Медицинский совет (Oct 2019)
Alcoholic liver disease: a modern look at diagnosis and treatment
Abstract
Alcohol is one of the leading etiological factors in liver damage. In alcoholic liver disease (ALD), hypoxia occurs due to an imbalance between the energy requirement of hepatocytes and energy production in the mitochondrial oxidative phosphorylation system. Diagnosis of ALD includes the taking of an anamnesis, questioning of patients, clinical examination data, laboratory and instrumental study. For the treatment of ALD, agents are used that protect cell membranes from oxidative stress factors and restore the energy potential of cells under conditions of tissue hypoxia. One such hepatotropic infusion is Remaxol®, the original polyionic succinatemethionine complex based on succinic acid. Aim of the study: to consider the effects of using Remaxol® infusion drug in the group of ALD patients. Materials and methods: treatment of 40 patients (male) with ALD was carried out, all of whom had a distinct history of the disease with regular and prolonged alcohol abuse. The duration of the disease in the group was 4.8 ± 0.7 years. Initially, all of them showed increased lipid peroxidation, depression of antioxidant protection, as well as pronounced sings of cytolysis, cholestasis and lipid metabolism. Then, all patients in the group were treated with Remaxol®. The course of treatment ranged from 5 to 10 daily intravenous drip infusions. After treatment, the parameters of lipid peroxidation malondialdehyde (MDA), diene conjugates (DC), enzymes of antioxidant system catalase (Cat), superoxide dismutase (SOD), glutathione peroxidase (GP), markers of cytolysis, cholestasis and lipid metabolism were again investigated in the serum of patients. Results of the study: a positive effect after monotherapy with Remaxol® was observed in 34 patients, which amounted to 85% of the group. They recorded a significant decrease in lipid peroxidation and a compensatory increase in antioxidant system enzymes. The indicators of cytolysis and cholestasis syndromes significantly decreased, lipid metabolism was restored, and the subjective status of patients improved. There were no side effects during the treatment with Remaxol® in the group of patients with ALD. Conclusions: It was noted that therapy with Remaxol® caused positive laboratory dynamics in 34 patients, which amounted to 85% of all treated patients with ALD. Thus, it has been shown that therapy with Remaxol® is an effective method of treating alcoholic liver disease.
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