EFFICIENCY OF DIFFEREN-TIATED HEPATOPROTECTIVE THERAPY IN PATIENTS WITH NON-ALCOHOLIC STEATO-HEPATITIS ON THE BACK-GROUND OF STABLE CORO-NARY HEART DISEASE

The aim if this research was to study the effect of differentiated hepatoprotective therapy on the liver functional state in patients with non-alcoholic steatohepatitis (NASH) on the background of stable coronary heart disease (CHD). 44 patients with NASH on the background of stable CHD - postinfarction cardiosclerosis were examined. Among them were 32 men and 12 women with average age 65.8 ± 5.3 years. In order to hepatoprotective therapy on the background of basic treatment ademetionin and heparizine were used; the schemes of the use of these drugs depended on the degree of liver fibrosis and the dynamics of enzymes cytolysis activity on the background of complex treatment. The assessment of the therapy effectiveness was carried out every 3 months. It was evaluated the liver functional state and ultrasound examination was conducted. The degree of liver fibrosis was evaluated according to the results of elastography. FIB-4, NFS indexes were calculated, and collagen type IV was determined by immuno-enzymatic method. It was established that the proposed differentiated approach to hepatoprotective therapy with ademetionin and heparizine in patients with NASH on the background of stable CHD, depending on the liver fibrosis stage contributes to improving the functional liver state by the level of enzymes cytolysis activity. Hepatoprotective therapy positively affected on the regression of the liver fibrotic processes by the most significant reduction in the shear wave velocity by the results of elastography, by the level of collagen type IV and FIB-4 index in the sixth month of treatment, that caused the necessity of lengthening the use of hepatoprotective agents according to the scheme up to 9 months of observation.