Liver functional state parameters in patients with nonalcoholic fatty disease associated with liver cardiovascular pathology in the dynamic of treatment
DOI:
https://doi.org/10.15587/2313-8416.2016.63016Keywords:
liver nonalcoholic fatty disease, liver functional state parameters, combined therapyAbstract
Aim. The liver functional state disorders at liver nonalcoholic fatty disease (LNAFD) were described in numerous researches carried out earlier but the data about the intensity degree of these disorders at LNAFD clinical course associated with hypertonic disease (HD) and ischemic heart disease (IHD) are absent or contradictory. The aim of this research was the study of liver functional state in patients with LNAFD at its isolated clinical course and also in combination with HD and IHD with following determination of influence of the offered differentiated complex therapy on studied parameters.
Methods. There were examined 140 patients with LNAFD divided into 3 groups: I – patients with LNAFD, II – patients with LNAFD associated with HD, III patients with LNAFD associated with HD and IHD. Parameters of the liver function state (general blood bilirubin level, transaminases, gammaglutalyltranspeptidase, thymol test and alkaline phosphatase) were studied in patients of all groups before and after 12 month differentiated complex therapy. Basis therapy of LNAFD that received patients of all groups included metformin (2000 mg/day) and ursodeoxycholic acid (750 mg/day) in combination with recommendations about the way of life modification. In addition to basis therapy patients of the II group received lisinopril (2,5 mg/day with dose titration) and patients of III group – combination of lisinopril (2,5 mg/day with dose titration) and carvedilol (3,125 mg/day with dose titration). Statistic processing of the results was carried out using the common methods of parametric and nonparametric statistics.
Results. Analysis of the received results demonstrated that patients with LNAFD had intense disorders of liver functional state and its intensity increased with addition of HD to LNAFD and especially of combination of HD and IHD. On the background of complex therapy in patients of all groups was formed the reliable tendency to normalization of liver functional state parameters especially intense in patients of III group that is probably explained by the mutual potentiation of lisinopril and carvedilol effects.
Conclusions. In patients with LNAFD there are intense disorders of liver functional state that are aggravated at addition of HD and especially of combination of HD and IHD to the main disease. Addition of lisinopril to the basis therapy of LNAFD in patients of II group and especially of combination of lisinopril and carvedilol in patients of III group allow attain the reliable tendency to normalization of the liver functional state parameters
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