Features of regional blood flow in patients with neurogenic dysfunction of urination on the background of connective tissue dysplasia

Objective. Determination of the nature of vascular dysfunctions in children with neuromuscular bladder dysfunction, taking into account the severity of connective tissue dysplasia (CTD) syndrome. Material and methods. The study included 60 children aged 5 to 15 years with an established diagnosis of neuromuscular bladder dysfunction. CTD was diagnosed in children when 6 or more external or visceral manifestations were detected, involving three or more organs from different systems. assessment of the ctd severity was carried out according to a scoring system proposed by T.I. Kadurina et al. The result to 12 points was regarded as the absence of dysplasia, 12-20 - i degree dysplasia, from 20 to 30 - ii degree dysplasia, more than 30 points - iii degree dysplasia. Two groups were formed: 37 children with mild ctd manifestations and 23 children with moderate CTD. Duplex scanning of the renal blood flow and brachycephalic vessels was performed on the sonoscape2012 device in the color doppler mode. The significance of differences in qualitative parameters was assessed using the pearson X2-test and fisher test for large groups and small groups, respectively. To assess quantitative parameters, a comparison was performed using the mann - whitney test method; p values <0.05 considered as signiwere ficant. Results. Moderate CTD is characterized by increased mobility of the kidneys and a decrease in vascular resistance in large arteries; in the brachiocephalic blood flow - an increase in the number of “small vessel” anomalies AND hemodynamic disturbances, such as increase in vascular resistance of the vertebral arteries at the extracranial level and venous dysfunction with disturbance of outflow in vertebral veins. Conclusion. In children with neuromuscular bladder dysfunction, two- or one-sided pyeloectasia (36.7%) and diffuse heterogeneous changes in the structure of the renal sinuses (68.8%) are identified with a high frequency. The most characteristic features of CTD include the increase in the number of “small vessel” anomalies: S-shaped tortuosity and ICA abnormalities, VA abnormalities at the extracranial level, and hemodynamic disturbances such as increase in vascular resistance of the VA at the extracranial level and venous dysfunction with disturbance of outflow in VV.

neuromuscular bladder dysfunction, connective tissue dysplasia syndrome, duplex scanning