UDK: 616.24-002.5:615.015.26:616.36-002 (04)
M. V. Koroleva
Волгоградский государственный медицинский университет
A comparative, prospective, open, randomized, parallel group study was conducted. 60 patients with acute toxic hepatitis, which developed due to poisoning with alcohol substitutes were recruited.The effectiveness of treatment was assessed considering the dynamics of the Lille index, Maddrey’s discriminant function, MELD index, immune status, duration of hospital treatment. We revealed that this pathology is characterized by intermittent clinical course with intense pruritus, pronounced intrahepatic and persistent cholestasis with fatty or ballooning degeneration of hepatocytes, infiltration of the portal tracts and focal necrosis, hyperbilirubinemia and cytolytic syndrome. We also found an imbalance in T-cell immu nity with hypoimmunosupression of CD3, CD4, CD16, decreased immune-regulatory index, increased levels of cytotoxic CD8- lymphocytes, overproduction of TNF-, IL-4 and IL-6 correlated with the severity of liver damage. The increased doses of prednisolone, ursosan, as well as higher number of sessions of plasmapheresis did not yield the expected positive effect. We proved the advisability of using taurine (Dibikor) and pyridoxine-L-2-pyrrolidone-5-carboxylate (Metadoxyl) in the combined therapy of toxic hepatitis.
toxic hepatitis, alcohol substitutes, dibikor, metadoxyl.
Королева Марина Владимировна — к. м. н., докторант кафедры клинической фармакологии и интенсивной терапии, Волгоградский государственный медицинский университет, врач-гастроэнтеролог МУЗ ГКБ СМП № 25, г. Волгоград, e-mail: mvkoroleva2012@yandex.ru