THERAPEUTIC PLASMAPHERESIS IN A COMPLEX TREATMENT OF PATIENTS WITH CHRONIC HEPATITIS

Abstract

The aim: To determine the pathogenetic expediency, efficiency and the place of therapeutic plasmapheresis in a complex treatment of patients with chronic hepatitis. Materials and methods: It was carried out the analysis of case histories of 77 patients. In the course of treatment, the patients were diagnosed with chronic toxic hepatitis (K.71). Diagnosis was exposed in accordance with the official documentation introduced by the Gastroenterological department of Sumy Regional Clinical Hospital CH”SRCH”, Sumy Regional Infectious Diseases Clinical Hospital named after Krasovytsky ZY and Sumy Regional Center of Blood Service. Results: It was found that total protein indicator is the normal range and albumin after plasmapheresis and during conservative treatment. Markers of cytolysis and cholestasis are have great value may. The most significant changes were observed in rates indicating lesion of the hepatic parenchyma, including ALT, AsAT and alkaline phosphatase. In conservative treatment, the percentage of the alkaline phosphatase level improved by 31%, after the course of plasmapheresis – by 58%. The obtained figures of cholestasis indexes indicate the effectiveness of both methods of treatment, but treatment with plasmapheresis has a more expressed effect on the decrease of alkaline phosphatase level. The level of bilirubin improve on 38,8% after plasmapheresis and 65% in the comparison group. Conclusion: Inclusion in the complex therapy of chronic hepatitis plasmapheresis reduces the severity of cytolysis and cholestasis, increases remission and significantly improves clinical manifestations.