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Laennec (Human placenta hydrolyzate) in monotherapy of mixed etiology of steatohepatitis Laennec(人胎盘水解物)在脂肪性肝炎混合病因单药治疗中的应用
Pub Date : 2023-10-09 DOI: 10.31146/1682-8658-ecg-216-8-37-47
I. Yu. Pirogova, T. V. Neuimina, O. V. Suchkova, M. N. Flegontova, S. P. Gogoleva, N. M. Gulyants, V. K. Sorokina
Liver regeneration is an important task in the treatment of any liver diseases. The key point is the restoration of the liver structure, regression of fibrosis and steatosis of the liver. Difficulties in the treatment of patients with steatohepatitis of metabolic and alcoholic etiology are associated with comorbidity and multicomponent drug load, problems of lifestyle modification. The use of a complex parenteral drug in the treatment of this group of patients increases patient compliance, minimizes the risks of drug interactions. The aim of the study: to evaluate the effect of course treatment with Laennec on insulin resistance, dyslipidemia, systemic inflammatory response, activity of inflammatory process in the liver, steatosis and liver fibrosis. Materials and methods. The study included 50 patients with steatohepatitis of mixed etiology with the presence of biochemical activity, obesity, dyslipidemia, insulin resistance, are having liver steatosis and liver fibrosis of at least stage 1 (determined by liver fibroscopy). 32 patients received Laennec 6 ml intravenously 3 times a week, then 6 ml intramuscularly once every 10 days up to 24 weeks, 18 patients took Omega 3 PUFAs orally 2000 mg per day for 24 weeks. Results. Significant differences (p<0.05) in the estimated parameters in the group of patients treated with Laennec: decreased activity of the inflammatory process-ALT-21% AST -24%, CRP -21%; GGTP cholestasis syndrome -26%; insulin resistance index -13%; correction of LDL dyslipidemia -17%, triglycerides -17%, CA -18%; liver steatosis- 20%. There was an 8% decrease in triglycerides (p<0,05) in the group receiving Omega 3 PUFAs. Conclusions. The use of Laennec in patients with steatohepatitis initiates a decrease in the activity of the inflammatory process in liver tissue, improves metabolic parameters and liver structure.
肝脏再生是治疗任何肝脏疾病的重要任务。关键是肝脏结构的恢复,肝纤维化和脂肪变性的消退。代谢性和酒精性脂肪性肝炎患者的治疗困难与合并症、多组分药物负荷、生活方式改变问题有关。在这组患者的治疗中使用复杂的肠外药物增加了患者的依从性,最大限度地减少了药物相互作用的风险。本研究目的:评价Laennec疗程对胰岛素抵抗、血脂异常、全身炎症反应、肝脏炎症过程活性、脂肪变性和肝纤维化的影响。材料和方法。该研究纳入了50例混合病因的脂肪性肝炎患者,存在生化活性、肥胖、血脂异常、胰岛素抵抗,肝脂肪变性和肝纤维化至少为1期(由肝纤维镜确定)。32例患者每周静脉注射Laennec 6 ml,每周3次,然后每10天肌肉注射6 ml,连续24周,18例患者口服Omega - 3 PUFAs,每天2000 mg,连续24周。结果。Laennec治疗组的估计参数有显著差异(p<0.05):炎症过程活性降低- alt -21% AST -24% CRP -21%;GGTP胆汁淤积综合征-26%;胰岛素抵抗指数-13%;LDL血脂异常-17%,甘油三酯-17%,CA -18%;肝脏脂肪变性- 20%。在接受Omega - 3 PUFAs的组中,甘油三酯降低了8% (p< 0.05)。结论。在脂肪性肝炎患者中使用Laennec可以降低肝组织炎症过程的活性,改善代谢参数和肝脏结构。
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引用次数: 0
The debut of autoimmune hepatitis after a new coronavirus infection (COVID-19) in an 11-month-old child 一名11个月大的婴儿在新型冠状病毒感染(COVID-19)后首次出现自身免疫性肝炎
Pub Date : 2023-10-09 DOI: 10.31146/1682-8658-ecg-216-8-191-196
T. N. Lebedeva, A. U. Marchukova, K. G. Bondar
In many countries fix cases of severe liver damage in children are recorded. A previous or existing coronavirus infection leads to a disruption in the body’s immune response to infections, which can lead to severe inflammation that caused liver damage. This article describes a clinical case of type 2 autoimmune hepatitis, a high degree of biochemical activity, that debuted in an 11-month-old child after a new coronavirus infection (COVID-19). The presented clinical example demonstrates the need for a thorough and comprehensive examination of children with the first clinical manifestations of liver damage and timely prescription of therapy
