PECULIARITIES OF THE CLINICAL COURSE OF NON-ALCOHOLIC STEATOHEPATITIS AND STEATOSIS OF THE LIVER AT COMORBID WITH CHRONIC KIDNEY DISEASE I-III STAGE

А.А. Antoniv
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Abstract

Purpose - to establish clinical peculiarities of the clinical course of the liver nonalcoholic steatosis (NALS) and steatohepatitis (NASH) at comorbidity with chronickidney disease (CKD) (chronic pyelonephritis) I-III stage.Material and methods. We have examined 444 patients: 84 patients with non-alcoholicadipose liver disease (NAALD) with obesity I degree (I group), containing 2 subgroups -32 patients with NALS and 52 patients with NASH; 270 NAALD patients with comorbidobesity I degree and CKD I-III stages (group 2), including 110 patients with NALS and160 patients with NASH. The control group consisted of 90 patients with CKD I-III stagewith normal body weight.Results. Clinical peculiarities of the liver non-alcoholic steatosis at comorbidity withCKD are a significant prevalence, in comparison with the clinical course without kidneypathology, of the frequency of manifestation of astheno-vegetative (70,9% to 40,6%),dyspeptic (33,6% to 18,8%), cholestatic (30,9% to 15,6%) syndromes, hepatomegaly(97,3% - 71,8%), predominance of steatosis II and III degree (47,2% and 31,8% to 25,0% and 15, 6% at NALS without kidney pathology). High frequency of asthenovegetative(98,1% to 61,5%) syndrome, dyspepsia (79,4% to 59,6%), discomfort in the rightsubcostal area (84,4% to 32,7%), cholestasis (37,5% to 17,3%), hepatomegaly (100,0%to 86,5%), prevalence of steatosis II and III degree (58,1% and 26,3% to 32,7% and11,5% at NASH without kidney pathology) is peculiar for non-alcoholic steatohepatitisclinical course at comorbidity with CKD as compared to the course without kidneypathology.Conclusions. Thus, the clinical course of nonalcoholic steatosis and steatohepatitis atcomorbidity with obesity and chronic kidney disease (CKD) is characterized by higherfrequency and intensity of the clinical and biochemical syndromes.
慢性肾脏疾病i-iii期合并非酒精性脂肪性肝炎和肝脏脂肪变性的临床病程特点
目的:探讨肝脏非酒精性脂肪变性(NALS)和脂肪性肝炎(NASH)合并慢性肾盂肾炎(CKD) I-III期临床病程的临床特点。材料和方法。我们研究了444例患者:84例非酒精性脂肪性肝病(NAALD)合并I级肥胖(I组),包含2个亚组-32例NALS患者和52例NASH患者;270例合并I级肥胖和CKD I- iii期的NAALD患者(2组),其中110例合并NALS, 160例合并NASH。对照组为90例体重正常的I-III期CKD患者。与无肾脏病理的临床病程相比,合并ckd的肝脏非酒精性脂肪变性的临床特点是显著流行,表现为植物性衰弱(70.9%至40.6%)、消化不良(33.6%至18.8%)、胆汁淤滞(30.9%至15.6%)综合征、肝肿大(97.3%至71.8%)、II和III级脂肪变性(在无肾脏病理的NALS中分别为47.2%和31.8%至25.0%和15.6%)。与无肾脏病理的非酒精性脂肪性肝炎合并CKD的临床病程相比,高频率出现植物性无力综合征(98.1% ~ 61.5%)、消化不良(79.4% ~ 59.6%)、右肋下区不适(84% ~ 32.7%)、胆汁淤滞(37.5% ~ 17.3%)、肝肿大(100.0% ~ 86.5%)、II级和III级脂肪变性(58.1% ~ 26.3% ~ 32.7% ~ 11.5%)。因此,非酒精性脂肪变性和脂肪性肝炎合并肥胖和慢性肾脏疾病(CKD)的临床病程以临床和生化综合征的更高频率和强度为特征。
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