抗纤软肝颗粒对肝纤维化大鼠肝脏MMP-1mRNA及TIMP-1mRNA表达的影响

目的观察抗纤软肝颗粒对实验性肝纤维化大鼠肝脏基质金属蛋白酶-1(MMP-1)、金属蛋白酶组织抑制因子-1(TIMP-1)的影响,探讨其防治肝纤维化的作用.方法采用250mL/L四氯化碳给大鼠皮下注射制备肝纤维化模型,并同时给与秋水仙碱及抗纤软肝颗粒小、大剂量治疗,免疫组织化学法检测肝组织Ⅰ、ⅢⅡ型胶原,原位杂交的方法检测MMP-lmRNA、TIMP-1mRNA.结果抗纤软肝颗粒能促进MMP-1的表达(P＜0.05),抑制TIMP-1的表达(P＜0.01),促进Ⅰ、Ⅲ型胶原的降解(P＜0.01).结论抗纤软肝颗粒能促进MMP-1的表达,抑制TIMP-1的表达,促进胶原的降解,产生抗肝纤维化的作用.     

地塞米松治疗有重症倾向的慢性乙型肝炎的临床观察

目的观察地塞米松对有重症倾向的慢性乙型肝炎患者的疗效及预后。方法将120患者分为3组,A组保肝抗炎、保护胃黏膜、预防感染、对症支持等综合治疗;B组在A组基础上加用地塞米松10mg冲击治疗3～5d后停用;C组在A组治疗基础上地塞米松3mg,间隔48～72h再使用,疗程6周。结果治疗6周,B组、C组总胆红素水平、消化道症状改善、重症肝炎发生率与A组比较有统计学意义(P<0.05)。C组并发症与B组对比差异显著(P<0.05)。结论有重症倾向的慢性乙型肝炎患者采用地塞米松冲击治疗或小剂量间断使用可以早期缓解消化道症状、降低重症肝炎发生率,但小剂量间断使用疗法更易出现并发症,地塞米松短期冲击治疗更安全。     

姜黄素对肝纤维化大鼠肝组织中NF-κB及ERK-1 mRNA表达的影响

目的 探讨核转录因子-κB(nuclear factor kappa B,NF-κB)及细胞外信号调节激酶(extracegular signal-reglulated kinase,ERK)mRNA在CCl4致实验性肝纤维化大鼠肝组织中的表达及姜黄素(curcumin,CUR)对它们的影响.方法 建立CCl4致大鼠实验性肝纤维化的模型,用免疫组化法比较正常组、模型组及CUR组的α平滑肌肌动蛋白(α-SMA)的表达,用RT-PCR法比较各组肝组织NF-κB及ERK-1 mRNA的表达.结果 模型组中,ERK-1及NF-κB mRNA的表达均增高,而CUR组α平滑肌肌动蛋白则较模型组低,NF-κB及ERK-1 mRNA的表达也降低.结论 CUR可能通过抑制α-SMA的表达,减弱NF-κB诱导的肝星状细胞的活化及抑制ERK-1促肝星状细胞的增殖,从而产生抗四氯化碳诱导的大鼠肝纤维化的作用.     

拉米夫定联合阿德福韦酯治疗乙型肝炎肝硬化失代偿期患者的临床观察

目的:探讨拉米夫定(LAM)联合阿德福韦酯(AVD)治疗乙型肝炎肝硬化失代偿期的疗效、安全性。方法:选择2006年6月～2008年6月门诊和住院乙型肝炎肝硬化失代偿期患者93例,随机分为3组。A组单用LAM(100mg·d-1);B组采用ADV(10mg·d-1);C组采用ADV(10mg·d-1)、LAM(100mg·d-1)联合治疗;3组均治疗52周。结果:治疗52周时3组患者间ALT水平、HBeAg阳性患者血清转换率比较,差异均无统计学意义(P>0.05);C组患者HBVDNA水平达到检测水平以下的百分率与B组患者比较,有显著性差异(P<0.05);3组间肝功能Child-Pugh评分比较差异无统计学意义(P>0.05)。3组患者的基因型耐药率分别为21.9%(7/32)、0、0。结论:乙型肝炎肝硬化失代偿期采用LAM联合ADV治疗更安全有效。     

病毒性肝炎特殊并发症2例

肝炎病毒可侵犯许多肝外组织器官，造成相应的病变。肝脏功能的异常，使体内物质代谢异常，亦可造成肝外组织器官病变。某些少见的肝外表现容易误诊、漏诊，临床医生应提高认识。     

丹参注射液与异甘草酸镁抗肝纤维化的临床对比研究

Objective To observe the change of liver function and liver fibrosis indexes of the chronic hepatitis B patients that were treated by Danshen injection(DI) and magnesium isnglyeyrrhizinate(MI). Methods 80 chronic hepati-tis B patients based on the conventional treatment were randomly divided into D1 group(40 patients) and MI group(40 pa-tients). The two groups were used with DI and MI injection for 30 days respaetively and then,the levels of liver function and serum hepatic fibrosis(HA, LN, Ⅳ -C) were detected and compared before and after treatment. Results Treatment by DI and MI could both improve liver function significantly, the effect of Ml group was better than DI group(P < 0.05). Moreover, in improving serum hepatic fibrosis, the effect of DI group was better than MI group (P < 0.05). Conclusions The efficacy of the improvement to hepatic fibrosis DI is better than MI, while in improvement of liver function MI is superior to DI.     

