乙型肝炎肝硬化并发腹膜炎患者血清及腹腔积液TNF-α、IL-8、IL-18水平临床意义的探讨

Study of changes of serum and ascetic levels of TNF-α,IL-8 and IL-18 in patients with type B hepatitis cirrhosis complicated with spontaneous bacterial peritonitis

目的:探讨乙型肝炎肝硬化并发自发性腹膜炎(SBP)患者血清和腹腔积液中肿瘤坏死因子(TNF-α)、白细胞介素-8(IL-8)、白细胞介素-18(IL-18)的水平,及其在疾病发生发展中的作用。方法:应用双单克隆抗体夹心法酶联免疫吸附测定(ELISA)法检测48例乙型肝炎肝硬化并发腹腔积液患者血清和腹腔积液中TNF-α、IL-8、IL-18的水平,其中肝炎肝硬化并发SBP患者24例,肝硬化腹腔积液未合并自发性腹膜炎患者24例,并与24例正常人比较。结果:乙型肝炎肝硬化合并SBP患者的血清和腹腔积液中的TNF-α、IL-8、IL-18的水平明显高于未合并SBP者及对照组,未合并SBP者亦明显高于对照组(P<0.05)。结论:乙型肝炎后肝硬化并发SBP患者血清和腹腔积液中的TNF-α、IL-8、IL-18明显升高,TNF-α、IL-8、IL-18参与了肝硬化腹腔积液并发SBP的发生与发展,检测乙型肝炎后肝硬化自发性腹膜炎患者血清及腹腔积液的TNF-α、IL-8、IL-18水平对SBP的早期诊断有重要的临床意义。

Objective： To investigate the changes of tumor necrosis factor-α（TNF-α）, interleukin-8（IL-8） and interleukin-18（IL-18） in serum and ascetic fluid of patients with type B hepatitis cirrhosis complicated with spontaneous bacterial peritonitis （SBP）,and to explore the role of TNF-α,IL-8 and IL-18 in the development and progression of hepatic cirrhosis complicated with SBP. Methods： Serum and ascetic fluid levels of TNF-α,IL-8 and IL-18 in 24 patients with type B hepatitis cirrhosis complicated with SBP,24 patients with type B hepatitis cirrhosis complicated without SBP and 24 healthy persons were measured with ELISA method. Results： The serum and ascetic levels of TNF-α,IL-8 and IL-18 in patients with cirrhosis complicated with SBP were significantly higher than those in the control group and higher than those in cirrhotic patients without SBP.In the control group the serum and ascitc fluid levels of TNF-α,IL-8 and IL-18 were less than those in the cirrhltic patients without SBP（P〈0.05）. Conclusion： The serum and ascetic levels of TNF-α,IL-8 and IL-18 in patients with type B hepatitis cirrhosis complicated with SBP significantly increase, the three factors partici-pate in the pathologic process of type B hepatitis cirrhosis complicated with SBP. Testing of the levels of serum and ascetic fluid TNF-α,IL-8 and IL-18 is helpful to the early diagnosis of patients with cirrhosis complicated with SBP.