Patologìâ (Dec 2019)
Clinical description of measles complications in adults in connection with changes in the functional state of the autonomic nervous system
Abstract
Aim of the work – to analyze measles complications in adults depending on the severity of the course and to find out their relationship with the functional state of the autonomic nervous system. Results. Clinical manifestations of measles in adults under present conditions retain typical signs, but the feature is the preservation of Filatov–Koplik sign in the period of rashes (77.1 %). In severe course of measles more often (P < 0.01), than with a moderate course, scleroconjunctivitis with eye irritation, hoarseness, hemorrhagic manifestations, nausea, vomiting is recorded, the period of fever is prolonger. In most adult patients, measles had a complicated course (70.5 %), with the spectrum of complications mainly represented by the damage of the respiratory system (61.4 %) and the gastrointestinal tract (43.8 %). The frequency of development of complications and their range clearly depended on the severity of the disease. Complications such as bronchitis (P < 0.05) and pneumonia (P < 0.0001) were more common in patients with severe course of measles. Some patients with a severe course of measles developed such complications as pulmonary edema and left lung atelectasis. The most severe complications from the respiratory organs arose in pregnant women. Gastrointestinal complications such as hepatitis and enteritis were recorded in 43.8 % of patients with measles, and the frequency of their development was also dependent on the severity of the disease (P < 0.01). The Mallory–Weiss syndrome was detected in one patient with a severe course of measles. Analysis of HRV indicators in adult patients with measles showed that in the presence of complications, the functional state of the ANS is characterized by a decrease in power in all regulatory units with the development of imbalance in the direction of sympathicotonia, compared with healthy people (P < 0.01). In patients with a complicated course of measles, indicators that characterize the total power of vegetative regulation, the parameter characterizing the humoral effects on the ANS (VLF), were lower (P < 0.05), and part of the sympathetic effects in the general spectrum of vegetative regulation is higher (P < 0.05) than in patients without complications of this infection. Conclusions. Clinical manifestations of measles in adults under present conditions remain typical, but in most adult patients (70.5 %) measles has a complicated character. The complications from the respiratory system (61.4 %) and the gastrointestinal tract (43.8 %) are often recorded, the frequency and spectrum of which depend on the severity of the disease. Complications from the nervous system and the organs of vision develop in single adult patients with severe course of measles. Disorders of ANS functional state play a role in depending of measles complications in adults. In the presence of complications, the functional state of ANS is characterized by a decrease in power in all regulatory units with the development of imbalance in the direction of sympathicotonia.
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