CLINICAL ASPECTS OF CHRONIC PANCREATITIS IN COMBINATION WITH VIRAL HEPATITIS C
DOI:
https://doi.org/10.11603/1811-2471.2019.v0.i2.10371Keywords:
chronic pancreatitis, viral hepatitis C, coprogram, structural state of the pancreas, clinical courseAbstract
The article analyzes the peculiarities of the combined course of chronic pancreatitis with viral hepatitis C. Studies conducted showed the negative effects of concomitant viral hepatitis C on the course of chronic pancreatitis, which was expressed more marked clinical pathological features compared with the group of isolated chronic pancreatitis.
In recent years, attention has increased to the infectious agent, whose influence may lead to the development of inflammation in the pancreas. Significant spread of viral hepatitis C among the population, the diversity of its extrahepatic manifestations condition the relevance of the problem. The inadequacy of the development of issues of primary and secondary prevention of chronic pancreatitis motivates a deeper study of the mechanism of its development against the background of viral hepatitis C.
The aim of the study – the clinical course of chronic pancreatitis in patients with concomitant viral hepatitis C.
Materials and Methods. A total of 57 patients with chronic pancreatitis with concomitant viral hepatitis C were examined. The comparison group consisted of 20 persons with chronic pancreatitis. In order to establish a clinical diagnosis of chronic pancreatitis and viral hepatitis C, all patients were examined in accordance with the protocols adopted for patients on orders No. 638 of the Ministry of Health of Ukraine dated September 10, 2014 and No. 729 of the Ministry of Health of Ukraine dated July 18, 2016. Diagnosis of chronic pancreatitis and viral hepatitis. They were verified on the basis of the medical history, clinical manifestations and research results. General clinical and biochemical examinations were performed in patients with chronic pancreatitis in the phase of exacerbation and unstable remission, patients with viral hepatitis C – in the phase of stable remission.
Results. In the clinical course of chronic pancreatitis with concomitant viral hepatitis C, pain, dyspeptic syndromes, and defecation were taken the leading place. They were more pronounced than in the comparison group (a significant difference in the parameters of the group of isolated chronic pancreatitis (p<0.05)). Patients with chronic pancreatitis with concomitant viral hepatitis C had mild anemia, decreased blood albumin, hyperbilirubinemia, hypercholesterolemia, elevations in ALT and AST, blood amylase and urinary diastase (p<0.05). In patients with chronic pancreatitis with concomitant viral hepatitis C, the total level of coprograms in points was (5.20±0.82), and in patients with chronic pancreatitis (3.10±0.32); Significantly lower levels of indicators were detected, more pronounced inflammatory syndrome and dysbiosis. In the two study groups, steatorrhea of type II prevailed. The depth of structural changes in the pancreas according to the data of ultrasound in the group of patients with chronic pancreatitis with concomitant viral hepatitis C was (2.56±1.10) points, which corresponds to the process of moderate severity, in the group of isolated chronic pancreatitis – (1.90±0.60) points.
Conclusions. According to the study data, the negative effect of the concomitant viral hepatitis C on the clinical course of chronic pancreatitis was established.
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