DIAGNOSTIC VALUE OF LABORATORY MARKERS OF SYNTROPIC LESIONS OF THE CIRCULATORY SYSTEM ORGANS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects almost all internal organs, among which circulatory system organs (CSO) lesions are not only among the most common but also at the top of the list of causes of mortality. The tactics of treatment of patients with SLE without and in combination with CSO lesions are fundamentally different, and therefore, improving diagnostic methods will help to enhance the effectiveness of the management of this category of patients. The aim of the study - to determine the diagnostic value of laboratory markers of syntropic lesions of the circulatory system organs in patients with systemic lupus erythematosus. The research included 125 patients with SLE with CSO lesions, among whom the vast majority were young women. Patients were stratified according to syntropy. Syntropic lesions were those whose frequency significantly increased with increasing severity of SLE: retinal angiopathy, capillaritis, Raynaud's syndrome, livedo reticularis, atherosclerosis, mitral valve insufficiency, mitral valve thickening, pericardial effusion, pulmonary hypertension, myocarditis, endocarditis, symptomatic arterial hypertension, and vein thrombosis. During the study, the diagnostic value of individual laboratory markers and their constellations in terms of sensitivity, specificity, and accuracy in patients with SLE with syntropic lesions of CSO was determined step by step, and the one with the highest diagnostic value for the diagnosis of these lesions was chosen. The difference was considered statistically significant if p<0.050. The association coefficient and the contingent coefficient were used to determine the closeness of the relationship between the marker and the syntropic lesion. The relationship was considered confirmed if the association coefficient was ≥ 0.50 or the contingent coefficient was ≥ 0.30. We studied the diagnostic value of individual laboratory markers and their constellations in terms of sensitivity, specificity, and accuracy in patients with SLE with syntropic CSO lesions. It was found that the best diagnostic value for the diagnosis of retinal angiopathy is the constellation of ↑ LDL + ↑ IA + ↑ anti-ds DNA + ↑ ANA; capillaritis - ↑ β-globulins + ↑ IA + ↑ anti-ds DNA + ↑ antiphospholipid antibodies Ig M + ↑ anti-Sm + ↓ C4; Raynaud's syndrome - a separate marker ↓ C3; livedo reticularis - ↑ ESR + ↑ small CIC + ↑ anti-ds DNA + ↑ anti-Sm; atherosclerosis - ↓ hemoglobin + ↑ LDL + ↑ ANA + ↓ C4; mitral valve insufficiency - ↑ ESR + ↑ anti-ds DNA + ↑ ANA + ↑ antiphospholipid antibodies Ig M; mitral valve stenosis - ↑ ESR+↑ LDL + ↑ small CK + ↑ ANA; pericardial effusion - erythropenia + ↑ C-RP + ↑ lupus anticoagulant; pulmonary hypertension - hypercholesterolemia + ↑ LDL + ↑ anti-ds DNA + ↑ ANA; myocarditis - an individual marker ↓ C4; endocarditis - ↑ ESR + ↑ total fibrinogen + ↑ γ-globulins + hypercholesterolemia + ↑ anti-Sm; symptomatic arterial hypertension - ↑ LDL + ↑ anti-ds DNA + ↑ ANA + ↑ anti-SSA (Ro); vein thrombosis - erythropenia + ↓ hemoglobin + ↑ LDL + ↑ ANA. For each syntropic lesion in patients with systemic lupus erythematosus, an individual laboratory marker or constellations have been identified that having the best diagnostic value for the diagnosis of these lesions.

INDICATORS OF BONE METABOLISM IN PATIENTS WITH RHEUMATOID ARTHRITIS WITH IMPAIRED BONE MINERAL DENSITY: CHARACTERISTICS, THEIR FEATURES AND DIAGNOSTIC VALUE

