促肝细胞生长素治疗婴儿肝炎综合征临床对照观察

婴儿肝炎综合征患儿发生肝功能损害后丙氨酸转氨酶(ALT)常很难恢复正常,是临床治疗的热点问题,目前虽有众多保肝降酶药,但尚无特效药物。本文应用促肝细胞生长素对婴儿肝炎综合征患儿进行治疗,取得较好效果,现将结果报告如下。 临床资料:观察组为2002年3月1日至6月30日在本科计院的婴儿肝炎综合征患儿21例,男17例,女4例,     

促肝细胞生长素联合甘利欣治疗儿童急性乙型病毒性肝炎

目的观察促肝细胞生长素（HGF）联合甘利欣治疗小儿急性乙型病毒性肝炎（乙肝）的效果。方法180例患儿分成治疗组和对照组,各90例。两组均给予维生素C、肌苷、门冬氨酸钾镁、能量合剂。治疗组给予促肝细胞生长素20～60mg及甘利欣注射液50～100mg各加入10%GS250ml静滴,qd,15～30d为一疗程。对照组给予强力宁20～60ml及复方丹参注射液10～20ml各加入10%葡萄糖250ml静滴,qd,15～30d为一疗程,两组患儿均治疗2个疗程。结果治疗组显效63例,有效22例,无效5例,总有效率94.4%;对照组显效48例,有效27例,无效15例,总有效率83.3%;治疗组肝功能指标改善优于对照组,P均〈0.05。结论治疗组疗效明显优于对照组,促肝细胞生长素联合甘利欣治疗小儿急性乙肝疗效满意。     

肝细胞生长因子治疗肝脏损害116例疗效观察

目的观察肝细胞生长因子(HGF)治疗肝脏损害患儿的效果。方法将肝脏损害患儿204例随机分成两组,对照组在治疗原发病同时,选用能量合剂保肝;治疗组在此基础上选用HGF保肝、降酶治疗,观察治疗过程中肝脏回缩及降酶效果。结果疗程结束后HGF治疗组丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)3项指标下降幅度明显大于对照组,治疗组总有效率达96.5%,而对照组总有效率为75.0%,治疗组明显优于对照组,有显著差异(χ2=5.27 P<0.05)。结论选用HGF治疗肝脏损害,可明显缩短病程,提高临床治愈率。     

不同疗程更昔洛韦治疗婴儿巨细胞病毒性肝炎的疗效

目的 观察不同疗程更昔洛韦(GCV)治疗婴儿巨细胞病毒性肝炎(CMV肝炎)的效果及不良反应.方法 选取2009年1月-2010年12月在本科住院的1～4月龄CMV肝炎患儿48例,随机分为治疗1组(n=25)和治疗2组(n=23).二组均予保肝、退黄治疗,治疗1组给予GCV 5 mg·kg-1,每日2次,连用2周.治疗2组诱导期给予GCV 5 mg·kg-1,每日2次,连用2周;维持期给予GCV 5 mg·kg-1,每日1次,连用7 d.治疗前后常规检查肝、肾功能及心肌酶谱,所有患儿出院后随访2个月,监测其血CMV-IgM水平.结果 二组患儿治疗后血清ALT、总胆红素、结合胆红素水平均显著下降,与治疗前比较差异均有统计学意义(Pa＜0.05);治疗后二组ALT、总胆红素及结合胆红素水平比较差异亦有统计学意义(Pa＜0.05).治疗后随访2个月,血CMV-IgM转阴率治疗2组高于治疗1组.血常规、肾功能及心肌酶谱二组比较无统计学差异(Pa＞0.05).结论 GCV治疗婴儿CMV肝炎的疗效肯定,且 3周二期治疗方案优于2周一期治疗方案,前者能够获得高病毒转阴率和较低复发率,同时较长程疗法更少引起不良反应,较经济且易于被小婴儿耐受,易于推广.     

