摘要
目的：探讨和分析乙型肝炎肝硬化并发自发腹膜炎（spontaneousbacterialperitoniti，SBP）患者血清和腹腔积液中细胞因子（肿瘤坏死因子TNF～、白细胞介素8、白细胞介素18）的变化和临床意义。方法：患者50例，25例为肝炎肝硬化并发自发性腹膜炎，25例为肝硬化腹腔积液未合并自发性腹膜炎患者，并有25例正常人作为对照研究。收集50例患者和25例正常人的血清和腹腔积液，应用EusA检测上述样品中TNF-、IL-8、JL-18的表述水平。结果：与乙型肝炎肝硬化未合并自发性腹膜炎和对照组相比较，在乙型肝炎肝硬化合并自发性腹膜炎患者中，其血清和腹腔积液中的TNF-、IL-8、IL～18的表达水平明显较高（P〈0．05）。与对照组相比较，乙型肝炎肝硬化未合并自发性腹膜炎患者上述细胞因子表达水平也明显升高（Pdo．05）。结论：在乙型肝炎后肝硬化并发自发性腹膜炎患者中，TNF-、IL-8、IL-18的表达水平与肝硬化腹腔积液并发自发性腹膜炎的发生与发展有着重要的关系，可以通过检测患者血清和腹腔积液中的TNF-、IL-8、IL-18的水平初步诊断乙型肝炎后肝硬化并发自发性腹膜炎的发生。
Objective： To investigate the changes of tumor necrosis factor- （TNF-）, 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- ,IL- 8. IL-18 in the development and progression of hepatic cirrhosis complicated with SBP. Methods：Serum and ascetic fluid levels of TNF- , IL-8, 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 per- sons were measured with ELISA mkthod. Results：The serum an d ascetic levels of TNF- ,IL-8,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 aseite fluid levels of TNF- . IL-8, IL-18 were less than those in the cirrhltlc patients without SBP（P〈0.05）. Conclusion：The serum and ascetic levels of TNF - .IL-8.IL-18 in patients with type B hepatitis cirrhosis complicated with SBP significantly increase, the three factors participate in the pathologic process of type B hepatitis cirrhosis complicated with SBP. Testing of the levels of serum and ascetic fluid TNF- .IL-8 .IL-18 is helpful to the early di- agnosis of patients with cirrhosis complicated with SBP.
