Abstract
The aim of the study was to evaluate the effect of the succinatecontaining antioxidants Reamberin and Cytoflavin on (1) free radical oxidation of lipids and functioning of the antioxidant system in patient with alcoholic liver disease and hepatic encephalopathy and (2) severity of hepatocellular dysfunction. Material and methods. Prospective study involved 150 patients with alcoholic liver disease divided into three groups: Group 1 (n=50), Group 2 (n=50) and the control group (n=50). Patients of two main experimental groups (Group 1 and Group 2) received antioxidants in addition to conventional basic therapy: patients of Group 1 were administered with Reamberin, whereas in Group 2 Cytoflavin was administered. Intensive care for the patients of the control group did not include any antioxidants. The study involved assessment of the clinical course of hepat ic encephalopathy, biochemical markers of hepatic cell dysfunction, and indicators of lipid oxidation and antioxi dant defense system of the body. Nonparametric statistic methods were used for evaluation of the results. Results. All examined patients had an increased intensity of free radical oxidation of lipids and low general antioxidant activity demonstrating oxidative distress. Patients from groups 1and 2 exhibited significant improve ment in cognitive and motor functions, positive dynamics of the clinical course of the disease and hepatocellular dysfunction. There was also a trend towards normalization of free radical oxidation of lipids antioxidant para metrs of blood. Conclusion. Administration of succinatecontaining drugs in alcoholic liver disease resulted in reduction of the period of patients' stay at the Intensive Care Unit and improved longterm effects manifested as prolonged periods of clinical remission of hepatic encephalopathy.
Highlights
Алкогольная болезнь ввиду универсальности поражения может рассматриваться как «хроничес кая полиорганная недостаточность» [1, 2]
Psychometric testing demonstrated that improvement in hepatic encephalopathy manifesta tions such as reduction in time spent on test with numbers, copying lines and symbolicnumerical test were more pronounced in patients Group 1 (Table 1)
Before the studies ammonia levels in venous blood was elevated in all hepatic encephalopathy patients, but it was not as high as 2—3 fold than in norm, which was consistent with the literature data on the level of ammonemia in patients with liver cir rhosis [11, 12, 17, 18]
Summary
Алкогольная болезнь ввиду универсальности поражения может рассматриваться как «хроничес кая полиорганная недостаточность» [1, 2]. Последняя в сочетании с прямым токсическим действием этанола обуславливает из быточное образование активных форм кислорода, что ведет к дисбалансу в системе перекисного окисления липидов и антиоксидантной защиты организма — оксидативному дистрессу [4, 6, 8, 9]. Активация свободнорадикального окисления в тканях головного мозга ведет к повреждению гема тоэнцефалического барьера, отеку головного мозга и гибели нейронов, усугубляя проявления пече ночной энцефалопатии [1, 10,11,12,13,14,15,16]. Нарушение функционального состояния печени и клиничес кие проявления заболевания возникают, как пра вило, уже при наличии глубоких, часто необрати мых, изменений этого органа [1, 2]. Все вышеизложенное диктует необходимость проведе ния у подобных пациентов комплекса мероприя тий посиндромной интенсивной терапии в услови ях реанимационных отделений и сопряжено с большими финансовыми затратами [3]
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