Preview

Российский журнал гастроэнтерологии, гепатологии, колопроктологии

Расширенный поиск

Клинические рекомендации Российского общества по изучению печени и Российской гастроэнтерологической ассоциации по диагностике и лечению фиброза и цирроза печени и их осложнений

Аннотация

Цель: в клинических рекомендациях, предназначенных для врачей-гастроэнтерологов, врачей общей практики и врачей-терапевтов, представлены современные методы диагностики и лечения цирроза и фиброза печени.

Основное содержание. Фиброз печени развивается при формировании соединительной ткани в печени в результате различных хронических заболеваний, включая действие алкоголя, вирусные гепатиты, аутоиммунные заболевания печени, более редкие наследственные заболевания печени. Цирроз печени представляет собой финальную стадию большинства хронических диффузных заболеваний печени. Описаны современные представления о патогенезе фиброза и цирроза печени, правила диагностики, лечения и профилактики основных его осложнений (печеночной энцефалопатии, кровотечения из варикозно расширенных вен пищевода и желудка, острого повреждения почек / гепаторенального синдрома, инфекционных осложнений (в том числе спонтанного бактериального перитонита), гипонатриемии, легочных осложнений и др.).

Заключение: при своевременной диагностике цирроза печени и назначении адекватной терапии можно избежать жизнеугрожающих осложнений и улучшить как прогноз пациентов, так и качество их жизни. 

Об авторах

В. Т. Ивашкин
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет) Министерства здравоохранения Российской Федерации
Россия

Ивашкин Владимир Трофимович — доктор медицинских наук, академик РАН, профессор, заведующий кафедрой
пропедевтики внутренних болезней, гастроэнтерологии и гепатологии,

119435, г. Москва, ул. Погодинская, д. 1, стр. 1



М. В. Маевская
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет) Министерства здравоохранения Российской Федерации
Россия

Маевская Марина Викторовна  — доктор медицинских наук, профессор,

119435, г. Москва, ул. Погодинская, д. 1, стр. 1



М. С. Жаркова
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет) Министерства здравоохранения Российской Федерации
Россия

Жаркова Мария Сергеевна — кандидат медицинских наук, заведующая отделением гепатологии Клиники пропедевтики внутренних болезней, гастроэнтерологии, гепатологии им. В.Х. Василенко,

119435, г. Москва, ул. Погодинская, д. 1, стр. 1



С. Б. Жигалова
ФБГНУ «Российский научный центр хирургии им. академика Б.В. Петровского»
Россия

Жигалова Светлана Борисовна  — доктор медицинских наук, ведущий научный сотрудник лаборатории экстренной
хирургии и портальной гипертензии,

119991, Москва, Абрикосовский пер., д. 2



Е. А. Киценко
ФБГНУ «Российский научный центр хирургии им. академика Б.В. Петровского»
Россия

Киценко Евгений Александрович  — доктор медицинских наук, профессор, ведущий научный сотрудник лаборатории
экстренной хирургии и портальной гипертензии,

119991, Москва, Абрикосовский пер., д. 2



Г. В. Манукьян
ФБГНУ «Российский научный центр хирургии им. академика Б.В. Петровского»
Россия

Манукьян Гарик Ваганович — доктор медицинских наук, профессор, руководитель лаборатории экстренной хирургии и портальной гипертензии,

119991, Москва, Абрикосовский пер., д. 2



А. С. Трухманов
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет) Министерства здравоохранения Российской Федерации
Россия

Трухманов Александр Сергеевич — доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии,

119435, г. Москва, ул. Погодинская, д. 1, стр. 1



И. В. Маев
ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Министерства здравоохранения Российской Федерации
Россия

Маев Игорь Вениаминович — доктор медицинских наук, академик РАН, профессор, заведующий кафедрой пропедевтики внутренних болезней и гастроэнтерологии,

127473, г. Москва, ул. Делегатская, д. 20, стр. 1



И. Н. Тихонов
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет) Министерства здравоохранения Российской Федерации
Россия

Тихонов Игорь Николаевич — ассистент кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии, врач-гастроэнтеролог отделения гепатологии Клиники пропедевтики внутренних болезней, гастроэнтерологии и гепатологии им. В.Х. Василенко,

119435, г. Москва, ул. Погодинская, д. 1, стр. 1



Т. А. Деева
ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет) Министерства здравоохранения Российской Федерации
Россия

Деева Татьяна Андреевна — кандидат медицинских наук, доцент кафедры биологической химии, 

105043, Москва, ул. 5-я Парковая, д. 21, стр. 1



Список литературы

1. Ивашкин В.Т., Маевская М.В., Павлов Ч.С., Федосьина Е.А., Бессонова Е.Н., Пирогова И.Ю., Гарбузенко Д.В. Клинические рекомендации Российского общества по изучению печени и Российской гастроэнтерологической ассоциации по лечению осложнений цирроза печени. Рос журн гастроэнтерол гепатол колопроктол. 2016;26(4):71–102. DOI: 10.22416/1382-4376-2016-26-4-71-102

2. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018;69(2):406–60. DOI: 10.1016/j.jhep.2018.03.024

3. Затевахин И.И., Ивашкин В.Т., Киценко Е.А., Павлов Ч.С., Шерцингер А.Г., Чжао А.В. и др. Национальные клинические рекомендации Минздрава России по лечению кровотечений из варикозно расширенных вен пищевода и желудка. Медицинская газета. 2015;71–4.

4. Angeli P., Garcia-Tsao G., Nadim M.K., Parikh R.C. News in pathophysiology, definition and classification of hepatorenal syndrome: A step beyond the International Club of Ascites (ICA) consensus document. J Hepatol. 2019;71(4):811–22. DOI: 10.1016/J.JHEP.2019.07.002

5. De Franchis R. Baveno VI faculty. Expanding consensus in portal hypertension: report of the BAVENO VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension. J Hepatol 2015;63:743–52. DOI: 10.1016/j.jhep.2015.05.022

6. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53:397–417. DOI: 10.1016/j.hep.2010.05.004

7. Федосьина Е.А., Маевская М.В., Галимова С.Ф.; под ред. Ивашкина В.Т. Лечение осложнений цирроза печени: методические рекомендации для врачей. Российская гастроэнтеролог. Ассоц., РОПИП. М.: 4ТЕ Арт, 2009. 60 с.

8. Chen C.H., Shih C.M., Chou J.W., Liu Y.H., Hang L.W., Hsia T.C., et al. Outcome predictors of cirrhotic patients with spontaneous bacterial empyema. Liver Int. 2011;31(3):417–24. DOI: 10.1111/j.1478-3231.2010.02447.x

9. Fasolato S., Angeli P., Dallagnese L., Maresio G., Zolla E., Mazza E., et al. Renal failure and bacterial infections in patients with cirrhosis: epidemiology and clinical features. Hepatology 2007;45:223–9. DOI: 10.1002/hep.21443

10. Guo J., Friedman S.L. Hepatic fibrogenesis. Semin Liver Dis. 2007;27:413–26. DOI: 10.1053/j.gastro.2008.03.003

11. Das S.K., Vasudevan D.M. Genesis of hepatic fibrosis and its biochemical markers. Scand J Clin Lab Invest. 2008;68:260–9. DOI: 10.1080/00365510701668516

12. Ramachandran P., Iredale J.P. Reversibility of liver fibrosis. Ann Hepatol. 2009;8:283–91. DOI: 10.1080/00365510701668516

13. Hernandez-Gea V., Friedman S.L. Pathogenesis of liver fibrosis. Annu Rev Pathol. 2011;6:425–56. DOI: 10.1146/annurev-pathol-011110-130246

14. Bernardi M., Moreau R., Angeli P., Schnabl B., Arroyo V. Mechanisms of decompensation and organ failure in cirrhosis: From peripheral arterial vasodilation to systemic inflammation hypothesis. J Hepatol. 2015;63:1272– 84. DOI: 10.1016/j.jhep.2015.07.004

15. Jalan R., Fernandez J., Wiest R., Schnabl B., Moreau R., Angeli P., et al. Bacterial infections in cirrhosis: a position statement based on the EASL Special Conference. J Hepatol. 2013;60:1310–24. DOI: 10.1016/j.jhep.2014.01.024

16. Масленников Р.В., Татаркина М.А., Маевская М.В., Павлов Ч.С., Жаркова М.С., Ивашкин В.Т. Влияние синдрома избыточного бактериального роста и системного воспаления на абдоминальную гемодинамику у больных циррозом печени. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2017;27(4):52–61. DOI: 10.22416/1382-4376- 2017-27-4-52-61

17. Claria J., Stauber R.E., Coenraad M.J., Moreau R., Jalan R., Pavesi M., et al. Systemic inflammation in decompensated cirrhosis: Characterization and role in acute-onchronic liver failure. Hepatology 2016;64:1249–64. DOI: 10.1002/hep.28740

18. Жаркова М.С. Бактериальная транслокация в патогенезе инфекционных осложнений у больных циррозом печени: автореф. дис. … канд. мед. наук. ГБОУ ВПО «Первый МГМУ им. И.М. Сеченова», Москва, 2012.

