2. The patient after allogeneic hematopoietic stem cell transplantation,
+ Ö$20Z\ Ò $ % day +190
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 99

$"#$ 3 Q ' < $" % $2 # and complete discontinuation of immunosuppres-
[Å* \ 5 7 5 ++ 3 +2 % 2 0*
32 + 2% # - 7 $$ Ò"+ $ 60 $ $
%"% 7 +2 Ò Ñ - % % 66 ÑZ7 ^ -
+ #$ 5 [5 $3 ç\ " + % 3 $$2 Ò # 3% Ò-
% $$ @ 7 + +2$ 8 Ò - 2 ÑZ7 7 $% Ò 3 %
# [ " 8 8 ç $ + $8 %+ " +" + $ +"-
+ ë 8 \ % " $ %" [ë" ç $ " ë"ç + Ç % Ñ#
ç $\ + 3% 5 % #" %% 6 Ò5 3 * % '+
+3 +" ÁÀÁ -5 Ò 3 7 " !" ['7 !\ 3 $3$ -
32 6 Ò5 %" $ 32 # % Á4-$ %+ %
Ó %%% " " ç% $ - 6 Á4-$ " 8 %
$ " $ #"$ < # %2 [ @$ #$\ ? 2 ÑZ7 $% %
2 % $ 5 $$ Ò% % $ $
2% Á% $2 % [ > Ò %2 ++
"#" " $2 32 Ò5 \ ? $ç" # Ò 2% % $ # $ + [ % Ò 2$ -
# 3% + 3 5 %- 3 % 2 \ 7 % 5 % #
% +$ % " $ #"- $2 + 3% $$ Ò
$ < Ñ Ò3 ++ +2 # 3% [> \
5 % Ò % Ó "%% +3 $ 3
7 $$ ÑZ7 %3% ++ $ '?10 #2 8 %3%" $
#$ % ÑÎQ% $ #$ % [ $% "$ % + # % 7 +3 $
# \ Ò + % Q"" " Ò 6Ä [-\ Q $ %$
2 % 6 % 2 7 % % + [ 6 8 \ Ò # 3% $2
" % $ + '?10 + # % % Ò #$ [# $ $
#" ç2 " 7 + +2$ 8 Ò 8 % # " " + 2
3 " % [ÖÀÑ'\ Ò + % Ò #$ % $2 %" ÑÎQ 2+
Ò 2$ + % 8 7 +$ $ for related donor).
Ò %% % 2 2 2
% 2 " +$ % 2 7 "
Discussion
+$ Ò % $2 7 '?10 %2 #% "-
%% " $ ? % 2 %2 Ò Ò $$2 % #%
Ò + 2% % % 2 6 % QÆ ÑÁ<Z Á 5 Ò$% "$5
ÖÀÑ' 7 $ " 3 " " - " $ % [Q'\ ÑÁ<Z " % #2 $
$ #"$ "% % 2 6 +$ " " Z7Q7* '?10 %-
Table 2
Clinical phenotype of a patient
Disease characteristics AD-HIES AR-HIES Patient
Gene STAT3 DOCK8 DOCK8
Discovered in 1966 2009 2012
Newborn rash +++ + swelling of the eyelids
Eczema ++++ ++++ ++++
Repeated abscesses of the skin +++ ++ +
Otosinopulmonary infections ++++ ++++ ++
Mucocutaneous candidiasis +++ ++ ++
Pneumatocele + – –
Facial dysmorphism +++ – +
Hypermobility of joints +++ + –
Preserved milk teeth ++++ + –
Bone fractures +++ + +
Severe / recurrent viral infections (HSV, VZV, HPV, MC) + +++++ ++++
Food allergy, asthma, anaphylaxis + +++ ++
Autoimmunity (cytopenias, vasculitis) – + –
Encephalitis, cerebral vasculitis – + –
Squamous cell carcinoma and lymphoma – ++ –

2 $ 5 " % 3 " % + % #2 3 # $ Ö3
+ Ò % #% + 2+ + 5 " " %%
Q'ÑÁ<Z ÂÃ Á " + % - % 8+
% $$ ÑÁ<Z 3 ¿ + Ò %3$ +% 3
Q' [ $ %2 + # " $5 +$$ Ò + #% " $ %"
\ % QÆ 3 [Ò 1 + + 2 +3 +$$ ¿
ç % $$2\ [7 #$ \ ç $ % * -5 % $2 Ó
Ö3 3 5 2% $% Ò %" 3 # +2
+ Ò %%% " $ç" # Ò +2$ $ 32 %
# ÑZ7 Ó 3 $% 8+ ç $ % 3 " " $ #"$
$$ " + Ò [ÁÀÁÖ\ Ò Ò #$ 3 % %3$ +
3 2 + % % $2 3 + % %
$3 % " Á< ÂÃ Ò ÑÁ<Z ÂÃ Ò$$ Q$$ % +
" Ò 8+ $ Ò "$$2 + #$ % #$% " 2
2+Á<$5 2% %" Ò $$$ " " "$ Ò # Ò
" '?10 Â*Ã Ó 3 $" % +$ %
% ã 2 % 2 $ç" # #"
%" + "$ "#" "
Conclusions
× + ÿ $ Ò % Z3 ç 2 # $ %
Ò % Ó % Ò Å6 Ò5 !Á' Ó 3 Ò
% " 5 % +$ 3$ + #Ò %@ ÑÁ<Z 3 + #$
$3$ % Á< Ò $ # 5 # $ QÁ< # % $+ %" ç
Ç 45 3 $ " 9 + # # Ò +$
$ $ % Ò Ò " 5 + ?" % %
#$ % 2 $ % +" ++ 2 # $ $$2 " "$
% Ò % % ++ ÑÁ<Z
severe persistent atopic dermatitis, manifested &' (')*+(, '/ +),0304,4 564 70(86307 9; ,<0
" 2% 6=,<'34>
'3'4 nGHBJ"H=J"
1. Alonso–Bello CD, Jiménez–Martínez M del C, Vargas– 4. Romanyshyn Y, Kostyuchenko L. (2020). Recurrent
Camaño ME et al. (2019). Partial and Transient qx`j j^_{{_ _` jÑ_j`q xq_j`q|
Clinical Response to Omalizumab in IL-21-Induced Acad J Ped Neonatol. 8 (5): 64–67. doi: 10.19080/
Low STAT3-Phosphorylation on Hyper-IgE Syn! AJPN.2020.08.555802.
drome. Case Reports Immunol: 1–5. doi: 5. Song C, Das P. (2018). Omalizumab Improves Severe Atopic
10.1155/2019/6357256. Dermatitis With Very High Ige. Ann Allergy, Asthma Immunol.
2. Biggs KM, Keles S, Chatila TA. (2017, Aug). DOCK8 121 (5): S130. doi: 10.1016/j.anai.2018.09.431.
jÑ_j`° `_^q _`q xq__{^<{_`_x{ 6. Su HC, Jing H, Angelus P, Freeman AF. (2019). Insights into
features and managment Clin Immunol. 181: 75–82. immunity from clinical and basic science studies of DOCK8
doi: 10.1016/j.clim.2017.06.003. _`jÑ_j` `j| `{ j¡| } J ;A° |
3. Osypchuk DV, Hilfanova AM. (2020). Hyper IgE syndrome as- doi: 10.1111/imr.12723.
_xqj ¥_q `¡j{ « jqjÃ^ qxq_`° xj 7. Switlyk SA, Taylor AL, Gaertner EM. (2017). Severe refractory
report. Modern Pediatrics. Ukraine. 1 (105): 63–65. doi: atopic dermatitis with elevated serum ige treated with omali-
10.15574/sp.2020.105.63. zumab. Cutis. 99 (4): E6–E8.

a#" (V!Æ*||!|<$|* G| &<!+&<!G*$! = *#! = =%Q% !Ù%#*& 8!&R* Ç! !+
Ù%#*+!%# |´# °| &%<#|´* * R*% <¯}|qq°»»_|^»~~~~~~~}}>¯~¤}J|
L- z +%Æ*|L|!|<!|#| L &!+&@ÀÉ'B´! * |µ|Ç|³*Á"!%&¸´Ç¸À* &! Ê|´# °| &%<%|B|Ç L < º
|¤ ;~¯¯A¯ ¤È}È|qq°»»_|^»~~~~~~~¤¯¯ J |
y/+^ , Æ %|%!!" !# ! $&*# *%+*¸@³Éµ²Ç´Ø@øØÊ|´# °| &%<%|¶|Ü!% <
} »º |¤ ;~¯¯A}~}J¤~|
( Æ* %!!" !# ! $&*# *%+*¸@³Éµ²Ç´Ø@øØÊ|´# °| &%<%|¶|Ü!% <} »º
|¤ ;~¯¯A}~}J¤~|
"! R *$&}È|~>|}~}¤|< !" *~È|~|}~}¤|
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 101

~ 0*09Ã*
W! X W [Y '
p k ' -

, ' '

`<9?;C8C;<GePochynok TV, Lutai TI, Gorobets NI. (2023). Diagnostic complications in the debut of systemic lupus erythematosus in
children. Modern Pediatrics. Ukraine. 5(133): 102-109. doi 10.15574/SP.2023.133.102.
Á >ÁÊ=@ , 2 6- ) * , ) 6'
Á 2 , ÁÊ= * , &Q)YË 86 Q 6*' Ê 8 ÁÊ= , 2
* 'Á 8 6 ) 6 ÁÊ=* )* ,
9)Q7%Q7%) * &7%%S7%'
V *- ÁÊ= '
_ 0 . %< 2 * .2 Ý %
1? 3 3 ) ,-) ,-) * 2
; 66)83'( '= , 4'
? * )*) > %)<Q V *) 9Q·QS)
YQ·9S·QS@'= *6-) * 2 6 *'Z
3 > 5 @' _ * '
R< '. > QS V *@) 9
2 ) * ) 6 )
2 3 , ' . > + V * > Y @; 9 V * > Y
@@'0 - -) 3 ) 2'
( * , Å+S) 6 * 6
>%U* @ 6 ÁÊ= 6ä 2- - ->MgvtO@ _ 2
- ,- >tO@):S%&'= 1ÁÊ='^- 3 >^0@)3 ) 6
6'_ 2 ; Î ' ; ;:·Y 2 4'
0 ÁÊ= , ) * 3
2'.2 ) MgvtOtO):S%&), *28 3
'^ , ^0, ; 6 6 2 '
¹ ÁÊ= ) 6MgvtO tO):S%&)* ,
- 8- ^0'
. ?2 2 '0 2 3 * 2
'
_ - 2 23 '
_ e )- 3 ) 2) '
6;8FG<>C;??<ESA;?8C;<G>;GCHD:DT@C<R>B>CDE;?A@S@>D9BCHDE8C<>@>;G?H;A:9DG
G8B3\;><30G(A*9/.=(]3-3H,9:
`HaHbHGLBEcCBDHdCGeLfDFCGgdDPLKEDBh)ihDP)gjKCDdL
AhEBLbDF GlWlE LKhBkLbCBHElE >AvM@ DE Cd ClBHDbbldL blGBDEhEBLb fDELCEL BkCB DE bHKL ELPLKL Dd FkDGfKLd BkCd Dd CflGBE' pkL bHKBCGDBh
HIWCBDLdBEJDBkAvMJDBkHlBBKLCBbLdBKLCFkLE&Q'YËflKDdaBkLIDKEBQhLCKEIKHbBkLHdELBHIBkLfDELCEL'AvMfLPLGHWEbHKLHIBLdDdJHbLd'
pkLKCBDHoLBJLLdaDKGECdfoHhECIILFBLfohAvMDdWKLWloLKBCGCaLDECWWKHrDbCBLGh9'Q7%Q7%)CdfDdWloLKBCGCaL&7%%S7%'
W@9S<>DBHEkHJ)HdBkLoCEDEHIFGDdDFCGHoELKPCBDHd)BkLfDIIDFlGBDLEHIfDCadHEDECdfBKLCBbLdBDdBkLfLolBHIAvMDdFkDGfKLd'
GDdDFCGFCEL't%<hLCKHGfFkDGfJCEBKLCBLfDdBkLFkDGfKLd]EfLWCKBbLdBHIOHCfmHEWDBCGcH'%JDBkCfDCadHEDEHI1CFlBLaGHbLKlGHdLWkKDBDE
JDBkGLCfDdaDdFHbWGLBLdLWkKHBDFEhdfKHbL)kLbCBlKDC)khWLKBLdEDHd)BlolGHDdBLKEBDBDCGFHbWHdLdB;CWLKDHfHILrBLdEDPLFGDdDFCGbCdDILEBCBDHdE)
JDBk DbWCDKLf jDfdLh IldFBDHd' ÀHEBCqHBLbDF CdLbDC' ALFHdfCKh bhLGHElWWKLEEDHd4' AkL JCE CfbDBBLf JDBk FHbWGCDdBE HI EJLGGDda HI BkL
GLaECdfICFL)FkCdaLEDdlKDdLBLEBE>WKHBLDdlKDC%'<QaVfCh)GLljHFhBlKDC9Q·QSDdBkLIDLGfHIPDEDHd)LKhBkKHFhBlKDCYQ·9S·QSDdBkLIDLGf
HIPDEDHd@'AkLFHdEDfLKLfkLKELGIEDFjJkLdEkLdHBDFLfEJLGGDdaHIBkLCdjGLuHDdBE'pkKLLJLLjEoLIHKLCfbDEEDHdBHBkLkHEWDBCG)EkLElIILKLf
CFlBL WkCKhdaDBDE >dLaCBDPL CdBDEBKLWBHGhEDd ! BDBLK@' tGGLKaHGHaDFCG kDEBHKh DE dHB olKfLdEHbL' tB < hLCKE HGf FkDFjLd WHr' pkL FkDGf JCE
WKLEFKDoLfFHKBDFHEBLKHDfBkLKCWh>WKLfdDEHGHdLQSbaVfCh@)CaCDdEBBkLoCFjaKHldfHIJkDFk)DdBkL9BkJLLj)BkLFKLCBDdDdLGLPLGdHKbCGDqLf)
olBkhWHWKHBLDdLbDC)LGLPCBLfFkHGLEBLKHG)CdfWKHBLDdlKDCWLKEDEBLf)JkDFkDdfDFCBLfBkLGCFjHILIILFBIKHbABkLKCWh'hBHEBCBDFBkLKCWhJCE
EBCKBLf>GLljLKCd+baVfCh>YJLLjE@;9baVfChYJLLjE@'$LEWDBLFHbWGLrBkLKCWh)BkLFkDGffLPLGHWLfFHbWGLBLdLWkKHBDFEhdfKHbL)
jDfdLhICDGlKLEDrbHdBkEGCBLK'$lKDdaBkLLrCbDdCBDHdHIBkLWCBDLdB)CdBDdlFGLCKCdBDoHfDLEJDBkCBDBLKÅ+SJLKLfLBLFBLf)JkDFkaCPLKDELBHBkL
FCGFlGCBDHdHICffDBDHdCGFKDBLKDCWHDdBE>%UWHDdBE@DdCFFHKfCdFLJDBkBkLfDCadHEBDFFKDBLKDCIHKAvMWKHWHELfohBkLMlKHWLCdtdBDKkLlbCBDF
vLCalL>MgvtO@CdfBkLtbLKDFCdHGGLaLHIOkLlbCBHGHah>tO@):S%&'tfDCadHEDEJCEbCfL7AvM'vlWlEdLWkKDBDE)dLWkKHBDFEhdfKHbL)

