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Pharmacological correction of the metabolic changes in patients with non-alcoholic steatohepatittis


Author: David Ludmila
Degree:doctor of medicine
Speciality: 14.00.25 - Pharmacology, Clinical Pharmacology
Year:2012
Scientific adviser: Victor Ghicavîi
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific consultant: Ion Butorov
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific council: DH 50-14.00.25
State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 18 January, 2012
Approved by NCAA on the 5 April, 2012

Abstract

Adobe PDF document5.23 Mb / in romanian

Keywords

nonalcoholic steatohepatittis, Imuheptin, Heptral, Choludexan, interleukines, superior fatty acids

Summary

“PharWork’s structure: 141 pages of computer-writing which include: introduction, literature revising, material and methods with clinical and laboratory particularities of patients with NASH, 4 chapters with the results of own researches, general conclusions, practical recommendations, bibliography which includes 231 sources, annexes, 48 tables and 32 figures. Were published 13 scientific articles on the basis of the work.

Aim and objectives: to determine the effectiveness of different hepatoprotective drug groups and optimize the treatment in patients non-alcoholic steatohepatitis; to study the effectiveness of Heptral, Imuheptin and Choludexan in the treatment of patients with NASH by the evolution of the clinical symptoms, systemic inflammation markers, cytolytic and cholestatic syndromes, liver synthetic function; comparative evaluation of treatment regimens with Heptral, Imuheptin and Choludexan and their individualization for patients with NASH.

Methodology of the scientific study. The performed research represents a prospective clinical and analytical study. The considered lots included comparable groups. The data selection for the clinical research was “case-control” type.

Novelty and originality of the work. The treatment of NASH is one of the most discussed problems in contemporary medicine, as it has not been discovered a defined theraputical scheme grounded on pathogenic terms yet. On the basis of our studies we established there is a possibility of efficiency increase in the treatment of NASH.

Theoretical significance. In NASH occurs dyslipidemia with an excessive concentration of triglycerides, atherogenic lipoproteins VLDL synthesis and decreased HDL antiaterogenic lipoprotein synthesis. Imuheptin, Choludexan and Heptral normalize the lipid spectrum of the blood, the concentration of proinflammatory cytokines, increases the total antioxidant capacity of the blood by influencing the links and the main triggering mechanisms of the inflammatory process in the liver.

Applicative significance. To determine the activity of the inflammatory process and the efficacy of the treatment of NASH it is advisable to conduct a complex examination which will include the determination of the activity of liver enzymes (ALT, AST, GGTP, AF), the concentration of proinflammatory citokines (IL-4, IL-6, TNFα), total cholesterol and triglycerides in the blood serum.

Implementing the results. The results of the study, especially the administration of Imuheptin, Choludexan and Heptral in the treatment of NASH, were implemented in the medical practice at the Clinical Hospital of MH RM, Clinical Republican Hospital; in the educational process of the University of Medicine and Pharmacy „Nicolae Testemiţanu” – departments of Internal medicine no. 5 and no. 6, Pharmacology and clinical pharmacology, Pharmacology and clinical pharmacy.