Rheumatoid arthritis (RA) is an autoimmune disease with a chronic inflammatory process that affects bone metabolism and leading to impaired bone mineral density (BMD). Therefore, the determination of laboratory markers of bone metabolism contributes to a better understanding of the pathogenesis of metabolic bone diseases. The aim of the study - to characterize the bone metabolism parameters in rheumatoid arthritis patients with impaired bone mineral density, to find out their features and diagnostic value. The study included 76 patients randomly stratified by RA status who were treated in the Rheumatology Department of Lviv Regional Clinical Hospital, a municipal non-profit enterprise of Lviv Regional Council, from 2013 to 2019. The goal was achieved by performing three consecutive stages of the study. At the first stage, markers of bone formation and bone resorption were characterized. At the second stage, the peculiarities of these indicators were determined. The third stage was to determine the diagnostic value of the content of the markers of OCN formation, P1NP and resorption marker β-CrossLaps. According to the results of the study at the first stage, it was found that, in RA patients with osteopenia, the serum content of markers of osteoblastic bone function OCN (p=0.000) and P1NP (p=0.035) was significantly lower compared to the healthy individuals of CG, while the content of the marker of bone resorption β-CrossLaps was significantly higher (p=0. 021); in RA patients with OP, the serum content of both markers of osteoblastic bone function OCN (p=0.000) and P1NP (p=0.001) is significantly lower, while β-CrossLaps (p>0.050) is only slightly higher compared to healthy CG subjects. According to the results obtained at the second stage of the study, it can be stated that the content of OCN and P1NP in the blood serum is significantly lower in RA patients both with osteopenia and OP compared to RA patients without BMD disorders. At the third stage of the study, it was found significant relationship between the content of P1NP and belonging to SG1 (AC -0.52). A confirmed relationship was found between the content of OCN and belonging to the group with OP (direct direction of AC 0.57; p=0.017). Bone structure disorders in rheumatoid arthritis patients with osteopenia are characterized by a weakening of bone formation and increased resorption processes; in rheumatoid arthritis patients with osteoporosis, the weakening of osteoblastic bone function is more pronounced compared to rheumatoid arthritis patients with osteopenia. For rheumatoid arthritis patients with unimpaired bone mineral density, the highest diagnostic value is provided by procollagen type I N-terminal propeptide. For rheumatoid arthritis patients with osteoporosis, osteocalcin is a diagnostically valuable marker.

INFECTIOUSNESS OF SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS WITH CYTOMEGALOVIRUS AND EPSTEIN-BARR VIRUS

Systemic lupus erythematosus (SLE) is an autoimmune disease caused by many polyclonal autoantibodies and characterized by numerous comorbid lesions of internal organs and systems. Research with respect to the role of various infectious agents in the development and course of SLE, and primarily the role of cytomegalovirus (CMV) and Epstein-Barr virus (EBV), is ongoing. It is important to find out whether patients with SLE are infected with CMV and EBV, since the clinical manifestations of SLE and active viral infection are similar. Aim - to find out the infection of SLE patients with CMV and EBV. The study included 115 patients with SLE, among whom women of working age predominated. The study was conducted in three stages: to find out CMV infection, to detect EBV infection, to determine the simultaneous infection of SLE patients with CMV and EBV and, in particular, their active phases. The actual material was processed on a personal computer in Excel (Microsoft) and IBM SPSS Statistics using descriptive statistics. It was found that the serum of the vast majority of SLE patients has specific antibodies to CMV, and only three have no antibodies to the virus. IgM antibodies to CMV were detected in 22.61% of patients, which may indicate an active phase of infection. Most often, the CMV seroprofile was detected as a combination of IgG (+) and IgM (-) (74.78%) among patients with SLE. It was established that the absolute majority of SLE patients are infected with EBV (98.26%). Active EBV infection was found in 15.65% of SLE patients, and chronic persistent - in 53.91%. Most often (53.91%) there are SLE patients with a seroprofile in the combination of EBV IgG to NA (+) IgG to EA (+) VCA IgM (-). Most often (41.74%) SLE patients had a combination of laboratory markers of viral infection in the form of seroprofile CMV IgG (+) IgM (-); EBV IgG to EA (+) IgG to NA (+) IgM to VCA (-). The active phase of CMV and/or EBV infection was present in 32.17% of SLE patients, of which: 16.52% had only active CMV infection, 9.57% - only active EBV infection, and 6.09% - a combination of active CMV and EBV infections, which indicates that more than a third of SLE patients have active CMV and/or EBV infections, which can affect the clinical manifestations of the disease and require specific treatment tactics. Almost all patients with SLE are infected with CMV, among whom 22.61% of patients have active infection. The absolute majority of SLE patients are infected with EBV, of which 15.65% had an active infection. Most often, SLE patients had a combination of laboratory markers of infection in the form of seroprofile CMV IgG (+) IgM (-); EBV IgG to EA (+) IgG to NA (+) IgM to VCA (-). The active phase of CMV and/or EBV infection was present in 32.17% of patients with SLE, of which: 16.52% had only active CMV infection, 9.57% only active EBV infection, and 6.09% - a combination of active CMV and EBV infections.

