Novel mutation of the TJP2 gene in a Chinese child with progressive cholestatic liver disease coexistent with hearing impairment

To the Editor:Diagnosis and management of infantile cholestatic liver disease with unknown etiology remain challenging.With recent rapid development of genetic technology,several gene mutations have been found to be the cause of this disease[1].Progressive familial intrahepatic cholestasis(PFIC)is a group of rare diseases that mainly occur in neonates and infants.Some children might progress to end-stage liver disease that requires liver transplantation.

Protective effect of early enteral feeding on postburn impairment of liver function and its mechanism in rats

AIM To study the protective effect of earlyenteral feeding(EEF)on the postburnimpairment of liver function and its mechanism.METHODS Wistar rats with 30% of total bodysurface area(TBSA)full-thickness burn wereemployed.The effects of EEF on the postburnchanges of gastric intramucosal pH,endotoxinlevels in portal vein,water contents of hepatictissue,blood concentrations of tumor necrosisfactor(TNF-α),plasma activities of alanineaminotransferase(ALT)and asparateaminotransferase(AST),as well as the bloodcontents of total(TB)and direct bilirubin(DB),total protein(TP)and albumin(ALB)wereserially determined within 48h postburn.RESULTS EEF could significantly improvegastric mucosal acidosis,reduce portal veinendotoxin level and water content of hepatictissue,as well as plasma concentrations of TNF-α at all timepoints after severe burns(P【0.01);postburn elevation of the plasma activities ofALT,AST and the contents of TB,DB wereeffectively prevented,whereas the plasmaconcentrations of TP and ALB were markedlyincreased 24 h and 48 h posturn in EEF groupcompared with that of the burn without EEFgroup(P【0.01).CONCLUSION EEF has significant beneficialeffects on the improvement of hepatic function in rats after severe burn,and is probably relatedwith an increase in splanchnic blood flow,reduction of the absorption of gut-originendotoxin and the consequent release ofinflammatory mediators.

Role of fecal microbiota transplant in management of hepatic encephalopathy: Current trends and future directions

Fecal microbiota transplantation(FMT)offers a potential treatment avenue for hepatic encephalopathy(HE)by leveraging beneficial bacterial displacement to restore a balanced gut microbiome.The prevalence of HE varies with liver disease severity and comorbidities.HE pathogenesis involves ammonia toxicity,gut-brain communication disruption,and inflammation.FMT aims to restore gut microbiota balance,addressing these factors.FMT's efficacy has been explored in various conditions,including HE.Studies suggest that FMT can modulate gut microbiota,reduce ammonia levels,and alleviate inflammation.FMT has shown promise in alcohol-associated,hepatitis B and C-associated,and non-alcoholic fatty liver disease.Benefits include improved liver function,cognitive function,and the slowing of disease progression.However,larger,controlled studies are needed to validate its effectiveness in these contexts.Studies have shown cognitive improvements through FMT,with potential benefits in cirrhotic patients.Notably,trials have demonstrated reduced serious adverse events and cognitive enhancements in FMT arms compared to the standard of care.Although evidence is promising,challenges remain:Limited patient numbers,varied dosages,administration routes,and donor profiles.Further large-scale,controlled trials are essential to establish standardized guidelines and ensure FMT's clinical applications and efficacy.While FMT holds potential for HE management,ongoing research is needed to address these challenges,optimize protocols,and expand its availability as a therapeutic option for diverse hepatic conditions.

Temporal Variations in Mortality after Liver Transplantation: Retrospective Investigation of Potential Risk Factors Using Propensity Score

Objective: We aim to detect over-time variations in mortality of liver transplant recipients stratified by the period of transplant. Since this is a retrospective investigation, bias reduction caused by possible confounding effects can be achieved by using propensity score weighting in a multivariate logistic regression model. Methods: Medical charts of all adult liver transplant recipients (n = 250) who were transplanted in three periods 2005-2009, 2010-2014 and 2015-2019 were retrospectively reviewed. The following recipient factors were analyzed: recipients and donors’ ages, sex, renal impairment, body mass index (BMI), presence of bacterial or viral infections, MELD (Model for end-stage diseases). Multivariate logistic model adjusted by Propensity Scores (PS) was used to identify the effect of the risk factors on mortality, and death within five years, in the targeted time frame. Patient outcomes are recorded as;(patient status = 1 if dead, or patient status = 0 if alive). Results: Meld score, recipient age, and renal impairments were shown to be predictors of mortality in transplanted patients. Multivariate regression model was used to identify the significance of the specified risk factors, followed by pairwise comparisons between periods. Pairwise comparisons between periods using logistic regression weighted by the inverse propensity score, correcting for the possible confounding effect of measured covariates showed that the death rate is significantly reduced in subsequent periods as compared to the initial period. Conclusions: The clinical implications of these findings are the ability to stratify patients at high risk of posttransplant death by planning more intensive and accurate management for them.

