大剂量维生素C对肝硬变患者肝功能及细胞免疫功能的影响  

Effect of high-dose vitamin C on hepatic function and cell immunity in patients with liver cirrhosis

作　　者：张晓岚[1] 姚希贤[1] 李永军[1] 王丽芳[1] 

机构地区：[1]河北医科大学第二医院消化内科,河北省石家庄市050000

出　　处：《世界华人消化杂志》2001年第6期649-652,共4页World Chinese Journal of Digestology

摘　　要：目的观察大剂量维生素C(Vit.C)对肝硬变患者肝功能及细胞免疫功能的影响。方法 Vit.C 10g稀释于50g·L^1葡萄糖300mL 500ml中静脉点滴.1次·d^1,连用14d 16d 观察应用与未用Vit.C治疗的肝硬变患者共58例,治疗前后的AL.T、胆红素(Bil)、血清Vii,C、淋巴细胞转化率、T淋巴细胞亚群、红细胞C3b受体花环率及红细胞免疫复合物花环率水平的变化结果治疗组应用Vit C治疗后ALT(1020±888 nk△_1·L^1vs 516±422 nk△_1·L^1.P<0.01)和Bil(47+42μmol·L^1vs36±50μmol·L^1.P<0.05)明显降低:而且肝硬变Vit(治疗组ALT(516±422nk△t·L^1 vs 703±582nk△·L^1.P<0.05)和Bil(36±50μmol·L^1vs 48±56μmol·L^1.P<0.05)明显低于病例对照组。CD4/CD8比值、淋转率虽治疗前(1.08％0.28％.46.70％±10.41％)、后(1.26％±0.24％.55.52％,7.83％)均仍明显低于正常(1.52％±0.29％).P<0.01;但治疗后明显高于治疗前,P<0.05,P<0.01,红细胞C31,受体花环率治疗后(20.37％±6.20％)明显高于治疗前(15.90％7.11％),P<0.05,维生素C与CD4/CD8比值、淋转率、红细胞C3b受体花环率均呈正相关(n-31,0.613,0.512,0.567,P<0.01)。结论大剂量维生素C静脉点滴在治疗肝硬变患者中,具有降酶退黄作用,是一种有效的临床护肝药物,其机制可能与提高细胞免疫和红细胞免疫粘附功能有一定关系。AIM To observe the effects of high-dose vitamin C (Vit. C) on hepatic function and cell immunity in cirrhotic patients, METHODS In the Vit. C-treated group, Vit. C (10 g/day) was given intravenously. The plasma Vit. C levels were measured in 58 patients with cirrhosis by high performance liquid chromatography (HPLC). The levels of lymphocyte transformation test (LTT), T lymphocyte phenotype, and red blood cell C3b receptor rosette (RBCC3bRR) as well as red blood cell immune complex rosette (RBC-ICR) were measured before and after vitamin C therapy. RESULTS ① ALT and Bil were significantly decreased respectively (ALT: 1020+888nk△t·L^1 vs 516±422nk△t·L^1, P<0.01; Bil: 47±42μmol·L^1 vs 36±50μmol·L^1. P<0.05) after treatment with Vit. C. In control group, ALT was significantly decreased (700±583 nk△t·L^1 vs 1000±733nk△t·L^1. P<0.05); but Bil was unchanged after treatment. When compared with control group, both ALT and Bil were lower after treatment with Vit. C (P<0.05). ② The CD4/ CD8 ratio, lymphocyte transformation ratio and RBC-C3bRR were significantly higher than that before treatment in patients with cirrhosis respectively (1.08±0.28, vs 1.26%±0.24%; 46.70%±10.41%, vs 55.52%±7.83%; 20.37%±6.20%, vs 15.90%±7.11%), P<0.01. And they were all lower than the normal (1.52%±0.29%, 59.14%±2.81%, 17.88%±3.30%, P<0.05 0.01). ③ The Vit. C level of patients was positively correlated with CD4/CD8 ratio, LTT and RBC-C3bRR (r=0.613, 0.512, 0.567, P<0.01). CONCLUSION Vitamin C as a drug of protecting hepatic function plays an active role in patients with cirrhosis, and improves immunological function in cirrhotic patients.

关 键 词：抗坏血酸 药理学 抗坏血酸 肝硬化 病理生理学 免疫学 

分 类 号：R575.2[医药卫生—消化系统]