GP73在酒精性肝病中的临床意义

目的探讨高尔基体蛋白73(GP73)在酒精性肝病中的临床应用价值。方法选取44例酒精性脂肪肝、43例酒精性肝炎、32例酒精性肝硬化、67例非酒精性脂肪肝患者和120例健康对照组,用ELISA法检测血清中GP73浓度,同时检测谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、γ谷氨酰转肽酶(GGT)、清蛋白(Alb)、总胆红素(TBil)、甲胎蛋白(AFP)等项目,使用SPSS17.0统计学软件对检测结果进行统计学分析。结果酒精性脂肪肝组、酒精性肝炎组、酒精性肝硬化组、非酒精性脂肪肝组、健康对照组GP73水平分别为(84.22±26.22)、(157.98±39.71)、(201.23±61.14)、(62.00±14.02)、(47.08±22.75)ng/mL,各组GP73水平与健康对照组比较差异有统计学意义(P0.05)。酒精性肝炎、酒精性肝硬化组治疗后GP73水平与治疗前比较差异有统计学意义(P0.05)。GP73诊断酒精性肝病的敏感度71.4%,特异度95.2%。结论 GP73在各类酒精性肝病时有不同程度升高,有辅助诊断意义,在酒精性肝炎、酒精性肝硬化组中治疗后浓度下降,可用于治疗效果的评估。     

体检人群中酒精性肝病患者健康教育的研究进展

一、酒精性肝病的研究进展 酒精性肝病（alcoholic liver disease,ALD）是由于长期大量饮酒导致的肝脏疾病.ALD是西方国家导致肝硬化的最主要病因,也是十大常见死因之一.我国ALD在所有肝病中的比例有逐年增加的趋势.ALD的疾病谱呈现多样化,根据中华医学会肝脏病学分会脂肪肝和ALD学组提出的酒精性肝病病理学诊断标准,ALD可分为轻型酒精性肝病、酒精性脂肪肝、酒精性肝炎、酒精性肝纤维化和酒精性肝硬化等5种类型.     

还原型谷胱甘肽治疗酒精性肝病63例临床效果

酒精性肝病是近年来常见的消化系疾病,初期通常表现为脂肪肝,进而发展成酒精性肝炎、酒精性肝纤维化和酒精性肝硬化,在严重酗酒时可诱发广泛肝细胞坏死甚至肝功能衰竭。我院应用还原型谷胱甘肽(阿拓莫兰)治疗酒精性肝病63例,疗效满意,现报道如下。1临床资料1·1病例选择选择酒精性肝病共114例,全部符合酒精性肝病诊断标准,按严重程度分为轻型(酒精性脂肪肝)、中型(酒精性肝炎)、重型(酒精性肝纤维化、肝硬化)[1]。采用简单随机法将114例分为两组。治疗组63例,均为男性;年龄19~68岁,平均41岁;病程4个月~18年,平均4年1个月。其中轻型25例(39·…     

血清天门冬氨酸氨基转移酶线粒体同工酶在酒精性肝病中的临床价值

目的探讨血清天门冬氨酸氨基转移酶线粒体同工酶(m-AST)活性在酒精性肝病(ALD)预后判断中的价值。方法采用免疫抑制法检测104例ALD患者[ALD组,包括酒精性脂肪肝(AFL)36例、酒精性肝炎(AH)52例和酒精性肝硬化(AC)16例]和100例病毒性肝炎患者[非酒精性肝病(NALD)组]治疗前(入院时)、治疗3周后及100名健康成人(对照组)血清m-AST活性,同时测定血清γ-谷氨酰基转移酶(GGT)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)活性;观察AFL、AH及AC患者治疗前、后GGT、ALT、AST、m-AST活性的变化。结果 ALD组、NALD组血清GGT、ALT、AST、m-AST活性均明显高于对照组(P<0.05),NALD组各项指标明显高于ALD组(P<0.05)。治疗后AFL、AH及AC组血清GGT、ALT、AST活性均明显下降(P<0.001),AFL和AH组下降幅度明显高于AC组;AFL组血清GGT、ALT、AST、m-AST活性基本降至正常水平;AH组血清m-AST活性有明显下降,但AC组下降不明显。结论血清m-AST对ALD的治疗监测具有一定的临床意义。     

