慢性乙型肝炎高胆红素血症患者氧化损伤的研究

目的探讨慢性乙型肝炎（CHB）高胆红素血症患者氧化损伤的情况。方法75例血清总胆红素（TBIL）高于正常上限值（ULN）的CHB患者，按TBIL为ULN的倍数分为A、B、C、D、E五组。测定患者血清丙二醛（MDA）、黄嘌呤氧化酶（XOD）、维生素C（VC）、维生素E（VE）浓度，并做出统计分析。11例健康志愿者为正常对照组，16例乙肝表面抗原（HBsAg）携带者为携带者组。结果各患者组与正常对照组比较：MDA、XOD浓度升高，差异有统计学意义（P〈0．05），VCVE浓度降低，差异有统计学意义（P〈0．05）；携带者组与正常对照组比较：XOD浓度升高，差异有统计学意义（P〈0．05），MDA、VC、VE浓度差异无统计学意义（P〉0．05）。在CHB高胆红素血症患者中，MDA、XOD浓度与TBIL水平呈正相关（r=0．670，P〈0．01；r=0．737，P〈0．01）；VC、VE浓度与TBIL水平呈负相关（r=-0．463，P〈0．01；r=-0．247，P〈0．05）。各患者组间的比较：除A、B组间外，其余各组间MDA浓度差异有统计学意义（P〈0．05）；A、B、C组与D、E组间XOD浓度差异有统计学意义（P〈0．05）；A组与D、E组，B、C、D组与E组间VC浓度差异有统计学意义（P〈0．05）；A、B组与E组间VE浓度差异有统计学意义（P〈0．05）。结论CHB高胆红素血症患者体内存在氧化-抗氧化功能障碍，血清TBIL水平升高时氧化损伤程度加重。HBsAg携带者体内氧化损伤程度不高。抗氧化损伤可能有助于CHB高胆红素血症患者的治疗。

Study of oxidative stress in chronic hepatitis B patients with elevated serum total bilirubin

Objective To investigate oxidative stress in chronic hepatitis B(CHB) patients with elevated serum total bilirubin(TBIL).Methods 75 CHB patients with elevated serum TBIL were enrolled in the present study.A,B,C,D and E group were defined.Serum Malondialdehyde (MDA),Xanthine Oxidase(XOD),VitaminC (V_C) and VitaminE (V_E) were determined.The control group contained 11 healthy donors and the carrier group contained 16 Hepatitis B surface antigen (HBsAg) carriers.Results The concentrations of MDA and XOD were significantly higher in each group of patients than in the control (P＜0.05),while V_C and V_E were significantly lower (P＜0.05).The concentration of XOD was significantly higher in the carrier group than in the control (P＜0.05),while MDA,V_C and V_E were not significantly different (P＞0.05).The concentrations of MDA and XOD were significandy positively correlated with TBIL (r=0.670,P＜0.01;r=0.737,P＜0.01,respectively) in the patients,while V_C and V_E were significantly negatively correlated with TBIL (r=-0.463,P＜0.01;r=-0.247,P＜0.05,respectively).The concentration of MDA was significantly different among all the groups in the patients except the comparison between group A and group B.The concentration of XOD was significantly different between group A,B,C and group D,E (P＜0.05).The concentration of V_C was significantly different between group A and group D,E and between group B,C,D and group E (P＜0.05).The concentration of V_E was significantly different between group A,B and group E (P＜0.05).Conclusion There was a disturbance between oxidative stress and anti-oxidative ability in CHB patients with elevated serum TBIL.Oxidative stress became more serious along with the increasing of serum TBIL.In HBsAg carriers,oxidative stress level was low.The results suggest antioxidant treatment for CHB patients with elevated serum TBIL may help to improve the effect of therapy.