丹参注射液与异甘草酸镁抗肝纤维化的临床对比研究

Objective To observe the change of liver function and liver fibrosis indexes of the chronic hepatitis B patients that were treated by Danshen injection(DI) and magnesium isnglyeyrrhizinate(MI). Methods 80 chronic hepati-tis B patients based on the conventional treatment were randomly divided into D1 group(40 patients) and MI group(40 pa-tients). The two groups were used with DI and MI injection for 30 days respaetively and then,the levels of liver function and serum hepatic fibrosis(HA, LN, Ⅳ -C) were detected and compared before and after treatment. Results Treatment by DI and MI could both improve liver function significantly, the effect of Ml group was better than DI group(P < 0.05). Moreover, in improving serum hepatic fibrosis, the effect of DI group was better than MI group (P < 0.05). Conclusions The efficacy of the improvement to hepatic fibrosis DI is better than MI, while in improvement of liver function MI is superior to DI.     

甲亢患者放射性131I治疗前后血浆LP(a)浓度的变化

目的　研究甲状腺激素对血浆脂蛋白 (a) [LP(a) ]浓度的影响。方法　采用ELISA法检测血浆LP(a)浓度 ,纵向观察 8例甲亢患者放射性13 1I治疗前后血浆LP(a)浓度的变化。我们测定下列 3种状态的LP(a)浓度 ,即治疗前甲亢状态 (H状态 )、丙基硫氧嘧啶治疗后的甲状腺功能呈基本正常状态 (E1状态 )和放射性13 1I治疗后甲状腺功能正常状态 (E2状态 )。结果　治疗前H状态血脂LP(a) ,TC ,HDL -C ,LDL -C ,apoA1和apoB浓度低于对照组 (P <0 .0 5 ) ;从H到E1,再到E2状态 ,LP(a)浓度逐渐升高 ,差异具有统计学意义 (P <0 .0 5～ 0 .0 1)。TC ,DL -C ,apoA1及apoB2亦有类似的变化 (P <0 .0 5～ 0 .0 1) ;治疗前后LP(a)的变化与FT3(r =- 0 .0 4 )和FT4 (r=- 0 .4 6 )的变化呈负相关 (P <0 .0 5 )。结论　甲状腺激素对LP(a)的代谢有调控作用。     

姜黄素对实验性肝纤维化大鼠肝脏bax和bcl-2表达的影响

[目的]探讨姜黄素(curcumin,CUR)对大鼠肝纤维化的防治作用及对肝组织bax和bcl-2蛋白及基因表达的影响.[方法]建立CCl4致大鼠实验性肝纤维化模型.用免疫组化法比较正常组、模型组以及CUR组的bcl2、bax蛋白的表达,用RT-PCR法比较各组肝组织bcb-2、bax mRNA的表达.[结果]CUR组肝组织炎症和纤维化程度较模型组显著减轻.bax蛋白主要表达在肝细胞质,而纤维间隔及汇管区呈低表达;beb-2主要表达在纤维间隔及汇管区.bax及bcl-2在模型组及CUR组表达均高于正常组(P<0.01),CUR组均较模型组降低(P<0.01).bax及bcI-2 mRNA在模型组及CUR组表达比正常组增高(P<0.01,<0.05),CUR组均较模型组降低(P<0.05).[结论]CUR可能通过降低肝细胞表达bax、减少肝细胞凋亡而减轻肝脏损伤,通过降低bcl-2表达、诱导肝星状细胞凋亡发挥减轻肝纤维化的作用,防治大鼠肝纤维化.     

丹参注射液与异甘草酸镁抗肝纤维化的临床对比研究

Objective To observe the change of liver function and liver fibrosis indexes of the chronic hepatitis B patients that were treated by Danshen injection(DI) and magnesium isnglyeyrrhizinate(MI). Methods 80 chronic hepati-tis B patients based on the conventional treatment were randomly divided into D1 group(40 patients) and MI group(40 pa-tients). The two groups were used with DI and MI injection for 30 days respaetively and then,the levels of liver function and serum hepatic fibrosis(HA, LN, Ⅳ -C) were detected and compared before and after treatment. Results Treatment by DI and MI could both improve liver function significantly, the effect of Ml group was better than DI group(P < 0.05). Moreover, in improving serum hepatic fibrosis, the effect of DI group was better than MI group (P < 0.05). Conclusions The efficacy of the improvement to hepatic fibrosis DI is better than MI, while in improvement of liver function MI is superior to DI.