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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">perinatology</journal-id><journal-title-group><journal-title xml:lang="ru">Российский вестник перинатологии и педиатрии</journal-title><trans-title-group xml:lang="en"><trans-title>Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1027-4065</issn><issn pub-type="epub">2500-2228</issn><publisher><publisher-name>Ltd. “The National Academy of Pediatric Science and Innovation”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21508/1027-4065-68-6-85-93</article-id><article-id custom-type="elpub" pub-id-type="custom">perinatology-1910</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ СЛУЧАИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL CASES</subject></subj-group></article-categories><title-group><article-title>Патофизиологические механизмы и клинические последствия воздействия на плод  и новорожденного новых психоактивных веществ — «солей»</article-title><trans-title-group xml:lang="en"><trans-title>Pathophysiological mechanisms and clinical consequences of exposure of the fetus and  newborn to new psychoactive substances — “bath salts”</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3043-8674</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лошкова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Loshkova</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Лошкова Елена Владимировна — к.м.н., доц. кафедры госпитальной педиатрии, кафедры факультетской педиатрии с курсом детских болезней лечебного факультета Сибирского государственного медицинского университета; ст. науч. сотр. отдела наследственных и метаболических заболеваний Научно-исследовательского клинического института детства Министерства здравоохранения Московской области</p><p>634050 Томск, Московский тракт, д. 4</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><email xlink:type="simple">loshkova.ev@ssmu.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0747-5952</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дорошенко</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Doroshenko</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дорошенко Иван Владимирович — студент V курса педиатрического факультета, член научного студенческого кружка по неонатологии на базе кафедры госпитальной педиатрии</p><p>634050 Томск, Московский тракт, д. 4</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2048-1852</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Люлька</surname><given-names>Т. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Lyulka</surname><given-names>T. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Люлька Татьяна Сергеевна — студент VI курса педиатрического факультета, член научного студенческого кружка по неонатологии на базе кафедры госпитальной педиатрии</p><p>634050 Томск, Московский тракт, д. 4</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3281-803X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рафикова</surname><given-names>Ю. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Rafikov</surname><given-names>Y. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рафикова Юлия Сергеевна– к.м.н., доц. кафедры госпитальной педиатрии</p><p>634050 Томск, Московский тракт, д. 4</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3903-2934</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Желев</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Zhelev</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Желев Виктор Александрович — д.м.н., проф., зав. кафедрой госпитальной педиатрии Сибирского государственного медицинского университета, Ермоленко Сергей Прокопьевич — к.м.н., асс. кафедры госпитальной педиатрии Сибирского государственного медицинского университета; врач-неонатолог, анестезиолог-реаниматолог отделения реанимации и интенсивной терапии новорожденных детской больницы №1</p><p>634050 Томск, Московский тракт, д. 4</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3903-2934</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ермоленко</surname><given-names>С. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Ermolenko</surname><given-names>S. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ермоленко Сергей Прокопьевич — к.м.н., асс. кафедры госпитальной педиатрии Сибирского государственного медицинского университета; врач-неонатолог, анестезиолог-реаниматолог отделения реанимации и интенсивной терапии новорожденных детской больницы №1</p><p>634050 Томск, Московский тракт, д. 2</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4439-151X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Михалев</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Mikhalev</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Михалев Евгений Викторович — д.м.н., проф. кафедры госпитальной педиатрии</p><p>634050 Томск, Московский тракт, д. 4</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8581-7049</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гришкевич</surname><given-names>И. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Grishkevich</surname><given-names>I. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гришкевич Иван Романович — студент IV курса педиатрического факультета, член научного студенческого кружка по неонатологии на базе кафедры госпитальной педиатрии</p><p>634050 Томск, Московский тракт, д. 4</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-4955-4364</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мельников</surname><given-names>Н. