vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/pf.v19i2.2407vsp-2920Research ArticleОРИГИНАЛЬНАЯ СТАТЬЯORIGINAL ARTICLESСвязь воспалительных заболеваний кишечника с выраженностью поражения печени при аутоиммунной гепатобилиарной патологии: одномоментное исследованиеCorrelation of Inflammatory Bowel Diseases with Liver Involvement Severity in Autoimmune Hepatobiliary Pathology: Cross-Sectional Studyhttps://orcid.org/0000-0003-0661-6976УсольцеваО. В.UsoltsevaOlga V.

Усольцева Ольга Владимировна, аспирант, врач-педиатр гастроэнтерологического отделения с гепатологической группой

Адрес: 119991, Москва, Ломоносовский пр-т, 2, стр. 1, тел.: +7 (499) 134-15-82

Moscow

usoltseva.olga93@gmail.comhttps://orcid.org/0000-0002-3697-4283СурковА. Н.SurkovAndrey N.

Москва

Moscow

https://orcid.org/0000-0003-2881-4703МовсисянГ. Б.MovsisyanGoar B.

Москва

Moscow

https://orcid.org/0000-0003-4905-2373ПотаповА. С.PotapovAlexander S.

Москва

Moscow

https://orcid.org/0000-0001-9798-9617КулебинаЕ. А.KulebinaElena A.

Москва

Moscow

https://orcid.org/0000-0002-1107-8693КуликовК. А.KulikovКirill A.

Москва

Moscow

https://orcid.org/0000-0002-8750-9285ЧерниковВ. В.ChernikovVladislav V.

Москва

Moscow

Национальный медицинский исследовательский центр здоровья детейРоссияNational Medical Research Center of Children’s HealthRussian FederationНИИ педиатрии и охраны здоровья детей НКЦ №2 ФГБНУ «РНЦХ им. акад. Б.В. Петровского»; Российский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияResearch Institute of Pediatrics and Children’s Health in Petrovsky National Research Centre of Surgery; Pirogov Russian National Research Medical UniversityRussian FederationНациональный медицинский исследовательский центр здоровья детей; Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияNational Medical Research Center of Children’s Health; Sechenov First Moscow State Medical UniversityRussian FederationНациональный медицинский исследовательский центр здоровья детей; Российский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияNational Medical Research Center of Children’s Health; Pirogov Russian National Research Medical UniversityRussian Federation202224052022212105112Copyright © Усольцева О.В., Сурков А.Н., Мовсисян Г.Б., Потапов А.С., Кулебина Е.А., Куликов К.А., Черников В.В., 20222022Усольцева О.В., Сурков А.Н., Мовсисян Г.Б., Потапов А.С., Кулебина Е.А., Куликов К.А., Черников В.В.Usoltseva O.V., Surkov A.N., Movsisyan G.B., Potapov A.S., Kulebina E.A., Kulikov К.A., Chernikov V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/2920Обоснование

Обоснование. Воспалительные заболевания кишечника (ВЗК) нередко протекают с поражением гепатобилиарной системы, в том числе аутоиммунной природы. Влияние ВЗК на развитие и выраженность фиброза печени у детей остается неизученным.

Цель исследования — изучить связь ВЗК с наличием и выраженностью фибротических изменений печени и нарушением ее функции при аутоиммунном поражении гепатобилиарной системы у детей.

Методы

Методы. В исследование включали больных, госпитализированных с аутоиммунной гепатобилиарной патологией (аутоиммунный гепатит, первичный склерозирующий холангит, overlap-синдром, аутоиммунный холангит или первичный билиарный холангит), изолированной (контрольная группа) или в сочетании с ВЗК. Наличие и выраженность фиброза печени устанавливали инвазивными (оценка активности воспаления и фиброза печени по шкале METAVIR, площади отложения коллагена IV в биоптате печени) и неинвазивными методами (транзиентная эластография печени, концентрация коллагена IV, активность печеночных ферментов).

Результаты

Результаты. Больные с аутоиммунной гепатобилиарной патологией (ГБП) в сочетании с ВЗК (n = 41) были сопоставимы с пациентами контрольной группы (n = 44) по полу и возрасту. У больных с ВЗК чаще диагностировали аутоиммунный гепатит и первичный склерозирующий холангит. При этом у больных с ВЗК в сравнении с больными контрольной группы отмечена более высокая частота умеренного фиброза, более высокая активность гамма-глутамилтрансферазы и низкая концентрация альбумина. По остальным показателям различий между группами не выявлено.

Заключение

Заключение. ВЗК ассоциированы с относительно высокой частотой и выраженностью фибротических изменений печени при аутоиммунной ГБП в сравнении со случаями изолированной аутоиммунной ГБП. Однако эти различия могут быть обусловлены различиями в структуре аутоиммунной ГБП и, соответственно, проводимом лечении.

Background

Background. Inflammatory bowel diseases (IBD) often occur with hepatobiliary system involvement, including autoimmune ones. The role of IBD in development and severity of liver fibrosis in children remains unknown.

Objective

Objective. The aim of the study is to study the correlation of IBD with the presence and severity of liver fibrotic changes and its malfunction at hepatobiliary system autoimmune disorders in children.

Methods

Methods. The study included patients hospitalized with isolated (control group) autoimmune hepatobiliary disorders (HBD) (autoimmune hepatitis, primary sclerosing cholangitis, overlap syndrome, autoimmune cholangitis, primary biliary cholangitis) or in combination with IBD. The presence and severity of liver fibrosis was evaluated via invasive (estimation of inflammation activity and liver fibrosis via the METAVIR scale, areas of collagen IV deposition in liver biopsy slides) and non-invasive methods (transient liver elastography, collagen IV levels, liver enzymes activity).

Results

Results. Patients with autoimmune hepatobiliary disorders associated with IBD (n = 41) were comparable to those in control group (n = 44) by gender and age. Patients with IBD were more likely to be diagnosed with autoimmune hepatitis and primary sclerosing cholangitis. Furthermore, patients with IBD had higher frequency of moderate fibrosis, higher gamma glutamine transferase activity, and lower albumin concentration in comparison with patients of control group. We haven't revealed any other differences between both groups on other indicators.

Conclusion

Conclusion. IBD are associated with relatively high incidence and severity of liver fibrotic changes in autoimmune HBD compared to isolated autoimmune HBD cases. However, these differences may be due to the differences in autoimmune HBD structure and, subsequently, its treatment.

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The authors declare that there are no conflicts of interest present.