人工肝支持系统治疗急性肝衰竭患者LPS、TNF-α、IL-2、IL-6水平变化的临床意义

The clinical significance of the changes of serum LPS、TNF-α、IL-2、IL-6 Levels in patients with acute liver failure treated by artificial liver support system

目的探讨人工肝支持系统(ALSS)治疗急性肝衰竭(ALF)患者内毒素(LPS)、肿瘤坏死因子(TNF-α)、白介素-2(IL-2)、白介素-6(IL-6)水平变化的临床意义。方法48例ALF患者随机分为治疗组25例及对照组23例,两组在综合护肝治疗的基础上,治疗组同时采用ALSS治疗。分别检测两组治疗前后血中LPS、TNF-α、IL-2、IL-6、白介素-8(IL-8)的水平。结果治疗后,对照组LPS、TNF-α、IL-6、IL-8水平虽有降低,但无统计学差异(P>0.05);治疗组LPS、TNF-α、IL-6、IL-8水平显著下降,IL-2水平明显上升,有统计学差异(P<0.05或P<0.01);治疗组治疗有效率为80.8%,对照组为39.1%,两组有显著性差异(P<0.01)。结论ALSS能显著降低ALF患者LPS、TNF-α、IL-6、IL-8等炎症介质,观察其水平变化,能较好地了解病情的程度及预后情况,对防止肝衰竭加重及并发多脏器功能不全综合征(MODS)具有重要的治疗意义。

Objective To evaluate the clinical significance of the changes of serum LPS TNF-α ,IL-2,IL-6 levels in patients with acute liver failure （ALF） treated by artificial liver support system（ALSS）. Methods 48 patients with ALF were randomly divided into the treatment group（25 cases） and the control group（23 cases）. Comprehensive liver- protecting therapy was given to all patients in two groups. Additionally, ALSS was given to the treatment group simuhaneously. Serum Levels of LPS, TNF-α, IL-2, IL-6 were determined in two groups before and after treatment. Results The levels of serum LPS, TNF-α, IL-6, IL-8 were fall obviously and IL-2 rised in the group affter treatment, the changes compared the controls were significant differences （P 〈 0.05 and P 〈 0.01）. In the control group, the levels were decreased, but not significant difference （P 〉 0.05）. The effective rate of the treatment group was significantly higher than that in the controls （P 〈 0.01 ）. Conclusions ALSS can reduce the serum contents of LPS, TNF-α, IL-6, IL-8 in ALF patients. The determinations of these levels are of help for judging the severity of disease as well as outcome prediction, so are for preventing the development of liver failure and decreasing the incidence of multiple organs inadequay syndrome.