大黄治疗婴儿肝炎综合征的作用机制

Exploration on Mechanism of Rhubarb on Infantile Hepatitis Syndrome

目的探讨大黄治疗婴儿肝炎综合征(IHS)的机制。方法采用全自动生化分析仪检测52例IHS患儿及18例非IHS择期手术前婴儿(对照组)血清总胆红素(TB)、结合胆红素(DB)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(γ-GT)、总胆汁酸(TBA)水平,采用双抗体夹心酶联免疫吸附法(ELISA)检测其血清及胆汁IL-6、TNF-α水平,硫代巴比妥酸比色法(TBA法)和黄嘌呤氧化酶法分别检测其血清及胆汁丙二醛(MDA)和超氧化物歧化酶(SOD)水平。结果大黄治疗后IHS患儿血清TB、DB、ALT、γ-GT、TBA分别为(58.7±20.9)μmol/L、(36.7±13.1)μmol/L、(56.8±22.1)U/L、(83.2±22.7)IU/L、(88.6±31.5)μmol/L,均较治疗前显著降低(Pa<0.05),血清及胆汁IL-6、TNF-α、MDA分别为(20.71±7.93)ng/L、(246.74±83.15)ng/L、(2.60±0.85)μmol/L、(81.96±17.05)ng/L、(627.91±193.37)ng/L、(6.32±2.05)μmol/L,均较治疗前降低(Pa<0.05),SOD与治疗前比较均升高[分别为(107.2±22.7)μU/L、(169.8±57.1)μU/LPa<0.05]。结论IL-6、TNF-α、MDA、SOD参与了IHS的病理过程,大黄通过降低血清及胆汁中IL-6、TNF-α、MDA水平,提高SOD水平而起到退黄护肝的作用。

Objective To explore the mechanism of action of rhubarb on infantile hepatitis syndrome（IHS）. Methods The constituents from 52 IHS subjects and 18 controls, whose total bilirubin （ TB ） , direct bilirubin （ DB ） , alanine aminotransferase （ALT） , glutamyhranspeptidase（ γ- GT）, total bile acid （TBA） in serum were assayed by fully -auto chemistry analyzer. The levels of interleukin -6 （IL- 6 ） , tumor necrosis factor α（TNF- α）, malondialdehyde （MDA） and superoxide dismutase（SOD） both in serum and bile were assayed hy enzyme linked immunosorbent assay（ELISA） ,thiobarbituric acid method and xanthine oxidase method, respectively. Results In IHS group, the values of TB, DB, ALT,γ - GT,TBA in serum were （58.7 ± 20.9） μmol/L, （ 36.7 ± 13.1 ） μmol/L, （56.8 ± 22.1 ） U/L, （ 83.2 ± 22.7 ） IU/L, （88.6 ± 31.5 ） μmol/L,respectively, which were significantly lower after treatment （P 〈 0.05 ） ;the values of IL - 6, TNF - α and MDA in serum and bile were （20.71 ±7.93） ng/L, （ 246. 74 ± 83. 15） ng/L,（2.60 ±0.85） μmol/L,（81.96 ±17.05） ng/L,（627.91 ± 193.37） ng/L, （6.32 ± 2.05 ） μmol/L, respectively, which were significantly lower after treatment （ Pa 〈 0.05 ） , while SOD both in serum and bile were elevated [the values were （ 107.2 ±22.7） μU/L, （ 169.8 ±57.1 ） μU/L,respectively,P 〈0.05]. Conclusions IL -6, TNF - α, MDA and SOD are involved in pathogenesis of IHS,rhubarb play a regressing capability on jaundice and a protective effect on hepatocytes through decreasing the levels of IL-6 ,TNF- α, MDA and elevating SOD both in serum and bile.