CHANGES IN FIBROSIS UNDER THE INFLUENCE OF TREATMENT OF PATIENTS WITH ALCOHOLIC CIRRHOSIS OF THE LIVER IN COMBINATION WITH OBESITY USING ADEMETHYANINIUM AND ARGININE GLUTAMATE

Abstract

Aim: to study the changes in liver parenchymal fibrosis under the influence of treatment of patients with alcoholic liver cirrhosis in combination with obesity using ademethionine and arginine glutamate.
 Material and methods. 215 patients, diagnosed with alcoholic liver cirrhosis (ALC), took part in the study, including 66 women and 149 men aged (48.1±9.7) years and a median disease duration (5.8 ± 2.6) years. 109 people had ALC with obesity (group I) and 106 people had ALC without obesity (group II). Patients were divided into subgroups depending on the stage of decompensation according to Child-Pugh: class A – group IA (n=40), class B – group IB (n=39), class C – group IC (n=30) and IIA (n=39), IIB (n=36), IIC (n=31) groups, respectively. Depending on the treatment protocol (b protocol – basic therapy, h protocol – basic therapy in combination with ademethionine and arginine glutamate), all patients were divided into subgroups.
 Results. In patients with ALC in combination with obesity, the elasticity of the liver parenchyma according to shear wave elastography and the FIB-4 index were higher than classes A, B and C compared to those in patients with ALC without obesity. According to the study results, obese patients with ALC had a more severe course of ALC according to the Child-Pugh and MELD scores. There is a direct relationship between the level of fibrosis in patients with ALC in combination with obesity according to elastography and the FIB-4 index with the severity of the disease according to the Child-Pugh ad MELD scores. The inclusion of ademethionine and arginine glutamate in the treatment regimen has improved the general condition of patients, compensated for clinical and laboratory parameters and reduced the rate of progression of liver fibrosis.
 Conclusion. In patients with ALC in combination with obesity, the inclusion in the treatment of ademethionine and arginine glutamate has improved the course of the disease, as evidenced by changes in the parameters of the disease severity by Child-Pugh and MELD scores, and helped to reduce the rate of progression of liver fibrosis according to elastography and the FIB-4 index.