Introduction. Article is devoted to the improvement of tactic of individual therapy of patients with liver cirrhosis (LC) complicated by ascites.
The aim of the work is the comparative determination of protein content together with blood plasma and ascetic liquid (AL) chemical properties at patients with LC during its different stages of manifestation for the patients’ individual tactic of treatment choice. Blood plasma, AL and urine certain ions concentration was calculated additionally for kidneys functional activity determination.
Material and methods. Blood plasma and AL proteins, general bilirubin level, other biochemical markers of endotoxicosis, lipid metabolism components were determined at 262 patients with LC complicated by ascites, randomized on 4 groups depending on severity of a disease. Sodium, potassium, calcium, magnesium, phosphorus and chloride ions concentration were determined additionally in blood plasma, AL and urine.
Results. The analysis of the received results revealed relative safety of liver and kidneys compensatory and regulatory mechanisms at patients with the first stage of LC manifestation. Liver function moderate activation with expressed protein-synthesizing function decrease together with blood plasma and AL moderate intoxication development were observed at patients in a stage of subcompensation. Kidneys’ functions during this stage of pathology were reduced. The expressed liver dysfunction with both cholestatic and cytolytic syndromes development that reflected regulatory mechanisms failure was registered in a stage of decomensation. The revealed dysfunction of kidneys were characterized by potassium-uresis and sodium-uresis decrease. Lipid metabolism disturbances promoted hepatocytes’ cellular membranes further damage and clinical state aggravation. Hypo- and a disproteinemy were evaluated in blood plasma and AL at patients in terminal stage followed blood system, respiratory organs and kidneys progressive disturbances, pulmonary, heart failure and electrolytic imbalance development.
Conclusions. Authors conclude that organs and systems pathological disregulation develops at patients with the LC complicated by ascites with liver primary damage accompanied with protein and lipid metabolism disturbances, endotoxicosis development, toxic metabolites transudation into AL. These disturbances should be considered at a choice of individual tactics of such patients treatment.