慢性肝病患者血清和腹水肿瘤坏死因子-α检测的临床意义

Detection of TNF-α Level in Serum and Ascites of Chronic Liver Disease

目的：了解慢性肝病患者血清和腹水肿瘤坏死因子-α检测的临床意义。方法：采用双抗体夹心EISA法，对20例慢迁肝、20例慢活肝和29例肝硬化代偿期病人血清TNF－α进行检测；对21例肝硬化腹水无自发性腹膜炎（SBP）者、23例肝硬化腹水并SBP者、25例肝癌腹水者和24例胃肠癌腹水者进行血清和腹水的TNF－α检测。结果：血中TNF-α水平在下列各组疾病呈逐渐上升（慢迁肝组＜慢话肝组和肝硬化代偿期组＜肝硬化失偿期不伴SPB组、肝癌组和胃肠癌组＜肝硬化失偿期伴SBP组，P＜0．05～0．01）。腹水INF－α水平在肝癌和胃肠癌组显著高于肝硬化腹水无SBP组（P＜0．05），而肝硬化腹水无SBP组、肝癌腹水组和胃肠癌腹水组血中TNF－α无显著差异（P＞0．05），但三组病人血中TNF-α均显著低于肝硬化并SBP组（P＜0．05）。结论：TNF-α在慢性肝病随病情加重而上升，血清与腹TNF-α同时检测有助于鉴别诊断良恶性腹水和是否合并SBP。

Objictive:To observe the changes of the TNF-αin serum and ascite in patients with chronic liver disease.Methods:Using ELISA we determined TNF-αlevels in the serum of 162 patients (ineluding 20 chronic persistent hepatitis,20chronic active hepatits,29 compensation liver cirrhosis,44 decompensation liver cirrhosis,25 primary hepatic carcimoma and24 gastroenteric cancer patients)and in the ascites of 93 patients among them[including 21 cirrhosis without spontaneous bacterial peritoitis(SBP)),23 cirrhosis with SBP,25 primary hepatic carcinoma and 24 gastroenteric cancer patients],Results:Serum TNF-αlevels were increased in 74 following various group diseaes(chuonic persistent hepatitis<compensation cirrhosisand chronie active hepatitis<decompensation cirrhosis without SBP.primary hepatic carcinoma and gastroenteric cancer<decompensation cirrhosis with SBP<primary hepatic carcinoma and gastroenteric cancer<decompensation eirrhosis with SBP).Conclusins:The TNF-αlevels may be a good indes for the prognosis of chronic liver disease.The TNF-αlevels in serum and ascites may be an important marker in differentiation benign and malignant ascites. in differentiating ascites with or without SBP.