EFFECTIVENESS OF NONALCOHOLIC STEATOHEPATITIS CORRECTION ON THE BAСKGROUND OF OBESITY WITH CONCOMITANT CHRONIC KIDNEY DISEASE.

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.