本文選題：非酒精脂肪性肝炎　切入點(diǎn)：抑胃肽　出處：《實(shí)用醫(yī)學(xué)雜志》2015年20期 　論文類型：期刊論文

【摘要】：目的:探討抑胃肽、膽囊收縮素在非酒精脂肪性肝炎患者中的變化和意義。方法:按照非酒精性脂肪肝防治指南選擇脂肪性肝炎60例,并根據(jù)飲食習(xí)慣不同分成規(guī)律飲食組(NASH1組)和不規(guī)律飲食組(NASH2組),選擇體檢正常者60例作為對(duì)照組。觀察空腹血清胰島素、肝功生化、血脂成分以及腸道內(nèi)分泌肽膽囊收縮素和抑胃肽含量,動(dòng)態(tài)檢查餐后0.5、1、2、4 h血清中上述指標(biāo)的變化情況,并進(jìn)行相關(guān)性分析。結(jié)果:脂肪肝炎患者血清中三酰甘油和膽固醇、空腹血糖和餐后動(dòng)態(tài)血糖、ALT明顯升高,以NASH2組表現(xiàn)更為明顯。脂肪肝患者的血清胰島素高于正常,分泌峰值在餐后1 h,較正常組胰島素分泌峰值在餐后0.5 h明顯滯后。NASH1組抑胃肽和膽囊收縮素水平在各個(gè)時(shí)間點(diǎn)均較正常組明顯增高,NASH2組的抑胃肽和膽囊收縮素較NASH1組明顯增高。脂肪肝炎組抑胃肽分泌峰值明顯早于正常組,膽囊收縮素分泌峰值晚于正常組。NASH組胰島素分泌峰值與抑胃肽分泌峰值一致。在脂肪肝的患者中,伴隨著膽囊收縮素和抑胃肽的升高,胰腺明顯增厚。結(jié)論:抑胃肽、膽囊收縮素參與NASH的胰島素抵抗和炎癥發(fā)生。
[Abstract]:Objective: to investigate the changes and significance of gastric inhibitory peptide and cholecystokinin in patients with non-alcoholic fatty hepatitis. Methods: sixty cases of fatty hepatitis were selected according to the guidelines for prevention and treatment of non-alcoholic fatty liver. According to different dietary habits, they were divided into regular diet group (NASH1 group) and irregular diet group (NAS H2 group). 60 normal subjects were selected as control group. Fasting serum insulin, liver function and biochemistry were observed. The changes of serum lipids, cholecystokinin and gastric inhibitory peptide in the intestinal endocrine peptide and cholecystokinin, and the changes of the above indexes in serum for 2 hours after meal were examined dynamically, and the correlation analysis was carried out. Results: the serum triglycerides and cholesterol in the patients with fatty hepatitis were determined. Fasting blood glucose and postprandial dynamic blood glucose and alt were significantly increased, especially in NASH2 group. Serum insulin in fatty liver patients was higher than that in normal group. Peak level of insulin secretion in NASH1 group was significantly lower than that in normal group at 0.5 h after meal. The levels of gastric inhibitory peptide and cholecystokinin in NASH1 group were significantly higher than those in normal group at all time points, and those in NASH2 group were significantly higher than those in NASH2 group. The peak value of antigastric peptide secretion in the fatty liver group was earlier than that in the normal group. The peak value of cholecystokinin secretion was later than that of the normal group. The peak of insulin secretion was consistent with the peak of anti-gastric peptide secretion. In fatty liver patients, the pancreas was significantly thickened with the increase of cholecystokinin and gastric inhibitory peptide. Cholecystokinin is involved in insulin resistance and inflammation in NASH.
【作者單位】： 無(wú)錫市第五人民醫(yī)院脂肪肝科;無(wú)錫市人民醫(yī)院消化科;
【基金】：浙江省自然科學(xué)基金項(xiàng)目(編號(hào):Y211316) 無(wú)錫市醫(yī)院管理中心醫(yī)學(xué)科研聯(lián)合攻關(guān)項(xiàng)目(編號(hào):YGZXL1324)
【分類號(hào)】：R575.1

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本文編號(hào)：1650533