抑胃肽、胆囊收缩素在非酒精脂肪性肝炎中的变化和意义

发布时间：2018-03-22 21:36

本文选题：非酒精脂肪性肝炎　切入点：抑胃肽　出处：《实用医学杂志》2015年20期 　论文类型：期刊论文

【摘要】：目的:探讨抑胃肽、胆囊收缩素在非酒精脂肪性肝炎患者中的变化和意义。方法:按照非酒精性脂肪肝防治指南选择脂肪性肝炎60例,并根据饮食习惯不同分成规律饮食组(NASH1组)和不规律饮食组(NASH2组),选择体检正常者60例作为对照组。观察空腹血清胰岛素、肝功生化、血脂成分以及肠道内分泌肽胆囊收缩素和抑胃肽含量,动态检查餐后0.5、1、2、4 h血清中上述指标的变化情况,并进行相关性分析。结果:脂肪肝炎患者血清中三酰甘油和胆固醇、空腹血糖和餐后动态血糖、ALT明显升高,以NASH2组表现更为明显。脂肪肝患者的血清胰岛素高于正常,分泌峰值在餐后1 h,较正常组胰岛素分泌峰值在餐后0.5 h明显滞后。NASH1组抑胃肽和胆囊收缩素水平在各个时间点均较正常组明显增高,NASH2组的抑胃肽和胆囊收缩素较NASH1组明显增高。脂肪肝炎组抑胃肽分泌峰值明显早于正常组,胆囊收缩素分泌峰值晚于正常组。NASH组胰岛素分泌峰值与抑胃肽分泌峰值一致。在脂肪肝的患者中,伴随着胆囊收缩素和抑胃肽的升高,胰腺明显增厚。结论:抑胃肽、胆囊收缩素参与NASH的胰岛素抵抗和炎症发生。
[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.
【作者单位】：无锡市第五人民医院脂肪肝科;无锡市人民医院消化科;
【基金】：浙江省自然科学基金项目(编号:Y211316) 无锡市医院管理中心医学科研联合攻关项目(编号:YGZXL1324)
【分类号】：R575.1

【参考文献】