在许多国家,记录了儿童严重肝损伤的固定病例。先前或现有的冠状病毒感染会导致人体对感染的免疫反应中断,从而导致严重的炎症,导致肝脏损伤。本文描述了一个在新冠病毒感染(COVID-19)后11个月大的婴儿首次出现的高生化活性的2型自身免疫性肝炎的临床病例。所提出的临床实例表明,需要彻底和全面的检查儿童与肝脏损害的第一个临床表现和及时的治疗处方
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引用次数: 0
Gender differences in the development of experimental liver steatosis in laboratory rats 实验大鼠实验性肝脂肪变性的性别差异
Pub Date : 2023-10-09 DOI: 10.31146/1682-8658-ecg-216-8-127-133
I. A. Bulatova, T. P. Shevlyukova, I. L. Gulyaeva
The aim. To study functional-morphological and biometric changes in the liver and lipid spectrum in an experiment in male and female laboratory rats when modeling fructose-induced liver steatosis. Materials and methods. The experimental study was conducted on 44 non-inbred sexually mature white rats, of which 20 were males aged 8-9 months with a body weight of 400-530 g. and 24 females aged 9-10 months with a body weight of 320-480 g. Modeling of liver steatosis was carried out for 28 days by adding fructose to drinking water throughout the experiment using 15%-th solution of fructose instead of drinking water. At the end of the experiment, body weight was measured, liver sampling for morphometric and histological studies and blood sampling for laboratory studies (transaminase, glucose and lipid spectrum levels) were performed. Results. When comparing body weight before the experiment and after its completion, a statistically significant increase in this indicator was found in females with experimental steatosis (p = 0.031), which indicates the formation of general obesity in them. The mass coefficient of the liver in the experimental groups of males and females with steatosis was significantly higher than in the controls (p= 0.009 and p = 0.009, respectively). During histological examination of liver tissue, the number of hepatocytes with steatosis in males and females in experimental models was significantly higher than in control groups and corresponded to the II-III degree of steatosis. A comparative analysis of the lipidogram parameters revealed that dyslipidemia developed during the formation of liver steatosis in animals of both groups with fructose-induced liver steatosis. Conclusion. In experimental modeling of fructose-induced liver steatosis in animals, regardless of gender, morphological changes in liver tissue are manifested by fatty dystrophy and hepatomegaly, dyslipidemia is registered. At the same time, males develop fermentemia, hyperglycemia without the formation of general obesity. In females, the course of experimental steatosis is accompanied by an increase in body weight without functional changes in the liver.
的目标。研究雄性和雌性实验大鼠在模拟果糖诱导的肝脏脂肪变性时肝脏和脂质谱的功能形态学和生物计量学变化。材料和方法。实验研究对象为44只非近交系性成熟大鼠,其中雄性8-9月龄大鼠20只,体重400-530 g,雌性9-10月龄大鼠24只,体重320-480 g。在整个实验期间,以15%的果糖溶液代替饮用水,在饮用水中添加果糖,进行肝脏脂肪变性模型28 d。实验结束时,测量体重,取肝脏标本进行形态学和组织学研究,取血液标本进行实验室研究(转氨酶、葡萄糖和脂质谱水平)。结果。对比实验前和实验结束后的体重,实验脂肪变性女性的这一指标有统计学意义的增加(p = 0.031),说明她们形成了全面性肥胖。脂肪变性雄性和雌性试验组肝脏质量系数显著高于对照组(p= 0.009和p= 0.009)。在肝组织组织学检查中,实验模型雄性和雌性发生脂肪变性的肝细胞数量明显高于对照组,与II-III级脂肪变性程度相对应。脂质图参数的比较分析显示,两组果糖诱导的肝脂肪变性动物在肝脂肪变性形成过程中出现了血脂异常。结论。在果糖诱导的动物肝脂肪变性实验模型中,无论性别,肝组织形态学改变均表现为脂肪营养不良和肝肿大,记录有血脂异常。与此同时,男性会出现发酵血症、高血糖症,但不会形成一般性肥胖。在女性中,实验性脂肪变性的过程伴随着体重的增加,但没有肝脏功能的改变。
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引用次数: 0
Alcolic liver disease: what’s new in the current decade? 酒精性肝病:最近十年有什么新进展?
