甘氨酸治疗慢性肝炎临床疗效观察及其机制分析.docxVIP

甘氨酸治疗慢性肝炎临床疗效观察 及其机制研究 研究生：黄彤 导师：赵龙凤教授 摘要 目的：探讨甘氨酸治疗慢性肝炎临床疗效及其机制。 方法：第一部分：48例慢性乙型肝炎（中度）患者随机分组，治疗组与 对照组各24例。对照组给予基础治疗，治疗组在此基础上加用甘氨酸。 治疗期间，观察患者症状、体征及肝功能各项指标（ALT、AST、TBiL、 PA）、ET、TNF-a和IL-6,并进行疗效评定。第二部分:采用复合因素 建立慢性肝损伤动物模型的同时, 实验组用含5%甘氨酸的食物喂养大 鼠。於实验的4 8周末在无菌无热源条件下采大鼠腹主动脉血, 整批检测ET、TNF-a 并以逆转录多聚酶链反应（RT-PCR）检测大鼠肝 显差异;（2） 显差异; （2）两组比较: 治疗组AST、ET、TNF- a、IL-6下降及PA上升 组织受体CD14mRNA的表达。 结果：第一部分：⑴治疗组服用甘氨酸4周末，用药前后比较各项指 标均有明显好转（PC0.05）,而对照组治疗前后各项指标比较，除ALT 比-6均无明和 PA 有显著改善（P0?05）外，AST、TBiL、ET 比-6均无明 均显著优于对照组（P〈0.05）° ALT和TBiL虽降幅优于对照组，但无显 62. 50%和 29. 17%(P0. 05),总有效率分别为 95. 83%和 66. 67%(P0. 05)； (4)相关分析：ET与ALT、AST、TBiL、TNF—a、IL-6皆呈明显正相关, 与PA呈显著负相关。第二部分：⑴ 大鼠血浆ET和TNF-a在8周末甘 氨酸治疗组虽高于正常组(P0.05),但均明显低于8周末慢肝组 (P0?05)。4周末甘氨酸治疗组与慢肝组间比较变化不明显；(2) CD。 niRNA的表达在8周末甘氨酸治疗组较4、8周末慢肝组明显减弱。 结论：⑴甘氨酸能够直接保护肝细胞并显著降低慢性肝病血浆ET、TNF- a及IL-6水平；⑵ 甘氨酸能阻断内毒素受体CD?抑制内毒素发挥其 生物效应，使肝细胞的炎症及坏死程度明显减轻，因而能够显著改善肝 功能，具有保肝、降酶、退黄作用。 关键词：甘氨酸；慢性肝病: Research of Glycine in The Treatment ofChronic Hepatic Diseases And If s Mechanism Postgraduater: Huang Tong Tutor: Zhao Long-Feng Professor Abstract Objective : The research of glycine on chronic hepatic diseases and ifs mechanism. Methods : Part I : 48 patients with chronic hepatic disease were equally divided into 2 groups. Among them ,24 patients were given basic treatment as control group. 24 patients were treated to basic medicine and glycine as therapy group. Clinical study has been analyzed. The plasma has been collected for measure of ALT, AST, TBiL, PA, ET ,TNF? a and IL-6 levels, etc. Part II: The chronic liver diseases model of wistar rats was established by complex pathogens which have been fed with control diet and treatment group which have been fed with control diet adding 5% glycine at the same time. The samples has been tdkcn on 4 and 8 weeks end. Hepatic tissue has been collected for measure the expression of CD14mRNA by reverse transcriptase-Polymerase chain reaction (RT-PCR). Results : Part I :⑴ All data showed that the therapy group get significantly improved aft