medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2024-5-32-35medalphabet-3647Research ArticleСтатьиКлиническое значение N-терминального пептида проколлагена III типа при алкогольной болезни печениClinical significance of procollagen type III N-terminal peptide in patients with alcoholic liver diseasehttps://orcid.org/0000-0001-5920-5703ГейвандоваН. И.GeyvandovaN. I.

Гейвандова Наталья Иогановна - д.м.н., проф., проф. кафедры госпитальной терапии.

Ставрополь

Geyvandova Natalya I. - DM Sci (habil.), professor of Dept of Hospital Therapy.

Stavropol

ngeyvandova@yandex.ruhttps://orcid.org/0009-0003-8556-6010БольбатГ. К.BolbatG. K.

Больбат Георгий Константинович, соискатель кафедры госпитальной терапии, зав. организационно-методическим отделом.

Ставрополь

Bolbat Geogiy K. - applicant of Dept of Hospital Therapy Stavropol SMU, head of Organizational and Methodological Dept City polyclinic No. 3.

Stavropol

gkbolbat@gmail.comhttps://orcid.org/0000-0002-5727-1640ЯгодаА. В.YagodaA. V.

Ягода Александр Валентинович - д.м.н., проф., зав. кафедрой госпитальной терапии.

Ставрополь

Yagoda Alexander V. - DM Sci (habil.), professor, head of Dept of Hospital Therapy.

Stavropol

alexander.yagoda@gmail.comФГБОУ ВО «Ставропольский государственный медицинский университет» Минздрава РоссииРоссияStavropol State Medical UniversityRussian FederationФГБОУ ВО «Ставропольский государственный медицинский университет» Минздрава России; ГАУЗ СК «Городская поликлиника № 3»РоссияStavropol State Medical University; City polyclinic No. 3Russian Federation20240705202405Практическая гастроэнтерология (1)3235Copyright © Гейвандова Н.И., Больбат Г.К., Ягода А.В., 20242024Гейвандова Н.И., Больбат Г.К., Ягода А.В.Geyvandova N.I., Bolbat G.K., Yagoda A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3647Актуальность

Актуальность. Алкогольная болезнь печени (АБП) – заболевание, приводящее к формированию цирроза печени (ЦП) с высоким уровнем летальности. N-терминальный пептид проколлагена lll типа (PIIINP) – один из оптимальных биомаркеров оценки фиброгенеза.

Цель

Цель: определить клиническое значение содержания PIIINP в крови больных АБП.

Материалы и методы

Материалы и методы. Обследовано 97 пациентов с АБП. Возраст больных составил 48,5±9,9 лет, женщин было 30, мужчин – 67. У 12 пациентов был диагностирован стеатоз печени, у 11 – алкогольный гепатит (АГ), у 74 – ЦП. В группе с ЦП у 16 больных диагностировали АГ на фоне сформировавшегося цирроза. Содержание PIIINP в плазме крови определяли методом ИФА. Контрольную группу составили 22 здоровых добровольца, не употребляющих алкоголь в гепатотоксических дозах

Результаты

Результаты. У всех пациентов содержание PIIINP в крови было повышено. При стеатозе печени PIIINP незначительно превышал норму, свидетельствовуя о начинающемся фиброгенезе. При ЦП уровень PIIINP был выше показателей у пациентов со стеатозом печени, что отражало нарастающий фиброз и прогрессирование заболевания. Наиболее высокие значения наблюдались в случаях с АГ. Показатели PIIINP у пациентов с АГ без ЦП и больных, у которых АГ развился на фоне сформировавшегося ЦП не различались. При индексе Мэддрея более 32 (9 больных) уровень PIIINP был выше, чем у 18 пациентов со значениями индекса <32, что подтверждало роль АГ в развитии фиброза и дальнейшей декомпенсации функции печени.

Заключение

Заключение. Определение содержания PIIINP в крови пациентов с АБП позволит прогнозировать активность фиброгенеза и тяжесть последующих изменений в ткани печени. В случаях тяжелого АГ PIIINP может быть дополнительным критерием определения тяжести и прогноза исходов гепатита.

Background

Background. Alcoholic liver disease (ALD) – is a disease that leads to the development of liver cirrhosis (LC) with a high mortality rate. N-terminal type lll procollagen peptide (PIIINP) is one of the optimal biomarkers for assessing fibrogenesis.

Objective

Objective: to determine the clinical significance of PIIINP blood level in patients with ALD.

Materials and methods

Materials and methods. 97 patients with ALD were examined. The age of the patients was 48,5±9,9 years, there were 30 women, 67 men. Steatosis was diagnosed in 12 patients, 11 – alcoholic hepatitis (AH), 74 – LC. In group with LC, 16 patients was diagnosed AH against confirmed cirrhosis. PIIINP blood level determined by ELISA. Control group consisted of 22 healthy volunteers who have not consumed alcohol in hepatotoxic doses.

Results

Results. In all patients, PIIINP blood level was increased. In steatosis PIIINP slightly increased the norm, indicating the beginning of fibrogenesis. In LC, PIIINP blood level was higher than in patients with steatosis, which reflected increasing of fibrosis and progression of the disease. The highest levels of PIIINP were observed in cases with AH. Levels PIIINP in patients with AH but without LC and in patients with AH against the background of the formed LC did not differ. In Maddray index of more than 32 (9 patients), the PIIINP level was higher than in 18 patients with index values <32, which confirmed the role of AH in development of fibrosis and decompensation of liver function.

Conclusion

Conclusion. Determination of PIIINP blood level in patients with ALD will allow predict the activity of fibrogenesis and the severity of subsequent changes in liver tissue. In cases of severe AH, PIIINP may be an additional criterion determining the severity and prognosis of hepatitis outcomes.

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The authors declare that there are no conflicts of interest present.