肿瘤坏死因子及层粘连蛋白与肝病的关系

Relationship between tumor necrosis factor as well as laminin and Hepatic Diseases

目的检测肿瘤坏死因子-α(TNF-α)及层粘连蛋白(LN)在不同阶段肝病患者血清中的水平,以观察二者之间是否具有相关性。方法血清标本均来自住院患者和健康体检者。将观察对象分为4组:对照组(A组)20例、急性肝炎组(B组)15例、慢性肝炎组(C组)80例、肝炎肝硬化组(D组)85例。采用放射免疫分析法检测患者血清TNF-α和LN。结果(1)肝病患者血清TNF-α含量均较对照组增高,差异有统计学意义(P<0.05)。急性肝炎、慢性肝炎、肝炎肝硬化患者的血清TNF-α含量逐渐增高(P<0.05)。慢性重度肝炎组血清TNF-α显著高于正常对照组,也明显高于慢性轻度肝炎组(P<0.01)。血清TNF-α含量从ChildA→B→C级逐渐升高,差异有统计学意义(P<0.05)。(2)急性肝炎组患者血清LN含量较对照组较有增高趋势,但无统计学意义(P>0.05)。慢性重度肝炎组血清LN含量明显高于正常对照组、急性肝炎组和慢性轻度肝炎组(P<0.05)。肝硬化组LN升高幅度较大,与慢性肝炎组相比差异有统计学意义(P<0.01)。ChildA→B→C级LN含量逐渐增高,且C级显著高于A级,差异有统计学意义(P<0.01)。(3)TNF-α与LN二者显著相关(P<0.01)。结论在肝细胞损伤及其纤维化发展进程中,随着病情进展,TNF-α及LN含量逐渐增高,二者之间呈正相关关系。

Objective To investigate the relationship between tumor necrosis factor （TNF） as well as laminin （LN） and hepatic diseases by detecting the levels of TNF and LN in patients with hepatic diseases at different stages. Methods The subjects were divided into four groups：control （A） group（ n = 20）,acute hepatitis （B） group（ n = 15） ,chronic hepatitis （C） group（ n = 80） and liver cirrhosis （D） group（ n = 85）.The levels of serum TNF and LN in the lour groups were detected respectively by radio irnmtmoassay methods. Results （ 1 ） The levels of serum TNF in various stages of patients with hepatic diseases including acute hepatitis, chronic hepatitis and liver cirrhosis were significantly higher than those of control group. There were significant differences between 3 patients groups and control group （P 〈 0.05） . The levels of serttmTNF in chronic hepatitis group were significantly higher than those in acute hepatitis group（ P 〈 0.05）, while the levels of TNF in liver cirrhosis group were higher than those of chronic hepatitis group（ P 〈 0.05）. In chronic hepatitis group at severe stage, the levels of TNF were significantly higher than those of control group（ P 〈 0.01）, and were higher than those of light degree stage（ P 〈 0.05）. In liver cirrhosis group, the levels of TNF in Child-Pugh grade C were significantlyhigher than those of B grade, which were significantly higher than those of grade A（ P 〈 0.05）. （2）Compared with those in control group, the levelsof LN in acute hepatitis group were higher, but there was no significant difference（ P 〉 0.05）. The levels of LN in chronic severe hepatitis group were significantly higher than those in control group （ P 〈 0.05）,in acutre hepatitis group（ P 〈 0.05） and chroalc light degree hepatitis group （ P 〈 0.05）. The levels of LN were highest in liver cirrhosis group, which were significantly higher than those of chronic hepatitis group（ P 〈 0.01 ）. What＇s more, the levels of LN were increased according to Child-Pugh grade in sequence,and the levels of LN in Child-pugh grade C were significantly higher than those in Child Pugh grade A（ P 〈 0.01）. （3）There was a significantly positive correlation between levels of TNF and LN （ P 〈 0.01）. Conclusion TNF and LN participate in the hepatic inflammatory activity and the courses of fibrosis and liver cirrhosis. With the development of the diseases, the levels of TNF and LN increase gradually, and there is a positive correlation between the levels of TNF and LN. Moaltoring dynamically the changes of levels of TNF and LN can be used to judge the condition of hepatocyte injury and the degree of fibrosis of liver.