Objective To explore the regulating mechanism of hepatic injury in obstructive jaundice (OJ). Methods①Rat hepatocytes were isolated by in situ collagenase perfusion and primary culture. Hepatocytes were pretreated with various concentrations of protein kinase C (PKC) agonist parsmeae (PMA) and inhibitor chelerythrine for 20 min. After pretreatment, 50 μmol/L glycochenodeoxycholate (GCDC) was added. Cells were next detected by FCM and TUNEL.②Experimental obstructive jaundice was induced by double ligation of the bile duct (BDL), BDL for 3, 7, 14, 21days.We detected apoptotic status in liver with TUNEL and PKC protein in liver with immunohistochemistry method. Results①PMA increased GCDCinduced apoptosis and chelerythrine decreased GCDCinduced apoptosis in a concentrationdependent manner. ②The apoptotic rate of liver was related to time of OJ. Apoptosis index (AI) was the highest in 14day bile duct ligation. The ber PKC expression, the more number of apoptotic cells in OJ.Conclusion PKC takes part in the regulation and the occurrence and progression of hepatic injury in OJ.
ObjectiveTo evaluate the effect of polymorphonuclear neutrophils (PMN) on liver damage in acute pancreatitis. MethodsSeventytwo wistar rats were randomly divided into acute pancreatitis (AP) group, acute pancreatitis with PMN depleted (APD) group and sham operation (SO) group. Liver damage was assessed by histological changes and the level of alanine aminotransferase (ALT) in serum. The number of PMN infiltration in liver was reflected by myeloperoxidase (MPO). ResultsMPO significantly increased from 6 to 24 hours in AP and APD groups. However, the level of MPO was significantly higher in AP group than that in APD group. ALT significantly increased from 3 to 24 hours in these two groups, but the level of ALT was significantly lower in APD group than that in AP group. Meanwhile, the hepatic pathological changes were more severe in AP group than that in APD group. ConclusionPMN play an important role in liver damage during acute pancreatitis.
The mumber of Polymorphonuclear leukocyte (PMN) in hepatic tissue increased in the rats with cholangitis, PMN infiltration was mainly in the hepatic sinus in the early stage; and PMN infiltration presented around the hepatocytes 12 hours after infection. Degeneration and necrosis of the hepatic cells was also observed in the rats with acute cholangitis. Only 40 percent of the rats survived 24 hours after infection. Depletion of circulating PMN decreased the damage and necrosis of hepatocytes and improving the survival rate of the infected rats. The results suggest that PMN infiltration plays an important role in hepatic damage in acute cholangitis.
目的 总结甲状腺功能亢进性肝功能损害 （ HLI ） 的临床特点和治疗方案。 方法 对2008年1月－2010年12月诊治的49例HLI患者临床资料进行回顾性总结分析，据其治疗方案的不同分抗甲状腺治疗组和单纯保肝治疗组，比较二组患者治疗后肝功能恢复情况。 结果 所有患者入院时均存在不明原因肝功能不全，而后明确为HLI。其中女29例（59.2%），男20例（40.8%），年龄10～70岁，平均45岁。 症状主要表现为体重下降（65.3%），心悸（51.1%），怕热多汗（49.0%）， 厌油纳差、食欲减退 （44.9%）。主要体征包括甲状腺肿大（36.7%），双下肢水肿（24.5%），心界扩大（16.3%），皮肤巩膜黄染（14.3%），肝脾肿大（12.2%）等。肝功能检验异常主要表现为谷丙转氨酶升高（68.9％），谷草转氨酶升高（57.8％）为主，其次是谷氨酰转移酶（69.4%）、直接胆红素（59.2%）、总胆红素（44.9%）、碱性磷酸酶（42.9%）、乳酸脱氢酶（26.5%）升高，以及白蛋白（32.7%）下降。死亡3例，病死率6.1%。采用Wilcoxon秩和检验结果提示抗甲状腺治疗组的总胆红素和直接胆红素低于单纯保肝治疗组，组间差异有统计学意义（P＜0.05）。 结论 此类患者可同时具备甲状腺功能亢进和肝功能不全的临床表现，肝功能常表现为淤胆型肝炎。HLI总体预后较好，抗甲状腺治疗是该病的关键。
