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Some of the aspects of Liver Function of People with Chronic Alcohol Intoxication


Author: Elina Berliba
Degree:doctor of medicine
Speciality: 14.00.05 - Internal Diseases (with specification: Pulmonology, Gastroenterology, Hepatology, Nephrology, Functional Diagnostics and Endoscopy)
Year:2005
Scientific adviser: Vlada-Tatiana Dumbrava
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Leonid Lîsîi
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 28 September, 2005
Approved by NCAA on the 22 December, 2005

Abstract

Adobe PDF document0.19 Mb / in romanian

Thesis

CZU 616.36-002+615.711.1-099-036.12

Adobe PDF document 0.76 Mb / in romanian
122 pages


Keywords

alcoholic liver disease, alcoholic and viral chronic hepatitis and cirrhosis, alcoholic chronic intoxication, CAGE questionnaire, objective findings of alcoholic intoxication, cytolisis, cholestasis, immunoinflamatory syndrome, biological markers of alcohol abuse, carbohydratedeficient transferrin.

Summary

There were examined 171 patients with chronic liver pathology. For estimating the state of chronic alcohol intoxication (CAI), a whole complex of tests was used: questionnaire “CAGE”; an inquiry for intensity estimation of the syndrome of alcohol post-intoxication; the modified “Le Go” test that consists of hunting out the objective symptoms of ethylic intoxication. Thus within 64,9 % (111) of the patients the CAI was identified. During a simple questioninaire of the patients only 44,1 % (49) of them admit sincerely the chronic alcohol consumption. The patients with CAI in accordance with etiology were divided into following groups: I group - 19, 8 % (34) patients with chronic alcoholic hepatitis (CAH); II group - 18, 2 % (31) patients with chronic hepatitis of mixed etiology (viral & alcoholic) (CHVA); III group - 26, 9 % (46) patients with alcoholic liver cirrhosis (ALC).

In all of the groups the clinical and paraclinical peculiarities of the liver function were investigated, inclusively the specific markers of the ethylic intoxication - gammaglutamiltranspeptidase (γ-GT), carbohydrate-deficient transferrin (CDT), alcohol-dehydrogenase (ADH), glutamate-dehydrogenase (GDH). Thus, it was ascertained that hepatomegalia, jaundice and portal high blood pressure are more frequently in patients with CAI and chronic hepatitis and liver cirrhosis of alcoholic etiology in comparison with viral chronic hepatitis, in which the asteno-neurotic syndrome prevails. The clinical perturbations are more severe within the mixed chronic hepatitis (viral and alcoholic) than in alcoholic hepatitis and viral hepatitis taken separately. In alcoholic chronic hepatitis and liver cirrhosis combined with CAI, the cholesatasis and hepatodepresiv syndrome were manifested stronger than in viral chronic hepatitis in which the citoliza syndrome was more vivid. The essential immunological alterations are characterized by the growth of IgA in patients with chronic hepatitis and liver cirrhosis of alcoholic origin and IgG in patients with chronic viral hepatitis. Within the chronic hepatitis and liver cirrhosis of alcoholic/viral etiology in association with chronic alcoholic intoxication there was established a essential growth of CDT, γ-GT, ADH and GDH in comparison with liver pathology of viral etiology without ethylic intoxication.

It was established that the complex cure of the patients having chronic hepatitis of alcoholic origin with ursodeoxicolic acid has exerted a beneficent effect in the evolution of clinical symptoms, of the citolitic parameters (ALT, AST, GDH activity reduction) and cholestatic (the remission of γ-GT level, of total bilirubin and of the conjugated fraction, alkalin fostaphase, triglicerides and γ-lipoproteines), that confirms the necessity of using the ursodeoxicolic acid in the therapy of such kind of patients.