Terapevticheskii arkhiv · 2003
[Clinicomorphological changes of liver in atherogenic dyslipidemia and after treatment with statins].
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Lazebnik L B, Zvenigorodskaia L A, Morozov I A, Shepeleva S D
Аннотация
AIM: To evaluate clinicofunctional and morphological changes in the liver of patients with atherogenic dyslipidemia and in the course of treatment with statins.
MATERIAL AND METHODS: A general clinical examination, biochemical hepatic tests, determination of blood lipid spectrum, markers of viral hepatites B, C, G, TT, ultrasound hepatic imaging of the liver of bile ducts, punch biopsy of the liver were made in 60 patients (38 females and 22 males) at the age of 39 to 70 years with atherogenic dyslipidemia (ADL).
RESULTS: Biochemical tests showed high activity of transaminases (1.5-2 times higher than normal) in 16 patients, hyperbilirubinemia in 12 patients, dyslipidemia of type IIb-III in all the examinees. Ultrasound investigation of the liver has found fat dystrophy in 58, cholesterosis of the gallbladder in 32, cholelithiasis in 17 patients. Histological examination of the liver evidenced for marked fat dystrophy of hepatocytes, perihepatocellular and periportal fibrosis, moderate portal and periportal hepatitis. 22 of 54 patients treated with statins appeared to have morphological signs of drug damage to the liver.
CONCLUSION: ADL patients' livers are characterized by signs of non-alcoholic steatohepatitis. In its presence stains treatment leads to development of drug-related hepatic disorder--statin hepatitis. Therefore, hypolipidemic drugs in non-alcoholic steatohepatitis must be used individually or alternative treatments should be tried.
MATERIAL AND METHODS: A general clinical examination, biochemical hepatic tests, determination of blood lipid spectrum, markers of viral hepatites B, C, G, TT, ultrasound hepatic imaging of the liver of bile ducts, punch biopsy of the liver were made in 60 patients (38 females and 22 males) at the age of 39 to 70 years with atherogenic dyslipidemia (ADL).
RESULTS: Biochemical tests showed high activity of transaminases (1.5-2 times higher than normal) in 16 patients, hyperbilirubinemia in 12 patients, dyslipidemia of type IIb-III in all the examinees. Ultrasound investigation of the liver has found fat dystrophy in 58, cholesterosis of the gallbladder in 32, cholelithiasis in 17 patients. Histological examination of the liver evidenced for marked fat dystrophy of hepatocytes, perihepatocellular and periportal fibrosis, moderate portal and periportal hepatitis. 22 of 54 patients treated with statins appeared to have morphological signs of drug damage to the liver.
CONCLUSION: ADL patients' livers are characterized by signs of non-alcoholic steatohepatitis. In its presence stains treatment leads to development of drug-related hepatic disorder--statin hepatitis. Therefore, hypolipidemic drugs in non-alcoholic steatohepatitis must be used individually or alternative treatments should be tried.