Khukhlina O, Antoniv A, Kanovska L, Mandryk O, Smandych V
Higher educational establishment of Ukraine «Bukovinian State Medical University», Chernivtsi, Ukraine.
Georgian Med News. 2018 Oct(283):76-80.
The article presents a theoretical generalization of the research results the effectiveness of heparisin on the state of the carbohydrate-protein components of the extracellular matrix of connective tissue in liver in patients with non-alcoholic steatohepatitis with obesity I-II degree and chronic kidney disease І-ІІ stage. The purpose of the study is to find out the effectiveness of heparisin (glycyrizine 40 mg, glycine 400 mg, L-cysteine hydrochloride 20 mg) on the state of the carbohydrate-protein components of the extracellular matrix in connective tissue of the liver in patients with non-alcoholic steatohepatitis (NASH) with obesity I-II degree and chronic kidney disease (CKD) І-ІІ stage. 98 patients with NASH on the background of obesity of the I-II degree were examined, including: 52 patients with NASH (I group) (without accompanying CKD), 46 patients with NASH with comorbid CKD І-ІІ stage (II group). The control group consisted of 20 practically healthy persons (PHPs) of the corresponding age and sex. Biopsy of the liver was performed on 32 NASH patients with CKD I-II, 28 patients with NASH without CKD. Patients on both groups of NASH received heparisin treatment (glycyrizine 40 mg, glycine 400 mg, L-cysteine hydrochloride 20 mg) (Valartin Pharma) by intravenous administration of 20 ml of the drug for 10 days followed by enteral administration of 2 tablets of heparysin (1 tablet : glycyrizine 25 mg, glycine - 25 mg, methionine - 25 mg) 3 times a day for 80 days. Patients with NASH and a comorbid flow of obesity and CKD of the І-ІІ stages, except for heparisin, received baseline therapy of CKD І-ІІ stage: chronic pyelonephritis. Heparizin therapy for 3 months contributed to the achievement of a collagen anabolic and catabolic balance by activating collagenase, inhibiting the activity of proteolytic inhibitors and collagenase, inhibition of fibroblast growth factor secretion, acute phase inflammation, reducing extracellular matrix fucoglycoproteinsdegradation in liver, and in general, reducing the activation of connective tissue components, by evidence which led to a decrease in the liver fibrosisindex according to the fibrotest in the range of 1.5-2.0 times.
本文介绍了关于肝素对肥胖I-II度且患有慢性肾脏病I-II期的非酒精性脂肪性肝炎患者肝脏结缔组织细胞外基质中碳水化合物-蛋白质成分状态影响的研究结果的理论概括。该研究的目的是探究肝素（甘草酸40毫克、甘氨酸400毫克、盐酸L-半胱氨酸20毫克）对肥胖I-II度且患有慢性肾脏病I-II期的非酒精性脂肪性肝炎（NASH）患者肝脏结缔组织细胞外基质中碳水化合物-蛋白质成分状态的影响。对98例I-II度肥胖背景下的NASH患者进行了检查，其中包括：52例NASH患者（I组）（无合并慢性肾脏病），46例合并I-II期慢性肾脏病的NASH患者（II组）。对照组由20名相应年龄和性别的实际健康者（PHPs）组成。对32例合并I-II期慢性肾脏病的NASH患者和28例无慢性肾脏病的NASH患者进行了肝脏活检。两组NASH患者均接受肝素治疗（甘草酸40毫克、甘氨酸400毫克、盐酸L-半胱氨酸20毫克）（Valartin Pharma），静脉注射20毫升药物，持续10天，随后口服肝肝素片（1片：甘草酸25毫克、甘氨酸-25毫克、蛋氨酸-25毫克），每日3次，持续80天。除肝素外，患有NASH且合并I-II期肥胖和慢性肾脏病的患者接受I-II期慢性肾脏病的基础治疗：慢性肾盂肾炎。肝素治疗3个月有助于通过激活胶原酶、抑制蛋白水解抑制剂和胶原酶的活性、抑制成纤维细胞生长因子分泌、急性期炎症、减少肝脏中细胞外基质岩藻糖糖蛋白降解，总体上减少结缔组织成分的激活，从而使根据纤维检测得出的肝纤维化指数降低1.5 - 2.0倍。