目的 总结甲状腺功能亢进症（甲亢）并肝损害的临床特征与治疗转归。 方法 回顾性分析2009年6月－2010年6月入院诊治的119例甲亢并肝损害患者（肝损害组）的临床特点与治疗转归资料，并与同期247例甲亢不伴有肝损害患者（无肝损害组）作比较。 结果 肝损害组占同期甲亢患者的30.4%，其中108例（90.8%）无明显肝损害的临床表现，以丙氨酸氨基转移酶和天门冬酸氨基转移酶升高为主，多为轻、中度升高；患者高代谢症候群、突眼、甲状腺肿大发生率及肿大程度明显高于无肝损害组，心率明显快于无肝损害组，血清游离三碘甲状腺原氨酸、游离甲状腺素及吸131I率明显高于无肝损害组，而体质量指数则明显低于无肝损害组（P＜0.05）。两组性别、年龄、病程、甲亢类型、甲状腺球蛋白抗体及甲状腺微粒体抗体滴度差异无统计学意义（P＞0.05）。肝损害组患者随访18个月以上，101例131I治疗患者随着甲亢控制，肝功能恢复正常，未见有再发肝损害；18例抗甲状腺药物治疗，其中10例随着甲亢控制，肝功能逐渐恢复正常；8例随着甲亢控制，肝功能逐渐恢复正常，但随着甲亢复发，再出现肝功能损害。 结论 肝损害是甲亢的常见并发症之一，其肝损害症状较轻，多数患者不典型，但并随甲亢病情较重。护肝治疗结合恰当的抗甲亢治疗预后良好。
目的:比较伴或不伴高脂血症的系统性红斑狼疮(SLE)患者的狼疮性肝损害的构成比例,了解高脂血症与狼疮性肝损害的相关性。方法:收集SLE患者100例,根据高脂血症和狼疮性肝损害的诊断标准,将患者分为高脂血症组,非高脂血症组和肝损害组,非肝损害组,收集其相关临床数据进行比较分析。结果:1高脂血症组发生肝损害的比例高于非高脂血症组(χ2=9.908,P=0.002);2血脂水平中甘油三酯与γGT(r=0366,P=0.000),碱性磷酸酶(r=0.241,P=0.018),强的松剂量(r=0.31,P=0.006),24h尿蛋白定量(r=0.273,P=0.007)相关;TC与24h尿蛋白定量(r=0.273,P=0.007)相关;HDL与γ谷氨酸转肽酶(r=0.233,P=0.022),碱性磷酸酶(r=0.265,P=0.009)相关;3-SLE活动组出现高脂血症的比例高于非活动组(χ2=6.986,P=0.008)。结论:长期的高脂血症可导致或加重SLE患者肝功能损害,高脂血症是狼疮性肝损害的危险因素之一。
摘要:目的:探讨系统性红斑狼疮（SLE）肝损害的临床特点、肝损害发生率与SLE的病情严重程度的关系。方法:对98例SLE的临床资料进行分析,收集所有研究对象的临床资料,对肝损害组(30例)的症状与体征、病情程度、肝功能指标、影像学检查结果进行数据分析,并将其部分生化及免疫学指标与无肝损害组(68对照组)进行比较。结果:SLE患者中SLE肝损害的发生率为30.61%。肝损害组中,病情重度16例(53.33%),17例患者(56.67%)无明显自觉症状,以ALT、AST轻中度升高为主。7例患者肝脏B超异常。肝损害组患者的白细胞值明显低与无肝损害组(Plt;0.05)。而2组的血红蛋白、血小板、CRP、ESR、抗核抗体、抗dsDNA抗体、IgG、补体3等比较差异均无统计学意义(P均gt;0.05)。11例患者接受肾上腺皮质激素(激素)、免疫抑制剂(环磷酰胺、甲氨蝶呤)等药物治疗,9例在出院时复查肝功能正常或好转,另2例肝功能无明显改善;19例患者在接受激素、免疫抑制剂治疗的同时,给予护肝治疗,15例出院复查肝功能正常或好转,另4例无明显改善。而对照组68例中病情重度8例(11.76%)。结论:肝脏是SLE常见累及的靶器官之一,SLE肝损害的临床表现缺乏特异性,以轻至中度肝细胞损害多见,肝损害发生率与SLE病情严重程度成正相关、与SLE的近期预后无关、与长期预后有待进一步研究。Abstract: Objective: To discuss the relationship between the clinical characteristic, The incidence of liver damage and the severity of SLE. Methods: Carries on the mathematical analysis to 98 example SLE clinical material, the collection all object of study clinical material, to liver harm group (30 examples) the symptom and the symptom，Severity the liver function target， the phantom study inspection result carries on the mathematical analysis, and (68 control groups) carries on its part of biochemistry and the immunology target with the nonliver harm group the comparison.Results: In the SLE patient the SLE liver harms the formation rate is 30.61%.In liver harm group, severe illness in 16 cases (53.33%), 17 example patient (56.67%) not obvious subjective symptom, by ALT, AST light moderate ascension primarily.7 example patient liver B ultra exceptionally.The liver harm group patient’s white blood cell value is lower than the nonliver harm group obviously (Plt;0.05), but 2 groups of hemoglobins, the blood platelet, CRP, ESR, the antinuclear immune body, the antidsDNA immune body, IgG, the complement 3 and so on the comparison differences do not have statistics significance (Pgt;0.05). 11 example patients accept the adrenal cortex hormone (hormone), the immunity inhibitor (endoxan, armor ammonia pterin) and so on the medicine treatments, 9 examples when out of hospital reexamines the liver function normal or the change for the better, another 2 example liver function improves not obviously; 19 example patients while accept the hormone, immunity inhibitor treatment, gives protects the liver treatment, 15 example out of hospital reexamination liver function normal or change for the better, another 4 examples improve not obviously. While the control group, 68 cases of severe illness in 8 cases (11.76%).Conclusion: The liver is one of target organs which SLE implicates common, the SLE liver harm. the clinical manifestation lacks the specificity, by sees lightly to the moderate liver cell harm,The incidence of liver damage and SLE severity is positively correlated with shortterm prognosis of SLE has nothing to do with the longterm prognosis remains to be further studied.
