THE USE OF COMBINED HEPATOPROTECTORS LESFAL VIT FOR COMPLEX TREATMENT AND PREVENTION OF TOXIC HEPATITIS IN PATIENTS WITH LYMPHOPROLIFERATIVE DISEASES

Abstract

According to the data of modern epidemiological and statistical research, recently, in Ukraine, a significant increase in the incidence rate of chronic liver disease has been noted. The course is accompanied by the exhaustion of the system of antioxidant protection and on its background a chronic intoxication with metabolic disorders develops that adversely affects the functional state of the liver.

The aim of the study – to learn the effectiveness of the complex hepatoprotector Lesfal VIT as a part of combined therapy in patients with hemoblastosis.

Materials and Methods. We observed 29 patients with lymphoproliferative diseases: 5 with acute lymphoblastic leukemia, 15 with chronic lymphoid leukemia, 9 with non-Hodgkin's lymphoma, 6 with non-Hodgkin’s lymphoma due to small lymphocytes, and 3 with non-Hodgkin’s lymphoma due to large granular cells. The age of the patients ranged from 32 to 67 years. The average duration of the disease was 5–6 years. All patients underwent ultrasound examination of abdominal cavity organs and biochemical parameter estimation of liver function, namely, alanine aminotransferase, aspartate aminotransferase, bilirubin, alkaline phosphatase, thymol and Takata-Ara tests.

Results and Discussion. In addition to complaints of the underlying disease (like general weakness, dizziness, malaise, heaviness in the lower extremities), the patients were also concerned about the heaviness and sensation of disassembly in the right hypochondrium, nausea. Occasionally, jaundice of the skin and mucous membranes was noted. With ultrasound examination in 22 patients an increase in liver size was observed. In most cases the liver was enlarged because of the simultaneous expansion of both right and left lobes. In 19 patients, there was an increase in ALT and AST, and in 11 patients, there was also an increase in total bilirubin due to its indirect fraction. The activity of the process largely corresponded to moderate degree in 58.7 % of cases, and to a severe degree in 21.3 % of cases. At time of receiving both mono- and polychemotherapy, the severity of toxic effects on the state of hepatocyte function increased, as was indicated by liver tests. Thus, ALT and AST elevations were observed, as well as an increase in alkaline phosphatase and total bilirubin due to its indirect fraction. In 5 patients with hemoblastomas jaundice of skin and eye sclera was observed.

Conclusions. As a consequence of combined treatment with the use of the drug Lesfal VIT a marked positive change in the clinical course of the main disease developed, which manifested itself in improvement of the state of patients’ health, their general condition and in the disappearance of heaviness sensations in the right hypochondrium. As a result of therapy an analysis of indicators of functional liver tests showed a decrease in the activity of the inflammatory process in the hepatocytes that was indicated by ALT, AST, total bilirubin, alkaline phosphatase level reduction. In patients with minimal and moderate activity, the levels of these indicators returned to normal values and in patients with severe activity they significantly decreased comparingly to initial values. Also, the positive effect of the drug on the protein metabolism has been established, as evidenced by an increase in the serum total protein.