Pub Date : 2023-10-09 DOI: 10.31146/1682-8658-ecg-216-8-167-175
D. I. Trukhan
Alcoholic liver disease (ALD) - damage to the liver parenchyma under the influence of ethanol consumption, which can manifest itself in several ways: steatosis, alcoholic hepatitis (steatohepatitis), fibrosis and cirrhosis of the liver. The present review considers publications of recent years (2020-2023) in the Pubmed and Scopus information databases devoted to the study of various aspects of the current state of the problem of alcohol-associated liver pathology. New data on the epidemiology and burden of ALD have been obtained; the pandemic of a new coronavirus infection has had a certain impact on the course of ALD. The study of individual links in the pathogenesis of ALD is actively continuing, a large number of publications are devoted to the participation and role in the pathogenesis of alcohol-associated liver diseases of the “gut-liver” axis. New therapeutic strategies for alcohol-associated liver disease are classified based on their mode of action: (1) anti-inflammatory therapies, (2) antioxidants, (3) therapies that modulate the gut-liver axis, and (4) therapies that enhance liver regeneration. At the same time, the often unfavorable prognosis and insufficient effectiveness of therapy require further study of alcohol-associated liver diseases.
酒精性肝病(ALD) -在酒精消耗的影响下对肝实质的损害,可表现为几种方式:脂肪变性、酒精性肝炎(脂肪性肝炎)、肝纤维化和肝硬化。本综述考虑了近年来(2020-2023年)在Pubmed和Scopus信息数据库中发表的关于酒精相关肝脏病理问题的各个方面的研究。获得了有关ALD流行病学和负担的新数据;新型冠状病毒感染的大流行对ALD的病程产生了一定影响。对ALD发病机制中的个体联系的研究正在积极进行,大量的出版物致力于“肠-肝”轴的酒精相关肝病发病机制的参与和作用。酒精相关肝病的新治疗策略根据其作用方式进行分类:(1)抗炎治疗,(2)抗氧化剂,(3)调节肠-肝轴的治疗,(4)增强肝脏再生的治疗。同时,往往预后不良,治疗效果不足,需要进一步研究酒精相关性肝病。
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引用次数: 0
The development of liver cirrhosis in a patient taking long-term weight loss supplements 长期服用减肥补充剂的患者肝硬化的发展
Pub Date : 2023-10-09 DOI: 10.31146/1682-8658-ecg-216-8-176-183
T. V. Goma, N. M. Kozlova, K. S. Boldyreva
Dietary supplements are often self-administered by patients for weight loss. However, the hepatotoxicity of such supplements remains underestimated. Liver damage is diverse: from asymptomatic reversible course to lethal fulminant hepatitis. In the case of a long unrecognized course and prolonged use of dietary supplements, irreversible structural and functional damage to the organ occurs. We present a retrospective analysis of the case histories of a patient with liver cirrhosis, who has a long history of using dietary supplements of Thai and Chinese origin, hellebore extract, during 5 years of follow-up. Despite the discontinuation of weight loss drugs, regular complex therapy, the patient has a steady progressive course of the disease. Obese patients with an increased risk of liver damage require a dynamic assessment of liver function, not only when prescribing drugs, but also when using various dietary supplements.
