Клініко-патогенетична значущість стану вегетативної нервової системи при ревматоїдному артриті

Background. Rheumatoid arthritis (RA) belongs to the most common inflammatory diseases of the joints, and in its pathogenetic constructions, a certain role is played by the changes in the autonomic nervous system (ANS). Aim of the study: to evaluate the vegetative passport in RA, the incidence and nature of vegetative dysfunction (VD) in different types of the disease, the relationship with the parameters of variation pulsometry. Materials and methods. There were examined 173 patients with RA aged 18 to 79 years (an average of 46 years), among them there were 21 % of males and 79 % of females. The duration of the disease was 10 years, type of RA, seropositive in terms of rheumatoid factor and citrulline antibodies, was detected in 3/4 of cases, extra-articular (systemic) form of the disease was diagnosed in 37 % of observations, osteoporosis was found in 67 % of patients. Results. VD is observed in 20 % of RA patients, mainly in those with seropositive variant of the disease that is associated with higher values of bone mineral density, larger changes in the variation pulsometry, with the influence on the integral nature of articular syndrome and the rate of involvement in the pathological process of elbow and hip joints, and the severity of autonomic disorders is closely linked to the presence of intra-articular arthrocalcifications, digital arteritis and dyscirculatory encephalopathy. Vegetative passport defines the integral clinical and laboratory and instrumental RA symptoms, while the ANS type is affected by the seropositivity of the disease and the bone density, with the highest level in cases of vagotonia, when VD directly correlates with the joint pathology progression rate, and in sympathicotonia — with intial parameters of rheumatoid factor and arthritis activity, also, regardless of the vegetative status, there are variance-correlation ratios of specific parameters of RA course and variation pulsometry. Conclusions. VD occurs in every fifth patient with RA, is associated with the peculiarities of the articular syndrome course and extra-articular signs of the pathological processes, is involved in disease pathogenesis constructions, and in the future it will be useful to identify actively ANS changes for subsequent timely rehabilitation.