19. Масленников Р.В., Дрига А.А., Ивашкин К.В., Жаркова М.С., Маевская М.В., Павлов Ч.С. и др. Роль синдрома избыточного бактериального роста и системного воспаления в патогенезе гемодинамических изменений у больных циррозом печени. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2017;27(3):45–56. DOI: 10.22416/1382-4376-2017-27-3-45-56

20. Ивашкин В.Т., Надинская М.Ю., Буеверов А.О. Печеночная энцефалопатия и методы ее метаболической коррекции. Болезни органов пищеварения. 2001;1:25–7.

21. Juan A.O., Elizabeth C.V. Afferent mechanisms of sodium retention in cirrhosis and hepatorenal syndrome. Kidn Intern, 2010;77(8):669–80. DOI: 10.1038/ki.2010.4

22. Ripoll C., Groszmann R., Garcia-Tsao G., Grace N., Burroughs A., Planas R., et al. Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. Gastroenterology. 2007;133:481–8. DOI: 10.1016/j.jhep.2009.01.014

23. Bosch J., Groszmann R.J., Shah V.H. Evolution in the understanding of the pathophysiological basis of portal hypertension: How changes in paradigm are leading to successful new treatments. J Hepatol. 2015;62:S121–30. DOI: 10.1016/j.jhep.2015.01.003

24. D’Amico G., De Franchis R. Upper digestive bleeding in cirrhosis. Posttherapeutic outcome and prognostic indicators. Hepatology. 2003;38:599–612. DOI: 10.1053/jhep.2003.50385

25. Trawale J.M., Paradis V., Rautou P.E., Francoz C., Escolano S., Sallee M., et al. The spectrum of renal lesions in patients with cirrhosis: a clinicopathological study. LiverInt. 2010;30:725–32. DOI: 10.1111/j.1478-3231.2009.02182.x

26. Angeli P., Gines P., Wong F., Bernardi M., Boyer T.D., Gerbes A., et al. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. J Hepatol. 2015;62:968–74.

27. Krag A., Bendtsen F., Henriksen J.H., Moller S. Low cardiac output predicts development of hepatorenal syndrome and survival in patients with cirrhosis and ascites. Gut. 2010;59:105–10. DOI: 10.1136/gut.2009.180570

28. Wiest R., Lawson M., Geuking M. Pathological bacterial translocation in liver cirrhosis. J Hepatol. 2014;60:197– 209. DOI: 10.1016/j.jhep.2013.07.044

29. Van Slambrouck C.M., Salem F., Meehan S.M., Chang A. Bile cast nephropathy is a common pathologic finding fo kidney injury associated with severe liver dysfunction. Kidney Int. 2013;84:192–7. DOI: 10.1038/ki.2013.78

30. Biggins S.W., Rodriguez H.J., Bacchetti P., Bass N.M., Roberts J.P., Terrault N.A. Serum sodium predicts mortality in patients listed for liver transplantation. Hepatology. 2005;41:32–9. DOI: 10.1002/hep.20517

31. Porcel A., Diaz F., Rendon P., Macias M., MartinHerrera L., Giron-Gonzalez J.A. Dilutional hyponatremia in patients with cirrhosis and ascites. Arch Intern Med 2002;162:323–28. DOI: 10.1001/archinte.162.3.323

32. Piano S., Fasolato S., Salinas F., Romano A., Tonon M., Morando F., et al. The empirical antibiotic treatment of nosocomial spontaneous bacterial peritonitis: Results of a randomized, controlled clinical trial. Hepatology. 2016;63:1299–309. DOI: 10.1002/hep.27941

33. Piano S., Brocca A., Mareso S., Angeli P. Infections complicating cirrhosis. Liver Int. 2018;38:126–33. DOI: 10.1111/liv.13645

34. Appenrodt B., Grunhage F., Gentemann M.G., Thyssen L., Sauerbruch T., Lammert F. Nucleotide-binding oligomerization domain containing 2 (NOD2) variants are genetic risk factors for death and spontaneous bacterial peritonitis in liver cirrhosis. Hepatology. 2010;51(4):1327– 33. DOI: 10.1002/hep.23440

35. Badillo R., Rockey D.C. Hepatic hydrothorax. Clinical features, management, and outcomes in 77 patients and review of the literature. Medicine. 2014;93:135–42. DOI: 10.1097/MD.0000000000000025

36. Garbuzenko D.V., Arefyev N.O. Hepatic hydrothorax: An update and review of the literature. World J Hepatol. 2017; 9(31):1197–204. DOI: 10.4254/wjh.v9.i31.1197

37. Rodriguez-Roisin R., Krowka M.J., Herve P., Fallon M.B. ERS task force pulmonary-hepatic vascular disorders (PHD) scientific committee. Pulmonary-hepatic vascular disorders (PHD). Eur Respir J. 2004;24:861–80. DOI: 10.1183/09031936.04.00010904

38. Machicao V.I., Balakrishnan M., Fallon M.B. Pulmonary complications in chronic liver disease. Hepatology. 2014;59:1627–37. DOI: 10.1002/hep.26745

39. Saleemi S. Portopulmonary hypertension. Ann Thorac Med. 2010;5(1):5–9. DOI: 10.4103/1817-1737.58953

40. Kaymakoglu S., Kahraman T., Kudat H., Demir K., Cakaloglu Y., Adalet I., et al. Hepatopulmonary syndrome in noncirrhotic portal hypertensive patients. Dig Dis Sci. 2003;48:556–60. DOI: 10.1023/a:1022549018807

41. Mukomolov S., Trifonova G., Levakova I., Bolsun D., Krivanogova E. Hepatitis C in the Russian Federation: сhallenges and future directions. Hepat med evid research. 2016;8:51–60. DOI: 10.2147/HMER.S50172

42. Bajaj J.S., Schubert C.M., Heuman D.M., Wade J.B., Gibson D.P., Topaz A., et al. Persistence of cognitive impairment after resolution of overt hepatic encephalopathy. Gastroenterology. 2010;138:2332–40. DOI: 10.1053/j.gastro.2010.02.015

43. Riggio O., Ridola L., Pasquale C., Nardelli S., Pentassuglio I., Moscucci F., et al. Evidence of persistent cognitive impairment after resolution of overt hepatic encephalopathy. Clin Gastroenterol Hepatol. 2011;9:181–3. DOI: 10.1016/j.cgh.2010.10.002

44. Zipprich A., Garcia-Tsao G., Rogowski S., Fleig W.E., Seufferlein T., Dollinger M.M. Prognostic indicators of survival in patients with compensated and decompensated cirrhosis. Liver Int. 2012;32(9):1407–14. DOI: 10.1111/j.1478-3231.2012.02830.x

45. Romero-Gomez M., Boza F., Garcia-Valdecasas M.S., et al. Subclinical hepatic encephalopathy predicts the development of overt hepatic encephalopathy. Am J Gastroenterol. 2001;96:2718–23.