CHARACTERISTICS OF CALCIUM-PHOSPHORUS METABOLISM AND BONE TURNOVER INDICATORS IN PATIENTS WITH LIVER CIRRHOSIS AND THEIR DIAGNOSTIC VALUE FOR ASSESSING BONE STRUCTURES DISORDER

Information about calcium-phosphorus metabolism (CPM) and bone turnover in patients with liver cirrhosis (LC), as well as clarifying their diagnostic value for assessing bone structure disorder, will help doctors to detect their lesions in timely manner and, based on the information received, to choose well-founded comprehensive treatment strategy. Aim - to characterize the indicators of calcium-phosphorus metabolism and bone turnover in patients with liver cirrhosis, and to find out their diagnostic value for detecting bone structure disorder. In randomized manner 90 patients with LC (27 women and 63 men of age from 18 to 66), who were treated at the Lviv Regional Hepatological Center (Communal Non-Commercial Enterprise of Lviv Regional Council "Lviv Regional Clinical Hospital") between 2016 and 2020, were included in the research. The research was carried out in two stages. The purpose of the first stage was to obtain information that would allow characterizing indicators of CPM (total calcium, ionized calcium, phosphorus, total vitamin D (25-hydroxyvitamin D), and parathyroid hormone) and bone turnover (osteocalcin, P1NP, alkaline phosphatase (bone formation markers), and β-Cross Laps (bone resorption marker)) in patients with LC, and the purpose of the second stage was to find out their diagnostic value for assessing bone structure disorder of them. To perform research, an experimental group (EG) (72 patients with impaired bone mineral density (BMD)), which was divided into EG A (46 patients with osteopenia) and EG B (26 patients with osteoporosis), and a comparison group (18 patients with normal BMD) were formed. The control group consisted of 20 relatively healthy people. At the first stage, it was established that the frequency of cases of increased alkaline phosphatase content was statistically significantly different in LC patients with osteopenia and osteoporosis (p=0.002), as well as with osteoporosis and normal BMD (p=0.049). Impaired BMD in general had significant direct stochastic relationship with vitamin D deficiency, decrease in osteocalcin content and increase in P1NP content in serum (Yule's Coefficient of Association (YCA))>0.50); osteopenia - with decrease in phosphorus content, vitamin D deficiency and increase in P1NP content (YCA>0.50); and osteoporosis - with vitamin D deficiency, decrease in osteocalcin content, increase in P1NP content, and increase in alkaline phosphatase content in serum (YCA>0.50). Significant inverse stochastic relationship was recorded between vitamin D insufficiency and each of the impaired BMD manifestations (YCA<-0.50), which most likely indicates that it is characteristic of normal BMD. At the second stage, it was found that among indicators of CPM and bone turnover, only increase in alkaline phosphatase content in serum can be diagnostically valuable marker of osteoporosis in patients with LC (р<0.050; YCA>0.50; coefficient contingency=0.32), which has medium sensitive (80.77%) and positive predictive value (70.00%) for it. Although other indicators of CPM and bone turover did not confirm their diagnostic value in our research, they may be useful for monitoring pathogenetic changes in bone structure disorder and evaluating the effectiveness of their treatment in patients with LC. Indicators of calcium-phosphorus metabolism and bone turnover, which are characteristic of bone structure disorder and its absence in patients with liver cirrhosis, were revealed. Among them, an increase in alkaline phosphatase content in serum, which is a moderately sensitive marker of osteoporosis, is diagnostically valuable.

