Chernega N. Clinical and pathogenetic features of liver diseases of early-aged children and the principles of their treatment.

The thesis is devoted to studying of the pathogenic aspects of liver diseases progression of early-aged children in order to improve diagnostic and preventive methods. The author shows that inflammatory and degenerative liver diseases, which have early-aged children in their vast majority are congenital lesions. The causal factors are viruses of the group of TORCH infections, including cytomegalovirus. At the heart of the studies it is examined the state of connective tissue, cytokine profile and the children's indicators of fatty-acid spectrum of blood serum who have diseases of the hepatobiliary system. It is identified the individual indicators of some fractions of hydroxyproline and collagenase activity that can be defined as prognostic criteria of liver damage. It is defined the correlation between indicators of cytokine status and fatty acid spectrum of blood, regardless of the duration of the damage. This fact justifies the possibility of the nutritional correction of liver diseases. It is proven the role of motility disorders of the children's biliary tract in the pathogenesis of congenital hepatitis and prolonged conjugation jaundice. It gives grounds to prove the usage of methods with holekinetic properties in composite therapy. It is shown that functional disorders of the hepatobiliary system of babies are accompanied by the changes of cytokine status. The study of miRNAs levels with the diagnosis hepatitis has shown new data concerning the possibility of using miRNA-21-3r as a diagnostic biomarker of liver diseases, and miRNA-885-5r as an indicator of the degree of damage. Having based on the results, it was developed an approach to the comprehensive treatment of children with congenital hepatitis with the includion of immunologic response modifier, a spectrum of medications that have antifibrotic, detoxificative and corrective characteristics for fatty acid level. On the background of an optimized nutritional support this metod is quite efficient.