Pharmacokinetics of antipyrine in viral and alcoholic lesions of the liver

Parameters of antipyrine pharmacokinetics have been studied in 82 patients with viral, alcoholic and combined liver affections and in 19 healthy subjects. All the patients exhibited changes showing a reduction of liver function responsible for drug metabolism. Disturbances of antipyrine pharmacokinetics were more pronounced in acute alcohol-aggravated hepatitis B than in hepatitis B without alcoholic aggravation.     

酒精性肝病与慢性病毒性肝炎的病理鉴别

本文对５４例单纯洒精性肝病（ＡＬＤ），６５例慢性乙型肝炎和１４例急慢性丙型肝炎的肝穿标本的病理变化进行了比较。在各型ＡＬＤ中常见的肝细胞变性，如肝脂变、小型肝细胞、巨大线粒体和麦氏小体，以及窦周纤维化，在病毒性肝炎中均少见，Ｐ值小于０．０５和０．０１。而病毒性肝炎中常见的汇管区及其周围炎、碎屑状坏死和桥接坏死以及肝窦内淋巴细胞渗出，在ＡＬＤ中少见，程度且轻。这对鉴别ＡＬＤ及病毒性肝炎有意义。     

Clinical value of determining serum levels of glycocholic acid in alcoholic lesions of the liver]

To assess the diagnostic value of radioimmunoassay determination of serum levels of glycocholic acid in alcohol-induced chronic diffuse hepatic lesions, this technique was compared by sensitivity and informative content with conventional hepatic tests. Hepatocytic function was measured in combined examination of 83 patients and 30 controls. It is shown that serum glycocholic acid concentration permits detection of early alcohol defects of the liver, excretory dysfunction in particular, control of cholestatic changes, of transformation of hepatic steatosis into hepatitis or cirrhosis, evaluation of cholestasis. The above radioimmunoassay is a useful prognostic tool in decompensated alcohol cirrhosis of the liver.     

改良小鼠酒精性肝损伤模型的建立

目的探索建立简便和稳定的酒精性肝病（ALD）的动物模型。方法利用简易胃造漏的方法,将实验动物分为四组,A组为正常小鼠（n=12）;B组为胃造瘘后给予生理盐水（n=12）;C组为胃造瘘后给予酒精（18g·kg-1·d-1）（n=22）;D组小鼠给予自制的ZQ液（n=22）。实验动态观察12周,分别在第4周、6周、8周、12周测四组小鼠肝重、体重值并检测肝脏ALT和AST水平,同时收集肝脏标本经HE染色后光镜观察肝组织的结构变化。结果 C组模型与A组和B组比较也出现不同程度的肝脏损害,但损害的程度较D组轻。D组小鼠在4周开始出现了肝细胞脂肪变性,8周开始出现酒精性肝炎和轻度的肝纤维化,12周时出现肝脏纤维化的表现。结论简易胃造瘘法配合ZQ液可以建立简便和稳定的酒精性肝损伤模型。     

Diagnostic and pathogenetic significance of determining lactate dehydrogenase isoenzyme activity in various biological media in patients with viral hepatitis

The activity of lactate dehydrogenase (LDH) and its isoenzymes was studied in various biological media in 850 patients with viral hepatitides (VH). The activity of LDH and its isoenzyme LDH5 in the blood serum, formed elements and in the urine of VH patients changed more noticeably in a grave form of disease and in antigen positive VH. A sharp rise of LDH and LDH5 activity in the blood serum of patients with a severe form of VH with its subsequent considerable decrease was indicative of the development of acute liver necrosis. Changes in the activity of LDH and its isoenzymes in the formed blood elements of VH patients pointed out to disturbance in the energetic system influencing their morphological and functional condition. Shifts of LDH and its isoenzymes in the urine of patients indicated renal lesion which could be used for the detection of latent disorders of renal function in VH. A study of the activity of LDH and its isoenzymes in the blood formed elements and in the urine of VH patients was of certain diagnostic value but inferior in many respects to its determination in the blood serum.     

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。     

Value of determining carbohydrate-deficient transferrin isoforms in the diagnosis of alcoholic liver disease

OBJECTIVE: To determine whether isoform separation of carbohydrate-deficient transferrin (CDT) is of value in the diagnosis of alcoholic liver disease (ALD) and is specific to ALD when compared with other liver diseases. PATIENTS AND METHODS: During 1995 and 1996, 47 patients with ALD were evaluated with CDT at the Mayo Clinic in Rochester, Minn. The diagnosis of ALD was based on biochemical and histological analyses and on a history of drinking that exceeded 5 years with an average alcohol intake of more than 60 g/d. Disease controls included nonalcoholic steatohepatitis (NASH) (n = 26) and other liver disease (n = 22). Normal controls (n = 21) were healthy individuals without liver disease. Transferrin isoforms were quantified by densitometry of Coomassie-stained transferrins after affinity purification and isoelectric focusing. The pentasialo, tetrasialo, trisialo, disialo, monosialo, and asialo isoforms were quantified as percentages of total band densities. RESULTS: Receiver operating characteristic (ROC) curves were constructed for each isoform. The curves for total desialated isoforms (sum of disialo, monosialo, and asialo) displayed the best relationship between sensitivity and specificity with an ROC-area under the curve (AUC) of 0.922. The ROC-AUC values for individual transferrin isoforms in ALD vs NASH for pentasialo, tetrasialo, trisialo, disialo, monosialo, and asialo were 0.806, 0.917, 0.885, 0.933, 0.804, and 0.785, respectively. Only 58% of patients with ALD were detected at a specificity that excluded ALD in 84% of those who did not have it. CONCLUSION: Within alcohol ingestion times reported to us, no associations with recent drinking were observed. Alcohol as a cause of liver disease is not perfectly established by CDT analysis, although a high total CDT value favors ALD over NASH.     

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。