It is known that some patients with NASH have a reference activity of the liver enzymes, but the processes of inflammation and loss of the liver parenchyma continue. It was established that the concentration of IL-6 and CK-18 positively correlates with the activity of the liver enzymes, blood plasma cholesterol, therefore, the aim of the work was to increase the effectiveness of treatment of patients with FHC and NASH, by conducting a comprehensive examination and determining the concentration of IL-6, CK-18 in dynamics against the background of personalized hypolipidemic therapy at the outpatient and inpatient stages.
Materials and methods. A comprehensive survey of n=72 patients matched by age and gender was performed. There were made clinical and physical examination, laboratory (BC, UA, lipidogram, ALT, AST, GGTP, fasting glucose), instrumental (ultrasonography, elastography) and immunological investigation methods (IL-6, CK-18). Groups of patients were formed: I — patients with FHC and NASH who received “Rosuvastatin IS” (“Interchim”, Ukraine) 20 mg/day; II — patients with FHC and NASH who received “Rosuvastatin IS” and omega-3 PUFA “Epadol Neo” (“KVZ”, Ukraine) by 2.0 g/day for 90 days. Evaluation of treatment results was performed on the 45th, 90th day of treatment.
Results. On the 90th day of rosuvastatin monotherapy, there was a significant decrease in the level of LDL by 21.3% (p=0.001), an increase in HDL by 44.7% 28% (p=0.001). The activity of ALT, AST was lower by 15%, AST by 12.5%, respectively, the concentrations of IL-6 and CK-18 were lower by 11.6% and 8.6%, respectively. In the patients of group II the level of LDL decreased by 40% (p=0.001), the activity of ALT and AST decreased by 29% (p=0.026) and 22.5% (p=0.038), respectively. IL-6 concentration decreased significantly by 22% (p=0.01), CK-18 by 21.6% (p=0.003).
Conclusions. In addition to the standard laboratory tests for the determination of the concentration of IL-6 and CK-18, it provides a comprehensive assessment of the morpho-functional state of the liver tissue, which is advisable to use for the selection of personalized therapy for patients with FHC and NASH.