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SPECIFIC FEATURES OF THE BLOOD LIPID SPECTRUM IN CHILDREN WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Summary. The aim of the study was to determine the features of blood lipid spectrum disorders in children with systemic lupus erythematosus (SLE) and factors contributing to their stabilization and progression. Materials and methods. At interval of 6–12 months, 38 patients with SLE at the age of 7–18 years were examined. The lipid spectrum of blood, indicators of inflammatory and immunological activity, indicators of a coagulation with the determination of the concentration of D-dimer were determined. Results. It was found that in children with SLE, the indicators of total cholesterol, low-density lipoprotein cholesterol and triglycerides increase both in the first years of the disease and in the future. In the early years of illness, high total cholesterol levels were accompanied by higher high-density lipoprotein cholesterol levels. In subsequent years, an increase in the level of total cholesterol was accompanied by a decrease in the level of high-density lipoprotein cholesterol, an increase in the values of the atherogenic coefficient. Comorbid conditions, especially changes in the liver, kidneys and blood coagulation system (high PTI values) had a significant effect on the deterioration of the blood lipid spectrum. Correlation analysis established inverse relationships between the values of C-reactive protein and complement, the levels of complement and triglycerides. Indicators of triglycerides had direct correlations with the levels of circulating immune complexes, serum creatinine and transaminases, as well as an inverse relationship with indicators of glomerular filtration rate. In the group of patients with pulse therapy, the indicators of low density lipoprotein cholesterol, triglycerides, atherogenic coefficient were significantly lower, and the indicators of high density lipoprotein cholesterol were significantly higher. Conclusions. The data obtained indicate that already in the early stages of the course of the disease in childhood, atherogenic dyslipoproteinemias develop, progressing while maintaining the activity of the process. The frequency of these disorders increases in the presence of comorbid conditions, especially with impaired renal and liver function and hypercoagulability (increased IPT values). The use of pulse therapy to remove the activity of the process is effective in preventing the formation and progression of dyslipoproteinemia in children with SLE.
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