46. Simonetti R.G., Perricone G., Robbins H.L., Battula N.R., Weickert M.O., Sutton R., Khan S. Portosystemic shunts versus endoscopic intervention with or without medical treatment for prevention of rebleeding in people with cirrhosis. Cochrane Database of Systematic Reviews 2020;10:CD000553. DOI: 10.1002/14651858.CD000553.pub3

47. Sharma P., Sharma B.C., Puri V., Sarin S.K. Critical flicker frequency: diagnostic tool for minimal hepatic encephalopathy. J Hepatol. 2007;47(1):67–73. DOI: 10.1016/j.jhep.2007.02.022.

48. Bajaj J.S. Management options for minimal hepatic encephalopathy. Expert Rev Gastroenterol Hepatol 2008;2:785–90 DOI: 10.1586/17474124.2.6.785

49. Evans L.T., Kim W.R., Poterucha J.J., Kamath P.S. Spontaneous bacterial peritonitis in asymptomatic outpatients with cirrhotic ascites. Hepatology. 2003;37(4):897– 901. DOI: 10.1053/jhep.2003.50119

50. Rimola A., Garcia-Tsao G., Navasa M., Piddock L.J., Planas R., Bernard B., et al. Diagnosis, treatment and prophylaxis of spontaneous bacterial peritonitis: a consensus document. International Ascites Club. J Hepatol. 2000;32(1):142–53. DOI: 10.1016/s0168-8278(00)80201-9

51. Arvaniti V., D’Amico G., Fede G., Manousou P., Tsochatzis E., Pleguezuelo M., et al. Infections in patients with cirrhosis increase mortality fourfold and should be used in determining prognosis. Gastroenterology. 2010;139(4):1246–56. DOI: 10.1053/j.gastro.2010.06.019

52. Шерцингер А.Г. Патогенез, диагностика, профилактика и лечение кровотечений из варикозных вен пищевода и желудка у больных портальной гипертензией: автореф. дис. … д-ра мед. наук. М., 1986. 310 с.

53. Жигалова С.Б. Эндоскопические технологии в лечении и профилактике кровотечений из варикозно расширенных вен пищевода и желудка у больных с портальной гипертензией: автореф. дис. … д-ра мед. наук. М., 2011. 46 с.

54. Garcia-Tsao G., Sanyal A.J., Grace N.D., Carey W. Prevention and management of gastroesophagealvarices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46(3):922–38. DOI: 10.1002/hep.21907

55. Павлов Ч.С., Дамулин И.В., Ивашкин В.Т. Печеночная энцефалопатия: патогенез, клиника, диагностика, терапия. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2016;26(1):44–53. DOI: 10.22416/1382-4376-2016-26-1-44-53

56. Patidar K.R., Bajaj J.S. Covert and overt hepatic encephalopathy: diagnosis and management. Clin Gastroenterol Hepatol. 2015 Nov.;13(12):2048–61. DOI: 10.1016/j.cgh.2015.06.039. Epub 2015 Jul 9.

57. Луньков В.Д., Маевская М.В., Цветаева Е.К., Мендез А.Г., Жаркова М.С., Ткаченко П.Е., Ивашкин В.Т. Отношение нейтрофилов к лимфоцитам как предиктор неблагоприятного исхода у пациентов с декомпенсированным циррозом печени. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2019;29(1):47–61. DOI: 10.22416/1382-4376-2019-29-1-47-61

58. Moss O. Nutrition priorities: Diet recommendations in liver cirrhosis. Clin Liver Dis. 2019;14(4):146–8. DOI: 10.1002/cld.831

59. Fernandez J., Acevedo J., Castro M., Garcia O., de Lope C.R., Roca D., et al. Prevalence and risk factors of infections by multiresistant bacteria in cirrhosis: a prospective study. Hepatology. 2012;55(5):1551–61. DOI: 10.1002/hep.25532

60. Magiorakos A.P., Srinivasan A., Carey R.B., Carmeli Y., Falagas M.E., Giske C.G., et al. Multidrug-resistant, extensively drug-resistant and pandrugresistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268– 81. DOI: 10.1111/j.1469-0691.2011.03570.x

61. Gines P., Arroyo V., Rodes J., Schrier R.W. Ascites and renal disfunction in liver disease. Blackwell publishing, 2005.

62. Soriano G., Castellote J., Alvarez C., Girbau A., Gordillo J., Baliellas C., et al. Secondary bacterial peritonitis in cirrhosis: a retrospective study of clinical and analytical characteristics, diagnosis and management. J Hepatol. 2010; 52(1):39–44. DOI: 10.1016/j.jhep.2009.10.012

63. Ninan J., Fakhran S. Mayo Clinic Proceedings. 2016;91(4):537–8. DOI: 10.1016/j.mayocp.2016.01.011

64. Moreau R., Lebrec D. Diagnosis and treatment of acute renal failure in patients with cirrhosis. Best Pract Res Clin Gastroenterol. 2007;21(1):111–23. DOI: 10.1016/j.bpg.2006.10.004

65. Moreau R., Lebrec D. Acute renal failure in patients with cirrhosis: perspectives in the age of MELD. Hepatology. 2003;37(2):233–43. DOI: 10.1053/jhep.2003.50084

66. Cordoba J., Garcia-Martinez R., Simon-Talero M. Hyponatremic and hepatic encephalopathies: similarities, differences and coexistence. Metab Brain Dis. 2010;25(1):73– 80. DOI: 10.1007/s11011-010-9172-3

67. Bloom S., Kemp W., Lubel J. Portal hypertension: pathophysiology, diagnosis and management. Intern Med J. 2015;45(1):16–26. DOI: 10.1111/imj.12590

68. Болезни печени и желчевыводящих путей. Под ред. В.Т. Ивашкина. М.: М-Вести, 2005. 536 с.

69. Singh S., Manrai M., Paravathi V.S., Dharmendra K., Srivastava S., Pathak B. Association of liver cirrhosis severity with anemia: does it matter? Ann gastroenterol. 2020;33(3):272. DOI: 10.20524/aog.2020.0478. Epub 2020 Apr 13.

70. Abd-Elsalam S., Habba E., Elkhalawany W., Tawfeek S., Elbatae H., El-kalla F., et al. Correlation of platelets count with endoscopic findings in a cohort of Egyptian patients with liver cirrhosis. Medic. 2016;95:23. DOI: 10.1097/MD.0000000000003853

71. Moreau R., Jalan R., Gines P., Pavesi M., Angeli P., Cordoba J., et al. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterol. 2013;144(7):1426– 37. DOI: 10.1053/j.gastro.2013.02.042. Epub 2013 Mar 6.

72. Rios R., Sangro B., Herrero I., Quiroga J., Prieto J. The role of thrombopoietin in the thrombocytopenia of patients with liver cirrhosis. Offic J Amer Coll Gastroenterol. 2005;100(6):1311–6. DOI: 10.1111/j.1572- 0241.2005.41543.x

73. Sharma S. K., Aggarwal R. Prediction of large esophageal varices in patients with cirrhosis of the liver using clinical, laboratory and imaging parameters. J gastroenterol hepatol. 2007;22(11):1909–15. DOI: 10.1111/j.1440-1746.2006.04501.x

74. Lammers W.J., van Buuren H.R., Hirschfield G.M., Janssen H. L.A., Invernizzi P., et al. Levels of alkaline phosphatase and bilirubin are surrogate end points of outcomes of patients with primary biliary cirrhosis: an international follow-up study. Gastroenterol. 2014;147(6):1338– 49. DOI: 10.1053/j.gastro.2014.08.029. Epub 2014 Aug 23.

75. Lee H.A., Jung J.Y., Lee Y.S., Jung K.Y., Kim J.H., An H., et al. Direct bilirubin is more valuable than total bilirubin for predicting prognosis in patients with liver cirrhosis. Gut Liv. 2021;15(4):599 DOI: 10.5009/gnl20171

76. Poynard T., Zourabichvili O., Hilpert G., Naveau S., Poitrine A., Benatar C., et al. Prognostic value of total serum bilirubin/γ-glutamyl transpeptidase ratio in cirrhotic patients. Hepatol. 1984;4(2):324–7. DOI: 10.1002/hep.1840040224

77. Agustanti N., Djumhana A., Abdurachaman S.A., Soetodjo N.M.N. Correlation between Serum Albumin and Fasting Blood Glucose Level in Patients with Liver Cirrhosis. Indones J Gastroenterol, Hepatol, Digest Endoscop. 2014;15(3):143–6. DOI: 10.24871/1532014143-146

78. Harrison M.F. The Misunderstood Coagulopathy of Liver Disease: A Review for the Acute Setting. West J Emerg Med. 2018;19(5):863–71. DOI: 10.5811/ westjem.2018.7.37893. Epub 2018 Aug 8.

