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目的分析非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)患者肝组织水通道蛋白(aquaporin,AQPs)3、7、9表达水平对多烯磷脂酰胆碱(plyene posphatidyl coline,PPC)疗效的影响。方法分析2014-2016年本院收治的NAFLD患者87例,按病程分组:肝硬化组(n=30),肝纤维化组(n=24),肝炎组(n=33);超声疗效评估分组:有效组和无效组。随访不同病程的NAFLD患者PPC治疗前后的肝功能酶变化,按照PPC疗效进行分组,比较患者肝组织AQP3、7、9蛋白的表达差异,并进一步分析PPC疗效与AQPs表达水平的相关性。结果 PPC对NAFLD患者治疗整体有效率35.63%,PPC对NAFLD疗效与病程严重程度无关,但与超声的评分密切相关,表现为按照超声评分有效和无效分组的不同病程组患者的谷丙转氨酶(ALT)在PPC治疗后,在每种病程患者中差异有统计学意义,且ALT在PPC治疗后,其变化程度与超声的变化程度呈正相关,肝硬化组(R=0.780,P<0.01),肝纤维化组(R=0.879,P<0.01),肝炎组最高(R=0.900,P<0.01)。PPC治疗NAFLD效果与患者初始的肝组织AQPs的表达存在相关性:NAFLD患者肝组织AQP7、9表达量与肝功能酶的变化量呈正相关(AQP9:R=0.972,AQP7:R=0.537),而AQP3的表达水平与肝功能酶的变化量呈负相关(R=-0.881);AQP7、9表达量与超声评分的变化量呈正相关(AQP9:R=0.763,AQP7:R=0.311),而AQP3的表达水平与肝功能酶的变化量呈负相关(R=-0.795)。结论多烯磷脂酰胆碱对非酒精性脂肪性肝病的疗效与水通道蛋白表达差异密切相关,提示AQPs表达水平可能影响PPC疗效。
Objective To investigate the effect of aquaporin 3, 7 and 9 levels on hepatic plyene posphatidylcholine (PPC) in patients with nonalcoholic fatty liver disease (NAFLD) influences. Methods 87 patients with NAFLD treated in our hospital from 2014 to 2016 were divided into two groups according to the course of disease: cirrhosis group (n = 30), liver fibrosis group (n = 24) and hepatitis group (n = 33) : Valid group and invalid group. The changes of hepatic function enzymes in patients with NAFLD with different course of disease before and after PPC treatment were followed up and grouped according to the therapeutic effect of PPC. The expression of AQP3, 7 and 9 in liver tissues was compared. The correlation between the therapeutic effect of PPC and the expression of AQPs was further analyzed. Results The overall effective rate of PPC in treating NAFLD patients was 35.63%. The effect of PPC on NAFLD was not related to the severity of the disease course, but was closely related to the score of ultrasound. The PTP was significantly correlated with the change of alanine aminotransferase (ALT) in patients with different course of treatment according to ultrasound score ) After PPC treatment, there was a significant difference in the patients of each course of disease, and the degree of change of ALT after PPC treatment was positively correlated with the degree of change of ultrasound. In cirrhosis group (R = 0.780, P <0.01), liver Fibrosis group (R = 0.879, P <0.01), Hepatitis group was the highest (R = 0.900, P <0.01). The correlation between PPC treatment of NAFLD and the expression of AQPs in the initial liver tissue of patients: The expression of AQP7,9 in liver tissue of NAFLD patients was positively correlated with the changes of liver enzymes (AQP9: R = 0.972, AQP7: R = 0.537) The expression of AQP3 was negatively correlated with the change of liver enzymes (R = -0.881). The expression of AQP7,9 was positively correlated with the change of ultrasound score (AQP9: R = 0.763, AQP7: R = 0.311) Negatively correlated with the changes of liver enzymes (R = -0.795). Conclusion The therapeutic effect of polyene phosphatidylcholine on non-alcoholic fatty liver disease is closely related to the difference of aquaporin expression, suggesting that the expression of AQPs may affect the efficacy of PPC.