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Abstract
SUMMARY AND CONCLUSION
The human may continuously be exposed to potentially harmful oxidative stresses as drugs, cigarette smoke, exhaust fumes, irradiations, endogenous sources of free radical (F .R) and phagocytosis processes during the course of life. There is delicate balance between F.R. and antioxidants which defend the cell against oxidative damage produced by F.R.
Any disturbance in this balance, F.R. become deleterious and induce injury. This has been obvious in the progression of liver damage in viral hepatitis. Our study was planned to explore the role of some antioxidants in progression of liver cell damage among groups of patients who were infected with virus C.
The study include 60 subjects classified into 4 groups:
* The first group (Control group): It is composed of 15 subjects with normal liver function, negative for HeV antibodies as detected by ELIZA.
* The Second group: Composed of 20 patients with normal liver functions and positive HCV detected by PCR.
* The third group: Composed of 20 patients with moderate rise of transaminases and moderate hepatomegally and positive HCV.
* The fourth group: Composed of 20 patients with sever impairment of liver functions and hepatosplenomegally with some complications and positive HCV.
All groups are subjected to the following investigations: - Full clinical history.
- Clinical examinations.
- Routine laboratory investigations including:
* Complete liver function tests. * Uric acid.
* HBsAg.
- Specific investigations include: * Glutathione peroxidase. * S.vitamin E.
* S.B. carotene.
The results of the present study revealed that:
I) Serum Bilirubin levels:
Showed a significant nse In all studied groups when compared with control group, also, within each other except between group III and IV there was non significant rise obtained.
There IS also a significant negative correlation between both vitamin A and vitamin E with serum bilirubin and a non significant correlation with GPX (glutathione peroxidase).
These results explained that serum bilirubin was decreased when the level of vitamin A and E was increased in serum denoting a possible protective (antioxidant) effect of these vitamins and their protection to the liver cells from damage.
II) Serum AL T and serum AST:
Our study revealed a high significant rise in AL T and AST among all studied groups when compared with that of the control group and also within each other. This rise was pronounced in group IV. There were a highly significant negative correlation between the two enzymes and other parameters such as vitamin A. vitamin E and GPx.
Ill) Serum albumin:
In our study we found that serum albumin levels were significantly decreased among studied groups when compared with that of control group but there was non significant difference among groups. There was positive correlation between S.albumin and both vitamin A and vitamin E.
IV) Serum uric acid:
There is non-significant difference in S.uric acid among all different groups of study in comparison with control group and among each other.
V) Glutathione peroxidase:
The activity of glutathione peroxidase enzyme in blood showed highly significant decrease in studied groups when compared to that of control group. Also, there was direct positive correlation between GPX level and both vitamin A, vitamin E level. Otherwise, there was non significant correlation between GPX and other studied parameters.
VI) S.vitamin A:
In our study serum vitamin A levels show highly significant decrease in studied groups in comparison with those of control group. Also, there was highly significant decline in vitamin A level with increased severity of the disease. There was positive correlation between vitamin A and both vitamin E and serum albumin.
VII) S.vitamin E:
In our results serum vitamin E level showed significant decrease in patients group when compared with control group and decreased much with the progression of the disease.
Both vitamin A and E had a significant negative correlation with level of AL T, AST and bilirubin where as they had non significant correlation with uric acid level.
Vitamin E as well as B-carotene, uric acid, albumin and bilirubin act as secondary antioxidants. They prevent chain reaction by trapping free radicals.
From this study we concluded that dietary supplementation with antioxidants like vitamin A CB-carotene), vitamin E and glutathione peroxidase CGPX) are peneficial in delay or preventing liver complications in HCV patients. So, HCV patients especially those who do not respond to interferone should take balanced diet containing these antioxidants.