Jain Sanjiv K, Pemberton Philip W, Smith Alexander, McMahon Raymond F T, Burrows Peter C, Aboutwerat Ali, Warnes Thomas W
The Liver Unit, Manchester Royal Infirmary, Manchester, UK.
J Hepatol. 2002 Jun;36(6):805-11. doi: 10.1016/s0168-8278(02)00060-0.
BACKGROUND/AIMS: Chronic hepatitis C infection is a major world-wide problem, frequently progressing to cirrhosis, liver failure or hepatoma. The pathological mechanisms of disease progression are unclear but oxidant stress may play a role.
Markers of lipid peroxidation, antioxidant status, hepatic fibrogenesis and liver function were measured in blood or urine from 42 chronic hepatitis C patients. Fibrosis was graded histologically in a subgroup of 33 patients.
The lipid peroxidation marker 8-isoprostane and the ratio of oxidized to reduced glutathione were significantly elevated (P<0.001, P=0.006). The antioxidants glutathione, selenium and vitamins A, C and E were significantly decreased (all P<0.001) compared to age and sex matched controls. Abnormal values were more marked in cirrhotics, but significant changes were also observed in the non-cirrhotic group. The fibrosis score correlated positively with urinary 8-isoprostane and type III procollagen peptide and negatively with vitamin A.
Oxidant stress, as reflected in blood and urine by a wide range of pro- and antioxidant markers, is a significant feature of hepatitis C infection. Although more severe in the cirrhotic group, there was clear evidence of oxidant stress in non-cirrhotic patients. Antioxidant therapy may therefore have a role in slowing disease progression to cirrhosis.
背景/目的：慢性丙型肝炎感染是一个全球性的主要问题，常进展为肝硬化、肝衰竭或肝癌。疾病进展的病理机制尚不清楚，但氧化应激可能起作用。
检测了42例慢性丙型肝炎患者血液或尿液中的脂质过氧化标志物、抗氧化状态、肝纤维化形成及肝功能指标。对33例患者的亚组进行了组织学纤维化分级。
脂质过氧化标志物8-异前列腺素及氧化型谷胱甘肽与还原型谷胱甘肽的比值显著升高（P<0.001，P=0.006）。与年龄和性别匹配的对照组相比，抗氧化剂谷胱甘肽、硒以及维生素A、C和E显著降低（均P<0.001）。肝硬化患者的异常值更为明显，但在非肝硬化组也观察到了显著变化。纤维化评分与尿8-异前列腺素和III型前胶原肽呈正相关，与维生素A呈负相关。
血液和尿液中多种促氧化剂和抗氧化剂标志物所反映的氧化应激是丙型肝炎感染的一个显著特征。虽然在肝硬化组更为严重，但在非肝硬化患者中也有氧化应激的明确证据。因此，抗氧化治疗可能在减缓疾病进展为肝硬化方面发挥作用。
