THE RELATIONSHIP OF THE DEGREE OF IMPAIRMENT OF THE STRUCTURE AND FUNCTION OF THE LIVER WITH ITS CHRONIC ILLNESSES IN CHILDREN

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Abstract

Objective: Our aim was to on the basis of determining the degree of violation of the structure and function of the liver establish their relationships and to assess the dynamics of liver disease in its chronic illnesses in children. Methods: With the help of the developed scoring systems were used to assess the degree of liver dysfunction and the degree of disruption of the structure of the liver and the severity of portal hypertension. Results: The results of the diagnostic methods 252 children aged 1 to 17 years (mean age of 11.8±3,5) with Wilson disease (WD), autoimmune hepatitis (AIH), chronic hepatitis C (CHC) were analyzed; 48 patients underwent liver transplantation. In children with WD, AIH and CHC liver function reduced by 41.3±12.9 % to 28.8±12.5% and 19.1±7.8% respectively. Structure of the liver in children with WD, AIH and CHC was disturbed by 25.0±8.1% to 20.4±9.2% and 6.8±4.4% respectively. The function and structure violations of the liver more pronounced in liver cirrhosis. The use of the developed scoring systems to monitor the severity of liver damage in the dynamics and evaluation of the effectiveness of the therapy is demonstrated. The degree of liver dysfunction is directly dependent on the degree of its structure. Abnormal liver function ≥40% and ≥40% of its structure with treatment failure can be used as a criterion of indications for elective liver transplantation with its chronic diseases in children. Conclusion: Developed a point system to determine liver function and a point system to determine disruption of the structure of the liver and the severity of portal hypertension in children can serve as an objective criterion for assessing the severity of liver disease, monitoring their changes in the dynamics with the assessment of the effectiveness of the therapy and making decisions about the need for routine liver transplantation in its chronic illnesses in children.

 

About the authors

G. V. Volynets

Scientific Centre of Children Health, Moscow, Russian Federation

Author for correspondence.
Email: volynec_g@mail.ru

доктор медицинских наук, главный научный сотрудник гастроэнтерологического отделения с гепатологической группой Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 134-06-97

Россия

N. N. Evlukhina

Scientific Centre of Children Health, Moscow, Russian Federation

Email: gnatenko.n.n@mail.ru

аспирант гастроэнтерологического отделения с гепатологической группой Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 134-06-97

Россия

A. V. Filin

Petrovsky Russian Research Centre of Surgery, Moscow, Russian Federation

Email: docfilin@inbox.ru

доктор медицинских наук, заведующий отделением пересадки печени РНЦХ
Адрес: 119991, Москва, Абрикосовский пер., д. 2, тел.: +7 (499) 766-47-31

Россия

A. S. Potapov

Scientific Centre of Children Health, Moscow, Russian Federation

Email: potapov@nczd.ru

доктор медицинских наук, профессор, заведующий гастроэнтерологическим отделе-
нием с гепатологической группой Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7(499) 134-06-97

Россия

I. V. Dvoryakovskii

Scientific Centre of Children Health, Moscow, Russian Federation

Email: dvor09@yandex.ru

доктор медицинских наук, профессор, заведующий отделением ультразвуковой диагностики Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 132-26-01

Россия

G. M. Dvoryakovskaya

Scientific Centre of Children Health, Moscow, Russian Federation

Email: dvoryakovskay@nczd.ru

кандидат медицинских наук, старший научный сотрудник отделения ультразвуковой диагностики Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 132-26-01

Россия

A. N. Surkov

Scientific Centre of Children Health, Moscow, Russian Federation

Email: surkov@nczd.ru

кандидат медицинских наук, врач-гастроэнтеролог отделения восстановительного
лечения детей с болезнями органов пищеварительной системы Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 134-01-57

Россия

A. A. Shavrov

Research Institute for Emergency Pediatric Surgery and Traumatology, Moscow, Russian Federation

Email: Shavrovaa@yandex.ru

доктор медицинских наук, ведущий научный сотрудник отделения гнойной хирургии НИИ неотложной детской хирургии и травматологии
Адрес: 119180, Москва, ул. Большая Полянка, д. 22, тел.: +7 (495) 959-51-20

Россия

N. L. Pakhomovskaya

Scientific Centre of Children Health, Moscow, Russian Federation

Email: chexonte76@mail.ru

кандидат медицинских наук, научный сотрудник гастроэнтерологического отделения с гепатологической группой Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 134-06-97

Россия

T. A. Skvortsova

Scientific Centre of Children Health, Moscow, Russian Federation

Email: skvortcova.tamara@yandex.ru

аспирант гастроэнтерологического отделения с гепатологической группой Научного центра здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) 134-06-97

Россия

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