肝硬化患者血清一氧化氮与肿瘤坏死因子-α的相关研究

Study on the correlation between serum NO and TNF-α in patients with cirrhosis

目的 了解肝硬化患者血清一氧化氮（ＮＯ） 与肿瘤坏死因子－ α（ＴＮＦ－ α） 的变化，并探讨二者之间的关系。方法 用Ｇｒｉｅｓｓ 方法及放免法分别检测５０ 例肝硬化及３０ 例正常人血清ＮＯ 与ＴＮＦ－ α水平。结果 肝硬化患者与正常人比较，其血清ＮＯ 水平升高（ Ｐ＜ ０ ．００１） ，有腹水患者较无腹水者为高（ Ｐ＜ ０ ．０５） ，且ＮＯ 水平随Ｃｈｉｌｄ － Ｐｕｇｈ Ａ、Ｂ、Ｃ 分级的次序而增加。同时肝硬化患者血ＴＮＦ－ α亦明显增加（ Ｐ＜ ０ ．００１） ，并与ＮＯ 呈正相关（ｒ ＝ ｏ ．６２ ，Ｐ＜ ０ ．００１） 。结论 肝硬化患者血ＮＯ 升高，有腹水者更高，且ＮＯ 水平随Ｃｈｉｌｄ － Ｐｕｇｈ Ａ、Ｂ、Ｃ 分级的次序而增加，提示ＮＯ 可能参与了肝硬化高动力循环与腹水的形成，并能反映患者的预后。同时ＴＮＦ－ α亦升高，且与ＮＯ 呈正相关，为ＴＮＦ－ α诱导ＮＯ

Aim To investigate the changes of nitric oxide (NO) and tumor necrosis factor-α(TNF-α) in patients with cirrhosis,and discuss the relationship between the NO and TNF-α.Methods NO and TNF-α were measured in 50 cirrhotic patients and 30 normal controls by Griess and radio immunological assay respectively.Results Comparing with control,the level of NO increased ( P <0.001) in cirrhosis group.The NO level in cirrhosis with ascites group was higher than that without ascites( P <0.05),and the NO level increased accompanying the Child-Pugh class A、B and C.In patients with cirrhosis,the TNF-α level also increased ( P <0.001),and showed a positive correlation with the NO level (r=0.62, P <0.001).Conclusion In cirrhotic patients,the NO level increased,especially in patints with ascites,and the NO level increased accompanying the Child-Pugh class A、B and C,which suggested that NO may relate to the pathogenesis of the hyperdynamic circulation and ascites formation,and reflected the prognosis of cirrhotic patients.The TNF-α level also increased in cirhosis group and showed a positive correlation with NO level,thus supplying the evidence for TNF-α inducing NO production.