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Melnikov</surname><given-names>N. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мельников Николай Евгеньевич — врач–анестезиолог-реаниматолог, зав. отделением реанимации и интенсивной терапии новорожденных</p><p>634050 Томск, Московский тракт, д. 4</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0596-635X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Солнышко</surname><given-names>А. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Solnyshko</surname><given-names>A. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Солнышко Андрей Леонидович — к.м.н., асс. кафедры анестезиологии, реаниматологии и интенсивной терапии Сибирского государственного медицинского университета; врач–анестезиолог-реаниматолог, зам. гл. врача по лечебной работе детской больницы №1</p><p>634050 Томск, Московский тракт, д. 4</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-3399-827X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Богунецкий</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Bogunetsky</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Богунецкий Антон Александрович — к.м.н., врач–рентгенолог</p><p>634050 Томск, Московский тракт, д. 4</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кондратьева</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Kondratieva</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кондратьева Елена Ивановна — д.м.н., проф., зам. дир. Научно-исследовательского клинического института детства Минздрава Московской области, рук. научно-клинического отдела муковисцидоза, зав. кафедрой генетики болезней дыхательной системы Медико-генетического научного центра им. академика Н.П. Бочкова</p><p>115093 Москва, ул. Большая Серпуховская, д. 62</p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7308-7280</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хавкин</surname><given-names>А. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Khavkin</surname><given-names>A. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хавкин Анатолий Ильич — д.м.н., проф., рук. Московского областного центра детской гастроэнтерологии и гепатологии; гл. науч. сотр. отдела  гастроэнтерологии Научно-исследовательского клинического института педиатрии и детской хирургии им. академика Ю.Е. Вельтищева; проф. кафедры педиатрии с курсом детских хирургических болезней Российского национального исследовательского медицинского университета им. Н.И. Пирогова</p><p>115093 Москва, ул. Большая Серпуховская, д. 62</p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5214-8072</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Одинаева</surname><given-names>Н. Дж.</given-names></name><name name-style="western" xml:lang="en"><surname>Odinaeva</surname><given-names>N. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Одинаева Нуринисо Джумаевна — д.м.н., проф., дир.</p><p>115093 Москва, ул. Большая Серпуховская, д. 62</p></bio><bio xml:lang="en"><p>Moscow</p></bio><xref ref-type="aff" rid="aff-9"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0008-1727-4485</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Макаревич</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Makarevich</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Макаревич Елизавета Игоревна — студент IV курса педиатрического факультета, член научного студенческого кружка по неонатологии на базе кафедры госпитальной педиатрии</p><p>634050 Томск, Московский тракт, д. 2</p></bio><bio xml:lang="en"><p>Tomsk</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России; ГБУЗ Московской области «Научно-исследовательский клинический институт детства Минздрава Московской области»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Siberian State Medical University; Reasearch Clinical Institute of Childhood of the Ministry of Health of the Moscow Region</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Siberian State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России; ОГАУЗ «Детская городская больница №1»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Siberian State Medical University; Children’s City Hospital No. 1</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Children’s City Hospital No. 1</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава России; ОГАУЗ «Детская городская больница №1»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Children’s City Hospital No. 1</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>ОГАУЗ «Детская городская больница №1»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Children’s City Hospital No. 1</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru"><institution>ГБУЗ Московской области «Научно-исследовательский клинический институт детства Минздрава Московской области»; ФГБНУ «Медико-генетический научный центр им. академика Н.