Prevalence and risk factors for impaired renal function among Asian patients with nonalcoholic fatty liver disease

Background:Nonalcoholic fatty liver disease(NAFLD)is associated with impaired renal function,and both diseases often occur alongside other metabolic disorders.However,the prevalence and risk factors for impaired renal function in patients with NAFLD remain unclear.The objective of this study was to identify the prevalence and risk factors for renal impairment in NAFLD patients.Methods:All adults aged 18-70 years with ultrasound-diagnosed NAFLD and transient elastography examination from eight Asian centers were enrolled in this prospective study.Liver fibrosis and cirrhosis were assessed by FibroScan-aspartate aminotransferase(FAST),Agile 3+and Agile 4 scores.Impaired renal function and chronic kidney disease(CKD)were defined by an estimated glomerular filtration rate(eGFR)with value of<90 mL/min/1.73 m^(2) and<60 mL/min/1.73 m^(2),respectively,as estimated by the CKD-Epidemiology Collaboration(CKD-EPI)equation.Results:Among 529 included NAFLD patients,the prevalence rates of impaired renal function and CKD were 37.4%and 4.9%,respectively.In multivariate analysis,a moderate-high risk of advanced liver fibrosis and cirrhosis according to Agile 3+and Agile 4 scores were independent risk factors for CKD(P<0.05).Furthermore,increased fasting plasma glucose(FPG)and blood pressure were significantly associated with impaired renal function after controlling for the other components of metabolic syndrome(P<0.05).Compared with patients with normoglycemia,those with prediabetes[FPG≥5.6 mmol/L or hemoglobin A1c(HbA1c)≥5.7%]were more likely to have impaired renal function(P<0.05).Conclusions:Agile 3+and Agile 4 are reliable for identifying NAFLD patients with high risk of CKD.Early glycemic control in the prediabetic stage might have a potential renoprotective role in these patients.

Resective surgery for liver tumor: a multivariate analysis of causes and risk factors linked to postoperative complications

BACKGROUND: In spite of accurate selection of patients eligible for resection, and although advances in surgical techniques and perioperative management have greatly contributed to reducing the rate of perioperative deaths, stress must be placed on reducing the postoperative complication rates reported to be still as high as 50%. This study was designed to analyze the causes and foreseeable risk factors linked to postoperative morbidity on the grounds of data derived from a single-center surgical population. METHODS: From September 1989 to March 2005, 287 consecutive patients, affected either with HCC or liver metastasis, had liver resection at our department. Among the HCC series we recorded 98 patients (73.2%) in Child- Pugh class A, 32 (23.8%) in class B and 4 in class C (3%). In 104 colorectal metastases, 71% were due to colon cancer, 25% rectal, 3% sigmoid, and 1% anorectal. In 49 non-colorectal metastases, 22.4% were derived from breast cancer, 63.2% gastrointestinal tumors (excluding colon) and 14.4% other cancers. We performed 80 wedge resections, 77 bisegmentectomies and/or left lobectomies, 74 segmentectomies, 22 major hepatectomies, 20 left hepatectomies, and 14 trisegmentectomies. RESULTS: The in-hospital mortality rate in this series was 4.5%, and the morbidity rate was 47.7%, because of pleural effusion (30%), hepatic abscess (25%), hepatic insufficiency (19%), ascites (10%), hemoperitoneum (10%), or biliary fistula (6%). The variables associated with the technical aspects of the surgical procedure thatwere responsible for the complications were: a Pringle maneuver length more than 20 minutes (P=0.001); the type of liver resection procedure, including major hepatectomy (P=0.02), left hepatectomy (P=0.04), trisegmentectomy (P=0.04), bisegmentectomy and/or left lobectomy (P=0,04); and a blood transfusion of more than 600 ml (P=0.04). CONCLUSION: The evaluation of causes and foreseeable risk factors linked to postoperative morbidity during the planning of surgical treatment should play the same role as other factors weighed in the selection of patients eligible for liver resection.

