DYNAMICS OF CLINICAL AND BIOCHEMICAL PARAMETERS AND FUNCTIONAL STATE OF THE AUTONOMIC NERVOUS SYSTEM IN PATIENTS WITH ACUTE HEPATITIS B WITH CHRONIC ALCOHOL USE IN HEPATOTOXIC DOSES

Abstract

Relevance of hepatitis B due to the high incidence complexity of pathogenesis, ineffective treatment, severe consequences of the disease. Among combined lesions of the liver, special attention is paid to viral-alcoholic type. One of the mechanisms of chronic hepatitis of different etiology is violation of the functional activity of the autonomic nervous system. The aim of this work- to determine the dynamics of spectral indices of heart rate variability in patients with acute hepatitis B from chronic use of alcohol in hepatotoxic doses. Materials and methods. 133 patients with acute hepatitis B were under observation. Patients were divided into groups taking account the presence or absence of chronic use of alcohol in hepatotoxic doses and using the classification of alcohol consumption based on the frequency and dose of consumed alcohol. I group comprised 52 patients with chronic use of alcohol in the hepatotoxic doses, II group consisted of 81 patient without this factor. Heart rate variability was diagnosed using computer cardiointervalometry performed by electrocardiographic diagnostic system CardioLab-2000. 20 healthy individuals were in the control group. Results and discussion. Prodromal period in patients of the I group was longer (p0,05). However, only patients in group I had marked hemorrhagic manifestations (5,8 %) and itching (7.7%). Average serum total bilirubin level was higher (p<0,05) in patients from the I group than in patients from II group. Functional state of autonomic nervous system in patients of both groups were decreased in acute period (vagotonia). Period of convalescence in patients from the I group was accompanied by more severe autonomic dysfunction in 33,6 % (p<0,05). Conclusions. 1. Acute hepatitis B in patients with chronic alcohol use in hepatotoxic doses is characterized by longer (p<0,05) prodrome, cholestatic (7,7%) and hemorrhagic manifestations (5,8%), higher levels of hyperbilirubinemia (p<0,05), and during convalescence maintaining higher (p<0,05), alanine aminotransferase activity compared with group II patients. 2. Acute period of acute hepatitis B regardless of whether chronic alcohol use in hepatotoxic doses is characterized by the development of autonomic imbalance towards vagotonia. 3. Period of convalescence in patients with acute hepatitis B with chronic alcohol use in hepatotoxic doses is accompanied by more severe autonomic dysfunction in 33,6% (p<0,05).

Keywords

• acute hepatitis В
• use alcohol in hepatotoxic doses
• heart rate variability