病毒性肝炎和肝硬化患者IL－6、TNF－α的变化

Determinations of IL-6 and TNF-α in patients with viral hepatitis and liver cirrhosis

为研究白细胞介素－６（ＩＬ－６）、肿瘤坏死因子（ＴＮＦ－α）在肝炎和肝硬化（ＬＣ）患者中的作用。检测了１５例正常人，１８例急性病毒性肝炎（ＡＨ），３７例慢性肝炎（ＣＨ），２０例ＬＣ患者血清及外周血单个核细胞（ＰＢＭＣ）的ＩＬ－６、ＴＮＦ－α水平。结果以ＣＨ患者ＩＬ－６、ＴＮＦ－α水平最高（血清及ＰＢＭＣ的ＩＬ－６水平分别为７２．１±３２．９４Ｕ／ｍｌ，１４０．７±３３．５Ｕ／ｍｌ；血清及ＰＢＭＣ的ＴＮＦ－α水平为３．９７±１．３８ｎｇ／ｍｌ，６．３５±１．４１ｎｇ／ｍｌ）。恢复期或稳定期ＴＮＦ－α和ＩＬ－６水平明显低于急性期或活动期（Ｐ＜０．０１）。ＣＨ患者肝组织学活动指数（ＨＡＩ）分数与ＰＢＭＣＩＬ－６和ＴＮＦ－α水平呈正相关（γ分别为０．８９，０．６８；Ｐ＜０．０５）。提示ＩＬ－６和ＴＮＦ－α是肝脏损害重要的炎症介质，介导肝细胞损害。

To investigate the possible immunopathogenic role of interleukin-6 (IL-6)and tu-mor necrosis factor-α in the liver damage,concentrations of IL-6 and TNF-αin the serum and PBMC were assayed in 15 normal subjects,18 patients with acute hepatitis(AH),37 with chronic liver dis-ease(CLD),and 20 with liver cirrhosis(LC).The results revealed that the levels of serum and PBMC IL-6、TNF-α were highest in patients with viral hepatitis,in particular those superinfected with hepatitis C and B. Hepatic histologic activity index(HAI)scores in patients with CLD were not correlated with serum IL-6 and TNF-α levels,but correlated with PBMC IL-6 and TNF-α levels.The above data suggested that the levels of PBMC TNF-α and IL-6 might reflect the severity of liver damage and IL-6 and TNF-α were very important rnediators of liver damage.The liver function im-proved with the declining of IL-6 and TNF-α both in serum and hepatic tissue. The abnormal eleva-tion of IL-6,TNF-α in serum and in hepatic tissue may lead to immunopathogenic reaction resulting in hepatocyte damage.