Вплив альбуміну на показники системного запалення та ендотеліальної дисфункції у хворих на алкогольний цироз печінки у поєднанні з ожирінням

Abstract

The aim of the study was to study the effect of albumin on the indicators of systemic inflammation and endothelial dysfunction in patients with ACL in combination with obesity. Material and Methods. The study included 52 patients with ACL in combination with obesity (confirmed before the onset of ascites) with the first-onset uncomplicated ascites of grade 2-3, 46 men and 6 women aged 35 to 59 years; 32 patients were diagnosed with Child-Pugh score of class B, and 20 with Child-Pugh score of class C. Depending on the treatment, the patients were divided into 2 groups: Group I included 26 patients who received albumin 40.0 g/week in combination therapy for 2 weeks of inpatient treatment, and 20.0 g/week for 12 weeks of outpatient treatment, followed by a maintenance dose of 20.0 g/month (10.0 g/2 weeks) for 12 weeks; Group II included 26 patients who received basic therapy without albumin. The control group was comprised of 20 virtually healthy donors. The patients' condition, indicators of systemic inflammation and endothelial dysfunction were assessed before treatment, 12 and 24 weeks after the treatment onset. Results and Discussion. Within 24 weeks, all patients in both groups remained alive. In obese patients with ACL, the inclusion in the complex therapy of long-term use of albumin helps to improve the course of the disease according to the Child-Pugh score. The use of albumin in the complex treatment of patients with ACL in combination with obesity during 12 weeks helps to reduce the systemic inflammatory process in terms of hs-CRP and TNFa and to reduce endothelial dysfunction in terms of ADMA and IAP-1. The use of maintenance albumin therapy helps to stabilize the process with a tendency for further reduction of the indicators of CRP, TNFa, ADMA and IAP-1. Increased systemic inflammation and endothelial dysfunction are reported in patients who did not receive long-term albumin therapy. Conclusions. The use of albumin at a dose of 20.0 g/week during 12 weeks of outpatient treatment helps to improve the course of ALC in combination with obesity according to the Child-Pugh score, along with a decrease in systemic inflammation and endothelial dysfunction. The use of maintenance therapy with albumin of 20.0 g/month during 12 weeks helps to stabilize the patient's condition with a tendency to further reduction of the incidence of systemic inflammation and endothelial dysfunction. Key words: alcoholic liver disease; liver cirrhosis; obesity; inflammation; endothelial dysfunction