INFLUENCE OF URSODEOXY-CHOLIC ACID ON CLINICAL COURSE OF CHRONIC NON-CALCULOUS CHOLECYSTITIS ON THE BACKGROUND OF NONALCOHOLIC FATTY LIVER DISEASE AND METABOLIC SYNDROME

The purpose of this work was to investigate the clinical efficiency of ursodeoxycholic acid (UDCA) in the complex therapy of chronic non-calculous cholecystitis (CNC) combined with nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS). Methods. 64 patients with CNC on the background of NAFLD and MS were examined, 45 women and 19 men, at the age of (49.3 ± 6.8) years. Depending on the treatment, the patients were divided into two groups: the I group - 32 patients with CNS and MS who received a diet and basic therapy for two weeks; the II group - 32 patients who received basic treatment and UDCA at the dose of 10-15 mg / kg / day for 3 months. General clinical, anthropometric, biochemical and ultrasound examination was performed before and after the course of treatment. Results. It was established that the application of UDCA in complex treatment contributes to faster decrise of clinical manifestations of CNC on the background of NAFLD and MS, in particular pain, dyspeptic and astenovegetative syndromes, compared with basic therapy. According to the results of ultrasound, the thickness of the wall of the gallbladder (GB) was reduced in (40.63 ± 8.68) %, the volume of GB - in (48.61 ± 8.82) % of cases (p <0.05). This was accompanied by improvement of the functional state of the liver with decrease in the activity of alanine and aspartate aminotransferases, alkaline phosphatase, gamma-glutamyl-transpeptidase, the content of total bilirubin and increase of cholinesterase activity in the blood. The application of UDCA in complex therapy contributed to the positive dynamics of the lipid profile of the blood, decrease of total cholesterol, triglycerides and low density lipoprotein level, as opposed to basic therapy. Conclusions. The application of UDCA in the complex therapy of patients with CNC on the background of NAFLD and MS contributes to the positive dynamics of clinical manifestations of the disease, ultrasound characteristics of GB, improvement of the functional state of the liver and lipid blood spectrum.