79. Castera L., Pauwels A., Levy V.G. Prognostic indicators in patients with liver cirrhosis admitted to an intensive care unit. Gastroenterol clin biolog. 1996;20(3):263–8.

80. Northup P. A history of coagulopathy in liver cirrhosis: legends and myths. Clin Liv Dis. 2020;16(S1):56–72. DOI: 10.1002/cld.954

81. Ariza X., Sola E., Elia C., Barreto R., Moreira R., Morales-Ruiz M., et al. Analysis of a urinary biomarker panel for clinical outcomes assessment in cirrhosis. PloS one. 2015;10(6):e0128145. DOI: 10.1371/journal.pone.0128145. eCollection 2015.

82. Lin K.H., Wang F.L., Wu V.S., Jiang B.Y., Kao W.L., Chao H.Y., et al. Serum procalcitonin and C-reactive protein levels as markers of bacterial infection in patients with liver cirrhosis: a systematic review and meta-analysis. Diagn Microbiol Infect Dis. 2014;80(1):72–8. DOI: 10.1016/j.diagmicrobio.2014.03.029. Epub 2014 May 21.

83. Kuo C.H., Changchien C.S., Yang C.Y., Sheen I.S., Liaw Y.F. Bacteremia in patients with cirrhosis of the liver. Liver. 1991;11(6):334–9. DOI: 10.1111/j.1600-0676.1991.tb00539.x

84. Han D., Wang R., Yu Y., Yang S.S., Mueller S., Gomes F., et al. Impact of elevated urine leukocyte and bacteria count per high-power field on the in-hospital outcome of patients with liver cirrhosis. J Publ Health Emerg. 2017;1(8):73. DOI: 10.21037/jphe.2017.08.02

85. Trifan A., Stoica O., Cojocariu C., Singeap A.M., Girleanu I., Mifttode E. Clostridium difficile infection in patients with liver disease: a review. Eur J Clin Microbiol Infect Dis. 2015;34(12):2313–24. DOI: 10.1007/s10096-015-2501-z. Epub 2015 Oct 6.

86. Lin-Lin H., Harry H.X., Sen-Lin Z. Ascitic Fluid Analysis in the Differential Diagnosis of Ascites: Focus on Cirrhotic Ascites. J Clin Transl Hepatol. 2014;2:58–64. DOI: 10.14218/JCTH.2013.00010. Epub 2014 Mar 15.

87. Moore K.P., Wong F., Gines P., Bernardi M., Ochs A., Salerno F., et al. The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club. Hepatology. 2003;38(1):258–66. DOI: 10.1053/jhep.2003.50315

88. Bruns T., Lutz P., Stallmach A. Nischalke H.D. Low ascitic fluid protein does not indicate an increased risk for spontaneous bacterial peritonitis in current cohorts. J Hepatol. 2015;63:527–8. DOI: 10.1016/j.jhep.2015.03.040

89. Gerbes A.L., Jüngst D., Xie Y.N., Permanetter W., Paumgartner G. Ascitic fluid analysis for the differentiation of malignancy-relatedandnonmalignantascites.Proposalofadiagnostic sequence. Cancer. 1991;68(8):1808–14. DOI: 10.1002/ 1097-0142(19911015)68:83.0.co;2-6

90. McGibbon A., Chen G.I., Peltekian K.M., van Zanten S.V. An evidence-based manual for abdominal paracentesis. Dig Dis Sci. 2007 Dec;52(12):3307–15. DOI: 10.1007/s10620-007-9805-5. Epub 2007 Mar 28.

91. Kimer N., Gluud L.L., Morris R.W., Morgan M.Y. Rifaximin for the prevention and treatment of hepatic encephalopathy: A systematic review with meta-analyses of randomised controlled trials. J Clin Exp Hepatol. 2017;7:S78–9. DOI: 10.1016/j.jceh.2017.01.105

92. Jain A.P., Chandra L.S., Gupta S., Gupta O.S., Jajoo U.N., Kalantri S.P. Spontaneous bacterial peritonitis in liver cirrhosis with ascites //The Journal of the Association of Physicians of India. 1999;47(6):619–21.

93. Mostafa M.S., El-Seidi E.A., Kassem A.M., Shemis M.A., Saber M., Michael M.N. Detection of ascitic fluid infections in patients with liver cirrhosis and ascites. Arab J Gastroenterol. 2011;12(1):20–4. DOI: 10.1016/j.ajg.2011.01.004

94. Titó L., Rimola A., Gines P., Llach J., Arroyo V., Rodes J. Recurrence of spontaneous bacterial peritonitis in cirrhosis: frequency and predictive factors. Hepatology. 1988;8(1):27–31. DOI: 10.1002/hep.1840080107

95. Kudo M., Zheng R.Q., Kim S.R., Okabe Y., Osaki Y., Iijima H., et al. Diagnostic accuracy of imaging for liver cirrhosis compared to histologically proven liver cirrhosis. Intervirology. 2008;51(S1):17–26. DOI: 10.1159/000122595. Epub 2008 Jun 10.

96. Garcia-Tsao G., Sanyal A.J., Grace N.D., Carey W. Practice Guidelines Committee of the American Association for the Study of Liver DiseasesPractice Parameters Committee of the American College of Gastroenterology. Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis. Hepatology. 2007;46(3):922–38. DOI: 10.1002/hep.21907

97. Merli M., Nicolini G., Angeloni S., Rinaldi V., De Santis A., Merkel C., et al. Incidence and natural history of small esophageal varices in cirrhotic patients. J Hepatol. 2003;38:266–72. DOI: 10.1016/s0168-8278(02)00420-8 98. Kibrit J., Khan R., Jung B.H., Koppe S. Clinical Assessment and Management of Portal Hypertension. Semin Intervent Radiol. 2018;35(3):153–9. DOI: 10.1055/s-0038-1660793

98. Люсина Е.О. Клиническое применение эластометрии в оценке жизненного прогноза и риска развития осложнений у больных с циррозом печени вирусной (HCV) и алкогольной этиологии: автореф. дис. …канд. мед. наук. М., 2017. 25 с.

99. Villanueva C., Escorsell A. Optimizing general management of acute variceal bleeding in cirrhosis. Curr Hepatol Rep. 2014;13(3):198–207. DOI: 10.1007/s11901-014-0241-7

100. Primignani M., Carpinelli L., Preatoni P., Battaglia G., Carta A., Prada A., et al. Natural history of portal hypertensive gastropathy in patients with liver cirrhosis. Gastroenterology. 2000;119(1):181–7. DOI: 10.1053/gast.2000.8555

101. Weissenborn K., Ennen J.C., Schomerus H., Ruckert N., Hecker H. Neuropsychological characterization of hepatic encephalopathy. J Hepatol 2001;34:768–73. DOI: 10.1016/s0168-8278(01)00026-5

102. Надинская М.Ю. Латентная печеночная энцефалопатия: как помочь пациенту. Клин. перспективы гастроэнтерол., гепатол. 2001;1:10–17.

103. Jeong J.H., Park I.S., Kim D.H., Kim S.C., Kang C., Lee S.H., et al. CLIF–SOFA score and SIRS are independent prognostic factors in patients with hepatic encephalopathy due to alcoholic liver cirrhosis. Medicine (Baltimore). 2016;95(26):e3935. DOI: 10.1097/MD.0000000000003935

104. Kang S.H., Lee Y.B., Lee J.H., Nam J.Y., Chang Y., Cho H., et al. Rifaximin treatment is associated with reduced risk of cirrhotic complications and prolonged overall survival in patients experiencing hepatic encephalopathy. Aliment Pharmacol Ther. 2017 Nov;46(9):845–55. DOI: 10.1111/apt.14275. Epub 2017 Aug 24.

