无痛纤维支气管镜检查的临床应用

加,但仍低于正常。Ben 2Ari 等[20]发现血清瘦素水平在原发性胆汁性肝硬化患者中明显低于正常对照人群及肝细胞性肝病患者;并且在胆汁性肝硬化患者中,瘦素与体重指数无明显相关,原因有待于进一步阐明。

血清瘦素水平与肝病严重程度的关系尚有争议。Testa 等[21]报道当肝功能恶化时,血清瘦素水平提高,而Greco 等[22]报道肝损害越严重,瘦素浓度越低。亦有学者认为[16]肝硬化患者血清瘦素水平与肝功能分级无关。但有证据表明肝硬化患者血清瘦素水平升高,可能会导致能量消耗和营养不良,因而影响肝硬化患者的预后。

总之,瘦素作为肥胖基因的产物,具有广泛的生物学效应,不仅能够调节体内能量代谢和脂肪沉积,而且与肝病密切相关。慢性肝病血清瘦素水平存在明显异常,但各家报道不一致,引起这些差异的可能原因包括研究人群的入选及排除标准不同、肝病病因及程度不同及观察例数的差异。瘦素与肝病的联系是否只通过脂代谢、HSC 和TGF 发生关系,脂代谢是否是这些关系的核心环节,瘦素与肝脏的炎症、脂肪变性、纤维化及硬化的机制仍有待于进一步研究。

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(收稿日期:2005202203)

▲广西南宁市科技局科技计划项目(合同号:ZC200502C )

无痛纤维支气管镜检查的临床应用

▲

广西南宁市第一人民医院　(南宁　530022)　周瑞仁　段敏超　综述　吴曙粤　审校

纤维支气管镜检查于20世纪70年代初开始在我国临床应用[1],现已成为呼吸道疾病诊断和治疗的重要手段之一。尽管如此,由于进行该项检查时一般都在局麻下进行,病人常承受较大的痛苦和心理压力。近些年来,临床上采用无痛技

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45Guangxi Medical Journal ,A pr 2005,V ol 127,No 14