WLKDHf HI LrBLdEDPL FGDdDFCG bCdDILEBCBDHdE' tKBLKDCG khWLKBLdEDHd; CdLbDC # EB' ELPLKDBh; CqHBLbDC; :·Y fLaKLL HI CFBDPDBh HI BkL WCBkHGHaDFCG
WKHFLEE'
2<G?A@>;<G>0AvMDdFkDGfKLdDEfDIIDFlGBBHfDCadHEL)LEWLFDCGGhDdBkLCoELdFLHIFGDdDFCGWHGhbHKWkDEbCdfEhEBLbDFGLEDHdE'#BDECfPDECoGL
BHlELBkLFKDBLKDCWKHWHELfohMgvtOCdftO):S%&)JkDFkCKLBkLbHEBELdEDBDPLCdfEWLFDIDFDdfDCadHEDE'pKLCBbLdBHIWCBDLdBEJDBkvcDE
DdfDPDflCGDqLf;BkLlELHIfDIILKLdBBKLCBbLdBEFkLbLEfLWLdfEHdBkLELPLKDBhHIBkLWCBkHGHaDFCGWKHFLEE'MCKGhfDCadHEDEHIjDfdLhfCbCaL
DdAvMlEDdaBkLFKDBLKDCWKHWHELfohMgvtOCdftO):S%&)CdfoDHWEhJDGGFHdBKDolBLBHBkLBDbLGhfLBLKbDdCBDHdHIBkLBCFBDFECdfEBKCBLahHI
BkLFkDGf]EbCdCaLbLdB)CdfDbWKHPLBkLWKHadHEDEHIvlWlEdLWkKDBDE'
pkLKLELCKFkJCEFCKKDLfHlBDdCFFHKfCdFLJDBkBkLWKDdFDWGLEHIBkLmLGEDdjD$LFGCKCBDHd'pkLDdIHKbLfFHdELdBHIBkLWCBDLdBJCEHoBCDdLf
IHKFHdflFBDdaBkLEBlfDLE
gDBI<9:>eFkDGfKLd)GlWlEdLWkKDBDE)KLdCGICDGlKL)EhEBLbDFGlWlELKhBkLbCBHElE'
ko^X\ ¬ ¥ ¡

£ °¤ ¢

¡ ¡ [¥\ ¿ £¤ 69 9
¬ ¢ £ [¡ 9 ¡¡\ ££¡
¤ ¡ ¢ £ ¤¬®£ ¿ 9 9 Â*Ã
¤¢ ¢ °¤ ¤ ¡¤ ¥ ¤
¬ ¤ ¡¤® ¬£ ° ® ¤¡ ¤
¬¡ ¢ ¦ ³ ¢
¤ [ _ ¢£¤ Ä
_\ Ä ¢ ¥ ¢ °
³ £ ¢ ¤ 0Ä Ä ¤ ¢
°¤ °¤ ¬ ¤ £ [z_\ ¢¡®¤
° Â6Ã *6Ä 60Ä ÂÃ
£¤ ¥ ¬® ¤¡ ¬¤ z_ ¢¦ £
¢¢¡ ¦® ¤¡ £ £
³ ¢ ¥ * ¬ ¬ z_
¤® *Ä ¤ ° ¦¤ ¢ °
¡ ¦ ÂÃ ¡ ¤ ¢ £
¢ ¥ £®¤ ¢ ¤ [¦\ ÂÃ
¢ §£ ¢¡ ¡ z_
¡£ £ [<4ÎQÆ\ ]£ ® ¡ ¦
®£ [QÆ\ ` £ £ ¤ z_ ®
¡£ ¤ ¬® ¡ ¦ ¤
90 ¦° [¡ ¡ z_ ¦
\ j ¤³ ® 9
¢¤£¤ ¡ ¦ j¢ ¡ ¤ -
£¤ ¦ ¢ ¤ ¦ ¡ ¤È ¤
¦ ¢ ®¤ ¤ ¥ ÂÃ ® ÁÁ z_
~ ¥ ®¤ * ¤ ° ¦ ¦¤
¤ ¥ ¤ ¤¡
° ¢ £¤ ¡®¤

_"/+ 1 " V # " '¾ # '% *
_ n 1 "
# ¸ 2 2^0
## ¸ 23 ^0
= ^0>[QSË*@
###>t@7
### ###>tV@7 6
###>@76
.3^0>àQSË*@
#" .3 >#"A@ * 2>#"s@^0
" ¸* ^0
"# (8 -^0>à&SË - 6** 8 @
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 103

¡ 9 £¡ ¦ £¡ ¤ °¤

¤ ¤ [¡ ¡ ¬ Â0Ã
\ ¡° ®¤ ¢®£ ¢¢¡ ³ ¤ z_
®£ ¿ 0Ä Ä ¦®¤ °
¡ _¤ ¢ ¢® ¤¡ ¦ ¦® °
¦ ¬ [ ¿ ¢ ¢ £¤ ¥ ¦
z_ ¦ ¡ ¦ \ ¡ ¦ ¡
¡ ® ¡ ¬ £® JW ¥
ÁÁÁ ÁÀ ¢ ¬®£ @ ¤ ¿ ¡
* \ ¡ ¤ ¢ ³
¡¤ ¢ ¡ ¤ ¦£ ¥
¢ ®¤ ¢ ¥ ¤
¤ ® ¬® ¬ ¬ _ ¤
¢ ¥ ¢¢ ° ¡ ¢ ¦
¢ ¦¢ [¤ ¤
¡ ¦
\ ¦¡ ¤
Qgeaeà_b [_\WdZY
¬ ¦ ³ !j>
* _¡ 9 ¤¤®¤ ¦ ¤¡
£ ®£ -¦ ¡ ¯ ®
®£ ¦®£ ¦¤ ¢ ¢ J ¢
® À ¢ ¬®£ * ¡
ÁÁÁ ÁÀ ¦ ®£ ¢®£ ¦¬
¡ È ¢ ¡
6 ¡ ¦ [_\9 ¤ ¤ ¢ °¤ ¬
¤®¤ £¡ ³¤ ¢¡ ¤ ®
¦ ¢¤ ¬ ¤W
¦¡ _ ®¤ ° ¬ ¢
¢¤ ¤ ¢¤ ¦¤ ¦¡¡¤ ¢ ¢ ¡
¦¡ ¦ _ ¡ [¤ ¿ -¦ ¬¤ ¿
® ÀÁ ¢ ¬®£ * 6Å ¢ ¬¤ ¿ *Å6Å
¡ À ¦ ¤ ÂÃ ¢\ ¦ £
¤ z_ ¢® ¦¤ ¤¬
¢ ¤ ¦ QÆ ¦ ¤ ¡ ¤ ³
® ¢¤ ¤ ¢¢¡ ¢ ³ ¢
¤ ¦ ¢ ¥ ¢ £ ¢¬ ¬ ¡
¤¤ ¡ ¢ z_9 ³¤ ¢ ¡
[¢ £¡ ¬ ¤ ]¡ ¢
¤ ° ¿ ¤ \È ¦¤ ¢ £
¤ ¦ ¡ ¤ ¤ ¡ ¬
¦ ¡ ¢ ®£ ¦ qwz! ¢¬9
¤ ¦ ¡ ¢ ¬ ¤È
q ¤ ¢¤ ¤ ¦ []\ ¿ Å*-0 È ¦ ¦¤
® ¡ ¦¡¡ ¡ ¬È
¡ £¡ ³¤ ¤ È ¬
¢ ©° ¡ ¢ ¤
³ ¢ ¤ ¦ ® ¬ ¤ ¢¤
¬ § ¤¡ ¤ È ¬¤ ¢ ¤
£¡£ ¡ £ ¬¤ ¡ ¢¡ ¡ ¬
-¦ £ ÂÃ ¡ - È ¤
¢¤ ¤ ¦ ¬ ¡ ¢ £
¬® ³ £ £ ¢ £ ¦ ¢ °¡
[\ ® ¦¢ ¦È ¡¤

