Неханевич, О.Б. and Дорофєєва, О.Є. and Смирнова, О.Л. and Логвиненко, В.В. (2015) Особливості лікарського контролю за спортсменами з ознаками дисплазії сполучної тканини. Вісник проблем біології і медицини, Вип. 4 (2). pp. 323-327. ISSN 2077-4214
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Abstract
Метою роботи було удосконалення лікарського контролю за особами з ознаками дисплазії сполучної тканини під час оздоровчого та спортивного тренування в аспекті профілактики раптової смерті. Нами були обстежені 669 осіб віком від 7 до 45 років. Обстеження включало клінічну, інструментальну (електрокардіографію, ехокардіографію, дослідження варіабельності серцевого ритму, холтерівське моніторування ЕКГ) та лабораторну частини (імуноферментний аналіз, аналіз поліморфизмів генів ангіотензинконвертуючого ферменту та альфа-1 ланцюгу колагену І типу). В роботі доведено, що наявність спадково обумовлених ознак дисплазії сполучної тканини у спортсменів при різних за прогнозом станах потребує від спортивних лікарів проведення глибокого аналізу та диференційної діагностики клінічних форм з метою попередження ускладнень під час тренувально-змагальних навантажень. Introduction. Despite great experience, disclosure of reasons and mechanisms of cardiovascular complications, including sudden death in sports, the problem remains valid and in date. The incidence of sudden death in sports according to various authors ranges from 2.3 to 6.5 per 100,000 active athletes. Particular risk in matters of access to physical loads are persons with the presence of small malformations of the heart, which may be a manifestation of connective tissue dysplasia. So important is the development of medical criteria for admission, diagnosis of early signs of strain the cardiovascular system, construction of training features, competitive pressures for people with connective tissue dysplasia in terms of prevention of sudden death. The aim was to improve the medical control of persons with connective tissue dysplasia signs in the health and sports training in terms of sudden death prevention. Materials and methods. To achieve the objectives we have examined 669 people ages 7 to 45 years. The examination included clinical, instrumental (electrocardiography, echocardiography, the study of heart rate variability, Holter ECG) and laboratory parts (ELISA, analysis of angiotensin-converting enzyme and alpha-1 chain of type I collagen gens polymorphisms). Results. According to a specially designed questionnaire prevention of sudden death in sport availability factor of sudden death among close relatives under the age of 45 years was found in 8.96% of athletes, with the main group in its frequency was 10.0% in the control group – 6.9% that had no statistically significant difference (χ²- Pearson = 1.78, p = 0.18). Body mass index and some signs dolyhostenomely (swing arms/height) in the presence of athletes with the factor of sudden death close relatives, were significantly higher than in athletes without this factor (20,9 ± 3,0 kg/m² and 19,8 ± 3,4 kg/m²; 1,08 ± 0,06 and 1,04 ± 0,07, respectively, p < 0.05). According to echocardiography in a group of athletes with recurring chest pain was statistically significantly increase the size of the interventricular septum to 0.87 ± 0.14 cm, diameter bulb aorta to 2.68 ± 0.39 cm, prolapse MV shutters to 0.11 ± 0.15 cm, left ventricular ejection fraction decreased to 65.9 ± 4.9%, the SF to 35.9 ± 3.6% compared with those of the athletes in the group without complaints of chest pain, they made up 0.79 cm ± 0.14, 2.46 ± 0.38 cm, 0.06 ± 0.13 cm, 70.5 ± 4.9% and 39.8 ± 3.8% (p < 0.05). Analysis of the distribution frequency of meetings of genotypes and alleles of the gene COL1A1 for the polymorphism rs1800012 (+ 1245G/T, (S/s) in the samples revealed an increase genotypes GT and TT and allele T in patients with high score SZST in dysplastic process (p < 0.05, χ2 = 7.96). In individuals with allele gene ACE DI level of physical performance was statistically significantly higher than the DD allele and amounted 3.84 ± 0,25 W/kg against 2.66 ± 0.98 W/kg, respectively (p < 0.05). The level SZST in groups did not differ (P > 0.05). Conclusions. 1. The paper demonstrated the need to consider signs of connective tissue dysplasia in the construction of the training, competitive pressures in athletes and individuals engaged wellness forms of physical culture. 2. The proposed questionnaire allows you to actively identify persons with risk factors for cardiovascular events during physical training. It can be used in sports and family physicians in matters of admission to employment wellness or sports training. 3. Functional unfavorable TT genotype of COL1A1 gene causes morphological changes in the state of the musculoskeletal system, changes in the morphology of the heart and major blood vessels, myocardial relaxation process deviations. 4. The presence of symptoms caused by hereditary connective tissue dysplasia in athletes with different prognosis states requires sports physicians an in-depth analysis and differential diagnosis of clinical forms in order to prevent complications during training, competitive pressures.
| Item Type: | Article |
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| Uncontrolled Keywords: | лікарський контроль, спортсмени, дисплазія сполучної тканини; врачебный контроль, спортсмены, дисплазия соединительной ткани; medical control, athletes, connective tissue dysplasia. |
| Subjects: | Physical rehabilitation, Sports Medicine |
| Divisions: | Departments > Department of Physical Rehabilitation, Sports Medicine and valeologii |
| Depositing User: | Елена Шрамко |
| Date Deposited: | 11 May 2017 10:12 |
| Last Modified: | 11 May 2017 10:12 |
| URI: | http://repo.dma.dp.ua/id/eprint/1670 |
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