AN INFLUENCE OF CHRONIC BRONCHITIS EXACERBATION ON THE COURSE OF ALCOHOLIC LIVER CIRRHOSIS
DOI:
https://doi.org/10.11603/2415-8798.2017.2.7817Keywords:
alcoholic liver cirrhosis, chronic bronchitis course.Abstract
Alcoholic cirrhosis of the liver is a diffuse disease characterized by fibrosis and transformation of the normal liver architectonics with the replacement of the last connective tissue and the formation of nodes, and the main cause of its occurrence is a systematized permanent abuse of moderate or large doses of alcohol.
The aim of the study – to assess the influence of exacerbation of chronic bronchitis on the course and progression of the alcoholic liver cirrhosis (ALC).
Materials and Methods. 100 patients with diagnosed alcoholic cirrhosis were examined – (82.00 %) men and (18.00 %) women aged (47.2±3.9): 48 patients with ALC, Child-Pugh class B without combination with chronic bronchitis (CB) (group I) 52 patients with ALC, ChildPugh class B in combination with CB in the acute phase (group II). The control group consisted of 20 healthy individuals. The diagnosis was established according to Adapted clinical guidelines "Alcoholic liver disease" (2014) and protocols providing medical care in the specialty "Gastroenterology" (MOH Ukraine Order # 271 of 13.06.2005), "Alcoholic hepatitis" (MOH Ukraine Order # number 826 of 06.11.2014).
Results and Discussion. It was established that chronic bronchitis exacerbations accompanied by increased frequency of asthenicvegetative (33.81 %), dyspeptic (19.39 %), intoxication (51.29 %) syndromes, jaundice (16.98 %), splenomegaly (19.23 %), the appearance of ascites (21.48 %), indicating the progression of liver cirrhosis decompensation. Cytolytic syndrome in ALC patients with exacerbation of chronic bronchitis manifested an increase in bilirubin 4.5 times, an increase in AST activity – in 4.8 times, ALT – 5.7 times HHTP – 5.6 times, whereas in patients with ALC but without CB these indicators increased 3.7 times, 2.8 times, 1.9 times, 3.8 times, respectively, compared with healthy. Cholestatic syndrome in ALC patients with exacerbation of chronic bronchitis characterized by an increase in activity of ALP and HHTP in 4.5 times and 5.6 times, respectively; whereas in ALC patients without exacerbation of chronic bronchitis these indicators increased less so in 3.6 times and 3.8 times compared to healthy. Patients in both groups marked increase in INR values above the standard indicators respectively 1.5 times for patients of group I and 2.4 times for the group II.
Conclusions. En exacerbation of concomitant chronic bronchitis in patients with ALC contributes to the progressive course of the disease and its decompensation increasing cytolytic, mesenchymal-inflammatory and cholestatic syndromes and intensification of liver failure.
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