VEGETATIVE REGULATION OF CARDIAC FUNCTION IN DIFFUSE TOXIC GOITER ASSOCIATED WITH PATHOGENETIC THERAPY

Objective: to study the vegetative regulation of cardiac function by means of Holter monitoring in patients diagnosed with diffuse toxic goiter associated with therapy with tireostatics and beta adrenoblockers (рropranololum, bisoprolol). Material and methods . 82 patients diagnosed with a diffuse toxic goiter aged 18-60, out of them 24 men and 58 women participated in the study. The patients were divided into two groups: the first group (46 patients) took non-selective beta adrenoblocker Propranololum (Anaprilin), the second group (36 patients) took beta1-adrenoblocker Bisoprolol. The control group included 30 almost healthy volunteers. All the patients were performed Holter monitoring with the assessment of heart rate variability, their thyroid status was studied. Results. We have done the comparative analysis of the thyroid status in the groups of the patients with diffuse toxic goiter following different schemes of pathogenetic therapy. We have analyzed the data of Holter monitoring with the assessment of heart rate variability related to the intake of cardioselective and non-selective beta adrenoblockers. Conclusion . Patients with compensated thyrotoxicosis taking Bisoprolol at a dose of 5 mg/day and Thiamazolum of 15 mg/day have signs of vegetative imbalance in the form of dominance of sympathetic section of the vegetative nervous system. When the compensation of thyrotoxicosis is achieved in patients using the scheme of 40 mg/day of Anaprilin and 20mg/day of Thiamazolum, the vegetative regulation of cardiac function is characterized by vegetative balance. The correction of medicamentous therapy of vegetative imbalance is possible taking into account results of Holter monitoring.

вегетативная нервная система, вариабельность сердечного ритма, диффузный токсический зоб, vegetative nervous system, heart rate variability, diffuse toxic goiter

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