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目的:探讨氧自由基和脂质过氧化损伤在乙型肝炎不同病理阶段及发病机理中的意义.方法:测定乙型肝炎后肝硬化、急性乙型肝炎、重型乙型肝炎患者血清中总超氧化物歧化酶(T—SOD)、谷胱甘肽过氧化物酶(GSH—PX)、黄嘌呤氧化酶(XOD)、丙二醛(MDA)的含量变化,并做统计学分析.结果:乙型肝炎后肝硬化、急性乙型肝炎、重型乙型肝炎患者血清中T-SOD(1.50±0.50,2.50±1.33,3.50±1.17nkat/L)活性明显低于正常对照组(7.33±0.67nkat/L)(P<0.01);各组患者血清中GSH-PX(乙型肝炎后肝硬化组0.78±0.34,急性乙型肝炎组1.17±0.65,重型乙型肝炎组2.25±0.94μkat/L)与正常组(3.20±0.45μkat/L)比较,活性明显明显降低(P<0.01).而乙型肝炎后肝硬化、急性乙型肝炎、重型乙型肝炎患者血清中XOD(199.21±47.34,261.72±59.68,361.74±3.67nkat/L)含量明显高于正常对照组(137.15±9.67nkat/L)(P<0.01);MDA的含量(乙型肝炎后肝硬化组9.90±3.43,急性乙型肝炎组16.41±7.74,重型乙型肝炎组56.24±15.26μmol/L),也明显高于正常对照组(3.65±2.18μmol/L)(P<0.01).结论:乙型病毒性肝炎患者存在严重的脂质过氧化损伤,而不同病理阶段脂质过氧化损伤的程度有明显的区别;血清中T—SOD、GSH-PX、XOD、MDA含量的水平是肝细胞损伤的重要指标之一.
Objective: To investigate the significance of oxygen free radicals and lipid peroxidation in different pathological stages of hepatitis B and its pathogenesis.Methods: The total serum levels of hepatitis B cirrhosis, acute hepatitis B and severe hepatitis B (SOD), glutathione peroxidase (GSH-PX), xanthine oxidase (XOD) and malondialdehyde (MDA) Serum levels of T-SOD (1.50 ± 0.50, 2.50 ± 1.33, 3.50 ± 1.17nkat / L) in patients with post-hepatitis B cirrhosis, acute hepatitis B and severe hepatitis B were significantly lower than those in the normal controls (7.33 ± 0.67nkat /L)(P<0.01). Serum levels of GSH-PX (0.78 ± 0.34 in patients with post-hepatitis B cirrhosis, 1.17 ± 0.65 in patients with acute hepatitis B and 2.25 ± 0.94μ kat / L in patients with severe hepatitis B) Compared with the normal group (3.20 ± 0.45μkat / L), the activity was significantly decreased (P <0.01), while the serum XOD in patients with posthepatitic cirrhosis, acute hepatitis B and severe hepatitis B was (199.21 ± 47.34, 261.72 ± 59.68, 361.74 ± 3.67nkat / L) was significantly higher than that of the normal control group (137.15 ± 9.67nkat / L) (P <0.01); the content of MDA (Hepatic cirrhosis group 9.90 ± 3.43, 16.41 ± 7.74 in acute hepatitis B group and 56.24 ± 15.26μmol / L in severe hepatitis B group), and also significantly higher than that in normal control group (3.65 ± 2.18μmol / L) (P <0.01) .Conclusion: Serum lipid levels of T-SOD, GSH-PX, XOD, and MDA were significantly higher in patients with viral hepatitis than those in patients with viral hepatitis One of the important indicators.