【摘要】 目的观察银杏叶片对燃煤型砷中毒慢性肝损害的临床疗效,并探讨其作用机制。方法将65例患者随机分为治疗组和对照组,另选健康30人为正常组。治疗组(34例)口服银杏叶片3月,对照组(31例)口服安慰片3月。观察两组治疗前后症状和体征、肝功能(ALT、ALB)、血小板活化因子(PAF)、肿瘤坏死因子鄄α(TNF鄄α)、血清肝纤维化指标(HA、C鄄Ⅳ、LN、PCⅢ)、血清抗氧化指标(MDA、SOD、GSH鄄Px),其中33例在治疗前后均进行肝穿病理光镜和电镜检查。结果治疗组治疗后临床显效率和总有效率(44.8%,77.7%)与对照组(16.8%,42.7%)比较差异有统计学意义(P<0.01)。治疗组治疗后血清PAF、TNF鄄α显著下降(P<0.01);治疗组治疗后肝功能指标及肝纤维化指标显著改善(P<0.01,P<0.05);治疗组治疗后血中SOD和GSH鄄Px显著提高(P<0.01,P<0.05),而MDA显著降低(P<0.05);治疗组治疗后其病理炎症和肝纤维化程度计分显著下降(P<0.01)。各项指标对照组治疗前后无显著变化(P>0.05)。结论银杏叶片能有效改善燃煤型砷中毒慢性肝损害,其机理与其具有强有力的PAF拮抗作用有关,一方面阻断细胞因子间的连锁反应,另一方面具有抗脂质过氧化,减少氧自由基对肝细胞的损害作用。更多还原

【Abstract】 Objective To clinically study the effect of Ginkgo leaf on hepatic damage resulting from coal- burning arsenism and its mechanism. Methods Sixty-five patients with coal- burning arsenism were randomly divided into two groups:experimental group and control group. Other thirty healthy people were enrolled into normal group. The experimental group (n = 34) was treated with Ginkgo leaf, the control group(n = 31) was given comfort tablet for three months. Serum platelet activating factor(PAF),TNFα,four markers for hepatic fibrosis, MDA?SOD?GSH-Px and histopathology of liver before and after treatment were observed. Results The markedly effective rate and the total effective rate in the experimental group were 44.8% and 77.7% respectively, while in the control group the corresponding rates 16.8% and 42.7%. Comparison between the two groups showed significant difference(P < 0.01). Serum levels of PAF, TNF, MDA and four hepatic fibrosis markers were lowered significantly in the experimental group after treatment (P < 0.01 or P < 0.05). Serum levels of SOD and GSH-Px increased significantly after treatment in the treated group (P < 0.01 or P < 0.05). The pathological examination of liver showed inflammation and fibrosis were alleviated after treatment in the treated group(P < 0.01), however, there were no significances compared with the corresponding parameter in the control group after treatment(P > 0.05). Conclusions Ginkgo leaf tablet significantly ameliorate chronic hepatic damage resulting from coal-burning arsenism. The mechanism may be related to that Gingko leaf is a strong PAF antagonist :on one hand it can block the concatenation among cytokines; on the other hand it has anti-lipid peroxidation effect, thus inhibiting oxygen free radicals to damage hepatic cells.更多还原