Features of the course of chronic liver disease in the elderly patients
Golovanova, E.V.; D'iakova, I.P.; Lazebnik, L.B.
Eksperimental'naia i Klinicheskaia Gastroenterologiia 12: 42-47
2010
ISSN/ISBN: 1682-8658 PMID: 21560620 Document Number: 644826
Chronic liver disease (CLD), often occurring with blurred symptomatic occupy not the last place in the morbidity of the elderly patients. We systematized the available literature data on the peculiarities of the morphological structure of the liver and its functional status in persons over age group, presented results of their research. Established that the incidence of CLD in patients with elderly reaches 2%, while long-term asymptomatic disease in 15.4% of patients with minimal clinical manifestations--in 46% of cases. The high (29.9%), the frequency of infection of hepatotropic viruses in the elderly. During 4 years of observation of the natural history of HCV-infection in elderly formation of CP was observed in 7.3% of patients, hepatocellular carcinoma (HCC)--in 5.1% of cases. Monotherapy with interferon-alpha (IFN-alpha) within 3 months older accompanied by a decrease of biochemical activity in 60% of cases, the development of early virological response--in 33.3% of sustained virological response--in 6.7%. The incidence of side effects (depressed mood--40%, depression--20% change in hematological parameters--26.7-40%) was higher than in young patients. The use of ursodeoxycholic acid (UDCA) at a dose of 12-15 mg/kg/day for 3 months in elderly patients (n = 25) with chronic HCV-infection in the 70.6-80% of the cases resulted in significant reduction in biochemical activity, as well as asthenic severity, pain and dyspeptic syndromes.