胰岛素抵抗与酒精性肝病血清瘦素水平的关系

摘要 目的：探讨胰岛素抵抗、血清瘦素在酒精性肝病(ALD)及其不同阶段中的变化关系。方法：采用放射免疫法分别测定22例酒精性脂肪肝(AFL)、11例酒精性肝炎(AH)、13例酒精性肝硬化(AC)患者的血清瘦素及胰岛素水平，同时生化检测46例患者的空腹血糖及肝功能。30例健康体检者作对照。结果：酒精性肝病患者血清瘦素(10.63±4.06)ug/L、空腹胰岛素（10.59±3.83）mU/mL明显高于正常对照组(4.98±2.89)ug/L、（6.38±2.11）mU/mL (均p<0.05），酒精性肝病患者瘦素水平与AST、TBIL均呈正相关（r=0.49、0.65，p<0.05、p<0.01）,酒精性肝硬化组血清瘦素水平与空腹血糖、空腹胰岛素、胰岛素抵抗指数均呈正相关（r=0.486、0.398、0.537，均p<0.05）。AC组胰岛素抵抗指数4.65±0.37明显高于AFL组1.80±0.14和AH组1.99±0.16(均均p<0.05）结论：酒精性肝病患者存在高胰岛素血症和高瘦素血症；胰岛素抵抗可能是加重酒精性肝病的重要因素。 关键词：酒精性肝病 胰岛素抵抗 瘦素 肝功能     

肝纤维化指标检测在非酒精性脂肪性肝病中应用价值

目的探讨非酒精性脂肪性肝病各期与血清肝纤维化标志物的关系。方法 126例非酒精性脂肪性肝病患者依据病情分为单纯性脂肪肝组51例,非酒精性脂肪性肝炎组42例,与非酒精性脂肪性肝炎相关肝硬化组33例,不嗜酒的体检健康者64名为对照组,检测4组血清透明质酸、Ⅲ型前胶原氨端肽、Ⅳ型胶原、层黏蛋白水平。结果非酒精性脂肪性肝炎组与非酒精性脂肪性肝炎相关肝硬化组各指标水平较对照组增高（P〈0.01）;单纯性脂肪肝组透明质酸与对照组比较差异有统计学意义（P〈0.05）;非酒精性脂肪性肝炎相关肝硬化组各指标水平高于非酒精性脂肪性肝炎组和单纯性脂肪肝组（P〈0.05）。结论肝纤维化血清学指标有助于了解非酒精性脂肪肝病患者肝纤维化程度。     

酒精性肝病患者血清TGF-β、IL-6和IL-8水平及临床意义

目的探讨酒精性肝病患者血清转化生长因子（transforming growth factor-β,TGF-β）白细胞介素-6（inter-leukin-6,IL-6）和白细胞介素-8（interleukin-8,IL-8）在酒精性肝病中的作用。方法 60例酒精性肝病患者按酒精性脂肪肝（n=20）、酒精性肝炎（n=20）和酒精性肝硬化（n=20）分为3组。采用ELISA法检测20例健康对照组和60例各类酒精性肝病患者血清中TGF-β、IL-6和IL-8水平。结果血清TGF-β、IL-6和IL-8水平随着肝脏病变程度加重而递增,酒精性脂肪肝组、酒精性肝炎组和酒精性肝硬化组3项指标水平均高于正常对照组,差异显著（P〈0.01）,其中以酒精性肝硬化组3项指标水平为最高。结论 TGF-β、IL-6和IL-8在酒精性肝病中具有重要作用,酒精性肝病患者血清TGF-β、IL-6和IL-8水平的检测可作为酒精性肝病病情监测和预后判断的有效指标。     