Increased liver markers are associated with higher risk of type 2 diabetes

AIM: To investigate the association between liver markers and the risk of type 2 diabetes(T2DM) and impaired fasting glucose(IFG).METHODS: A total of 8863 participants(3408 men and 5455 women) over 30 years of age were analyzed from the fifth Korean National Health and Nutrition Examination Survey(2010-2011). The associations of serum liver markers such as aspartate aminotransferase(AST), alanine aminotransferase(ALT), AST/ALT, and gamma-glutamyltransferase(GGT) with T2 DM and IFG were analyzed using logistic regression models. Participants were divided into sex-specific quartiles on the basis of liver markers.RESULTS: The prevalence of T2 DM and IFG were 11.3% and 18.3%. Increasing quartiles of ALT and GGT were positively and AST/ALT were negatively correlated with T2 DM and IFG. Analysis of the liver marker combinations showed that if any two or more markers were in the highest risk quartile, the risks of both T2 DM and IFG increased significantly. The risk was greatest when the highest ALT and GGT and lowest AST/ALT quartile were combined, with the riskof T2 DM at 3.21(95%CI: 1.829-5.622, P < 0.001) in men and 4.60(95%CI: 3.217-6.582, P < 0.001) in women. Men and women with the highest AST and ALT and lowest AST/ALT quartile had a 1.99 and 2.40 times increased risk of IFG.CONCLUSION: Higher levels of GGT and ALT and lower AST/ALT within the physiological range are independent, additive risk factors of T2 DM and IFG.

Efficacy and safety of once daily tacrolimus compared to twice daily tacrolimus after liver transplantation

BACKGROUND Once daily tacrolimus regimen was found to exhibits similar bioavailability,safety and efficacy properties compared to twice-daily tacrolimus in kidney transplantation patients.AIM To compare the efficacy and safety of once-daily prolonged release tacrolimus compared to twice-daily tacrolimus in liver transplantation patients.METHODS MEDLINE,EMBASE,CENTRAL databases were searched for clinical trials until December 2020.Efficacy outcome measured as the rate of treatment failure indicated by biopsy-proven acute rejection,Serum creatinine,graft loss,or death.Two reviewers independently selected studies,collected data and assessed risk of bias.The results are reported as risk ratio with 95%confidence interval(CI)for dichotomous data.RESULTS Seven studies included with 965 patients.All the included studies were of moderate quality according to the risk of bias assessment using Cochrane Risk of Bias tool.Biopsy-proven acute rejection was reported in four studies,and pooled analysis of those studies indicated similar rejections in both twice daily and once daily tacrolimus groups(risk ratio:1.06,95%CI:0.84-1.34,n=758,I2=0%)and also we found no significant difference between both groups for renal outcome(serum creatinine;mean difference,0.001 mg/dL,95%CI:-0.042 to 0.043,n=846,I2=18.6%).Similarly,there was similar number of adverse events such as hypertension,headache,back pain,blood related disorders,infections and nausea observed in both groups.CONCLUSION The analysis findings confirm that both once daily and twice daily tacrolimus formulations are comparable in terms of efficacy and safety outcomes.

EFFECT OF METHIONINE ENKEPHALIN ON MIGRATION OF MACROPHAGES FROM MICE WITH IMPAIRED LIVER

Objective To observe the effects of methionine enkephalin (M Enk) on migration of macrophages from mice with impaired liver and its immunomodulatory mechanisms. Methods Liver of mice was impaired by feeding CCl 4 and macrophage migration inhibitory factor (MMIF) was produced by Con A stimulated spleen lymphocytes. Inhibition of macrophage migration was measured in reaction system by adding M Enk. Results Migration of macrophages in both liver impaired and control group were suppressed by MMIF, but the suppression might be reversed by adding 1 μmol/L M Enk ( P <0.05).M Enk could significantly inhibit in vitro both of the combination of MMIF with macrophages and production of MMIF from lymphocytes ( P <0.01).Macrophages from liver imparied group showed a higher sensitivity compared to the control group ( P <0.05).Conclusion The study suggests that opioid peptieds play an important role in the modulation of the immune response under stress as liver impairment.