¢ ¿ ¤ q! G" 9 ¢

¢¬ ¿ 6 ¢ [¬¤
[7$\" 4])#%%+ ¿ Ä\
{G ! | ¬ [\ ¿ °¡ [¤
*0Ô -È ¦ [Ñ#\ ¿ 0 -È °¡\
¢ [\ ¿ È ¬ ¿ ! q] !J
Ô -9 ¢ [\ ¿ ÄÈ ! J9 ¤
¡ [\ ¿ ÄÈ [\ ¿ ^]_$%$%%+ *%47$ "%3*-
ÄÈ ¬ [\ ¿ 0ÄÈ ¬ [\ ¿ 764`%%+
ÄÈ ° ¤ ¬ [q\ ¿ ¢ ¢ ¦
* - [¤ ¢ ¤ ¢¬
¬ q\ ¡¤
} F J ! 9 ¢ ¢ ¡ ¤ ¦¢
¦ ¿ 6*0 -È ¦ ¿ 66ÄÈ ¦ ¿ °¤ ¬ ° ¡
Ä9 D ¿ ÄÈ D ¿ ÄÈ E ¿ ÄÈ J ¿ ÄÈ ¤ ¢ ¦ ¢ £¤
¦ ¦ ¬® []-\ ¿ ¡ ¤
¿ -È ¡ ¿ ¦¤ ³ ¢¦
-È ¢ []z\ ¿ °¤ [¢ 6 \È
-È ¢ []\ ¿ ¢®£ *-0 È ¢¦
-È ¿ -È £ ¤ È ¢¡£
¢ ¿ 6 -È ¿ * -È ®£ ¦£ ®£
¿ * -È ¢ ¦¦ ¿ -¦È ¬®£ ¬®£È
-È ¢ q ¿ È °¤ ¢ ¬
¦ ¿ È ¬¤ ° ¿ ¬¬
¿ [¤ ¢ ¦ò
¦¤ ¦¤ ¿ ³¤ D ¤ ¤ ¤ ¡
D ¬ ¦È E¬È ¢¤ ¤ ¡ ¢
¦¦ ¢\ ¬®£ ¢®£ ¢ ¦
{G 9 ¿ ¬ °¤
6 È ¦ ¿ -È ¿ Å* ¬ ¤ ¢¡¤ ¡
¢È ¬ ¿ ÅÅ* ¢È ¢È ¿ [¢ ¿ -¦\
¬ ¿ Å [¤ ¬ ¦¢ ¡
¤ ¬¤\ ¦ ¬¤ ¦ ¿ [ ¢ ° ° ¤
-¦ [³ ¦ ¬¤ ¢È °\ ¤ ¤ ¤
¦\ ¦¤ ¦
{J!J| ¿ ¡ °
Å ¿
~ ! G ¡ ¦
!9 ¡ ¿ : ~ ¢ ¢¤
È ¡ ¿ ¡ ¡¤ ¢¦°¤ ¤
¿ * ¡ ¢ ¿ 0 - ¢
° ¢¢ ¿ ¡ ° ¢¤ ¤
¢ ¡ ¢ 6
¢¡ ¢ ¡ ¤ q °¤
¢ 9 Ô ¿ ¬ ¢¬ ¤ ¤
z 9 *Ô ¿ ¦
_ ¢° [¢¦ ¦¬
°¤ ¢ ¡ ¡ ¡ ¬¡ ¢¤
° ¢¢
¿ ¦¢ ¦\ ¡ ¡¤ ¢¦°¤ ¤
! ! G" j9 ¦ ¦ ¡
¤È ¤ ¡ [ 0 -¦\ ¢¦¤ ¤
¬¤ ¢¤ ¡ ¡
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 105

¤ ³ ¢ ] ¿ 0 -È ¿ 6 -È

¡ £¢ ¿ 6 -È ¢ ¦¦ ¿
¬ - [¤\
¡ ¤ ¬£ ¢ {G 9 ¿ 0 È
¢ ¦ ¢°¤ ¦ ¿ ** -È ¿ 0Å ¢È
¢ ¢ -¦ 6 -¦ ¤ ¬ ¿ Å ¢È ¬
¢¤ _ Å ¿ Å [¤ ¬¤
¤ ¤ ¤ ¬¤ ¬¤\
¢¤ ¤ ¦ ¦ ¡ ! ! ! ¿ ** -¦ [\
[ -¦ ¿ ** -¦\ ! J| ¬ ¿
£¡ ¤ ¢ *Ô È ¿ Ô [³¤ ¤
¤ ¢ ¬ ¬ ¬ ¡\
¢ ¦ ¤ ¢ {J!J| ¿
¤ ¢ ¬ Å0 [\
¤ ¬¡ £ [ ¿ ~ ! G
0 -¦\ ¤ ¤ !9 ¡ ¿ :
¤ ¦¢ ¡ [0*Ô \ ¡
** -¦È ¬¤ ¿ Å ¢È ¿ ¡
¬¤ ¿ ÅÅ ¢È ° ¢¢ ¿ ¡
¢¤ ] ¢
_ ¬¡ ¢¡ ¢
¢¤ ®¤ ¢ ¤¢ ¢ 9 0Ô6 ¿
¢ ¡ ¡ ¬ ³ ³ z 9 *Ô
¢¡¤ ¢ [ -¦\ ¿ 0 ³ _
¢ ¢° [¢¦°¤ ¢
[ -¦\ ¡ ¡ ¡
¤ ¢¬ ¤ ¬ ° ¢¢
£ ¢ 6 -¦ ³ ¢°¤ ¢ ¤
[ ¢ ¿ ¢ ¦¤ ¢¬\
0 -¦\ ³ j9 ¤È
¢ ¢ -¦ ¡¢ ¤ ¡ ¬¤È ¢¡ ¢
¿ -¦ ¡¢
° ¤ ¤ ! q] !J
¢ ! J9 ¤
¢ -¦ ¤ ¡
¦
¡ ¢ ¬®£ _ ¡ ©
¢¤ ] ¢ ¡ £ j
È ¦ ¦¤È ¡ 9
³¤ ¢ ¦ ¢ V03 '4 ¢ ¦ ¢
[ -\ ¡ ¢¦¤ * È ¿ 6 ¦ ¢
¡ ³ ¢¡ È ¢ ¢
¦¤ £ ¢ ¬ ¤ ¢ ¢ ¦È
{G ! | ¿ *Ô -È ¢ * ¿ ¬ ¤
Ñ# ¿ 6 -È ¿ 6È [¢¬¢\È ¬ ¢ ¢ ¦ ¡¢
¿ *Ô -9 ¿ 6ÄÈ ¿ 0ÄÈ ¿ ÄÈ z V03 '4 ¢ 0 ¦
¿ ÄÈ ¿ ÄÈ ¦¬ ¿ Ô -È ¢ È ¢ ¤¢
q ¿ - [¤ ¢ ®£ ¦
¢¬¢È ¤ ¢ ¬ £¡ È ¢
È q\ ¢
} F J ! 9 ¢ ¦ 6 ¦
¿ -È ¿ 6 -È ¡ ¤9 ³
¡ ¿ 6 -È ]z ¿ -È ¤ ¬

¦¡ 9 ®¤È [** -\

¬¢ ¤ ¤
¢
¢ ¬¤9 ¤ ¢ ¢
¿ ¤ 0 ¯ * ¢
¡ ¤È
¿ ¤ ¤ ¢ ¡ ¡ ¤ ¦
¢ -¦ ¡¢ 6* ¤ ¢ ¦¤ ¦
¢ ° ¢¤ ¢¤ ¤ ¤
È _
¿ ¤ ¤ ¢ £¡ ¢
6 -¦ ¢ ° ¢ ¡ ¦ ¦
¤ ¢ -¦È ¢ J¥ z£
¿ ¡ ¤9 ¢ [¡ ¢
¢-¦È ¡ ¤\ ]¤ ¢¤
¤¬¤È ] ]¤ j ¤ ]¢¤ Å*
¿ ¢ ¢ ¡ ¿ ¢ ¡ ¬W
¤ ¤¬¤ ¿ ¢
¢ È ¢ ¢ ¿ ¬ ¢ <4ÎQÆ
¢ ¢ QÆ 9 ¤ ¤¤
¬ ¦¬È Ì90 ¦
¦ ¡ ¤ [¢ ¥ [¡9 ¤ ¿
¦ ¦ ¬ ¢ * ¦ ¡ ¤ ¿ 6 ¦È ¿
£¢ \ ¿ ¢ ¤¬ ¤ Ì -¦ ¿ 6 ¦È
_¢£¡ £ _ ¿ ¦\ ¦
¬ ¡¢ £® ³ ¢
¢¤ ¡ ¢ ¥
¢ ¦¤ £ ¢®£ j*-$%%+ jk $ *; ¦¡® ¢
®£ ®£ £ ¤ ¢ ¦¬ ¬
®£ ¬®£ ¬®£ [¦ ¤ ¦ ¬
°¤ ¢ ¬ ¦ ¢ ¦ °\È
~ ¢ ¢ ¤ ¦ ¬ [¦ ¬
¤ ¤ q \
¤ [¢\
_ ¤ ¤ z_ [¢
£¡ ¢ ¡ ¦ ¦¢\ ¢
¦ ¢ £ V03 '4 ¢ --¦
J¥ z£ [¡ --¦È ¢¤ Å --¦
¢ °¤ ¢ ¬ \ £ ¢
¦ Å* z_ [ ¿ 0 \ ~ ¤
¡ ¬W ³ ¢£ £ ¢£ °
¢¤ ¢ £¤ £ ¢
¦ ¤¬ ¢ ¢ [Å* -\ ¦° ¤
¦¤ ¦ _¦¤ Å ¦ ¤ ¢
¢ ¤ ¢¤ ¢ z_ 6 0
] ¢ ¡ ¢ °£ £ £ ÅÄ
¢ ¢ ³¤ ** - ¡ ¢ ³ 6
¢ ° ° ¢¤ ¢ ¢ ¢ [Å \
¡ ¢ z_
¢ ¤£ ¦ Å* ¦ ¢
Ê - Â0Ã
¡ ¤ q ³¤
¢ ¢ [] ¿ - \ ¦¡ ¤
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 107

¢ ¥ z_ £¡ ¦9 ¡
¢¡ ¢ z_ ¢¤ ¦9 ¦ ®
[' ¿ \ ¢®¤ £¡ °
¦ ¤® ¡£ ¬££¡ £¡ ¤ ¿
¬ ¤ ¬ ¬
¦ ¤ ¦ ° ¦¡¡¤ ¦9
¬® ¢ z_ ¤ ¦ ¡ ¦ ¢ ¤¤®¤ ¦ ¤
0Ä [ ÁÁÁ\ Ä [ ÁÀ\ Ä ¢¤ ~¤
[ À\ ¬® ¦ ¢ ° ¡®¤ ¡¢ Å*
9 \ * - ¢ ® ¦ 9 ¢¤
6 ¤ \ - ¢ ¢
¢¤ ¢¤ ¦ ¡ ¦9 ¦®¤
® ¢ ¡ ¤ ¡
¤ ¬ ÂÃ ¤ _ ¡ ¢ £¤
Ç$" # [ ³ ¦ ¤ ¦ ¢
¦® ¢ ¤¢¤ ¢¡ ¤ ³ ® ¢ ¡
¬ [ÇÎ2Z\ ¢ ~ ° ¦
> % % '" Q% [>'Q\ ¤ ® ° `
¤ ¥ ¢ z_ ¡ ¢ °¤
¦ ] ÂÃ ¡ ¦ ®
] ¤ ¿ j>^D ° ¢ £
[¦ ¦\ ¿ ¢ ¢ ¤ ÂÃ
¢ ¬® q ¡ ¤ ¥ ® ¢
¢ ¥ [ ¦ ¢
¤ ¤ ¢ z_\ ÂÃ ¦ ¡
¤ ¬ ¢ ¥
¤ [ \ z_ ¢ J¤W £ ¢
® ¡ ¢¤ ¡ ¬ ¡ ¤ ¡° ¢¡£
°® ¬ ¢ ¦ ¤ ¤ ¡ ¬ z_ ¬£®¤
¤ ¢ ³ ¢ ¢ £
¢°® £ ¤® ¢¦ ¤ ¥ ¤
£ ¬ °® £ ®¡ ¢
¤® £ ¢ z_ ¥ ÂÃ ¤ ¢
¬¤ ® ¦ ° ¢ ¢ £¤
¢ £¤ ¤ ® ¡ ¦£ ¥
¢ ¡ ¤ ® £¡£ ³ ®
¬ ¢ £¤ ¤ ¡ ¦ ¡ JW ¥
® *Ä ¢¢¡ ³ ¡
¤ ¬® ¤ ¬ ¢£¡ ¢
° ¢ ¡ ¤ ¢ ° £ ®¤
¤ ¤ ³ ¢°® ¤
ÂÃ
¢ ¥ ° ¢ z_ _¢ ¢¡¤
£¡ ¤ ÅÄ ¢ _
®¤ ¢ ¤¡ ¢ ¬ ¢
¡ ¤
vqZ[Z]caa ³ z_ ¦£ ¥
¡ ¡ ®
k_oaZ[Y_
¢ £¤ ¢ ¢
¢¤ ¢ ³ ¡ ¡ ®
¢®¤ £¡ ¦ ³ ¤ ¢ ¦ ¢
¤ ¢ ¢ ¬ ¡ ¢
¤ ¦ ¥