中西医结合治疗婴儿肝炎综合征疗效观察

目的观察中西医结合治疗对婴儿肝炎综合征的疗效。方法将60例婴儿肝炎综合征患儿随机分为两组，治疗组30例采用中西医结合治疗，对照组30例采用传统西医治疗。结果治疗组、对照组总有效率分别为93％和67％，两组比较差异有显著性（P〈0．05）。结论中西医结合治疗婴儿肝炎综合征比单用西医治疗效果好且安全。     

更昔洛韦治疗婴儿巨细胞病毒肝炎疗效观察

目的 观察更昔洛韦治疗婴儿巨细胞病毒(CMV)肝炎的疗效。方法 将60例CMV肝炎婴儿随机分成两组。治疗组(n=31)在常规护肝的基础上加用更昔洛韦5 mg/kg静脉点滴,每日2次,连续14 d。对照组(n=29)予常规护肝治疗。结果 治疗组的治愈率和好转率为48.4%和38.7%,对照组分别为24.1%和34.5%(P<0.05)。治疗组较对照组黄疸消退平均提前10.2 d,ALT恢复正常平均提前7.1 d(P<0.05)。治疗组治疗后CMV-DNA阴转率为60.0%,显著高于对照组的14.3%。未见粒细胞或血小板减少。结论 更昔洛韦是治疗婴儿CMV肝炎的有效药物。     

巨细胞病毒肝炎婴儿血清白细胞介素-18及肿瘤坏死因子-α测定的临床意义

目的测定婴儿巨细胞病毒(CMV)肝炎治疗前后血清白细胞介素-18(IL—18)及肿瘤坏死因子-α(TNF—α)水平,研究其在婴儿CMV肝炎中的临床意义。方法采用酶联免疫吸附法(ELISA)检测36例CMV肝炎患儿治疗前后及健康婴儿21 例血清IL-18和TNF—α水平。结果CMV肝炎患儿血清IL—18和TNF-α水平明显高于正常对照组(P<0.001),且均与血清ALT呈显著正相关(P<0.01);阴转组治疗结束后血清IL-18和TNF-α水平均较治疗前显著降低(P<0.001),而未阴转组IL-18和TNF-α治疗前后无明显变化(P>0.05)。结论血清IL-18及TNF—α检测可作为婴儿CMV肝炎炎症活动性和肝损害程度的评判指标,并对预测药物抗病毒疗效有重要指导价值。     

胆道闭锁与婴儿肝炎综合征肝活检病理对比分析

目的对比分析胆道闭锁、婴儿肝炎综合征患儿肝组织活检病理表现,明确胆道闭锁与婴儿肝炎综合征的相关性及不同病理表现。方法收集2004年1月至2014年1月在本院因黄疸保守治疗效果不佳而疑为胆道畸形并行胆道探查、胆道造影患儿的肝活检标本32例,其中胆道闭锁25例,婴儿肝炎综合征7例,分别就两者肝活检HE染色切片肝细胞淤胆、变性,毛胆管淤胆,汇管区胆管增生,胆管内胆栓,汇管区炎性细胞浸润,肝脏纤维化程度进行比较。结果虽然婴儿肝炎综合征胆道造影存在胆道形态异常,但同年龄段胆道闭锁与婴儿肝炎综合征患儿肝细胞淤胆、变性,毛胆管淤胆,汇管区炎性细胞浸润等情况比较无明显差异;胆道闭锁患儿汇管区胆管增生,肝脏纤维化程度明显高于婴儿肝炎综合征组(P0.05)。结论婴儿肝炎综合征与胆道闭锁病理表现明显不同;汇管区胆管增生、肝纤维化程度是鉴别胆道闭锁与婴儿肝炎综合征的主要病理依据;婴儿肝炎综合征能否最终发展为胆道闭锁尚需进一步随访研究。     

淤胆型婴儿肝炎综合征患儿治疗前后血清γ-谷氨酰转移酶水平变化

目的研究淤胆型婴儿肝炎综合征在患儿治疗前后血清γ-谷氨酰转移酶(GGT)的变化,与探讨血清GGT和黄疸程度相关性及治疗后反应。方法淤胆型婴儿肝炎综合征62例根据最初的黄疸直接胆红素(DB)高低分组:≤136.8μmol/L(组Ⅰ)30例,>136.8μmol/L(组Ⅱ)32例。予常规保肝退黄治疗,治疗前后常规进行血生化检测。结果组ⅡALT及碱性磷酸酶(ALP)指标略高于组Ⅰ,但二者之间差异无显著性,而二组GGT差异有显著性,在组ⅡGGT水平明显升高。治疗后总胆红素(TB)及DB明显下降,ALT及ALP指标也表现为下降,组Ⅱ和组ⅠGGT水平在治疗前后差异显著,GGT水平与TB及DB均呈显著正相关。结论GGT可作为淤胆型婴儿肝炎综合征患者胆汁淤积的敏感指标之一;动态观察淤胆型婴儿肝炎综合征患者GGT变化是婴儿肝炎综合征治疗中的一项重要指标,是判断病情和预后敏感的指标。     

