慢性病毒性肝炎患者血清抗氧化能力状况与乳果糖保护效应

目的研究不同内毒素水平的慢性病毒性肝炎患者血抗氧化能力差别,探讨乳果糖对慢性病毒性肝炎患者体内抗氧化能力的影响。方法 72例慢性病毒性肝炎患者根据内毒素水平分为两组,比较两组体内抗氧化水平;并随机分为乳果糖治疗组(n=36)和对照组(n=36),观察两组病人治疗前及治疗2周后血清抗氧化能力、血内毒素水平的变化。结果内毒素血症阴性患者(内毒素水平<45ng/L)与内毒素血症阳性患者(内毒素水平≥45ng/L)比较,丙二醛(MDA)水平降低,超氧化物歧化酶(SOD)活性明显升高,差异均有统计学意义(t分别=4.27、-3.47,P均<0.05),而一氧化氮合酶(NOS)活性在两组间比较,差异无统计学意义(t=1.26,P>0.05)。Pearson相关性分析显示,血内毒素水平与MDA水平呈正相关(r=0.57,P<0.05),内毒素水平与SOD和NOS水平呈负相关(r分别=-0.62、-0.30,P均<0.05)。乳果糖治疗组治疗后血中SOD水平和NOS水平明显升高,MDA和内毒素水平明显下降,治疗前后差异均有统计学意义(t分别=-3.88、-3.12、4.69、3.74,P均<0.05)。且与对照组治疗后比较,SOD水平升高,内毒素水平下降,差异均有统计学意义(t分别=-3.08、3.19,P均<0.05),但两组治疗后MDA和NO水平差异均无统计学意义(t分别=1.63、-1.54,P均>0.05)。结论乳果糖能改善慢性病毒性肝炎患者抗氧化系统损伤,可能与降低血清内毒素水平有关。

Serum antioxidant capacity and protective effect of lactulose in patients with chronic viral hepatitis

Objective To study the differences of the ability of serum antioxidant among different endotoxin levels in patients with chronic viral hepatitis and the protective role of lactulose on antioxidant capacity： Methods A total of 72 patients with chronic viral hepatitis were divided into two groups according to endotoxin levels. The serum antioxidant capacity of two groups were measured. Patients were randomly divided into two groups： lactulose group （n=36） and control group （n=36）. Serum antioxindant capacity and plasma endotoxin level were measured before treatment and two weeks after treatment. Results Compared with the patients with positive endotoxemia （the level of endotoxin ≥45 ng/L）, the level of MDA of the patients with negative endotoxemia （the level of endotoxin〈45 ng/L）was significantly reduced and the activity of SOD was significantly increased as well （t=4.27 ,-3.47 ,P〈0.05）. Pearson correlation coefficient showed that endotoxin level was positive related to the MDA （r=0.57,P〈0.05） while negative related to the SOD and NOS （r=-0.62,-0.30,P〈 0.05）. The levels of SOD and NOS were significantly increased （t=-3.88,-3.12,P〈0.05）while the levels of MDA and endotoxin were significantly decreased after lactulose treatment （t=4.69,3.74,P〈0.05）. Compared with the control group after treatment, the level of SOD was significantly increased while the endotoxin level was significantly decreased（t=-3.08, 3.19 ,P〈0.05）. The differences of MDA and NO after treatment between two groups were not statistically significant （t= 1.63,-1.54, P〉0.05）. Conclusions Lactulose could exert favorable protective effect on the antioxidant capacity in patients with chronic viral hepatitis through decreasing the levels of plasma endotoxin.