^(13)C-美沙西丁呼气试验与非酒精性脂肪肝病理改变的相关性研究

Correlation between ^(13)C-methacetine breath test and pathological changes of non-alcoholic fatty liver

目的:13C-美沙西丁(methacetine)呼气试验评价非酒精性脂肪肝肝细胞损害程度的方法及意义. 方法:自行设计大鼠13C-美沙西丁呼气试验检测程序与方法;采用高脂饲料喂养方法建立脂肪肝模型;Wistar ♂大鼠40只,重量200±20 g,随机分为高脂饲料喂养组(试验组) 及普通饲料喂养组(正常对照组).于实验的2,4,6,8 wk分别对二组大鼠进行肝穿,观察其病理改变,根据Brunt积分系统评分;同时应用红外线能谱分析仪(IPIS)进行13C-美沙西丁呼气试验检测,观察呼气峰值(DOB)、达峰时间(T)和60 min累积呼气量(CU 60 min)各参数的动态变化,并结合动物的生理学特征分析;观察呼气试验中各参数的动态变化与病理变化的相关性. 结果:试验组,对照组实验前的DOB分别为34.9±3.9‰和35.4±3.8‰,试验组2,4,6,8 wk的DOB分别为32.2±3.0‰,21.0±2.5‰,16.1±2.8‰和11.6±2.2‰, 对照组2,4,6,8 wk的DOB分别为34.7±3.8‰, 35.3±3.7‰,35.1±4.3‰和35.0±3.5‰;试验组各时间段之间的差别有显著性意义(P=0.00,P<0.01);与同期正常对照组大鼠相比,差别有统计学意义.而正常对照组各时间段之间差别无统计学意义(P>0.05).呼气试验结果(DOB)与同期的病理积分负相关(r=0.89,P=0.00,P<0.01). 结论:13C-美沙西丁呼气试验有可能作为非酒精性脂肪肝病变程度无创性评价方法.

AIM: To investigate and assess 13C-methacetine breath test as a method to evaluate the degree of pathological lesion in liver of non-alcoholic steatohepatitis. METHODS: High fat diet was adopted to establish an animal model. Forty male Wistar rats, weighing 200±20 g, were randomly assigned into two groups, high fat diet group (test group) and normal diet group (control group). Liver puncture biopsy was performed in two groups of mice at 2, 4, 6, 8 wk respectively. The pathological changes were observed and graded according to Brunt System. At the same time, the isotope-selective nondispersive infrared spectrometer (NDIRS ), was applied to practice the 13C-methacetine breath test and peak value of breathing (DOB), the duration to peak (T), cumulative expiration within 60 min (CU/60 min ) were determined. Then, correlation between the dynamic and pathological changes of all parameters in the breath test was analyzed. RESULTS: The values of DOB in the test and control groups before the test were 34.9±3.9‰,35.4±3.8‰ respectively. The results in the test group at 2,4,6,8 wk were 32.2±3.0‰, 21.0±2.5‰, 16.1±2.8‰, 11.6±2.2‰ respectively, and 34.7±3.8‰, 35.3±3.7‰, 35.1±4.3‰, 35.0±3.5‰ in the control group respectively. Significant differences existed among the different period of time in the test group (P <0.01), but not in the control group. The differences between the test group and the control group at the same period of time were also significant. The breath test (DOB) negatively related to the pathological scores (r =0.89, P=0.00,P<0.01) CONCLUSION: 13C-methacetine breath test can be a non invasive method to evaluate the pathological changes of non-alcoholic steatohepatitis.