105. Bernardi M., Laffi G., Salvagnini M., Azzena G., Bonato S., Marra F., et al. Efficacy and safety of the stepped care medical treatment of ascites in liver cirrhosis: a randomized controlled clinical trial comparing two diets with different sodium content. Liver. 1993;13(3):156–62. DOI: 10.1111/j.1600-0676.1993.tb00624.x

106. Bernardi M., Trevisani F., Gasbarrini A., Gasbarrini G. Hepatorenal disorders: role of the renin-angiotensin-aldosterone system. Semin Liver Dis. 1994;14:23–34.

107. Santos J., Planas R., Pardo A., Durandez R., Cabre E., Morillas R.S., et al. Spironolactone alone or in combination with furosemide in the treatment of moderate ascites in nonazotemic cirrhosis. A randomized comparative study of efficacy and safety. J Hepatol. 2003;39(2):187–92. DOI: 10.1016/s0168-8278(03)00188-0

108. Fiaccadori F., Pedretti G., Pasetti G., Pizzaferri P., Elia G. Torasemide versus furosemide in cirrhosis: a longterm, double-blind, randomized clinical study. Clin Investig. 1993;71(7):579–84. DOI: 10.1007/BF00208486

109. Abecasis R., Guevara M., Miguez C., Terg R. Longterm efficacy of torsemide compared with frusemide in cirrhotic patients with ascites. Scand J Gastroenterol. 2001;36(3):309–13. DOI: 10.1080/003655201750074672

110. Elsabaawy M.M., Abdelhamid S.R., Alsebaey A., Abdelsamee E., Obada M.A., Salman T.A., et al. The impact of paracentesis flow rate in patients with liver cirrhosis on the development of paracentesis induced circulatory dysfunction. Clin Mol Hepatol. 2015;21(4);365–71. DOI: 10.3350/cmh.2015.21.4.365. Epub 2015 Dec 24.

111. Salerno F., Maerli M., Riggio O., Cazzaniga M., Valeriano V., Pozzi M., et al. Randomized controlled study of TIPS versus paracentesis plus albumin in cirrhosis with severe ascites. Hepatology. 2004;40(3):629–35.

112. Guardiola J., Baliellas C., Xiol X., Fernandez Esparrach G., Gines P., Ventura P., et al. External validation of a prognostic model for predicting survival of cirrhotic patients with refractory ascites. Am J Gastroenterol. 2002; 97(9):2374–8. DOI: 10.1111/j.1572-0241.2002.05928.x

113. Lv X.Y., Ding H.G., Zheng J.F., Fan C.L., Li L. Rifaximin improves survival in cirrhotic patients with refractory ascites: A real-world study. World J Gastroenterol. 2020 Jan 14;26(2):199–218. DOI: 10.3748/wjg.v26.i2.199. PMID: 31988585; PMCID: PMC6962437

114. Durand F., Graupera I., Gines P., Olson J.C., Nadim M.K. Pathogenesis of hepatorenal syndrome: implications for therapy. Am J Kidney Dis 2016;67:318–28. DOI: 10.1053/j.ajkd.2015.09.013. Epub 2015 Oct 21.

115. Albillos A., Banares R., Gonzalez M., Catalina M.V., Molinero L.M. A metaanalysis of transjugular intrahepatic portosystemic shunt vs. paracentesis for refractory ascites. J Hepatol. 2005;43(6):990–6. DOI: 10.1016/j.jhep.2005.06.005

116. Bai M., Qi X.S., Yang Z.P., Yang M., Fan D.M., Han G.H. TIPS improves liver transplantation-free survival in cirrhotic patients with refractory ascites: an updated meta-analysis. World J Gastroenterol. 2014;20(10):2704– 14. DOI: 10.3748/wjg.v20.i10.2704

117. Chen R.P., Zhu Ge X.J., Huang Z.M., Ye X.H., Hu C.Y., Lu G.R., et al. Prophylactic use of transjugular intrahepatic portosystemic shunt aids in the treatment of refractory ascites: metaregression and trial sequential meta-analysis. J Clin Gastroenterol. 2014;48(3):290–9. DOI: 10.1097/MCG.0b013e3182a115e9

118. Villanueva C., Colomo A., Bosch A., Concepcion M., Hernandez-Gea V., Aracil C., et al. Transfusion strategies for acute upper gastrointestinal bleeding. N Engl J Med. 2013;368:11–21.

119. Christidis C., Mal F., Senejoux A., Callard P., Navarro R., Trinchet J.C., et al. Worsening of hepatic dysfunction as a consequence of repeated hydroxyethylstarch infusions. J Hepatol. 2001;35(6):726–32. DOI: 10.1016/s0168-8278(01)00200-8

120. Fernandez J., Ruiz del Arbol L., Gomez C., Durandez R., Serradilla R., Guarner C., et al. Norfloxacin vs ceftriaxone in the prophylaxis of infections in patients with advanced cirrhosis and hemorrhage. Gastroenterology. 2006;131(4):1049–56. DOI: 10.1053/j.gastro.2006.07.010

121. Tandon P., Abraldes J.G., Keough A., Bastiampillai R., Jayakumar S., Carbonneau M., et al. Risk of bacterial infection in patients with cirrhosis and acute variceal hemorrhage, based on child-pugh class, and effects of antibiotics. Clin Gastroenterol Hepatol. 2015;13(6):1189–96. DOI: 10.1016/j.cgh.2014.11.019

122. Altraif I., Handoo F.A., Aljumah A., Alalwan A., Dafalla M., Saeed A.M., et al. Effect of erythromycin before endoscopy in patients presenting with variceal bleeding: a prospective, randomized, double-blind, placebocontrolled trial. Gastrointest Endosc. 2011;73(2):245–50. DOI: 10.1016/j.gie.2010.09.043

123. Bai Y., Guo J.F., Li Z.S. Meta-analysis: erythromycin before endoscopy for acute upper gastrointestinal bleeding. Aliment Pharmacol Ther. 2011;34(2):166–71. DOI: 10.1111/j.1365-2036.2011.04708.x. Epub 2011 May 25.

124. Banares R., Albillos A., Rincon D., Alonso S., Gonzalez M., Ruiz-del-Arbol L., et al. Endoscopic treatment vs. endoscopic plus pharmacologic treatment for acute variceal bleeding: a meta-analysis. Hepatology. 2002;35(3):609– 15. DOI: 10.1053/jhep.2002.31354

125. García-Pagán J.C., Caca K., Bureau C., Laleman W., Appenrodt B., Luca A., et al. Early use of TIPS in patients with cirrhosis and variceal bleeding. N Engl J Med. 2010;362(25):2370–9. DOI: 10.1056/NEJMoa0910102

126. Maimone S., Saffioti F., Filomia R., Alibrandi A., Isgro G., Calvaruso V., et al. Predictors of re-bleeding and mortality among patients with refractory variceal bleeding undergoing salvage transjugular intrahepatic portosystemic shunt (TIPS). Dig Dis Sci. 2019;64(5):1335–45. DOI: 10.1007/s10620-018-5412-x. Epub 2018 Dec 17.

