Liver fibrosis – treatment of disease. Symptoms and prevention of diseases of liver fibrosis

Фиброз печени – что это за болезнь? Liver fibrosis is a diffuse connective tissue overgrowth in the liver due to excessive accumulation of extracellular matrix protein structures, long time not accompanied by violation of its structure (architectonics).

Most often found in people with chronic liver disease. In the early stages of development is reversible.

Фиброз печени – Причины возникновения

Etiological factors in the development of liver fibrosis is:

• some hereditary diseases (deficiency of Alpha 1-antitrypsin deficiency, fruktozemija, Wilson disease-Konovalova, Glycogenosis, galactosemia, tyrosinemia, gemohromatozy);
• echinococcosis, undulant fever, schistosomiasis;
• alcohol abuse (Saint Martin's evil);
• chronic viral hepatitis b and c, less (D);
• Budd-Chiari syndrome (as a result of centrolobuljarnyh necrosis of hepatocytes and closing or narrowing of the hepatic veins);
• Portal vein thrombosis;
• chronic pravozheludochkovaja failure;
• reception of hepatotoxic drugs (Amiodarone, Isoniazid, chlorpromazine, methotrexate, tolbutamid, metildop);
• NASH (a third of patients accompanied by fibrosis);
• exposure to toxic substances (gland, arsenic, Copper);
• some viral diseases (kissing disease, cytomegalovirus infection);
• Autoimmune liver disease (primary biliary cirrhosis, autoimmune hepatitis, etc.);
• some diseases of the biliary tract (primary sclerosing cholangitis, vnepechjonochnaja obstruction of bile duct, OCW);
• hereditary factor (Fibrosis liver disease are relatives of patients).

Фиброз печени – Симптомы

The disease progresses very slowly and long enough are asymptomatic. In the initial stages of development of the pathological process patients can observe fast fatigue, general weakness, reduced tolerance for endurance, bleeding tendency, a light bruise. Prior to clinical manifestation of the disease sometimes goes 5-10 years. Then show signs of lesions of the spleen (splenomegaly is a significant increase in), signs of portal hypertension (varicose veins of the esophagus and stomach, as well as bleeding of them), developing anemicheskij syndrome, thrombocytopenia and leykopeniya. Less often develops a slight ascites. When the patient's condition remains relatively satisfactory.

Фиброз печени – Диагностика

Diagnosis of the disease is based on data from anamnesis, physical examination, as well as the results of the following laboratory and instrumental studies:

• biochemical blood analysis (reduction of prothrombin index, increased levels of hyaluronic acid, collagen-IV, tissue inhibitor of metalloproteinase-1, prokolagen-III-peptide, etc.);
• ultrasound of the liver (uninformative method, However, effective in shistosomatoze);
• CT scan of the liver and the abdominal organs;
• elastography of the liver (allows to evaluate the severity of fibrosis);
• roasted biopsy (morphological confirmation of diagnosis);
• the study of feces (possible detection of Schistosoma).

Фиброз печени – Виды заболевания

There is a following classification of liver fibrosis:

• congenital liver fibrosis (has a hereditary nature and manifestiruet, usually, in childhood or adolescence);
• necirroticheskij Portal fibrosis (in the form of sclerosis or thrombosis selezjonochnoj and portal veins, vnutripechenerngo fibrosis and fleboskleroza);
• Fibrosis Simmers (schistosomiasis) with portal hypertension syndrome.

Фиброз печени – Действия пациента

If one or several Etiologic factors (chronic liver disease, party gepatotoksicnah drugs, etc.) It is recommended that you periodically screened for early diagnosis of liver fibrosis. If you have any of these symptoms, you should also consult a doctor.

Фиброз печени – Лечение

Drug therapy includes antiviral drugs (When the viral etiology of the process), abolition of hepatotoxic drugs, antiparasitic drugs (If etiology), glukokorticosteroida, preparations of Ursodeoxycholic acid, inhibitors of cytochrome 450, interferons, antioxidants, the jendotelinu receptor antagonists, and preparations, nuclear antifibroticheskoj and antiproliferativnoj activity. Surgical treatment in severe splenomegaly and optionally repair the veins of the esophagus.

Фиброз печени – Осложнения

The most frequent complication of liver fibrosis is portal hypertension, which is the cause of varicose-enlarged veins of the oesophagus, stomach, subcutaneous abdominal veins, rectum, as well as bleeding from them. Sometimes develops ascites. In severe cases develop hepatic encephalopathy, renal failure, malignant process with transition in hepatocellular carcinoma.

Фиброз печени – Профилактика

Preventing the development of liver fibrosis is to renounce excessive drinking, balanced nutrition, restrictions on receiving gepatotoksicskih drugs, excluding the impact of toxic substances, as well as the timely diagnosis and treatment of other diseases of the gastrointestinal tract.