血浆同型半胱氨酸水平与酒精性肝硬化关系的初步探讨

目的:观察血浆同型半胱氨酸(Hcy)水平对酒精性肝硬化的影响。方法:选择酒精性肝硬化12例、肝炎后肝硬化51例、混合性肝硬化21例及健康人群40例,测定血浆Hcy、叶酸、维生素B12(VitB12)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、总胆红素(T-Bil)、总胆汁酸(TBA)、白蛋白(Alb)的水平。结果:酒精性肝硬化患者血浆同型半胱氨酸水平明显升高(P<0.01),酒精性肝硬化患者较肝炎后肝硬化患者明显升高(P<0.05);同型半胱氨酸水平与酒精性肝硬化患者Child-Pugh得分呈负相关(r=-0.602,P<0.05)。结论:肝硬化患者血浆Hcy水平较正常人是升高的,且其在酒精性肝硬化患者升高更为显著。酒精性肝硬化患者随着肝脏损伤程度的逐渐增加,血浆Hcy水平是降低的。     

安络化纤丸治疗酒精性肝病66例

<正>近年来酒精性肝病发病情况在我国呈迅速增长趋势,已成为仅次于病毒性肝炎的第二大肝病病种。在临床上酒清性肝病可分为轻型酒精性肝病、酒精性脂肪肝、酒精性肝炎和酒精性肝硬化。     

酒精性肝病患者血清LPS、LPO和NOS检测及临床意义

正ALD是因长期大量摄入酒精而造成的肝脏损伤性疾病,随着酒精摄入量的增加,可从最初的酒精性脂肪肝发展为酒精性肝炎、酒精性肝纤维化及酒精性肝硬化,ALD病因明确,但其发病机制目前尚不完全清楚。在美国ALD是导致肝病患者死亡的     

Homocysteine, vitamin B12, and serum and erythrocyte folate in peritoneal dialysis and hemodialysis patients.

BACKGROUND: Plasma homocysteine (Hcy) is an independent risk factor for cardiovascular disease. High levels of plasma Hcy have been observed in end-stage renal disease patients. Few studies have compared peritoneal dialysis (PD) and hemodialysis (HD) patients and few data are available on erythrocyte folate (ery-F) levels in dialysis patients. OBJECTIVES: To evaluate plasma Hcy concentrations, vitamin B12 (B12), and folate status in dialysis patients; to analyze the possible causes of high Hcy levels; to follow up changes in folate and B12 concentrations after 6 months. DESIGN: A cross-sectional observational study. SETTING: Nephrology division and laboratory of hematology in a university and clinical research hospital. PATIENTS: The study included 82 patients treated with PD for 37 + 37 months and 70 patients treated with HD for 136 + 95 months. LABORATORY METHODS: Plasma Hcy was measured by the immunoenzymatic IMx Hcy FPIA method (Abbott Laboratories, Diagnostic Division, Abbott Park, IL, U.S.A.), serum folate (s-F) and ery-F by the Stratus folate fluorometric enzyme-linked assay, and B12 by the Stratus vitamin B12 fluorometric enzyme-linked assay (DADE-Behring, Newark, DE, U.S.A.). RESULTS: Ninety-six percent of PD and 97% of HD patients had Hcy levels above the cutoff (13.5 micromol/L). Homocysteine level was higher in HD than in PD patients, while the prevalence of hyperhomocysteinemia was similar with the two techniques. Erythrocyte folate was significantly higher in PD (1333 +/- 519 pmol/L) than in HD (1049 +/-511 pmol/L, p < 0.01). Statistically significant correlations were observed between Hcy and B12, s-F, ery-F, and dialysis duration. Multivariate analysis showed a strong correlation between s-F and Hcy. After 6 months there were no differences in Hcy, B12, s-F, and ery-F levels. CONCLUSIONS: Plasma Hcy levels were high in more than 95% of our dialysis patients, with no relation to the type of dialysis. Vitamin B12 and folate were normal in the majority of our patients. However, serum folate was the major determinant of Hcy levels. Such a relation between Hcy and folate suggests that levels of folate within the reference interval are inadequate for dialysis patients.     

