Interrelationship of the endothelial dysfunction markers in endothelial dysfunction in purulent cholangitis in patients, suffering chronic hepatitis and without chronic hepatitis on background of obturation jaundice
Abstract
Objective. Studying of interrelationship of the endothelial dysfunction markers in endothelial dysfunction in purulent cholangitis in patients, suffering chronic hepatitis and without chronic hepatitis on background of obturation jaundice, revealing of its early transition into hepatic cirrhosis and optimization of the treatment tactics in pre- and postoperative periods with estimation of the laboratory tests indices investigated.
Маterials and methods. The investigation was conducted in 15 patients with purulent cholangitis, of them in 9 patients was chronic hepatitis, in 6 patients chronic hepatitis was absent. Of 9 patients, suffering chronic hepatitis, in 4 antiviral therapy was not conducted, while in 5 - conducted.
Results. Immediate results of the diagnosis-treatment investigation conducted witnesses about similar signs of endothelial dysfunction in purulent cholangitis in patients, suffering chronic hepatitis and without chronic hepatitis.
In all the patients, suffering purulent cholangitis, decompression of biliary ducts was accomplished, the obturation causes were eliminated, detoxication therapy was conducted.
In accordance to correlation analysis of indices of the endothelium functional state in patients, suffering chronic hepatitis, who obtained antiviral therapy, improvement was noted on the 10th day, in 1 mo it was more significant, than in patients, who did not obtained antiviral therapy.
In 6 patients, suffering purulent cholangitis without chronic hepatitis, a timely surgical, desintoxication treatment with ozonotherapy have resulted in improvement of the endothelial functional state indices on the 10th day, in 1 mo they have approached to norm.
Conclusion. A timely revealing of endothelial dysfunction in purulent cholangitis in patients, suffering chronic hepatitis and without chronic hepatitis, promotes an early prognostication of its transition into stage of hepatic cirrhosis and correct selection of the treatment tactics before and after the operation. Here may be concluded, that in purulent cholangitis in patients, suffering chronic hepatitis, it is expedient to conduct antiviral therapy before and after the operation.
References
2. Friedrich–Rust M, Rosenberg W, Parkes J, Herrmann E, Zeuzem S, Sarrazin C. Comparison of ELF, Fibro Test and Fibro –Scan for the noninvasive assessment of liver fibrosis. BMC Gastroenterology. 2010;(10):103. doi: org/10.1186/1471-230X-10-103.
3. Zvjagincev TD, Gridneva SV. Sovremennye predstavlenija o sosudistom jendotelija v norme i pri patologii zheludochno-kishechnogo trakta. Jeksp Klin Gastrojenterol. 2005;(4):6-12. [In Russian].
4. Tomas H, Baldus S, Rudolph V, Yskert von Kodolitsch, Volker R, Thomas M. Systemic endothelial dysfunction as an early predictor of adverse outcome in heart failure. Article in Arteriosclerosis Thrombosis and Vascular Biology. 2005 June;25(6):1174-9. with 102 Reads. doi: 10.1161/01. ATV.0000166516.52477.81.
5. Rodford JL, Torrens C, Siow RC, Mann GE, Hanson MA, Clough GF. Endothelial dysfunction and reduced antioxidant protection in an animal model of the developmental origins of cardiovascular disease. J Physiol. 2008 Oct 1;586(19):4709-20. doi: 10.1113/jphysiol.2008.156976.
6. De Castro IF, Micheloud D, Berenguer J, Guzmán-Fulgencio M, Catalán P, Miralles P, еt al. Hepatitis C virus infection is associated with endothelial dysfunction in HIV/hepatitis C virus coinfected patients. CLINICAL SCIENCE. AIDS. 2010 Aug 24;24(13):2059-67. doi: 10.1097/QAD.0b013e32833ce54d.
7. Shhekotova AP, Kotel'nikova LP, Mugatarov IN, Fedachuk NN. Jendotelial'naja disfunkcija vospalenie i fibroz pri gepatobiliarnoj patologii. Fundamental'nye issledovanija. 2013;5(2):451-5. [In Russian].
8. Non WM, Lee WH, Khoo HE. Nitric oxide in liver diseases:friend, foe, orjust, passerby. New York Academy of Sciences. 2002;962:275-95. doi: org/10.1111/j.1749-6632.2002.tb04074.x.
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