Dankiv L. Сlinical-pathogenetic characteristic of the course of rheumatoid arthritis when combined with nonalcoholic steatohepatitis: connection with clinical manifestations and efficiency of treatment.

The dissertation presents the analysis of improvement of early diagnosis methods and increase of treatment efficiency of patients with rheumatoid arthritis when combined with nonalcoholic steatohepatitis on the basis of comprehensive study of clinical and pathogenetic mechanisms of disease development. In patients with comorbid nonalcoholic steatohepatitis, a high percentage of pa-tients with metabolic syndrome and obesity in combination with arterial hypertension and type 2 diabetes mellitus have been identi-fied. It has been shown that in patients with rheumatoid arthritis in combination with nonalcoholic steatohepatitis, the parameters of morphofunctional state of the liver, lipid peroxidation, endogenous intoxication are increased, and the parameters of antioxidant defense system, especially in postmenopausal woman, in patients with elevated body mass index, prolonged and active course of rheumatoid arthritis, under constant use of glucocorticoids and methotrexate at a dose of 11-25 mg/week. It has been established that the presence of nonalcoholic steatohepatitis in patients with rheumatoid arthritis is associated with dyslipidemia. The work sub-stantiates that the use of essential phospholipids and L-glutathione in the complex treatment of patients with rheumatoid arthritis with concomitant nonalcoholic steatohepatitis effectively influences the reduction of clinical manifestations of the disease, reduc-tion of lipid peroxidation index, rigidity of the hepatic parenchyma, improvement of its functional status, lipid blood spectrum.