Kopiychenko Y. Clinico-laboratory indices of course and correction of microbiocenosis breach of intestine in patients with viral hepatitis A

Results of clinical and laboratorial investigation of 199 patients with hepatitis A were presented in thesis. Study of species composition and population level of the microflora of the colon cavity, contents of SIgA in the faeces, acute phase proteins in the blood serum was carried out. Performed research proved that deficit of Enterococci and physiological anaerobes, first of all Bifidobacteria, qualitative changes of Esherichiae with significant increase of aggressive cultures, partial contamination of colon by opportunistic pathogenic bacteria are revealed in 93,52% cases in acute period of hepatitis A. Correlation between intensity of colon microflora dysbiotic changes, SIgA indices and disease state was established. Normobiocenosis and dysbacteriosis of I degree prevail at mild clinical course, dysbacteriosis of II and III degrees - at moderately severe clinical course. The most reliable differences of SIgA indices were discovered at dysbacteriosis of III degree. Indices of SIgA do not change at normobiocenosis. Research of acute phase proteins quantity in the blood serum reveals their increase at the height of the disease, more essential at dysbacteriosis of III degree. Correlated analysis shows feedbacks between acute phase proteins levels and contents of Bifido- and Lactobacteria and feedforwards with opportunistic pathogenic bacteria. Also feedforwards were established between acute phase proteins levels and contents of SIgA. Rises of SІgA excretion and acute phase proteins levels occur in patients with favorable current of hepatitis A in period of clinical signs increase. Unfavourable current is characterized by absence of stated indices rise in this period. Mathematical algorithm for prediction hepatitis A course was elaborated on basis of rating out laboratorial indices. It was revealed that complex therapy of hepatitis A with use of Lactulosa or Lactulosa and Altanum contributes to earlier regression of disease clinical symptoms and is characterized by positive influence on colon microflora, content of SIgA in the faeces and acute phase proteins in the blood serum.