急性肝炎和肝硬化患者血清NO、IL-8、IL-10、IL-12及TNF-α和尿NO的检测及意义

Detection of serum NO, IL-8, IL-10 , IL-12 , and TNF-αand urine NO in patients with acute viral hepatitis and cirrhosis and their significances

目的探讨肝硬化患者ＮＯ与ＩＬ－８，ＩＬ－１０、ＩＬ－１２和ＴＮＦ－α的关系及意义。方法用比色法及ＥＬＩＳＡ法检测了２６例急性肝炎，３５例肝硬化和３０例正常人血清及尿中ＮＯ、ＩＬ－８、ＩＬ－１０、ＩＬ－１２和ＴＮＦ－α的浓度。结果急性肝炎和肝硬化患者血中ＩＬ－８和ＴＮＦ－α明显升高，血清ＩＬ－１０、ＩＬ－１２和ＮＯ仅肝硬化患者升高。低白蛋白血症的肝硬化患者的ＩＬ－８、ＴＮＦ－α和ＮＯ水平明显增高。伴有腹水及门脉高压患者的血清ＮＯ水平也明显升高，有少尿和腹水的患者２４小时尿ＮＯ排出减少。结论炎症因子ＩＬ－８、ＴＮＦ－α升高和抗炎因子ＩＬ－１０减少是肝硬化病情加重的原因之一。检测血清ＮＯ可作为判断肝硬化病情严重程度的指标，尿２４小时ＮＯ排出量既可用作判断肝硬化的病情严重程度，也可用于对肾功能的判断。

Objective To determine the inflammatory cytokines and NO so as to ascertain their significance in patients with acute hepatitis and cir- rhosis. Method Serum. and urine NO and serum interleukins IL-8, IL-10, IL-12 , TNF-αwere detected in 25 patients with acute hepatitis, 35 cirrhotics and 30 normal controls by colorimetric and ELISA method, respectively . Correlation of above mentioned indices with cirrhotic complications were analyzed. Results The patients with acute hepatitis showed higher levels of serum IL-8 and TNF than normal controls. The serum NO, IL-12, IL-10, IL-8 and TNF-αof cirrhotic patients were significantly higher than that of acute hepatitis and controls. In hypoal- buminemia patients, serum levels of TNF-α IL-8 and NO showed negative correlation. With ascites and portal hypertension, NO was also high, With oliguria and ascites, 24 hours excretion of urine NO decreased. Conclusion TNF-αand IL- 8 were involved in hepatocyte damage in acute hepatitis. Increased serum IL-8, TNF-α NO enhanced the hepatic damage of cirrhotic patients. Decrease in anti-inflammatory cytokine and increase in proinflammatory cytokines and NO level were the cauae of increased 24 hours urine excretion of NO which can be used as an index for predicting the severity of cirrhosis and judging the status of renal function in these patients. [