THE PECULIARITIES OF THE DATA OF INSTRUMENTAL EXAMINATIONS OF WOMEN AFFECTED BY UTERINE FIBROIDS WITH CONCOMITANT HEPATOBILIARY DISEASES

Nowadays, women’s reproductive health is a topical issue of obstetrics and gynecology, therefore, great importance is attributed to timely diagnosis and prevention of diseases that influence fertility. The topicality of the issue of uterine hyperplasia, in particular, uterine fibroids, is accounted for by the social significance of the disease. Its incidence rate is constantly growing and makes up from 30 to 50% in women older than 35 years and, according to the data of autopsy, - up to 80%. No doubt, the peculiarities of development and progression of hyperplasia are determined by the reserve potential of various systems and organs, including the hepatobiliary system.The aim of research is to analyze the results of instrumental examinations of the functional capacity of hepatocytes in women affected by uterine fibroids and functional disorders of the hepatobiliary system. Research materials and methods. To accomplish the set objective, we used the following contemporary instrumental examination methods: ultrasonography and rheovasohepatography as well as a clinical and paraclinical analysis of caserecords of 150 women aged between 35 and 45 and affected by uterine fibroids, who were treated at the gynecological department of the Regional Perinatal Centre.Research results. As the research result show, uterine fibroids and the related hormonal disorders often go together with functional and morphological lesion of hepatocytes. Patients affected by uterine fibroids have preconditions for the development of functional disorders of hepatocytes as they present significant disorders of hepatic hemodynamics, decreased blood supply of the liver, as a result of pre- and postcapillary resistance.Conclusions. There is a close connection between uterine fibroids with concomitant hepatobiliary disorders and the severity of hormonal disorders, and the significant lesion of hepatocytes may be irreversible. Thisrequires pathogenetic correction by introducing drugs with hepatoprotective and antioxidant effects.

Structural and functional changes of abdominal organs in patients with hepatocerebral degeneration

The paper presents the results of ultrasound diagnostic of 76 patients with neurological forms of hepatocerebral degeneration (HCD) or Wilson’s disease (WD), who were examined and treated at the clinic of the Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine. According to ultrasound diagnostic, all patients had pathological changes in the liver. In 58% of patients these changes corresponded to chronic hepatitis, in 42% - liver cirrhosis, and in 32% of patients were reported for portal hypertension. Background hepatic hemodynamics of patients was within normal limits, but in 82% of them the reaction to food load was negative. Doppler study showed that background hepatic hemodynamics in patients with neurological forms of hepatocerebral degeneration (GCD) was within normal limits. However, the food load showed that 82% of patients had impaired reciprocal autoregulation of liver microcirculation. This indicates a decrease in their compensatory-adaptive capacity of the liver. This position is confirmed by the fact that 70% of these patients have a decrease in vasoactive endothelial function. Our study of the functional state of the vascular endothelium showed that patients with GCD have a significant decrease in vasoactive endothelial function. In general, the group was only 8.12% at a rate of 10% or more. Despite the young average age of our patients (29.7 years), only 30% of patients had a normal vasoactive reaction. These were patients under the age of 25 from the group of chronic hepatitis. The degree of endothelial dysfunction was significantly higher in patients with liver cirrhosis compared with chronic hepatitis. According to ultrasound elastography, in the vast majority of examined patients with GCD (88%) there was increased stiffness of the liver parenchyma. On the average on group of patients it made 10,62 KPA with a range from 4,74 to 20,69 KPA (norm 0,4-6,0 KPA). Thus, patients with neurological forms of GCD, which are observed by a neurologist, it is necessary before each course of treatment, but at least 1-2 times a year, to conduct ultrasound of the abdominal cavity.