从“肝郁胃衰”理论解析肠道微生物对于轻度认知功能障碍的影响

基于《辨证录·呆病门》中的相关论述,从中医的角度辨析肠道微生物、“肝郁胃衰”之变与认知功能之间的相关性,从中医“肝郁胃衰”的理论阐述认知功能障碍的发病机制、病理变化及临床论治。

从肾肝论治卵巢储备功能减退合并不孕症

卵巢储备功能减退可致月经不调、闭经,甚者不孕,对育龄期妇女身心具有一定负面影响。卵巢储备功能减退合并不孕症者的病机关键在于肾虚肝郁,肾气不足,肝气郁结,肝肾亏损,气血化生不畅,冲任运行受阻,难以受孕。本文从肝肾论治角度出发,结合经典及现代文献,总结相关医案,治法上以补肾疏肝为主,预培其损,调畅气机,辅以益气养血、健脾益胃之法,补肾、调肝的同时,兼顾健脾,三法齐驱,使冲任通盛,具有良好的临床疗效。

针刺联合穴位按摩治疗脑卒中后认知障碍肝肾阴虚型疗效观察

目的:观察针刺联合穴位按摩治疗脑卒中后认知障碍(PSCI)肝肾阴虚型的疗效。方法:82例用随机数字表法分为观察组和对照组各41例。对照组用盐酸多奈哌齐治疗,观察组用针刺太溪三阴交联合按摩治疗。结果:观察组总有效率高于对照组(P<0.05),治疗后观察组主症、次症、以及总分低于对照组(P<0.05),观察组认知评估量表(MocA)、正常生活功能评分(BI)高于对照组(P<0.05)。结论:针刺联合穴位按摩治疗PSCI肝肾阴虚型疗效较好。

sTfR、肝脾CT比值与老年非酒精性脂肪性肝病患者轻度认知功能障碍的相关性

目的探讨可溶性转铁蛋白受体(sTfR)、肝脾CT比值与非酒精性脂肪性肝病(NAFLD)患者轻度认知功能(MCI)的相关性。方法回顾性纳入2019年3月5日-2020年3月5日于北京中医药大学东方医院就诊的老年NAFLD患者110例和健康体检者50例,其中老年NAFLD患者蒙特利尔认知功能量表(MoCA)评分<26分定义为MCI组(61例),MoCA≥26分定义为非MCI组(49例),健康体检者为对照组。收集并对比3组的基线资料差异,利用MoCA进行认知功能的评估,进一步采用Pearson相关性分析老年NAFLD患者MoCA评分与上述指标的相关性,然后采用logistic回归分析NAFLD患者MoCA评分<26分(发生MCI)的危险因素。结果左侧NAA/Cr、右侧NAA/Cr、sTfR、肝脾CT比值在对照组、非MCI组、MCI组依次下降,组组比较差异有显著性(P<0.05);BMI≥25、TG、LDL-C、MoCA在对照组和非MCI组中比较差异无显著性(P>0.05),与对照组和非MCI组比较,MCI组BMI≥25、TG、LDL-C明显更高,MoCA明显更低(均P<0.05)。老年NAFLD患者MoCA评分与左侧NAA/Cr、右侧NAA/Cr、sTfR、肝脾CT比值呈正相关,与LDL-C呈负相关(P<0.05)。logistic回归分析显示,sTfR、肝脾CT比值、BMI≥25、TG是老年NAFLD患者发生MCI的危险因素(P<0.05)。结论sTfR、肝脾CT比值是老年NAFLD患者MCI发生的危险因素,二者与其MCI发生均呈正相关。

