J Clin Med Kaz 2014;1(31):38-44
Corrections of Cholestasis in the Conditions of Comorbid Liver Pathology
Authors: Mariya Derbak, Serhiy Tsyapets, Gabriela Tsyapets
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The aim: the study of methods of correction at syndrome of cholestasis at patients with chronic hepatitis C (CHC) and type 2 of diabetes mellitus (DM), which for diverse reasons antiviral therapy (AVT) was not got.
Methods. In this prospective comparative study was included 98 patients with CHC and type 2 of diabetes mellitus (44 males and 54 famels), middle age 58,5 ± 2,7 years. Depending on the variants of the conducted therapy three groups were formed. The patients of the I group (n=30) got monotherapy of ademetioninom by 800 mg of intravenosis 1 times daily during 10 days, with a further peroral reception 1600 mg in a day, dividing the dose of preparation into two receptions (in the morning and in the evening) 20 days. The reception of ademetionina was repeated on 4-th, 8-th and 12-th months of treatment.
To the II group of patients (n=32) monotherapy of UDCA was appointed for 13-15 mg/kg of body wait for the night during 12 months. The third group of patients (n=36) got the combined therapy of UDCA+ademetionin in the higher offered dosages. The course of treatment for all of groups made 12 months. A kind and doses of hypoglycemic therapy remained without changes during all of period of treatment.
Results. In all of three groups of patients it is set that diminishing of clinical syndromes is marked in 3 months of treatment: astenovegetative, dispeptic and pain in the right upper quadrant. To the end of supervision these syndromes were saved not more than in one tenth part of patients not dependency upon the type of treatment.
More expressive improvement of clinical and laboratory indexes is marked at patients, which accepted ursodeoxycholic acid (UDCA ) and ademetionin on the developed chart by comparison to monotherapy of UDCA or ademetioninom due to positive influence on the syndrome of cholestasis, level of dislipidemi and biochemical indexes of blood serum.
Conclusion. Taking into account influence of the combined therapy on the different links of pathogenesis of comorbid pathology, deem it wise to utillize it in treatment of patients with chronic hepatitis C and type 2 of diabetes mellitus.