CHARACTERISTICS OF THE AUTONOMIC NERVOUS SYSTEM STATE, ASSESSED BY THE HEART RATE VARIABILITY STUDY IN CIRRHOTIC PATIENTS WITH SYNTROPIC CARDIOMYOPATHY AND ITS FEATURES DEPENDING ON THE QT INTERVAL DURATION

The patients with liver cirrhosis (LC) have autonomic nervous system (ANS) imbalance that can be evaluated by the heart rate variability (HRV) study. ANS imbalance results into cirrhotic cardiomyopathy (CCMP) and the most easily diagnosed feature of CCMP is the prolonged QT interval. Usually, in the literature not all HRV parameters are characterized, or their assessment period is short, not allowing covering all the important moments and therefore needing further study. In a randomized way with the preliminary stratification by the presence of LC 33 patients after signing the informed consent were examined. In addition to routine screening methods, all patients underwent 24-hour ECG monitoring. Patients with LC and syntropic CCMP have the ANS disorders with a HRV decrease, predominance of the sympathetic over the parasympathetic system, heart rate regulation at the humoral-metabolic level. The ANS disorders severity depend on the LC severity according to C. G. Child-R. N. Pugh criteria. During the analysis of the received results the significant positive correlation between the SDNN index and maxQT, avg QT, positive correlation between HF and max QTc, avg QTc were found. The diagnostic sensitivity of SDNN index and HF was high in the patients with LC and CCMP. The ANS imbalance can be regarded as syntropic comorbid disorder in the cirrhotic patients. The diagnostic sensitivity of SDNN index and HF was found to be high in the patients with LC and CCMP, serving as diagnostic markers of CCMP.

BONE MINERAL DENSITY AND THE PREVALENCE OF ITS DISORDERS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND SYNTROPIC COMORBID LESIONS

The state of bone mineral density has not been properly examined yet in patients with systemic lupus erythematosus (SLE) and the pathogenetically associated syntropic comorbid lesions of organs and systems. In a randomized manner, after stratification by the presence of SLE, we enrolled 123 premenopausal women aged 21 to 51 years into the study. Patients with SLE, depending on the diagnosed pathogenetically associated syntropic comorbid lesions of organs and systems, were stratified into twenty groups (with hemorrhagic vasculitis, capillaritis, Raynaud syndrome, atherosclerosis, livedo reticularis, venous thrombosis, myocarditis, secondary hypertension, stable angina, pneumonitis, pneumosclerosis, autoimmune hepatitis, steatohepatitis, chronic pancreatitis, aseptic bone necrosis, arthralgia, myalgia, autoimmune thyroiditis, obesity, and alopecia). The bone mineral density (BMD) was determined for patients in each group through dual-energy X-ray absorptiometry (DXA) scans of the lumbar spine and proximal femur, taking into account the worst T-score result. Having analyzed the data from densitometric examinations of 20 patient groups, we arrived at the following conclusions: a) all patients from seven groups (with hemorrhagic vasculitis, capillaritis, stable angina, autoimmune hepatitis, steatohepatitis, aseptic bone necrosis, autoimmune thyroiditis) had reduced BMD disorders, and the largest proportion of patients with normal BMD were from the group with syntropic venous thrombosis; b) there was only one group of patients (with stable angina) without the cases of the first degree osteopenia, and the largest proportion of such patients was in the group with syntropic venous thrombosis; c) there was only one group of patients (with aseptic bone necrosis) without the cases of the second degree osteopenia, and the largest proportion of such patients was in the group with stable angina; d) there were patients with the third degree osteopenia in all groups, and the largest proportion of the third degree osteopenia cases was in the group with stable angina; e) there were no cases of osteoporosis in groups with syntropic venous thrombosis and stable angina, and the largest proportion of osteoporosis cases was in the groups with syntropic autoimmune hepatitis; the prevalence of osteoporosis is significantly higher than the prevalence of normal BMD and the first degree osteopenia in patients with atherosclerosis and chronic pancreatitis; the prevalence of osteoporosis is also significantly higher that the prevalence of normal BMD and all degrees of osteopenia in patients with autoimmune hepatitis.

