Title Bolesti jetre povezane s bolestima ovisnosti Title (english) Addiction related liver diseases Author Luka Perajica Mentor Lucija Virović Jukić (mentor)Committee member Neven Baršić (predsjednik povjerenstva)Committee member Ivana Vuković Brinar (član povjerenstva)Committee member Lucija Virović Jukić (član povjerenstva)Granter University of Zagreb Defense date and country 2023-07-13, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Alkoholna bolest jetre povezana je s pretjeranom konzumacijom alkohola. Više je načina metabolizma alkohola u jetri, a glavni od njih je putem alkoholne dehidrogenaze. Toksičnim djelovanjem alkohola na jetru nastaju patološke promjene od masne jetre, preko alkoholnog steatohepatitisa, pa sve do nakupljanja vezivnog tkiva i razvoja ciroze koja predstavlja terminalni stadij. Klinička slika ovisi o stadiju bolesti. Masna jetra najčešće nema simptoma, glavni simptom alkoholnog hepatitisa je žutica, a ciroza se često prezentira simptomima koji su posljedica oštećene jetrene funkcije ili razvijenih komplikacija poput portalne hipertenzije. Alkoholna se bolest jetre dijagnosticira na temelju kliničke slike te laboratorijskih nalaza, a za postavljanje dijagnoze značajno pomažu slikovne pretrage poput ultrazvuka, kompjuterizirane tomografije te magnetske rezonance. Terapija bolesti se temelji na apstinenciji od alkohola i liječenju ovisnosti, nutritivnoj potpori, farmakološkoj terapiji kod hepatitisa, simptomatskoj i potpornoj terapiji u uznapredovalom stadiju te transplantaciji kao jedinom obliku liječenja završnog stadija bolesti. S druge strane, virusni hepatitis C predstavlja značajnu bolest jetre u intravenskih ovisnika o drogama. Virus se prenosi kontaktom s krvlju zaražene osobe, a do oštećenja jetrenih stanica dolazi direktnim citopatskim učinkom, ali i moduliranjem imunološkog odgovora domaćina. Klinički i patološki razlikuje se akutni i kronični hepatitis, a kao krajnji stadij bolesti razvija se ciroza. Većina bolesnika s akutnim hepatitisom nema simptome i razvija kronični oblik bolesti koji se teško prepoznaje zbog nespecifičnih simptoma, a prvi simptomi nerijetko mogu biti simptomi jetrenog zatajenja. Osnovu dijagnostike hepatitisa C čine laboratorijske pretrage za dokaz specifičnih protutijela i virusne RNA u krvi oboljelih. U bolesnika s kroničnim hepatitisom važno je procijeniti stupanj fibroze što se danas većinom izvodi neinvazivnim metodama. Terapija je hepatitisa C modernizirana uvođenjem direktno djelujućih antivirusnih lijekova koji su značajno povećali preživljenje oboljelih.
Abstract (english) Alcohol related liver disease is associated with excessive alcohol consumption. There are several metabolic pathways for alcohol in the liver, and the main one is through alcohol dehydrogenase. The toxic effect of alcohol on the liver causes pathological changes ranging from fatty liver, through alcoholic steatohepatitis, to the accumulation of connective tissue and the development of cirrhosis, which represents the end stage. Clinical picture depends on the stage of the disease. Fatty liver usually has no symptoms, the main symptom of alcoholic hepatitis is jaundice, and cirrhosis often presents with symptoms that are the result of impaired liver function or developed complications such as portal hypertension. The diagnosis of alcoholic liver disease is based on the clinical picture and laboratory findings, and imaging modalities such as ultrasound, computerized tomography and magnetic resonance imaging. Treatment of the disease is based on abstinence from alcohol and addiction treatment, nutritional support, pharmacological therapy for hepatitis, symptomatic and supportive measures in advanced stages and liver transplantation as the only effective treatment for the final stage of the disease. On the other hand, hepatitis C represents a common liver disease among intravenous drug users. The virus is transmitted through contact with the blood of an infected person, and the liver cells are damaged by a direct cytopathic effect, but also by modulating the immune response of the host. Clinically and pathologically, acute and chronic hepatitis are distinguished, and cirrhosis develops as the final stage of the disease. Most patients with acute hepatitis have no symptoms and develop a chronic form of the disease that is difficult to recognize due to non-specific symptoms, and the first symptoms can often be related to liver failure. The basis for the diagnosis of hepatitis C is a laboratory evidence of specific HCV antibodies and viral RNA. In patients with chronic hepatitis, it is recommended to assess the degree of fibrosis using noninvasive methods. The introduction of direct-acting antiviral drugs has significantly increased the survival of patients.
Keywords
ovisnost o alkoholu
ovisnost o drogama
alkoholna bolest jetre
virusni hepatitis C
Keywords (english)
alcohol addiction
drug addiction
alcohol related liver disease
hepatitis C
Language croatian URN:NBN urn:nbn:hr:105:127286 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2023-10-27 11:44:15
