重症病毒性肝炎患者血清TNF-α和IL-6水平变化及其意义

The Changes of Serum Levels of TNF-α and IL-6 and Its Significance in Patients with Severe Viral Hepatitis

应用双抗体夹心法检测 30例重症病毒性肝炎（SH）患者血清TNF-α和IL-6水平。结果显示,SH患者血清TNF-α和IL-6水平均显著高于急性肝炎、乙型慢性肝炎和乙型肝炎肝硬化患者（P<0.05和P<0.01）,其升高水平与血清胆红素和凝血酶原时间呈显著相关（P<0.001）,提示TNF-α和IL-6水平与肝细胞坏死程度密切相关,在SH的发病中有重要作用。重叠甲、丙、丁、戊型肝炎病毒感染的乙型SH患者血清TNF-α和IL-6水平显著高于单纯乙型SH患者（P<0.01和P<0.005）,合并严重细菌感染的SH患者血清TNF-α和IL-6水平也显著高于无感染的SH患者（P<0.05和P<0.02）,表明SH患者血清TNF-α和IL-6的显著升高与肝炎病毒的重叠感染和内毒素血症有密切关系。

In this paper the serum levels of TNF-a and IL-6 in 30 patients with severe viral hepatitis (SH) were measured by ELISA. The results showed that the serum levels of both TNF-a and IL-6 in patients with SH were significantly higher than those in patients with acute hepatitis, chronic hepatitis and liver cirrhosis (F<0. 05 and <0. 01), and that the elevated levels of both TNF-a and IL-6 were shown positively correlated with serum bilirubin and prothrombin time (P< 0. 001) . It is suggested that TNF-a and IL-6 are closely associated with the degree of hepatocyte necrosis and play an important role on the pathogenesis of SH. It was also found that the serum levels of TNF-a and IL-6 were markedly higher in patients with B type SH superinfected with HAV. HCV. HDV or HEV than those in patients with B type SH alone (P<0. 01 and<0. 005),and in patients with SH complicated by severe bacterial infections than those in patients without infections (P<0. 05 and <0. 02) . It is thus revealed that the significant elevation of both cytokines in SH is closely correlated with the superinfection of hepatitis virus and endotoxemia.