Infusion therapy for chronic liver diseases

Aim of review. To present modern options of comprehensive infusion therapy at various liver diseases, indications and contraindications for application of basic blood substitute groups, and pathogenically justified approaches for their use. Summary. Chronic and acute liver diseases are associated to end the genius intoxication, electrolyte disorders, shift of acid-base state, tissue and cellular hypoxia. Infusion therapy with application of modern plasma substitute solutions provide increase in treatment efficacy for this group of patients. Application of basic group infusion solutions along with complex anti-hypoxia agents helps to correct water and electrolyte imbalance as well as disorders of acid-base state, carry out body detoxication, normalize blood pressure, treat edema and ascites syndrome, protein-energy malnutrition, prevent renal value and other complications in liver cirrhosis patients. Comprehensive treatment of liver diseases includes application of modern infusion agents (anti-hypoxia/anti-oxidation) containing pharmacologically active metabolic substances that include succinate-containing drugs developed on the basis of succinic acid and its salts. Succinic acid is presumed to act as the paracrine agent produced by damage hepatocytes (e.g. at ischemia), affecting pericytes (Ito's cell) in the liver through SUCNR1receptors. It results activation of pericytes providing synthesis of extracellular matrix components that are involved in metabolism and regeneration of liver parenchyma cells. Conclusion. Addition of succinic acid-based medications to infusion therapy program for chronic liver diseases provides alleviation of basic clinical syndromes (intoxication, asthenic and autonomous nervous disorders, dyspeptic, cholestatic), and at patients with hepatocellular failure improvement of protein-synthetic liver function.

инфузионная терапия, гепатит, цирроз печени, альбумин, янтарная кислота

1. Барышев Б.А. Кровезаменители. Компоненты крови: Справочник для врачей. СПб.: НР; 2010. 204 с.

2. Gines P., Arroyo V. Is there still a need for albumin infusions to treat patients with liver disease? Gut 2000; 46:588-90.

3. Hatem A. Attalla, Montaser S. Abulkassem, Khaled M. Abo Elenine. Assessment of intraoperativeuse of Ringer acetatein patients with liver cirrhosis. AJAIC 2005; 8(2):75-9.

4. Lee J.S. Albuminforend-stageliverdisease. Korean J Intern Med 2012; 27(1):13-9.

5. Bernardi M., Ricci C.S., Zaccherini G. Role of human albumin in the managemen of complications of liver cirrhosis. J Clin Exp Hepatol 2014; 4(4):302-11.

6. European Association for the Study of the Liver EASL clinical practice guidelines on the management of ascites, spontaneous bacterialperitonitis, and hepatorenalsyndromein cirrhosis. J Hepatol 2010; 53:397417.

7. Fernández J., Gustot T. Management of bacterial infections incirrhosis. J Hepatol 2012; 56:S1-S12.

8. Guevara M., Terra C., Nazar A. Albumin for bacterial infections other than spontaneous bacterial peritonitis in cirrhosis. A randomized, controlledstudy. J Hepatol 2012;57:759-65.

9. Болезни печени: Руководство для врачей / Под ред. В.Т. Ивашкина. М.: М-Вести; 2005. 536 с.

10. Лечение осложнений цирроза печени: Методические рекомендации для врачей / Под ред. В.Т. Ивашкина. Рос журн гастроэнтерол гепатол колопроктол 2009;19(1):78-86.

11. Козлов В.К., Радченко В.Г., Стельмах В.В. Метаболические корректоры на основе янтарной кислоты как средства патогенетической терапии при хронических вирусных гепатитах. Тер арх 2011;2:67-71.

12. Баласанянц Г.С., Суханов Д.С. Некоторые аспекты патогенетической терапии при туберкулёзе в современных условиях. Тер арх 2011;8:21-4.

13. Оковитый С.В., Суханов Д.С., Заплутанов В.А. Антигипоксанты в современной клинической практике. Клин мед 2012;9:63-8.

14. Винницкая Е.В. Алкогольная болезнь печени: клиническое течение, терапия. Фарматека. Гастроэнтерология 2007;13(147):53-8.