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[前列腺癌雌激素治疗所致肝脏疾病:6例尸检病例的组织病理学检查]

[Liver disorder owing to estrogen therapy in prostatic cancer, examined histopathologically in six autopsy cases].

作者信息

Yamauchi T, Kokuho M, Yoshino S, Tachibana Y, Kawai T, Kitagawa T

出版信息

Nihon Hinyokika Gakkai Zasshi. 1989 Dec;80(12):1706-12. doi: 10.5980/jpnjurol1989.80.1706.

Abstract

The parenchymal damage of the liver after estrogen therapy for prostatic cancer, mainly treated with diethylstilbestrol diphosphate (DES-DP), was studied in the six autopsied cases, herein. The parenchymal disorder of the liver was "nonalcoholic steatohepatitis", reported by Ludwig et al., and its degree of disorder was dependent upon the administered dose of estrogen. The acceptable total dose of DES-DP was supposed to be about 150 g at maximum, according to the various degrees of damage examined histopathologically in the six cases who were administered at total doses of DES-DP from 12.6 g to 619 g. Comparison of the histopathologic damage to the liver function tests performed within 10 days before death revealed that only the serum levels of cholinesterase (ChE) were abnormally decreased, suggesting its importance to predict the degree of "nonalcoholic steatohepatitis" by monitoring of ChE.

摘要

本文对6例尸检病例进行了研究,这些病例主要接受二磷酸己烯雌酚(DES-DP)治疗前列腺癌,之后出现了肝脏实质损害。肝脏的实质病变为路德维希等人报道的“非酒精性脂肪性肝炎”,其病变程度取决于雌激素的给药剂量。根据6例接受DES-DP总剂量从12.6克至619克的病例经组织病理学检查的不同损伤程度,DES-DP的可接受总剂量估计最大约为150克。对死亡前10天内进行的肝功能检查的组织病理学损伤进行比较发现,只有血清胆碱酯酶(ChE)水平异常降低,这表明通过监测ChE来预测“非酒精性脂肪性肝炎”的程度具有重要意义。

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