膳食补充剂通常由患者自行服用以减轻体重。然而,这种补充剂的肝毒性仍然被低估了。肝损害是多种多样的:从无症状的可逆过程到致命的暴发性肝炎。在长期不明病程和长期使用膳食补充剂的情况下,器官会发生不可逆转的结构和功能损伤。我们提出了一个回顾性分析的病例史肝硬化患者,谁有长期使用泰国和中国的膳食补充剂,希腊提取物的历史,在5年的随访。尽管停止了减肥药,常规的综合治疗,患者的病情仍呈稳定的进展过程。肝损害风险增加的肥胖患者不仅在开药时需要动态评估肝功能,在使用各种膳食补充剂时也需要动态评估肝功能。
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引用次数: 0
Blebbing of the plasma membrane of lymphocytes as a marker of endothelial dysfunction in the development of post-resection insufficiency in patients with focal liver lesions 在局灶性肝病变患者切除术后功能不全的发展中,淋巴细胞质膜起泡作为内皮功能障碍的标志
Pub Date : 2023-10-09 DOI: 10.31146/1682-8658-ecg-216-8-110-115
S. S. Dunayevskaya, N. A. Malinovskaya, A. A. Kosik
Purpose of the study. To evaluate the intensity of blebbing of the plasma membrane of lymphocytes and the formation of microparticles of lymphocytic origin in patients with postresection hepatic failure. Material and methods. The study involved 54 patients with focal liver diseases. The study involved 32 (59%) women, 22 (41%) men. The average age was 59.5 [49.75; 66,00]. Patients were divided into groups, 1 group - 10 patients with developed acute liver failure and 2 group - 44 patients with a favorable course of postoperative period. The following surgical interventions were performed: 36 (67%) patients underwent surgery - laparotomy, segmental liver resection, 10 (18%) - left-sided hemihepatectomy and 8 (15%) - right-sided hemihepatectomy. Results. Predictors of early postoperative hepatic failure are a decrease in initial blebbing and an increase in terminal blebbing and free microparticles of lymphocytic origin. Conclusions. Thus, changes in lymphocyte blebbing and the presence of free microparticles of lymphocytic origin are due to the development of endothelial insufficiency and apoptosis of lymphocytes in the context of liver failure and are determined by the reduced function of residual liver volume.
研究目的:目的:探讨肝衰竭患者淋巴细胞质膜泡的强度及淋巴细胞源性微粒的形成。材料和方法。该研究涉及54例局灶性肝病患者。该研究涉及32名(59%)女性和22名(41%)男性。平均年龄59.5岁[49.75岁;66,00)。患者分为两组,1组10例出现急性肝功能衰竭,2组44例术后病程良好。采取以下手术干预措施:36例(67%)患者接受手术-剖腹手术,肝节段切除术,10例(18%)-左侧半肝切除术,8例(15%)-右侧半肝切除术。结果。术后早期肝功能衰竭的预测因子是初始水泡减少,终末水泡和淋巴细胞来源的游离微粒增加。结论。因此,淋巴细胞起泡的变化和淋巴细胞来源的自由微粒的存在是由于肝衰竭背景下内皮功能不全和淋巴细胞凋亡的发展,并由剩余肝容量功能降低决定。
{"title":"Blebbing of the plasma membrane of lymphocytes as a marker of endothelial dysfunction in the development of post-resection insufficiency in patients with focal liver lesions","authors":"S. S. Dunayevskaya, N. A. Malinovskaya, A. A. Kosik","doi":"10.31146/1682-8658-ecg-216-8-110-115","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-110-115","url":null,"abstract":"Purpose of the study. To evaluate the intensity of blebbing of the plasma membrane of lymphocytes and the formation of microparticles of lymphocytic origin in patients with postresection hepatic failure. Material and methods. The study involved 54 patients with focal liver diseases. The study involved 32 (59%) women, 22 (41%) men. The average age was 59.5 [49.75; 66,00]. Patients were divided into groups, 1 group - 10 patients with developed acute liver failure and 2 group - 44 patients with a favorable course of postoperative period. The following surgical interventions were performed: 36 (67%) patients underwent surgery - laparotomy, segmental liver resection, 10 (18%) - left-sided hemihepatectomy and 8 (15%) - right-sided hemihepatectomy. Results. Predictors of early postoperative hepatic failure are a decrease in initial blebbing and an increase in terminal blebbing and free microparticles of lymphocytic origin. Conclusions. Thus, changes in lymphocyte blebbing and the presence of free microparticles of lymphocytic origin are due to the development of endothelial insufficiency and apoptosis of lymphocytes in the context of liver failure and are determined by the reduced function of residual liver volume.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Functional gastrointestinal disorders in patients with chronic opisthorchiasis and rosacea 慢性蛇胸腺病和酒渣鼻患者的胃肠功能紊乱
