Терапевтический архив (Feb 2020)
Evaluation of the effectiveness of differentiated therapy of non-alcoholic fatty liver disease
Abstract
Aim.Study of the effectiveness of differentiated therapy of non-alcoholic fatty liver disease taking into account the clinical and pathogenetic features of its course. Materials and methods.168 patients with non-alcoholic fatty liver disease were examined, 108 of them were women and 60 men aged from 30 to 70 years. For treatment, depending on the characteristics of the course of the disease, 3 groups of patients were formed. The first group included patients (n=47) with liver steatosis with a high content of lipids in the blood and an increased atherogenic coefficient; they received therapy with ursodeoxycholic acid with atorvastatin. The second group consisted of patients (n=65) with liver steatosis with an increased level of glycemia, insulin and insulin resistance, they were prescribed therapy with ursodeoxycholic acid and metformin. Patients of the third group (n=56) with steatohepatitis with concomitant bacterial overgrowth received еssentiale forte H therapy with rioflora immuno. Clinical data, blood biochemical parameters, insulin and HOMA-IR levels, intestinal microbiota status, as well as regression of liver steatosis and steatohepatitis were evaluated in the dynamics of treatment. Results.In the dynamics of treatment, there was a decrease in the clinical manifestations of the disease in all observed groups of patients, an improvement in lipid metabolism and indicators of the functional state of the liver, a decrease in excessive bacterial growth. On the basis of ultrasound, elastography and fibrotest, the reverse development of liver steatosis was found in 20% and steatohepatitis in 66.6% of patients. Conclusion.The data obtained indicate the feasibility of differentiated treatment of patients with non-alcoholic fatty liver disease depending on thecharacteristics of its course and stage.
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