THE PECULIARITIES OF AVERAGE VALUES OF THE INDICES OF NON-VIRUS LABORATORY MARKERS OF ACTIVE EPSTEIN-BARR VIRUS INFECTION IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Epstein Barr Virus (EBV) originates from the subgroup of herpes viruses which have infected more than 90,0 % of adults worldwide. A special importance is attached to its affection of the patients with Systemic Lupus Erythematosus (SLE). We still have not found out which indices of active virus infection for SLE patients are the most productive and informative. We have involved 120 patients with the diagnosis of SLE. The results of the evaluation of changes in blood parameters indicate that in patients with active EBV infection the average hemoglobin content is significantly lower, and the average number of monocytes, the average content of AlT, C-RP, total protein and γ-globulins is significantly higher than in patients without active EBV infection. There are also significantly higher values of anti-dsDNA and ANA in patients in the experimental group and a lower average value of the total complement, which may indicate a negative effect of the active virus on the immune system in patients with SLE. The patients with SLE with active EBV infection have the features of the average values of non-viral laboratory markers which are reliably higher than for those infected without active virus replication and they are the indices of hyperalaninamino- transferaseemia, the content of C-reactive protein, of the average caption of antibodies to double-stranded deoxyribonucleic acid and the caption of antinuclear antibodies; the average values of the indices of average content of hemoglobin are also reliably lower as well as the index of a total complement. The regularities of changes of the indices of the conducted research discovered in the process of our research allow us to suspect active EBV Infection for the patients with SLE. The ultimate verification of this needs the application of direct serological tests.

ANALYSIS OF THE INDEXES OF CALCIUM AND PHOSPHORUS EXCHANGE, THE MARKERS OF THEIR REGULATION AND INDEX OF THE ACTIVITY OF SYSTEMIC LUPUS ERYTHEMATOSUS

In the article we have analyzed the interrelations of the indexes of calcium and phosphor exchange, the markers of their regulation and the indexes of Systemic Lupus Erythematous activity. As a result of an examination of 123 premenopausal women with systemic lupus erythematosus and 25 mostly healthy women at premenopausal status of a relative age it was established that: according to the average values, the indexes of total calcium, ionized calcium, phosphor in the blood, phosphor in the daily urine, parathormone for the patients with Systemic Lupus Erythematous and healthy people did not differ. The content of calcium in the urine was authentically higher, while the content of vitamin D for the patients with Systemic Lupus Erythematous was lower in comparison to the healthy ones. There is a direct authentic connection between the content of calcium in urine and the activity index by SLEDAI that is why it is possible to claim that in case of the decrease of the illness activity the excretion of calcium in kidneys increases. A total index of activity by SLEDAI intercorrelates with the content of vitamin D in blood serum, namely the rise of activity by SLEDAI leads to the decrease of the vitamin D content in the blood serum.

THE EFFECT OF OXIDATIVE STRESS ON THE AUTONOMIC NERVOUS SYSTEM IN PATIENTS WITH LIVER CIRRHOSIS

Aim - to investigate the effect of oxidative stress on the autonomic nervous system state in patients with liver cirrhosis. In a randomized way with the preliminary startification by the presence of LC 81 patients - 55 (67.9%) males, 26 (32.1%) females, aged 46.9±10.8 years were included to the study after the signing the informed cosent. All the patients underwent the comprehensive clinical laboratory and instrumental examination of all organs and systems in accordance with the requirements of the modern medicine.Among the indicators of redox homeostasis the content of malondialdehyde (MDA) and of catalase (CAT) were determined. The study of autonomic nervous system (ANS) status was carried out using the registration of heart rate variability (HRV) before and after the physical activity. The results were processed on a personal computer in Statistica 6.0, RStudio v. 1.1.442 and R Commander v.2.4-4 using descriptive statistics. The difference was considered statistically significant if p<0.05. The results of HRV time parameters analysis before the physical activity revealed that MDA content negatively correlated with mean duration of NN (RR) intervals (RRNN), standard deviation of NN intervals (SDNN), the square root of the mean squared differences of successive NN interval (RMSSD), percent of consecutive NN intervals with difference more then 50 mc between (pNN 50%), percent of variation coefficient (CV%) and positively - with heart rate. This is verified by the fact that the CAT content positively correlated with RRNN, SDNN, RMSSD, pNN 50% and negatively - with heart rate.The results of the study of HRV spectral analysis correlation relationships revealed that MDA content negatively and CAT - positively correlated with total power (TP), high frequency (HF), low frequency (LF), very low frequency (VLF), LF/HF index, percent of very low frequency (%VLF), percent of low frequency (%LF), percent of high frequency (%HF). The results of analysis of HRV time analysis parameters after the physical activity revealed that the MDA content negatively correlated with CV% and the content of CAT positively correlated with SDNN, CV%. The results of the study of the correlation relationships of the HRV spectral analysis parameters after the physical activity revealed that the content of CAT positively correlated with TP, LF, VLF. Oxidative stress and the antioxidant defense system activity lack, as important pathogenetic parts of vascular tone dysfunction, have a significant effect on the ANS in patients with LC, causing the predominance of the sympathetic branch activity over the parasympathetic one. Oxidative stress, triggering the relevant pathogenetic mechanisms has an effect on the autonomic nervous system in patients with liver cirrhosis. However, the realization of the dominant influence of the sympathetic branch of the autonomic nervous system is minimized due to the decrease in the sensitivity of receptors to vasoconstrictors, including to neurotransmitters.

