380
~30% из средств, выделяемых фондом ОМС. Эти затраты обосновываются
увеличением числа обращений пациентов и оказываемых им услуг по
исследуемому профилю. Следовательно, при формировании бюджета ОМС
необходимо планировать рост финансирования затрат на оказание
стоматологической помощи хирургического профиля
Список литературы:
1.
Каюмова, Н., & Эшмаматов, И. (2022). Инновационные технологии
обучения
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ОКАЗАНИЕ
СТОМАТОЛОГИЧЕСКОЙ
ПОМОЩИ
В
ПЕРИОД
РЕФОРМ
ЗДРАВООХРАНЕНИЯ.
Stomatologiya
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1
(2(79),
24–28.
извлечено от
https://inlibrary.uz/index.php/stomatologiya/article/view/1128
CHANGES IN SALIVA IN PERSONS WITH SEVERE COVID-19
Jabbarova F.U.
Bukhara State Medical Institute named after Abu Ali ibn Sina Republic of
Uzbekistan
RELEVANCE:
The available data have not yet identified an effective and
safe pharmacological therapy against COVID-19, and the available potential
antiviral drugs lead to adverse reactions [4,5,7,9,11]. Therefore, acute COVID-19
infection and associated therapeutic interventions can contribute to adverse oral
health outcomes. Oral signs and symptoms associated with COVID-19 are known
to include taste disturbances, nonspecific mouth ulcers, desquamative gingivitis,
petechiae, and coinfections such as candidiasis [7,8,9,11,12].
However, it is still not clear whether these manifestations can be a true clinical
picture resulting from direct infection with SARS-CoV-2, or systemic
consequences, given the possibility of coinfections, weakening of local immune
reactivity and adverse reactions to therapy [2 ,5,7,9,11].
Since the prevalence of clinical manifestations is still not fully understood,
the spectrum of manifestations of COVID-19 in the oral cavity is considered a
subject of wide and current interest, therefore, a live systematic review approach is
needed that will allow continuous monitoring of recently published studies through
periodic searches to include new relevant information, especially on a topic that is
constantly being updated in the context of COVID-19.
In recent years, much attention has been paid not to the study of cellular and
humoral factors of systemic immunity, but most of all the emphasis is on the factors
of local immunity, especially depending on the clinical features of the course of the
disease, which gives a broader and more correct understanding of changes in local
immunity, especially against the background of the course of infectious pathology
[2,4,7,9,11]. This paper will present the main immunological parameters of local
immunity and blood, which are important in the immunopathogenesis and course of
respiratory infectious pathology associated with the course of COVID-19. The
381
factors of innate immunity will be investigated. These factors include such values as
humoral factors: cytokines, interferons, immunoglobulins and circulating immune
complexes of various sizes.
The purpose of the study.
Study of the features of local mucosal immunity
of the oral cavity and systemic immunity in persons with severe COVID-19.
Material and Research Methods.
In the city of Tashkent, Zangiotinsky district, 70 patients with coronavirus
infection (moderate to severe, severe) and without disease were examined
Results and its Discussion.
Results shows the immune factors studied in saliva. Thus, it was revealed that
the content of secretory IgA in saliva in the control was 12.45 ± 0.41 g / l, while in
persons with moderate course of Covid-19 - 5.42 ± 1.5 g / l, and in severe patients -
1.22 ± 0.11 g / l, which was significantly reduced in both study groups of patients
with COVID-19. It can be seen that in the group of moderately severe patients the
level of secretory immunoglobulin A was suppressed by 2.3 times compared with
the control values, and in the group of severe patients the level of secretory
immunoglobulin was reduced 10 times compared to the control values.
So, it can be seen from the table that there are also differences between the
groups of patients; it can be seen that the group of persons with severe COVID-19
has the lowest content of secretory immunoglobulin A in saliva. Thus, the analysis
of the sIgA content revealed the presence of reliable suppression in the saliva of
persons with moderate and severe COVID-19. Moreover, a pronounced suppression
of sIgA was noted in the group of persons with a severe course of COVID-19 (p>
0.05). Further, the concentration of IFN-alpha, which is a potent antiviral cytokine
protein, was studied. As can be seen from the table, the content of IFN-alpha in
saliva in the control was 24.27 ± 1.50 ng / ml, while in persons with moderate
COVID-19 it was 14.7 ± 2.13 ng / ml, and in severe patients - 3.36 ± 0.82 ng / ml,
which was also significantly reduced in both study groups of patients with COVID-
19.
Thus, we have studied the main two pro-inflammatory cytokines TNF-a and
IL- 1 beta, which are pro-inflammatory in nature. The analysis showed that the
comparative analysis revealed an increase in proinflammatory cytokines in
comparison with the control values. It is known that the cytokine TNF-a is of cellular
origin, that is, it is produced mainly by cells of the immune system and is a product
of monocytes / macrophages, in special cases - activated T-lymphocytes. It was
found that the inducers of TNF-a formation are microorganisms and their products,
the process of phagocytosis itself. Its level increases with virus infection. It is
obvious that TNF-a is involved in the implementation of the cytotoxic action of
natural killer cells and LAK cells, which play an important role in anti-infectious
and antitumor immunity. These factors explain the T-cell immunodeficiency that is
observed in coronavirus infection. Consequently, TNF-alpha is a cytokine, which,
in terms of properties and spectrum of biological action, is a product of
macrophages. In coronavirus infection, especially in severe cases, it was revealed
that there is lymphopenia with suppression of the cellular link of immunity, humoral
382
immunity factors and an increase in TNF-alpha, which in turn supports the
inflammatory process.
Conclusions:
Antiviral local immunity in salivary fluid in patients with
Covid-19 with moderate and severe course is characterized by decreased IFN-alpha
values by 1.7 times and 7.2 times, respectively. The lowest content of IFN-alpha in
saliva is typical for persons with severe COVID-19, also pro-inflammatory potential
is presented by studying the content of IL-1 beta and TNF-alpha in salivary fluid in
persons with moderate and severe COVID-19. Thus, in the group of moderately
severe individuals, the concentration of IL-1 beta was increased by 2 times, and in
the group of severe patients - by 2.7 times, which indicates the current inflammatory
process. The concentration of TNF-a in saliva was increased in the group of persons
with moderate and severe COVID-19 by 2.8 times and 4.9 times, respectively.
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