ObjectiveTo describe the current situation of the prevalence of hepatic hydatidosis, analyze the clinical characteristics and treatment method of the disease, in order to provide scientific basis for personal treatment plans of hepatic hydatidosis. MethodThe clinical data of 121 patients with recurrent hepatic hydatidosis treated between July 2006 and December 2013 were analyzed retrospectively. The general information of hydatid disease of liver, mass of liver, clinical manifestations, laboratory test results, treatment method, effectiveness of the treatment during hospitalization, and follow-up results were collected and analyzed. ResultsMost of the patients were adults from Sichuan and Tibet, and the majority of them had no clear occupation or clear animal contact history and had not taken raw or fresh meat. Lesions in the right lobe occurred in 87 cases, accounting for 71.90%. Abdominal pain and distension were the main clinical manifestations. Twenty-five (20.66%) of these patients were associated with hepatic dysfunction, among whom 23 patients had mild hepatic dysfunction. Alpha-fetoprotein level was increased in one (0.83%) of these cases. A total of 119 of the 121 patients received surgical treatment (98.35%) and all the surgeries were successful. Follow-up results revealed that three of the patients had recurrence. ConclusionsHepatic hydatidosis is an epidemic mainly in the Tibetan district of the West of China. The disease mainly occurs in the right lobe of the liver, which mainly causes mile liver damage. Hepatocellular carcinoma has not been found in these cases. Surgery treatment is the main therapy for liver hydatidosis and may result in good effectiveness.
ObjectiveTo investigate the significance of carbohydrate antigen 199 (CA199), alanine aminotransferase (ALT), gamma-glutamyl transferase (γ-GT) levels in the diagnosis of liver damage caused by hyperthyroidism. MethodA total of 106 patients confirmed to have hyperthyroid liver damage between February 2012 and February 2014 were selected to form the hyperthyroidism liver injury group (group A). Ninety-five hyperthyroidism patients without liver damage were regarded as the hyperthyroidism without liver injury group (group B). In the same period, 72 healthy subjects were designated to form the control group (group C). Automatic chemiluminescence detector was used to determine free triiodothyronine, free thyroid hormone and CA199, and automatic biochemical analyzer was adopted to measure the levels of γ-GT and ALT. Then we performed the statistical analysis. ResultsThe levels of serum CA199, γ-GT and ALT in group A were significantly higher than those in group B and group C, and the differences were statistically significant (P<0.05). CA199 and γ-GT levels in group B were significantly higher than those in group C (P<0.05). The area under the receiver operating characteristic curve for CA199, γ-GT, ALT was respectively 0.840, 0.895, and 0.818, the maximum Youden indexes were 0.593, 0.703, and 0.578, with the corresponding critical values 37.25 U/mL, 60.81 U/L, and 43.14 U/L, respectively. The parallel dectection of the three indexes improved Youden index to 0.763. ConclusionsCA199, γ-GT and ALT as diagnosis indexes of hyperthyroidism liver damage have good diagnostic value, and combined detection of the three indexes is more favorable for early diagnosis and prediction.