PATHOMORPHOLOGY OF FIBROSING PROCESSES IN THE LIVER AND LUNGS IN PATIENTS WITH NON-ALCOHOLIC STEATOHEPATITIS AND OBESITY AT COMORBIDITY WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Objective - to study the histochemical and histological features of the liver and lungtissues in patients with non-alcoholic steatohepatitis (NASH) and obesity under conditionof a comorbid course with chronic obstructive pulmonary disease (COPD).Material and methods. The autopsy material of 27 cases with NASH, including 13 casesof NASH and obesity of I degree (group 1), 14 cases of NASH, obesity of I degree withcomorbid COPD of II-III stage (group 2) was used. The groups of comparison includedautopsy material of 12 patients with isolated COPD of II-III stage (Group 3), as wellas 11 practically healthy persons (PHP), their main causes of death were polytraumaor traumatic brain injury or sudden coronary death. The groups were randomizedaccording to age, sex, degree of obesity. The average age of patients was (59,3 ± 3,21)years.Results. The volume of the connective tissue (CT) in the liver parenchyma in the 2nd groupwas in 1,9 times higher than in the 1st group (p<0,05), the specific volume of collagenfibers in 1,4 times, the optical density of collagen fibers by 1,2 times (p<0,05). In the 2ndgroup, the maximum damage to the respiratory parts of the lungs (RPL) was establishedin terms of percentage of filling of the RPL spaces with desquamated cells (in 9.4 times incomparison with PHP, by 1,3 times compared to the indicator in the 3rd group); specificvolume growth of the blood vessels in the peribronchial CT by 1,4 times (p<0,05). Thephenomena of venous thrombosis are most pronounced both in the peribronchial CT(they exceed the indicator in the 3rd group by 1,2 times) and respiratory parts of the lungs(by 2,4 times) (p<0,05). Patients of the 2nd group had the highest values of the specificvolume of CT in the lungs among all groups under study (19,8 ± 0,37 (p <0,05)).Conclusions. The comorbidity of COPD in patients with NASH and obesity contributedto the higher degree of activation of the connective tissue components in the liverparenchyma in comparison with the NASH indicators against a background of obesitywithout COPD, with an increase in the volume of the connective tissue (in 1,9 times,p<0,05), specific volume collagen fibers (by 1,4 times, p<0,05), optical density ofcollagen fibers coloring (in 1,2 times, p<0,05).