Pub Date : 2023-10-09 DOI: 10.31146/1682-8658-ecg-216-8-79-85
S. A. Khardikova, M. L. Aripova, O. I. Urazova, Yu. V. Kolobovnikova
Introduction. Rosacea is a very common disease among dermatological diagnoses, it is from 5% to 20%. Dysfunctional disorders of the gastrointestinal tract are described in rosacea and chronic opisthorchiasis (HO). The study of gastrointestinal pathology as a factor aggravating the course and manifestation of rosacea on the background of HO, is of practical interest. Purpose of research. To study the features of the gastrointestinal tract in patients with rosacea in combination with HO. Materials and methods. 144 patients were examined, including the 1st group consisted of 80 patients with rosacea without opisthorchiasis, the 2nd group-64 patients with rosacea in combination with HO. 3rd control group - 20 healthy volunteers. Patients underwent duodenal intubation with microscopy of bile; ultrasound examination of abdominal cavity; FGDS with the use of endoscope “Olympys” with biopsy of fondling and pyloric stomach; the complex of histological and histochemical methods; the index of the SHDOR to determine the severity of rosacea. Results. Clinical manifestations of rosacea in patients with HO were more pronounced, as evidenced by a high index of SHDOR 11.3 (6;16) points compared to group 1 (p<0.001). In most patients of group 2, according to ultrasound data, changes in the hepatobiliary system (85.9%) and according to the data of the FGDS (96.8%), pathology of the upper gastrointestinal tract (p<0.001) were detected, which was significantly higher than in patients of group 1 and due to the presence of HO. In patients of group 2, histological changes in the stomach were inflammatory-degenerative. Summary. Examination of the gastrointestinal tract (duodenal sounding with microscopy of bile, ultrasound, FGDS) in patients with rosacea in combination with HO is recommended in practical health care, which will contribute to timely deworming, and as a consequence, positive dynamics in the clinical course of rosacea.
介绍。酒渣鼻是皮肤科诊断中非常常见的疾病,占5% ~ 20%。胃肠功能失调是描述在酒渣鼻和慢性蛇胸腺病(HO)。在HO背景下,胃肠道病理作为加重酒渣鼻病程和表现的因素进行研究,具有实际意义。研究目的。探讨酒渣鼻合并HO患者的胃肠道特点。材料和方法。144例患者接受检查,其中第一组为80例无蛇胸病的酒渣鼻患者,第二组为64例合并HO的酒渣鼻患者。第三组——20名健康志愿者。患者行十二指肠插管,显微镜下观察胆汁;腹腔超声检查;“奥林匹斯”内窥镜下的FGDS,并对抚摸和幽门胃进行活检;组织和组织化学方法的结合;确定酒渣鼻严重程度的SHDOR指数。结果。HO患者的酒渣鼻临床表现更为明显,SHDOR指数为11.3(6;16)分,较1组高(p<0.001)。2组多数患者超声资料显示肝胆系统改变(85.9%),FGDS资料显示上消化道病变(96.8%)(p<0.001),明显高于1组患者和HO的存在。2组患者胃组织学变化为炎性退行性。总结。在实际的医疗保健中,建议酒渣鼻患者联合HO进行胃肠道检查(用胆汁显微镜、超声、FGDS检查十二指肠),这将有助于及时驱虫,并因此对酒渣鼻的临床病程产生积极的影响。
{"title":"Functional gastrointestinal disorders in patients with chronic opisthorchiasis and rosacea","authors":"S. A. Khardikova, M. L. Aripova, O. I. Urazova, Yu. V. Kolobovnikova","doi":"10.31146/1682-8658-ecg-216-8-79-85","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-79-85","url":null,"abstract":"Introduction. Rosacea is a very common disease among dermatological diagnoses, it is from 5% to 20%. Dysfunctional disorders of the gastrointestinal tract are described in rosacea and chronic opisthorchiasis (HO). The study of gastrointestinal pathology as a factor aggravating the course and manifestation of rosacea on the background of HO, is of practical interest. Purpose of research. To study the features of the gastrointestinal tract in patients with rosacea in combination with HO. Materials and methods. 144 patients were examined, including the 1st group consisted of 80 patients with rosacea without opisthorchiasis, the 2nd group-64 patients with rosacea in combination with HO. 3rd control group - 20 healthy volunteers. Patients underwent duodenal intubation with microscopy of bile; ultrasound examination of abdominal cavity; FGDS with the use of endoscope “Olympys” with biopsy of fondling and pyloric stomach; the complex of histological and histochemical methods; the index of the SHDOR to determine the severity of rosacea. Results. Clinical manifestations of rosacea in patients with HO were more pronounced, as evidenced