П. Бочкова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Reasearch Clinical Institute of Childhood of the Ministry of Health of the Moscow Region; Bochkov Medical Genetic Research Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru"><institution>ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov Russian National Research Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-9"><aff xml:lang="ru"><institution>ГБУЗ Московской области «Научно-исследовательский клинический институт детства Минздрава Московской области»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Reasearch Clinical Institute of Childhood of the Ministry of Health of the Moscow Region</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>13</day><month>01</month><year>2024</year></pub-date><volume>68</volume><issue>6</issue><fpage>85</fpage><lpage>93</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Ltd. “The National Academy of Pediatric Science and Innovation”, 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Ltd. “The National Academy of Pediatric Science and Innovation”</copyright-holder><copyright-holder xml:lang="en">Ltd. “The National Academy of Pediatric Science and Innovation”</copyright-holder><license xlink:href="https://www.ped-perinatology.ru/jour/about/submissions#copyrightNotice" xlink:type="simple"><license-p>https://www.ped-perinatology.ru/jour/about/submissions#copyrightNotice</license-p></license></permissions><self-uri xlink:href="https://www.ped-perinatology.ru/jour/article/view/1910">https://www.ped-perinatology.ru/jour/article/view/1910</self-uri><abstract><p>Число случаев употребления новых психоактивных веществ с каждым годом увеличивается среди различных социальных групп во всем мире. Употребление наркотических препаратов во время беременности по данным разных авторов остается на высоком уровне — от 2,8 до 7% беременных женщин употребляют такие препараты. Употребление новых психоактивных веществ, как и других групп наркотических препаратов, во время беременности характеризуются мультиорганным поражением плода, однако органо- и тканеспецифичность для новых психоактивных веществ не описана. В экспериментальных исследованиях продемонстрированы негативные патофизиологические механизмы, запускаемые синтетическими катинонами в виде усиления проапоптотической активности, образования аутофаголизосом и активных форм кислорода, провоспалительной направленности иммунной системы. Клиническое наблюдение описывает преимущественное поражение нервной системы (пороки развития головного мозга, поражение дыхательного центра) и опорно-двигательного аппарата (выраженный миотонический синдром, врожденные патологические переломы бедренных костей), что приводит к мультиорганной дисфункции, неконтролируемому воспалительному ответу и, как итог, к тяжелой инвалидизации таких детей и увеличению когорты паллиативных педиатрических пациентов. В представленном обзоре литературы авторы делают упор на патофизиологические механизмы действия новых психоактивных веществ для более глубокого и целостного представления о патологическом процессе, происходящем в организме, с целью формирования и совершенствования клинического мышления врачей-специалистов и приводят собственное клиническое наблюдение в качестве иллюстрации последствий употребления новых психоактивных веществ во время беременности. Авторы считают, что настоящий обзор литературы с описанием клинического случая является ценным с точки зрения практикоприменимости как для клиницистов различных направлений, так и для научных сотрудников.</p></abstract><trans-abstract xml:lang="en"><p>The use of new psychoactive substances (NPS) is increasing every year among various social groups around the world. The use of narcotic drugs during pregnancy, according to various authors, remains at a high level from 2.8% to 7% of pregnant women. The use of new psychoactive substances during pregnancy is characterized by multi-organ damage to the fetus, like other groups of narcotic drugs, however, no organ and tissue specificity for new psychoactive substances has been described. Experimental studies have demonstrated negative pathophysiological mechanisms triggered by synthetic cathinones in the form of increased proapoptotic activity, the formation of autophagolysosomes and reactive oxygen species, and the pro-inflammatory orientation of the immune system. A clinical observation describes a predominant lesion of the nervous system (malformations of the brain, damage to the respiratory center) and the musculoskeletal system (pronounced myotonic syndrome, congenital pathological fractures of the femur), which leads to multiorgan dysfunction, an uncontrolled inflammatory response, and, as a result, to the development of severe disability in such children and growth of the cohort of palliative pediatric patients. In the presented literature review, the authors focus on the pathophysiological mechanisms of action of NPS for a better, deeper and more holistic understanding of the pathological process occurring in the body, in order to form and improve the clinical thinking of medical specialists and cite their own clinical observation as an illustration of the consequences of using new psychoactive substances during pregnancy. The authors believe that this review of the literature with a description of a clinical case is valuable in terms of practical applicability, both for clinicians in various fields and for researchers.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>новорожденные</kwd><kwd>новые психоактивные вещества</kwd><kwd>«соли»</kwd><kwd>беременность</kwd><kwd>недоношенность</kwd><kwd>переломы костей</kwd><kwd>негативные последствия для плода</kwd></kwd-group><kwd-group xml:lang="en"><kwd>newborns</kwd><kwd>new psychoactive substances</kwd><kwd>“bath salts”</kwd><kwd>pregnancy</kwd><kwd>prematurity</kwd><kwd>bone fractures</kwd><kwd>negative consequences for the fetus</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Palamar J.J., Su M.K., Hoffman R.S. Characteristics of novel psychoactive substance exposures reported to New York City Poison Center, 2011–2014. 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