Vіsnik Naukovih Doslіdžen' (Nov 2017)
THE USE OF HEPADIF COMBINED HEPATTROTECTOR FOR COMPLEX TREATMENT AND PREVENTION OF TOXIC HEPATITIS IN PATIENTS WITH HEMOBLASTOSIS
Abstract
According to the modern epidemiological and statistical studies, recently, in Ukraine, a significant increase in the incidence rate of chronic liver disease was noted. The course is accompanied by the exhaustion of the antioxidant system against to the background of chronic intoxication with metabolic disorders that adversely affect the functional state of the liver. The aim of the study – to learn the effectiveness of the combined hepatoprotector Hepadif as a part of complex therapy in patients with hemoblastomas. Materials and Methods. We observed 33 patients with hemoblastomas (3 acute lymphoblastic leukemias, 5 with acute myeloid leukemia, 13 with chronic lymphoid leukemia, and 11 patients with chronic myeloid leukemia) aged 32–67 years. The average duration of the disease was 4–6 years. All patients underwent ultrasound examination of the abdominal cavity (ultrasound examination) and biochemical parameters of the liver function, namely, alanine aminotransferase, aspartate aminotransferase, bilirubin, alkaline phosphatase, timolol and sulam samples. Results and Discussion. In addition to complaints of the underlying disease (which is general weakness, anomalies, heaviness in the lower extremities, dizziness, mischief), the patients were concerned about the severity and sensation of dislocation in the right hypochondrium, nausea. Occasionally, jaundice of the skin and mucous membranes was observed. With ultrasound examination in 17 patients, an increase in liver size was observed. The liver was enlarged at the expense of both particles. In 27 patients, there was an increase in ALT and AST , and in 11 patients, increased bilirubin was observed due to an indirect fraction. The activity of the process mostly corresponded to an average of 67.7 %, and a pronounced 22.3 % degree. In the process of obtaining both mono and polychemotherapy, the activity of the severity of toxic effects on the state of hepatocyte function increased, as indicated by an increase in liver samples. Thus, ALT and AST elevations were observed, as well as an increase in alkaline phosphatase, bilirubin due to an indirect fraction. Conclutions. Thus, in the complex treatment of patients with hemoblastomas, the use of the combined preparation Hepadif, which has a wide spectrum of pharmacological action, namely detoxification, antihypoxic, anti-inflammatory, metabolic effects of its components, is substantiated. Such a wide range of pharmacological action of the drug has identified the possibility of using it in the complex treatment of patients with hemoblastomas, both for the treatment of toxic hepatitis and its prevention. In patients treated with Hepadif on the background of cytostatic therapy, a statistically significant normalization of the biochemical parameters characterizing the state of the liver function was found. Correction of the liver status allowed for all patients to have planned cytostatic treatment. At the end of the course of mono- or polychemotherapy, no liver function deterioration was observed in any patient. Thus, as a result of the study, it was found that in patients with oncohematological diseases in order to prevent hepatotoxicity against the background of chemotherapy and to reduce the severity of already developed manifestations of hepatopathy, it is necessary to add to the protocol of treatment of preparations of pathogenetic therapy of the cytolysis syndrome. The protective effect of the combined drug Hepadif will reduce the amount of forced changes in protocols of polychemotherapy associated with liver damage. In most patients, improve the tolerability of mono and polychemotherapy, improve the quality of life of patients during treatment and rehab.
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