НеалкогольНая жировая болезНь печеНи и атерогеННая дислипидемия. какие проблемы возНикают у кардиолога?

Abstract

The article examines the modern concepts of non-alcoholic fatty liver disease as a component of metabolic syndrome, as well as the experience of studying lipid-lowering effect of the drug ursodeoxycholic acid (drug «Ursodez» manufacturer JSC «Northern Star», Russia) as monotherapy and in combination with statins. Materials and Methods. On the basis of clinical gastroenterology department of the hospital FKUZ NFM Russian Ministry of Internal Affairs in the Republic of Tatarstan was a clinical study, the effectiveness of combination therapy with a statin drug and ursodeoxycholic acid («Ursodez» manufacturer JSC «Northern Star», Russia) and monotherapy with ursodeoxycholic acid («Ursodez» manufacturer JSC «Northern Star», Russia), including 45 patients with metabolic syndrome and signs of NAFLD by ultrasound. Patients were divided into 3 groups. Patients of Group 1 (n — 15) received a standard dose of a statin 20 mg/day ( from this group of patients was excluded from the active stage to steatohepatitis or increase of transaminases more than 3 times the upper limit of normal) . The second group consisted of patients with elevated transaminases more than 3 times and have contraindications to statins , they received ursodez a daily dose of 10 mg / kg for 3 months. The third group of patients were classified with atherogenic dyslipidemia , syndrome cytolysis taking statins in doses of 10 mg per day in combination with ursodezom 10 mg/kg per day. Results. In one group of patients treated with statins, total cholesterol decreased by 1,4% in a month, by 2,9% in 2 months and 5,8% by the end of the third month of treatment, LDL cholesterol decreased by 2,1—6,4% by the end of the third month on 17%, triglycerides decreased after 3 months to 10,5 %, the ratio decreased by atherogenic 14, 25, 38%, respectively. HDL cholesterol increased by 37,5% by the end of the third month . In the group of patients receiving ursodez percentage reduction of triglycerides and LDL cholesterol was lower than in patients taking statins. Increasing HDL in both groups comparable In the third group of patients had greater significant reduction in total cholesterol, LDL cholesterol, triglycerides, atherogenic factor, increase HDL cholesterol compared to patients receiving monotherapy with statins or Ursodez.