温肾升阳汤治疗非酒精性脂肪肝35例

笔者从脾肾论治,采用自拟中药温肾升阳汤治疗非酒精性脂肪肝35例,与同期采用脂必妥治疗的35例对照,取得了较满意的疗效.现总结如下:     

降脂清肝汤治疗脂肪肝疗效观察

目的:观察降脂清肝汤治疗脂肪肝的临床疗效。方法:将212例脂肪肝患者随机分为治疗组和对照组,在综合治疗的基础上,治疗组加服降脂清肝汤。3个月为1个疗程,连用2个疗程。结果:治疗组总有效率、临床治愈率、显效率、有效率均高于对照组,经!2检验,有显著性差异(P<0.05)。结论:降脂清肝汤对脂肪肝有较好疗效。     

近似人病理生理过程动物脂肪肝模型的综合建立方法

Objective To establish animal model of fatty liver similar with human pathophysiology used for the study of imaging quantitative diagnosis or verification of medicine curative effect. Methods Forty-five New Zealand white rabbits were used in this study. They were divided randomly into five groups : 10 rabbits in normal control group, 10 rabbits in experiment group 1,10 rabbits in experiment group 2,10 rabbits in experi-ment group 3,and remaining 5 rabbits were in a supplement group. Rabbits in normal control group were given free access to normal food and water for 9 weeks. Rabbits in the experimental groups were fed a high-fat and high-sucrose diet for 3,6,and 12 weeks,respectively. Rabbits in the supplement group were fed the same diet as the experimental groups. Liver specimen stained with HE and Sudan Ⅳ was examined histological. Results The success rate of hepatic steatotie models was 87 % (39 of 45 ) ;mortality was 13 % (6 of 45 ). There were 10 nor-mal livers, 10 mildly fatty livers, 9 moderately fatty livers, and 10 severely fatty livers in results (stained with HE), and the rate of conforming to Sudan Ⅳ was 75%. Conclusion The animal model of fatty liver with differ-ent severity can be established by being fed a high fat, high sucrose and alcohol diet.     

脂联素对体外培养肝细胞乙醛氧化酶1分泌的影响

目的探讨脂联素（Apm）对体外培养人肝脏细胞乙醛氧化酶1（AOX1）分泌的影响。方法采用基因芯片、逆转录．聚合酶链反应（RT-PCR）分析AOX1 mRNA的表达，用免疫印迹试验分析Apm、5-氨基咪唑4-氨基甲酰胺（AICAR）、二甲双胍、非诺贝特酸（FBA）、棕榈酸及瘦素对体外培养细胞分泌AOX1的影响及AOX1在大鼠脂肪肝中的表达情况。结果Apm、FBA能降低人肝细胞中AOX1 mRNA及其蛋白质的水平，而二甲双胍、AICAR、棕榈酸及瘦素对AOX1的表达没有明显影响。FBA能降低AOX1活性达35％，而二甲双胍对其活性基本没有影响。大鼠脂肪肝肝细胞中Apm分泌明显减少，AOX1的表达明显增多。结论AOX1与肝脏脂肪化有关，Apm能抑制体外培养的人肝脏细胞分泌AOX1。     

近似人病理生理过程动物脂肪肝模型的综合建立方法

Objective To establish animal model of fatty liver similar with human pathophysiology used for the study of imaging quantitative diagnosis or verification of medicine curative effect. Methods Forty-five New Zealand white rabbits were used in this study. They were divided randomly into five groups : 10 rabbits in normal control group, 10 rabbits in experiment group 1,10 rabbits in experiment group 2,10 rabbits in experi-ment group 3,and remaining 5 rabbits were in a supplement group. Rabbits in normal control group were given free access to normal food and water for 9 weeks. Rabbits in the experimental groups were fed a high-fat and high-sucrose diet for 3,6,and 12 weeks,respectively. Rabbits in the supplement group were fed the same diet as the experimental groups. Liver specimen stained with HE and Sudan Ⅳ was examined histological. Results The success rate of hepatic steatotie models was 87 % (39 of 45 ) ;mortality was 13 % (6 of 45 ). There were 10 nor-mal livers, 10 mildly fatty livers, 9 moderately fatty livers, and 10 severely fatty livers in results (stained with HE), and the rate of conforming to Sudan Ⅳ was 75%. Conclusion The animal model of fatty liver with differ-ent severity can be established by being fed a high fat, high sucrose and alcohol diet.     

综合干预对单纯性脂肪肝患者治疗效果的影响

目的 运用健康信念模式,探讨采用综合干预措施对单纯性脂肪肝患者治疗效果的影响.方法 将100例单纯性脂肪肝患者随机分为对照组(50例)和实验组(50例).对照组给予常规降脂治疗,实验组在此基础上以健康信念模式作为理论框架,采用综合干预措施,如对疾病的认知,饮食及运动行为干预,电话随访等,1年后比较脂肪肝程度和生化指标.结果 实验组脂肪肝程度、肝功能恢复及血脂下降程度显著优于对照组(P&lt;0.01).结论 综合干预措施能使单纯性脂肪肝患者建立良好的健康生活行为,减低不良生活行为对单纯性脂肪肝患者治疗效果的不利影响.     

