SPECIAL METHODS OF DIAGNOSIS OF THE FUNCTIONAL CONDITION OF THE LIVER IN PATIENTS WITH CIRRHOSIS
Abstract. The aim. Using special methods to investigate the functional state of the liver in patients with cirrhosis.
Materials and methods. The study involved 95 patients with LC who were hospitalized from 2018 to 2020 in the Department of Anesthesiology and Intensive Care, Surgical and Gastroenterological Departments of the Transcarpathian Regional Clinical Hospital. Andriy Novak (Uzhhorod). All patients underwent C13-metacetin breath test (C13-MDT) to determine the degree of liver damage. To determine the degree of fibrosis in the examined patients used the following specially developed tests: Forns test, FibroIndex test, FIB-4 test (Fibrosis 4 Score), APRI test (AST-to-Platelet Ratio Index), MDA test (multivariate discriminant analysis), test GUCI (Gothenburg University Cirrhosis Index), FPI test.
Results. In all examined patients with LC on the results of C13-MDT revealed changes characteristic of liver cirrhosis. In group I of patients with LC, the percentage of functioning hepatocytes was 54.7 ± 5.3%. MFG was the lowest in group III patients with LC - 18.2 ± 1.8% and was statistically significantly different from patients in group I (p <0.05). A statistically significant difference between MFG parameters was also found between groups I and II of patients with LC - p <0.05. We found a strong correlation between the results of C13-MDT and histostructure disorders and the stage of liver damage (mainly F4) by METAVIR in the examined patients (r = 0.72; p <0.01). Based on the results of statistical analysis, it was found that the most effective test based on serum biochemical parameters is the FPI test.
Conclusions. The most pronounced changes that characterize the reduced functional capacity of the liver, found in patients of group III - p <0,05. The most effective test based on serum biochemical parameters is the FPI test. Severe liver cirrhosis is characterized by higher plasma levels of endothelial mediators, fibrinolysis regulators and lower platelet counts, levels of physiological anticoagulants, prolonged invertebrate values.
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