EFFECT OF 2-ETHYL-6-METHYL-3- HYDROXYPYRIDINE SUCCINATE ON THE STRUCTURAL AND FUNCTIONAL STATE OF LIVER IN PATIENTS WITH CHRONIC HEART FAILURE AND TYPE II DIABETES MELLITUS

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Purpose of the work was to evaluate the effect of 2-ethyl-6-methyl-3-hydroxypyridine succinate on the structural and functional state of liver in patients with heart cardiac failure of ischemic origin and type II diabetes mellitus. Materials and methods of the study: the investigation involved 60 patients with chronic heart failure (CHF) I-III functional class (FC) (classification of CHF PRAs 2002), ischemic and related type II diabetes mellitus (DM) in the age range 45-60 years with ultrasonic (US) signs of hepatic steatosis, of which 2 groups were formed. Basic (group 1) group of patients (30 patients) during 16 weeks in addition to the basic treatment of chronic heart failure (enalapril, bisoprolol, aspirin, atorvastatin, at the request of diuretics, nitrates) and SD (glibenclamide±metformin) received 2-ethyl-6- methyl-3-hydroxypyridine succinate (EMOPS) (Mexicor, LLC "Ekofarminvest", Russia) at a dose of 400 mg / day orally. Control (Group 2) patients were prescribed only basic therapy of chronic heart failure and diabetes. The patient groups were comparable in age, sex, clinical and laboratory parameters, conductivity basic therapy. All patients underwent ultrasound (US) examination of the liver c-class assessment of hepatic steatosis by E. Yilmaz (1999), determination of the activity of alanine aminotransferase (ALT) and aspartate (AST) aminotransferase, gamma glutamyltranspeptidase (GGT), alkaline phosphatase (ALP), the calculation of the index of hepatic steatosis by Jeong-Hoon Lee. Results: when the EMOPS was included into the combination of basic therapy after 16 weeks of the study group was a statistically significant decrease of AST and ALT in the main group of patients (Δ,% -39.06 and Δ,% -26.93 respectively vs Δ,% - 4, and Δ 1, 0.98% in the control group). Decreased activity of the enzymes of cholestasis: GGT at 41.86% vs 6.94% (p <0.05) respectively in the 1st and 2nd groups, and alkaline phosphatase by 22.27% vs 0.34% (p<0.05). It is worth noting that in the main, and in the control group showed significant positive changes in the level hyperenzymemia GGT: a reduction by 69% vs 31.9% in the control group. However, in the group of patients who underwent a part of the basic treatment with EMOPS, we noted the disappearance hyperenzymemia, while in the second group 66.6% of patients had hyperenzymemia. The index of hepatic steatosis in the main group of patients significantly decreased by 9.43%, while in the control group it increased by 2.46%. In group 1 ultrasonic class of hepatic steatosis changed by E. Yilmaz (1999). We decreased the number of patients with II (3.33%) and the IC (at 6.67%) steatosis classes by increasing the number of patients with IA and IB class (Δ,% IA = 33.3%, Δ% IB = 40%, p<0.05) in the absence of significant changes in patients with chronic heart failure without concomitant type 2 diabetes mellitus. Conclusions: the use of 2-ethyl-6-methyl-3-hydroxypyridine succinate in a combined therapy of patients with CHF and type II DM influences positively the structural and functional state of liver, which reduces the expressiveness of ultrasonic signs of hepatic steatosis, significantly reduces the degree of cytolysis and cholestasis syndrome according to the data of the liver enzymes level estimation, a there is also a per cent of hyper enzyme prevalence.