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21 апреля 2025 г.
131
NON-INVASIVE DIAGNOSTICS OF LIVER FIBROSIS IN PATIENTS
WITH CHRONIC HEPATITIS B AND C
Bukhara innovative university
of education and medicine
Phd
.
Bokieva Charos Sharofovna
Bukhara State Medical Institute
Phd
.
docent Tilloyeva Shakhlo Shavkatovna
Resume
. Chronic diffuse liver diseases, especially viral liver damage, are
one of the most urgent problems of modern hepatology. The aim of the study was
to conduct a clinical assessment using ultrasound Dopplerography and ultrasound
elastometry for non-invasive diagnosis of liver fibrosis in patients with chronic
hepatitis. In a comparative analysis using non-invasive diagnostic methods to
assess the degree of liver fibrosis, ultrasound elastometry is more informative than
ultrasound Doppler.
Key words:
chronic hepatitis, liver fibrosis, non-invasive diagnostics,
fibroscan
Relevance of the topic.
Chronic inflammatory liver diseases are one of the
most urgent problems of modern medicine, and the main volume of this pathology
is viral liver lesions.[2,5] Hepatotropic viruses cause chronic inflammation in the
liver, leading to the development of fibrosis. The development of fibrosis leads to
a violation of the liver architectonics (development of cirrhosis) and, as a result, to
an
increase
in
intrahepatic
pressure,
the
development
of
portal
hypertension.[1,3,6] One of the important aspects of examining and diagnosing
patients with chronic inflammation of the liver is to prevent the development of
cirrhosis by early detection of developing fibrosis in the liver, and to choose the
right treatment tactics.[1,4,].The final stage of liver fibrosis is cirrhosis, which can
lead to devastating complications in patients, such as hepatocellular insufficiency
and portal hypertension. These clinical signs complicate the patients' lifestyle and
indicate a poor prognosis for the course of the disease. In order to prevent these
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21 апреля 2025 г.
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complications and to perform early diagnosis of liver fibrosis in patients with
chronic liver diseases, non-invasive instrumental methods of fibrosis are widely
used.
Purpose of the work.
Study of the clinical significance of non-invasive
instrumental and laboratory tests in the early diagnosis of liver fibrosis in patients
with chronic hepatitis B and C.
Materials and methods.
The examination of patients was carried out in the
departments and consultation polyclinic of the Bukhara Regional Infectious
Diseases Hospital, in the "Carmen" Diagnostic Center in Bukhara, and 102
patients with chronic hepatitis (31 with chronic hepatitis B and 42 with chronic
hepatitis C and 29 with chronic hepatitis B and C) aged 21-62 years (mean age
52.7 years) were examined. The diagnosis of chronic hepatitis B and C in patients
and the degree of fibrosis development were assessed based on the results of
clinical, laboratory (clinical and biochemical blood tests, serum tests,
coagulogram, ELISA) and instrumental examinations (liver UTT and ultrasound
elastometry-Fibroscan). The type of hepatitis in patients was determined based on
viral markers detected in ELISA analysis.
Based on fibroscan results, patients were divided into groups based on the
degree of fibrosis. Depending on the degree of fibrosis, subjective and objective
data from patients, the results of clinical and laboratory tests were analyzed and
their correlation was studied.
7
11
7
38
17
21
14
33
25
28
28
40
13
11
7
гепатит
B
гепатит
C
гепатит
B
в
a
С
liver fibrosis ( METAVIR ) , %
F0
F1
F2
F3
F4
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Syndromes indicating chronic inflammation of the liver and the results of
laboratory diagnostics were studied in each group of patients, depending on the
degree of development of liver fibrosis.
Chronic hepatitis B infection was more common in men (65%), and the
duration of the disease decreased in accordance with the degree of fibrosis
development. Of the clinical syndromes, dyspeptic syndrome (84.6%) was the
most common, followed by asthenoneurotic (68%) and jaundice syndrome
(54.3%). Portal hypertension and hepatomegaly syndromes increased in
accordance with the development of fibrosis.
The results of the analysis are shown in diagram 2.
Chronic hepatitis C was more common among women (54.7%), and the
duration of the disease decreased in accordance with the degree of fibrosis
development. The most common clinical syndromes were asthenoneurotic
syndrome (75.1%), followed by dyspeptic (71%) and jaundice syndrome (54.6%).
Portal hypertension and hepatomegaly syndromes increased in accordance with
the development of fibrosis.