更昔洛韦治疗婴儿巨细胞病毒肝炎疗效观察

目的　观察更昔洛韦治疗婴儿巨细胞病毒 (CMV)肝炎的疗效。方法　总结分析 6 0例婴儿CMV肝炎更昔洛韦治疗前后血清总胆红素 (TBIL)、丙氨酸氨基转移酶 (ALT)、碱性磷酸酶 (AKP)、γ 谷氨酰转肽酶 (γ GT)的变化 ,观察药物不良反应。结果　更昔洛韦治疗后血清TBIL、ALT水平下降 ,肝脾回缩 ,所有指标的差异均有显著性 (P均 <0 .0 1) ,未发现更昔洛韦有明显副作用。结论　正规应用更昔洛韦诱导、维持治疗CMV肝炎 ,具有安全、有效、副作用小的特点     

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??Abstract??Objective??To explore influence of probiotics ??lactobacillus acidophilus?? on the intestinal flora and bile composition in infantile hepatitis syndrome??IHS??. Methods??Researchers randomly assigned 60 IHS children who were the patients in Tongji Hospital from Mar.2002 to May 2008 into treatment group and control group in desired random number table. The treatment group received Lactobacillus LB sachet ??two times a day?? a packet each time??15 days as a course of treatment??and the control group received freeze dried culture medium??both on the basis of basic therapies such as UDCA??three times a day?? 25 mg each time?? and liver protection therapy. Total bilirubin??TB????direct bilirubin??DB????alanine aminotransferase??ALT???? γ-glutamyltranspeptidase??γ-GT???? totle bile acid??TBA?? of serum and intraduodenal drain??bile?? were observed before and after the treatment. SPSS 10.0 software was used to analyze the data. Results??After two treatment courses?? the effective rates were 92.86% in the treatment group and 74.07% in the control group respectively. Significant differences were observed between the two groups??P < 0.05??. Compared with the control group??the levels of TB??DB??ALT??γ-GT and TBA in serum of treatment group reduced significantly??P < 0.05????and the liver size reduced obviously??P < 0.05????while the level of TB??DB??γ-GT and TBA in bile of treatment group increased significantly ??P < 0.05?? . There was no obvious side effect in the two groups. Conclusion??There is intestinal flora disturbance in infantile hepatitis syndrome. Probiotics ??Lactobacillus acidophilus?? and UDCA can increase the excretion of bile flow?? improve the function of liver?? and stabilize the balance of intestinal flora?? which has significant curative effect on infantile hepatitis syndrome ??IHS??.     

更昔洛韦治疗婴儿巨细胞病毒性肝炎疗效观察

目的　探讨更昔洛韦对婴儿巨细胞病毒 (CMV)性肝炎的疗效及副作用。方法　 2 0 0 3年 1月至 2 0 0 4年 4月重庆医大儿童医院通过检测血抗CMV IgG、IgM ,血CMV DNA及肝功能检测而确定 4 0例婴儿CMV肝炎 ,随机分为更昔洛韦治疗组和综合治疗组两组 ,均常规给予保肝治疗 ,退黄 ,补充维生素处理 ,更昔洛韦治疗组加用更昔洛韦。结果　更昔洛韦治疗可使血CMV DNA阴转约 5 0 % ,在降低转氨酶、肝脏回缩、黄疸消退方面与综合治疗组比较有显著性差异 (P <0 0 5 ) ;更昔洛韦治疗组中出现白细胞下降及血小板降低的比例分别为 4 0 %、30 %。结论　更昔洛韦治疗巨细胞病毒性肝炎疗效好 ,为一较理想药物 ,但要注意该药对白细胞和血小板的影响     