127. Escorsell A., Pavel O., Cardenas A., Morillas R., Llop E., Villanueva C., et al. Esophageal balloon tamponade vs. esophageal stent in controlling acute refractory variceal bleeding: A multicenter randomized, controlled trial. Hepatology 2016;63:1957–96. DOI: 10.1002/hep.28360

128. Chau T.N., Patch D., Chan Y.W., Nagral A., Dick R., Burroughs A.K. “Salvage” transjugular intrahepatic portosystemic shunts: gastric fundal compared with esophageal variceal bleeding. Gastroenterology. 1998;114(5):981–98. DOI: 10.1016/s0016-5085(98)00640-4

129. Patidar K.R., Bajaj J.S. Antibiotics for the treatment of hepatic encephalopathy. Metab Brain Dis. 2013;28(2):307– 12. DOI: 10.1007/s11011-013-9383-5

130. Bass N.M., Mullen K.D., Sanyal A., Poordad F., Neff G., Leevy C.B., et al. Rifaximin treatment in hepatic encephalopathy. N Engl J Med. 2010;362(12):1071–81. DOI: 10.1056/NEJMoa0907893

131. Zullo A., Hassan L., Lorenzetti R., Campo M.P.S., Riggio O. Rifaximin therapy and hepatic encephalopathy: Pros and cons. World J Gastrointest Pharmacol Ther. 2012 Aug 6;3(4):62–7. DOI: 10.4292/wjgpt.v3.i4.62

132. Hudson M, Schuchmann M. Long-term management of hepatic encephalopathy with lactulose and/ or rifaximin: a review of the evidence. Eur J Gastroenterol Hepatol. 2019 Apr;31(4):434–50. DOI: 10.1097/MEG.0000000000001311

133. Wu D., Wu S.-M., Lu J., Zhou Y.-Q., Xu L., Guo C.-Y. Rifaximin versus Nonabsorbable Disaccharides for the Treatment of Hepatic Encephalopathy: A Meta-Analysis. Gastroenterology Research and Practice. 2013. DOI: 10.1155/2013/236963

134. Kimer N., Krag A., Møller S., Bendtsen F., Gluud L.L. Systematic review with meta-analysis: the effects of rifaximin in hepatic encephalopathy. Aliment Pharmacol Ther. 2014;40(2):123–32. DOI: 10.1111/apt.12803

135. Cardenas A., Gines P., Marotta P., Czerwiec F., Oyuang J., Guevara M., et al. Tolvaptan, an oral vasopressin antagonist, in the treatment of hyponatremia in cirrhosis. J Hepatol. 2012;56(3):571–8. DOI: 10.1016/j.jhep.2011.08.020

136. Butterworth R.F., Kircheis G., Hilger N., McPhail M.J.W. Efficacy of L-Ornithine L-Aspartate for the Treatment of Hepatic Encephalopathy and Hyperammonemia in Cirrhosis: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Clinical and Experimental Hepatology. 2018;8(3):301–13. DOI: 10.1016/j.jceh.2018.05.004

137. Butterworth R.F., McPhail M.J.W. L-Ornithine L-Aspartate (LOLA) for Hepatic Encephalopathy in Cirrhosis: Results of Randomized Controlled Trials and Meta-Analyses. Drugs. 2019 Feb;79(Suppl 1):31–7. DOI: 10.1007/s40265-018-1024-1

138. Canbay A., Sowa J-P. L-Ornithine L-Aspartate (LOLA) as a Novel Approach for Therapy of Non-alcoholic Fatty Liver Disease. Drugs. 2019 Feb;79(Suppl 1):39–44. DOI: 10.1007/s40265-018-1020-5

139. Butterworth R.F. L-Ornithine L-Aspartate for the Treatment of Sarcopenia in Chronic Liver Disease: The Taming of a Vicious Cycle. Canad J Gastroenterol Hepatol. 2019;8182195:1–6. DOI: 10.1155/2019/8182195

140. Vela C.I.B., Ramirez J.L.P. Efficacy of oral L-ornithine L-aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy. Ann Hepatol. 2011;10(2);S55–9. DOI: 10.1016/S1665-2681(19)31608-4

141. Garioud A., Cadranel J.F., Pauwels A., Nousbaum J.B., Thévenot T., Dao T., et al. Association Nationale des Hépato-gastroentérologues des Hôpitaux Généraux de France, Association Française pour l’Etude du Foie, Club de Réflexion des Cabinets et Groupes d’Hépato-Gastroentérologie. Albumin Use in Patients With Cirrhosis in France: Results of the “ALBULIVE” Survey: A Case for Better EASL Guidelines Diffusion and/or Revision. J Clin Gastroenterol. 2017;51(9):831–8. DOI: 10.1097/MCG.0000000000000735

142. Les I., Doval E., Garcia-Martinez R., Planas M., Cardenas G., Gomez P., et al. Effects of branched-chain amino acids supplementation in patients with cirrhosis and a previous episode of hepatic encephalopathy: a randomized study. Am J Gastroenterol. 2011;106(6):1081–8. DOI: 10.1038/ajg.2011.9. Epub 2011 Feb 15.

143. Rimola A., Salmeron J.M., Clemente G., Rodrigo L., Obrador A., Miranda M.L., et al. Two different dosages of cefotaxime in the treatment of spontaneous bacterial peritonitis in cirrhosis: results of a prospective, randomized, multicenter study. Hepatology. 1995;21:674–9.

144. Lutz P., Nischalke H.D., Kramer B., Goeser F., Kaczmarek D.J., Schlabe S., et al. Antibiotic resistance in healthcare-related and nosocomial spontaneous bacterial peritonitis. Eur J Clin Invest. 2017;47:44–52. DOI: 10.1111/eci.12701

145. Zhang S.H., Zhu Z.Y., Chen Z., Li Y., Zou Y., Yan M., et al. Population pharmacokinetics and dosage optimization of linezolid inpatients with liver dysfunction. Antimicrob Agents Chemother. 2020;64(6):e00133-20. DOI: 10.1128/AAC.00133-20

146. Sort P., Navasa M., Arroyo V., Aldeguer X., Planas R., Ruiz-del-Arbol L., et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N EnglJ Med. 1999;341:403–9. DOI: 10.1056/NEJM199908053410603

147. Merli M., Lucidi C., Di Gregorio V., Lattanzi B., Giannelli V., Giusto M., et al. An empirical broad spectrum antibiotic therapy in health-care-associated infections improves survival in patients with cirrhosis: A randomized trial. Hepatology. 2016;63(5):1632–9. DOI: 10.1002/hep.28332

148. Nadim M.K., Durand F., Kellum J.A., Levitsky J., O’Leary J.G., Karvellas C.J., et al. Management of the critically ill patient with cirrhosis: A multidisciplinary perspective. J Hepatol. 2016;64(3):717–35. DOI: 10.1016/j.jhep.2015.10.019

149. Garcia-Martinez R., Caraceni P., Bernardi M., Gines P., Arroyo V., Jalan R. Albumin: pathophysiologic basis of its role in the treatment of cirrhosis and its complications. Hepatology. 2013;58(5):1836–46. DOI: 10.1002/hep.26338

150. Umgelter A., Reindl W., Wagner K.S., Franzen M., Stock K., Schmid R.M., et al. Effects of plasma expansion with albumin and paracentesis on haemodynamics and kidney function in critically ill cirrhotic patients with tense ascites and hepatorenal syndrome: a prospective uncontrolled trial. Critical care. 2008;12(1):R4. DOI: 10.1186/cc6765

151. Kulkarni A.V., Arab J.P., Premkumar M., Benitez C., Ravikumar S.T., Kumar P., Sharma M., et al. Terlipressin has stood the test of time: Clinical overview in 2020 and future perspectives. Liv Int. 2020;40(12):2888–905. DOI: 10.1111/liv.14703

152. Wang H., Liu A., Bo W., Feng X., Hu Y. Terlipressin in the treatment of hepatorenal syndrome: A systematic review and meta-analysis. Medicine (Baltimore). 2018 Apr;97(16):e0431. DOI: 10.1097/MD.0000000000010431

153. Saxena R., Anand A., Deep A. Use of terlipressin in critically ill children with liver disease. BMC Nephrol. 2020;21(1):360. DOI: 10.1186/s12882-020-01914-6

154. Gluud L.L., Christensen K., Christensen E., Krag A. Terlipressin for hepatorenal syndrome. Cochrane Database Syst Rev. 2012;12(9):CD005162. DOI: 10.1002/14651858.CD005162.pub3

155. Facciorusso A., Chandar A.K., Murad M.H., Prokop L.J., Muscatiello N., Kamath P.S., Singh S. Comparative efficacy of pharmacological strategies for management of type 1 hepatorenal syndrome: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2017;2(2):94–102. DOI: 10.1016/S2468-1253(16)30157-1

156. Rodriguez E., Elia C., Sola E., Barreto R., Graupera I., Andrealli A., et al. Terlipressin and albumin for type-1 hepatorenal syndrome associated with sepsis. J Hepatol. 2014;60(5):955–61. DOI: 10.1016/j.jhep.2013.12.032

