Patologìâ (Dec 2018)
Analysis of heart rate variability in patients with primary and secondary invasion with pinworms before and after a course of specific therapy
Abstract
Objective: to study the state of the autonomic nervous system and adaptation-compensatory mechanisms in adult patients with enterobiasis with different duration of pinworm invasion before and after the course of anthelmintic therapy with the help of the heart rate variability method. Materials and methods. We examined 60 military cadets (men aged 19–24 years) with enterobiasis (the main group), among whom two groups of patients with different duration of enterobiasis invasion were formed. The 1st group included 35 military cadets with a primary enterobiasis invasion. The 2nd group with re-invasion – 25 military cadets, control group – 30 practically healthy military cadets. The course of specific therapy was carried out with mebendazole. To assess the state of autonomic nervous system, the method of mathematical analysis of the heart rate was used based on the results of heart rate variability. Results. Patients with primary enterobiotic invasion had heart rate variability data characterized by high absolute and relative values of high-frequency HF-component of heart rate variability (2314.9 ± 314.7 ms2 and 55.6 ± 3.1 %), and patients with re-invasion – high absolute and relative values of the very low-frequency VLF component of heart rate variability (1918.4 ± 205.9 ms2 and 49.7 ± 2.9 %). We observed normalization of heart rate variability indicators up to the control group level in patients with primary enterobiasis invasion after the course of anthelmintic therapy. Whereas, high absolute and relative values of very low-frequency VLF-component of heart rate variability indicators in patients with re-invasion were preserved. Conclusions. Patients with primary pinworm infestation have predominant parasympathetic regulation in cardiac rhythm modulation. Patients with re-invasion have excessive centralization of cardiac rhythm control due to a disruption in the interaction between suprasegmental and segmental parts of the central autonomic nervous system, which persists after the course of anthelmintic therapy.
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