Abstract

Annotation. Liver cirrhosis is characterized by an increase in morbidity and prevalence, life-threatening complications, disability and increased mortality of the working population. The aim of the study was to study the effect of albumin on the course of alcoholic liver cirrhosis in combination with obesity at the stage of decompensation. The study included 52 patients with alcoholic liver cirrhosis in combination with obesity (confirmed before the onset of ascites) with the primary uncomplicated ascites of 2-3 degrees, 46 men and 6 women aged 35 to 59 years; 32 patients were diagnosed with class B and 20 – with class C according to the Child-Pugh score. Depending on the treatment, patients were divided into 2 groups: Group I included 26 patients who received in their combination therapy albumin 40.0 g/week 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; 24 weeks after the start of treatment, 16 patients gave their consent and continued maintenance therapy for another 24 weeks. Group II included 26 patients who received basic therapy without albumin. Assessment of patients was performed before treatment, 12, 24, 48 weeks after treatment onset; in 96 weeks – according to medical documentation. Statistical processing of the results was performed using software Microsoft Excel spreadsheet and application package Statistica v. 12.0 StatSoft, USA. In patients with alcoholic liver cirrhosis in combination with obesity, the inclusion in the complex therapy of long-term use of albumin improves the course of the disease according to the Child-Pugh score, MELD, DMF and CLIF-SOFA indices. There was a reduce the recurrence of ascites, the number of complications, a re-hospitalization within a year, an increase in the survival of patients within 48 months. No side effects of albumin were noted. Thus, long-term use of albumin in complex treatment of patients with alcoholic liver cirrhosis in combination with obesity contributes to an increase in the effectiveness of treatment.

Highlights

  • Liver cirrhosis (LC) is characterized by an increase in morbidity and prevalence, life-threatening complications, disability and increased mortality of the working population [1, 13]

  • The study included 52 patients with alcoholic liver cirrhosis in combination with obesity with the primary uncomplicated ascites of 2-3 degrees, 46 men and 6 women aged 35 to 59 years; 32 patients were diagnosed with class B and 20 - with class C according to the Child-Pugh score

  • In patients with alcoholic liver cirrhosis in combination with obesity, the inclusion in the complex therapy of long-term use of albumin improves the course of the disease according to the Child-Pugh score, MELD, DMF and CLIF-SOFA indices

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Summary

Introduction

Liver cirrhosis (LC) is characterized by an increase in morbidity and prevalence, life-threatening complications, disability and increased mortality of the working population [1, 13]. Alcoholic LC (ALC) leads to the loss of 22.2 million years of life, taking into account disability [10, 15]. Treatment of LC, especially at the stage of decompensation, is rather complicated due to the variety of links in the pathogenesis, metabolic disorders of a number of drugs in the affected liver, the need for an individual approach; it is usually expensive, but not effective enough [9, 13]. A new concept and prospects for the treatment of decompensated LC includes long-term use of albumin in combination therapy [6, 7]. The aim of the study was to study the effect of albumin on the course of ALC in combination with obesity at the stage of decompensation

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