Фиброзирующий холестатический гепатит как вариант течения инфекции, вызванной гепатотропными вирусами
- Авторы: Сюткин В.Е.1, Чуланов В.П.2
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Учреждения:
- Научно-исследовательский институт скорой помощи имени Н.В. Склифосовского
- Национальный медицинский исследовательский центр фтизиопульмонологии и инфекционных заболеваний
- Выпуск: Том 29, № 2 (2024)
- Страницы: 126-141
- Раздел: ОБЗОРНЫЕ СТАТЬИ
- URL: https://ogarev-online.ru/1560-9529/article/view/257363
- DOI: https://doi.org/10.17816/EID627312
- ID: 257363
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Аннотация
Фиброзирующий холестатический гепатит — особый вариант течения инфекционного гепатита, характеризующийся быстрым прогрессирующим ухудшением функции печени; обычно развивается в условиях иммуносупрессии, хотя описан и у иммунокомпетентных больных вирусными гепатитами В и С. В основе диагностики фиброзирующего холестатического гепатита лежит гистологическое исследование ткани печени, при котором выявляют преобладание повреждения гепатоцитов с их выраженной баллонной дистрофией над слабой воспалительной реакцией, перицеллюлярный и перисинусоидальный фиброз, а также внутриклеточный и канальцевый холестаз. Анализ литературы подтверждает предположение авторов о том, что патологические изменения в печени, описанные как фиброзирующий холестатический гепатит, могут развиваться в различных условиях под воздействием различных инфекционных агентов. Несмотря на наличие эффективной противовирусной терапии гепатитов В и С, исходы фиброзирующего холестатического гепатита часто неблагоприятны, особенно в случаях, не связанных с трансплантацией солидных органов. В настоящее время в связи с появлением большого количества лекарств, избирательно действующих на иммунную систему, развитием новых направлений медицины в гематологии, ревматологии, онкологии, трансплантологии, инфекционных болезнях, врачи этих специальностей все чаще сталкиваются с неожиданно тяжёлыми формами поражения печени на фоне проводимой специфической терапии. Авторы полагают, что имеет место недооценка врачами, не работающими в Центрах трансплантации печени, возможности развития фиброзирующего холестатического гепатита у больных с вирусными гепатитами В и С в клинике как инфекционных, так и внутренних болезней.
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Владимир Евгеньевич Сюткин
Научно-исследовательский институт скорой помощи имени Н.В. Склифосовского
Автор, ответственный за переписку.
Email: vladsyutkin@gmail.com
ORCID iD: 0000-0001-8391-5211
SPIN-код: 5011-6287
д-р мед. наук
Россия, МоскваВладимир Петрович Чуланов
Национальный медицинский исследовательский центр фтизиопульмонологии и инфекционных заболеваний
Email: vladimir@chulanov.ru
ORCID iD: 0000-0001-6303-9293
SPIN-код: 2336-4545
д-р мед. наук, профессор
Россия, МоскваСписок литературы
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