Functional state of the autonomic nervous system in patients with chronic pancreatitis combined with chronic bronchitis

Abstract

60 patients with chronic pancreatitis (acute exacerbation) combined with chronic bronchitis (mild exacerbation) were examined. 33 almost healthy patients (the control group) were also examined.
 The functional state of the autonomic nervous system was assessed using an analysis of heart rate variability.
 The study was carried out in two stages. The electrocardiogram was recorded in standard lead II at rest and in active orthostasis for 100 cardiocycles. The obtained data were processed using the Korveg computer program. Based on the data obtained, the following indices were calculated: the regulatory system stress index (SI), which reflects the total activity of the central regulatory mechanisms, allows us to assess the degree of shift of the autonomic balance towards sympathetic regulation, characterizes the stress of compensatory mechanisms, and the level of functioning of the central circuit of heart rate regulation; vegetative balance index (VBI), which reflects the ratio of the activity of the sympathetic and parasympathetic divisions of the autonomic nervous system; an indicator of the adequacy of regulation processes (IARP), which reflects the adequacy of the activity of the sympathetic division of the autonomic nervous system; vegetative rhythm index (VRI), which reflects the vegetative balance in terms of assessing the activity of the autonomic regulation circuit; orthoprobe ratio (OR), which is the ratio of the 30th R–R interval to the 15th R–R interval after standing up, this coefficient reflects the state of the parasympathetic division of the autonomic nervous system.
 SI was statistically significantly higher in the group of chronic pancreatitis combined with bronchitis at rest than in controls, indicating a shift in the autonomic balance towards the sympathetic system.
 VBI in patients with chronic pancreatitis combined with bronchitis was significantly higher in the lying position, but significantly lower in the standing position than in the control group.
 IARP was statistically significantly lower in the group of patients in the standing position, which indicates some excessive centralization of heart rate control in comorbidities.
 VRI did not differ statistically significantly in the control group and in the group of chronic pancreatitis combined with bronchitis, which indicates the normalization of parasympathetics in the group of patients during exercise.
 OR was significantly lower in chronic pancreatitis combined with bronchitis, which indicates an increase in the effect of the parasympathetic nervous system.
 Thus, there is an imbalance in the sympathetic and parasympathetic divisions of the autonomic nervous system in patients with chronic pancreatitis combined with chronic bronchitis, which depends on the position of the patient (lying or standing).