¤ ¤ ¥ z¤ ¬® ¢ z_ ® ¢

¢ ¤ ¢ È ¢¤ ¢ ¤ ¢
<4ÎQÆ QÆ [\ ¦ ¤ ® ¤ ¡ ¬
¡ ¢¡£ ! " !
¤ °£ ¢ z_ >
'3'4 nGHBJ"H=J"
1. Calvo-Rio V, Santos–Gomez M, Calvo I et al. (2017). Anti-Inter- 7. Mina R, Brunner HI. (2010). Pediatric lupus — are trere dif-
leukin-6 Receptor Tocilizumab for severe Juvenile idiopathic ferences in presentation, genetics, response to therapy, and
arthritis — associated uveitis refractory to anti-tumor necro- damage accrual compared with adult lupus? Rheum. Dis. Clin.
_xqqjx°{q_j`qjqq¥j`qÑ¡jxq_j`q| North. Am. 36 (1): 53–80.
Arthritis Rheumatology. 69 (3): 668–676. 8. _`x < ¡` ªj¡j` E< _` ª jq x{| ;}~}A|
2. q½<xjÒ½<¡_`§jqx{|;}~JA|Ejx`j¡_j`jÆ Consensus treatment plans for induction therapy
based recommendations for diagnosis and treatment of newly diagnosed proliferative lupus nephritis in juvenile
of childhood — onset sestemic lupus erythematosus: systemic lupus erythematosus. Arthritis Care Res. 64 (3):
qjªE_`_q_xq_¡j|``|j|_|JÈ;A°J JÈ| 375–383.
3. j¥x`¥_<ªx`jÊ<§_j{x`½<q_<«x{{x< 9. jq½<j`Ãx<_{xjqx{|;}~A|§j{q
Okpechi I et al. (2017). Severe disease presentation and poor Study: intravenous bilimumab in children with systemic lupus
outcomes among pediatric systemic lupus erythematosus pa- erythematosus. Ann. Rheum. Dis. 78: 74–75.
tients in South Africa. Lupus. 26 (2): 186–194. 10. §_`xj < x`j_ªxx_ < `x E<
4. Lythgoe H, Lj M, Hedrich CM, Aringer M. (2022, Jan). Clas- Silva CA. (2021, Jul). An Update on the Management
_Ñxq_` qj_ { jqjxq _` _{j` x` _{`jq ªqj_ Eqjxq|
x{q| {_` `{| }¤¯° ~ | E }~} ½¡ }| xj_xq ^| }¤ ;¯A° ¤¤¤¯J| E }~} ®{ ~| _°
doi: 10.1016/j.clim.2021.108898. PMID: 34856381. 10.1007/s40272-021-00457-z. PMID: 34244988; PMCID:
5. Mai « jq x{| ;}~}}A| «_`j qx`{x`q qj _` _{j` PMC8270778.
and adolescents with systemic lupus erythematosus. Pediatr 11. Tucker IB, Uribe AG, Fernandez M et al. (2008). Adolescent
transplant. 26: 1. onset of lupus results in more aggressive disease and worse
6. Markowitz GS, D’Agati VD. (2007). The ISN/RPS 2003 classi- outcomes: results of nestedmatched case-control study with-
Ñxq_`{`j_q_°`xjj`qxq¤jx|«_`j in LUMINA, a multiethnic US cohort (LUMINA LVII). Lupus. 17
international. 71 (6): 491–495. (4): 314–322.

n + Æ||!|<G|<G|* G| &á¸ÇÀ!µ|µ|·+$"|´# °| &%<%|Ç| $QL !#*+< ´|
https://orcid.org/0000-0003-0802-2071.
yn +v Æ*||!|<$|<$|* G| &á¸ÇÀ!µ|µ|·+$"|´# °| &%<%|Ç| $QL !#*+< ´|
a - /#q+vÆ*||!|<$|<$|* G| &á¸ÇÀ!µ|µ|·+$"|´# °| &%<%|Ç| $QL !#*+< ´|
https://orcid.org/0000-0002-8296-879X.
"! R *$&}}|~¯|}~}¤|< !" *~È|~|}~}¤|
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 109

~ 069Â-60696*0Ã*
#Z X $ " I

p , ,
+ + , /%X0
;+ /X 9(
`<9?;C8C;<Ge Boyarchuk OR, Volianska LA. (2023). Seizures in a teenager as a manifestation of 22q11.2 deletion syndrome. Modern
Pediatrics. Ukraine. 5(133): 110-114. doi 10.15574/SP.2023.133.110.
Á ::w%%':> .. @, 886 6 6 )6 , 2 -
- *2 - 6 7 ))) ) '
V 2 ::w%%': ,
'
5 . . > ::w%%':@ 6 )
%986 3 -'. 3 *-
2, *- * '0 -
2 \ =3) 6 * 3 ' = 2 26
::w%%': 2) ) 2 6 ) 66 3) 63)
2'
= 6- 8 2) 2 *2 2 2 6
::w%%':) , 2 2 '( , -
8 *6 - ::w%%':* 2'Ú8 * 2 36 -
6 2 6- ) *,2 6
'
. ?2 2 '0 2 3 * 2-
'
_ - 2 23 '
_ e ::w%%':) .. ) ) 2,) '
PD;Y@9D>;G8CDDG8FD98>8E8G;RD>C8C;<G<RX0:DADC;<G>BG:9<ED
5D^3>/-\;*0AE83C./<:0/
#'mHKoCFkLPEjhpLKdHWDGcCBDHdCGeLfDFCGgdDPLKEDBh)gjKCDdL
::w%%':fLGLBDHdEhdfKHbL>$DsLHKaLEhdfKHbL@DEHdLHIBkLbHEBFHbbHdFkKHbHEHbCGCodHKbCGDBDLE)JkDFkDEFkCKCFBLKDqLfohblGBDWGDFDBh
CdfPCKDCoDGDBhHIfCbCaLBHPCKDHlEHKaCdECdfEhEBLbE7FCKfDHPCEFlGCK)DbbldL)dLKPHlE)LdfHFKDdL)EjLGLBCG'
pkLS@9S<>DDEBHDdFKLCELfHFBHKEÜCJCKLdLEEKLaCKfDdaBkLfDCadHEDEHI::w%%':fLGLBDHdEhdfKHbLDdWCBDLdBEJDBkELDqlKLfDEHKfLKoCELf
HdCFGDdDFCGFCELCdCGhEDE'
mLKLJLKLWHKBC?A;G;?8A?8>DHI$DsLHKaLEhdfKHbL>::w%%':fLGLBDHdEhdfKHbL@DdCoHhJDBkELDqlKLEfDCadHELfCBBkLCaLHI%9hLCKE
ohaLdLBDFBLEBDdaoLFClELHIElEWLFBLfLWDGLWBDFLdFLWkCGHWCBkh'$DCadHELfkhWHIldFBDHdHIBkLWCKCBkhKHDfaGCdfCdfkhWHFCGFLbDCCKL
HoPDHlEGhBkLFClELHIELDqlKLECdfKLwlDKLfCFkCdaLDdBKLCBbLdB'$LEWDBLBkLWKLELdFLHIpCdf`GhbWkHWLdDC)BkLoHhfDfdHBkCPLC
IKLwlLdBDdILFBDHlEEhdfKHbL'pkLCoELdFLHIfLIDdDdaEDadEHIBkL::w%%':fLGLBDHdEhdfKHbLCBCdLCKGhCaL)dCbLGhBkLCoELdFLHIfCBCIHK
CFHdaLdDBCGkLCKBfLILFB)WKHdHldFLfICFDCGfhEbHKWkDCE)IKLwlLdBDdILFBDHdE)fDfdHBaDPLCdHWWHKBldDBhBHElEWLFBBkDEEhdfKHbLCBCdLCKGh
CaL'
pCjDdaDdBHCFFHldBBkLWKLPCGLdFL)blGBDWGDFDBhCdfPCKDCoDGDBhHIBkLGLEDHdCdfBkLPCKhDdafLaKLLHIELPLKDBhHIFGDdDFCGbCdDILEBCBDHdEDd::w%%':
fLGLBDHdEhdfKHbL)WCBDLdBEJDBkBkDEEhdfKHbLFCdoLIHldfDdBkLWKCFBDFLHILPLKhfHFBHK'nDBkELDqlKLEDdFHboDdCBDHdJDBkfLPLGHWbLdBCG
fDEHKfLKE)DBDEdLFLEECKhBHKlGLHlB::w%%':fLGLBDHdEhdfKHbLCBCdhCaL'nDfLKCJCKLdLEEHIBkLfhEbHKWkDFCdfFGDdDFCGbCdDILEBCBDHdEHI
BkDEEhdfKHbLJDGGCGGHJoLBBLKfDCadHEDEHIBkDEfDELCEL)JkDFkKLwlDKLECblGBDfDEFDWGDdCKhCWWKHCFkBHbCdCaLbLdB'
pkLKLELCKFkJCEFCKKDLfHlBDdCFFHKfCdFLJDBkBkLWKDdFDWGLEHIBkLmLGEDdjD$LFGCKCBDHd'pkLDdIHKbLfFHdELdBHIBkLWCBDLdBJCEHoBCDdLf
IHKFHdflFBDdaBkLEBlfDLE'
cHFHdIGDFBHIDdBLKLEBJCEfLFGCKLfohBkLClBkHKE'
gDBI<9:>e::w%%':fLGLBDHdEhdfKHbL)$DsLHKaLEhdfKHbL)khWHWCKCBkhKHDfDEb)khWHFCGFLbDC)ELDqlKLE'
ko^X\ £¡ ³ ¬

¦®¤ ¡

¬ [â\ ¢³ ¤
® ¢ °° ¦ ¢£ ¤
ÂÃ ¡ ¤ ¤£ ¦°
9Å9 ¡ ¤9 ¬¤ ¢
Â*Ã ` ¤ ¡ ¦¡¡¤ ¢£ ¢³
ÂÃ ©° [ÅÄ\ - ¤ ¦¤
¬ â ® ¡ ¬®£ ¢ ¢ ÂÃ
¢ de novo Â6Ã ¬¤ ¦°

® ¤ ² ¡ ¡¤ ¤

¢ ¦ ¬¤ ¬®¤ Â6Ã ¬®¤
¢¬¤ ¦ ¡£ ¦¤ ¬
°¡ ÂÃ z¬ ¬® ¤ ¢ ¦
¢ ¢£¤ ¬®£ ¬® -¦ ¡¢ ¬£ ³
¢ ¢ ¢³ ¦ ¢¢ ÂÃ
¢ ° @ ¤ Å ³
¢ ¡ ³ ³
®£ ¦ ®£ ¬ â ¬® ¢
¢¢ ¡ £¡ ¢ ¢ ¡
¡ ¦ ¡ q
¢ £ £ ¦£ [¬ â\ ¡ ¢
¢¦ ¬ 6
®£ ¦¡¡¤ ¬®¤ ¡ ¢ °¤ ¡ ¤ ¡¢ ¢
¢ ¢¤ ¦ ¢¤ ¡ ¬£
¢ ¢ ¬ ¬¤ ³¦ ¢¢
¤ ®¤ Ä ¢ ¬®¤ ¦ ¡£
¬ Â0ÅÃ ¦£ ¢
` £ ¤
¤ ¦ ¤
¬ ¢ ¬ ¬ ¬ _
ÂÃ ~ Ä '* ¦ ¤ ¢
Ê ¢¡¤ ¢ ¦
¡ ¬ ¬
7Æ< [7$$ + 8 $ \ ¢ ¢
Qgeaeà_b [_\WdZY
¤ ¡ ¤
¦ ¬ ÂÃ ¢ ¡
¢ ¦ ¢ ¢ 6¡ ¡
£ ¤ ¡ ¦ ÂÃ ¤ [ ¢ *Å6 \ ¡
q ¡ ¦° ¡
¢ ¢ ¢ ¤
¤¤¤ ¡ ¢ ° [ 6¡
¦ ¢ ¤ ¤ ¢ ¬\ ¬£
¤ ¢ ~ ¤ * - [\ ¢
¢ ¢ ¬£ ¿ - [ ¿ Å*0 -\
¢ ¦ ¬ ¢ ¤ ³ ¡
¡ ¦ ¢¤ j j ¤ ¢ £
¢¤ ¤ Â0Ã * £¦ _ °
¢ -¦ ¦ ¢ ¬ ¤ ¢
¡¤ ® ¡£ ¦£ ¤ ¢ ¬ ¬ ¢ ®
¡®¤ ¦¢ Ä ` ¤ ¢ ª¤
£ ¤ ¡ ¬ ~
® ¤ ¡ ¢ ¤ ¡
¢¬ ÂÃ ¦ *£ ¦ ¤
¡ ¬ ¤ ¢ ¢ ¤
¤ ¤ ¤ ¡° _ ¤ ¡ ³
¤¢ ¢ ¬®®£ ¡ £¡ ¤ ¿ 00 [ç¢¡¤ 6\ ¢ ¿
¡ ¢¡¤ Â*Ã Ä [ç¢¡¤ \ ¿
Ä ¢ â £ *6 -s [ç¢¡¤ 6È 0 ¬\
³ ¢¡ ¦° ¢ ¬ ¢9 ¤
¤¬ [ÅÄ\ Â6Ã £¡ ¡ ¦¡¡¤ ¢ ¢ ¡ ³
¦ ¤ ¡ ¦¦¦ ¡
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 111


v, ' - + /d
. /d q ,
$Y)Ë <S)9 53–81
$YV 610 1100–2600
$9)Ë 38 YS·99
$9V 390 <SS·%9SS
$+)Ë %+)< 25–35
$+V 190 9SS·%:SS
$%&)Ë 12.3 12–22
$%&V 120 300–900
$%<VQ<)Ë :<)% 6–20
$%<VQ<V 256 100–800
#at)aVG %)%< S)9U·:)9&
#ae)aVG S)<Q S)%Q·%)++
#as)aVG %%): U)%<·%U)%%
#aM)#gVbG Y<)U %)Q·%Q+
_ 2 )^5 &% 9%·+Y
¬¤ ¬¤ ¿ ¤ q ¢ ¦¤