熊脱氧胆酸治疗早产儿胃肠外营养相关性胆汁淤积症的疗效

目的探讨熊脱氧胆酸(UDCA)对早产儿胃肠外营养相关性胆汁淤积(PNCA)的疗效。方法选取给予胃肠外营养并PNAC的早产儿65例为研究对象,根据不同UDCA治疗剂量,将其分成低剂量治疗组、高剂量治疗组、对照组。其中高剂量治疗组24例。UDCA 20 mg.kg-1.L-1,分2、3次服用。治疗前ALT(73.5±31.9)U.L-1,谷氨酰转肽酶(GGT)(107.5±27.9)U.L-1,总胆红素(TBIL)(217.0±24.3)μmol.L-1,结合胆红素(DBIL)(71.8±18.8)μmol.L-1,总胆汁酸(TBA)(61.5±18.2)μmol.L-1。低剂量治疗组18例。UDCA 10 mg.kg.L-1,分2、3次服用。ALT(76.8±32.1)U.L-1,GGT(116.8±29.8)U.L-1,TBIL(207.7±20.8)μmol.L-1,DBIL(71.0±20.1)μmol.L-1,TBA(63.9±19.8)μmol.L-1。对照组23例采用综合治疗,但未服用UDCA。ALT(70.3±33.8)U.L-1,GGT(108.3±30.8)U.L-1,TBIL(220.0±25.8)μmol.L-1,DBIL(67.9±19.7)μmol.L-1,TBA(63.5±22.6)μmol.L-1。治疗2～4周比较3组肝功能指标改善情况。结果高剂量治疗组3例因不能耐受高剂量转为低剂量治疗,统计时将其剔除。其他UDCA治疗患儿均未观察到有变应性皮疹、腹泻、血糖升高、白细胞升高等UDCA的不良反应。治疗前3组肝功能指标差异均无统计学意义(Pa>0.05),治疗2周、4周,高剂量治疗组与对照组ALT、GGT、TBIL、DBIL、TBA比较差异均有统计学意义(Pa<0.05),肝功能指标明显降低;低剂量治疗组与对照组指标比较差异均有统计学意义(Pa<0.05),肝功能指标明显降低;高、低剂量治疗组间各指标比较差异均无统计学意义(Pa>0.05)。结论各剂量UDCA治疗早产儿PNCA疗效显著且安全。     

胆盐输出泵基因多态性与特发性婴儿肝炎肝内胆汁瘀积的关系

目的 探讨特发性婴儿肝炎肝内胆汁瘀积患儿胆盐输出泵(BSEP)基因的突变情况.方法 收集2008年10月- 2010年2月就诊于广西医科大学第一附属医院儿科的婴儿胆汁瘀积性肝炎患儿81例(病例组),48例无肝内胆汁瘀积、肝功能正常的婴儿为对照组.提取病例组和对照组儿童外周血DNA,采用聚合酶链反应-单链构象多态性(PCR-SSCP)和DNA测序技术检测BSEP基因上2、3、4、5、6、9、10、16、17、23、24外显子基因多态性,分析BSEP基因多态性与特发性婴儿肝炎肝内胆汁瘀积之间的关系.结果在外显子24上检测到BSEP A1028A同义突变,编码的氨基酸未改变,均为丙氨酸；其他10个外显子均未发现异常突变.A1028A基因型在病例组,CC型53例(占65.4％),TC型28例(占34.6％),C等位基因频率为82.7％；对照组中CC型32例(占66.7％),TC型16例(占33.3％),C等位基因频率为83.3％.二组基因型差异经Fisher's精确概率法检验,差异无统计学意义(P＞0.05)；等位基因频率经Fisher's精确概率法检验,差异亦无统计学意义(P＞0.05).结论 尚不能认为BSEP A1028A是特发性婴儿肝炎肝内胆汁瘀积的一个危险因素.BSEP A1028A与特发性婴儿肝炎肝内胆汁瘀积发生的易感性无关.     

Virus genotype 1b and long-term response to interferon alpha monotherapy in children with chronic hepatitis C