by a high index of SHDOR 11.3 (6;16) points compared to group 1 (p<0.001). In most patients of group 2, according to ultrasound data, changes in the hepatobiliary system (85.9%) and according to the data of the FGDS (96.8%), pathology of the upper gastrointestinal tract (p<0.001) were detected, which was significantly higher than in patients of group 1 and due to the presence of HO. In patients of group 2, histological changes in the stomach were inflammatory-degenerative. Summary. Examination of the gastrointestinal tract (duodenal sounding with microscopy of bile, ultrasound, FGDS) in patients with rosacea in combination with HO is recommended in practical health care, which will contribute to timely deworming, and as a consequence, positive dynamics in the clinical course of rosacea.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of Hyperammonemia and Cognitive Impairment in post-COVID patients 新冠肺炎后患者高氨血症与认知功能障碍的评价
Pub Date : 2023-10-09 DOI: 10.31146/1682-8658-ecg-216-8-66-72
D. D. Mukhametova, E. N. Belousova, Z. I. Fashieva, M. G. Nazarova, M. V. Knyazeva, D. I. Abdulganieva
The paper presents the results of an assessment cognitive function and ammonium levels in individuals who have had a novel coronavirus infection (COVID-19). The study included 60 people: 41 - confirmed COVID-19 during last 3 months and 19 - the control group. There have been performed clinical examination, psychometric test - connect-the-numbers test (CNT) and Mini-Mental State Examination (MMSE). Blood ammonium level has been determined. Post-COVID-19 syndrome (PCS) was diagnosed in 70.7% of patients, which was manifested by complaints of memory loss, weakness and anxiety. In patients who underwent COVID-19, cognitive impairment was detected on the MMSE scale in 27 people (45%), and the changes were more pronounced in the group with PCS. In the post-COVID group, 66% of the subjects had an increase CNT result. The cognitive impairment according to the MMSE correlated with the CNT results. Hyperammonemia was found in 54% of COVID-19 survivors, with higher values observed in the PCS group. No correlation was found between hyperammonemia and cognitive impairment.
本文介绍了新型冠状病毒感染(COVID-19)个体的认知功能和铵水平评估结果。该研究包括60人:41人在过去3个月确诊为COVID-19, 19人为对照组。进行了临床检查,心理测量测试-数字连接测试(CNT)和简易精神状态检查(MMSE)。血铵浓度已经测定出来了。70.7%的患者被诊断为新冠肺炎后综合征(PCS),表现为记忆丧失、虚弱和焦虑。在新冠肺炎患者中,27人(45%)在MMSE量表上检测到认知障碍,PCS组的变化更为明显。在covid后组中,66%的受试者CNT结果增加。MMSE显示的认知障碍与CNT结果相关。54%的COVID-19幸存者发现高氨血症,PCS组的高氨血症更高。高氨血症与认知功能障碍无相关性。
{"title":"Evaluation of Hyperammonemia and Cognitive Impairment in post-COVID patients","authors":"D. D. Mukhametova, E. N. Belousova, Z. I. Fashieva, M. G. Nazarova, M. V. Knyazeva, D. I. Abdulganieva","doi":"10.31146/1682-8658-ecg-216-8-66-72","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-66-72","url":null,"abstract":"The paper presents the results of an assessment cognitive function and ammonium levels in individuals who have had a novel coronavirus infection (COVID-19). The study included 60 people: 41 - confirmed COVID-19 during last 3 months and 19 - the control group. There have been performed clinical examination, psychometric test - connect-the-numbers test (CNT) and Mini-Mental State Examination (MMSE). Blood ammonium level has been determined. Post-COVID-19 syndrome (PCS) was diagnosed in 70.7% of patients, which was manifested by complaints of memory loss, weakness and anxiety. In patients who underwent COVID-19, cognitive impairment was detected on the MMSE scale in 27 people (45%), and the changes were more pronounced in the group with PCS. In the post-COVID group, 66% of the subjects had an increase CNT result. The cognitive impairment according to the MMSE correlated with the CNT results. Hyperammonemia was found in 54% of COVID-19 survivors, with higher values observed in the PCS group. No correlation was found between hyperammonemia and cognitive impairment.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hyperammonemia in patients with stable angina pectoris and nonalcoholic fatty liver disease at the steatosis stage 脂肪变性期稳定型心绞痛和非酒精性脂肪肝患者的高氨血症
