[Possibilities of using the noninvasive methods of investigating the morphofunctional changes in the liver in patients with non alcoholic steatohepatitis and type 2 diabetes mellitus].

Unlabelled: PURPOSE OF A STUDY: To estimate the possibility of applying the complex of the noninvasive methods of investigating the state of the liver for finalizing of the ways of the differentiated pathogenetic therapy.

Materials And Method: Over the 2008 to 2013 period was carried out the open comparative study, in which were included 75 patients with non alcoholic steatohepatitis (NASH) and type 2 diabetes mellitus (SD). The Menghini Method of Liver biopsy was carried out for histological study. The FibroMaksTest was used for the to diagnose of inflammatory and necrotic changes, steatosis and fibrosis of the liver. The determination of the stage of the fibrosis of the liver was conducted with the aid of transient elastography. Was performed the calculation of sensitivity (SE), of specificity (Sp) the results of noninvasive methods with respect to the results of the histological examination of the liver.

Results: According to the data of FibroMaksTest, for steatosis 1 of degree the sensitivity composed 81,0%, specificity--100%; for steatosis 2 and 3 degrees--100 and 100%. For determining the inflammatory--necrotic changes 1 of degree the sensitivity composed 100%, specificity--96.9%; 2 degrees-- 95.2 and 93.3%, correspondingly, of 3 degrees--81.8 and 100%, respectively. During the estimation of the stage of fibrosis 1 sensitivity was 85.4%, specificity--94.4%, respectively; 2 stages--94.1 and 97.1%, respectively; 3 stages--90 and 100%, respectively. During the estimation of the stage of fibrosis by the method of transient elastography of the liver for the degree of fibrosis F1 the sensitivity composed 83.8%, specificity 93.8%; for F it is 2nd 87.5 and 98.6%, respectively; F3-87.5 and 100%, respectively.

Conclusion: The results of the noninvasive methods of diagnostics of the state of parenchyma of the liver in patient with NASG (transient elastography and the FibroMaksTest) are compared with the data of histological studies, that they make it possible to enlarge the possibilities of the morphological interpretation of the defeat of the liver in patients with SD of 2 types.