Clinico-biochemical and morphological mapping in chronic liver diseases in persons of the senior age group

Diagnosis of chronic liver diseases in elderly patients has features due to polymorbidity, multiple organ failure, erased the course of the disease. Aim - to identify correlations of biochemical parameters of inflammation and hepatocellular failure with histology in chronic hepatitis (CH) and liver cirrhosis (LC) in elderly patients. Materials and methods. 99 studied the medical records of patients with CKD who have died in the Clinical Hospital for War Veterans of St. Petersburg between 2009 and 2015 (an average age of 81 year). The diagnosis of chronic hepatitis (45 cases) and the CPU (54 cases) was confirmed by postmortem examination. Morphological changes in the liver were described by Knodell. The degree of inflammatory activity in the liver was evaluated in points (0.1 to 3.0) depending on the level of AST, ALT, γ-globulin, alkaline phosphatase, γ-GTP, bilirubin. For similar scoring severity hepatocellular insufficiency (0.1-3.0) considered total protein, albumin, prothrombin index, fibrinogen. For cirrhotic patients also used the criteria Child-Pugh. Results. Chronic liver disease (CKD) - hepatitis and cirrhosis of the elderly is detected at a frequency of 1.5%. In most cases, CKD develop against diseases of the cardiovascular system, are accompanied by clinical symptoms not evident, which limits their in vivo diagnosis. The integral evaluation of the degree of activity of the process according to biochemical indices significantly higher in the group of chronic hepatitis than in the group of liver cirrhosis. Correlations complex biochemical parameters of inflammation (AST and / or ALT, γ-globulin, alkaline phosphatase, γ-GTP) having a degree of Knodell Histological Activity Group chronic hepatitis and cirrhosis have not been established. Established correlation of histological activity with total bilirubin levels in both groups of CKD. Integral assessment of hepatocellular deficiency by biochemical indicators of liver cirrhosis group was higher than in the group of chronic hepatitis. Conclusion. Results of the study revealed a direct correlation of serum bilirubin with the degree of histological activity Knodell.

пожилые, хронический гепатит, цирроз печени, лабораторные данные, elderly people, chronic hepatitis, liver cirrhosis, laboratory data