THE PECULIARITIES OF THE STATE OF THE AUTONOMIC NERVOUS SYSTEM ESTIMATED BY THE METHOD OF HEART RATE VARIABILITY IN PATIENTS WITH CIRRHOSIS AND SYNTROPIC DAMAGES OF CARDIOVASCULAR SYSTEM

In the article the features of the autonomic nervous system state were estimated by the method of heart rate variability in patients with cirrhosis with syntropic damages of cardiovascular system - cardiomyopathy and arterial hypotension. As a result of an examination of 50 patients with liver cirrhosis and cardiomyopathy (investigational group A), 54 patients with liver cirrhosis and arterial hypotension (investigational group B), and 45 patients with liver cirrhosis also those who don't have the damages of cardiovascular system (group of comparison) it was established that: 1) they have the peculiarities of vegetative imbalance the characteristics of which are the low summarized activity of vegetative influence on heart rhythm and special dynamics of indexes of percentage structure of general spectral power; 2) they depend on the clinical variant of this damage - in patients with cirrhosis and syntropic cardiomyopathy the regulating of internal processes involve the humoral-metabolic influence, i.e. local vasoactive conjunctions, catecholamines, renin-angiotensin-aldosterone system, with a simultaneous influence of sympathetic system and activity reduction of parasympathetic vegetative nervous system, and in patients with cirrhosis and syntropic arterial hypotension - the internal regulation involves the local humoral-metabolic factors with the lack of both sympathetic and parasympathetic parts of vegetative nervous system.

CHARACTER AND FREQUENCY OF THE VARIATIONS OF CO- AND POLYMORBID SYNTROPIC EXTRAHEPATIC LESIONS AND THEIR DEPENDENCE ON THE HEPATOPULMONARY SYNDROME SEVERITY DEGREE IN CIRRHOTIC PATIENTS

In this study, we comprehensively examined 93 patients with liver cirrhosis, selected in a randomized manner, with the preliminary stratification by the presence of hepatopulmonary syndrome with the aim to study the nature and frequency of extrahepatic syntropic lesions of organs and systems and their dependence on the severity of lung injury that is necessary for the appointment of the most effective individualized comprehensive treatment. The results of our calculations showed that with the increasing of the hepatopulmonary syndromeseverity degree, the nature and the frequency of the syntropic co- and polymorbid functional and organic extrahepatic lesions of the organs and body systems was significantly (p<0.05) changing. Also some polymorbid disorders' combinations and/or combined variants of the syndromes and nosologies have been increasing in case of growing the severity of the hepatopulmonary syndrome, that shows their significant (p<0.05) dependency.

DEPENDENCE OF HEART RATE IN TERMS OF THE DAILY MONITORING INDICATORS ON THE ACTIVITY OF PATHOLOGICAL PROCESS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

The article studies the dependence of indicators of daily monitoring of heart rate on the pathological process activity in patients with systemic lupus erythematosus. As a result of examination of 83 patients (71 women and 12 men aged 17 - 68) with the first, second and third levels of disease activity (first, second and third group respectively) it was found that: 1) the average, maximum and minimum heart rate in patients with systemic lupus erythematosus during the day is significantly higher than the comparable figures in healthy individuals and the dependence of the increase of heart rate on the progress of disease activity was demonstrated by the results of the evaluation of minimum heart rate and in patients with the third degree of disease activity; 2) the vast majority of indicators of heart rate in patients with systemic lupus erythematosus, evaluated separately in active and passive periods of the day, were above the comparable indicators in healthy individuals and higher in the active period compared to the passive, with statistical significance of differences in average and maximum heart rate; 3) the regularity of an increase of average, maximum and minimum heart rate with the increase of activity of systemic lupus erythematosus is characteristic of patients with high activity of the disease (third degree) and is more pronounced in passive (night) period.