高脂饮食对大鼠非酒精性脂肪肝中解偶联蛋白2的诱导作用

背景:至今非酒精性脂肪肝的发病机制不十分清楚,而线粒体膜上的解偶联蛋白可使线粒体氧化磷酸化解偶联,导致线粒体合成ATP效率降低,通过能量代谢的改变,参与脂肪肝的发生。目的:观察解偶联蛋白2在大鼠非酒精性脂肪肝动物模型各时相点的表达规律。设计:随机对照动物实验。单位:解放军第三军医大学大平医院野战外科研究所消化科。材料:实验于2004-11/2005-12在解放军第三军医大学大坪医院野战外科研究所国家重点实验室进行。取清洁级Wistar成年雄性大鼠64只,普通饲料正常喂养1周后,随机分为模型组和正常对照组2组,每组32只,每组又分饲养2,4,8,12周4个时间点,每个时间点8只。方法:模型组大鼠喂高脂饮食(基础饲料88%、猪油10%、胆固醇2%)饲养12周,正常对照组普通饲料喂养,分笼(每笼6只)饲养。主要观察指标:两组于相应时间点麻醉后采血,处死动物,迅速取出肝脏。①免疫组织化学和Westernblot技术检测肝组织中解偶联蛋白2表达变化。②生化检测大鼠血清三酰甘油、游离脂肪酸和丙氨酸氨基转移酶活性。③检测肝组织丙二醛含量。结果:64只大鼠全部进入结果分析。①血清生化指标:模型组饲养4,8,12周时血清三酰甘油、游离脂肪酸和丙氨酸氨基转移酶水平明显高于正常对照组,以8,12周最显著(P<0.01)。②模型组解偶联蛋白2蛋白表达随脂肪肝程度的加重,其表达逐渐增强,而正常对照组几乎阴性表达。③肝组织丙二醛含量:模型组饲养4,8,12周明显高于正常对照组,以8,12周最显著[(4.07±0.15),(4.93±0.14),(5.20±0.20)μmol/g;(3.14±0.20),(3.12±0.18),(3.13±0.16)μmol/g,P<0.01]。结论:随着非酒精性脂肪的形成和程度加重,血清三酰甘油、游离脂肪酸和丙氨酸氨基转移酶及肝组织丙二醛含量增加,解偶联蛋白2表达也逐渐增强,提示高脂饮食可诱导肝细胞表达解偶联蛋白2,使细胞内ATP生成减少,促进脂肪肝的形成和发展。     

左旋卡尼汀治疗非酒精性脂肪肝伴代谢综合征临床观察

目的评价左旋卡尼汀治疗非酒精性脂肪肝（NAFLD）伴代谢综合征（MS）的疗效。方法NAFLD伴MS患者168例,随机均分为2组,治疗组给予左旋卡尼汀口服液1g,3次,d,对照组给予门冬氨酸钾镁片2片,3次／d口服治疗。两组疗程均为24周。结果治疗组和对照组治疗后患者临床症状评分、AST、GGT、B超积分均较治疗前改善（P〈0．05）,对照组ALT较治疗前也有明显下降（P〈0．05）,治疗组ALT下降不明显（P〉0．05）。两组治疗后各指标比较差异均无统计学意义（P值均〉0．05）。治疗组治疗后腹围、血糖、甘油三酯、动脉血压较治疗前有所下降（P〈0．05）,而对照组均无明显变化（P〉0．05）。治疗组和对照组问治疗后腹围、动脉舒张压差异有统计学意义（P值分别为0．025和0．023）。两组均未出现明显不良反应。结论左旋卡尼汀联合饮食、运动等基础治疗可有效改善NAFLD伴有代谢综合征患者的血糖、血脂代谢,降低动脉血压,减轻脂肪肝程度,耐受性较好,不良反应少。     

妊娠急性脂肪肝5例临床分析

妊娠急性脂肪肝(acute fatty liver pregnancy,ADLP)是发生在妊娠晚期的一种严重疾病，起病急而凶险，尽管其发生率低，但所致的母婴病死率高达75％～80％。早期诊断、积极有效的治疗与及时合理的产科处理可明显改善预后，现对我院收治的5例急性脂肪肝患者的临床资料进行回顾性分析，为进一步提高AFLP的诊治水平提供参考。     

邻接点算子二和邻接点算子一分析正常肝与脂肪肝、正常甲状腺与结节性甲状腺肿超声纹理的对比研究

目的：通过邻接点算子二和邻接点算子一的对比研究，验证两算子在超声纹理区分能力上的差别。方法：在完全相同的条件下，用邻接点算子二对邻接点算子一选用的正常肝、脂肪肝、正常甲状腺、结节性甲状腺肿超声纹理资料进行纹理参数测算，对比分析其结果。结果：在正常肝组与脂肪肝组、正常甲状腺组与结节性甲状腺肿组之间，邻接点算子二计算的相对不均匀度（HSR2）都有显著差异（P＜0．01），而且这些差异都大于邻接点算子一测算的差异（P＜0．01）。结论：在区分超声细小纹理，及细小纹理和粗大纹理的分析中，邻接点算子二的确优于邻接点算子一。