大剂量维生素C对肝硬化患者脂质过氧化损伤的保护作用

目的 :观察大剂量维生素C(Vit .C)对肝硬化患者脂质过氧化损伤的保护作用。方法 :将 5 8例肝硬化患者随机分为Vit .C治疗组与对照组。应用Vit .C 10 g稀释于 5 %葡萄糖 30 0～ 5 0 0ml中静脉滴注 ,每日 1次 ,连用 14天。观察治疗前后ALT、胆红素 (Bil)、血清Vit.C、丙二醛 (MDA)、超氧化物歧化酶 (SOD)、谷胱甘肽过氧化物酶 (GSH Px)水平的变化。结果 :肝硬化组血清Vit .C、SOD水平、SOD/MDA比值显著低于正常对照组 (P <0 .0 5 ) ;而MDA显著高于正常对照组 (P <0 .0 1)。应用Vit.C治疗后ALT ( 61.19± 5 3.2 8uvs 30 .95± 2 5 .33u ,P <0 .0 1)和Bil( 46.81± 41.96μmol/Lvs 36.42± 5 0 .33μmol/L ,P <0 .0 5 )明显降低 ;GSH Px、SOD/MDA比值显著性升高 ,P <0 .0 5。而且ALT( 30 .95± 2 5 .33uvs ,42 .2 0± 34 .89u ,P <0 .0 5 )和Bil( 36.42± 5 0 .33μmol/Lvs 47.89± 5 6.2 0 μmol/L ,P <0 .0 5 )明显低于对照组 :GSH Px、SOD/MDA比值显著高于 (MDA显著性低于 )对照组。结论 :氧自由基所引发的脂质过氧化作用可能是肝硬化肝损害发病机制中的重要因素之一 ,应用大剂量Vit .C( 10g/d)疗法确有降酶、退黄、改善肝功能的作用 ,其作用机制与清除OFR、抑制LP有关。

The Effect of High-dose Vitamin C on Lipid Peroxidization Injury in Patients with Hepatic Cirrhosis

To observe the effects of highdose Vit. C on hepatic function and lipid peroxidization injury in cirrhotic patients. Methods: In the Vit. C-treated group, Vit. C(10 g/day) was given intravenously. The sennn Vit. C levels were measured in 58 patients with cirrhosis and 20 normal controls by high performance liquid chromatography (HPLC). The levels of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase were measured before and after treatment with Vit. C and without Vit. C by chemocolorimetry. Results: ALT and Bil were significantly decreased respectively (ALT:61. 19 ± 53.28 u vs 30.95 ± 25.33 u, P ＜ 0.01; Bil:46.80 ± 41.96 μmol/L vs 36.42 ± 50.33μmol/L, P ＜ 0. 05) after treatment with Vit. C. In control group ALT was significantly decreased (42.22 ± 34.89 u vs 59. 63 ± 44.30 u, P ＜ 0.05), but Bil was unchanged after treatment. When compared with control group, both ALT and Bil were all lower after treatment with Vit. C (P ＜0.05). SOD/MDA ratio and GSH-Px were significantly lower than that of normal respectively (P ＜0.01, P ＜0105). After treatment with Vit. C the SOD/MDA ratio and GSH-Px levels were significantly increased than that of control group. And MDA were significantly lower than that of control group. Conclusions: Intravenous infusion of a large dose of Vit. C as a protecting liver function drug plays an active role in patients with cirrhosis, and the effects of Vit. C can be attribute to scavenging radical and suppressing the peroxidaive reactions.