CHANGES IN INDICATORS OF ENDOGENOUS INTOXICATION, IMMUNEINFLAMMATORY REACTION AND ENDOTHELIAL DYSFUNCTION UNDER THE INFLUENCE OF TREATMENT OF PATIENTS WITH ALCOHOLIC LIVER CIRRHOSIS IN COMBINATION WITH OBESITY USING ADEMETHIONINE AND ARGININE GLUTAMATE

Abstract

The аim of research was to investigate the effect of a complex treatment with ademethionine and arginine glutamate on the state of endogenous intoxication, immune-inflammatory reaction and endothelial dysfunction in patients with alcoholic liver cirrhosis (ALC) in combination with obesity. Methods. 215 patients, diagnosed with ALC, took part in the study, including 66 women and 149 men. 109 people had ALC with obesity and 106 people had ALC without obesity. Patients were divided into subgroups depending on the stage of decompensation according to Child-Pugh. Depending on the treatment protocol (b protocol – basic therapy, h protocol – basic therapy in combination with ademethionine and arginine glutamate), all patients were divided into subgroups. Results. In patients of groups I and II who received the h protocol, at the stage of compensation, subcompensation and decompensation, the indicators of sorption capacity of erythrocytes (SCE), leukocyte index of intoxication (LII), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNFα), asymmetric dimethylarginine (ADMA) and the resistin level significantly improved (p<0.05). In patients of groups I and II, who received basic treatment, at the stage of compensation such indicators worsened, but no significant difference was observed before and after treatment (p>0.05). At the stage of subcompensation and decompensation in patients of groups I and II, who received basic treatment, SCE, LII, hs-CRP, TNFα, ADMA and the resistin level significantly worsened (p<0.05). Conclusions. Inclusion in the complex treatment of ademethionine and arginine glutamate for obese patients with ALC helps to reduce the manifestations of endogenous intoxication, immune-inflammatory reaction and endothelial dysfunction.