¬¤ ¡ ¢¡ ¦ ¤ ¬® ¢
[-\ ¡ ° ¬ À ¡¬ ¤ ¤
~ ¤ ¿ ¢¤ ¤ ´ ¤ ¡ ¦ ¤ ¢¤ ¦
¦£¡ ¡ ¿ £ £ ¦¤¬ ¬ '*
¦ ¢ ¤ '6 '0 ' ³ ¤ ¬
~ ¢ ¢ ¿ _¢£¡ ¤ ¢
¤ [*Ô-\ ¢ ¬ ¬
£¡ ¦ ¬ ¡ ¡
[ ¡\ ¢ ¤
¤ ¢ ¢ ¡ ¬¤ ~¢
¤ ¤ ¡ ¦¤ ¤ ¢ ¢ ¢ ¦ °
¤ £¡¤ ¡ ¬
¤ ¢ [*Ç<8 \
¦ J*Ç$$ W [ ¤\
vqZ[Z]caa
¢ ¤ ¤ q¦ ¡
¬ â ¿ ¢¤
° ¦¤ ¤ ¢
¢¡¤ ¬ ³¦ ¢ ¢¡ ¢ ¬ â
¢ ¤ ¬£ ¢¡¤ ¡ ¦ ¬ ¢
¬®¤ ¡£ ¬¤ ¬ ¢
¦¤ ° ¢ ¡ ¬ ¢ ¢
¢ ¦ ¤ £¤ ¢ ¬ ° _
9 ¬ ¡ ¢ ¬£ ¢ ¤ °
¢ ¬
¦¤ ¢ ³¦ ¢¢
¿ * q- ¡°
¢¡ ¢¤ ¤ ' ¿ ®¤ ¢ ¬¤
60* - [¬ Ê -\ ¢¡ ¦ ¡ ¡
¢¤ ¤ - ¤¤£ ¦ ¢£
[ ¿ 0Å00 -\ ¢¤ ¤ ¢ ÂÃ ¢ ¤
¬£ * - [ ¿ ¬ ¢ ¤ ¬
0Å -\ ¢ ¤
¢ ¡ ¦¤ ¬ ¬ ¡
¦¬ ¤

j¬ ¬ â ¬®£ â ¤ ¡ ¦® ¦
¦ ÂÃ ¦ £ ³ ¢
¢ ¦ ¡ ¤ ¡ ®
ÂÃ ¡¤ 6ÅÄ ¬® ÂÃ ¬ ¢¤ ® ¦ ¢¢
¢¡ ¢°®¤ ¬ ¤ ¬ ¦ ¢ ¡¤
~ ¢¡ ¬® ¢ ° Â0Ã ~ ¬® ¢ ¬®£
¢®¤ ¦ â °®¤ ¤¬¤ ¬ ¤
Å*Ä ¢ ¦£ ¢ £ ¦ ¬
¦ ÂÃ °¤ ¢ -¦ ¡
¬® ¢ ¬ ¤ ¦ ÂÃ ¦
â ¦ ¢ £ £¤ ¦¤ -¦ ¢£
£ ¢ ¢®£ ¦ ¢®£ ¥ ¢¢¤ ¡ ¢ -¦ ¢
¤ ¡ ¤¬¤ ®£ ¤ ¡ ¦ ¬®
¡£ ¬ ÂÃ £ ¤
~ £¡ ¡ ¤ °¤ ® ÂÃ
¬ ¦ ¢ ¤ ¡ ¬ °
¢ ¬® ¡ ¡ ¦® ¦£ ¬®
¬® ¢ ¬ â ¤ ¤³ ¢¡
¦ ° ¤¢ ¢ ¤ ¢¦
¬®®£ ¡£ ¦ ¤ ¢¤ ÂÃ
¬ ¤ ¤ q ¤
¤ ¢ ¤ ¦ ¦ ¡ ¤
¢¤ ÂÃ ¬ â ¢£ ³ ¬
¢¡¤ ¬£ ¤® ¬ ¦¤
¢¬ ¤ £ ¤ ¢ ¡
¬®¡ °
Â6Ã ¤
¤¤ ¢¡ ¢ ¢¡ ¡ ¢°£¤
¢ ¦£ ¤ ¦ ¦ ³ ® ¢
¢ ¢ ¢ ¦ ³ ¤ ¤ °
¡ ° ¢ ¤ ° ¤ ¤ ¤
¡ ~ ¬¤ Â6Ã ¤
¢ ° ¤ ° °¢¤ ¡ ¦
¬¤ ¤ ® £ ¤ ¢ £¤
_ ¤ ¦ ¦ ¤¢ ¢ ¬
° ¬¤ ¤ â
¤ ¤ ¢ ¦¡ z¦ ¬
¢ ¤ â ³
ª ®£ £ ¢£ ¤ ³ ¤® ¤ ¬
¢¢¡ ¦ °¤ >ÁZÑ¢ ¤
® ¢ ¤ ¦ ¦® ¬
¦° ° ¤ ¤ ¬® ¢
°¤ ¬ â
¢ ¬ â ® ¢¡
k_oaZ[Y_
¦ Â*Ã ¢
¦ ¬¡ ¦ ¢ ¡ £¡ °
¤ °¤ ¦ ¤ ¢ ¤
¬¤ Â*Ã ¬ ¤ °¤ ¡ ¤ ¬
¦ ¡ ¤ â ¬® ¢
¬¬¤ ¤ ¢¡ ¬ ¤
¢¢ ¢ Â*Ã ® ¢ °¤
¡£ ¦ ¤ ¬® ¢ ¢ £¡ ¬
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 113

â ¦¤ ¬ ° ¦¢ kdàeo^w ] ££ ¤
³ ¢¡ ¡ ¤ ¡ ¦ J*Ç$$ W [
¢ ³ ³¢¢ ¤\ ¢ ¤
¡ ¢ £¤ ¤ ¦® ¬ ¡ ¦¤ _
¤ ¡ ¬ JÎ Ö<^W
! " !- [ z\ ¢ ¬£ ¦
>
'3'4 nGHBJ"H=J"
1. Andrade DM, Krings T, Chow EW, Kiehl TR, Bassett AS. (2013). with 22q11 deletion syndrome and moderate and severe
Hippocampal malrotation is associated with chromosome intellectual disability. J Intellect Disabil Res. 58 (10): 915–25.
22q11.2 microdeletion. Can J Neurol Sci. 40: 652–656. doi: 10.1111/jir.12117.
2. Bassett AS, McDonald–McGinn DM, Devriendt K et al. (2011). 13. Fiksinski AM, Breetvelt EJ, Lee YJ et al. (2019). Neurocognition
Practical guidelines for managing patients with 22q11.2 and adaptive functioning in a genetic high risk model of
deletion syndrome. J Pediatr. 159: 332–339. schizophrenia. Psychol Med. 49 (6): 1047–1054. doi: 10.1017/
3. Boot E, Óskarsdóttir S, Loo JCY et al. (2023). Updated clinical S0033291718001824.
practice recommendations for managing adults with 22q11.2 14. Fung WL, Butcher NJ, Costain G et al. (2015). Practical
deletion syndrome. Genet Med. 25 (3): 100344. doi: 10.1016/j. guidelines for managing adults with 22q11.2 deletion
gim.2022.11.012. syndrome. Genet Med. 17 (8): 599–609. doi: 10.1038/
4. Boyarchuk O, Kinash M, Hariyan T, Bakalyuk T. (2019). gim.2014.175.
E¡x{xq_` `¥{j^j xq _x _`jÑ_j`_j 15. Khlunovska LY, Maslianko MM. (2020). A clinical case of di
among postgraduate medical students. Archives of the Balkan georgi syndrome in twins. Neonatology, Surgery and Perinatal
Medical Union. 54 (1): 11–19. Medicine. 10; 1 (35): 79–84. https://doi.org/10.24061/2413-
5. Boyarchuk O, Lewandowicz–¿Ã x < «_`x < 4260.X.1.35.2020.11.
Haliyash N, Sahal I, Kovalchuk T. (2018). Physicians’ awareness 16. Kobrynski LJ, Sullivan KE. (2007). Velocardiofacial syndrome,
`j`_`^_x_`jÑ_j`_j_`qj§j`_{j^_` DiGeorge syndrome: the chromosome 22q11.2 deletion
of Ukraine. Pediatria Polska. 93 (3): 221–228. syndromes. Lancet. 370: 1443–1452.
6. Boyarchuk O, Volyanska L, Dmytrash L. (2018). Clinical 17. Lackey AE, Muzio MR. (2023, Jan). DiGeorge Syndrome.
variability of chromosome 22q11.2 deletion syndrome. Cent Treasure Island (FL). URL: https://www.ncbi.nlm.nih.gov/
Eur J Immunol. 42 (4): 412–¯J|_°~|>¯»j¼_|}~J|J} | books/NBK549798/.
7. Boyarchuk O, Volyanska L, Kosovska T, Lewandowicz– 18. McDonald–McGinn DM, Sullivan KE, Marino B et al. (2015).
Uszynska A, Kinash M. (2018). Awareness of primary 22q11.2 deletion syndrome. Nat Rev Dis Primers. 1: 15071.
_`jÑ_j` _jxj x`^ j_x{ qj`q| 19. Patel K, Akhter J, Kobrynski L et al. (2012). International
Georgian Med News. 285: 124–130. _j^j ª`j `jÑ_j` `q_|
8. Butcher NJ, Chow EW, Costain G, Karas D, Ho A, Bassett AS. `^{{_` jÑ_j`_j° qj {qj _j
(2012). Functional outcomes of adults with 22q11.2 deletion DiGeorge Syndrome. J Pediatr. 161: 950–953.
syndrome. Genet Med. 14 (10): 836–843. doi: 10.1038/ 20. Shveikina VB, Martyniuk VY. (2022). To the issue
gim.2012.66. of diagnosis of neuropsychological development
9. Campbell LE, Swaab L, Freeman EE et al. (2022). The of newborns and young children. Modern pediatrics.
qx`j ¿`jqx`_`^ `_¡_x{ _Òjj`j Ukraine. 8 (128): 45–ÈJ| ±î%*! ¶·< Ç
Emotion Regulation Abilities in 22q11.2 Deletion Syndrome. !Q*¶â|;}~}}A|@ !!" +!# * !# =8!+
J Autism Dev Disord. 52 (7): 3076–3087. doi: 10.1007/s10803- % * !%! ! = !!+ %*|
021-05172-9. 8 #! "| À* &! | ;} A° ¯>–67]. doi:
10. Cheung EN, George SR, Andrade DM, Chow EW, Silver- 10.15574/SP.2022.128.45.
sides CK, Bassett AS. (2014). Neonatal hypocalcemia, 21. Sullivan KE. (2002). Immunologic issues in VCFS/chromosome
neonatal seizures, and intellectual disability in 22q11.2 deletion 22q11.2 deletion syndrome. Prog Pediatr Cardiol.
syndrome. Genet Med. 16: 40–44. 15: 103–108.
11. Cirillo A, Lioncino M, Maratea A et al. (2022). Clinical 22. §x`^jª<{jÃ£<Ñxjqx{|;}~}}A|x```
Manifestations of 22q11.2 Deletion Syndrome. Heart Fail Clin. E `_q° }~}} ¿xqj ` qj {x_Ñxq_`
18 (1): 155–164. doi: 10.1016/j.hfc.2021.07.009. the International Union of Immunological Societies Expert
12. Evers LJ, van Amelsvoort TA, Candel MJ, Boer H, Committee. J Clin Immunol. 42 (7): 1473–1507. doi: 10.1007/
Engelen JJ, Curfs LM. (2014). Psychopathology in adults s10875-022-01289-3.

