A method of treatment of liver diseases

 

(57) Abstract:

The invention relates to medicine, in particular for the treatment of patients with liver diseases, and the development of a treatment method that increases the effectiveness of therapy by improving the hemodynamics of the liver. For this purpose, patients are prescribed oral WESSEL DU f (Sulodexide) one capsule at night every day for 2-12 months. The method leads to an improvement of the venous system of blood vessels of the hepatic veins and reduced cytolytic mesenchymal and inflammatory syndrome. 2 Il.

The invention relates to medicine, in particular for the treatment of patients with liver disease.

There is a method of treatment of patients with liver diseases by correcting the hemodynamics of the liver drug vasopressin. The mechanism of action of vasopressin is to reduce the diameter of the arterioles of the internal organs, causing an increase in resistance to the current in the intestines, the result is a reduction of pressure in the portal vein. Vasopressin is administered intravenously at a dose of 20 ME in 100 ml of 5% glucose solution.

The use of vasopressin causes contraction of the coronary vessels. During infusion may appear cricoarytenoid blood flow, what is undesirable cirrhosis of the liver (Valla D, Girod S. Lee S, et al. Lakt of vasopressin action on splanchnic hemodynamics during bleeding, conscious, portal hipertensive rats. Hepatology 1988, 810 S.).

There is a method of treatment of patients with liver diseases by improving the microcirculation of the liver nitroglycerin. Nitroglycerin is a powerful venous and moderately active blood vasodilatator. This drug causes a decrease in intrahepatic resistance. Its use helps to reduce the amount of bleeding from varicose veins and frequency of esophageal tamponade. Nitroglycerin injected 40 mg/min or transdermal.

When using nitroglycerin possible headache, hypotension, dizziness. (Cestari R, Ugada M, Missale G et al. Haemodynamic effect oftriglycyl-lysine-vasopressin (glypressin) on intravascular oesophageal variceal pressure in parents with cirrhosis. A randomized placebo controlled trial. J. Hepatol. 1990, 10:205.

Millikan WJ, Warren WD, Henderson JM et al. The Emory prospective randomized trial: selective versus non-selective shunt to control variccal bleeding. Ten year follow-up. Ann. Surg. 1985; 201: 712.).

There is a method of treatment of patients with liver diseases by somatostatin. Somatostatin reduces the resistance in the arteries of the internal organs and thereby reduces the pressure in the portal vein. Intravenous infusion of the drug adversely affects krovoobrasheniya somatostatin possible discomfort in the abdominal cavity, nausea, bradycardia, feeling the tides blood to a person. Treatment with somatostatin is produced only in conditions of a hospital under the control of the blood sugar level. (Gines A, Salmeron JM, Gines somatostatin on renal function in cirrhos 1992 103; 1868).

There is a method of treatment of patients with liver diseases by octreotide. Octreotide is a synthetic analogue of somatostatin, share with him the same 4 amino acids. This product unlike Somatostatin does not reduce the rate of early recurrence of bleeding (Primignan: M, Andreoni B, Carpinel Sclerotherapy plus octreotide versus sclerotheraf the prevention of early rebleeding from esophagea randomized double-blind, plb-controlled r trial. Hepatology 1995; 21: 1322.)

There is a method of treatment of patients with liver disease by reducing cardiac output, blocking B1-adrenergic receptors in the myocardium. Partially this effect propranolol. Metoprolol and atenolol - cardioselektivee blockers, reducing the pressure in the portal vein, less effective than propranolol. The use of this group of drugs has a large number of contraindications. Absolute contraindications include: obstructive disease, bradycardia, hypotension, impaired peripheral circulation, etc. that restricts the use of these drugs. (W. Sherlock, J. Dooley. TableName the liver by the correction of hemodynamic ketanserin. Ketanserin inhibited sensitivity S2receptors of the vascular gantry system. Ketanserin is an inhibitor of serotonin, which reduce the pressure in the Vena Porta. The use of this drug is limited due to frequent side effects. (Vorobioff j, Garcia - Tsao G., Gamen M., Picabea E. Long-term hemodynamic effects of ketanserin, a 5-hydrotrjptamine blocker, in portahypertenzie patients. Hepatology 1989 18; 9; 88).

As a prototype for closest to the technical nature of our chosen method of treatment of patients with liver disease verapamil. Verapamil - blocker calcium channels reduces the pressure in the portal vein and intrahepatic resistance due postsinusoidal vascular resistance. Isoptin hypotension contraindicated for circulatory failure, sick sinus. (Moreau R., Lee, S., Hadengue A. et al. Hemodynamic effects of a clonidine-induced decrease in sympathetic tone in patients with cirrhosis. Hepatology 1987; 7: 149.).

The objective of the invention is to develop a treatment that increases the effectiveness of therapy by improving the microcirculation of the blood vessels of the liver. The task is achieved by the known method of treatment of liver diseases undergo drug VESSEL DUE f (sulodexide), and patients take this is given on the background of basic therapy. The drug VESSEL DUE f (sulodexide) - extract from the mucosa of the small intestine of animals. The drug is a natural mixture mastrodicasa heparinate fraction (80%) and dermatan sulfate (20%). The drug VESSEL DUE f is associated with functional and structural integrity of endothelial cells of blood vessels, restores the normal density of the negative charge of the vessels, normalizes the flow properties of blood by decreasing triglyceride levels and reduces blood viscosity. The drug increases the level of tissue activator of plasminogen in the blood and reduces blood levels of tissue inhibitor of plasminogen (Reference VIDAL. "Drugs in Russia". 1998, S. 120.).