肿瘤坏死因子-α与支原体抗体滴度对肺炎支原体肺炎患儿肝功能损伤的诊断价值及其危险因素分析

目的分析肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)与支原体抗体滴度对肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)患儿肝功能损伤的诊断价值及其发生肝功能损伤的危险因素。方法回顾性分析2021年2月至2022年4月新余市人民医院收治的80例MPP患儿的临床资料,根据是否发生肝功能损伤分为观察组(发生肝功能损伤,n=22)与对照组(未发生肝功能损伤,n=58)。采用单因素及多因素Logistic回归分析MPP患儿发生肝功能损伤的影响因素,并通过绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)分析TNF-α、支原体抗体滴度对MPP患儿肝功能损伤的诊断价值。结果两组年龄、性别、肺不张、胸腔积液情况比较差异无统计学意义;两组TNF-α水平、支原体抗体滴度、肺实变、乳酸脱氢酶(lactate dehydrogenase,LDH)水平、C反应蛋白(C-reactive protein,CRP)水平、维生素A水平、大环内酯类抗生素使用时间、联用抗菌药物种类、糖皮质激素使用情况比较差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,TNF-α水平较高、支原体抗体滴度(>1∶640)、肺实变、LDH(≥120 U/L)、CRP(≥5 mg/L)、维生素A(<0.20 mg/L)、大环内酯类抗生素使用时间(≥7 d)、联用抗菌药物种类(≥2种)是MPP患儿发生肝功能损伤的独立危险因素(P<0.05),而使用糖皮质激素是MPP患儿发生肝功能损伤的保护因素(P<0.05)。TNF-α诊断MPP患儿发生肝功能损伤的AUC为0.761(95%CI:0.653~0.849),灵敏度为68.18%,特异度为74.14%,截断值为>27.81 ng/L;支原体抗体滴度诊断MPP患儿发生肝功能损伤的AUC为0.718(95%CI:0.607~0.813),灵敏度为63.64%,特异度为75.86%,截断值为>1∶640,均具有一定诊断价值。结论TNF-α水平较高、支原体抗体滴度(>1∶640)、肺实变、LDH(≥120 U/L)、CRP(≥5 mg/L)、维生素A(<0.20 mg/L)、大环内酯类抗生素使用时间(≥7 d)、联用抗菌药物种类(≥2种)是影响MPP患儿并发肝功能损伤的独立危险因素,而使用糖皮质激素是影响MPP患儿并发肝功能损伤的保护性因素,临床应及时识别上述危险因素,并通过检测TNF-α、支原体抗体滴度辅助诊断,及时给予针对性治疗与干预,加快患儿预后转归。

运用“滋补肝肾”法联合醒脑开窍针刺法治疗卒中后轻度认知障碍经验总结

探讨总结从“滋补肝肾”“标本兼顾”角度治卒中后轻度认知障碍的临床经验。通过分析黔西南州中医院李发荣主任医师运用滋补肝肾法(左归丸加减)治疗卒中后轻度认知障碍(肝肾不足证)的临床医案,查阅相关文献,与李发荣医师交流探讨,总结出从“肝肾同源”“标本兼顾”角度出发运用左归丸加减联合醒脑开窍针刺法治疗卒中后轻度认知障碍的辨证思路和用药规律。研究发现,左归丸通过补益气血、滋补肝肾、育阴涵阳使肝血肾精得以充盈于脑,再联合醒脑开窍针刺法醒神开窍,达到“标本兼顾”目的,从“肝肾同源”“肾主骨,生髓,通于脑”“标本兼顾”角度论治卒中后轻度认知功能障碍切入点开拓了该病治疗的新思路。

Advances in hepatitis C therapy: What is the current state-what come's next?

Chronic hepatitis C virus(HCV) infection affects 80-160 million people worldwide and is one of the leading causes of chronic liver disease.It is only a few years ago that standard treatment regimes were based on pegylated interferon alpha and ribavirin.However,treatment of HCV has undergone a revolutionary change in recent years.The admission of the nucleotide polymerase inhibitor Sofosbuvir enabled an interferon-free regimen with direct antiviral agents(DAA).Meanwhile seven DAAs are available and can be applied in several combinations for 8 to 24 wk depending on HCV genotype and patient characteristics such as cirrhosis and chronic renal failure.High rates of sustained virological response(SVR) rates can be achieved with these novel drugs.Even in difficult to treat populations such as patients with liver cirrhosis,HCV-human immunodeficiency virus co-infections,after liver transplantion,or with chronic kidney disease comparable high rates of SVR can be achieved.The anticipated 2nd generation DAAs are strikingly effective in patients so far classified as difficult to treat including decompensated liver cirrhosis or posttransplant patients.These 2nd generations DAAs will have higher resistance barriers,higher antiviral effects and a pan-genotypic spectrum.This review highlights the current state of the art of antiviral treatment in hepatitis Cand gives an outlook for upcoming therapies.

Cirrhotic cardiomyopathy:Isn't stress evaluation alwaysrequired for the diagnosis?

