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Aim. To study significance of platelet count and values of aspartate aminotransferase and tumor necrosis factor-α in the evaluation of the severity of liver fibrosis in chronic hepatitis C and for the development of fibrosis index calculation formula.Material and Methods. The study included 70 patients with chronic hepatitis C end 30 healthy persons. Liver density was estimated by ultrasound elastography.Results. The correlation analysis revealed strong relationships between the ultrasound elastography findings of fibrosis stage and the platelet count (r=0.83), aspartate aminotransferase (r=0.83), and tumor necrosis factor-α (r=0.81). The optimal separation points of laboratory tests for fibrosis exclusion were identified as follows: platelet count>270×109 /L (test sensitivity=96.2%), aspartate aminotransferase level2.5 corresponded to the severe fibrosis/cirrhosis of the liver (F3-4) with diagnostic sensitivity of 83% and specificity of 78%.Conclusion. Platelet count, the values of aspartate aminotransferase and tumor necrosis factor-α levels, fibrosis index, and laboratory test data can be used for ruling out fibrosis in chronic hepatitis C patients as well as for stratification of liver fibrosis stages.

Aim. To study the blood serum interleukin-6 (IL) and circulating immune complexes (CIC) levels in patients with ulcerous colitis (UC), depending on the severity of disease attack, colonic inflammation dissemination, and presence of abenteric manifestations. Materials and methods. One hundred patients with UC in the phase of active inflammation were examined. Blood serum IL-6 and CIC concentrations were studied with IFA method. Results. 88,5 % of UC patients in the phase of active inflammation showed an elevated mean IL-6 index, 80 % had increased CIC concentration as compared with normal values. The highest IL-6 and CIC levels were obtained in case of severe forms of disease (11,50 (7,30–23,65) pg/ml and 115,50 (105,00–118,00), respectively); CIC and IL-6 levels were significantly higher in patients with abenteric manifestations and frequently relapsing course in comparison with patients, having rare UC relapses (p < 0,005). Strong direct correlations of IL-6 and CIC with each other (r = 0,65; p = 0,001) as well as with the severity of pathological changes in the colon were established. Conclusions. Among patients with UC, significantly elevated blood serum IL-6 and CIC concentrations were determined. Patients with severe attack of disease as well as those with abenteric manifestations and frequent relapses demonstrated reliably higher levels of these indices. It is recommended to use determination of blood serum IL-6 and CIC levels as an available and informative method, permitting to estimate the degree of severity of inflammatory process in the colonic wall among patients with ulcerous colitis.

Aim. To study the possibility of using MELD scale for determining the degree of severity of hepatic cirrhosis (HC) and determine its diagnostic characteristics. Materials and methods. Thirty patients with HC, including 15 patients with compensated HC stage (class A+B) by Child-Pugh scale and 15 persons with decompensated HC (class C), were examined. Total blood bilirubin and creatinine concentrations were assessed, INR and MELD index were calculated. Results. Meld index with use of total bilirubin, creatinine indices and INR is increasing as HC is progressing from 5 at the compensated stage to 26 at the decompensated stage ( p < 0,001) and directly correlates with the degree of severity of cirrhosis, estimated by Child-Pugh scale ( r = 0,64; p = 0,005). The threshold value of MELD index to differentiate the compensated HC stage from the decompensated one was 11. Conclusions. Design parameter of MELD permits to differentiate the degrees of HC severity with sensitivity equal to 73,3 % and specificity - 84,6 %. When MELD index is less than or equal to 11, the compensated stage of HC is diagnosed, when it exceeds 11, the decompensated cirrhosis is specified.

To study the rs1001179 polymorphism of the catalase (CAT) gene and to estimate the serum levels of the enzymes catalase and glutathione peroxidase (GP) in patients with chronic hepatitis C (CHC) and in those with ulcerative colitis (UC) in the Perm Territory.Ninety patients with reactivation-phase CHC and 50 patients with exacerbation-phase UC were examined. The serum levels of catalase and GP were determined and the polymorphic variants of the marker of CAT gene rs1001179 in the DNA isolated from whole blood were found in all the patients.In the CHC and UC groups, the levels of catalase and GP were found to be lower than that in apparently healthy individuals. Furthermore, both groups showed a direct correlation between the activities of the enzymes. In the patients with CHC and in those with UC, the spread of genotypes and alleles generally failed to virtually differ from that in the control group. The G/G genotype was prevalent in all the groups. In the patients with CHC, the minor A allele demonstrated a significant inverse correlation with the enzyme catalase (r = -0.16; p = 0.02) and GP (r = -0.13; p = 0.047).The lower serum levels of catalase and GP are indicative of oxidative stress in the patients with CHC or UC. In the patients with CHC, the significant correlation of the pathological rs1701179 A allele marker with the processes of synthesis of antioxidant enzymes may suggest that CAT gene polymorphism in the A/A homozygotes might affect the regulation mechanism involved in the antioxidant system in the liver.Цель исследования. Изучить полиморфизм rs1001179 гена каталазы (CAT) и оценить уровень ферментов каталазы и глутатионпероксидазы (ГП) в сыворотке крови у больных хроническим гепатитом С (ХГС) и язвенным колитом (ЯК) в Пермском крае. Материалы и методы. Обследовали 90 пациентов с ХГС в фазе реактивации и 50 больных ЯК в фазе обострения. У всех больных определяли уровень каталазы и ГП в сыворотке крови и выявляли полиморфные варианты маркера rs1001179 гена САТ в ДНК, выделенной из цельной крови. Результаты. Уровень каталазы и ГП в группах пациентов с ХГС и ЯК оказался достоверно ниже, чем у практически здоровых лиц. Кроме того, в обеих группах выявлена прямая корреляция активности ферментов между собой. Распространенность генотипов и аллелей у больных ХГС и ЯК в целом практически не отличалась от таковых в контрольной группе. Во всех группах преобладал генотип G/G. У больных ХГС минорный аллель А демонстрировал достоверную обратную корреляцию с ферментом каталазой (r=–0,16; р=0,02) и ГП (r=–0,13; р=0,047). Заключение. Снижение в сыворотке крови уровня каталазы и ГП свидетельствует о наличии оксидантного стресса у больных ХГС и ЯК. Наличие у больных ХГС достоверной корреляции патологического аллеля А маркера rs1001179 с процессами синтеза антиоксидантных ферментов позволяет сделать предположение о возможном влиянии полиморфизма гена САТ у гомозигот А/А на механизмы регуляции антиоксидантной системы в печени.