- 學位論文
非酒精性脂肪肝炎患者血清中的Hedgehog蛋白濃度與相關生化值之分析
Analysis of serum Hedgehog protein and relevant biochemical parameters in patients of non-alcoholic steatohepatitis
摘要
非酒精性脂肪肝炎與一般的肝臟疾病特徵相似，有許多因素會造成脂肪堆積在肝臟中，造成肝臟發炎、肝臟纖維化及肝臟硬化。有研究證實Hedgehog (Hh) 訊息傳遞參與肝臟的形成及內胚層之分化，但是只存在於與幹細胞類似的未成熟肝細胞中，在正常的成人肝臟中是測不到的。先前的研究指出，Hedgehog蛋白在維持組織的恆定扮演很重要的角色，且知與膽固醇修飾作用有關。本研究利用林新醫院所提供118筆成人健康檢查資料，探討Hh是否連結其他因素共同作為罹患非酒精性脂肪肝炎的重要因子。研究方法包括一般物理檢查、生化檢查、免疫檢查、超音波檢查及血清Hh蛋白濃度等五大項檢查，利用Excel XP 進行資料儲存及分析，以SPSS14.1統計軟體進行資料分析，以平均值及標準差來描述變數資料。由資料分析得知21位非酒精性脂肪肝患者血清檢查結果中Hh蛋白濃度與肥胖、血糖、膽固醇、三酸甘油脂、高密度脂蛋白、肝功能異常及超音波異常者有明顯的關聯性(p值<0.05)。雖然在正常者血清檢查結果中有Hh蛋白表現，在酒精性脂肪肝患者血清中卻有大量的表現。本研究說明Hh蛋白可考慮作為肝臟發炎及脂肪變性的診斷指標。
並列摘要
Nonalcoholic steatohepatitis (NASH) includes a wide spectrum of liver injury ranging from simple steatosis to liver inflammation, fibrosis and cirrhosis. Hedgehog (Hh) signaling is required for hepatogenesis and endodermal commitment, but the possibility that it regulates liver turnover in adults had not been considered because mature liver epithelial cells lack Hh signaling. Hh signaling plays an important role in maintenance of adult adipose tissue, with relevance to cholesterol modification. This study examined the files of 118 patients provided by Lin-Shin Hospital in an attempt to investigate Hh signaling and its relevant factors, that may be causing nonalcoholic steatohepatitis. Five panels of parameters, including general physical examination, biochemistry, immunoassay, ultrasonography examination and serum Hh protein contents were studied, and the data were analyzed with Excel XP. Statistical analysis was performed with SPSS14.1. The mean and standard deviation were used to describe the data. Our data indicated that Hh protein was significantly (p<0.05) related to obesity, elevated blood sugar, elevated cholesterol, elevated triglycerides, decreased high-density lipoprotein, elevated GOT and GPT and fatty liver on ultrasonography in the 21 NASH patients. In addition, serum Hh protein can be detected in the serum of the normal adults, our data indicated that Hh protein was significantly higher in the NASH patients. In conclusion, Hh signaling may be used as a new therapeutic and diagnostic marker in patients with liver inflammation and fatty deposition.