还原型谷胱甘肽对酒精性肝炎患者血清TNF-α、瘦素的影响  

Effect of reduced glutathione on serum leptin and TNF-α levels in patients with alcoholic hepatitis

作　　者：余小虎[1] 朱金水[2] 邱夏地[1] 顾国妹[1] 

机构地区：[1]上海市南汇区中心医院消化科,201300 [2]上海交通大学附属第六人民医院消化科

出　　处：《实用肝脏病杂志》2005年第3期140-142,共3页Journal of Practical Hepatology

摘　　要：目的观察还原型谷胱甘肽治疗酒精性肝炎的效果及其对患者血清瘦素、TNFα水平的影响。方法酒精性肝炎病人40例,随机分为试验组20例,在戒酒的同时采用还原型谷胱甘肽治疗,对照组20例在戒酒的基础上予葡萄糖醛酸内酯(肝泰乐片)治疗,疗程均为6周。测定治疗前后各组血清肝纤维化指标(HA、IVC及LN)、生化指标(TBIL、ALT、AST、Alb)、血清瘦素及TNFα水平并进行统计学处理。结果试验组患者的血清HA、IVC及LN水平于治疗后均明显降低,其中尤以HA降低显著(P=0.00),试验组患者治疗后血清TBIL、ALT、AST水平与治疗前相比均有显著下降,尤以TBIL、ALT降低显著(P<0.01),同时治疗后血清瘦素、TNFα水平亦显著下降(P=0.00)。而对照组治疗后各项肝纤维化指标中仅HA水平下降(P=0.018),生化指标中仅TBIL、ALT下降明显(P<0.05),同时治疗前后血清瘦素、TNFα水平亦下降(P<0.05),但下降幅度均明显低于试验组。用药期间两组患者均未出现显著不良反应。结论还原型谷胱甘肽对酒精性肝炎患者具有明显的疗效且用药安全,其作用机理与下调瘦素和TNFα表达有关。Objective To investigate the effect of reduced glutathione on serum leptin and TNF α in patients with alcoholic hepatitis.Methods 40 patients with alcoholic hepatitis were randomly divided into experiment group treated with reduced glutathione (n=20) or control group treated with glucuronolactone (n=20) for consecutive 6 weeks.The serum fibrosis markers including hyaluronic acid (HA)、type IV collagen (IV C) and laminin (LN),biochemical markers including total bilirubin(TBIL)、ALT、AST and albumin(Alb),serum leptin and tumor necrosis factor alpha (TNF α) of the two groups were determined pre and post treatment respectively.All data were processed by statistics.Results The serum levels of fibrosis markers in experiment group were all significantly reduced after treatment,especially HA( P =0.00),while only serum level of HA in control group was obviously decreased( P =0.018);the abnormity of all biochemical markers except serum Alb in experiment group and only TBIL,ALT in control group were obviously ameliorated at the end point,meanwhile,the serum levels of leptin and TNF α in both groups were all decreased at the end point,especially in experiment group(both P =0.00).No severe side effects happened during treatment.Conclusion Reduced glutathione is an effective and safe remedy for treatment of alcoholic hepatitis,which may be related to the reduction of serum levels of leptin and TNF α.

关 键 词：还原型谷胱甘肽 肝炎患者 血清TNF TNF-Α 血清肝纤维化指标 葡萄糖醛酸内酯 血清瘦素 TBIL 治疗前后 生化指标 酒精性肝炎 统计学处理 ALT 治疗后 肝炎病人 肝泰乐片 血清HA 不良反应 用药期间 用药安全 作用机理 对照组 

分 类 号：R575.1[医药卫生—消化系统]