同型半胱氨酸、叶酸及VitB12与血管性痴呆的相关性研究

目的:探讨血浆同型半胱氨酸(Hcy)、叶酸(FA)、VitB12与血管性痴呆(VaD)的相关性。方法:检测VaD患者86例(VaD组),非VaD患者87例(非VaD组),健康体检正常者90例(正常组)血浆Hcy、FA、VitB12浓度。并对3组受检者进行简易智能状态量表(MMSE)评定。结果:VaD组患者Hcy浓度显著高于非VaD组及正常组(P<0.01)。FA、VitB12浓度与Hcy浓度负相关。血浆Hcy、FA、VitB12水平与VaD、MMSE得分显著相关(P<0.01)。结论:VaD高危人群应定期检测Hcy浓度,推荐服用VitB12和FA可预防VaD的发生。     

血浆同型半胱氨酸、叶酸和维生素B12水平与非小细胞肺癌的关系

目的 探讨非小细胞肺癌(NSCLC)患者血浆同型半胱氨酸(Hcy)、叶酸和维生素B12(VB12)水平的变化,及其与NSCLC肿瘤分期的关系.方法 比较42例NSCLC患者(NSCLC组)和60例健康者(健康组)血浆叶酸、Hcy和VB12水平,并分析其与肿瘤分期的关系.结果 NSCLC组血浆叶酸和VB12水平低于健康组(P＜0.05),Hcy水平则高于健康组(P＜0.05);血浆叶酸、Hcy和VB12水平与NSCLC肿瘤分期无显著相关性.结论 血浆Hcy、叶酸和VB12水平与NSCLC存在相关性.     

酒依赖患者血浆同型半胱氨酸含量的变化

目的比较酒依赖患者的血浆同型半胱氨酸(Hcy)含量与正常人群的区别,探讨酒依赖患者Hcy含量变化及其与叶酸和维生素B12(VitB12)的相关性.方法对酒依赖患者组、正常对照组各20例进行血浆Hcy的测定,同时测定血清叶酸、ViB12的浓度.结果 (1)酒依赖患者血Hcy显著高于对照组(P＜0.01);(2)酒依赖患者叶酸及VitB12水平低于对照组(P＜0.05);(3)Hcy浓度与叶酸水平之间存在相关性(P＜0.05).结论酒依赖患者出现Hcy代谢障碍,其原因可能与血清叶酸、VitB12降低有关.     

高同型半胱氨酸血症与急性脑血管病及颈动脉狭窄的关系

目的研究高同型半胱氨酸血症(HHcy)与急性脑血管病及颈动脉狭窄的关系。方法应用荧光定量分析法测定68例急性脑梗死(ACI组)、52例急性脑出血(AICH组)患者血浆同型半胱氨酸(Hcy)浓度,放免方法测定各组的叶酸、维生素B12水平,并与正常对照组比较。对脑梗死患者采用彩色多普勒超声进行颈动脉检测。结果ACI组、AICH组的血浆Hcy水平均显著高于正常对照组(均P<0.01),而叶酸、维生素B12水平均显著低于正常对照组(均P<0.05)。单因素相关分析显示ACI组、AICH组血浆Hcy水平与叶酸水平均呈负相关(r=-0.37、-0.34,P<0.01),与维生素B12水平也均呈负相关(r=-0.33、-0.29,P<0.01)。ACI组中,颈动脉重度狭窄者血浆Hcy浓度显著高于中度狭窄者及无狭窄或轻度狭窄者(均P<0.01),中度狭窄者血浆Hcy浓度显著高于无狭窄或轻度狭窄者(P<0.01)。结论HHcy是急性脑血管病的一个新的重要危险因素。Hcy水平受叶酸、维生素B12的影响,Hcy水平与脑梗死患者颈动脉狭窄的严重程度有关。     

脑血管病高Hcy血症与维生素B12和叶酸的相关性研究

目的：研究脑血管病患者的高同型半胱氨酸（Hcy）血症与血清维生素B12（VitB12）和叶酸（FA）水平的相关性。方法：采用酶法检测171例脑血管病患者和76例健康体检志愿的血清Hcy水平,用化学发光方法检测其血清FA和VitB12水平。结果：脑血管病组患者血清Hcy水平明显高于对照组（P＆lt;0.01）,其中脑梗死组患者的血清Hcy水平明显高于脑出血组（P＆lt;0.01）;而对照组的血清FA和VitB12水平明显高于脑血管病组（P＆lt;0.01）;脑血管病组患者血清的Hcy水平与其血清VitB12和FA的水平呈负相关（r1=-0.82,r2=-0.86）。结论：血浆Hcy水平升高与脑血管病的发病密切相关,是脑血管病的独立危险因素,而血清中的FA和VitB12的下降可能为导致高同型半胱氨酸血症的关键因素之一。     

Plasma homocysteine levels in L-dopa-treated Parkinson's disease patients with cognitive dysfunctions.

