FUNCTIONAL STATE CHANGES OF THE VEGETATIVE NERVOUS SYSTEM IN PATIENTS WITH ACALCULOUS CHOLECYSTITIS DEPENDING ON THE TYPE OF SOMATOFORM VEGETATIVE DYSFUNCTION AND ESSENTIAL HYPERTENSION

Abstract

Objective: to establish the features of the functional state changes of the autonomicnervous system in patients with chronic noncalculous cholecystitis, depending on the typeof concomitant somatoform autonomic dysfunction and hypertension stage II.Material and methods. 138 patients were examined: 98 of them with chronic acalculouscholecystitis in the exacerbation phase and concomitant somatoform autonomicdysfunction, 40 patients with chronic noncalculous cholecystitis in the phase ofexacerbation with accompanying essential hypertension stage II and 30 practicallyhealthy persons who made up the control group. To characterize the state of theautonomic nervous system we used A.M. Vein vegetative symptoms scale, Ashner-Danyini,Danielopulu (orthoclinostatic) tests.Results. Indices’ analysis of the carried out investigation of the general vegetativesymptoms have shown that the skin color changes during excitement, physical activity inpatients with somatoform autonomic dysfunction according to hypertensive type, cardiacneurosis and hypertension had a negative tendency, that is, the skin was pale, whatreflects an increase of the sympathetic nervous system tone and forms a decrease fromthe state of eutonia in scores by 1.7 times, 1.6 times and 2.0 times respectively (p<0.05).Pulse rate veritably increased (51.6%, 41.9% and 54.8% (p<0.05)) in patients of the 1st,3rd and 4th groups, in patients of the 2nd group it veritably decreased (29.0% (p <0.05))when conducting orthostatic test. During clino-orthostatic test, the pulse rate changed inthe diametrically opposite direction: in patients of the 1st, 3rd and 4th groups it sloweddown (21.9%, 28.1% and 31.3%, respectively (p< 0.05)), in patients of the 2nd groupit probably accelerated (21.9% (p <0.05)). During Ashner’s test in patients of the 1stand 3rd groups the pulse rate paradoxically tended to accelerate (20.0% and 26.7% (p<0.05)); in patients of the 4th group it veritably increased 30.0% (p <0.05), in patients ofthe 2nd group it veritably decreased (52.8%, p <0.05).Conclusions. Thus, an increase in the tone of the sympathetic part of the autonomicnervous system with frequent sympathoadrenal crises is observed in patients withchronic acalculous cholecystitis and concomitant somatoform vegetative dysfunction byhypertension type and cardiac neurosis as well as hypertension type II, and vagotonia witha predominance of the vago-insular crises is peculiar for the patients with concomitantsomatoform vegetative dysfunction according to hypotonic type.