【摘 要】
：
目的 探讨细胞角蛋白18(CK18)、内毒素血症在非酒精性脂肪性肝病(NAFLD)发生中的作用,以及肥胖与NAFLD之间存在的关联.方法 将38只大鼠分为正常对照、单纯性脂肪肝(NAFL)、非酒精性脂肪性肝炎(NASH)和单纯性肥胖组.造模成功后,ELISA法检测前3组血清中CK18(M30)片段,自动生物化学仪测定各组血清转氨酶,动态比浊法测定血清内毒素水平,ELISA检测血清IL-18,RT-
【机 构】
：
710000 西安交通大学医学院第二附属医院消化内科
【出 处】
：
The 14th Congress of Gastroenterology China(第十四届全国消化系病学术会议)
论文部分内容阅读
目的 探讨细胞角蛋白18(CK18)、内毒素血症在非酒精性脂肪性肝病(NAFLD)发生中的作用,以及肥胖与NAFLD之间存在的关联.方法 将38只大鼠分为正常对照、单纯性脂肪肝(NAFL)、非酒精性脂肪性肝炎(NASH)和单纯性肥胖组.造模成功后,ELISA法检测前3组血清中CK18(M30)片段,自动生物化学仪测定各组血清转氨酶,动态比浊法测定血清内毒素水平,ELISA检测血清IL-18,RT-PCR分析肠道粪便中肠道菌群的改变,取肝脏和末端回肠标本HE染色,光学显微镜下观察病理学变化.结果 NASH组大鼠血清中CK-18(M30)显著高于正常对照组和NAFL组,而NAFL组与正常对照组差异无统计学意义.CK-18片段与肝脏炎症活动度、ALT、AST、IL-18和内毒素均呈正相关,而与肝脏脂肪变性无关.NASH组大鼠大肠埃希菌属数量、ALT、AST、IL-18、内毒素、TC、TG、空腹血糖均显著高于其余组,而乳酸杆菌属、双歧杆菌属数量均显著低于其余组.NAFL组与单纯性肥胖组大肠埃希菌属数量、TC、TG、空腹血糖和内毒素均高于正常对照组,而乳酸杆菌、双歧杆菌属数量均低于正常对照组.NAFL组大肠埃希菌数、内毒素高于单纯性肥胖组,双歧杆菌数低于单纯性肥胖组,而乳酸杆菌数、TC、TG、空腹血糖、IL-18、ALT和AST差异无统计学意义.内毒素与大肠埃希菌、IL-18、ALT、AST均呈正相关,而与乳酸杆菌属呈负相关,与双歧杆菌无关.正常对照组可见小肠黏膜表面微绒毛排列整齐,相邻细胞间细胞连接结构清晰.从单纯性肥胖组、NAFL组到NASH组,可见肠道黏膜屏障和间质炎性反应由轻到重的变化.结论 NASH血清中CK-18(M30)可作为NASH评判和预测的独立因素.肠道菌群紊乱可能是单纯性肥胖进展为NAFLD的高危因素.NAFLD早期存在肠源性内毒素血症,可能是促进肝脏损伤的病因,肠道屏障的损伤可能是促使内毒素升高的始动因素,肠源性内毒素又可引发肝内炎性反应,导致NASH的发生.
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