肝硬化合并SBP患者血清及腹水中TNF-α和IL-6水平检测及意义

Examination of TNF-αand IL-6 in serum and ascites of patients with hepatic cirrhosis complicated with spontaneous bacterial peritonitis

目的:探讨TNF-α和IL-6在肝硬化(Lc)合并自发性细菌性腹膜炎(SBP)中的作用及其临床意义。方法:Lc合并腹水患者共48例,分为SBP组(22例),非SBP组(26例),分别测定血清及腹水中TNF-α和IL-6水平。结果:Lc合并SBP时,血清和腹水中TNF-α和IL-6显著高于非SBP组(P<0.05,P<0.01),且腹水IL-6水平显著高于血清(P<0.01),但血清TNF-α水平显著高于腹水(P<0.05);感染控制后,血清和腹水TNF-α和IL-6水平明显下降(P<0.05,P<0.01),但仅能降至接近单纯腹水组水平;并发SBP经治疗无效组,初始血清和腹水TNF-α、IL-6水平显著高于治疗有效组(P<0.05)。结论:失代偿肝硬化并发SBP时,血清和腹水中TNF-α、IL-6均有较高的表达,并与疾病严重程度及预后密切相关,对SBP早期诊断、判断疗效及预后均具有临床意义。

Objective：To investigate the changes of TNF - aand IL - 6 in serum and ascites of patients with hepatic cirrhosis（LC） complicated with spontaneous bacterial peritonitis（SBP） and their clinical signiticance. Methods：44 cases with LC were divided into SBP group（n= 22, complicated with SBP） and control group（n= 26, without SBP）. The levels of TNF - aand IL- 6 in their serum and ascites were examined, respectively. Results：The levels of TNF - aand IL - 6 of SBP group were higher than those of the control group（P〈0. 05 to 0.01）. In SBP group, the level of IL - 6 in the ascites was higher than that in the serum（P〈0.01） and the level of TNF- αin the serum was higher than that in the ascites（P〈0. 05）. After the abdominal cavity infection was controlled, the levels of TNF - α and IL - 6 in the serum and aseltes decreased（P〈0. 05 to 0. 01）. The levels of TNF - αand IL - 6 in the serum and ascites of patients who were sensitive to anti - infection therapy were lower than those of ones who were not sensitive to first anti - infection therapy（P〈0. 05）. Conclusion：When LC is complicated with SBP, the levels of TNF - αand IL - 6 in the serum and ascites of patients increase, and the changes of TNF - αand IL - 6 are correlated with the condition and prognosis of this disease.