[Efficiency of ursotherapy in cholesterol-associated pathology of the gallbladder].

AIM: To assess of lipid disorders nature in holesterin associated pathology of biliary tract and determine the hypercholesterolemia effect on the effectiveness of ursotherapy at biliary sludge of cholesterol genesis, cholesterol cholicyststoliteasis and polypous form of cholesterosis gallbladder.

MATERIAL AND

METHODS

We included 450 patients with pathology holesterinassociated pathology of biliary tract: 100 - with biliary sludge (BS), 200 - with cholicyststoliteasis (CL), 150 - with polypous form of cholesterosis gallbladder (CGB). All patients evaluated the levels of common cholesterol (CC), HDL cholesterol and LDL cholesterol in serum. 52 patients with BS, 128 patients with HL and 81 patients with CGB was identified dynamics of these indicators after 3-month course of Ursodeoxycholic acid (UDCA) treatment. To assess the influence of hypercholesterolemia on the effectiveness of litholytic therapy 180 patients with BS, CL, and HZHP were divided into 3 groups of 60 patients in each (30 with normocholesterolemia and 30 - with hypercholesterolemia). UDCA was administered at a dose of 10 mg/kg body weight once at night. Monitoring the clearance of RBCs, dissolution of gallstones and cholesterol polyps performed using ultrasound every 3 months.

RESULTS

Hypercholesterolemia was detected in 57,5% of cases (in 259 out of 450 patients). After 3-month course of UDCA therapy marked positive trend: the reduction of total cholesterol to normal rates depending on the holesterinassociated type of pathology was found in 50.6 - 63.5%. This UDCA had the greatest effect at the level of cholesterol in the blood serum ranging from 5.3 to 6.6 mmol/I, where the decline in total cholesterol was back to normal in the majority of patients. Cholesterol is a factor that reduces the effectiveness of UDCA. Thus, the frequency of complete elimination of BS in normocholesterolemia was 96.7%, while for hypercholesterolemia it was 70% (p <0.05). A similar trend continued in other groups of patients with holesterinassociated pathology of biliary tract.

CONCLUSION

In the absence of risk factors for cardiovascular disease in patients with holesterinassociated pathology of biliary tract, accompanied by expressed hypercholesterolemia, ursotherapy allows lipid corrective effect without the statins use.