157. Cavallin M., Kamath P.S., Merli M., Fasolato S., Toniutto P., Salerno F., et al. Terlipressin plus albumin vs. midodrine and octreotide plus albumin in the treatment of hepatorenal syndrome: A randomized trial. Hepatology. 2015;62(2):567–74. DOI: 10.1002/hep.27709

158. Cavallin M., Piano S., Romano A., Fasolato S., Frigo A.C., Benetti G., et al. Terlipressin given by continuous intravenous infusion vs. intravenous boluses in the treatment of hepatorenal syndrome: A randomized controlled study. Hepatology. 2016;63(3):983–92. DOI: 10.1002/hep.28396

159. Moreau R., Durand F., Poynard T., Duhamel C., Cervoni J.P., Ichai P., et al. Terlipressin in patients with cirrhosis and type 1 hepatorenal syndrome: a retrospective multicenter study. Gastroenterology. 2002;122(4):923–30. DOI: 10.1053/gast.2002.32364

160. Uriz J., Gines P., Cardenas A., Sort P., Jimenez W., Salmeron J.M., et al. Terlipressin plus albumin infusion: an effective and safe therapy of hepatorenal syndrome. Journal Hepatol. 2000;33(1):43–8. DOI: 10.1016/S0168-8278(00)80158-0

161. Narahara Y., Kanazawa H., Taki Y., Kimura Y., Atsukawa M., Katakura T., et al. Effects of terlipressin on systemic, hepatic and renal hemodynamics in patients with cirrhosis. J Gastroenterol Hepatol. 2009;24(11):1791–7. DOI: 10.1111/j.1440-1746.2009.05873.x

162. Маевская М.В., Жаркова М.С. Роль человеческого альбумина в ведении пациентов с циррозом печени. Медицинский Совет. 2020;(5):62–9. DOI: 10.21518/2079-701X-2020-5-62-69

163. Alessandria C., Ottobrelli A., Debernardi-Venon W., Todros L., Cerenzia M.T., Martini S., et al. Noradrenalin vs terlipressin in patients with hepatorenal syndrome: a prospective, randomized, unblinded, pilot study. J Hepatol. 2007;47(4):499–505. DOI: 10.1016/j.jhep.2007.04.010

164. Duvoux C., Zanditenas D., Hezode C., Chauvat A., Monin J.L., Roudot-Thoraval F., et al. Effects of noradrenalin and albumin in patients with type I hepatorenal syndrome: a pilot study. Hepatology. 2002;36(2):374–80. DOI: 10.1053/jhep.2002.34343

165. Singh V., Ghosh S., Singh B., Kumar P., Sharma N., Bhalla A., et al. Noradrenaline vs. terlipressin in the treatment of hepatorenal syndrome: a randomized study. J Hepatol. 2012;56(6):1293–8. DOI: 10.1016/j.jhep.2012.01.012

166. Sharma P., Kumar A., Shrama B.C., Sarin S.K.. An open label, pilot, randomized controlled trial of noradrenaline vs. terlipressin in the treatment of type 1 hepatorenal syndrome and predictors of response. Am J Gastroenterol. 2008;103(7):1689–97. DOI: 10.1111/j.1572-0241.2008.01828.x

167. Piano S., Morando F., Fasolato S., Cavallin M., Boscato N., Boccagni P., et al. Continuous recurrence of type 1 hepatorenal syndrome and long-term treatment with terlipressin and albumin: a new exception to MELD score in the allocation system to liver transplantation? J Hepatol. 2011;55(5):491–6. DOI: 10.1016/j.jhep.2011.02.002

168. Restuccia T., Ortega R., Guevara M., Gines P., Alessandria C., Ozdogan O., et al. Effects of treatment of hepatorenal syndrome before transplantation on posttransplantation outcome. A case-control study. J Hepatol. 2004;40(1):140–6. DOI: 10.1016/j.jhep.2003.09.019

169. Rodriguez E., Henrique Pereira G., Sola E., Elia C., Barreto R., Pose E., et al. Treatment of type 2 hepatorenal syndrome in patients awaiting transplantation: Effects on kidney function and transplantation outcomes. Liver Transpl. 2015;21(11):1347–54. DOI: 10.1002/lt.24210

170. Alonso J.C. Pleural effusion in liver disease. Semin Respir Crit Care Med. 2010;31(6):698–705. DOI: 10.1055/s0030-1269829

171. Rodriguez-Roisin R., Krowka M.J., Herve P., Fallon M.B. ERS task force pulmonary-hepatic vascular disorders (PHD) scientific committee. Pulmonary-hepatic vascular disorders (PHD). Eur Respir J. 2004;24(5):861– 80. DOI: 10.1183/09031936.04.00010904

172. Tsauo J., Weng N., Ma H., Jiang M., Zhao H., Li X. Role of transjugular intrahepatic portosystemic shunts in the management of hepatopulmonary syndrome: a systemic literature review. J Vasc Interv Radiol. 2015;26(9):1266– 71. DOI: 10.1016/j.jvir.2015.04.017

173. Ditah I.C., Al Bawardy B.F., Saberi B., Ditah C., Kamath P.S. Transjugular intrahepatic portosystemic stent shunt for medically refractory hepatic hydrothorax: A systematic review and cumulative meta-analysis. World J Hepatol. 2015;7(13):1797–806. DOI: 10.4254/wjh.v7.i13.1797

174. Sauerbruch T., Mengel M., Dollinger M., Zipprich A., Rossle M., Panther E., et al. Prevention of rebleeding from esophageal varices in patients with cirrhosis receiving small-diameter stents vs. hemodynamically controlled medical therapy. Gastroenterology. 2015;149(3):660–8. DOI: 10.1053/j.gastro.2015.05.011

175. Riggio O., Angeloni S., Salvatori F.M., De Santis A., Cerini F., Farcomeni A., et al. Incidence, natural history, and risk factors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt with polytetrafluoroethylene-covered stent grafts. Am J Gastroenterol. 2008;103(11):2738–46. DOI: 10.1111/j.1572-0241.2008.02102.x

176. Malinchoc M., Kamath P.S., Gordon F.D., Peine C.J., Rank J., ter Borg P.C. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000;31(4):864–71. DOI: 10.1053/he.2000.5852

177. Bureau C., Metivier S., D’Amico M., Peron J.M., Otal P., Pagan J.C., et al. Serum bilirubin and platelet count: a simple predictive model for survival in patients with refractory ascites treated by TIPS. J Hepatol. 2011;54(5):901–7. DOI: 10.1016/j.jhep.2010.08.025

178. Boyer T.D., Sanyal A.J., Garcia-Tsao G., Regenstein F., Rossaro L., Appenrodt B., et al. Impact of liver transplantation on the survival of patients treated for hepatorenal syndrome type 1. Liver Transpl. 2011;17(11):1328–32. DOI: 10.1002/lt.22395

179. Xiol X., Tremosa G., Castellote J., Gornals J., Lama C., et al. Liver transplantation in patients with hepatic hydrothorax. Transpl Int. 2005;18(6):672–5. DOI: 10.1111/j.1432-2277.2005.00116.x

180. Sersté T., Moreno C., Francoz C., Razek W.A., Paugham C., et al. The impact of preoperative hepatic hydrothorax on the outcome of adult liver transplantation. Eur J Gastroenterol Hepatol. 2010;22(2):207–12. DOI: 10.1097/MEG.0b013e3283311140

181. Krowka M.J., Mandell M.S., Ramsay M.A., Kawut S.M., Fallon M.B., Manzarbeitia C., et al. Hepatopulmonary syndrome and portopulmonary hypertension: a report of the multicenter liver transplant database. Liver Transpl. 2004;10(2):174–82. DOI: 10.1002/lt.20016

182. Fallon M.B., Krowka M.J., Brown R.S., Trotter J.F., Zacks S., Roberts K.E., et al. Impact of hepatopulmonary syndrome on quality of life and survival in liver transplant candidates. Gastroenterology. 2008;135(4):1168–75. DOI: 10.1053/j.gastro.2008.06.038

183. Kadry Z., Schaefer E., Krok K. Excellent Outcomes With Liver Transplantation in Hepatopulmonary Syndrome Across Pre-Transplant PaO2 Spectrum. JHEP Reports. 2021;3(8):100351. DOI: 10.1016/j.jhepr.2021.100351

184. Andersen M.M., Aunt S., Jensen N.M., Homann C., Manniche J., Svendsen S., et al. Rehabilitation for cirrhotic patients discharged after hepatic encephalopathy improves survival. Dan Med J. 2013;60(8):A4683.

