Fayura O. Disorders of redox homeostasis, endothelial and autonomic functions in patients of varying severity liver cirrhosis and syntropic lesions of internal organs; pathogenetic justification and effectiveness of treatment

The dissertation is devoted to the study of redox homeostasis disorders, endothelial and autonomic functions in patients with liver cirrhosis (LC) of the varying severity and syntropic lesions of internal organs, as well as pathogenetic justification and determination of the effectiveness of their treatment. It was found that the increase of the serum malonic dialdehyde content in the cirrhotic patients is accompanied by the catalase content decreases, followed by the increase LC severity increase according to the criteria of C. G. Child - J. G. Turcotte - R. N. Pugh. Determination of the redox homeostasis index (RHI) revealed that 94.7 % of the cirrhotic patients have redox homeostasis disorders, among which most (88.0 %) of the patients have signs of prooxidant system predominance and antioxidant system weakening, the frequency of such cases significantly increases, and the value of RHI decreases with the LC severity increase. It is stated that the oxidative stress in the cirrhotic patients can be a trigger mechanism of endothelial dysfunction and autonomic imbalance, participating in the pathogenesis of syntropic lesions of internal organs. The severity of cirrhotic gastropathy, varicose hemorrhoidal veins, cirrhotic cardiomyopathy, hypotension, hepatic encephalopathy, coagulopathy, osteoporosis increases significantly with the malonic dialdehyde content increase and the catalase content decrease. It is pathogenetically justified, taking into account the state of the redox system, the appointment of antioxidants in the complex treatment of the cirrhotic patients with the reduced RHI; the effectiveness of treatment depends on the indicators of RHI before the treatment and LC severity.