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The effect of low iron loads on Nonalcoholic Steatohepatitis in rats
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摘要: 目的研究非酒精性脂肪性肝炎(NASH)大鼠肝铁负荷的变化及低铁负荷对大鼠NASH的影响。方法SD雄性大鼠随机分为4组:正常对照组1、低铁对照组2、模型组3、低铁模型组4。实验的12周末观察血清胆固醇(TG)、甘油三酯(TC)、转氨酶(ALTAST)、血清铁(SI)、过氧化物歧化酶(SOD)、丙二醛(MDA)的含量以及肝匀浆铁、TG、TC、SOD、MDA的含量,观察肝组织病理学改变的特点。结果与正常对照组相比,模型组血清TG、TC、ALT、AST、MDA的含量明显升高,SOD的含量明显降低,血清铁含量升高不明显;肝匀浆TG、TC、ALT、AST、MDA及铁的含量明显升高,肝匀浆SOD的含量明显降低。与模型组相比,低铁模型组血清TG、TC、ALT、AST、SI、MDA含量明显降低,SOD的含量明显升高;肝匀浆TG、TC、SI、MDA含量明显降低,SOD含量明显升高。肝脏病理学切片示:模型组大鼠肝小叶内脂滴比率大于三分之一,造模成功,低铁模型组大鼠肝脏的炎症活动度计分及铁染色计分明显低于模型组。结论NASH大鼠肝脏铁负荷增加,低铁负荷可以减轻大鼠NASH的损伤程度。Abstract: Objective To study the significance of low liver iron load in the pathogenesis of Nonalcoholic steatohepatitis (NASH) in rats.Methods SD rats were randomly divided in to 4 groups:group 1 (control group) , group 2 (low liver iron load) , group 3 (model group) and group 4 (low liver iron load) .The levels of TG, TC, ALT, AST, SI, SOD and MDA in the serum and liver were measured after 12 weeks.Liver histopathologic change was observed.Results The serum levels of TG, TC, ALT, AST and MDA in group 3 were significantly higher than the control group.The serum SOD in group 3 was significantly lower than the control.There was no significant difference in SI between group 3 and the control group.The liver TG, TC, MDA and iron content in group 3 were significantly higher, and SOD was significantly lower than the control group.The serum TG, TC, ALT, AST, MDA and SI in group 4 were significantly lower and serum SOD was significantly higher than those in group 3.The TG, TC, MDA and iron content in the liver were significantly lower than those in group 3.The SOD in the liver of group 4 was significantly higher than those in group 3.The rate of lipid droplet in group 3 was higher.The liver inflammation scores and the iron load in group 4 were significantly lower than those in group 3.Conclusion Iron content highly increases in the liver of NASH rats.Low iron level can lessen the liver damage.
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Key words:
- liver ferrum /
- NASH
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【据Journal of Gastroenterology and Hepatology 2021年1月报道】题：自发性脾肾分流对肝硬化患者长期生存的影响(作者Yi F等)
自发性脾肾分流(SSRS)是肝硬化门静脉高压的表现之一。然而，SSRS对肝硬化患者长期生存的影响尚不清楚。来自北部战区总医院消化内科的Yi等推测SSRS可能通过减少肝血流灌注使肝功能恶化，并增加肝硬化死亡的风险。
研究筛选了于2014年12月—2019年8月连续住院且接受腹部增强CT/MRI检查的肝硬化患者。测量门静脉系血管和SSRS的最大直径，计算肝腹面积比(LAAR)。对所有患者进行随访，最后一次随访日期为2019年8月31日。研究共纳入122例肝硬化患者，其中30.3%发现有SSRS，SSRS患者门静脉右支、门静脉主干最大直径和LAAR评分中位数明显小于无SSRS患者(9 mm vs 11.20 mm、15.30 mm vs 16.80 mm、25.39 vs 31.58，P值分别为0.001、0.017、＜0.001)；SSRS患者Child-Pugh B/C级占比、MELD评分中位数、死亡率明显高于无SSRS患者(62.1% vs 43.5%、12.17 vs 9.79、18.9% vs 4.7%，P值分别为0.026、0.006、0.012)。Kaplan-Meier曲线分析发现，SSRS患者累积生存率明显低于无SSRS患者(P=0.014)。Cox回归分析显示，SSRS是肝硬化患者死亡率增加的危险因素(RR=4.161，95%CI: 1.215~14.255，P=0.023)。
研究表明，肝硬化SSRS患者的门静脉直径更细，肝功能更差，肝体积更小，死亡率更高。
摘译自YI F, GUO X, WANG L, et al. Impact of spontaneous splenorenal shunt on liver volume and long-term survival of liver cirrhosis[J]. J Gastroenterol Hepatol, 2021. [Online ahead of print]. DOI: 10.1111/jgh.15386.
(北部战区总医院消化内科 易芳芳 祁兴顺 报道)
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