还原型谷胱甘肽对慢性肝病患者肝细胞损害及肝纤维化程度的影响  

Influence of Glutathione on liver damage and fibrosis degree in patients with chronic liver diseases

作　　者：张佳光[1] 肖和杰[1] 王永华[1] 黄利青[1] 

机构地区：[1]三峡大学第三临床医学院葛洲坝中心医院肝病科,宜昌443002

出　　处：《药品评价》2008年第7期300-301,309,共3页Drug Evaluation

摘　　要：目的探讨还原型谷胱甘肽治疗慢性肝病患者的疗效及作用机制。方法对40例慢性肝炎(CH)、30例活动性肝硬化(HC)、25例慢性重症肝炎(CHH)患者,使用还原型谷胱甘肽1.2g静脉滴注,每日1次,疗程为45d,治疗前后检测患者血清中白细胞介素6(IL-6)、IL-8、肿瘤坏死因子α(TNF-α)、Ⅲ型前胶原(PCⅢ)、透明质酸(HA)、ALT、AST、TBil,同时25例患者进行了肝组织活检。结果慢性肝炎组、活动性肝硬化组、慢性重症肝炎组治疗后IL-6、IL-8、TNF-α、PCⅢ、HA、ALT、AST、TBil各项检测值均比治疗前明显下降,P值均<0.01,差异有统计学意义。25例肝组织活检治疗前肝纤维化1、2、3、4期病例数分别为8、7、5、5例;炎症活动度1、2、3、4级病例数分别为6、4、7、8例;治疗后肝纤维化1、2、3、4期病例数分别为12、10、2、1例;炎症活动度1、2、3、4级病例数分别为13、8、2、2例,治疗后肝纤维化程度和炎症活动度得到明显改善。结论还原型谷胱甘肽可以降低慢性肝病患者血清中IL-6、IL-8、TNF-α浓度,控制肝脏炎症,保护肝细胞,对阻止肝纤维化有明显作用。Objective To investigate the effect of Glutathione （GSH） on patients with chronic liver diseases. Methods The activity of IL-6, IL-8, TNF- α, PCⅢ, HA, ALT, AST, TBil in sera were detected from patients with chronic hepatitis （CH）, hepatocirrhosis （HC）, chronic severe hepatitis （CHH） at the same time before and after treatment. 25 patients were examined in liver tissues. Results It showed that activity of IL-6, IL-8, TNF- α, PCⅢ, HA, ALT, AST, TBil in sera from patients with CH, HC and CHH were lower than that before treatment; there was significant difference （P〈0.01）. In addition, the inflammation and liver fibrosis degree after treatment were obviously lighter than that before treatment. Conclusion GSH could reduce activity of IL-6, IL-8, TNF- α in sera from patients with chronic liver diseases, protect liver cells from inflammation, prohibitive liver fibrosis.

关 键 词：肝疾病 肝纤维化 谷胱甘肽 药物治疗 

分 类 号：R575[医药卫生—消化系统] R9[医药卫生—内科学]