Streptococcal infection in children, its complications and adverse long-term consequences remain an urgent problem in pediatrics. Scientists continue to search for factors that shape the course of the disease. One of them is the timely and adequate response of the autonomic nervous system, which provides both short-term and long-term strategic adaptation of the organism. Violations of this adaptation can lead to the presence of comorbid conditions, which are increasingly common. The share of children is growing. infected with the herpes virus group, including human herpes virus type 6 (HHV-6).
The aim of the work was to study the state of vegetative reactivity (VR) of children with streptococcal tonsillitis on the background of HHV-6 infection. In 68 children aged 4 - 15 years with tonsillitis of streptococcal etiology of moderate severity, vegetative reactivity was determined by cardiointervalography (CIG) followed by analysis of heart rate variability (CP) depending on the presence or absence of concomitant HHV-6 type of infection. The studies were performed in the acute period of the disease and in the period of early convalescence. The control group consisted of 20 healthy children, similar in age and sex. Static processing of the obtained results was performed using Excel and Statistica 6.0 using parametric and non-parametric research methods.
Results.
In the acute period of streptococcal tonsillitis in children of both groups there was a decrease in the humoral component in the regulation of the system and the level of activity of the parasympathetic ANS, as evidenced by a decrease in Mo and ΔX, independent of background, p> 0.05. There was an activation of the influence of the sympathetic link of the VNS, increased the degree of centralization of heart rate control in all patients, and this was confirmed by an increase in AMO and IN. Prior to the convalescence period, CIG parameters were restored only in patients without concomitant VGL-6 infection, and the interrelationships of the sympathetic and parasympathetic links of the VNS were restructured with increasing role of the latter. In patients with concomitant VGL-6 infection, the values of ΔX and IN differed significantly from the control group, p˂0.05. Thus, in children with streptococcal tonsillitis on the background of HHV-6 infection, there was a decrease in the level of functioning of the sympathetic VNS, but complete recovery did not occur, indicating instability of adaptation processes, depletion of the parasympathetic VNS, which hides the possibility of failure of adaptation, recurrence of the disease and / or chronicity, the development of secondary disorders of the cardiovascular system.
Conclusions.
The acute period of streptococcal tonsillitis is accompanied by stress of the sympathetic VNS, the severity of which does not depend on the presence of concomitant herpes virus infection. In the period of convalescence of streptococcal tonsillitis in the presence of children with HHV-6 infection there is no complete recovery of autonomic reactivity, among which the most informative are ΔX and IN.
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