Хронический гастрит типа в как фактор, способствующий развитию вирусного гепатита а

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Содержание Эффективность методов озонотерапии в лечении острого вирусного гепатита Parameters free radicals oxidation at the patients sharp virus hepatitis Technique of research. Results of research. Table 1 Parameters malone dialdehyde in whey of blood at the patients virus hepatitis B and C (mmol/l) Table 2 Parameters restored cytochrom C in leukocytes at the patients virus hepatitis B and C (mM/min)

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ЭФФЕКТИВНОСТЬ МЕТОДОВ ОЗОНОТЕРАПИИ В ЛЕЧЕНИИ ОСТРОГО ВИРУСНОГО ГЕПАТИТА

Яковлев А.Ю., Бричкин Ю.Д., Фуфаев А.Н., Суворов М.А., Ершов В.В.

Военно-медицинский институт ПС России, Нижний Новгород ВГ при СККРУ ПС России, Кисловодск (Россия)

Под наблюдением находилось 14 пациентов с диагнозом "острый вирусный гепатит", которым в комплекс лечения была включена озонотерапия. Больные были разделены на 2 группы. В первой группе проводили ежедневное ректальное введение озонокислородной смеси в дозе 8-10 мл/кг с концентрацией озона 4 мг/л в течение 5 дней, во второй - ежедневные внутривенные инфузии озонированного физиологического раствора в количестве 400 мл с концентрацией озона 2 мг/л в течение 5 суток.

Проведенные исследования показали однонаправленность изменений клинических и лабораторных показателей при ректальном и внутривенном способе озонотерапии: снижение гипербилирубинемии, показателей АсАТ, АлАТ, ГГТ, щелочной фосфатазы, тимоловой и сулемовой проб, нормализация альбуминсинтезирующей функции печени. Клинически определялись улучшение общего самочувствия, снижение кожного зуда, чувства тяжести и боли в правом подреберье, диспепсии, нормализация аппетита и сна. Однако следует отметить более выраженный детоксицирующий эффект при внутривенном способе озонотерапии, что может быть использовано у больных вирусным гепатитом с тяжелой степенью эндотоксикоза. Ректальный способ введения озонокислородной смеси из-за его достаточной эффективности, неинвазивности и дешевизны также может быть использован у больных с компенсированным течением вирусного гепатита.

Таким образом, проведенные исследования эффективности различных способов озонотерапии показали высокую перспективность их включения в комплекс терапии острого вирусного гепатита.

PARAMETERS FREE RADICALS OXIDATION AT THE PATIENTS SHARP VIRUS HEPATITIS

Ivanova M.R., Nagoev B.S

The Kabardino-Balkarian state university, Nalchik (Russia)

In a basis of morphological changes developing in a liver at virus hepatitis, the initiating process progressing necroboise of hepatocytes. One of universal mechanisms of damage and even destructions of crates of any bodies, especially of liver, is excessive peroxidation of membrane structures caused by amplified development of the active forms of oxygen (AFO) [5,7,10,14]. Superfluous production AFO becomes the reason of damage of fibers, nucleic of acids, starts processes peroxidation, that, in turn, can result in damage of crates, autoimmune to condition, allergization of organism, alteration of intracellular substance, maintenance of a chronic inflammation [6,11]. Though the mechanism of damaging influence of viruses on hepatocytes continues to be studied, a beginning of a defeat of crates connect to development fabric hypoxia [3,4,9,12,14] and infringements oxidizing phosphorylate in mitochondrion. The estimation immune reactivity in dynamics of development of infectious process has essential meaning in definition of its weight and forecast. One of integrated parameters immune reactivity is served by intensity of processes peroxidation of lipids in whey of blood. For an estimation of development of the active forms of oxygen it is possible to use definition of concentration of an ancestor of all active forms of oxygen in vivo- superoxid anion, which has the expressed damaging action on cells membrane. The most powerful source superoxid anion in organisme are the circuits of carry electrons- mitochondrion and microsome.