) + ^l ,Æ||!|<G|< %|* G| "8 ==%L "8Q=+HQØ!#*+¸ÇÀ!'|Û|L 8%#*+|
´# °|Ø!< !¶<º |¤ ;~¤>}A>}¯¯}|qq°»»_|^»~~~~~~~}}¤¯~~¯~|
+#y- ('Æ*||!|<$|* G| "8 ==%L "8Q=+HQØ!#*+¸ÇÀ!'|Û|L 8%#*+|
´# °|Ø!< !¶<º |¤ ;~¤>}A>}¯¯}|qq°»»_|^»~~~~~~~>¯¯J ~>|
"! R *$&¯|~È|}~}¤|< !" *~È|~|}~}¤|

~ :*:*
Y%X 1Z I 1$" Ig 1,
t& 2 1
q /" %! -n+e
/
1/*Z
2;6 !' !. @# /*Z
`<9?;C8C;<Ge Dutchak HM, Synoverska OB, Alekseeva YuI, Tsaruk OY, Kuzenko OV. (2023). Nonspecific aortoarteritis
(Takayasu’s disease): a clinical case in pediatric practice. Modern Pediatrics. Ukraine. 5(133): 115-122. doi 10.15574/SP.2023.133.115.
0 * 6- 3 >6* \ @
* 'Ù 6- 2 6 ) 2 3
3 ) 2 3 8 'R ,
6 2 6 2 '
V 6*\ ) 6- 2 6- ) -* 2
2 6 , '
5 3 , %U ) * *
/0(1Î Õ 2 * Î Õ 2* 4'0 * )
* 6* ) 26 '( 6-
6 >MgvtO):S%+@'
00 3 , ) 2 6-
'( , 'Á - 28 2
)- 6- * '
. ?2 2 '0 3 * 2
, '
_ - 2 23 '
_ e6* \ ) ) ) ) ) '
r<G>SD?;R;?8<9C<89CD9;C;>\8K8B8>@b>:;>D8>De8?A;G;?8A?8>D;GSD:;8C9;?S98?C;?D
F*9\;/015^+><34,-:0/1)*(EC,0:,,4/15)G:/-*02586*,<031
%#PCdHÂKCdjDPEjcCBDHdCGeLfDFCGgdDPLKEDBh)gjKCDdL
:vv1eLfDFCGLdBLK1$HFBHKpECKlj4)#PCdHÂKCdjDPEj)gjKCDdL
pkLCKBDFGLWKLELdBEbHfLKdfCBCHdCKLGCBDPLGhKCKLCdfGDILBkKLCBLdDdafDELCELdHdEWLFDIDFCHKBHCKBLKDBDE>pCjChCEl]EfDELCEL@CdfDBE
ILCBlKLEDdFkDGfkHHf'pkDEfDELCELoLGHdaEBHBkLaKHlWHIEhEBLbDFPCEFlGDBDE)JkDFkDEoCELfHddHdEWLFDIDFdHdDdILFBDHlEDdIGCbbCBDHdHI
BkLCHKBCCdfDBEoKCdFkLE)JkDFkGLCfEBHfLIHKbCBDHdHIBkLPCEFlGCKGlbLdCdfELFHdfCKhBDEElLDEFkLbDC'$CbCaLBHPDBCGHKaCdEDdBkDE
fDELCELGLCfEBHBkLfLPLGHWbLdBHIELPLKLFHbWGDFCBDHdECdfBkLKDEjHIElffLdfLCBk'
W@9S<>D BH FDBL C FCEL HI pCjChCEl]E fDELCEL IKHb HlK HJd WKCFBDFL) BCjDda DdBH CFFHldB BkL KCKDBh HI BkL fDELCEL) GCFj HI CJCKLdLEE
CdfFGDdDFCGPDaDGCdFLHIWLfDCBKDFDCdECdfICbDGhfHFBHKEKLaCKfDdaBkDEWCBkHGHah'
tFGDdDFCGFCELHIdHdEWLFDIDFCHKBHCKBLKDBDEDdC%UhLCKHGfWCBDLdBJkHJCELrCbDdLfCdfBKLCBLfCBBkL#PCdHÂKCdjDPEjOLaDHdCGkDGfKLd]E
mHEWDBCGJCEFHdEDfLKLf'ÂLCBlKLEHIFGDdDFCGEhbWBHbE)GCoHKCBHKhoDHbCKjLKE)bLBkHfEHIPDElCGDqCBDHdBkLGLPLGHIGLEDHdEHIbCDdPLEELGECKL
aDPLd'#dIHKbCBDHdHdbLBkHfEHIBKLCBbLdBHIBkDEWCBDLdBCFFHKfDdaBHBkLlWfCBLfKLFHbbLdfCBDHdEHIBkLMlKHWLCdtdBDKkLlbCBDFvLCalL
>MgvtO):S%+@DEWKHPDfLf'
2<G?A@>;<G>0 cHdEWLFDIDF CHKBHCKBLKDBDE DE C KCKL) fDIIDFlGB BH fDCadHEL Cdf DdElIIDFDLdBGh EBlfDLf ClBHDbbldL fDELCEL' vCBL fDCadHEDE
EDadDIDFCdBGhDdFKLCELEBkLKDEjHICFkDGf]EElffLdfLCBk'eHfLKddHdDdPCEDPLDbCaDdabLBkHfECKLFKlFDCGIHKbCjDdaCfDCadHEDE)CEELEEDda
BkLLrBLdBHIBkLfDELCELCdfFkHHEDdaBKLCBbLdBBCFBDFE'
pkLKLELCKFkJCEFCKKDLfHlBDdCFFHKfCdFLJDBkBkLWKDdFDWGLEHIBkL$LFGCKCBDHdHImLGEDdjD'pkLDdIHKbLfFHdELdBHIBkLFkDGf]EWCKLdBECdf
BkLWCBDLdBJCEHoBCDdLfIHKBkLfLEFKDWBDHdHIBkLFGDdDFCGFCEL'
gDBI<9:>epCjChCEl]EfDELCEL)FkDGfKLd)LBDHGHah)FGDdDF)fDCadHEDE)BKLCBbLdB'
ko^X\ ¬ ¢ £ ¤

¢ ÂÃ
¢ £ £

¬¡ [_]]\ ¦
¦ ¤ ¿ ¬
_¬¡ ¢¡®
¤ ¢ £
®¤ * **
³ ® ¤ ° ¿ *
¢ ¢ ¤ ¢ ¡
¬ ¬ ³ ¢
° ~¤ ® £¤ ]¢
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 115

¤ ¢ ¢

¬®£ ¡ ¢°£
¢ ¦¢ ³¤ ¢
£¢ ¢ ®¤ ¦¢ ~
¬ ¡
¬ ¢£¤ ¡ ¬¤
¢ Â*Ã
¡ _]] ¡ ®
¬¡ ¡ £ ° ¢
° ¢¢¡ ® ¤¡
¡ ¦ £
#I J Ü # % "+!!!" # ! !#$ G8! ¤ ¢¤
& % ±¹ ~ ¬ ¢¢¡ ¢
¢°®¤ ¢¢ ~
° 6 ¤ ¢ ¤¤£¤
¤ [0 \ ] ¿ ° ¡ ° ¢
¤ [ \ ® ¢¬ ° ¡
¤ ¢ ° ¬ Â0Ã
£¤ 6 ** § ¬ ¡
¤ [ \ ÂÃ _ ¬ ¢ £¤ ¡ _]] ¢ ¬®£
° £ ¦ ¡ [0ÅÄ\ ^" [\ _]] ¤£ ° 9
Å6 £ _]] Á ¿ È ÁÁ ¿
® ¡£ ¤ ¢ È ÁÁ# ¿
¡ ¤¡ ¬ ¢
¤ ¤® ³ ¡ È ÁÁÁ ¿ ¢ ¡
¢ £ 6 -¦ È ÁÀ ¿
¬£ ^ $ Ñ $ ¡ -¦ È
Á " % # Z " 1 ° À ¿ ®¤ ÁÁ# ÁÀ ~¤
®¤ 6 ¤ ¢¡®¤ ¤ [:\
Å6 * ¿ [:\ Â6Ã > Q $
Å ÂÃ ¦ ¤ ¡ ¤
¤ [ \ ÂÃ9
¡ ¢ £¤ ¡ _¡° £¤
¤¬ Â60Ã ¡
¤ _]] ¢°®¤ ¤
¡£ £ ¡ ¡ ¢ ¡ ¦ ¢
¤ ¡ ¦ ¡¤ ¢ °¡
¬ ¤¤ ¡ ¬
¤ ¬ ¤¬ £¡¡ ¢£® ¢¤
¤ ³ Â*Ã ¢¬£
¢ ¬® ¦£ ¦ ¦
¢ ¢¤ ¡¤ ¤ ³ £ ¢ ¢¡
¢ ¡ ¤ ¬ ¬
¡ ¦ []\ ® ¦°
¬ ¢ ° ¬
¢¡ ¤ ¤ °¡ ¦ ¬¤
¤ ¬ ¢ £¤
Ä Ä
³ ¤ ¤®¤ Ä
¢® ¬ Â0Ã ¢ _]] ] ¢¤ ¢¡®
¡ ¢ ¬ ¢¢¡ ® ¤ ¢ £ ¡£ [ÅÄ \
¬ ¤¢ ¢ ¢
° _ ® ° ¦ ¡ ¤¢


UJÊjf¾Wf5r\3¾WfDP ' % + /" ' % + ,/* 0
_ a
_ 3> )/\)¸¹\@ * 6 ) 6 )
_ 3 , V -))-- * 2
>*] @ 3*]- ,- *
%'.3 2 *2 = VV2 3 '
2 /2 27 ]*2), 2 3
¹ 2 26 6Å%S ' '
:'¹ 2 * 2
Y'Ú = 6, 2 8 * 2
9'? Á V &Q
Ú 2 Å:SV ** 2 Á
Q'( 3 * > * @
¢ ¡ ¦ ¢ ¤ ¢ ¬¦
Â0Ã
¢ _]] ò®¤ ¡ ¤¡ ¤¬ ® £ Â0Ã
¤ ¡ ¤ ¬¤ <4ÎQÆ [0\
¡ ¢¢¬ ¢ £ [\ ¢°£
®¤ ¢ ¦ ¤ ¢¦ ¬ ¤
¬ ¢ ® ¦ ¢¡ ¤
<" + Î " Q Æ" ¤ ¢ ¡ ¦ ¢ ¢
[<4ÎQÆ\ - !% Æ" $ 2 Á $ [¦ \ ¿ -
7 $ ? ç [!ÆÁ^7?\ - !% ¦ ¢ ¿ 6Å ¤¬¤ ¢
Æ" $ 2 <" + Z 2 [!Æ<Z\ ¢¤ ¤ ¤¤
Â0Ã [¦\ £ Â6Ã ¢£ ³
¤ ¤ _]] ¬£¤ ¬® ¤ £ £
¢ ¤ ® ¡ ¡£¤ ¬ ¦¡
¡ ¦ ¢¢¬ ¢¤ ¢
¬ ¦ ¦¤ ¦ ¦ Â60Ã
¢¢¡ ®¤ ¬¢ ©¢ 6Ä ¬® ¢
¦¬¢ ³¤ ¢¡¤ ¦£ ¦¬ ¢ ¬¡
¦ [©\ ° ¤
¬ [q\ ¤ ¤ ¡ ¢¤ ¤ ¿
¢¤ ®¤ ¡ ¬£ ¢
¤ ¢ £¤ ³¤ ` ¢¡£ ¢ ¤
£¤ ° ÅÄ ¢ ¦ ¦
¬® ³¤ ¢ ¤ Â*0Ã
¬ ÁÎ ¢ ¡¤ ¢ _]]
¢ £¤ ÂÃ £¤ ¢ ¤ ¦¡
¦ * ò£¡ ³ §
Â*0Ã ¬¤ ~
¢¢¬¤ ® ¦¢ ¤®¤ ¤ ¢
¡ ³ ¢£ ¤ ¬ ¢ £¤ ¢
® ° ¢¡¤ ¤ ¤ ¦ [¦ 7^>D\
¤ ¬£¤ ¤ ¢ ¬¢¦ [¦ ÁÎ\ Â0Ã
£¤ ° ¤ _]] ¢ 0Ä ¬® ¢ ¦
¢¢¬ £¡£ ¢¡ £ ¦ ¢¤
¢ £ £ ¬¢¦ q ¢ ¬¦
£ [\ ¢ ³ ¡
¤ ¢£¢¢ ¬¢¦ ® ] [7 5 2 " Q 7 %
£ [-\ ¢ ¬ Ò 7 $ç" #\ Â6Ã ¦
® Â*0Ã ¡ £¤ ¦
¬ ³ ¤ _]] ¤ ¬ ¦ ¢
¢ ¤ ³ £ ¢ £¤
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 117