Pub Date : 2023-10-09 DOI: 10.31146/1682-8658-ecg-216-8-57-65
E. J. Zykina, Zh. G. Simonova
The aim. To assess the severity of hyperammoniemia in patients with non-alcoholic fatty liver disease at the steatosis stage in conditions of comorbidity with stable angina. Research materials and methods. During the clinical trial, three groups of patients with stable angina were formed. Group I (n = 43) consisted of patients with NAFLD at the stage of hepatic steatosis in combination with obesity and a stable form of CHD. Group II (n = 41) - patients with NAFLD at the stage of hepatic steatosis against the background of normal body weight and stable CHD. Group III (control) (n = 42) - patients with stable angina without NAFLD, with normal body weight. The results of laboratory examination (clinical and biochemical blood tests, lipidograms, insulin levels (calculated by HOMA-IR), glycosylated hemoglobin (HbAlc)) were evaluated; non-invasive markers for the diagnosis of liver injury. Hyperammonemia was evaluated by quantitative rapid ammonia analysis using a Pocket Chem TM BA PA-4140 analyzer. All patients underwent ultrasound of the liver using Philips Epiq 5 (USA). Results. In all patients with stable angina (group I and II), the diagnosis of non-alcoholic fatty liver disease, steatosis stage, was confirmed. The lipid profile of patients in Groups I and II showed more significant hypertriglyceridemia compared to those in the control group, with no statistical difference in Groups I and II. The mean ammonium level in patients with NAFLD in combination with stable CHD (group I, II) was above the threshold and was 87 (57-127.5) and 79 (57-97) μmol/L, respectively, and did not differ significantly (p > 0.05). In patients of group III (without liver disease), the mean values of ammonia in the blood were in the target range. According to the results of correlation analysis, we established the relationship of ammonium with liver enzymes, calculated steatosis indices and basic metabolic indicators. Conclusion. Patients with non-alcoholic fatty liver disease in the steatosis stage with a combination of stable angina have more severe hyperammonemia compared to patients with stable CHD without concomitant liver injury.
的目标。评估伴有稳定型心绞痛的非酒精性脂肪肝患者脂肪变性期高氨血症的严重程度。研究材料和方法。在临床试验中,将稳定型心绞痛患者分为三组。第一组(n = 43)由肝脂肪变性合并肥胖和稳定型冠心病的NAFLD患者组成。II组(n = 41):体重正常、冠心病稳定的肝脂肪变性期NAFLD患者。III组(对照组)(n = 42) -无NAFLD的稳定型心绞痛患者,体重正常。评估实验室检查结果(临床和生化血液检查、血脂、胰岛素水平(通过HOMA-IR计算)、糖化血红蛋白(HbAlc));诊断肝损伤的无创标志物。采用Pocket Chem TM BA PA-4140分析仪定量快速氨分析法评估高氨血症。所有患者均使用飞利浦Epiq 5(美国)进行肝脏超声检查。结果。所有稳定型心绞痛患者(I组和II组)均确诊为非酒精性脂肪性肝病,即脂肪变性期。与对照组相比,I组和II组患者的脂质谱显示出更明显的高甘油三酯血症,但I组和II组之间无统计学差异。NAFLD合并稳定型冠心病患者(I、II组)的平均铵离子水平均高于阈值,分别为87 (57-127.5)μmol/L和79 (57-97)μmol/L,差异无统计学意义(p >0.05)。III组患者(无肝脏疾病)血氨均值在目标范围内。根据相关分析结果,建立了铵与肝酶的关系,计算了脂肪变性指数和基本代谢指标。结论。非酒精性脂肪性肝病合并稳定型心绞痛的脂肪变性期患者比不伴有肝损伤的稳定型冠心病患者有更严重的高氨血症。
{"title":"Hyperammonemia in patients with stable angina pectoris and nonalcoholic fatty liver disease at the steatosis stage","authors":"E. J. Zykina, Zh. G. Simonova","doi":"10.31146/1682-8658-ecg-216-8-57-65","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-57-65","url":null,"abstract":"The aim. To assess the severity of hyperammoniemia in patients with non-alcoholic fatty liver disease at the steatosis stage in conditions of comorbidity with stable angina. Research materials and methods. During the clinical trial, three groups of patients with stable angina were formed. Group I (n = 43) consisted of patients with NAFLD at the stage of hepatic steatosis in combination with obesity and a stable form of CHD. Group II (n = 41) - patients with NAFLD at the stage of hepatic steatosis against the background of normal body weight and stable CHD. Group III (control) (n = 42) - patients with stable angina without NAFLD, with normal body weight. The results of laboratory examination (clinical and biochemical blood