Optimized treatment of patients with alcoholic steatohepatitis taking into account comorbid anaemic conditions and H.pylori contamination

Abstract

The prospective study of patients with alcoholic steatohepatitis (ASH) showed that 40 % of patients with ASH were diagnosed with anaemic conditions (AC), among which vitamin B12-deficiency anaemia was registered - in 17.5% of cases, anaemia of chronic disease (ACD) – in 10.0% of cases and hemolytic anemia (HA) - in 12.5% of cases. In patients with SH of mixed (including alcoholic) etiology AC was found in 32.0%: vitamin B12 - deficient - in 16.0%, ACD - in 8.0% and hemolytic - in 8.0 % of patients. In patients with ASH, H. pylori contamination was present in 32 (80.0%) individuals, including 100% of patients with B12-deficient anaemia. Among patients with SH of mixed (including alcoholic) etiology, H. pylori was detected in 100.0% of people with AS. The use of Hepadif in the complex therapy of ASH contributed to the elimination or reduction of the intensity of the main clinical syndromes (astheno-vegetative, dyspeptic, cholestatic, hepato-, splenomegaly, hepatic steatosis) and biochemical syndromes (mesenchymal-inflammatory cholestasis, hepatocellular insufficiency), in the range of 1.3-4.3 times (p <0.05), as well as higher efficiency of treatment of patients with ASH with anaemic syndrome in 6.0 times (p <0.05). The efficiency of eradication of H. pylori in the main and control groups accompanied by the use of the 3-component programme of the first line according to the stool test was the same (85.7% and 84.2% (p> 0.05), respectively), but in 57.9 % of patients in the control group, the symptoms of dyspepsia increased or appeared on the background of antibacterial therapy, while no side effects of the drug were found during the study in the main group.