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№2' 2014
GASTROENTEROLOGYInternational Medical Journal, Vol. 20., Iss. 2, 2014, P. 29−32.
NONALCOHOLIC STEATOHEPATITIS AND PATHOGENETIC CORRECTION METHODS
Kharkiv Medical Academy of Postgraduate Education
Increase in the incidence of nonalcoholic fatty liver disease (NAFLD), which can be a component of the diseases associated with insulin resistance (metabolic syndrome, type 2 diabetes mellitus, obesity). has been noted recently. The problems of diagnosis and treatment of NAFLD are urgent. Main tasks of treatment of the patients with NAFLD are reduction of steatosis and steatohepatitis, prevention of liver fibrosis and liver cell failure. To investigate dynamically the influence of Hepadif in complex therapy on the metabolic indices, the levels of proinflammatory cytokines and LP we investigated 40 patients with nonalcoholic steatohepatitis. In all patents the diagnosis was verified with ultrasonography and clinical laboratory methods (ALT, AST, lipid profile, TBA active metabolites, NO, TNF−α and IL−6). Positive dynamics (significant reduction of liver cytolytic enzymes activity, p<0.001, normalization of lipid metabolism levels, p<0.001) was noted against a background of the administered treatment. Investigation of cytokine profile parameters after the treatment revealed significant reduction of proinflammtory cytokines level: TNF−α (p<0.001) and Il−6 (p<0.001). The analysis of LP indices demonstrated significant reduction of TBA active metabolites (p<0.001) and nitrogen oxide (p<0.001). After the course of treatment asthenovegetative syndrome was observed in 2 (5,0%) of patients, discomfort and heaviness in the right hypochondrium in 3 (7.5%), liver enlargement in 4 (10,0%) patients. The obtained findings suggest the influence of combination treatment with L−carnitine, antihypoxants and folic acid on the pathological chains in nonalcoholic steatohepatitis development. Administration of Hepadif, Actovegin and folic acid in combination therapy improved the general condition of the patients, normalized biochemical parameters, and prevented the disease progress.
Key words: nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, lipid peroxidation, cytokines, L−carnitine.