慢性丙型肝炎患者氧化损伤的研究

Oxidative stress in chronic hepatitis C patients

目的探讨慢性丙型肝炎（CHC）患者体内氧化损伤的情况。方法52例CHC患者，按丙氨酸转氨酶（ALT）水平分为A组（ALT上升组）和B组（ALT正常组）。正常对照组为20例健康志愿者。利用酶联免疫吸附法（ELISA）测定研究对象血清黄嘌呤氧化酶（XOD），丙二醛（MDA），氧化型谷胱甘肽（GSSG），谷胱甘肽（GSH），谷胱甘肽过氧化物酶（GSH—Px），谷胱甘肽巯基转移酶（GST），谷胱甘肽还原酶（GR）及维生素C（Vc）水平，并作出统计分析。结果CHC患者血清XOD，MDA，GST和GR水平较正常对照组显著升高，而GSH，GSH—Px和Vc水平则明显降低。同时，A组患者血清XOD，MDA，GSSG，GST及GR水平较B组患者显著上调，而GSH，GSH—Px和Vc水平则显著下调。在CHC患者中，血清XOD，MDA，GSSG，GST水平与ALT水平呈正相关，血清GSH，GSH—Px，Vc与Au水平呈负相关；血清XOD，MDA，GSSG，GR，GST水平与AST水平呈正相关，血清GSH—Px水平与AST水平呈负相关；血清GR水平与GGT水平呈正相关，血清GSH水平与GGT水平呈负相关；血清MDA，GR水平与AKP水平呈正相关。在CHC组中，仅血清XOD水平与血清HCVRNA水平间存在正相关关系。结论CHC患者体内存在一定程度的氧化损伤，随血清ALT水平的升高，机体氧化损伤程度进一步加重。

Objective This study is aimed to investigate oxidative stress status in chronic hepatitis C （CHC） patients. Methods 52 CHC patients were divided into two groups according to the serum level of alanine aminotransferase （ALT） ： group A （elevated ALT group） and group B （normal ALT group）. 20 healthy controls were included in this study. Serum levels of xanthine oxidase （XOD） , malondialdehyde （MDA）, oxidizided glutathione （GSSG）, glutathione （GSH）, glutathione peroxidase （GSH-Px）, glutathione S-transferase （GST）, glutathione reductase （GR） and vitamin C （Vc） were determined by enzyme-linked immunosorbent assay （ELISA）. Results Serum levels of XOD, MDA, GST and GR increased in CHC patients compared with healthy controls. While, serum levels of GSH, GSH-Px and Vc decreased compared with healthy controls. Furthermore, serum levels of XOD, MDA, GSSG, GST and GR in group A were up-regulated compared with group B. Serum levels of GSH, GSH-Px and Vc in group A were down-regulated compared with group B. In CHC patients, serum ALT level positively correlated with serum levels of XOD, MDA, GSSG and GST, while, negatively correlated with serum levels of GSH, GSH- Px and Vc. Serum aspartatc aminotransferase （AST） level positively correlated with serum levels of XOD, M DA, GSSG, GR and GST, while, negatively correlated with serum GSH-Px level in C HC patients. Serum gamma-glutamyl transpeptidase （GGT） level positively correlated with serum GR level and negatively correlated with serum GSH level in CHC patients. Serum alkaline phosphatase （AKP） level positively correlated with serum levels of MDA and GR in CHC patients. In CHC patients, serum XOD level was positively related with serum HCV RNA level. Conclusion Oxidative stress was increased in CHC patients. In CHC patients with elevated serum ALT level, oxidative stress usually became serious.