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影响非生物型人工肝治疗急性肝衰竭患儿预后的危险因素分析 被引量:2
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作者 赵劭懂 葛许华 +2 位作者 时珺 缪红军 周兆群 《中国中西医结合急救杂志》 CAS CSCD 北大核心 2023年第2期180-184,共5页
目的分析应用非生物型人工肝(NBAL)治疗儿童急性肝衰竭(PALF)的临床特点及影响患儿预后的危险因素,为临床诊治和预后判断提供依据.方法采用回顾性研究方法,选择南京医科大学附属儿童医院2015年1月至2019年12月在儿科重症监护病房(PICU)... 目的分析应用非生物型人工肝(NBAL)治疗儿童急性肝衰竭(PALF)的临床特点及影响患儿预后的危险因素,为临床诊治和预后判断提供依据.方法采用回顾性研究方法,选择南京医科大学附属儿童医院2015年1月至2019年12月在儿科重症监护病房(PICU)应用NBAL治疗的PALF患儿的临床资料,包括性别、年龄、体质量、发热、呕吐、黄疸、萎靡、腹水、肝性脑病、外周血白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)、降钙素原(PCT)、凝血酶原活动度(PTA)、凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、凝血酶时间(TT)、总胆红素(TBil)、直接胆红素(DBil)、间接胆红素(IBil)、DBil/TBil、DBil/IBil、血肌酐(SCr)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、血氨(SA)、甲胎蛋白(AFP)、血清白蛋白(ALB)、前白蛋白(PAB).采用单因素和多因素Logistic回归方法分析影响PALF行NBAL治疗患儿预后的危险因素,并绘制受试者工作特征曲线(ROC曲线)分析各危险因素对患儿预后的预测价值.结果研究共纳入113例患儿,存活74例,死亡39例.单因素分析显示,与存活组比较,死亡组年龄更小(岁:29.56±19.78比45.70±31.14),体质量更轻(kg:13.16±7.26比17.37±9.33),黄疸和肝性脑病发生率及WBC、PT、INR、APTT、TT、TBil、DBil、IBil、SA水平均更高[黄疸:46.15%(18/39)比25.68%(19/74),肝性脑病:56.41%(22/39)比36.49%(27/74),WBC(×10^(9)/L):19.30±5.89比12.85±3.26,PT(s):29.14±14.32比20.15±9.38,INR:3.44±1.15比1.75±0.81,APTT(s):87.59±20.75比43.54±12.22,TT(s):28.50±6.99比20.71±5.88,TBil(μmol/L):719.77±109.19比176.46±68.52,DBil(μmol/L):409.61±89.96比123.66±52.24,IBil(μmol/L):290.56±45.45比52.67±18.03,SA(μmol/L):356.92±72.29比73.31±43.28,均P<0.05],Hb、PLT、PTA、Fib、DBil/TBil、DBil/IBil、ALB、PAB均明显降低[Hb(g/L):72.33±28.91比91.98±37.02,PLT(×10^(9)/L):50.82±26.38比114.88±54.21,PTA:0.3 展开更多
关键词 急性肝衰竭 非生物型人工肝 预后 儿科
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Sulforaphane,an NRF2 agonist,alleviates ferroptosis in acute liver failure by regulating HDAC6 activity
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作者 Yan-qiong Zhang Chun-xia Shi +3 位作者 Dan-mei Zhang Lu-yi Zhang Lu-wen Wang Zuo-jiong Gong 《Journal of Integrative Medicine》 SCIE CAS CSCD 2023年第5期464-473,共10页
Objective Acute liver failure(ALF)is characterized by severe liver dysfunction,rapid progression and high mortality and is difficult to treat.Studies have found that sulforaphane(SFN),a nuclear factor E2-related facto... Objective Acute liver failure(ALF)is characterized by severe liver dysfunction,rapid progression and high mortality and is difficult to treat.Studies have found that sulforaphane(SFN),a nuclear factor E2-related factor 2(NRF2)agonist,has anti-inflammatory,antioxidant and anticancer effects,and has certain protective effects on neurodegenerative diseases,cancer and liver fibrosis.This paper aimed to explore the protective effect of SFN in ALF and it possible mechanisms of action.Methods Lipopolysaccharide and D-galactosamine were used to induce liver injury in vitro and in vivo.NRF2 agonist SFN and histone deacetylase 6(HDAC6)inhibitor ACY1215 were used to observe the protective effect and possible mechanisms of SFN in ALF,respectively.Cell viability,lactate dehydrogenase(LDH),Fe2+,glutathione(GSH)and malondialdehyde(MDA)were detected.The expression of HDAC6,NRF2,glutathione peroxidase 4(GPX4),acyl-CoA synthetase long-chain family member 4(ACSL4)and solute carrier family 7 member 11(SLC7A11)were detected by Western blotting and immunofluorescence.Results Our results show that NRF2 was activated by SFN.LDH,Fe2+,MDA and ACSL4 were downregulated,while GSH,GPX4 and SLC7A11 were upregulated by SFN in vitro and in vivo,indicating the inhibitory effect of SFN on ferroptosis.Additionally,HDAC6 expression was decreased in the SFN group,indicating that SFN could downregulate the expression of HDAC6 in ALF.After using the HDAC6 inhibitor,ACY1215,SFN further reduced HDAC6 expression and inhibited ferroptosis,indicating that SFN may inhibit ferroptosis by regulating HDAC6 activity.Conclusion SFN has a protective effect on ALF,and the mechanism may include reduction of ferroptosis through the regulation of HDAC6. 展开更多
关键词 acuteliverfailure SULFORAPHANE NRF2 HDAC6 Ferroptosis
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