The aim: Was increase the effectiveness of treatment in patients with non-alcoholic fatty liver disease (NAFLD) comorbid with chronic obstructive pulmonary disease (COPD) by using ursodeoxycholic acid (UDCA) in combination with ademethionine.
Materials and methods: Under observation was 98 patients with a diagnosis of NAFLD and COPD group II or their combination. Patients were divided into 3 groups: 1 (n = 36) – COPD + NASH – in addition to standard COPD therapy received UDCA 15 mg / kg / day – 6 months and ademethionine 1000 mg IV once a day for 10 days, followed by oral administration of 500 mg 2 times per day – 20 days, and group 2 (n = 32) – COPD + hepatic steatosis – in addition to standard therapy – UDCA 15 mg / kg / day – 6 months. Group 3 (n = 30) – COPD received standard therapy for COPD.
Results: UDCA with ademethionine on the background of standard COPD therapy reduces the clinical manifestations of NAFLD and normalizes liver function. The combination of UDCA with ademethionine not only has a positive effect on the course of NAFLD, but also reduces the intensity of dyspnea, systemic inflammation, improves the external respiration function and reduces anxiety and depression. Patients receiving UDCA + ademethionine for 6 months of follow-up had no exacerbations of COPD.
Conclusions: UDCA in combination with ademethionine in COPD courses have a positive effect on the course of NAFLD, and also reduces the intensity of dyspnea, improves the external respiratory function and reduces the frequency of COPD hospitalization.
This article presents the results of studies obtained by observing patients with non-alcoholic fatty liver disease (NAFLD) on the background of chronic obstructive pulmonary disease (COPD). As a result of the analysis it was found that the frequency of exacerbations of COPD with hospitalization in overweight patients in the presence of NAFLD leads to increased imbalance of adipose tissue hormones in the form of decreased adiponectin and increased leptin, and correlates with impaired lipid metabolism and severe grade of hepatic steatosis. In patients with frequent exacerbations, there is a significant positive correlation between leptin levels and TNF-a factor, which may be associated with an increase in overall inflammation. The revealed imbalance of adiponectin and leptin content in patients with COPD with overweight is a factor in the progression of NAFLD.
This article presents data on the influence of enzymatic activity of serum on the processes of liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) and chronic obstructive pulmonary disease (COPD). Clinical, biochemical, immunological research methods and enzyme-linked immunosorbent assay (ELISA) were used in the work. All patients were determined for the degree of liver fibrosis using a non-invasive method – Fibromax. It was found that in patients with NAFLD and COPD with frequent exacerbations, the levels of CRP, IL-6, TNF-α and neopterin are significantly higher than in patients who had one or no exacerbation of COPD. Stably high levels of systemic inflammation markers of TNF-α, neopterin, CRP lead to the activation of TGF-β, which increases with the deepening stage of liver fibrosis. The average values of IgG antibodies to neutrophil elastase significantly increase depending on the stage of fibrotic changes in the liver and the activity of inflammatory changes in it, with the highest concentration in fibrosis F2. In F3-4 fibrosis, the levels of antibodies to elastase are reduced, although they remain higher than the control values. Significant increase IgG antibody levels to neutrophil elastase depending on the stage of fibrosis and the activity of inflammatory changes indicates the role of serum enzymatic activity in the mechanisms of formation of more severe stages of NAFLD and can be considered as additional diagnostic markers.
В работе описан процесс обеспечения и повышения тактико-технических характеристик боевых машин путем применения комбинированных элементов и компонентов боевой техники и технологических систем (используемые для их изготовления), выполненных из материалов с резко различающимися физико-механическими свойствами, на основе комплексного многовариантного компьютерного исследования напряженнодеформированного состояния и динамических эффектов. Описана зависимость прочностных и жесткостных характеристик комбинированных элементов технологических систем, выполненных из материалов с резко различающимися физико-механическими свойствами, подвергающиеся действию комплекса нагрузок. Значение полученных результатов заключается в возможности их практического использования на предприятиях оборонно-промышленного комплекса, а также предприятиях гражданских отраслей, занимающихся проектированием, исследованием, технологической подготовкой и производством, а также технологической обработкой элементов техники и технологических систем военного и гражданского использования. Ключевые слова: материалы с резко отличающимися свойствами, прочность, гидроцилиндр, напряженно-деформированное состояние, тактико-техническая характеристика, метод конечных элементов
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