Clinical and laboratory methods for estimation the stage of fibrosis in case of chronic liver diseases


DOI: https://dx.doi.org/10.18565/therapy.2023.7.32-44

Medvedev Yu.V., Bakulin I.G.

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg

Abstract. Despite the presence in clinical practice of various methods for hepatic fibrosis estimation, assessing the functional state of that organ remains a serious problem for specialists in various areas of clinical medicine. The aim: to evaluate and compare the results of laboratory and instrumental research methods with a non-invasive 13C-methacetin analog test (13C-MDT) for liver function estimation.


Material and methods. During the study, in patients with chronic liver diseases (CLD) of various etiologies, indexes of clinical and biochemical blood tests, coagulograms were measured, also results of 13C-MDT were studied. Liver fibrosis was assessed according to current standards. 13C-MDT was performed to characterize the functional reserve of the liver, which was assessed by the rate and volume of substrate metabolism (13C-methacetin) in the cytochrome P450 1A2 system.


Results. During the study, threshold indexes for the level of platelets, INR, albumin as biochemical markers of liver damage were identified. The values of the cumulative dose of 13CO2 for 13C-MDT in CKD have been identified, which allow predicting the risk of fibrosis


Conclusion. Differences identified in the results of clinical and laboratory research methods between groups can be used as differential diagnostic criteria for severe fibrosis and cirrhosis of liver. In the future, using the obtained data, it is planned to identify laboratory markers that can be used for early diagnosis of a pronounced stage of fibrosis. It is possible to use laboratory markers of fibrosis in combination with 13C-MDT for early diagnosis of severe fibrosis and cirrhosis of the liver.

Keywords: coagulogram, biochemical blood test, 13C-methacetin breathing test, clinical blood test, laboratory diagnostics, liver fibrosis, liver cirrhosis
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About the Autors

Yuri V. Medvedev, PhD in Medical Sciences, assistant at the Department of propaedeutics of internal diseases, gastroenterology and dietology named after S.M. Ryss, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str.
E-mail: yurii.medvedev@szgmu.ru
ORCID: https://orcid.org/0000-0002-7407-346X
Igor G. Bakulin, MD, professor, head of the Department of propaedeutics of internal diseases, gastroenterology and dietology named after S.M. Ryss, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str.
E-mail: igor.bakulin@szgmu.ru
ORCID: https://orcid.org/0000-0002-6151-2021


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