慢性肝病141例与微量元素关系的研究

本文对141例慢性肝病(慢活肝30例,肝硬化111例)患者血、肝组织中微量元素锌、铜、铁的含量测定,并测定肝硬化患者血清铜兰蛋白含量及尿锌的排出量。结果血清中锌值均明显低于对照组(P<0.05),肝硬化较慢活肝更低,而铜与铜兰蛋白含量均明显高于对照组(P<0.01)。其中19例肝硬化患者作肝组织锌、铜测定,锌含量特别低,其均值比对照组低3倍(P<0.05),而铜含量则高于对照组1倍以上(P<0.05)。肝硬化患者24h尿锌排出量明显高于对照组(P<0.001)。通过对这些微量元素代谢变化的探讨,为慢性肝病治疗中纠正其代谢障碍提供了科学依据。     

Chronic liver diseases with negative laboratory findings]

Chronic liver diseases may be overlooked, when regular laboratory-chemical findings are overvalued. This is important especially for those which coincide with a particupation of the bile ducts. Even in insignificant clinical references laparoscopy and biopsy under direct vision are necessary. The blind biopsy of the liver is not always sufficient as it does not regularly deliver characteristic tissue.     

瘦素、肿瘤坏死因子和脂肪性肝病

肥胖已成为世界性疾病,2000年世界卫生组织估计发达和发展中国家肥胖在人类历史上已首次超过营养不良人群[1],在中国,人群超重、肥胖和脂肪性肝病患者也日益增多.     

非酒精性脂肪性肝病相关慢性肾病研究进展

非酒精性脂肪性肝病是与胰岛素抵抗和遗传易感性密切相关的代谢应激性肝损伤。该病已经成为全球性的公共卫生问题之一。近几年来,有研究显示非酒精性脂肪性肝病可能与慢性肾病越来越高的患病率有关。本文将重点阐述这两个疾病的相互关系以及相关发生机制,比如胰岛素抵抗、炎症、氧化应激、高凝状态、胎球蛋白-A和脂联素等在该病发病中的作用,为更全面管理非酒精性脂肪性肝病患者和慢性肾病患者提供有用的建议。     

Steatosis as o-factor n chronic liver diseases

The finding of lipid accumulation in the liver, so-called hepatic steatosis or non-alcoholic fatty liver disease, is a ommon condition frequently found in healthy subjects.Its prevalence, in fact, has been estimated by magnetic resonance studies to be about 35% in the general population and 75% in obese persons. Nevertheless,its presence generates liver damage only in a small percentage of subjects not affected by other liver diseases.It should be defined as a co-factor capable of affecting severity and progression, and also therapeutic perspectives, of liver diseases to which it is associated.Herein we will valuate the impact of hepatic steatosis and obesity on the most common liver diseases: chronic viral hepatitis C and B, and alcoholic liver disease.     

慢性腹泻与肝胆胰疾病

引起慢性腹泻的众多疾病中 ,肝胆胰疾病相当常见。这些脏器的疾病导致腹泻可有不同机制 ,其临床表现及治疗也有所差别。1　消化不良1.1　糖、蛋白质、脂肪的消化生理　食物中的糖类在小肠上部几乎全部被消化成为各种单糖 ,然后由肠绒毛的吸收细胞迅速吸收。正常生理状况下 ,小肠腔内有充足的胰α 淀粉酶 ,故对淀粉的不耐受情况极为少见。蛋白质在胃中的消化是很不完全的 ,小肠是消化蛋白质的主要部位。分泌入小肠的胰蛋白酶原在肠激酶的作用下被激活 ,从而迅速将胰液中的其它蛋白酶都转变成具有活性的酶。这些酶可水解蛋白质肽链内部的一些…     

Steatosis as a co-factor in chronic liver diseases

The finding of lipid accumulation in the liver, so-called hepatic steatosis or non-alcoholic fatty liver disease, is a common condition frequently found in healthy subjects. Its prevalence, in fact, has been estimated by magnetic resonance studies to be about 35% in the general population and 75% in obese persons. Nevertheless, its presence generates liver damage only in a small percentage of subjects not affected by other liver diseases. It should be defined as a “co-factor“ capable of affecting severity a...     

Chronic non-communicable diseases

Chronic non-communicable diseases (NCD) account for almost 60% of global mortality, and 80% of deaths from NCD occur in low- and middle-income countries. One quarter of these deaths--almost 9 million in 2005--are in men and women aged <60 years. Taken together, NCD represent globally the single largest cause of mortality in people of working age, and their incidences in younger adults are substantially higher in the poor countries of the world than in the rich. The major causes of NCD-attributable mortality are cardiovascular disease (30% of total global mortality), cancers (13%), chronic respiratory disease (7%) and diabetes (2%). These conditions share a small number of behavioural risk factors, which include a diet high in saturated fat and low in fresh fruit and vegetables, physical inactivity, tobacco smoking, and alcohol excess. In low- and middle-income countries such risk factors tend to be concentrated in urban areas and their prevalences are increasing as a result of rapid urbanization and the increasing globalisation of the food, tobacco and alcohol industries. Because NCD have a major impact on men and women of working age and their elderly dependents, they result in lost income, lost opportunities for investment, and overall lower levels of economic development. Reductions in the incidences of many NCD and their complications are, however, already possible. Up to 80% of all cases of cardiovascular disease or type-2 diabetes and 40% of all cases of cancer, for example, are probably preventable based on current knowledge. In addition, highly cost-effective measures exist for the prevention of some of the complications of established cardiovascular disease and diabetes. Achieving these gains will require a broad range of integrated, population-based interventions as well as measures focused on the individuals at high risk. At present, the international-assistance community provides scant resources for the control of NCD in poor countries, partly, at least, because NCD continue to be wrongly perceived as predominantly diseases of the better off. As urbanization continues apace and populations age, investment in the prevention and control of NCD in low-and middle-income countries can no longer be ignored.     

Chronic liver disease manifesting as Waldenstr?m's macroglobulinemia

A 59-year-old woman was initially seen with anemia, purpura, gastrointestinal tract and vaginal bleeding, pronounced hyperglobulinemia, and an increased serum viscosity, all suggestive of Waldenstr?m's macroglobulinemia. Subsequent investigation, however, indicated that these abnormalities were more likely due to chronic active hepatitis with cirrhosis. The striking similarity of this patient's symptoms to those of Waldenstr?m's macroglobulinemia and the pathophysiologic characteristics of polyclonal hypergammaglobulinemia in chronic liver disease are discussed.     

Oxidative stress as a crucial factor in liver diseases

Redox state constitutes an important background of numerous liver disorders. The redox state participates in the course of inflammatory, metabolic and proliferative liver diseases. Reactive oxygen species (ROS) are primarily produced in the mitochondria and in the endoplasmic reticulum of hepatocytes via the cytochrome P450 enzymes. Under the proper conditions, cells are equipped with special molecular strategies that control the level of oxidative stress and maintain a balance between oxidant and antioxidant particles. Oxidative stress represents an imbalance between oxidant and antioxidant agents. Hepatocytic proteins, lipids and DNA are among the cellular structures that are primarily affected by ROS and reactive nitrogen species. The process results in structural and functional abnormalities in the liver. Thus, the phenomenon of oxidative stress should be investigated for several reasons. First, it may explain the pathogenesis of various liver disorders. Moreover, monitoring oxidative markers among hepatocytes offers the potential to diagnose the degree of liver damage and ultimately to observe the response to pharmacological therapies. The present report focuses on the role of oxidative stress in selected liver diseases.