q ¢¤ ¬® ¬¤9 ¡ ¢¡ ¢ ¡
³ ° £ À ¡£
¦® ¤ ° ¥ ¬ ¡
~ ¢ ¢ ¡ ° ¤ [¥\ ¿ 0 ¢ ] ¿ -
¤ ¡¤ [6> =8)63+4 70,36\ 6- [6> =8)63+4
£ ~ ¢ _]] ¡¤ 4+)+4,36\ 6-0 [6> V'V8+,06 70,36\
¤ ¢ ¢ ¬¤ ¤
¤ ¢ ¬ ¢ ¤ ¢ ¡ ´
®¤ ¦¢ ¬® ¤ ¬ ¦£¡ ¢
¤ Â*0Ã °¡ ¿ ¦¢ ¦ ¡ ¿
@ ¤ ¿ : È ¢ ¿ £ ¦
¦ ¤ ¢ £¡ ¡ ¦¤ ¡
¢ £¤ £ ¢
¦¢ ¡ ¦ ¦
³ ¬® ¤ ¢ ¢ 9
¤ ¦ ¿ - ¬ ¿ 6Ô-
¬ ¬ _ ¤ ¬ ¿ Ô- ¢ ¿ Ä
¤ ¡¤ ¿ 0Ä ¤ ¿
¢ ¦ ¬® *Ä ¬ ¿ *Ä ¬ ¿ Ä
¦¬ ¿ *Ô- q ¿ -
Qgeaeà_b [_\WdZY q*46*3*(%"; %*7 -4*:
z]> ¢ ¢q ¿ 6 q- [ ¿ q-\
¡ ¢ ¡ ¿ ° q-
¤ _ Jj² ¦ [ ¿ q-\ © ¿ *0 -
¤¡ ¤ j² ¦ [ ¿ -\ ¡
W ¬ £ * ¢ © ¿ - [ ¿ -\
¦ ¢¤ ¬® ¬¬
¤¡ ¢ ³ ¢ ¿ [ ¿ 0\
¡ ¡¤ ¢ ³¤ '")3% $4*3$%% %\ v: [\
*0Å*Õ z ¤
¢¤ q £ _¢£¡ 4/%43z ¿ Ä [ ¿
¢¡ ¦ £ ¬ ÅÄ\ ¿ 6Ä [ ¿ Å*Ä\
¤¡ ¤ ¦¦ ¿ 6Ä [ ¿ 0Å6Ä\
¤ ¦¢ ¤¬ ¢ ¤¢ ¢ ¡ ¦ ¿ 6Ä [ ¿ ÅÄ\
¢ ¤¡ ¦ ¿ 0Ä [ ¿ ÅÄ\ ¦
j² ¢ ¿ 0Ä [ ¿ **Å6*6Ä\ ¦
¤ ¤ ¢¡ ¦ ¬® ¿ 6
°¤ ¤¬ {\%"; %*7 )(* ¿
¡ ¢¢ ¦ |-4-*4}*+ ~|9
¤ ¤ ¥ ¿ 6Å - ¦¤
¦ ¤¡ ¡ ¢ ³
£ ¦¤ ¬ ¢ ¦ ¤
|64-*4)-4*+9 ÅÅ6
_ ¢¬ ¢ ¿ *0 ¿ **
¦¤ ¤ ¢ ¡ ¿ * [\
¢ £¤ ¦ ¡ [\ ¦¡ ¦¬ ¿
¢ ¡ £ 0 ¤ ¿ °
¤ ³ ° ¤ ¡ ¿ °¡ ¿
¢ ¢¦° ª¦ °¡ ¿
¢¢ ®¤ ¤ ° ¤ ¤ ¿ 6 ¬¤ ¿ Ä
¡ ~ ¤ ¤ ¢¤ ¿ ¬¤ ¦¡
£¤ ¬ £¡¤
° £ Ô ¬ ¿

#IKÀ %*%L# !!"#$" +# - #ILÇ # ! *ÁQ ! + G" -
! =# !° Æ+ ! ! !+#- + G"° Æ R !!" % #=!+ %
8!!"ºLÆ # !*%%% %F!!" !& %=! !ºLÆR !!"# ! !+%-
# !* ;!% *Q8! + ! A;% !A ;! 8!A
¬ ¿ 6 ~ ®¬ _¢ ¢
¢ ®¤ ¢¢®
¤ ¢ ¤ ¢ ¢°
Ô [ \ ¿ ¦¢ ¿
¦ ¥ 9 ¢ * [ *¦\ j
¿ * ¿ Å0 ¦ ¢ 6
¡ ¬¤ ¦¬ ¿ 0 ]¢ ¡ ° ¤¢ ¿ ¢
¢ ¢ k_oaZ[ZY; ¦ ¤ [À \
³¤ ¢¢® "-)% )-%$%%+ -)-%*\-
¤ ¢ ³¤ ¢ %"6 *** )$"% "/,'z ¦ ¬
¤¢ ]¢¡ ¢ ¦9 ¢¢
°¤ ¡ £¡¡ ¤9 ¢¢
¢ ³¤ 0 [j\ ¢
[ £¡ \ [ ¦\ ¤ []\9 ¬¡ ³
@$\")*\% -43:`% 434- ¤¢ 0Å* [ ¿
}*+ ~@' 44}*+z \ ¢ ¬£
¤¢ ¬¤ ¿ ¢ ¤ ° ®¤ [ 6\
³¤ ¦° ¢ ¤¢ Ä [¢
¢ ¡ ^Q<7\ ¿ [ 6¦\ ¤
¡ ¡ _ 9 ¿ ]
¢ ¿ ¢¡ ¢° [ 6\
¢ ° ¿ 0 ¢
¤¢ ¢ ¤ ³ ¢
¢° ¤ ³
¤ ¢ * [ *\ {*z j ]9 [ ¿ \
¤ ¤ ¢ ¢ ¬£¤
¢ ¤ ¿ ¢ ° ¢¦ ¤
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 119

#I M Ø *#! #* !% !!" *# * ! ! = %% # ! R &° Æ *!$! 8! %F!!" Â +´º
LÆ# !Â +´! %# "º%Æ* ! !% 8!R !!"Â +´;! 8!A
¢ ¬ ¡ - ¤

¦ ¢ ¤ ] ¿ ¦¢ ¢
¢ ¦ ¤ ¿ ¢£ ¬¢
¢ ¦ £
¦ ¤ ¿ ¢ ¢
°¤ ¤ ¦ q¦¤ ¢¬
¢° ¢ ¢ ¤ ¡ ¤ ¤ ¢¦°¤
!| ~¢ ¢ ¬® ¤ ¦ ¦¡¡
] ¢ ] ¢¤ ¤¢
¢ ³ ¡¤® ¢ Ä ¬ ¢¤ ¤
q [ ¦ ³¤ ] ¬ ¿ ¦¢
¢¤ ³¤ ® © ¿ * - ¡
\ ¢ [¤ © ¿ ° -
¤¬ ¢ ¢ ¢ ¢ 44% 64-*4)-4*+z ¢¡
\ ¦ ® ¦¤ [¤ ¢°¤ ¡
¢¬ ¢¬¤ ] ¢ ³¤
¬ \ ¦ [ 0 _¡ ¤ ¦
³ q © ¤\ ¢°¤ 6 ¦¡ ¤
¢¢¬ [¢ ] ¢ ¦¬ ¦
¢¡ ¢°¤ ¢ ¡ ¡ ¢° * [ £¡
\
¡¤\ "-)% )-%$%%+ -)-%*\-
J_]] %"6 *** )$"% "/z ]
[ ¦ ¤\ À ¢ ¡ ¢ ¢ ³¤
¢ ¢ j ¢ ¢ 0Å06Ä ³ [ÅÄ
¡ °¤ ] ¤ ^Q<7\ z ¢ ¡
W ¢ J¬ ¤ ° ¤¬ ¢¤
W ¢¡ ¤9 ] ¿ - [¢
¢ ¿ - ¦ ¬¢ ¦ ¿ 6 -\
¦ ¿ 0 - ¢¤ [ ¢-¤¬\ £¡ ³¢ ¢ ¢
¡ £ ¡
¤ ¬ °¤ ¦¤ ¢
¢¤ q ¿ ¢ ® ¢ ¢¡
¬®£ ¢¤ © ¢¢¤ ** - ¤ ¤ ] ¤
¬® ¡¢ 6 ¦ ¢ °¤ [¢ ¢ 66 -¦ ¢
¦ ¦¤ *6* ¢¤ ¢ 0 ¦\
¢ ¢¤ q * - ¦¡ [¬¢¦ ¢ 60
¬£ ¢¬ ¬ ° ¢¤ ¡¢ ¤¬\
¿ *Ô- © ¿ ¬® ¬£

¤ °¤ ¤ ¦ò ¦
¤ ] ¤ ¤ ¬® q¦
~ * ° ¦ ¬ ®¤ ¡ ¦
¤ ~ J_¡ ¡ ¤ ® ¢ ¬¡
¬ ¤¡ W ¡ ®¤
[ \ ¢¬ ¤ ¤ ¢ ¢
¢ ¬ ¢ ¤ °
¤ ¢9 ] ¢ ¢¤ °® ¢ ³®
¤ ¿ ¢
¢ ³¤ 0 ¬¡ ¦
¿ ¢¤
¢ ¦¤ ¢ ®¤ ¿ ¢¤ ¬
* ¿ *0 ¢ _]] ¢¢¬¤ ¡ ¢
¤ ¡ ¦ Å *0 ®
¿ 0 ° ¢¡¤ ¤ ¤ ¬£
¿ ] ¿ ¤ ¤ ¢ £¤ °
¿ ¢ ¤ ¤ ¬ £¤ ¢
¿ * ¡ ¤ ¤ ¢
¿ * ¡ ¤
¿ * _ ¡ ¤ ¥ ¢
¤ ¡ ¢ ® ¦
6 ¡ ~ ¡
³ * ¢¤ ® ¦¡
¢ _]] £¡ ¢ ³ ¦¢¬
¤ ¡ ¤ ] ¦ ¢ ¢¤
¤ °¤ ¬ ~ ¤¬ ¤ ¤
¤ ¢ ¢¤
¢¤ ® ¢
vqZ[Z]caa ^W [_oaZ[Y_ ¦¡ £ ¦®
q _]] ® ¤
¢ £¤ z ! " !-
¬ £¤ ¢ £ >
'3'4 nGHBJ"H=J"
1. Aeschlimann FA, Eng SWM, Sheikh S, Laxer RM, ²=% ´¶< Ø% ·Ç| (2020). ´ Ø * "#| -
Hebert D, Noone D et al. (2017). Childhood Takayasu =+" ! %!$! * +"| ¤ ;¤~A° >–14¹|
arteritis disease course and response to therapy. https://doi.org/10.31928/2305-3127-2020.3.514.
Arthritis Research and Therapy. 19 (1): 255. doi: 6. Hellmich B, Agueda F, Monti S et al. (2020). Update of the
10.1186/s13075-017-1452-4. EULAR recommendations for the management of large ves-
2. Aeschlimann FA, Yeung RSM, Laxer RM. (2022). An Update sel vasculitis. Ann. Rheum. Dis. 79 (1): 19–30. doi: 10.1136/
`_{`jq§xxxqj_q_|¢`q|j_xq|¤º~° annrheumdis-2019-215672.
872313. doi: 10.3389/fped.2022.872313. 7. Isayeva GS, Trypilka SA. (2020). ½`j_Ñ xqxqj_q_
3. Alnabwani D, Patel P, Kata P, Patel V, Okere A, Cheriyath P. (Takayasu’s disease). Ukrainian Journal of Cardiology. 27
(2021). The Epidemiology and Clinical Manifestations of ;>A° J >| ±'# H% < Ø* ´| (2020). ¸#$ G8-
Takayasu Arteritis. A Descriptive Study of Case Reports. ! & ;=%L Ø * "#A| À* &!#* * -
j|>º¤;A°J |_°~|JJ>»j|J | +8! ! |}Jº>°J –85¹|_°~|¤} »È~ È¤>
4. Bereghnoy VV, German OV. (2015). Takayasu’s disease 2020.5.7885.
;½`j_Ñ xqxqj_q_A| ª¡jj``xx j_xq_x| 8. qxj < Ã | ;}~ A| ½`j_Ñ
;J}A° ¤¯¯~| ±·! ¶µ< ! µ·| (2015). ²%L aortoarteritis (Takayasu’s disease) and the cardiovascular
Ø * "#;!#$ G8! & A|%!! "- system. Cardiology, Rheumatology, Cardiosurgery. 4 (59):
"| ;J}A°¤¯–40¹|_°~|>>J¯»ª|}~>|J}|¤¯| ¤}¤¤< ¤È¤J| ±Ç# L ¶< @# Ç·| (2018). ¸-
5. Bortnyak NV, Yepanchintseva OA, Khokhlov AV, Todurov BM. #$ G8! & ;=%L Ø * "#A #-
(2020). Takayasu arteritis. Cardiac Surgery and Interventional $%# !! # # | +"< % +"<
x_{^| ¤ ;¤~A° >¯| ±· !"* ¸¶< !8 !$% µ´< =+"| ¯ ;>A° ¤}–33, 36–37¹| URL: https://health-
ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 121