A method of treatment of liver diseases VESSEL DUE f (sulodexide) is carried out as follows: after carrying out biochemical analyses and studies of hemodynamics of the liver using rogatory or ultrasonic dopplerography on the background of basic therapy undergo drug VESSEL DUE f (sulodexide), where the drug is taken orally one capsule (250 lindens. ED) on the night of mg daily for 2-12 months.

As examples of the extracts from the stories batic With pronounced activity. Ill for 2 years. Repeatedly treated in therapeutic hospitals, with no effect. Objectively: the patient's condition is relatively satisfactory, the liver acts from under the edge of the costal arch on 3 cm, is palpable spleen. In the analysis: total protein 65 g/l, albumin 38%, gamma globulins 32%, sublimate sample 1.5 ml, ALT 33.0 mmol/l, bilirubin up to 66.5 mmol/l, erythrocyte sedimentation rate of 35.1 mm/h, the CEC 40 op. units of HCV (+), RNA-PCR (+), Rogatory (RGG): expressed human hemodynamics of the liver, signs and intrahepatic portal hypertension. Treatment: CREON, reglan, b vitamins, C. Infusion therapy: glucose, crystalline drugs. Ongoing therapy of significant effect is not exerted, and as a result was appointed VESSEL DUE f (sulodexide), which the patient has ingested one capsule (250 lindens. ED) on the night of mg daily for 2 months. After therapy the patient's condition has improved, declined weakness. In the analysis: total protein 75 g/l, albumin 52%, gamma-globulins 22%, sublimate sample 2.0 ml, ALT 17.3 mmol/l, bilirubin 17,0 Ámol/l, erythrocyte sedimentation rate of 16 mm/h, the CEC 19,0 RNA PCR (+) HCV (+) RGG: Significant improvement in hemodynamics of the liver, a decrease in the amplitude dicrotism waves, the improvement of outflow. Normalization formasi viral hepatitis To severe activity, cirrhotic stage with symptoms of portal hypertension and hypersplenism, ascites. When receiving complaints of weakness, reduced efficiency, joint pain and right upper quadrant. Ill for about 8 years, repeatedly treated in hospitals, with short-term effect. Objectively the state of moderate severity, skin jaundice, belly swollen, liver stands out from the edge of a costal arch on a 3 cm thick palpation. Objectively: the patient's condition is relatively satisfactory, the liver acts from under the edge of the costal arch on 3 cm, is palpable spleen. In the analysis of total protein 64 g/l, albumin 34%, gamma-globulins 33%, sublimate sample of 1.4 ml, ALT is 32.8 mmol/l, bilirubin 67,0 Ámol/l, erythrocyte sedimentation rate, 33 mm/h, the CEC 39 opt% HBsAg (+), HBeAg (+) DNA PCR (+). RGG: hemodynamic liver, intrahepatic hypertension. Patient treatment was conducted: Mezim-Forte, reglan, vitamins b, C, tocopherol acetate. Despite ongoing therapy essential dynamics has been received. Due to lack of effect was appointed VESSEL DUE f (sulodexide), ingested one capsule (250 lindens. ED) on the night of mg daily for 12 months. After therapy the patient's condition has improved, passed weakness, decreased pain in the right is a sample of 1.8 ml, ALT of 17.1 mmol/l, bilirubin 17.8 Ámol/l, erythrocyte sedimentation rate of 18 mm/h, the CEC 19,1. RGG: improved hemodynamics of the liver mainly due to the improvement of outflow from the liver.

The control example.

History 219. Patient Y., 36 years. Diagnosis: chronic hepatitis b virus pronounced activity. Upon receipt of a complaint: weakness, pain in the right hypochondrium, swelling in the legs. Ill 2 years, treated in various therapeutic hospitals. Objectively, the patient's condition is satisfactory, belly swollen, the liver acts from under the costal arch on a 3 cm thick palpation of the spleen is palpated, there pastos of the lower extremities. In the analysis of total protein 72 g/l, albumin of 40.8 %, gamma-globulins 31%, sublimate the sample with 0.9 ml, bilirubin 68,9 Ámol/l, ALT of 31.1 mmol/l, ESR 30.8 mm/h, the CEC op 39% HBsAg (+). RGG: impaired hemodynamics of the liver mainly due to violation of the outflow. Treatment: triampur, vitamins b and C, Mezim-Forte, gemodez. To improve the hemodynamics of the liver patient assigned to verapamil at a dose of 120 mg per day. On the background of therapy was weakness, pain in the right hypochondrium. In the analyses HsAg, determined by ELISA, protein total 73 g/l, albumin 44.3 percent of gamma-globulins and 28.3%, sublimate prakticheskoi waves.

The above extracts from the records showed that using the proposed method can more effectively in comparison with the prototype to treat patients with diseases by improving the hemodynamics of the liver.

The presented method of treatment was applied to 15 patients with liver disease. The treatment results of the proposed method is shown in Fig. 1. Data treatment according to the method prototype is shown in Fig. 2.

As can be seen from the data presented, the inventive method compared to the prototype is more efficient improves clinical, biochemical and immunological data.

A method of treatment of liver disease through medication, characterized in that the patients are prescribed oral VESSEL DUE f (Sulodexide) one capsule at night every day for 2-12 months.

 

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