乙型肝炎患者血清可溶性肿瘤坏死因子受体的检测及临床意义

Detection of Serum sTNFR in Patients with Chronic Hepatitis B and Its significance

应用酶联免疫吸附试验法测定了30例慢性活动型肝炎及24例慢性重型肝炎患者血清可溶性肿瘤坏死因子受体（sTNFR）水平。结果显示：慢性重型肝炎及慢性活动型肝炎患者sTNFR水平显著升高，尤以慢性重型肝炎患者为甚，升高程度与总胆红素呈正相关，与凝血酶原活动度呈负相关。对24例慢性重型肝炎患者进一步分析表明；伴有感染或肝肾综合征时，sTNFR水平显著高于无感染或肝肾综合征患者，最终死亡者其水平也显著高于存活者。提示测定慢性活动型肝炎和慢性重型肝炎患者血清sTNFR水平对判断病情及预测转归有一定的价值。

Serum levels of soluble turnor necrosis factor receptor (sTNFR) were detected with ELISA in 30 patients of chronic active hepatitis B and 24 patients of chronic severe hepatitis B. The results showed that the serum levels of sTNFR in chronic severe hepatitis B and chronic active hepatitis B were obviously increased,especially in patients with chronic severe hepatitis B. It's degree was positively correlated with serum total bilirubin concentration and negatively correlated with prothrombin activity. The further analysis for 24 patients with chronic severe hepatitis B showed that serum levels of sTNFR was more higher in patients accompanied by infection or hepatorenal syndrome than those unaccompanied by. The increase of serum sTNFR was more marked in patients with lethal outcome than in those who survived. These results indicated that detection of serum sTNFR in patients with chronic active hepatitis B and chronic severe hepatitis B is of significant value in evaluating the clinical seventy and in assessing the prognosis of the disease.