Technique of research. Under supervision there were 167 patients in the age of from 16 till 68 years, including virus hepatitis B (HBV) -77 men and virus hepatitis C (HCV) -90. The diagnosis was confirmed clinical and epidemiological data, laboratory results and markers diagnostics. In the patients virus hepatitis B in blood found out HBsAg, anti-coreAg, HBeAg, anti-HBeAg, DNA-HBV; at the patients virus hepatitis C defined in whey of blood anti-HCV Ig M, absence NS4, RNA-HCV. As healthy 30 donors of republican station of transfusion of blood were surveyed. All hepatitis patients were surveyed in the period of heat of disease, at height of clinical displays, with expressed intoxication and icterus, in the period of recession icterus and before an extract of the patients from hospital. The intensity peroxidation of lipids was estimated under the contents in whey of blood of substances reacting with thiobarbituric acid on the method Uchiyama, Michara (1978) [15]. Basic weight from these substances makes malone dialdehydes- an intermediate product lipoperoxidation of membrane structures. Concentration superoxid anion defined spectrophotometric way on the basis of restoration by it цитохрома C on a method Mc Cord, Fridovich (1968) [13].

Results of research. The following laws are established. In the period of heat of disease has a place authentic increase of a level malone dialdehyde (MDA) (tab. 1). On the second week icterus period, which corresponds to the period of recession icterus, at the patients had a place proceeding increase of a level MDA, which was much higher, than in 1-th the period. At the patients virus hepatitis B in this period the parameters malone dialdehyde were authentically above, than at the patients virus hepatitis В. Apparently, it is connected to the large accumulation of products oxidation in whey of blood, which are not removed yet from organisme. Higher parameters malone dialdehyde at the patients virus hepatitis B specify on higher intensity icterus in the given group of the patients.

Table 1

Parameters malone dialdehyde in whey of blood at the patients virus hepatitis B and C (mmol/l)

Group of the surveyed patients	n	Period	Хm	P	P1
Healthy	15		1,30,07
The patients HBV	77		3,90,2	0,001
	74		10,20,6	0,001
	68		2,70,2	0,001
The patients HCV	90		3,50,2	0,001	0,05
	88		8,10,4	0,001	0,001
	84		2,90,2	0,001	0,05

The note here and in table 2: I- the period of heat of disease; the II-period of recession icterus; the III-period early recovery; P-reliability of distinctions in relation to parameters at healthy; Р1-reliability of distinctions in relation to parameters at the patients virus hepatitis С.

In the period early recovery, before an extract of the patients from hospital there is a significant decrease of a level MDA, which, however, remains authentically raised in comparison with group of the healthy persons. Thus a level malone dialdehyde at the patients virus hepatitis C has not authentic difference with those at the patients virus hepatitis B (tab. 1).

Table 2

Parameters restored cytochrom C in leukocytes at the patients virus hepatitis B and C (mM/min)

Group of the surveyed patients	n	Period	Хm	P	P1
Healthy	15		1,30,02
The patients HBV	77		6,30,1	0,001
	68		3,70,1	0,001
The patients HCV	95		6,70,1	0,001	0,01
	88		4,50,1	0,001	0,001

In the period of heat of disease there is an authentic and significant increase of concentration superoxid anion in leukocytes at the patients virus hepatitis B and C, and the concentration of this parameter is higher at the patients virus hepatitis C (tab. 2). Before an extract of the patients from hospital, in the period early recovery there is a decrease of a level cytochrom C, which, however, remains authentically above at the patients virus hepatitis C and in researched groups much above, than in control (tab. 2).

Thus, on the one hand there is an increase of concentration of the active forms of oxygen in leukocytes at the patients virus hepatitis, on the other hand, as a consequence it increase of the contents of products peroxidation in whey of blood, which is most expressed in heat of disease and is reduced before an extract of the patients from hospital, however, not coming to norm. Pays on itself attention authentically higher concentration superoxid anion, and consequently, indirectly, and all active forms of oxygen at the patients virus hepatitis C in the period early recovery. It testifies to a deeper immune and biochemical defeat hepatocytes and can serve criterion of the forecast early chronic of process.

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