联合检测血清INSTNF-αSOD对NAFLD的临床意义

Significance of combined assay of serum INS,TNF-α and SOD in diagnosis of nonalcoholic fatty liver disease

目的:探讨血清胰岛素(INS),肿瘤坏死因子α(TNF-α),超氧化物岐化酶(SOD)浓度变化对非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)诊断及预后判断的临床应用价值。方法:采用放射免疫法检测INS TNF-α,化学法检测SOD,根据HOMA-IR=[FBG(mmol/l)×FIN(mIU/l)]/22.5计算胰岛素抵抗指数(IRI)〔1〕。结果:(1)NASH组INS浓度(24.810±9.017)mIU/l及IRI(6.733±2.501)显著高于NC组(15.460±6.012)mIU/l,(4.131±2.158)(P<0.05),NASFL组INS浓度(21.180±11.610)mIU/l及IRI(6.462±2.872)显著高于NC组(P<0.05),NASH组INS浓度及IRI与NASFL组比较差异无显著性(P>0.05)。(2)NASH组TNF-α浓度(0.322±0.165)ng/ml显著高于NC组(0.254±0.093)ng/ml(P<0.05),NASFL组与NC组TNF-α浓度比较差异无显著性(P>0.05),NASH组TNF-α浓度显著高于NASFL组(0.271±0.098)ng/ml(P<0.05)。(3)NC组SOD浓度(112.200±7.978)U/ml显著高于NASH组(72.540±1.325)U/ml(P<0.05),NASFL组SOD浓度(109.900±8.903)U/ml显著高于NASH组(P<0.05),NASFL组与NC组SOD浓度比较差异无显著性(P>0.05)。结论:联合检测血清INS、TNF-α、SOD对NAFLD的诊断及预后判断具有一定的临床参考价值。

Objective： To investigate the clinical significance of combined assay of serum insulin（INS）, TNF - α and SOD in diagnosis and prognosis of nonal .coholie fatty liver disease（NAFLD）. Methods：The levels of INS, TNF - α and SOD in sera from 64 NAFLD patients including 32 NASFL ones and 32 NASH ones were determined with chemical assay or radioimmunoassay and compared with those from the normal subjects. The insulin resistant index（IRI） was calculated based on the formula of HOMA - IRI=FBG（mmol/L× FIN（mIU/ L） ）/22.5. Results： 1, The levels of INS and IRI in NASH group and NASFL group were higher than that in the normal group, but there was not significant difference between NASH group and NASFL group. 2. The level of TNF - α in NASH group was much higher than those in the normal group and NASFL group, but there was not significant difference between the normal group and NASFL group. 3. The level of SOD in NASH group was much lower than those in the normal group and NASFL group, but there was not significant difference between the normal group and NASFL group. Conclusion： Combined assay of serum INS, TNF - α and SOD is helpful to diagnosis and prognosis of nonalcoholic fatty liver disease.