Interferon alpha (IFN-) remains the basic modality in the treatment of chronic hepatitis C in children, but the effects of therapy are still unsatisfactory. The aim of this study was to evaluate parameters linked to IFN- response within a 2-year period. Human C virus (HCV) infected children (n=34) were subdivided into IFN-treated (n=20) and IFN-untreated (n=14 control) groups. The IFN-treated group received a dosage 3 MU of IFN- three times a week for 24 weeks. Liver biopsy was performed in all IFN-treated children and the HCV genotype was determined before the start of the study. Patients were sequentially screened for alanine transaminase (ALT) activity and tested for the presence of HCV-RNA in serum. All patients had either mild persistent or moderate active hepatitis, which was diagnosed from the liver biopsy. In the IFN-treated group ALT normalisation was observed by the end of treatment in 9/20 patients, but after 6 months 10 patients (50%) had sustained ALT normalisation and in 4 of them the virus was eliminated. They continued to show these features up to the end of the observation period (2 years). Eighteen out of 24 children tested had 1b genotype of virus. Out of 10 responders, all patients who were clear of HCV had the 1b genotype. The median age of responders (6.0, range 3.8–16) was significantly lower than non-responders (14.0, range 4–15) In the control group none of the children were clear of HCV-RNA. Conclusion: The negative predictive effect of HCV genotype 1b in the course of IFN- treatment may be not valid in children and other features have to be taken into account in the assessment of the efficacy of therapy.Abbreviations HCV human C virus - RNA ribonucleic acid - PCR polymerase chain reaction - ALT alanine aminotransferase - RBC red blood cells - HBsAg hepatitis B surface antigen - ELISA enzyme linked immunosorbent assay - CMV cytomegaly virus - IFN interferon - MU mega units - ETR end of treatment response - SR ALT sustained biochemical (ALT) response - HAI histological activity index - R responders - NR non-responders - U/l units per litter - CPH chronic persistent hepatitis - CAH chronic active hepatitis - APC antigen presenting cells - MHC major histocompatibility complex - ALL acute lymphoblastic leukaemia - CML chronic myelogenous leukaemia     

Lymphoblastoid interferon alfa treatment in chronic hepatitis C

Interferon is becoming the standard treatment in adults for chronic hepatitis C. Twenty one children with histologically proved chronic hepatitis C (10 boys, range 2.5-13 years), who were otherwise healthy, were enrolled in a randomised controlled study to test their response to interferon alfa. Eleven children were treated with lymphoblastoid interferon alfa (3 million units/m2) for 12 months; 10 children received no treatment. All had raised transaminases and positive antihepatitis C virus (HCV) antibodies and HCV-RNA. Alanine aminotransferase (ALT) serum levels became normal in five (45%) treated patients after a mean of three weeks (range 1-6 weeks) and no relapse had occurred by the end of follow up (30th month). Only one (10%) untreated patient had normal ALT serum levels from the 11th until the 30th month. Disappearance of serum HCV-RNA, persisting throughout the follow up period, was observed in the six children (five treated) whose ALT became normal. Biopsy specimens in treated patients showed a significant improvement in Knodell's score (median (SD) basal 9.0 (2.2); final 2.0 (0.4)). Interferon treatment was well tolerated in all. This study confirms the efficacy of interferon in children with chronic hepatitis C, not only by restoring normal ALT serum levels, but also viral clearance and histological amelioration of liver inflammation. Contrary to reports in adults no biochemical and virological relapses occurred in responder children.     

Lamivudine treatment in maternally transmitted chronic hepatitis B virus infection patients

BACKGROUND: Lamivudine treatment in chronic carriers who acquired hepatitis B virus through maternal transmission were investigated. METHODS: A total of 29 subjects (Male:Female, 24:5; mean age, 14.7 +/- 5.6 years) who were hepatitis B e antigen (HBeAg) seropositive for >6 months, alanine aminotransferase (ALT) was >1.3 times of upper limit of normal value, and receiving a 52 week-long treatment, received open-label lamivudine (3 mg/kg per day, maximum 100 mg/day). Another 29 subjects matched for gender, age, liver function, and HBeAg status followed up before the introduction of lamivudine served as the control group. The control group did not receive any treatment and were evaluated at week 52 after the onset of abnormal ALT. Mothers of all study subjects were hepatitis B surface antigen (HBsAg) carriers. A successful treatment response at week 52 was defined as: (i) undetectable hepatitis B virus DNA by real time polymerase chain reaction; (ii) normal ALT; and (iii) HBeAg/anti-HBe seroconversion. Lamivudine-resistant YMDD mutants were checked at week 52. RESULTS: The lamivudine group did not reach a better successful treatment response rate than the control group (17 vs 10%, P = 0.44), except in patients with a baseline ALT >5 times of the upper limit of normal value. YMDD mutants developed in 34% of patients in the lamivudine group. CONCLUSION: Lamivudine treatment is effective for maternally transmitted subjects with high ALT.     

