Філіппова, О.Ю. (2017) Динаміка показників обміну сполучної тканини у пацієнтів з неалкогольним стеатогепатитом у поєднанні з ожирінням і патологією біліарного тракту на тлі комплексного лікування. Вісник проблем біології і медицини, № 1 (№4(139). pp. 282-285. ISSN 2077-4214
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Abstract
Досліджено вплив комплексного лікування (профілактичних та лікувальних заходів) на показники обміну сполучної тканини у хворих з неалкогольним стеатогепатитом (НАСГ) у поєднанні з ожирінням і патологією біліарного тракту. Отримані результати дослідження свідчать, що комбінована терапія з включенням до стандартного лікування препаратів урсодезоксихолієвої кислоти та аргініну глутамату при коморбідному перебігу НАСГ може розглядатися як перспективний напрямок в лікуванні цієї категорії пацієнтів, який дозволяє добитися поліпшення основних метаболічних показників обміну сполучної тканини та зворотному розвитку фіброзу печінки. The presence of liver fibrosis in patients with NAFLD associated with the highest mortality rates from liver disease and the risk increases with increasing extent of fibrosis. The aim of the work to evaluate the influence of different schemes of complex treatment on the indexes of connective-tissue metabolism in patients with nonalcoholic steatohepatitis combined with obesity and pathology of the biliary tract, according to 6-month followup. Оbject and methods. The study involved 100 patients with nonalcoholic fatty liver disease (NAFLD) in the stage of non-alcoholic steatohepatitis (NASH) associated with obesity (OB) and pathology of the biliary tract (BT). The control group consisted of 30 practically healthy persons. The process of liver fibrosis was evaluated according to the content of hydroxyproline free, total hydroxyproline and protein binding hydroxyproline, hexosamines and copper. To assess the effectiveness of different treatment NAFLD all patients were divided into 3 groups by the method of adaptive randomization. Patients of all groups for 6-months was assigned to the correction of lifestyle: diet, exercise, work and rest. Patients of the 1st group (n=34) received standard treatment for 30 days. Patients of the 2 nd group (n=33) were prescribed standard treatment combined with the use of ursodeoxycholic acid (UDCA) for 30 days at a dose of 10-15 mg/kg/day. Patients of the 3rd group (n=33) received standard treatment and UDCA combined with the use of arginine glutamate for 30 days. All immunological tests were performed at the beginning and at the end of treatment in all patients and 6 months after treatment in 20 patients in each group of observation. Results. The maximum efficiency of the stabilizing effect on the metabolism of collagen was set in the analysis parameters in patients 2 groups and 3 groups with the availability of reliable intergroup difference on the level of protein binding hydroxyproline (p<0.05). A possible mechanism restore the balance of synthesis and degradation of collagen was the activation of collagenolysis under the influence of complex therapy with inclusion of drugs UDCA or UDCA and arginine glutamate (2 and 3 groups). Conclusions. In patients with NASH combined with OB and pathology BT revealed activation processes of the connective tissue and the imbalance between the processes of synthesis and degradation of extracellular matrix components with the prevalence of processes fibrogenesis. Combined therapy with the inclusion of the standard treatment of ursodeoxycholic acid of arginine glutamate in comorbid course NASH can be considered as a perspective direction in treatment of this category of patients, which allows an improvement in metabolic indicators of connective tissue metabolism and promotes regression of liver fibrosis.
| Item Type: | Article |
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| Uncontrolled Keywords: | неалкогольний стеатогепатит, ожиріння, біліарний тракт, показники обміну сполучної тканини, урсодезоксихолієва кислота, аргініну глутамат. non-alcoholic steatohepatitis, obesity, biliary tract, indicators of exchange of connective tissue, ursodeoxycholic acid, arginine glutamate. |
| Subjects: | Internal Medicine |
| Divisions: | Departments > Department of Internal Medicine 2 and phthisiology |
| Depositing User: | Анастасия Жигар |
| Date Deposited: | 19 Oct 2018 11:08 |
| Last Modified: | 19 Oct 2018 11:08 |
| URI: | http://repo.dma.dp.ua/id/eprint/3399 |
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