Cieśla A, Mach T, Pierzchała-Koziec K, Skwara P, Szczepański W
Jagiellonian University Medical College, Chair of Gastroenterology, Hepatology and Infectious Diseases, Cracow, Poland.
Adv Med Sci. 2006;51:261-4.
The aim of the study was to assess the liver Met-enkephalin concentration in chronic viral hepatitis type B and C as well as in liver cirrhosis in order to estimate the role of opioid system in pathogenesis of liver disease.
The concentration of Met-enkephalin was examined in liver tissue of 103 consecutive patients with chronic hepatitis type B and C. Control group consisted of uninfected patients. Met-enkephalin concentration was analyzed in relation to the degree of hepatic necroinflammatory activity and the extent of fibrosis estimated by histopathological examination of liver bioptates and compared to such parameters as age, sex and concomitant diseases.
Significant differences in Met-enkephalin concentration were found between cases with advanced fibrosis (stage 3 and 4 acc. to Batts and Ludwig classification) and cases with fibrosis classified as stage 2 (p < 0.05). Met-enkephalin concentration was higher in HCV infected patients in comparison to HBV infected patients (p < 0.05) and uninfected controls (0.05 < p < 0.1). There wasn't found any correlation between Met-enkephalin level and necroinflammatory activity in the liver, age, sex and concomitant diseases.
Met-enkephalin concentration measurement in the liver tissue seams to be a useful method for differentiation of stage 2 from stages 3 and 4 of severe liver fibrosis. There is increased concentration of Met-enkephalin in liver tissue in HCV infected patients in comparison to HBV infected or uninfected individuals. The degree of necroinflammatory activity in the liver as well as sex and age of patients with chronic hepatitis do not correlate with changes in opioid system.
本研究旨在评估慢性乙型和丙型病毒性肝炎以及肝硬化患者肝脏中甲硫氨酸脑啡肽的浓度，以估计阿片系统在肝脏疾病发病机制中的作用。
对103例连续的慢性乙型和丙型肝炎患者的肝组织进行甲硫氨酸脑啡肽浓度检测。对照组为未感染患者。根据肝活检组织的组织病理学检查评估甲硫氨酸脑啡肽浓度与肝坏死炎症活动程度及纤维化程度的关系，并与年龄、性别及伴发疾病等参数进行比较。
在晚期纤维化患者（根据Batts和Ludwig分类为3期和4期）与2期纤维化患者之间，甲硫氨酸脑啡肽浓度存在显著差异（p<0.05）。丙型肝炎病毒感染患者的甲硫氨酸脑啡肽浓度高于乙型肝炎病毒感染患者（p<0.05）和未感染对照组（0.05<p<0.1）。未发现甲硫氨酸脑啡肽水平与肝脏坏死炎症活动、年龄、性别及伴发疾病之间存在任何相关性。
肝组织中甲硫氨酸脑啡肽浓度测定似乎是区分严重肝纤维化2期与3期和4期的有用方法。与乙型肝炎病毒感染或未感染个体相比，丙型肝炎病毒感染患者肝组织中甲硫氨酸脑啡肽浓度升高。慢性肝炎患者肝脏的坏死炎症活动程度以及患者的性别和年龄与阿片系统的变化无关。
