Veliieva T. Echinococcosis of the liver: clinical and epidemiological characteristics and optimization of treatment and diagnostic

The dissertation work is based on an in-depth clinical and epidemiological, clinical and laboratory and clinical and instrumental examination of patients with echinococcosis, a study of the frequency and relationships of identified disorders in comparison with the control group, their dynamics after treatment and determination of the diagnostic value of indicators of cellular and humoral immunity, substantiation of the use of complex treatment with the addition of interferons and a comparative economic analysis of the main methods of treatment of echinococcosis. The work is based on in-depth clinical-epidemiological, clinical-laboratory and clinical-instrumental examination of patients with echinococcosis, study of the frequency and relationships of detected disorders in comparison with the control group, their dynamics after treatment and determining the diagnostic value of cellular and application of complex treatment with the addition of interferons and comparative economic analysis of the main methods of treatment of echinococcosis. To achieve this goal, 253 patients with echinococcosis aged 20 to 70 years (115 men and 138 women) who were on outpatient examination and treatment at the Department of Medical Parasitology and Tropical Diseases of the Kharkiv Medical Academy of Postgraduate Education in 2012-2018 were examined. In order to assess the state of the cytokine system in patients with echinococcosis were examined 53 people aged 20 to 70 years. For comparison and control, 30 practically healthy individuals of the appropriate sex and age were examined. Criteria for inclusion: the study group included patients after obtaining the informed consent of a patient with a reliable diagnosis of «echinococcosis». The clinical diagnosis of echinococcosis was based on a combination of clinical symptoms and instrumental features, which was assessed using phased ultrasound (US), computed tomography (CT), or magnetic resonance imaging (MRI), enzyme-linked immunosorbent assay (ELISA 100), which allowed% of cases to establish a nosological and topical diagnosis, to determine the stage of the parasitic process in 96.7%. To exclude mixed invasions, the presence of antibodies to roundworm antigens, Giardia, opisthorchiasis and Trichinella was determined by ELISA. In all individuals, feces for helminth eggs and perianal-rectal scraping for enterobiosis were examined three times. In order to exclude from the study of patients with other comorbidities were examined for systemic, autoimmune and parasitic diseases. Treatment of patients with echinococcosis was performed by the use of complex therapy with albendazole at a dose of 400 mg 2 times a day after meals for 28 days with 14-day breaks (1 group) and with the addition of ɑ-2b interferon at a dose of 3 million intramuscularly № 10 in 2 days on the 3rd on water for injections (group 2). Pathogenetic and symptomatic therapy was performed together with specific therapy. A comparative economic analysis of the costs of therapeutic and surgical treatment of echinococcosis of the liver was conducted on the basis of methodological approaches and principles of calculating the cost of complex medical services in accordance with the methodology of «step-downЦ».