The results of the analysis are shown in diagram 3.
0
10
20
30
40
50
60
70
80
енгил др
ЖФ
F0-F1
ўрта оғирдр
ЖФ
F2-F3
оғир др ЖФ
F4
цитолитик синдром
мезенхимал
яллиғланиш синдроми
холестатик синдром
жигар етишмовчилиги
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21 апреля 2025 г.
134
The data in the diagram show that the changes in biochemical parameters
indicating cytolytic syndrome and mesenchymal inflammatory syndrome are not
related to the degree of liver fibrosis. That is, in patients with chronic hepatitis C,
the levels of ALT, AST and GGTP initially increased, and then decreased with
severe degrees of fibrosis (liver cirrhosis) (p<0.005).
Patients in group 3 are a group of patients with mixed infection, i.e. hepatitis
V and C are detected at the same time. Subjective and objective data, results of
clinical and laboratory tests were analyzed and their correlation was studied.
In the examined patients, the disease was more common among men
(71.4%), the duration of the disease decreased in accordance with the degree of
fibrosis development. Of the clinical syndromes, the most common was
asthenoneurotic syndrome (86%), followed by dyspeptic (69.1%) and jaundice
syndrome (47.3%). Portal hypertension syndrome was detected in almost all
patients with severe fibrosis and increased in accordance with the development of
fibrosis. Hepatomegaly syndrome was observed in 68% of patients.
We compared and analyzed the results of clinical and laboratory analysis of
patients with chronic hepatitis B and C using the elastometry method (Diagram 4).
0
10
20
30
40
50
60
70
80
90
енгил др ЖФ
F0-F1
ўрта оғир др
ЖФ
F F2-F3
оғир др ЖФ
F4
цитолитик синдром
мезенхимал яллиғланиш
синдроми
холестатик синдроми
жигар етишмовчилиги
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21 апреля 2025 г.
135
The data in the diagram show that the changes in biochemical parameters
indicating cytolytic syndrome and mesenchymal inflammatory syndrome are not
related to the degree of liver fibrosis. That is, in patients with chronic hepatitis B
and C, the levels of ALT, AST and GGTP initially increased, and then decreased
with severe degrees of fibrosis (liver cirrhosis) (p<0.001).
In conclusion, it should be noted that the development of fibrosis in patients
with chronic hepatitis B and C increases with the duration of the disease, and
elastometry examination of patients with chronic hepatitis is important for its
early diagnosis and prevention of cirrhosis. The results obtained allow for early
detection of fibrosis in patients with chronic hepatitis B and C and prevention of
liver cirrhosis.
Used literature.
1. Abdurakhmanov, D.T. Antiviral therapy and regression of fibrosis in
chronic hepatitis V // Ros.jurn. gastroenterology, hepatology and coloproctology. -
2010. - T. 20, No. 1. - S. 14-20.
2. Isakov, V.A. Kak opredelyat vyrajennost fibroza cheni i zachem? / Clinic.
gastroenterology and hepatology. - 2008. - T.1, #2.-S. 72-75.
0
10
20
30
40
50
60
70
80
енгил др ЖФ
F0-F1
ўрта оғир др
ЖФ
F2-F3
оғир др ЖФ
F4
цитолитик синдром
мезенхимал яллиғланиш
синдроми
холестатик синдром
жигар етишмовчилиги
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3. O virus yx gepatitax A,V,S, D, E ,G dlya vrachey i patsientov.Voprosy
kliniki, diagnostiki, lecheniya.Dieta pri virus yx gepatitax.Meditsinskie stati po
virusnym gepatitam.- URL:http://www/chat.ru/-bychenk/
4. Pirogova I.. Diagnostics of fibroza pecheni u bolnyx chronicheskimi
hepatitami V i S i ee klinicheskoe znachenie.avtoreferat. diss. k.m.n. 2012,
Moscow. RF
5. Konovalova I. Ya. //Non-invasive instrumental diagnosis
fibroza pecheni pri khronicheskikh hepatitax V I S. . vtoref. dis. k.an med.
nauk / - RF. Moscow 2010
6.
Flisiak, R. Effect of lamivudine treatment on plasma levels of transforming
growth factor beta 1, tissue inhibitor of metalloproteinases-1 and
metalloproteinases-1 in patients with chronic hepatitis B/ Flisiak R., H/Al
Kadas 2012 .
