RESUMEN
The aim of the investigation was to study the myocardium in patients with chronic viral hepatitis concurrent with chronic opisthorchiasis. Ninety patients with chronic viral hepatitis, including 52 patients with this disease concurrent with chronic opisthorchiasis, were examined. Doppler echocardiography indicated a statistically significant increase in left ventricular mass regardless of the presence of Opisthorchis infestation. Analysis of left ventricular diastolic dysfunction showed its great degree in chronic hepatitis C. Single-photon emission computed tomography with 99mTc-pyrophosphate revealed focal tracer incorporation in the myocardium of most patients with Opisthorchis infestation. A third of patients with chronic viral hepatitis showed moderate diffuse trace accumulation that was significantly more frequently found in chronic hepatitis C. Single photon-emission tomography with labeled leukocytes demonstrated abnormal accumulation in none of the patients; troponin T levels were in the normal allowable range. Myocardial lesion was detected in the chronic course of viral hepatitis C concurrent with chronic opisthorchiasis that was unattended by cardiomyocyte necrosis and that was dystrophic.
Asunto(s)
Corazón/fisiopatología , Hepatitis B Crónica/complicaciones , Hepatitis C Crónica/complicaciones , Hepatitis C Crónica/fisiopatología , Miocardio/patología , Opistorquiasis/fisiopatología , Enfermedad Crónica , Hepatitis B Crónica/patología , Hepatitis B Crónica/fisiopatología , Hepatitis C Crónica/patología , Humanos , Opistorquiasis/complicaciones , Opistorquiasis/patología , Disfunción Ventricular Izquierda/patología , Disfunción Ventricular Izquierda/fisiopatologíaRESUMEN
AIM: To study a relationship of the plasma activity of elastase-like and collagenase-like proteinases and their inhibitors to hepatic collagen metabolism and to detect the serum markers of fibrosis severity. SUBJECTS AND METHODS: Three hundred and fifty-nine patients with chronic liver diseases (CLD), including 118 patients with chronic viral hepatitis (CVH), 113 with CVH concurrent with alcoholic liver disease (ALD), 109 with ALD, and 19 with CLD in the presence of opiomania were examined. The activities of alpha1-proteinase inhibitor and alpha2-macroglobulin (alpha2-MG) were determined by the unified spectrophometric assay from the inhibition of N-benzoyl-arginine ethyl ester hydrolysis. The activity of elastase-like proteinases was determined by enzymatic assay from the hydrolysis of the synthetic substrate N-butyloxycarbonyl-L-alanine-para-nitrophenyl ester. That of collagenase-like proteinases was determined, by using a collagen type 1 substrate and expressed in terms of micromoles of the resultant hydroxyproline. The content of hydroxyproline was determined by a color reaction with demethylbenzaldehyde, a free, peptide- and protein-bound hydroxyproline; their fraction was obtained under various conditions of plasma protein isolation and hydrolysis. Plasma fibronectin levels were measured by solid-phase immunoassay. Liver biopsy specimens were morphologically studied in the majority of patients to determine the histological hepatitis activity index and the stage of fibrosis. RESULTS: Fibrois formation in the liver in its chronic diseases was attended by a significant reduction in the activity of collagenase-like proteinases hydrolyzing collagen and by the lower activity of alpha2-MG, an inhibitor limiting collagen formation. CONCLUSION: The identified changes make themselves evident just in early fibrosis, which suggests the rapid onset of imbalance in the mechanisms responsible for regulation of connective tissue synthesis and promotes intensified fibrosis formation.
Asunto(s)
Enfermedad Hepática Crónica Inducida por Sustancias y Drogas/metabolismo , Colágeno/metabolismo , Fibronectinas/metabolismo , Hepatitis Viral Humana/metabolismo , Hígado/metabolismo , Péptido Hidrolasas/metabolismo , alfa 1-Antitripsina/metabolismo , Biomarcadores/metabolismo , Biopsia , Enfermedad Hepática Crónica Inducida por Sustancias y Drogas/patología , Progresión de la Enfermedad , Hepatitis Viral Humana/patología , Humanos , Hidroxiprolina/metabolismo , Hígado/patología , Pronóstico , Índice de Severidad de la EnfermedadRESUMEN
AIM: to estimate quality of life (QL) indices in patients with chronic viral hepatitis (CVH) and their relationships to the clinical characteristics of the disease. SUBJECTS AND METHODS: One hundred and ten patients with chronic viral hepatitis (CVH), including 58 patients with chronic hepatitis C (CHC), 27 with chronic hepatitis B, and 25 with CHC + HBCor, were examined. The personality psychological profile, reaction and personality anxiety were evaluated; the Beck inventory was used to identify borderline mental disorders. The test developed by the Karelian Research Center, Russian Academy of Medical Sciences, modified by Ya. M. Rutgaizer, and the Nottingham Health Profile were applied to estimate QL indices. RESULTS: Parameters characterizing the social and personality indices of life, such as qualitative performance of paid work, participation in social life, impossibility of adequate rest, and sexual life are most frequently influenced. The main indicators of worse QL were diminished vitality (vital energy), sleep disorders, and emergence of emotional reactions. This was largely seen in patients with active CVH infection and in those who had isolated HBcor antibodies. CONCLUSION: QL is directly related to the duration of viral infection.