185. Schmidt N.P., Fernandes S.A., Silveira A.T., Rayn R.G., Henz A.C., Rossi D., et al. Nutritional and functional rehabilitation in cirrhotic patients. J Gastroenterol Hepatol Res. 2021;10(2):3470–7. DOI: 10.17554/j.issn.2224- 3992.2021.10.991

186. Caraceni P., Riggio O. Angeli P., Alessandria C., Neri S., Foschi F.G., et al. Long-term albumin administration in decompensated cirrhosis (ANSWER): an openlabel randomised trial The Lancet. 2018;391(10138):2417– 29. DOI: 10.1016/S0140-6736(18)30840-7

187. Fernandez J., Tandon P., Mensa J., Garcia-Tsao G. Antibiotic prophylaxis in cirrhosis: Good and bad. Hepatology. 2016;63(6):2019–31. DOI: 10.1002/hep.28330

188. Soni H., Kumar-M P., Sharma V., Bellam B.L., Mishra S., Mahendru D., et al. Antibiotics for prophylaxis of spontaneous bacterial peritonitis: systematic review & Bayesian network meta-analysis. Hepatol Int. 2020;14(3):399–413. DOI: 10.1007/s12072-020-10025-1

189. Loomba R., Wesley R., Bain A., Csako G., Pucino F. Role of fluoroquinolones in the primary prophylaxis of spontaneous bacterial peritonitis: meta-analysis. Clin Gastroenterol Hepatol. 2009;7(4):487–93. DOI: 10.1016/j.cgh.2008.12.018

190. Saab S., Hernandez J.C., Chi A.C., Tong M.J. Oral antibiotic prophylaxis reduces spontaneous bacterial peritonitis occurrence and improves short-term survival in cirrhosis: a meta-analysis. Am J Gastroenterol. 2009;104(4):993–1001. DOI: 10.1038/ajg.2009.3

191. Goel A., Rahim U., Nguyen L.H., Stave C., Nguyen M.H. Systematic review with meta-analysis: rifaximin for the prophylaxis of spontaneous bacterial peritonitis. Aliment Pharmacol Ther. 2017;46(11–12):1029–36. DOI: 10.1111/apt.14361. Epub 2017 Oct 9.

192. Varakanahalli S., Sharma B.C., Srivastava S., Sachdeva S., Dahale A.S. Secondary prophylaxis of hepatic encephalopathy in cirrhosis of liver: a double-blind randomized controlled trial of L-ornithine L-aspartate versus placebo. Eur J Gastroenterol Hepatol. 2018;30(8):951–8. DOI: 10.1097/MEG.0000000000001137

193. Ginés P., Rimola A., Planas R., Vargas V., Marco F., Almela M., et al. Norfloxacin prevents spontaneous bacterial peritonitis recurrence in cirrhosis: results of a double-blind, placebo-controlled trial. Hepatology. 1990;12(4):716–24. DOI: 10.1002/hep.1840120416

194. Min Y.W., Lim K.S., Min B.H., Gwak G.Y., Paik Y.H., Choi M.S., et al. Proton pump inhibitor use significantly increases the risk of spontaneous bacterial peritonitis in 1965 patients with cirrhosis and ascites: a propensity score matched cohort study. Aliment Pharmacol Ther. 2014;40(6):695–704. DOI: 10.1111/apt.12875

195. Dam G., Vilstrup H., Watson H., Jepsen P. Proton pump inhibitors as a risk factor for hepatic encephalopathy and spontaneous bacterial peritonitis in patients with cirrhosis with ascites. Hepatology. 2016;64(4):1265–72. DOI: 10.1002/hep.28737

196. Albillos A., Banares R., Gonzalez M., Ripoll C., Gonzalez R., Catalina M.V., et al. Value of the hepatic venous pressure gradient to monitor drug therapy for portal hypertension: a meta-analysis. Am J Gastroenterol. 2007;102(5):1116–26. DOI: 10.1111/j.1572-0241.2007.01191.x

197. Li T., Ke W., Sun P., Chen X., Belgaumkar A., Huang Y., et al. Carvedilol for portal hypertension in cirrhosis: systematic review with meta-analysis. BMJ Open. 2016;6(5):e010902. DOI: 10.1136/bmjopen-2015-010902

198. González-Abraldes J., Albillos A., Banares R., Del Arbol L.R., Moitinho E., Rodriguez C., et al. Randomized comparison of long-term losartan versus propranolol in lowering portal pressure in cirrhosis. Gastroenterology. 2001;121(2):382–8. DOI: 10.1053/gast.2001.26288

199. Kim S.G., Kim T.Y., Sohn J.H., Um S.H., Seo Y.S., Baik S.K., et al. A randomized, multi-center, open-label study to evaluate the efficacy of carvedilol vs. propranolol to reduce portal pressure in patients with liver cirrhosis. Am J Gastroenterol. 2016;111(11):1582–90. DOI: 10.1038/ajg.2016.327. Epub 2016 Aug 30.

200. Garcia-Pagan J.C., De Gottardi A., Bosch J. Review article: the modern management of portal hypertension–primary and secondary prophylaxis of variceal bleeding in cirrhotic patients. Aliment Pharmacol Ther. 2008;28(2):178–86. DOI: 10.1111/j.1365-2036.2008.03729.x

201. Senzolo M., Cholongitas E., Burra P., Leandro G., Thalheimer U., Patch D., et al. Beta-blockers protect against spontaneous bacterial peritonitis in cirrhotic patients: a meta-analysis. Liver Int. 2009;29(8):1189–93. DOI: 10.1111/j.1478-3231.2009.02038.x

202. Reiberger T., Ferlitsch A., Payer B.A., Mandorfer M., Heinisch B.B., Hayden H., et al. Non-selective betablocker therapy decreases intestinal permeability and serum levels of LBP and IL-6 in patients with cirrhosis. J Hepatol. 2013;58(5):911–21. DOI: 10.1016/j.jhep.2012.12.011

203. Serste T., Melot C., Francoz C., Durand F., Rautou P.E., Valla D., et al. Deleterious effects of beta-blockers on survival in patients with cirrhosis and refractory ascites. Hepatology. 2010;52(3):1017–22. DOI: 10.1002/ hep.23775

204. Puente A., Hernandez-Gea V., Graupera I., Roque M., Colomo A., Poca M., et al. Drugs plus ligation to prevent rebleeding in cirrhosis: an updated systematic review. Liver Int. 2014;34(6):823–33. DOI: 10.1111/liv.12452

205. Bureau C., Thabut D., Oberti F., Dharancy S., Carbonell N., Bouvier A., et al. Transjugular intrahepatic portosystemic shunts with covered stents increase transplant-free survival of patients with cirrhosis and recurrent ascites. Gastroenterology. 2017;152(1):157–63. DOI: 10.1053/j.gastro.2016.09.016


Рецензия

Для цитирования:


Ивашкин В.Т., Маевская М.В., Жаркова М.С., Жигалова С.Б., Киценко Е.А., Манукьян Г.В., Трухманов А.С., Маев И.В., Тихонов И.Н., Деева Т.А. Клинические рекомендации Российского общества по изучению печени и Российской гастроэнтерологической ассоциации по диагностике и лечению фиброза и цирроза печени и их осложнений. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2021;31(6):56-102.

For citation:


Ivashkin V.T., Maevskaya M.V., Zharkova M.S., Zhigalova S.B., Kitsenko E.A., Manukyan G.V., Trukhmanov A.S., Maev I.V., Tikhonov I.N., Deeva T.A. Clinical Recommendations of the Russian Scientific Liver Society and Russian Gastroenterological Association on Diagnosis and Treatment of Liver Fibrosis, Cirrhosis and Their Complications. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2021;31(6):56-102. (In Russ.)

Просмотров: 1514


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.


ISSN 1382-4376 (Print)
ISSN 2658-6673 (Online)