二氧化碳气腹对幼兔肝肾功能影响的实验研究

目的 观察CQ气腹对幼兔肝肾功能的影响,为临床新生儿腹腔镜外科气腹的选择提供参考.方法 32只健康新西兰幼兔(3周龄,体重0.8～1.0 kg)按随机数字表法平均分为4组:对照组(单纯腹腔麻醉)、开腹手术组(麻醉后行开腹手术)、低压力组(腹腔压力维持在6 mmHg)、高压力组(腹腔压力维持在12 mmHg),采用10％水合氯醛3ml/kg腹腔麻醉,术中追加用4％水合氯醛1 ml.麻醉时间持续4h.麻醉4h后每组随机取4只处死,余4只复苏后继续饲养7d后处死,均切取肝肾组织浸泡福尔马林,行HE染色,观察组织学改变.分别于麻醉前30 min、麻醉后4h及术后7d取幼兔静脉血3 ml,-80℃保存.收集血清,进行肝肾生化指标检测,包括:谷丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)、谷氨酰转肽酶(GGT)、肌酐(CR)、尿素氮(BUN)和尿酸(UA).结果 四组幼兔麻醉前和麻醉后4h、术后7d血清CR、BUN、UA、AST、TBIL及DBIL变化差异均无统计学意义(P＞0.05).气腹高压力组麻醉后4h和术后7d血清ALT值分别为(81.24 U/L,59.87 U/L),两者相比,差异无统计学意义(P＞0.05);与本组麻醉前30 min(8.14 U/L)比较,差异有统计学意义(P＜0.05);且与对照组、开腹手术组及气腹低压力组麻醉后4h血清ALT值(8.50、9.09和9.40 U/L)及术后7d血清ALT值(13.07、8.58和12.83 U/L)比较,差异有统计学意义(P＜0.05).气腹高压力组麻醉后4h和术后7d血清GGT值分别为193.72 U/L和156.74 U/L,两者比较,差异无统计学意义(P＞0.05);与本组麻醉前30 min血清GGT值14.85 U/L比较,差异有统计学意义(P＜0.05);且与对照组、开腹手术组及气腹低压力组麻醉后4h血清GGT值(20.31、15.11和15.98 U/L)及术后7d血清GGT值(22.26、14.70和27.44 U/L)比较,差异有统计学意义(P＜0.05).HE染色显示高压组幼兔麻醉后4h和术后7d均可见弥漫肝淤血,且术后7d无明显改善,肾无明显组织形态学改变.结论 幼兔可良好耐受6 mmHg和12 mmHg的气腹压力,术后可存活.气腹压力为6 mmHg时肝肾功能均不受显著影响,12 mmHg时肾功能影响不显著,但肝出现了肝淤血改变,且术后7d无明显恢复.     

肾上腺素对内毒素致大鼠炎症性肝损害的保护作用

目的 探讨肾上腺素(Epi)对内毒素（脂多糖，LPS）致大鼠炎症性肝损害的保护作用及其作用机制。方法 50只SD大鼠随机分为5组（每组各10只）：对照组：静脉滴注生理盐水2.4 mL·kg-1·h-1；LPS组：静脉注射LPS 6 mg·kg-1后，静脉滴注生理盐水2.4 mL·kg-1·h-1；低、中和高剂量Epi组：静脉注射LPS 6 mg·kg-1后，分别静脉滴注Epi 0.12、0.3和0.6 μg·kg-1·min-1。在LPS注射前、注射后2和6 h 3个时点取血，检测血清ALT、AST、TNF-α、IL-1β和IL-10水平，并在6 h时点观察肝脏的组织病理学改变。结果 LPS组注射LPS后2、6 h血清AST和ALT水平较对照组显著升高，同时血清TNF-α、IL-1β和IL-10水平亦较对照组显著升高（P<0.05）。病理检查结果示：LPS组肝窦扩张、充血，局灶性肝细胞坏死。高剂量Epi可显著降低血清AST和ALT水平，减轻肝脏病理损伤，并显著可降低TNF-α水平和升高IL-10水平 (vs LPS组，P均<0.05)，但对IL-1β水平无影响。中、低剂量Epi对LPS致炎症性肝损害无明显保护作用。结论 Epi可通过抗炎作用减轻LPS诱导的炎症性肝损害。