Elevated plasma homocysteine (Hcy) concentrations are associated with Alzheimer's disease and vascular dementia. Several recent reports have indicated that L-dopa treatment is an acquired cause of hyperhomo-cysteinemia. Despite the fact that a large proportion of Parkinson's disease (PD) patients develop cognitive dysfunctions or dementia, particularly in the late stages of the illness and after long-term L-dopa treatment, the relationship between Hcy and dementia in PD has not been fully investigated. The aim of this study was to evaluate plasma Hcy levels in a group of L-dopa-treated PD patients with cognitive impairment and to elucidate a possible role of Hcy in the development of cognitive dysfunctions in PD. We compared Hcy, vitamin B12 and folate levels in 35 parkinsonian patients treated with L-dopa (14 with cognitive dysfunctions, 21 without cognitive impairment). Analysis of the data revealed that mean Hcy levels were significantly higher in the group with cognitive dysfunctions (21.2+/-7.4 vs. 15.8+/-4.4 micromol/L; p=0.0001), while there was no difference in age, sex, B12 and folate levels. In addition, logistic regression analysis showed that the risk of cognitive dysfunction progressively increased according to Hcy levels after correction for age, sex and B-vitamin status (odds ratio, 19.1; 95% CI, 1.5-241.4; p=0.02). Our results raise the possibility of a relationship between Hcy levels and cognitive dysfunctions in this group of L-dopa-treated PD patients. However, prospective studies on large cohorts of patients should be performed to clarify such an association.     

彩色多普勒对酒精性肝病的诊断价值

目的探讨彩色多普勒对酒精性肝病（ALD）的诊断价值。方法对40例ALD的病人的多普勒图像进行综合分析。结果ALD组固有动脉（PHA）内径明显宽于健康对照组,脉冲多普勒显示血流速度均高于100cm／s;ALD组门脉主干（PV）内径明显宽于健康对照组,血流速度则低于健康对照组。结论通过对40例ALD病人的彩色多普勒图像进行综合性分析,彩色多普勒是诊断ALD的快速、便捷、可靠、经济、无创的方法。     

Elevated plasma homocysteine levels in L-dopa-treated Parkinson's disease patients with dyskinesias.

BACKGROUND: Elevated plasma homocysteine (Hcy) concentrations are associated with increased risk of systemic vascular diseases, Alzheimer's disease and vascular dementia. Several cross-sectional reports and two prospective clinical studies have recently reported elevated plasma Hcy levels in L-dopa-treated Parkinson's disease (PD) patients and Hcy has been proposed as a possible mediator for the development of long-term L-dopa motor complications (such as wearing off and on-off phenomena, and dyskinesias). The aim of the study was to elucidate a possible role of L-dopa-related hyperhomocysteinemia in the development of dyskinesias. METHODS: In this cross-sectional study we compared Hcy, B(12) and folate levels in 53 PD patients treated with L-dopa (29 with dyskinesias, 24 without dyskinesias). RESULTS: Mean plasma Hcy levels were higher in the group of PD patients with dyskinesias (19 vs. 15.4 micromol/L; T: 2.12; p=0.04). After taking into account potential confounding factors, analysis of the data revealed that the occurrence of dyskinesias progressively increased with plasma Hcy levels (relative risk 1.2, 95% CI 1.015-1.4; p=0.03). CONCLUSIONS: Our results raise the possibility that Hcy plays a role in the development of dyskinesias, through its toxic effects on both dopaminergic neurons and non-substantia nigra, non-dopaminergic neurons.