AIM:To describe the proportion of patients with cirrhotic cardiomyopathy(CCM) evaluated by stress echocardiography and investigating its association with the severity of liver disease.METHODS:A cross-sectional study was conducted.Cirrhotic patients without risk factors for cardiovascular disease were included.Data regarding etiology and severity of liver disease(Child-Pugh score and model for end-stage liver disease),presence of ascites and gastroesophageal varices,pro-brain natriuretic peptide(proBNP) and corrected QT(QTc) interval were collected.Dobutamine stress echocardiography(conventional and tissue Doppler imaging) was performed.CCM was considered present when diastolic and/or systolic dysfunction was diagnosed at rest or after pharmacological stress.Therapy interfering with cardiovascular system was suspended 24 h before the examination.RESULTS:Twenty-six patients were analyzed,17(65.4%) Child-Pugh A,mean model for end-stage liver disease(MELD) score of 8.7.The global proportion of patients with CCM was 61.5%.At rest,only 2(7.7%)patients had diastolic dysfunction and none of the patients had systolic dysfunction.Dobutamine stress echocardiography revealed the presence of diastolic dysfunction in more 6(23.1%) patients and of systolic dysfunction in 10(38.5%) patients.QTc interval prolongation was observed in 68.8%of the patients and increased pro-BNP levels in 31.2%of them.There was no association between the presence of CCM and liver impairment assessed by Child-Pugh score or MELD(P= 0.775,P= 0.532,respectively).Patients with QTc interval prolongation had a significant higher rate of gastroesophageal varices comparing with those without QTc interval prolongation(95.0%vs 50.0%,P= 0.028).CONCLUSION:CCM is a frequent complication of cirrhosis that is independent of liver impairment.Stress evaluation should always be performed,otherwise it will remain an underdiagnosed condition.

Should people with chronic liver diseases be vaccinated against COVID-19?

Hepatic impairment in coronavirus disease 2019(COVID-19)may derive from cholangiocyte damage in the beginning,but not from direct infection of hepatocytes.Chronic liver disease patients co-infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)exhibited overexpression of angiotensin-converting enzyme 2 receptors and overwhelming cytokine storm.Consensus has been reached that we should encourage as many people as possible to be vaccinated in order to achieve herd immunity.SARS-CoV-2 vaccines can prevent or alleviate severe infection and cytokine storm.It is recommended that all adult patients with chronic liver diseases and liver transplant recipients should receive COVID-19 vaccines using the standard dose and schedule.Data is not yet sufficient to compare the efficacy of different types of vaccines used in chronic liver disease patients.

基于“长期负性情绪积累肝失疏泄加速脑老化进程”假说的创新性研究

七情内伤是中医病因学的重要命题。针对脑老化过速这一亟待解决的社会问题,课题组提出“长期负性情绪积累肝失疏泄加速脑老化进程”假说。首先创建间接电击法长期负性情绪应激大鼠模型,创制愤怒情绪诱发影片;而后分别从动物实验、病例对照和正常人群角度揭示无论单一负性情绪(愤怒)还是复合负性情绪长期积累均可加速脑老化进程及其机制;并且找到中医肝疏泄太过与不及可能的生物学基础,深化了对肝藏象证候及生理功能个体差异的认识;最后借助事件相关电位(ERPs)、功能磁共振成像(fMRI)等技术发现长期肝气郁结的轻度认知功能障碍(MCI)患者潜在的客观诊断指标及疏肝法确能改善患者认知功能,并揭示其疗效机制。上述研究有利于弥补目前国内外在靶情绪诱发方面存在的缺陷,完善脑老化过速的中医病因病机理论,为肝疏泄失常诱发疾病的早期预警提供可能的生物学指标,并为MCI的早期筛查、诊断和治疗提供借鉴。

糖异平对糖耐量减低合并非酒精性脂肪肝大鼠氧化应激及炎症因子表达的影响

目的 观察糖异平对糖耐量减低(IGT)合并非酒精性脂肪肝(NAFLD)大鼠氧化应激及炎症因子表达的影响。方法 将40只大鼠随机分为对照组(n=10)以及实验组(n=30)。对照组给予正常饮食,实验组通过高糖、高脂饮食培养IGT合并NAFLD模型的大鼠,8周后选取20只实验组模成功大鼠根据随机分配原则分为成模型组(n=10)及治疗组(n=10)。对照组及模型型组均给予生理盐水灌胃,治疗组给予中药糖异平灌胃。药物干预4周后,比较各组大鼠血清中血糖水平[空腹血糖(FBG)、餐后2 h血糖(2 hPG)]、血脂水平[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)]、炎症因子水平[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和白细胞介素1β(IL-1β)]以及氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽(GSH)]。取出大鼠肝脏称重后再行HE染色,光镜下观察大鼠的肝脏组织病理情况。结果 与模型组相比,糖异平治疗组可以有效降低大鼠血糖、血脂及炎症因子水平,并改善氧化应激反应,差异有统计学意义(P <0.05)。结论 糖异平可能通过下调大鼠炎症因子IL-6、TNF-α以及IL-1β的表达,来改善氧化应激反应,从而对IGT合并NAFLD起到治疗作用。