ua.com/article/39871-nespetcifchnij-aortoartert-hvoroba- 30–32¹| URL: https://health-ua.com/article/39871-

takayasu-tasertcevosudinna-sistema. nespetcifchnij-aor toar ter t-hvoroba-takayasu-
9. qxj < Ã | ;}~ A| ½`j_Ñ tasertcevosudinna-sistema.
aortoarteritis (Takayasu’s disease) and the cardiovascular 10. Nakaoka Y, Isobe M, Takei S eq x{| ;}~ A| Eèx
system (part two). Cardiology, Rheumatology, and safety of tocilizumab in patients with refractory
x_^j| > ;È~A° ¤~¤}| ±Ç# L ¶< @# Takayasu arteritis: results from a randomized,
Ç·| (2018). ¸#$ G8! & ;=%L double-blind, placebo-controlled, phase 3 trial in Japan (the
Ø * "#A #$%# !! # # ;8 # ! - TAKT study). Ann. Rheum. Dis. 77 (3): 348–354. doi: 10.1136/
+ A| +"< % +"< =+"| > ;>A° annrheumdis-2017-211878.

zaV %Æ*||!|< # # ! * G| &'% !ï !*%#*+¸ÇÀ|´# °|'% !ï !*%#*<%| !% $"<¤}|
qq°»»_|^»~~~~~~~}>>¯¯ ²|
p #^#') ' Æ||!<G|< %|* G| "8 ==%L#" !&#% '% !ï !*%#*+¸ÇÀ|
´# °|'% !ï !*%#*<%| !% $"<¤}|qq°»»_|^»~~~~~~~¤~J}¤J }|
( d{+vÆ*||!|<$|* G| &'% !ï !*%#*+¸ÇÀ|´# °|'% !ï !*%#*<%| !% $"<¤}|
qq°»»_|^»~~~~~~~}J¤J¯~²|
~ ^ ½ Æ*||!<$|<* %*%& +!# * |´# °|'% !ï !*%#*<%||· ! <J|
https://orcid.org/0000-0002-4394-8059.
_. ^ , Æ # # ! * G| &'% !ï !*%#*+¸ÇÀ|´# °|'% !ï !*%#*<%| !% $"<¤}|
qq°»»_|^»~~~~~~~J¯È ¤ ~²|
"! R *$&~È|~È|}~}¤|< !" *~È|~|}~}¤|

ÍJK98;GDÎ>@SS<9C]\6N
} ' Ë
Ми прагнемо підвищити обізнаність про тромбоз, включаючи його причини,

фактори ризику, симптоми та доказову профілактику і лікування. Зрештою, ми
прагнемо зменшити смертність та інвалідність, спричинену цим станом.
Наша місія підтримує глобальну ціль Всесвітньої Асамблеї охорони здоров'я
щодо скорочення передчасної смертності від неінфекційних захворювань на 25
відсотків до 2025 року.
z #ËL- , . Ì+/%Ë

^-.# ' Â + . Ë
l. ,,Ë
V МІЖНАРОДНИЙ КОНГРЕС
v листопада 202 on\line
Antibiotic resistance STOP!
Стійкість до антибіотиків зростає до загрозливо високих

рівнів у всьому світі. Нові механізми стійкості з'являються
і поширюються всюди, створюючи перешкоди для лікування
розповсюджених інфекційних захворювань
\ World Health Organization
Розвиток нових антибіотиків має надзвичайне значення, оскільки

еволюція мікробів продовжуватиметься безперервно, а резистентність до
лікарських засобів зростає.
Проблема антибіотикорезистентності стала глобальним викликом
сьогодення. Головною його причиною вважають нераціональне
застосування антибактеріальної терапії.
Тож під час Всесвітнього тижня поінформованості про антибіотики,

в Українї традиційно буде проведено
V міжнародний конгрес «Antibiotic resistance STOP!»,
який об'єднає провідних спеціалістів медичної галузі для розробки
стратегії контролю розвитку антибіотикорезистентності
antibioticcongress.com

MPU 05 2023 Web

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

MPU 05 2023 Web

Uploaded by

Copyright:

Available Formats

СУЧАСНА ISSN 26637553

MODERN PEDIATRICS. UKRAINE

MODERN PEDIATRICS. UKRAINE

1!2' ,'(1 (3 (% *4! %# 5 '6) 

© Shupyk National Healthcare University of Ukraine, 2023

Attention! Subscribe to «MODERN PEDIATRICS. UKRAINE»

<=>"<?" @BFG"HJGL =QJ"V?"

kzF"kB{| Hvk }lJ=@" Qvr@"?G~ rBF BQ<@BJH

± _¬    ¢ ¤ ~  z  *

 "" #$% &'$()% **+, -/%1

?"{Gv?"n|?z~ =?GkBJ<zHBH 21 +7 4*6!(4*

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 3

4 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

ǁǠǩǚǟǠǜǄƴƽǥǤǒǛǄƩƵǠǢǠǓǗǨǮƿƩ  3RFK\QRN79/XWDL7,*RUREHWV1,

ƳǠǱǢǩǥǜǀǂƴǠǝǱǟǣǮǜǒƽƲ  %R\DUFKXN259ROLDQVND/$

ƶǥǤǩǒǜƵƾǃǚǟǠǔǗǢǣǮǜǒǀƳ 'XWFKDN+06\QRYHUVND2%

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 5

 1   1  1

 1 1   1 1

$  + /  1  % ,

Modern Pediatrics. Ukraine. (2023). 5(133): 6-16. doi 10.15574/SP.2023.133.6

6 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

ko^X\ ¬ ¢£

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 7

8 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 9

 ­¤    JcyXgw^W^_ dZogedfcaa ^W  ZqZ[Z]caa

10 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

 * [Ä\ ¢ 00  ~  ¤  ¬ ¦ °£ ³  ¢¡¤

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 11

¡  ­¤ ¬ Qgeae`a_b [_\WdZY

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 13

14 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

¬® ¢ ?ÀÁ'  ¢ ¤     ³ ­®   ¢

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 15

kedZsZo^e \]Z W[^Z]e[;

16 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

L + 9>MNO' !  /  .  +  

Introduction to the predominance of orexigenic over anorexigenic

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 17

18 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 19

20 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 21

22 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

kedZsZo^e \]Z W[^Z]e[;

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 23

#W X 1 " I 1%Y  I1

W%Z" I1$ [X 2

24 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

ko^X\    ¢ 

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 25

³ ® £   rW^c]eWg_ ^W sc^Zd_ dZogedfcaa

26 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

¤¢ ¢ £¤ ¢    ¿ ¢¡¤ ¦ ¡

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 27

q  ¤¢¬  ¢¡ [¢\  ¦¡£¤ ¢ 

28 ISSN 2663-7553 Modern pediatrics. Ukraine 5(133)/2023

L +   h +  1   h +  1

Ae2ÅS):Q ' %9)U S)+Q %Y)& S):

Ae2ÅS):U ' %&)< S&Y Y+ S)+Q

AeY[%)9Q %+)< S)++ Q)< S)S:

 £ ¡£ ¬£ k_oaZ[Y_

1!2' ,'(1 (3 (% *4! %# 5 '6)

<=>"<?" @BFG"HJGL =QJ"V?"

kzF"kB{| Hvk }lJ=@" Qvr@"?G~ rBF BQ<@BJH

± _¬ ¢ ¤ ~ z *

"" #$% &'$()% +, -/%1

?"{Gv?"n|?z~ =?GkBJ<zHBH 21 +7 46!(4

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 3

ǁǠǩǚǟǠǜǄƴƽǥǤǒǛǄƩƵǠǢǠǓǗǨǮƿƩ 3RFK\QRN79/XWDL7,*RUREHWV1,

ƳǠǱǢǩǥǜǀǂƴǠǝǱǟǣǮǜǒƽƲ %R\DUFKXN259ROLDQVND/$

ƶǥǤǩǒǜƵƾǃǚǟǠǔǗǢǣǮǜǒǀƳ 'XWFKDN+06\QRYHUVND2%

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 5

1 1 1

1 1 1 1

$ + / 1 % ,

ko^X\ ¬ ¢£

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 7

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 9

¤ JcyXgw^W^_ dZogedfcaa ^W ZqZ[Z]caa

* [Ä\ ¢ 00 ~ ¤ ¬ ¦ °£ ³ ¢¡¤

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 11

¡ ¤ ¬ Qgeae`a_b [_\WdZY

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 13

¬® ¢ ?ÀÁ' ¢ ¤ ³ ® ¢

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 15

L + 9>MNO' ! / . +

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 17

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 19

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 21

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 23

#W X 1 " I 1%Y I1

W%Z" I1$ [X 2

ko^X\ ¢

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 25

³ ® £ rW^c]eWg_ ^W sc^Zd_ dZogedfcaa

¤¢ ¢ £¤ ¢ ¿ ¢¡¤ ¦ ¡

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 27

q ¤¢¬ ¢¡ [¢\ ¦¡£¤ ¢

L + h + 1 h + 1

£ ¡£ ¬£ k_oaZ[Y_

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 29

¢£ ¤¢¬ ¢¦ °¤ ¢£¤ £ ¬¡

[ - +, + # %

Introduction 7 +3 $ Ò

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 31

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 33

Ñ !<> Í **6È +Ê 7 Ò $ -

% $3$ ÀÓ> Ò "% $-

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 35

ÂÃ 7 "%-

Gratitude. Ó 5 $$ + % - 7 $ + Ò 5

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 37

# 1 qt 1,2$j 1,3

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 39

¿ ]q²] [¢ ¬ ¡ ¦¦ ¢

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 41

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 43

¤ [¢ ¦ \ ¬ ¢ £ ¦ ¦¡

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 45

W X $$ X

L ++ %, % ' .%1

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 47

ko^X\ ¬¤ ¦ ® ¤¬¤

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 49

^ ' a ++ _ #'

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 51

^ - -'234561 0_

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 53

7 " ?ÀÁ' 6Ä [Í\ 70

+ Ö "+ Á Ò + % 58.1

Ä [Í\ 7 +% 32

% %3$ + +" 0Ä 0

[Í\ + Ò +

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 55

Conclusions 7 32 % %"

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 57

! [X 1WX 1%2W X[1

ko^X\ ¤ ¬ £

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 59

ISSN 2663-7553 ¡ ¤ Україна 5(133)/2023 61

? ³£ q ¢¡ ¡°