Laboratory and clinical peculiarities of the measles course in adult patients against the background of the use of a ribonucleic acid medicine in a comprehensive approach to treatment during the 2017-2019 outbreak period

Abstract

Vaccine-controlled viral diseases require a deeper study of the pathogenesis and immunological component. When performing this work, we've set the following goals: to study and distinguish the clinical and laboratory peculiarities of the measles course in adults, to describe the method of forecasting severe and complicated forms of the disease, as well as the possibility of using the ribonucleic acid medicine in the comprehensive treatment of the studied patients. During the performance of the work, there were analyzed 32 cases of measles in people of working age. Among the patients there were 6 (18.75%) people who confirmed the presence of two doses of the MMR vaccine. At the phase of the admission to the hospital, patients were divided into two groups, and they were compared according to the severity of the disease. The group I of patients received basic therapy; group II, in addition to basic therapy, received a ribonucleic acid medicine as an etiotropic agent. Evaluation of the clinical picture, hematological data, calculation of endogenous intoxication indices was performed at the phase of admission to the hospital, as well as during the third and fifth days of treatment. In the course of the study, the average severity of the disease was determined in most patients-27 (84.4%), and 5 (15.6%) patients-had severe disease. In all patients with measles, at the early stage of the disease, there was a significant increase in the integrative indices of endogenous intoxication: LII, ILS, RINM, NI, II, and IK. This was accompanied by a violation of immunological reactivity (increased ILS and decreased ILG) and an active adaptive response of the body (decrease in RIEL). When evaluating clinical data during the third and fifth days of the disease, it was noted that the main clinical manifestations of the disease subsided relatively faster in patients of the group II in contrast to the patients of the group I. A severe course of the disease was registered in 4 (25%) cases in patients of the group I, in 1 (6.25%) case in patients of the group II (р<0.05). The average length of hospital stay in patients of the group II was 7.8 ± 0.8 days against 9.2 ± 0.7 days of the patients of the group I (p<0.05). Integrative indices of endogenous intoxication against the background of the use of the ribonucleic acid medicine during the 3 rd and 5 th day of the disease had significant differences in the compared groups of patients, indicated the fading of the inflammatory reaction, activation of factors of a specific immunological response, and reduction of the extent of the endogenous intoxication syndrome. The application used by us for calculating indices of endogenous intoxication is a convenient and accessible method of visualization of pathogenetic and immunological processes of a viral disease, it makes it possible to influence these processes with medications and adjust therapy in a timely manner, and it is also a way of predicting possible complications.