Філіппова, О.Ю. (2017) Структурні зміни печінкової тканини у хворих з жировою хворобою печінки неалкогольного та алкогольного генезу на тлі ожиріння і патології біліарного тракту за даними ультразвукового дослідження. Одеський медичний журнал, № 4 (162). pp. 52-60. ISSN 2226-2008
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Abstract
Цель работы - исследовать акустическую характеристику печеночной ткани у больных неалкогольной и алкогольной жировой болезнью печени (ЖБП) на фоне ожирения (ОЖ) и патологии билиарного тракта (БТ) в зависимости от индекса массы тела (ИМТ). Обследовано 300 больных ЖБП неалкогольного и алкогольного генеза в сочетании с ОЖ и патологией БТ. Для диагностики стеатоза печени использовали ультразвуковой метод исследования. Анализ структурных изменений органов пищеварения содержал оценку размеров, контуров, акустической структуры и эхогенности печени, определяли косой вертикальный размер правой доли печени и кранио-каудальный размер левой доли печени, состояние билиарной системы. Характерными признаками акустического строения печени у больных ЖБП неалкогольного и алкогольного генеза в сочетании с ОЖ и патологией БТ были увеличение размеров, неоднородность и повышение акустической плотности структуры с дистальным затуханием звука, которые зависели от параметров ИМТ. Relevance. Ultrasonographic diagnosis of fatty infiltration of the liver is important in each clinical case, especially when there is a combined course of fatty liver disease. Аim. To investigate the acoustic characteristics of the liver tissue of patients with nonalcoholic and alcoholic fatty liver disease (FLD) on the background of obesity (OB) and pathology of the biliary tract (BT), depending on the body mass index (BMI). Materials and methods. Surveyed 300 patients with FLD non-alcoholic and alcoholic origin in combination with the OB and pathology of BT. For the diagnosis of liver steatosis has used ultrasound methods. The analysis of structural changes of the digestive system contained an assessment of the size, contours, acoustic structure and echogenicity of the liver was determined oblique vertical dimension (OVD) of the right lobe of the liver and cranio-caudal dimension (CCD) of the left lobe of the liver, as the biliary system. BMI was determined according to the Quetelet formula. Depending on the degree of increase in BMI, each groups of patients with nonalcoholic steatosis (NAHS), nonalcoholic steatohepatitis (NASH), alcoholic steatosis liver (AHS), alcoholic steatohepatitis (ASH) and associated OB were divided into three groups: BMI 25-29.9 kg/m2 – overweight; with a BMI of 30-34.9 kg/m2 – OB I degree; with BMI 35-39.9 kg/m2 – OB IІ degree. Results and their discussion. NAHS and NASH in the background of the increase in BMI lead to different degrees the increase of the size of the right lobe of the liver (rs=0.598, р<0.001 and rs=0.682, р<0.001) and left lobe of the liver (rs=0.501, р<0.001 and rs=0.590, р<0.001) and OVD (rs=0.509, р<0.001 and rs=0.665, р<0.001) and CCD (rs=0.505, р<0.001 and rs=0.618, р<0.001) and a significant increase in column distal attenuation of sound in right and left lobes of the organ in patients with NAHS (rs=0.462, р<0.001 and rs=0.368, р<0.01) and indices of acoustic density in patients with NASH (rs=0.397, р<0.001 and rs=0.459, р<0.001). The increase in BMI in patients with AHS and ASH leads to a significant increase in the size of the right lobe of the liver (rs=0.552, р<0.001 and rs=0.722, р<0.001) and left lobe of the liver (rs=0.706, р<0.001 and rs=0.376, р<0.01) and OVD (rs=0.518, р<0.001 and rs=0.673, р<0.001) and CCD (rs=0.749, р<0.001 and rs=0.338, р<0.05). Conclusion. The characteristic features of the acoustic structure of the liver in patients with FLD non-alcoholic and alcoholic origin in combination with the OB and pathology BT was the increase in size, heterogeneity, and the increase in acoustic density structures with distal sound attenuation, which depend on parameters BMI.
| Item Type: | Article |
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| Uncontrolled Keywords: | non-alcoholic fatty liver disease, alcoholic fatty liver disease, obesity, body mass index, biliary tract, diagnostic ultrasound. неалкогольная жировая болезнь печени, алкогольная жировая болезнь печени, ожирение, индекс массы тела, билиарный тракт, ультразвуковая диагностика. |
| Subjects: | Internal Medicine Obesity Hepatology |
| Divisions: | Departments > Department of Internal Medicine 2 and phthisiology |
| Depositing User: | Анастасия Жигар |
| Date Deposited: | 26 Sep 2018 12:42 |
| Last Modified: | 26 Sep 2018 12:42 |
| URI: | http://repo.dma.dp.ua/id/eprint/3274 |
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