tests, lipidograms, insulin levels (calculated by HOMA-IR), glycosylated hemoglobin (HbAlc)) were evaluated; non-invasive markers for the diagnosis of liver injury. Hyperammonemia was evaluated by quantitative rapid ammonia analysis using a Pocket Chem TM BA PA-4140 analyzer. All patients underwent ultrasound of the liver using Philips Epiq 5 (USA). Results. In all patients with stable angina (group I and II), the diagnosis of non-alcoholic fatty liver disease, steatosis stage, was confirmed. The lipid profile of patients in Groups I and II showed more significant hypertriglyceridemia compared to those in the control group, with no statistical difference in Groups I and II. The mean ammonium level in patients with NAFLD in combination with stable CHD (group I, II) was above the threshold and was 87 (57-127.5) and 79 (57-97) μmol/L, respectively, and did not differ significantly (p &gt; 0.05). In patients of group III (without liver disease), the mean values of ammonia in the blood were in the target range. According to the results of correlation analysis, we established the relationship of ammonium with liver enzymes, calculated steatosis indices and basic metabolic indicators. Conclusion. Patients with non-alcoholic fatty liver disease in the steatosis stage with a combination of stable angina have more severe hyperammonemia compared to patients with stable CHD without concomitant liver injury.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135147198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical aspects in treatment of gallblader parenchymatous polyps 胆囊实质息肉的外科治疗
Pub Date : 2023-10-09 DOI: 10.31146/1682-8658-ecg-216-8-116-119
O. V. Galimov, V. U. Sataev, V. O. Khanov, D. O. Galimov
Aim of this work is to pay attention to tactical approaches to patients with gallbladder polyps. Materials and methods. Authors analyze the experience of surgical treatment of 84 patients with gallbladder polyps for the period 2015-2021 yy. at the University Clinic. Results. Histological examination showed that hyperplastic polyps met most frequently in 47.6%, adenomatous polyps occurred in 45.3% and cholesterol (cholesterosis) in 7.1%. Conclusions. Gallbladder polyps have no specific symptoms. The potential for malignant transformation implies an active surgical approach, which leads to an increase in the number of surgical benefits. At the same time, minimally invasive, videoendoscopic technologies have sufficient capabilities for the radical removal of gallbladder polyps.
这项工作的目的是关注胆囊息肉患者的策略入路。材料和方法。作者分析了2015-2021年84例胆囊息肉的手术治疗经验。在大学诊所。结果。组织学检查显示增生性息肉发生率最高(47.6%),腺瘤性息肉发生率最高(45.3%),胆固醇(胆固醇升高)发生率最高(7.1%)。结论。胆囊息肉没有特殊的症状。潜在的恶性转化意味着积极的手术方法,这导致手术的好处增加的数量。同时,微创内镜技术有足够的能力根治性切除胆囊息肉。
{"title":"Surgical aspects in treatment of gallblader parenchymatous polyps","authors":"O. V. Galimov, V. U. Sataev, V. O. Khanov, D. O. Galimov","doi":"10.31146/1682-8658-ecg-216-8-116-119","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-216-8-116-119","url":null,"abstract":"Aim of this work is to pay attention to tactical approaches to patients with gallbladder polyps. Materials and methods. Authors analyze the experience of surgical treatment of 84 patients with gallbladder polyps for the period 2015-2021 yy. at the University Clinic. Results. Histological examination showed that hyperplastic polyps met most frequently in 47.6%, adenomatous polyps occurred in 45.3% and cholesterol (cholesterosis) in 7.1%. Conclusions. Gallbladder polyps have no specific symptoms. The potential for malignant transformation implies an active surgical approach, which leads to an increase in the number of surgical benefits. At the same time, minimally invasive, videoendoscopic technologies have sufficient capabilities for the radical removal of gallbladder polyps.","PeriodicalId":11555,"journal":{"name":"Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135146778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology
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